The pump that gave too much: accidental overinfusion of prostacyclin.
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Biomedical subjects
Publications and source records attributed to C Wise.
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The Medical University of South Carolina integrated instruction in information science and computer technology into a required freshman-level course. Analytic and Community Medicine. The advantages of this placement in the curriculum are two-fold. First, the course provides an opportunity to integrate computer methodology with clinically relevant topics such as medical decision-making. This integration enhances the students' view of the computer as a useful tool that can aid the physician in the practice of medicine. Course organizers are convinced that the success of the first offering is attributable to this integration. Second, the instruction comes early in the medical education process and allows the concepts learned to be utilized throughout the students' medical school careers. The degree to which these concepts and methods are actually utilized by students will depend upon the degree of reinforcement of these ideas in the clinical years and residency. Thus, faculty members must act as role models who not only acknowledge the importance of mastering the use of computers in medicine but also manifest those skills.
A patient who experienced exacerbation of a previously diagnosed condition of lymphomatoid papulosis during infertility treatment with danazol is reported. The condition worsened over the first month of treatment with medication and resolved completely upon discontinuation of the medication.
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Ultrastructural analyses of retinal development in the guppy embryo show that at midgestation all types of photoreceptors are differentiated in the fundus, and at birth differentiation extends over the whole retina. Formation of discs of outer segments is more rapid in rods than in cones. Double cones differentiate simultaneously with long single cones and are formed by the adhesion of two primordial inner segments; short single cones develop last. Wherever cones are differentiated, they are arranged in an adult-type square mosaic. The rods in the embryo, as opposed to the adult, are likewise regularly arranged within the mosaic unit. These results are at variance with the generally held opinion that adult teleosts which possess duplex retinae have larvae with pure cone retinae, and that rods, double cones and mosaics appear in late larval life or only at metamorphosis. In the double cones of the guppy embryo subsurface cisternae develop along the adjoining primordial inner segments. Additionally, regularly distributed subsurface cisternae are formed in the regions of intimate contact of long single cones with double cones and rods. We suggest that the early development of rods and double cones, and a square-mosaic with regular distribution of rods and subsurface cisternae, provide the newly born with a fully functional optical apparatus, especially suited to perception of movements. This is necessary for its survival against predatory, especially maternal, attacks.
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Mammalian erythrocytes have been shown to bind, but not to respond to, physiologic doses of insulin. Insulin binding was studied in normal rat erythrocytes and erythroblastic leukemic (EBL) cells by standard 125I-insulin competitive binding assays. EBL cells exhibited marked insulin degradation, which was time, temperature, and concentration dependent and was mediated by both cell-bound and soluble enzymes. Bacitracin or bovine serum albumin was used to inhibit such degradation in a dose-dependent fashion to allow meaningful data analysis. Insulin binding studies showed a greater than 10-fold increase of specific binding to EBL cells compared with erythrocytes. Scatchard analysis was consistent with increases predominantly in the number of receptors on EBL cells. Concordant with increased insulin binding, EBL cells demonstrated increased transport of alpha-aminolsobutyric acid and increased incorporation of uridine into ribonucleic acid in response to physiologic doses of insulin (100 microunits/ml). It can be concluded that EBL cells may serve as useful models of erythroblasts to explore the relationships between insulin binding, response, and cell maturation.
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The density and size distribution of intramembranous particles (IMP) were determined for cells of the erythroid series. The number and size of IMP were measured on both fracture faces of erythroblastic leukemia cells, phenylhydrazine-induced reticulocytes and mature erythrocytes. We found that the number of IMP adhering to the protoplasmic fracture face of the plasma membrane increased with increasing maturation, while the number of particles adhering to the external fracture face did not correlate with maturational stage. In general, the mean size of particles adhering to both fracture faces decreased with increasing maturation after the erythroblastic stage. We interpret these results to mean that the IMP seen are derived from more than one macromolecular species and that they are distributed asymmetrically in the plasma membrane.
The ultrastructure of the accessory outer segment (AOS)--a cilium-like structure emanating from the inner segment and running alongside the outer segment of photoreceptors--is described. The AOS occurs in both rods and cones of Poecilia reticulata. Its ultrastructure, including the arrangement of microtubules, which originate from the ciliary stalk, is the same in rods and cones. The cone-AOS is connected with the outer segment by a thin plasmabridge, whereaa the rod-AOS lies embedded within the outer segment. The outer segment of the cone, in contrast to that of the rod, is separated from the pigment epithelium by a large extracellular space. An intimate contact, however, is secured by the AOS; its membrane is closely appositioned to the pigment epithelium membrane. The functional significance of the AOS and its possible occurrence in other vertebrate classes, are discussed.
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The present study examines disease distributions in patients with multiple nuclear immunofluorescent staining patterns detected by FANA testing. Among 4003 consecutive patient sera examined, we found that 813 yielded conventional well-defined single staining patterns, while 46 produced multiple pattern combinations. Homogeneous plus nucleolar was the most prevalent combination, and 5 other combinations were identified. Multiple FANA patterns occurred independently of FANA titers and antibodies to dsDNA and Sm. Compared to control patients with single FANA patterns, patients with multiple patterns were found to have an increased frequency of SLE and diseases of the scleroderma spectrum (DDS) while rheumatoid arthritis (RA) and non-immunologic disease were reduced in frequency. These specific correlations indicate that recognition of multiple FANA patterns adds useful diagnostic information to existing antinuclear antibody testing procedures.
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