Biomedical subjects
Publications and source records attributed to C Nichols.
There have been numerous reports of subconjunctival dislocation of the lens resulting from nonsurgical trauma. This paper is the first to describe such a dislocation following surgical trauma (unplanned extracapsular cataract extraction).
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The National Football Head and Neck Injury Registry has documented 1,129 injuries since 1971 that involved hospitalization for more than 72 hours, surgical intervention, fracture-dislocation, permanent paralysis, or death. Of this group of injuries, 550 were fracture-dislocations of the cervical spine, of which 176 were associated with permanent quadriplegia. It appears that during the last two decades, there has been a decrease in the incidence of direct fatalities, head injuries associated with intracranial hemorrhage, and injuries associated with death. Conversely, cervical spine injuries with fracture-dislocation and with permanent quadriplegia have increased. We believe that these observations are the result of the development of a protective helmet-face mask system that has effectively protected the head, and by so doing has allowed it to be used as a battering ram in tackling and blocking techniques, thus placing the cervical spine at risk of injury.
A sample of 54 patients with diabetes mellitus were subjects to detailed assessment of periodontal disease levels using standard indices. In order to determine whether the severity of periodontal disease was related to the severity of diabets mellitus, a series of parameters of the diabetes mellitus population was simultaneously studied. There were no significant relationships between the levels of periodontal disease and the duration of diabetes, the type of treatment and the frequency of systemic complications. Periodontal disease in the diabetic appeared to the affected by the same etiologic factors [plaque, calculus, neglect] as would be expected in nondiabetic patients. Further studies with larger population samples would be appropriate.
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Mutants of Serratia marcescens Nima, designated as Aut, Hut, or Put, did not utilize L-alanine, L-histidine, or L-proline, respectively, as a sole carbon source but did utilize other amino acids or glycerol as carbon sources. The bacteria were permeable to alanine, histidine, and proline but lacked the enzymes responsible for degradation of these amino acids. The Aut mutant contained no L-alanine dehydrogenase activity, whereas the Hut and Put mutants contained only 7 and 4% of the histidase and proline oxidase activities, respectively, found in the wild-type strain. Rates of oxygen uptake and protein synthesis were significantly lower when the mutants were incubated in the presence of amino acids they could not degrade. Studies of L-[14C]alanine, L-[14C]histidine, and L-[14C]proline incorporation into prodigiosin synthesized by these mutants and the wild-type strain revealed that proline was incorporated intact, whereas all of alanine except the carboxyl group was incorporated into the pigment molecule. Histidine did not enter prodigiosin directly. These data suggested that the presence of unique biosynthetic pathways, independent of primary metabolism, leads to formation of prodigiosin from specific amino acids.
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Infection of mammalian cells with herpes simplex virus (HSV) results in the production of a number of virus-induced soluble antigens. Immunodiffusion analyses of the soluble antigen mixture (SAM) obtained from HSV-infected KB or BHK cells revealed at least six well-defined immunoprecipitin bands. Calcium phosphate chromatography (Brushite) was employed to separate one immunoprecipitin (designated CP-1) from the remaining viral and host antigens. We conclude that CP-1 is a viral-specific antigen because (i) specific antiserum, which had been repeatedly absorbed with uninfected cell extracts or serum components, still retained the capacity to react in gel diffusion with CP-1 antigen; (ii) anti-CP-1 serum reacted in gel diffusion with SAM, yielding one precipitin band in identity with the band formed against human gamma globulin; (iii) the CP-1 fraction stimulated the production of HSV-neutralizing antibody of high capacity. The last observation suggests that fraction CP-1 contains a biologically active structural component of the virus which is associated with the envelope. The CP-1 immunoprecipitin was separated from SAM by an alternative method by using a cyanogen bromide-linked immunosorbent prepared from anti-CP-1 gamma globulin. The observation that the CP-1 antigen isolated from the immunosorbent effectively blocked serum-neutralizing activity provided further evidence that neutralizing antibody was directed against CP-1. Acrylamide gel electrophoresis and immunological experiments suggest that the CP-1 antigen is in part a glycoprotein. The finding that CP-1 contains only one antigenic component of the virus will permit future biological studies to be made with a monoprecipitin antiserum. In addition, the techniques described in this paper represent initial steps in the purification of HSV antigens.
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Although thyrotoxicosis and orbital complications of acute ethmoid or frontal sinusitis are among the most common causes of unilateral exophthalmos, inflammatory pseudotumor is frequently accompanied by progressive acute unilateral proptosis. Because the associated chemosis, scleral erythema, and ophthalmoplegia constitute a spectrum of clinical findings present in numerous inflammatory orbital disorders and systemic diseases, the diagnosis of inflammatory pseudotumor is one of exclusion, often requiring orbital biopsy. Four patients without evidence of sinusitis, endocrinopathy, collagen vascular disease, or Wegener's granulomatosis are described. The diagnosis of orbital pseudotumor was disclosed by computed axial tomography, thus avoiding orbitotomy. The finding of scleral and choroidal thickening with enhancement following intravenous contrast injection represents a select group of patients with orbital pseudotumor and differentiates them from patients with endocrine exophthalmopathy or neoplasms. This noninvasive technique is extremely valuable because early diagnosis is critical for successful treatment. All four patients responded dramatically to high-dose corticosteroid therapy. In the absence of significant clinical response, however, Wegener's granulomatosis, lymphoma, and rhabdomyosarcoma, especially in younger patients, must be carefully excluded. Orbital exploration or decompression or both are used when proptosis, headache, or orbital pain does not resolve promptly, visual acuity deteriorates, or the diagnosis remains unknown.
Data on cervical spine injuries resulting from participation in football have been compiled by a national registry established in 1975. Information has been collected retrospectively by defined criteria since 1971. Efforts have been made to establish the mechanism of injury responsible in the majority of instances on the basis of epidemiologic evidence and recognized biomechanical principles. During the 5-year period, 77 deaths resulted from severe neck injuries. During this period, 1,275,000 players were exposed. Ninety-nine cervical fracture-dislocations resulting in permanent quadriplegia and 259 cervical fractures-dislocations occurred. There may be a "trend" towards an increase in permanent quadriplegia resulting from serious cervical spine injuries sustained while playing football. Apparently, the cause can be attributed to the helmet-face mask that has encouraged the use of the head as the primary point of contact in blocking, tackling, and head butting. The figures clearly identify defensive backs, linebackers, or specialty team members making tackles by using the head as the initial point of contact, as the individuals at greatest risk to sustain cervical spine injuries resulting in permanent quadriplegia.
We assessed the isokinetic and isometric strength and power profile of the knees of 37 patients who had a previous grade II sprain (partial tear) of the anterior cruciate ligament. Of the 37 knees, 11 had an isolated partial anterior cruciate ligament rupture and 26 had a partial anterior cruciate ligament rupture combined with a partial medial collateral ligament rupture. The Cybex II isokinetic dynamometer was used in the measurements. Eight years after the injury, the mean strength deficit of the injured knees was minimal when compared with the uninjured side. In the hamstrings of both groups, the relative strength deficit increased significantly with a higher speed of isokinetic movement (P less than 0.05). Compared with the strength parameters (peak torques), the other functional parameters (total work, average power, and peak angular impulse) of the injured knees showed some, but not significantly greater, deficits (hamstrings, 7% to 10%; quadriceps, 4% to 10%). We found that the general thigh muscle function in knees with old grade II sprains of the anterior cruciate ligament appears adequate except in flexion where the strength deficits are significantly greater in higher speeds of isokinetic movement. Therefore, rehabilitation using high-speed flexion (and extension) exercises is recommended.