Biomedical subjects
G Gordon
Publications and source records attributed to G Gordon.
Pulmonary alveolar microlithiasis: case report.
Alveolar microlithiasis is a rare disease with only about 150 cases reported in the literature. Although some patients present with progressive respiratory symptoms, the discovery is in most cases an incidental finding on a chest radiograph. The management of the condition has essentially supportive in all reported cases. We describe a case first discovered in 1976 and finally diagnosed in 1985.
Injury from silage wagon accident complicated by mucormycosis.
Infection due to farm machinery injuries may be caused by microorganisms found in soil or decaying vegetable material. A case of injury due to entrapment of a young boy in a silage wagon is reported here. His injuries were complicated by infection with Aspergillus species, Absidia species, Rhizopus species (the latter two are members of the Mucorales order), and Pseudomonas maltophilia. Successful treatment of his infection followed aggressive surgical debridement of the anterior abdominal wall, amphotericin B, hyperbaric oxygen therapy, and surgical closure utilizing delayed placement of split-thickness skin grafts.
A coordinated AIDS home care program. VNA of Boston.
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Home health care takes on a new role. The Visiting Nurse Association of Boston expands home care to AIDS patients.
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Film-making: the search for a storyline.
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Perinatal infection with cryptosporidium.
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Thalidomide induction of bone marrow transplantation tolerance.
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The effect of mitoxantrone treatment in beagle dogs previously treated with minimally cardiotoxic doses of doxorubicin.
Low-grade chronic cardiotoxicity as determined by myocardial biopsy specimens was induced in beagle dogs after four courses of doxorubicin hydrochloride (1.64 mg/kg, 34.0 mg/sq m) given intravenously once every 3 weeks. After this initial treatment, these dogs were separated into three groups. Two groups received six courses of mitoxantrone (0.25 mg/kg, 5 mg/sq m) commencing at 7 weeks or 19 weeks after the final doxorubicin treatment. The third group was treated with six additional courses of doxorubicin after an interval of 7 weeks. Up to seven sequential endomyocardial biopsies were performed to monitor the myocardial changes which were observed after the initial doxorubicin treatment. The low-grade cardiotoxic changes progressed for at least 7-11 weeks without any additional doxorubicin treatment, and stabilized or even partially reversed after 19 weeks of a treatment-free period. Dogs that received additional doxorubicin demonstrated progressive cardiotoxicity, associated with clinical signs, that resulted in death after a total of seven to ten courses of treatment (12-16 mg/kg, 238-340 mg/sq m cumulative dose). In dogs treated with doxorubicin followed by mitoxantrone after a 19-week treatment-free period, myocardial changes were shown to have stabilized and/or partially regressed. This study indicated that in beagle dogs four courses of doxorubicin (7 mg/kg, 136 mg/sq m cumulative dose) are the threshold dose at which non-life-threatening cardiotoxicity occurs. Residual toxic effects of doxorubicin may be erroneously interpreted as adverse findings attributable to other agents given subsequently during the susceptible period, ie, prior to stabilization of the myocardium. Mitoxantrone given after stabilization of doxorubicin-induced low-grade myocardial changes did not show additive or synergistic effects.
[Study of phages used in lysotyping of Listeria monocytogenes and proposal of classification by multidimensional treatment].
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Relationship between tidal volume and deadspace during high frequency ventilation.
Physiological (VDphys) and anatomical (VDanat) deadspaces were measured in seven anaesthetized, paralysed and intubated adult patients ventilated at normal and high frequencies. To maintain a constant PaCO2 while increasing the ventilation frequency from 15 to 120 b.p.m., the mean VT was decreased from 454 +/- 62 ml (mean +/- SD) to 117 +/- 9 ml. The mean VDanat and VDphys decreased from 130 +/- 11 ml to 74 +/- 12 ml and 165 +/- 24 ml to 92 +/- 3 ml, respectively, by 80 b.p.m., above which frequency there was no further significant reduction in either. The mean VD/VT ratio increased from 0.36 +/- 0.04 to 0.76 +/- 0.05. This study showed that the deadspace volume measured conventionally was not a constant factor, was mainly a function of VT and was a determinant of tidal and minute volume requirement even during high frequency ventilation. The variable VDphys showed a wide variation between subjects, and appeared to have a mean minimal value of approximately 1.1 ml kg-1 at 80 b.p.m. in adult human subjects with a tracheal tube in situ--a value about half the VDphys measured at conventional normal tidal volumes and ventilation frequencies.
Treatment and prevention of acute graft-versus-host disease with thalidomide in a rat model.
We have investigated the immunosuppressive effects of thalidomide (Thal) in a bone marrow transplant (BMT) model for graft-versus-host disease (GVHD). Lewis rats received RT1-incompatible marrow transplants from ACI rats after total-body irradiation. Twenty-two of twenty-three rats with established severe acute GVHD were successfully treated with Thal. Thal was given for therapy by gavage at 50 mg/kg/day or 100 mg/kg/day for 40 days after GVHD was clinically and histologically present. Fourteen of twenty-two received prophylaxis successfully with Thal at a dose of 50 mg/kg/day or 100 mg/kg/day. Acute GVHD did not develop after the drug was stopped. Three animals treated for severe GVHD later developed chronic GVHD. Chimerism was shown by permanent acceptance of ACI skin grafts and rejection of third-party skin grafts. Lymphocytes from Thal-treated animals likewise did not respond to Lewis or ACI cells in mixed lymphocyte culture but responded to third-party BN lymphocytes. Thal appears to be a potent new agent for therapy and prophylaxis of GVHD.
Fetal heart rate changes and uterine activity during coitus.
Fetal heart rate and uterine activity were monitored during sexual intercourse in three otherwise normal gravid women at varying gestational ages. Increased uterine activity and a variety of fetal heart rate changes, some of which are traditionally identified as ominous, were seen in most instances immediately following orgasm. An increase in fetal activity was also commonly reported by the mothers. It is postulated that coitus is equivalent to an unmonitored contraction stress test.
Martial arts for the quadriplegic.
A program has been developed for teaching of martial arts to the spinal cord injured. Despite the great challenges, quadriplegic patients have been able not only to participate along with paraplegics, but have helped to develop innovative methods to modify techniques to their abilities. The benefits of the program are described.
Case report: prosthetic valve endocarditis caused by Pseudallescheria boydii and Clostridium limosum.
This report describes a patient with a combined infection due to Pseudallescheria boydii and Clostridium limosum on a prosthetic dura mater aortic valve homograft. While this patient had C. limosum only growing in blood cultures, both organisms were isolated from the surgically resected aortic valve. Because P. boydii is generally resistant to amphotericin B but susceptible to miconazole, accurate differentiation of P. boydii from other fungi which may appear similarly in tissue sections (e.g., aspergillus) is important.
Ipecacuahana induced emesis in the treatment of self-poisoned adults.
One hundred consecutive adult patients presenting to an Accident and Emergency Department following intentional self-poisoning were given 50 to 80 ml Paediatric Ipecacuahana Emetic Mixture BP as an emetic, together with two or three glasses of strong orange juice. A satisfactory emetic result was obtained in 99 patients. No toxic effects were noted in these patients, or in the one patient in whom emesis did not occur, and who subsequently refused gastric lavage. The potential toxicity of Ipecacuahana Syrup itself is discussed, and attention drawn to the lower Emetine content of Paediatric Ipecacuahana Emetic Mixture (BP), rather than that of the formulations used in previously published reports. The use of Paediatric Ipecacuahana Emetic Mixture B.P. in adults is effective and safe in this dosage.
Hyperpigmentation of the skin associated with minocycline therapy.
Skin biopsy specimens and discolored fingernails from minocycline-treated patients were examined by light and electron microscopy, histochemistry, and energy-dispersive x-ray analysis. Both hyperpigmented and adjacent normally pigmented skin samples contained pigment-laden macrophages in the dermis, although these cells were more numerous in the hyperpigmented skin samples. Elemental analysis showed that both pigment deposits and stratum corneum of hyperpigmented skin samples contained iron and calcium. Discolored areas of fingernails from a minocycline-treated patient also contained iron and calcium. Both skin and nail discoloration were possibly due to the presence of an iron chelate of minocycline and/or quinoid derivatives of minocycline. The presence of iron-containing pigment in normal as well as hyperpigmented skin may have predisposed to formation of minocycline-associated pigment in these patients.
Roller injury to the upper extremity.
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