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Biomedical subjects

G J Harris

Publications and source records attributed to G J Harris.

At least 109 records · Page 6Linked to original sources
PubMed1990

Pediatric first rib fractures.

First rib fractures are associated with a high incidence of thoracic, vascular, abdominal, and central nervous system injuries. Usually reported in the adult population, first rib fractures are infrequently described in the pediatric population. We take this opportunity to describe six pediatric patients who sustained traumatic first rib fractures. Overall, five patients required operative intervention. Two patients sustained major vascular injuries which were detected on physical examination and confirmed by arch aortography. In view of the high percentage of patients with vascular injury, first rib fracture in a pediatric patient should prompt a search for major vascular injury.

Adolescent↗
PubMed1989

Primary adrenal lymphoma.

A case of non-Hodgkin's lymphoma (large cell immunoblastic sarcoma) arising as a primary malignancy in the adrenal gland is reported and the literature concerning this unusual tumor is reviewed. Although extremely rare, it is possible to make the diagnosis preoperatively. Therefore, primary adrenal lymphoma should be included in the differential diagnosis of a suprarenal mass.

Adrenal Gland Neoplasms↗
PubMed1989

Serial bilirubin determinations as a prognostic marker in clinical infections.

Patients with documented serious infection and total bilirubin values of greater than 2 mg/dl were surveyed for serial changes in bilirubin and other laboratory and clinical features. Of 19 patients studied, 12 (Group A) had persisting or increasing hyperbilirubinemia, and 7 (Group B) had decline in bilirubin after infection onset. None demonstrated marked changes in other liver tests. Only one patient had infection directly involving the hepatobiliary system. There were no significant differences between the two groups with respect to underlying illnesses, active hepatobiliary diseases, pathogens, bacteremia, or administration of cholestatic drugs. All Group A patients died because of uncontrolled infections, whereas all Group B patients survived with resolution of infection (p less than .001). Ten of 15 patients with available preinfection liver tests demonstrated serial bilirubin increases without marked changes in other liver tests prior to clinical recognition of infection. These findings demonstrate that hyperbilirubinemia disproportionate to increases in other tests may manifest before recognition of infection and that persistent or progressive hyperbilirubinemia is indicative of ongoing active infection.

Adult↗
PubMed1989

Orbital aspergillosis. Conservative debridement and local amphotericin irrigation.

A patient maintained on long-term immunosuppressive agents after bone marrow transplantation developed an Aspergillus abscess in the right orbit. The abscess was resected without visual compromise and the orbit was irrigated regularly with amphotericin B via an indwelling catheter. Follow-up computed tomography, surgical exploration, and histological analysis demonstrated suppression of fungal growth in the orbit. Persistent fungus was recovered from nonirrigated sinuses despite their previous surgical evacuation and continued systemic amphotericin B administration. Treatment of orbital aspergillosis should include surgical reduction of the local fungal inoculum, supplementation of intravenous antifungal agents with local delivery to minimize systemic toxicity, and attempts to reverse the immunosuppression. If the last is not possible, extensive extirpation of normal surrounding tissues will not prevent repopulation by the ubiquitous fungus.

Adult↗
PubMed1989

Gastrointestinal carcinoid tumor metastatic to the orbit.

Primary gastrointestinal carcinoid tumors rarely metastasize to the orbit, but an aggressive approach is warranted for any patient with a history of carcinoid tumor and ocular complaints. The diagnosis can be established only by obtaining tissue for histologic examination. Treatment, usually with radiation, can result in symptomatic improvement and should be considered after confirmation of the diagnosis.

Aged↗
PubMed1989

Color Doppler flow imaging of the normal and abnormal orbit.

Twenty-six normal orbits (16 subjects) and seven patients with suspected orbital disease were studied with color Doppler flow imaging CDFI). Arterial structures consistently identified included the ophthalmic artery, central retinal artery, and posterior ciliary branches. The terminal lacrimal branch was seen in the majority of orbits (n = 19). Venous structures consistently seen included the central retinal vein and venae vorticosae; the superior ophthalmic vein was identified in the majority of normal orbits (n = 22). Response of the superior ophthalmic vein to the Valsalva maneuver was assessed in six of the normal subjects (12 orbits). Retrograde flow was typically seen during the maneuver and accentuated antegrade flow after cessation of the maneuver. Pathologic entities correctly diagnosed with CDFI included a dural arteriovenous malformation (AVM) with spontaneous carotid-cavernous fistula, an orbital AVM, and superior ophthalmic vein thrombosis. Vascular lesions were excluded in two patients with orbital masses. Bilaterally enlarged superior ophthalmic veins were identified in a patient with unilateral symptoms suggestive of a varix; CDFI results were confirmed with computed tomography, but orbital venograms were interpreted as normal. These findings suggest that CDFI may be helpful in the evaluation of suspected vascular orbital disease.

Adult↗
PubMed1988

Subperiosteal inflammation of the orbit. A bacteriological analysis of 17 cases.

Seventeen cases of subperiosteal inflammation of the orbit secondary to sinusitis were analyzed from a bacteriological perspective. The recovered pathogens ranged from single aerobes to mixed aerobes and anaerobes. The bacteriology was not related to the duration of symptoms of sinusitis. Three cases with the diagnostic criteria for subperiosteal inflammation resolved with antibiotics alone. The most refractory infections had the most complex bacterial constituencies and persisted despite in vitro antibiotic susceptibility of individual organisms. In these cases, local physical conditions may be drastically altered in favor of the bacteria. Ventilation of the subperiosteal space and sinuses by surgical drainage can help to normalize the milieu in favor of the host.

Anti-Bacterial Agents↗
PubMed1988

Superior oblique myectomy and trochlectomy in recurrent superior oblique myokymia.

In patients operated on for superior oblique myokymia with superior oblique tenotomy or tenectomy, symptoms of oscillopsia recur in approximately one-half. Failure of treatment may be caused by incomplete transection of the tendon or by residual attachments and postoperative adhesions between the proximal segment of superior oblique tendon and the globe which allow superior oblique muscle contractions to be partially transmitted to the globe. We report a patient with recurrent symptoms of superior oblique myokymia following superior oblique tenectomy who was successfully managed with superior oblique myectomy and trochlectomy via an anterior orbital approach.

Adult↗
PubMed1988

Respiratory epithelial cyst of the orbit.

An 88-year-old woman presented with a longstanding superomedial cyst of the orbit complicated by recurrent acute infection. Despite a clinical picture typical for a sino-orbital mucocele, no sinus abnormality was demonstrated. Histopathologic examination revealed a respiratory epithelial lining similar to that of the paranasal sinuses. Possible pathogenetic mechanisms are discussed.

Aged↗
PubMed1987

Fluorescent labeling of bacteriorhodopsin: implications for helix connections.

Purple membrane from Halobacterium halobium was reacted with dansyl (5-dimethylamino-1-naphthalenyl fluorescent labels that have specificity for different protein side chains of bacteriorhodopsin. Dansyl chloride was found to react primarily with Lys-41. Dansyl hydrazine was coupled, with water-soluble carbodiimide, to Glu-74 and/or Asp-85, which was the major modified site after papain-cleavage of the carboxyl-terminal 17 amino acids. Fluorescence energy transfer was used to probe the proximity of the modified sites to the retinal chromophore of bacteriorhodopsin. The dansyl group on Lys-41 was greater than 2.99 nm from retinal, while the dansyl group on Glu-74/Asp-85 was greater than 2.10 nm from retinal. Information available on the location of retinal in the transmembrane profile and probable surface locations of the fluorescent labels was combined with the energy transfer results to calculate distances projected in the plane of the membrane. The projected distances to retinal were 1.64 nm (Lys-41) and 1.65 nm (Gly-74). These measurements, combined with many other labeling experiments that have been reported, restrict the number of likely helix-connection models to only three: EDCABGF, FEDCBAG and FGEABDC (in the nomenclature of Engelman et al. (1980) Proc. Natl. Acad. Sci. USA 77, 2023-2027).

Bacteriorhodopsins↗
PubMed1987

Somatostatinoma: a case report and review of the literature.

Somatostatinomas are rare endocrine tumors that were first described in 1977. In addition to the present case report, there have been 31 cases reported in the literature. We have reviewed the literature to integrate the symptoms, physical findings, diagnostic tests, treatment, and length of survival of these patients. Although the symptoms that occurred in the majority of cases were those that are seen in most patients with intra-abdominal neoplasms, symptoms relating to the presence of excess circulating somatostatin--diabetes, maldigestion, and cholelithiasis--were frequently seen. Physical findings and the results of diagnostic tests were usually nonspecific. The majority of the patients underwent radical surgical procedures (Whipple procedure or pancreatic resection). The pancreas was the most frequent site of involvement (21/31 cases), but primaries in the duodenum, ampulla of Vater, cystic duct, and jejunum have been described as well. Metastases were most frequently seen in the liver and lymph nodes. Chemotherapeutic agents were administered to 10 patients, usually as adjuvant therapy, and appear to be useful in treating recurrent and metastatic disease. The one-year survival of these patients is 48%, which is better than that for patients with carcinoma of the pancreas or biliary tree. Therefore, it is important that the diagnosis of somatostinoma be made so that the patient may be treated accordingly and followed by serial somatostatin levels for evidence of metastasis or recurrent disease.

Adenoma, Islet Cell↗
PubMed1987

Standard biplane roentgenography is highly sensitive in documenting mediastinal masses.

The records of 30 patients with mediastinal masses were reviewed to evaluate the signs, symptoms, and preoperative tests that were most useful in diagnosing and localizing the masses. Sixteen (53%) of the tumors were benign, and 14 (47%) were malignant. Twenty patients were seen with symptoms. The most common symptoms suggesting malignancy were pain, weight loss, fever, and cough. Four of the 5 patients who were truly asymptomatic had benign lesions. All 4 patients with palpable adenopathy had malignant tumors. Posteroanterior and lateral chest roentgenograms detected the mediastinal mass in 29 (97%) of the 30 patients. All patients were operated on for tissue diagnosis or resection (13, median sternotomy; 8, right thoracotomy; 3, left thoracotomy; 2, low anterior cervical approach). Eight patients underwent mediastinoscopy, which was diagnostic in 6 and obviated the need for operation in 4. It was of particular value for patients with lymphoma, who can be managed without resection.

Adult↗