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Biomedical subjects

G A Pankey

Publications and source records attributed to G A Pankey.

At least 55 records · Page 3Linked to original sources
PubMed1985

The histopathology of Mycobacterium marinum synovitis.

Eight patients with culture-proven Mycobacterium marinum synovitis had synovial specimens with a remarkably similar histologic appearance. There was considerable synovial hyperplasia, and the synovium was thickened by a moderately intense lymphohistiocytic infiltrate, notably devoid of plasma cells. Fibrin covered some synovial surfaces. Giant cells were both of the Langerhans' and foreign body types. Granulomas were noncaseating but varied in frequency and degree of definition. Knowledge of this morphologic picture has proved to be useful in patient care.

Adult↗
PubMed1984

Studies in homosexual patients with and without lymphadenopathy. Relationships to the acquired immune deficiency syndrome.

We studied the immunologic function of 19 sexually active homosexual men, ten of whom had persistent lymphadenopathy. Analysis of mononuclear cell populations distinguished homosexuals from heterosexual controls since, as a group, homosexuals had increased percentages of natural killer cells (Leu 7+), decreased helper-inducer T lymphocytes (OKT-4+), increased suppressor/cytotoxic (OKT-8+) T lymphocytes, low OKT-4:OKT-8 ratios, and depressed mitogenic responses. Homosexuals without lymphadenopathy were distinguishable from controls by increased percentages of Ia+ cells, decreased OKT-4+ cells, and decreased OKT-4:OKT-8 ratios. Four had positive findings simultaneously for hepatitis B surface antigen (HBsAg) and surface antibody, and five had positive findings for HBsAg alone. Homosexuals with lymphadenopathy were distinguishable from controls by increased percentages of Leu 7+ cells, increased total lymphocyte numbers per cubic millimeter, decreased percentages of both OKT-4+ and OKT-8+ cells, abnormal OKT-4:OKT-8 ratios, and depressed mitogenic responses. Only histories of larger numbers of sexually acquired diseases, higher numbers of OKT-8+ cells per cubic millimeter, and lower mitogenic responses in homosexuals with lymphadenopathy distinguished this group from homosexuals without lymphadenopathy. Furthermore, none of the nine patients tested in this group was HBsAg positive. We conclude that homosexuals without lymphadenopathy are distinguishable from those with lymphadenopathy by both immunologic and serologic abnormalities.

Acquired Immunodeficiency Syndrome↗
PubMed1982

Pneumonia in the elderly.

The organisms to which the elderly are most susceptible are different from those affecting younger pneumonia patients. Furthermore, the pathogenesis of the disease varies with age, partly because of an increased incidence of underlying disease in older persons and partly because of the effects of the aging process itself. Presenting symptoms of pneumonia may be more subtle in the elderly than in younger patients, and clinical findings may also vary. Elderly pneumonia patients should always be hospitalized and treated immediately and aggressively with parenteral antibiotics according to results of the Gram stain. Once the pathogen involved is identified, more specific antibiotic therapy is begun. If physicians understand the unique characteristics of pneumonia in the elderly and act accordingly, they should play an important part in decreasing the relatively high mortality from the disease in this age-group.

Aged↗
PubMed1982

In vitro activities of trimethoprim and sulfamethoxazole against Listeria monocytogenes.

The in vitro activities of trimethoprim and sulfamethoxyazole against clinical isolates of Listeria monocytogenes were examined separately and in combination with a microtiter broth dilution system. Sulfamethoxazole demonstrated variable activity and was generally bacteriostatic. Trimethoprim alone was bactericidal against 96% of isolates at less than 0.5 microgram/ml. The bactericidal action of trimethoprim against L. monocytogenes was generally potentiated by sulfamethoxyazole even when isolates were relatively resistant to sulfamethoxyazole alone.

Humans↗
PubMed1981

Histopathology of marine vibrio wound infections.

Although marine vibrio wound infections and septicemia are being reported with increasing frequency, description of the histopathologic changes has been scanty. The histologic alterations in three patients with primary marine vibrio wound infections are presented. The lesions are characterized by intense acute cellulitis of the subcutis with much tissue destruction and extension into the adjacent dermis. The superficial dermis is devitalized and lacks an inflammatory cellular infiltrate. Subepidermal noninflammatory bullae are formed. Many organisms are seen both within the areas of intense acute inflammation and in devitalized areas. Organisms and inflammation are especially oriented around vessels, with associated acute vasculitis. It is concluded that the morphologic picture in marine vibrio wound infections is nonspecific yet characteristic.

Adult↗
PubMed1981

Wound infection and septic shock due to Vibrio vulnificus.

Vibrio vulnificus is an organism commonly found in the marine environment whose pathogenic potential for humans has been recently recognized. Two patients are described who developed rapidly progressing wound infections and bacteremia due to this halophilic, lactose-positive vibrio. The clinical manifestations of the resulting infection differed from patterns reported by other authors.

Aged↗
PubMed1981

Oral ulceration mimicking midline (nonhealing) granuloma.

Destructive facial or oropharyngeal lesions, or both, require aggressive diagnostic inquiry. Early differentiation of clinically similar lesions is vitally important but often difficult. Both cases presented in this report were initially diagnosed as having midline (nonhealing) granuloma. Further diagnostic efforts were required to establish a definitive diagnosis.

Aged↗
PubMed1979

Disk diffusion testing of susceptibility of Mycobacterium fortuitum and Mycobacterium chelonei to antibacterial agents.

Although recent studies have suggested that some antibacterial agents have good activity against the rapidly growing mycobacteria Mycobacterium fortuitum and Mycobacterium chelonei, an easily applicable method for susceptibility testing of clinical isolates is not yet available. We evaluated a disk diffusion method with Mueller-Hinton agar and 48-h readings with 59 strains of M. fortuitum and 11 strains of M. chelonei and compared the results to agar dilution susceptibilities for nine antimicrobial agents. All isolates were susceptible to 16 micrograms of amikacin or kanamycin per ml with minimum zone diameters of 14 and 18 mm, respectively. Amikacin inhibited 100% of isolates of M. fortuitum at 2 micrograms/ml, whereas 10 of 11 (91%) of M. chelonei strains had minimum inhibitory concentrations of 4.0 micrograms/ml or greater. Doxycycline and minocycline had almost identical activities, inhibiting 44% of strains at 4.0 micrograms/ml, and both allowed easy differentiation between susceptible and resistant strains by disk diffusion. Although most isolates of M. chelonei grew better on 7H10 agar, this media gave two- to eight-fold higher minimum inhibitory concentrations than were obtained with Mueller-Hinton agar. Disk diffusion susceptibility testing appears to be a simple and reliable means of predicting susceptibility results for M. fortuitum and most isolates of M. chelonei by the agar dilution method.

Aminoglycosides↗
PubMed1978

In vitro susceptiiblity of Mycobacterium fortuitum and Mycobacterium chelonei to amikacin.

Infections due to Runyon group IV atypical mycobacteria, Mycobacterium fortuitum and Mycobacterium chelonei, in humans have been difficult to treat in the past because of the organisms' resistance to all of the conventional antimycobacterial drugs. Determinations of minimal inhibitory concentrations (MICs) by the agar dilution method suggest that amikacin may be useful in the treatment of infections due to M. fortuitum and M. chelonei. Further support for the efficacy of antimicrobial agents with good in vitro activity in the treatment of infections with M. fortuitum and M. chelonei will depend on correlation of future clinical experience with standardized data on the MICs for these organisms.

Amikacin↗
PubMed1978

Tuberculous otitis media with complications.

Tuberculous otitis media, although uncommon today, is still a differential diagnosis of suppurative otitis media. Our patient's otitis progressed from a draining ear with hearing loss to include facial nerve paralysis and meningitis. Several surgical procedures including radical mastoidectomy were insufficient to halt progression of the disease. After culture of acid-fast bacilli from the aural drainage and the cerebrospinal fluid, antituberculous chemotherapy was started and the patient responded well to treatment.

Adult↗
PubMed1978

Problems in diagnosis and therapy of Mycobacterium fortuitum infections.

Mycobacterium fortuitum was isolated 11 times from 8 patients during a 6-year period. Six of the isolates were from sputum; one was from aspiration of a lymph node, and 4 were from wound cultures. The isolation from sputum was believed not to be associated with pulmonary infection in all 6 instances. The difficulty in diagnosis and therapy of infections with Mycobacterium fortuitum is illustrated by these cases and by others from the literature. Amikacin and doxycycline may offer some therapeutic benefit for patients with Mycobacterium fortuitum infections.

Adolescent↗
PubMed1978

Subacute thyroiditis with increased serum alkaline phosphatase.

Three patients had subacute thyroiditis and elevated serum alkaline phosphatase, presumably related to the thyroiditis. Concomitant elevation of the serum gamma-glutamyl transferase suggested that the alkaline phosphatase was of hepatic origin. The elevation of the serum alkaline phosphatase could not be definitely related to the degree or duration of elevation of the serum thyroxine. The combination of elevated serum alkaline phosphatase with the systemic symptoms of subacute thyroiditis may obscure the diagnosis, especially if patients have little or no neck pain.

Adult↗