High-resolution three-dimensional measurement of localized cerebral blood flow by CT scanning and stable xenon clearance: effect of cerebral infarction and ischemia.
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Brain↗
Biomedical subjects
D Armstrong
Publications and source records attributed to D Armstrong.
Prognosis for survival in neonatal meningitis: clinical and pathologic review of 52 cases.
A retrospective review of 52 cases of neonatal meningitis diagnosed and treated at the Hospital for Sick Children, Toronto, was undertaken to determine which clinical or laboratory features were useful in predicting survival. Escherichia coli and group B streptococci were the most common bacteria isolated. Ventriculitis, cerebritis and arteritis were seen at autopsy with either gram-positive or gram-negative infection. Features associated with a good prognosis for survival were (a) peripheral neutrophil count greater than 2,000 x 10(9)/L; (b) normal platelet count or estimate (more than 100 x 10(9)/L), (c) birth weight greater than 2500 g and (d) age at the time of diagnosis more than 1 day. Information on all four features was available for 44 newborn infants. Of those with three or four of the features 87% survived, while of those with one or two features 14% survived. The overall mortality was 48%. The features outlined are useful in determining the severity of disease and therefore may alert the attending physician to the need for more intensive therapeutic and supportive care.
Female↗
A case of Schwartz-Jampel syndrome with unusual muscle biopsy findings.
A case of Schwartz-Jampel syndrome with electrical, radiographic, biopsy, and pharmacological studies is presented along with a summary of the 12 other reported cases. Radiological study showed nonspecific but definite abnormalities. The muscle biopsy revealed myopathic and neurogenic features. No drug was effective in reducing our patient's stiffness.
Biopsy↗
Cerebral hypoperfusion in the sudden infant death syndrome? Brainstem gliosis and vasculature.
Gliosis is increased in the respiratory control area of the brainstem in victims of sudden infant death syndrome (SIDS), as it is in infants who have died of congenital heart disease. In the latter, the lesions appear to result from hypoxia or ischemia, and studies of the brainstem microvasculature of SIDS victims indicated a close relationship between the gliosis and adjacent vasculature. It is postulated that cerebral hypoperfusion may play a role in SIDS.
Astrocytes↗
Muscle changes in lambs with surgically created scoliosis produced in utero.
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Animals↗
Comparison of a commercial identification kit and conventional biochemical tests used for the identification of enteric gram-negative rods.
A comparison between 11 Minitek biochemical tests and corresponding conventional tubed media was undertaken with 1,089 isolates of enteric gram-negative rods. Overall correlation between Minitek and conventional biochemicals was 97.4%. Minitek proved to be a time- and space-saving miniaturized biochemical system that can be used effectively for the identification of enteric gram-negative rods.
Bacteriological Techniques↗
Acute febrile neutrophilic dermatosis: Sweet's syndrome.
A case of acute febrile neutrophilic dermatosis (Sweet's syndrome) is described in a patient with chronic myelogenous leukemia, with a review of all published reports in the English literature. The disease is characterized by an acute febrile illness with painful plaques involving the extremities, face, and neck, and responds dramatically to corticosteroids with occasional recurrences. Histologically, the skin biopsy shows a dense dermal infiltrate of polymorphonuclear leukocytes without evidence of vasculitis.
Adrenal Cortex Hormones↗
Peroxidases in the neural retina and pigment epithelium.
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Animals↗
Common bile duct obstruction secondary to infection with Candida.
A patient is reported who had biliary tract obstruction secondary to infection of the common bile duct with Candida albicans, with the formation of a fungus ball. Treatment consisted of surgical removal of the fungus ball and drainage. Chemotherapy was not necessary. Ureteral obstruction through fungus ball formation, and even pulmonary fungus ball formation, has been attributed to candida, but this is the first case reported, to our knowledge, of bile duct obstruction.
Bile↗
Studies on the retina and the pigment epithelium in hereditary canine ceroid lipofuscinosis. II. The subcellular distribution of lysosomal hydrolases and other enzymes.
Observations on the progressive course of retinal degeneration in canine ceroid lipofuscinosis (CCL) showed dramatic changes in enzyme activity and subcellular compartmentation. Thus, in affected animals, a new particle containing high levels of hexosaminidase and galactosidase was found in fractions lighter than seen in controls. In the later stages of disease and in normal aging, a progressive increase in dense fractions with high titers of acid lipase and acid phosphatase was observed. Peroxidase was found predominantly in the heavier fractions (1.24 to 1.28 gm/ml) and was lower than normal in affected retina and RPE. These fractions were located above the pigment granule fraction. Changes of peroxidase activity in the pigment granules were age dependent in controls, but a decrease of similar magnitude occurred much earlier in affected dogs. The accumulation of large numbers of dense bodies in the retina and RPE in CCL may indicate an impairment of intracellular digestive mechanisms. The early and marked reduction of peroxidase activity in affected dogs is an important indicator for major changes in the biochemistry of the entire eye in this disease. Therefore the initial pathogenic event seems to be the inability of affected cells to cope with peroxidative damage at an early stage, followed by an exaggerated attempt by the cells to digest accumulating lipopigments.
Age Factors↗
Studies on the retina and the pigment epithelium in hereditary canine ceroid lipofuscinosis, I. The distribution of enzymes in the whole retina and pigment epithelium.
The massive accumulation of autofluorescent lipopigments, representative of autoxidation, is a key morphological feature in canine ceroid lipofuscinosis (CCL). In the eye peroxidase, catalase, and four acid hydrolases were compared with regard to aged and clinical condition in a series of English setters affected with CCL. In unaffected English setters "soluble" peroxidase increased in the RPE to adult levels at 2 yr of age. Affected dogs had higher RPE peroxidase activity earlier in life, which then decline with age. The soluble retinal peroxidase of both unaffected and CCL dogs increased steadily with age, but the latter group of dogs were much lower in activity. By 2 yr of age, RPE and retinal peroxidase values were only 25% and 47% of unaffected dog levels. Although the soluble enzyme of unaffected dogs exhibited a maturational profile, membrane-bound RPE peroxidase showed a hyperbolic curve reaching a maximum at 10 mo of age. By 2 yr of age, the "bound" enzyme in affected dogs was below unaffected levels in the RPE and retina. Three acid hydrolases were slightly increased in the RPE and retina of affected dogs. Acid lipase activity, however, was similar in both unaffected and CCL dogs. Catalase was not found in the RPE of either group of dogs. The catalase activity in the retina of both affected and unaffected dogs was at similar levels. Since catalase is not present in the RPE, the major defense against peroxidase accumulation and peroxide toxicity probably depends upon peroxidase. The present study indicates that a decrease in this key regulating enzyme may be related to the formation of lipopigments in the retina and RPE of dogs with CCL.
Age Factors↗
Cerebral white matter lesions in sudden infant death syndrome.
In 21.6% of infants who died of sudden infant death syndrome, the cerebral white matter showed areas of leukomalacia. Of those infants with congenital heart disease, 24.8% had lesions, whereas 4.4% of infants who died from known acute causes had lesions. The sites of the cerebral white matter lesions, subcortical or periventricular, seem to be related to the age of the infant.
Age Factors↗
Cryptococcal interstitial pneumonia: value of antigen determination.
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Acute Disease↗
Nude mouse: a new experimental model for Pneumocystis carinii infection.
Experimental infection with both human- and rat-derived Pneumocystis carinii has been produced in nude mice by intrapulmonary injection of lung homogenates that contained P. carinii and by environmental transmission. Most infected mice did not appear ill, and their lungs exhibited a mild and nonspecific inflammatory response. Thus, P. carinii can be transmitted from one animal species to another, and this result suggests that a defect in thymic-dependent lymphocytes is important in the development of the infection. Experimental work with P. carinii in the nude mouse should be performed in isolators because of the communicability of the organism.
Animals↗
Cryptococcosis in a cancer hospital: clinical and pathological correlates in forty-six patients.
The clinical and pathological findings in 46 patients with cryptococcosis at Memorial Sloan-Kettering Cancer Center from 1956 to 1972 are reported. The striking predilection for cryptococcal infection in patients with leukemias and lymphomas is again confirmed. Of 41 patients with neoplastic disease, those with chronic lymphatic leukemia (CLL), Hodgkin's Disease, chronic myelogenous leukemia (CML), myeloma and lymphosarcoma had the highest incidence of cryptococcosis. In all cases, neoplastic disease was widespread when infection occurred. All of these patients had leukopenia and absolute lymphopenia at the time of infection. Thirty-nine were on steroids. Thirty-one patients with neoplastic disease had disseminated infection. Review of pathology revealed a spectrum of inflammatory lesions. Histiocytic-lymphocytic infiltrates occurred in the central nervous system in 10 patients. In six cases, reaction was granulomatous. There were single instances of suppurative and fibrotic reactions. Mortality from infection was high in patients with neoplastic disease. Twenty-four of 28 deaths occurred within 60 days as a result of infection. Within one year, 10 more patients died, nine of cryptococcosis. Only three survived more than one year, and all patients died within 600 days. Twenty-nine patients with neoplastic disease received amphotericin B. Only nine survived more than 60 days.
Amphotericin B↗
Central nervous system infections in patients with cancer. Changing patterns.
Central nervous system infections in patients with cancer at Memorial Sloan-Kettering Cancer Center from 1971 to 1974 were surveyed and compared with a previous survey from 1955 to 1970. The two periods were similar in that: 1) There was a high incidence of CNS infection in patients with lymphoma, leukemia, and head and spine tumors, 2) specific organisms tended to infect patients with certain primary neoplasms, and 3) fungal infections were common and difficult to diagnose. The two periods differed in that: 1) the overall incidence of CNS infection was lower in 1971 to 1974, 2) there was a decreased incidence of cryptococcal meningitis, and 3) there was an increase in Listeria monocytogenes meningitis. Early recognition of CNS infection and aggressive therapy appears to increase survival.
Bacterial Infections↗
Pulmonary disease caused by Candida species.
Candida species are often found in sputum specimens. Their role as a possible cause of pulmonary disease is a frequent consideration, particularly in patients receiving immunosuppressive or long-standing antimicrobial therapy. At Memorial Hospital and New York Hospital, 30 patients with histologic evidence of Candida pulmonary infection were identified over a two year period. These infections reached the lungs by hematogenous spread in 10 patients and by aspiration in 16 patients. Most the patients had malignant neoplastic disease. The Candida pulmonary disease appeared to be significant clinical factor in only three cases. Experience from our institutions and from the literature indicates that Candida species rarely cause significant pulmonary disease. When such involvement is extensive, the patient is usually terminally ill from multiple other factors.
Biopsy↗
Bacteremia and fungemia complicating neoplastic disease. A study of 364 cases.
During a 14 month period there were 364 episodes of bacteremia and fungemia at Memorial Sloan-Kettering Cancer Center. The first nine months of the study were retrospective, and the next five prospective. In patients with leukemia or lymphoma (group 1), Escherichia coli, Pseudomonas aeruginosa, Klebsiella pneumoniae and Staphylococcus aureus were the most frequently isolated organisms. The mortality in this group was 40.5 per cent. In the patients with solid tumor (group 2), Esch. coli, Staph. aureus, Bacteroides sp. and Candida sp. were most frequent. Mortality was 27.8 per cent. The source of infection in both groups was often indeterminate. High mortality was associated with pulmonary and intraabdominal infection and with Ps. aeruginosa, K. pneumoniae or polymicrobic sepsis. Factors of prognostic significance were the causative microorganism, source of infection and shock. Although mortality was higher in patients with leukopenia than in those with normal leukocyte counts, the differences were not significant. The mortality in this series was low considering the severity of the underlying diseases and the immunosuppressed state of many of the patients. In a prospective, randomly controlled study, mortality was further diminished by infectious disease consultation at the time the positive blood culture was reported. Severe fungal superinfection, predominantly aspergillosis and candidiasis, was found in 52 per cent of the autopsy patients with leukemia or lymphoma (group 1), but in only 8 per cent of those with solid tumors (group 2).
Adolescent↗