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Biomedical subjects

D Armstrong

Publications and source records attributed to D Armstrong.

At least 649 records · Page 36Linked to original sources
PubMed1976

An aspergillus immunodiffusion test in the early diagnosis of aspergillosis in adult leukemia patients.

An Aspergillus fumigatus immunodiffusion test was performed biweekly for one year on 80 hospitalized patients with acute leukemia to determine if serologic conversion accompanied clinical aspergillosis. A micro-ouchterlony technique with agarose was used. The antigens were prepared from concentrated A. fumigatus culture filtrates and the sera were concentrated 3-fold before testing. Of 80 patients, 10 were proved at autopsy, lung biopsy, or closed space culture to have invasive aspergillosis. Six of 10 patients converted from a negative to a positive immunodiffusion test, whereas a seventh patient's weakly positive test became strongly positive. Three patients with documented aspergillosis did not develop a positive immunodiffusion test. Four of the patients who converted from a negative to a positive test were treated early and successfully with amphotericin B. A fifth patient developed immunodiffusion test antibody late in the course and died despite therapy. A sixth patient died of concomitant mucormycosis despite early therapy. Six additional patients who converted from a negative to a positive immunodiffusion test could not be evaluated because of inadequate documentation of aspergillosis. In severely immunosuppressed patients, our immunodiffusion test proved to be a specific but not always a sensitive test for aspergillosis. In 4 patients, biweekly tests showed conversion associated with invasive aspergillosis, which was diagnosed early and treated successfully.

Acute Disease↗
PubMed1976

Hearing without hair cells? A case report.

Audiograms from a five year old accident victim with a profound hearing loss are compared to temporal bone and brain stem histological findings. One temporal bone was evaluated using surface preparation and transmission electron microscope techniques. The other temporal bone was evaluated using serial section procedures. No sensory cells were present in either cochlea. This unusual finding is discussed. Evaluation of ventral cochlear nuclei showed a 50 per cent loss of neurons on both sides.

Auditory Threshold↗
PubMed1976

Malaria complicating neoplastic disease.

Two patients with neoplastic disease had transfusion-induced malaria. In a patient with acute myelogenous leukemia infected with Plasmodium vivax, neither his underlying disease nor intensive cytotoxic chemotherapy appeared to ameliorate or worsen the clinical course of his infection. In a splenectomized patient with metastatic carcinoma of the colon, P malariae infection was associated with a fulminant course simulating cerebral malaria. Despite delay in diagnosis, both patients responded dramatically to antimalarial chemotherapy and both developed appreciable antibody responses.

Adult↗
PubMed1976

The Determination of Peroxidase in Amniotic Fluid.

Analyzing total peroxidase activity in amniotic fluid is extremely simple, requiring only 1 1/2 minutes of incubation at room temperature and a spectrophotometer. Peroxidase, clearly detectable at as early as 17 weeks' gestation in the amniotic fluid, increases 100-fold by term. The increase follows a predictable rising curve and can be used to estimate the fetal age. Maturation of the fetal salivary gland is most probably the source of rising amniotic fluid peroxidase levels. Samples from complicated pregnancies are lower than normal, do not increase as rapidly, and probably can be bracketed into their own ranges for gestational age evaluation.

Amniotic Fluid↗
PubMed1976

Predicting respiratory distress by thin-layer chromatography of the newborn gastric aspirate.

The analysis of gastric fluid from newborns for lecithin/sphingomyelin (L/S) ratio evaluation is useful in determining whether respiratory distress will follow an early delivery. Without exception, the L/S ratios obtained on 14 gastric aspirates paralleled and were slightly higher than intrapartum values obtained from corresponding amniotic fluids (5.6 vs 3.7). Of 46 normal infants, only 1 had a gastric aspirate L/S ratio less than 2:1. No false positive results were found. The obstetrician can easily obtain gastric fluid at delivery, and by ordering an L/S ratio determination, the neonatologist can have an estimation of lung surfactant levels within 2 hours after birth. In cases where true respiratory distress syndrome (RDS) must be differentiated from other problems of respiratory distress, this information can assist in the early management of patients with RDS. Even after the development of RDS, the procedure offers a prognostic tool which the clinician can use in discussing the outcome with the parents.

Amniocentesis↗
PubMed1975

Cryoprecipitate.

Explore the source record for details and available documents.

Blood Transfusion↗
PubMed1975

Imported mucocutaneous leishmaniasis in New York City. Report of a patient treated with amphotericin B.

A case of mococutaneous leishmaniasis in a patient referred to Memorial Sloan-Kettering Cancer Center, New York, with a presumptive diagnosis of lethal mid-line granuloma is described. The patient had lived in Bolivia and had been treated with antimony during and after which his mucosal lesions progressed. These lesions completely healed with 971 mg of amphotericin B. Mucocutaneous leishmaniasis is endemic in many areas of Central and South America and may occur in patients in the United States who have lived in or traveled to these areas. Organisms may be difficult to identify, and multiple biopsies and cultures may be necessary. The use of amphotericin B for the treatment of leishmaniasis is reviewed. It is an effective alternative to antimony therapy, and in some cases resistant to antimony, it may be the drug of choice.

Adult↗
PubMed1975

Pneumocystis carinii pneumonia. Diagnosis by lung biopsy.

Pneumocystis carinii pneumonia was suspected in 52 patients who underwent lung biopsy for diagnosis of diffuse pulmonary infiltrates. All but five of the procedures were limited thoracotomies. There were no instances of significant postoperative hemorrage or of pneumothorax compromising ventilation. The diagnosis of P. carinii pneumonia was made rapidly from imprints of the lung stained by the Gram-Weigert method in the 18 patients who had P. carinii pneumonia. Over-all, the rate of recovery from Pneumocystis pneumonia after treatment with pentamidine isethionate was 41 percent. However, among patients with no other pulmonary lesion (group A), the survival rate was 58 per cent; none of the patients with coexisting pulmonary disease (group B) recovered. The pulmonary infiltrates in the other 32 patients represented a variety of processes, of which 5 were fungal infections and 5 were due to lymphoma. Fifteen patients had an organizing interstitial and intraalveolar pneumonia of undertermined origin.

Adolescent↗
PubMed1975

Anti-Pseudomonas heat-stable opsonins in acute lymphoblastic leukemia of childhood.

Heat-stable opsonic activity against Pseudomonas aeruginosa and Staphylococcus epidermidis was measured in sera of 33 children with acute lymphoblastic leukemia at selected times during treatment of their disease. Compared to adults, opsonization of P. aeruginosa was normal in children tested at the time of diagnosis and before chemotherapy. Immediately after achievement of remission, opsonic activity against Pseudomonas was significantly decreased (P smaller than 0.05) compared with pretreatment activity. Activity usually returned to normal and remained so during long-term remission maintenance therapy. In children studied just prior to death from unremitting leukemia, however, anti-Pseudomonas opsonic activity was significantly decreased when compared with that of a group of children before any leukemic treatment (p smaller than 0.005). Anti-S. EPIDERMIDIS OPSONIC ACTIVITY SHOWED NO CHANGES DURING THE PATIENT'S COURSE. Decreased serum opsonic activity may significantly contribute to the increased incidence of severe Pseudomonas infections in patients with acute lymphoblastic leukemia.

Acute Disease↗
PubMed1975

Recurrent Aeromonas sepsis in a patient with leukemia.

A case of recurrent sepsis due to Aeromonas hydrophila in a patient with acute myelogenous leukemia is reported. The patient's first infection leading to bacteremia followed contamination of a mosquito bite by stagnant water. After recovery from the first bacteremia, the patient again became septic with a second strain of Aeromonas hydrophila, which again responded to antimicrobial therapy. It is hypothesized that contamination of the local water supply may have led to the establishment of a gastrointestinal carrier state that produced the second bout of Aeromonas sepsis when the patient was markedly leukopenic. The importance of the oxidase test to differentiate Aeromonas species from members of the family Enterobacteriaceae is re-emphasized.

Adult↗
PubMed1975

Pneumocystis carinii pneumonia: a cluster of eleven cases.

An unusual cluster of 11 patients with Pneumocystis carinii pneumonia occurred in a 3-month period at Memorial Hospital, New York. Ten of the 11 patients had lymphoma or leukemia. In 7 patients, corticosteroid therapy was decreased or stopped shortly before pneumocystis pneumonia was diagnosed. The pediatric patients had extensive contact in the outpatient department, and three of them had roomed together, suggesting the possibility of man to man transmission. Tree of 4 adult patients with Hodgkin's disease and pneumocystis pneumonia had the same physician. This physician had an indirect immunofluorescent titer of 1:16, as did an infectious disease resident involved in the care of 6 patients. Three of 9 patients tested showed indirect immunofluorescent titers of 1:16 or above, with rising or falling titers on serial specimens. Although definitive evidence of communicability was not established, patients with suspected or proved pneumocystis pneumonia are now isolated in this hospital.

Adolescent↗
PubMed1975

Thyroid peroxidase deficiency in Batten-Spielmeyer-Vogt disease.

Thyroid tissue from two patients with Batten-Spielmeyer-Vogt disease (BSV) was studied for peroxidase enzyme activity and for morphological abnormalities by light and electron microscopy. Diagnosis was confirmed by the demonstration of intracytoplasmic material identical to that described in other reported cases of BSV. There was a substantial decrease in peroxidase activity in the thyroid tissue from both patients. An abnormally low level of peroxidase activity had previously been demonstrated in the white blood cells of these patients. Thyroid biopsy offers obvious advantages over brain biopsy, provides adequate tissue for enzyme analysis, and allows the demonstration of the intracytoplasmic structures characteristic of BSV.

Autopsy↗