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Biomedical subjects

G Anderson

Publications and source records attributed to G Anderson.

At least 253 records · Page 14Linked to original sources

HIV preventive medicine services and public health interventions: the Bethesda experience.

A basic Public Health approach to the Human Immunodeficiency Virus (HIV) epidemic has been considered by many to be the most appropriate initial strategy against the spread of this infection. Comprehensive Preventive Medicine services were implemented at Naval Hospital Bethesda, which utilized a sexually transmitted disease (STD) model and included: counseling and education; sexual contact interviews and spouse evaluations; Blood Bank Look Back tracking of donated blood; reporting of notifiable diseases; and screening of transfusion recipients, STD cases, and other at-risk populations. This coordinated approach is highly efficient and capable of evaluating the increasing numbers of HIV-positive individuals.

Acquired Immunodeficiency Syndrome↗

Immunoglobulins in Hassall's corpuscles of the human thymus.

Ninety nine human thymuses were examined immunohistochemically for the presence of immunoglobulins G, A, M. D and E, light-chains, secretory component and albumin in the cells of Hassall's corpuscles. Igs G, A, M and secretory component were present. These showed a rise after birth until the age of 20 years and also increased with the degree of involution, falling when involution became complete. Albumin was also consistently demonstrated. There was a degree of correlation between the presence of Igs and production of Igs G, A and M by plasma cells in the thymic medulla. There was a close correlation between the amounts of IgA and secretory component in the cells of Hassall's corpuscles and the thymus may have to be regarded as a part of the secretory-IgA system. Light chains of the immunoglobulin molecule were also present, with lambda predominating over kappa, possibly reflecting the same kappa/lambda ratio found with thymic immunoglobulin production. No IgD or IgE was demonstrated. The presence of albumin may represent a passive uptake of protein in senescent cells but a more active uptake of Igs, particularly IgG and IgA, could be postulated. The production of Igs in the thymus and their presence in Hassall's corpuscles could be of significance in the maturation and regulation of the immune response.

Adolescent↗

Identification of T-cell receptor V beta deletion mutant mouse strain AU/ssJ (H-2q) which is resistant to collagen-induced arthritis.

Our laboratory is involved in investigating the role of T-cell receptor (Tcr) in collagen-induced arthritis (CIA). During these studies we found AU/ssJ (H-2q) mice to be resistant to CIA like SWR (H-2q), as compared with other H-2q strains with wild-type Tcr like DBA/1 and B10.Q. Upon screening with monoclonal antibodies F23.1 and KJ23a, AU/ssJ was found to be F23.1 negative (V beta 8 Tcr negative) and KJ23a positive (V beta 17a Tcr positive). Southern blot analysis on liver DNA using specific Tcr-V beta probes confirmed the deletion of V beta 8 gene family and also showed that AU/ssJ mice have deletions of V beta 9, V beta 13, V beta 12, and V beta 11 genes of Tcr. Further, these mice show a restriction fragment length polymorphism pattern with V beta 10, V beta 6, and V beta 17 probes similar to SWR mice as compared with B10 mice. Since SWR and AU/ssJ are from different backgrounds, these studies indicate that specific variable region beta chain genes of Tcr are crucial for susceptibility to CIA in mice. Furthermore, these studies identify an additional inbred strain which has also deleted 50% of its Tcr-V beta genes.

Animals↗

An experimental investigation in the dog into the mode of osseous integration of total joint implants.

An uncemented scaled down version of the Mueller SLS femoral component was inserted into 30 dogs. The material (Protasul 100), geometry, and finish were identical to those designed for clinical use. Half of the prostheses inserted were fitted out with a modular collar to improve stability. Initial stability was achieved through press fit which was made possible by the special modification of the surface area and external configuration of the prosthesis. The function of the prosthesis was assessed through clinical assessment and force plate gait analysis. This was correlated with the degree of osseous integration which was evaluated on the basis of regular radiological examinations, and at post mortem by microradiography of the serially sectioned undecalcified femurs, and histological examination of selected sections under regular and ultraviolet light. The animals were sacrificed at 4, 8, and 12 months. Force plate gait analysis revealed that all animals walked with a normal gait by the 4th post-operative month. Evaluation revealed that 29/30 femoral prostheses became successfully integrated. The prostheses without the collar were less stable and most achieved stability only by incorporation of the distal tip of the prostheses in bone and the remainder in dense fibrous tissue. The prostheses with the collar were stable and achieved without fail full bony integration. The stability was provided by appositional growth of bone which came into direct contact with the implant over the proximal 1/3 and the distal 1/3 without an intervening fibrous membrane. Despite failure of full integration of the collarless prostheses clinically and by force plate analyses the two groups were indistinguishable.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

Court-ordered cesarean section: an analysis of ethical concerns in compelling cases.

Two previously unreported cases are presented in which court-ordered cesarean sections were considered appropriate by physicians. An analysis of the factors that compel physicians to deem court-ordered intervention appropriate is presented. When the significance of a third-trimester fetal death or a lifetime physical or mental disability is balanced against the demand to uphold maternal autonomy at all costs, the recognized ethical principles of beneficence, nonmaleficence, justice, obstetric contract keeping, and acting in the patients' best interests combine, in rare situations, to override concerns for individual maternal autonomy and justify court-ordered intervention.

Adult↗

Prevention of amputation by diabetic education.

This prospective randomized study evaluated the influence of a simple education program on the incidence of lower extremity amputation in diabetic patients. Two hundred three patients were randomized into two groups: Group 1, education (103 patients, 203 limbs) and Group 2, no education (100 patients, 193 limbs). There were no significant differences in medical management or clinical risk factors between the two groups. The amputation rate was three times higher in Group 2 (21 of 177 limbs versus 7 of 177 limbs; p less than or equal to 0.025), the ulceration rate was three times higher in Group 2 (26 of 177 limbs versus 8 of 177 limbs; p less than or equal to 0.005), and there was no difference in the overall incidence of infection (2 of 177 limbs). Overall success in Group 1 was highly significantly different from Group 2 (160 of 177 limbs versus 128 of 177 limbs; p less than or equal to 0.0005). This study demonstrated that a simple education program significantly reduced the incidence of ulcer or foot and limb amputation in diabetic patients.

Amputation, Surgical↗

Knowledge management as a decision support method: a diagnostic workup strategy application.

We have explored the potential of a computer-based approach called "knowledge management" to aid in clinical problem solving and education. The major features of the approach are its ability to support flexible and immediate access by a user to relevant knowledge and annotation and organization of the knowledge for personal use and subsequent retrieval. We illustrate this approach with its application to diagnostic workup strategy problems. In this application, knowledge may be in the form of static narrative text, diagrams, pictures, graphs, tables, flow charts, or bibliographic citations. Other more dynamic forms of knowledge may be the result of simulations, "what if" analyses or modeling, quantitative mathematical or statistical calculation, or heuristic inference. User assessment has demonstrated the system's ease of use and user perception of its desirability, but underscores the need for a "critical mass" of knowledge before such an approach will be widely utilized.

Decision Support Techniques↗

Differentiating multiple personality disorder and complex partial seizures.

A number of reports have suggested that some cases of multiple personality disorder might be due to temporal lobe epileptic discharges. We have administered a structured interview, the Dissociative Disorders Interview Schedule, to 20 subjects with multiple personality disorder, 20 with complex partial seizures, and 28 neurologic controls. Subjects also completed the Dissociative Experiences Scale. Results show that multiple personality can be differentiated from complex partial seizures on a large number of items. The seizure patients did not differ from controls. The data indicate that the phenomenologies of these two disorders are distinct, and, therefore, there is little reason to assume a common etiology.

Adult↗

Somatic symptoms in multiple personality disorder.

A structured interview, the Dissociative Disorders Interview Schedule, was administered to 20 patients with multiple personality disorder, 20 with panic disorder, 20 with eating disorders, and 20 with schizophrenia. The frequencies of somatization disorder and of individual somatic symptoms in the four groups were compared. The multiple-personality patients reported more somatic symptoms than the other groups. Of the 20 multiple-personality patients, seven met the criteria for somatization disorder. The average number of somatic symptoms per multiple-personality patient was 13.5.

Adult↗

Evaluation of IVAC Variable Pressure Volumetric Pump Model 560 for the delivery of red blood cells, adenine-saline added.

Mechanical pump systems for the delivery of intravenous solutions have been used for the transfusion of red blood cells. In this study, the IVAC Variable Pressure Volumetric Pump Model 560 was evaluated for that purpose using flow rates of 70 mL/hour and 999 mL/hour through 16-, 19-, and 23-gauge needles and an 18-gauge angiocatheter. The largest degree of hemolysis induced by the delivery system resulted in a mean increase of plasma hemoglobin of 150 mg/L (15 mg/dL); this is equivalent to the loss of 0.03% of the red blood cells. When programmed to deliver 15 mL of red blood cells, the IVAC 560 delivered 15.0 +/- 0.3 mL at a rate of 70 mL/hour and 14.9 +/- 0.3 mL at 999 mL/hour. The authors conclude that the IVAC 560 can be used to deliver red blood cells with a minimal, acceptable level of hemolysis. It also delivers an accurate and precise volume of red blood cells that may be an aid to the transfusionist.

Adenine↗

Differences between multiple personality disorder and other diagnostic groups on structured interview.

The Dissociative Disorders Interview Schedule was administered to 20 subjects with multiple personality disorder, 20 with schizophrenia, 20 with panic disorder, and 20 with eating disorders. The findings showed that multiple personality can be differentiated from the other groups on variables such as history of physical abuse, sexual abuse, substance abuse, sleepwalking, childhood imaginary playmates, secondary features of multiple personality and extrasensory and supernatural experiences. Those with multiple personality also differ from the other groups on DSM-III criteria for multiple personality, psychogenic amnesia, and psychogenic fugue. The groups did not differ on the number of subjects who had had a major depressive episode.

Adult↗

Diagnostic criteria for intraarticular T.M. disorders.

Epidemiological investigations about the prevalence of TMJ ID and osteoarthritis have largely reported the symptoms and signs associated with these disorders without specific criteria to establish the diagnosis. In this study, specific diagnostic criteria have been developed, using historical, clinical and tomographic items that are predictive of the presence and stage of TMJ internal derangement. The diagnostic criteria were compared to arthrotomography to assess their diagnostic accuracy. Overall, the percent agreement was 75%. The predictability of specific stages of TMJ ID varied. Overall, sensitivity and specificity of the criteria were acceptable. The diagnosis of osteoarthritis was predicted only with tomography. Utilization of these diagnostic criteria in epidemiological studies is valid due to their high overall predictiveness when applied to a large population.

Adolescent↗

Chickenpox pneumonia: an association with pregnancy.

Three pregnant patients with chickenpox pneumonia are described. A review of reports published since 1965 together with these cases shows that 28 of the 46 women (61%) were pregnant, and 21 were in the last trimester. Although the disease is more common and more severe in pregnancy, the proportion of deaths was no greater than usual. In this retrospective analysis there was no evidence that treatment with acyclovir conferred benefit but this may have reflected its use only in very ill patients.

Adult↗

Ultra-high-speed teleradiology with ISDN technology.

A solid-state, personal computer-based, image digitization and transmission system was developed that uses integrated services digital network (ISDN), a technology under development for ultra-high-speed data transmission over normal phone lines. Thousands of images have been transmitted to a site more than 15 miles away, with data rates exceeding 56,000 bits or 7,000 bytes (1 byte = 8 bits) per second with nearly perfect accuracy. Present modification of the system hardware and software should increase the data rate to 128,000 bits, or 16,000 bytes, per second. With this rate of transmission, remote radiologic image transmission should become a practical, routinely available diagnostic tool.

Computer Communication Networks↗