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Biomedical subjects

C Grimes

Publications and source records attributed to C Grimes.

10 recordsLinked to original sources

The relationship in neonates between clinically measured head circumference and brain volume estimated from head CT-scans.

OBJECTIVE: To determine if the frontal-occipital head circumference correlates with brain volume on CT and to investigate correlations between the volumes of different brain subdivisions in live neonates. METHODS: Records were studied from 27 neonates with anatomically normal head CT-scans which were ordered for clinical reasons, and which were performed at Johns Hopkins Hospital. Clinical data were abstracted from medical records. Brain volumes were estimated by digitizing the structures of interest on each slice of head CT-scans. RESULTS: In this sample of 27 infants with a mean birth weight of 3000.4 +/- 668 g, mean head circumference of 33.5 +/- 1.8 cm, and mean gestational age of 37 weeks and 4 days +/- 24 days, the mean of total brain volume was 333.0 +/- 78.3 ml. The correlation between clinically measured head circumference and total brain volume was 0.55 (P < 0.003). Regression of total brain volume on head circumference and its second and third powers accounted for 43% of the variation in total brain volume. Other predictor variables, namely infant race, sex, gestational age, and maternal age, were not significant in this regression once head circumference was included. The slope of the cubic function of head circumference as a predictor of brain volume was greatest below the mean head circumference of 33.5 cm. Brain volume leveled off at head circumferences greater than the mean. CONCLUSION: Head circumference is a powerful predictor of total brain volume in the neonate: below the approximate head-circumference mean of 33.5 cm, smaller head circumference indicates smaller total brain volume.

Birth Weight↗

Otosclerosis surgery in a resident training program.

Controversy exists regarding the appropriateness of offering all residents training in stapes surgery due to dwindling case loads in residency programs nationally. A recent study indicated poorer results for stapes surgery performed by residents than results obtained by practicing otologists. One hundred consecutive stapedectomies performed by residents over a three-year period at our institution were reviewed retrospectively, with the objective of determining whether these results should be generalized.

Adult↗

Melkersson-Rosenthal syndrome.

The Melkersson-Rosenthal syndrome (MRS) is a rare condition characterized by the triad of familial relapsing peripheral facial palsy, facial edema, and lingua plicata. Within a well-documented family aggregate of MRS, an index case simultaneously demonstrated all the elements of the triad, as well as gingival changes similar to those of cheilitis granulomatosa. When the incomplete or oligosymptomatic forms are considered, the MRS may be more common than previously thought.

Adolescent↗

Laryngeal tuberculosis: review of twenty cases.

Despite a dramatic reduction in incidence of laryngeal tuberculosis over the last three decades, tuberculous involvement still has to be considered in the differential diagnosis of laryngeal lesions. The majority of the 20 cases in our series consists of patients in whom the working diagnosis of carcinoma of the larynx was initially made. These patients presented with the chief complaint of hoarseness of several months duration, frequently associated with dysphagia, but in most cases with chest symptoms that were not prominent despite the fact that most of these patients had far advanced pulmonary tuberculosis. This presentation consists of a detailed analysis of 20 cases, and a discussion of the incidence, pathogenesis, clinical presentation and management of laryngeal tuberculosis.

Adult↗

Orbital abscess.

Although orbital or subperiosteal abscess may originate from a number of sources, paranasal ethmoidal sinus disease is the most common source of infection, particularly in children. Prompt diagnosis and treatment are necessary to prevent severe visual loss and even death. The authors review the five-group classification of orbital abscess and summarize data regarding source, bacteriology, treatment and visual results from 13 series reporting 148 patients. Four new cases are presented in detail. Diagnostic procedures, including laboratory testing, sinus radiography, ultrasound and CT scanning, are discussed and recommendations are given for medical and surgical management.

Abscess↗

Specific membrane receptor gene expression targeted with radiolabeled peptide employing the erbB-2 and DF3 promoter elements in adenoviral vectors.

Radioimmunotherapy is limited by a variety of factors, including poor tumor penetration of monoclonal antibodies and low levels of intratumoral antigen expression. To address these limitations, a gene therapy strategy was devised to genetically induce tumor cells to express enhanced levels of membrane receptors with high affinity for a radiolabeled peptide. We designated this approach as genetic radioisotope targeting strategy. To this end, an adenoviral vector (AdCMVGRPr) encoding the murine gastrin-releasing peptide receptor (GRPr) was used to achieve a high level of binding of radiolabeled bombesin (BBN). To achieve genetic induction of membrane GRPr specifically to tumor cells, we constructed two adenoviral vectors encoding the GRPr gene under the control of the tumor-specific regulatory elements, DF3 (AdDF3GRPr) or erbB-2 (AderbGRPr). We investigated the binding of [125I]BBN to the GRPr following infection with AdDF3GRPr and AderbGRPr in a panel of human breast, pancreatic, and cholangiocarcinoma tumor cell lines. [125I]BBN binding and GRPr expression increased with increasing multiplicities of infection of AdCMVGRPr in all of the cell lines tested. Breast cancer cell lines expressing erbB-2 showed significant GRPr expression using AderbGRPr. A similar result was observed in breast and cholangiocarcinoma cells infected with AdDF3GRPr expressing MUC1 as detected by immunohistochemistry but was not seen in the pancreatic cell lines tested. Thus, adenoviral vectors with tissue-specific promoter elements can be used to achieve a selective expression of membrane receptors that can be targeted with a radiolabeled peptide. The use of such a transcriptional targeting approach may restrict gene expression to tumors and limit the radiation dose deposited in normal tissues in vivo.

Adenoviridae↗

Cervicovaginal cytology in an indigent population. Comparison of results for 1964, 1981 and 1989.

To evaluate the usefulness of cervicovaginal cytology in decreasing the incidence of cervical carcinoma in an indigent population, the cytologic findings from 10,000 consecutive smears in 1964 (when cytology screening started) were compared to the results of 10,000 consecutive smears in 1981 and 1989. There was a marked (statistically significant) decrease in invasive cervical squamous carcinoma at all ages between the first and later periods. Squamous carcinoma in situ showed a significant decrease beginning in patients under 40 in 1981. The number of atypias and mild dysplasias showed a proportional increase, from 2% in 1964 to 13.4% in 1981 to 21.8% in 1989, predominantly in young patients. These results reaffirm that cervicovaginal cytology remains the most inexpensive and effective diagnostic tool for the elimination of cervical cancer.

Adult↗