Ultrasound in congenital hip disease. Part 1--Review of technique.
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Acetabulum↗
Biomedical subjects
J C Brown
Publications and source records attributed to J C Brown.
Ultrasound in congenital hip disease. Part II--Prospective study.
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Hip Dislocation, Congenital↗
Right aortic arch with aberrant left subclavian artery demonstrated by MR imaging: case report.
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Abnormalities, Multiple↗
The effect of dietary restriction on gastrin secretion in the obese Zucker rat.
It has been hypothesized that G-cell hyperplasia secondary to increased food consumption in the obese Zucker rat was responsible for the hypergastrinemia observed in vivo and from the isolated perfused stomach preparation. This possibility was investigated in pair-feeding experiments wherein the food intake of obese animals was restricted to match that of lean littermates from 5 to 8 weeks of age. Dietary restriction reduced the antral G-cell population of the obese rat to a similar level as that seen in lean animals, supporting the view that hyperphagia is the trigger for G-cell hyperplasia. However, basal gastrin levels measured in vivo and in vitro from the stomach preparation of the pair-fed obese animals were not significantly lower than those of obese animals fed ad libitum. Thus, abnormal feeding behavior in the obese phenotype cannot be directly related to gastrin hypersecretion and G-cell hyperplasia is not the primary cause of hypergastrinemia.
Animals↗
Refractory congestive heart failure after ribavirin in infants with heart disease and respiratory syncytial virus.
Although treatment with ribavirin has been known to be associated with a decreased mortality in infants with congenital heart disease (CHD) who have respiratory syncytial virus (RSV), few data are available regarding morbidity. We reviewed records of 10 consecutively hospitalized infants with CHD during a recent RSV epidemic. Despite the presence of left-to-right shunt in each patient, symptoms of RSV were respiratory at presentation. After ribavirin, decreased respiratory symptoms were found in 8 infants but in 2 assisted ventilation were required 1 and 3 days after admission. Congestive heart failure worsened in 8 patients, 6 of whom had improved respiratory status after ribavirin. Of the 8 patients with worse CHF (pulmonary edema), 3 responded to medical management but 5 were refractory and 4 required surgical repair of CHD. One patient died of pulmonary hemorrhage. Medically refractory CHF may develop in infants with CHD who become infected with RSV and are treated with ribavirin. Further studies are needed to determine whether the pulmonary edema is caused by RSV, ribavirin, or combination of effects on pulmonary capillary function or some other unrecognized mechanism.
Heart Defects, Congenital↗
Somatostatin-like immunoreactivity in rat main olfactory bulb: extent of coexistence with neuropeptide Y-, tyrosine hydroxylase- and vitamin D-dependent calcium binding protein-like immunoreactivities.
A double-labeling immunofluorescence colocalization technique was used to examine the extent of coexistence of somatostatin (SOM)-like immunoreactivity with neuropeptide Y (NPY)-, tyrosine hydroxylase (TH)- and vitamin D-dependent calcium binding protein (D-CaBP)-like immunoreactivities in neurons of the rat main olfactory bulb. SOM-like immunoreactivity (SOM-I) was distributed within restricted populations of periglomerular neurons and deep short-axon cells, and rarely within superficial short-axon cells at the glomerular layer/external plexiform layer (GL/EPL) border region. Double-labeling analysis revealed that all of the SOM-I deep and superficial short-axon cells also contained NPY-I. Colocalization of SOM-I and TH-I or of SOM-I and D-CaBP-I was infrequently observed within periglomerular neurons. The rare SOM-I short-axon cells at the GL/EPL border always exhibited D-CaBP-I. These results demonstrate virtual complete coexistence of SOM and NPY in short-axon neurons of the main olfactory bulb. With a few exceptions, however, bulbar SOM neurons appear to constitute subclasses of periglomerular cells immunohistochemically distinct from those containing TH or D-CaBP.
Animals↗
1H NMR studies of urine from premature and sick babies.
High-frequency proton nuclear magnetic resonance (1H NMR) has been applied to a study of urine from premature and sick newborn babies with a variety of clinical disorders. These included severe birth asphyxia, necrotizing enterocolitis, ketosis, and drug treatment. Abnormal levels of metabolites such as lactate, ketone bodies, betaine, dicarboxylic acids, and 4-hydroxyphenolic acids were detected, as was the antibiotic metronidazole and one of its metabolites. The assignment of betaine was confirmed by two-dimensional 1H NMR studies of urine obtained from two adults with homocystinuria receiving treatment with oral betaine. High-resolution 1H NMR spectroscopy of urine is a potentially useful research technique for monitoring metabolism during early life.
Creatinine↗
Maternal and cord blood plasma. Comparative analyses by 1H NMR spectroscopy.
Normal and 'Hahn' spin-echo 500 MHz 1H NMR spectra of 21 pairs of plasma from mother and cord taken at the time of delivery are reported. The concentrations of 'NMR-visible' lactate, alanine, and valine in the cord plasma significantly exceed those in the maternal plasma. In both maternal and cord plasma, measured lactate levels appear to increase with the length of the second stage of labour. Ethanol was unexpectedly detected in five samples of cord plasma. Lipoprotein--CH3 and--(CH2)n--resonances are more intense in the spectra of maternal plasma compared to cord plasma, and are unusual in composition. The intensities of N-acetyl signals from 'acute-phase' plasma glycoproteins are greater in spin-echo spectra of maternal plasma compared to those of cord plasma (mean ratio 2.1 (SD 0.8]. These results suggest that high resolution NMR spectroscopy may provide a useful new insight into the comparative biochemistry of maternal and cord plasma.
Acute-Phase Proteins↗
NMR studies of body fluids.
High resolution, high frequency, in vitro, proton NMR spectra of various body fluids, including urine, sweat, aqueous humour, amniotic fluid, seminal plasma, cerebrospinal fluid, synovial fluid and blood plasma are described and discussed. Applications include the detection of metabolic disorders, investigations of the biochemical basis of drug and xenobiotic metabolism, organ damage, and diagnoses for sick babies. The determination of metabolite concentrations is straightforward for fluids with a low protein content such as urine. In fluids with a high protein content such as blood plasma, it is possible to detect not only small molecules but also mobile regions of macromolecules, and to demonstrate the interaction of anions such as lactate with proteins. It seems likely that these methods will soon become established in modern pathology laboratories.
Body Fluids↗
Somatostatin expression in the cerebellar cortex during postnatal development. An immunohistochemical study in the rat.
The distribution of somatostatin-immunoreactive (SOM-IR) elements in the cerebellar cortex of the rat has been studied at different stages of postnatal development (from birth to day 30) and in adult animals using immunohistochemistry. The results showed that in vermis of new born animals there are three main groups of SOM-IR structures within the cortex which subsequently spread along the Purkinje cell layer. In addition, both in the vermis and in the lateral lobes, numerous more evenly distributed SOM-positive cells and fibers could be seen. SOM-IR Golgi cells, Purkinje cells and climbing fibers could then be recognized during the subsequent developmental stages. In the vermal zone, SOM-IR Purkinje cells formed patches, which seemed to be part of a sagittal columnar or band-like organization. This was most obvious between days 5 and 21 of postnatal development. Subsequently there was a reduction in the number of immunoreactive Purkinje cells but a patchy disposition remained. In addition high numbers of SOM-IR Purkinje and Golgi cells and also climbing fibers were identified in the flocculus and paraflocculus at all stages of development studied, and they were also seen in the adult rats in these regions. In the lateral lobes expression of SOM-like immunoreactivity (LI) decreased and almost completely disappeared in adult animals. The present results demonstrate that a SOM or a SOM-LI peptide can be transiently detected in many Purkinje and Golgi cells in the cerebellar cortex, suggesting a role in events related to developmental processes. However, in some regions and structures SOM-LI can be seen also in adult animals.
Animals↗
Calcitonin gene-related peptide-like immunoreactivity in nerve fibers in the human skin. Relation to fibers containing substance P-, somatostatin- and vasocactive intestinalpolypeptide-like immunoreactivity.
Calcitonin gene-related peptide-like immunoreactivity was demonstrated in in sensory nerve fibers in the epidermis and dermis as free nerve endings and around blood vessels and hair follicles of the human finger pad and arm skin. The vast majority of the calcitonin gene-related immunoreactive fibers was shown to display also substance P-like immunoreactivity and a few fibers in the dermis were somatostatin positive. No fibers displaying both substance P and somatostatin-like immunoreactivity were found but a few substance P immunoreactive fibers in the dermis-epidermis region were found to contain also vasointestinal polypeptide-like immunoreactivity. In the sweat glands, abundant calcitonin gene-related peptide positive, but substance P negative, fibers were observed with a similar distribution pattern as the vasoactive intestinal polypeptide immunoreactive fibers and these fibers were suggested to be of sympathetic origin.
Adult↗
Psychosexual aspects of virilization syndrome.
A case is reported of a 35-year-old black woman with marked hirsuitism. The focus is on the psychosexual aspects of her illness. Physicians must attend to the potentially devastating effects of virilization syndrome on their female patients.
Adult↗
Gastrin release in obese Zucker rats.
In this study, gastrin release in the obese Zucker rat was investigated by in vivo and in vitro experiments. Obese rats exhibited normal plasma gastrin levels at 3 weeks (preobese), were moderately hypergastrinemic at 3 months and severely hypergastrinemic at 5 months, compared to lean littermates. Following oral peptone, plasma gastrin levels doubled in both lean and obese rats. Basal and vagally stimulated gastrin release from perfused stomachs was greater in obese compared to lean rats and atropine had no effect on basal gastrin release in either group. Basal somatostatin release from the perfused stomach was found not to differ in both groups of animals. Morphological studies revealed an increase in the number of gastrin-containing G-cells in adult obese rats compared to lean littermates, but not in 3-week-old pups compared to lean littermates, indicating a strong correlation between cell number and plasma gastrin levels. These data indicate that the obese Zucker rat exhibits fasting hypergastrinemia in vivo, a condition which appears after weaning and increases in severity with age. Gastrin hypersecretion persists from the vascularly perfused stomach preparation. The basal hypergastrinemia of the obese Zucker rat is independent of a hyperactive postganglionic cholinergic drive but is associated with and probably causally related to an increase in antral G-cell numbers.
Animals↗
Effect of oat gum on the physical properties of the gastrointestinal contents and on the uptake of D-galactose and cholesterol by rat small intestine in vitro.
Recent reports indicate that oats have a relatively low glycaemic effect in comparison with other carbohydrate food, and that their consumption leads to a reduction in plasma-cholesterol levels in man. These properties may be due to a soluble non-starch polysaccharide in oats. The present study was undertaken to explore the physiological properties of this material. Three groups of male Wistar rats were meal-fed on a control diet free of soluble dietary fibre for 10 d before being given a 10 g meal of either the control diet, a diet containing oat gum (beta-glucan), or finely ground rolled oats. The contents of the stomach, small intestine and caecum were later recovered and the weight, water content and viscosity were measured. The small intestinal contents from oat-gum-fed or oat-fed rats had a higher wet: dry weight ratio than that of the controls, and a higher viscosity. In in vitro studies the rate of uptake of D-galactose by jejunal rings was reduced in the presence of oat gum. The estimated Michaelis-Menten constant for the carrier-mediated component in the presence of oat gum was higher than that for controls, but the maximum transport rates were similar. Cholesterol uptake by everted jejunal sacs was progressively inhibited by increasing concentrations of oat gum in the mucosal medium. It is concluded that increased viscosity of the contents of the small intestine may contribute to the low glycaemic index and hypocholesterolaemic effects of oats in man. Oats appear to be amongst the few palatable sources of viscous dietary fibre in the conventional Western diet.
Animals↗
Spine fusion in cerebral palsy with L-rod segmental spinal instrumentation. A comparison of single and two-stage combined approach with Zielke instrumentation.
The benefits of achieving rigid internal fixation and eliminating the need for postoperative external orthotic support with L-rod spinal instrumentation made it desirable for use in the surgical treatment of neuromuscular scoliosis. From May 1981 to May 1985, 31 severely involved cerebral palsy patients with progressive spinal deformity underwent posterior fusion and L-rod instrumentation. All patients except one were nonambulatory. Surgical indications included prevention of curve progression, correction of pelvic obliquity, and achievement of balanced spinal alignment in order to improve sitting balance and tolerance without external spinal orthotic support. Ten patients (Group I), with an average age of 15.2 years, with double major or flexible paralytic C-curves or scoliosis measuring less than 70 degrees, underwent posterior fusion and L-rod instrumentation only. Twenty-one patients (Group II), with an average age of 22.1 years, with thoracolumbar, lumbar, or rigid paralytic C-curves or scoliosis measuring greater than 70 degrees, underwent initial anterior release, bone grafting, and Zielke instrumentation followed by second-stage L-rod instrumentation. In Group I, scoliosis averaged 57 degrees and postoperatively 27 degrees (53% correction). In Group II, scoliosis averaged 88 degrees and postoperatively 36 degrees (63% correction). Fifteen Group II patients had posterior fusion extend into the sacrum using the Galveston technique. Six Group II patients were not fused into the sacrum. Scoliosis and pelvic obliquity were corrected in both groups. Torso decompensation improved to 2.7 cm in the Galveston group, but increased to 5.6 cm at follow-up in the patients not fused into the sacrum.(ABSTRACT TRUNCATED AT 250 WORDS)
Adolescent↗
Surgical and functional results of spine fusion in spinal muscular atrophy.
From 1965 to 1987, 84 spinal muscular atrophy patients were followed at Rancho Los Amigos Medical Center (RLAMC). Twenty-seven patients were excluded from this study due to insufficient medical documentation (16), lack of follow-up (5), and death (6); leaving 57 patients in the general study group. Group I (34 patients) had posterior spinal fusion (PSF) with Harrington rod instrumentation (HRI); mean age at surgery was 12 years, average preoperative curve was 57 degrees, average postoperative correction was 42%, with a loss of correction of 9 degrees. The complication rate in this group was 35%. The average follow-up interval was 9 years (range, 4-19 years). Group II (six patients) underwent PSF with Luque segmental spinal instrumentation (SSI); mean age at surgery was 11 years, preoperative curves averaged 37 degrees, average postoperative correction was 42% with a loss of correction of 3 degrees. The complication rate in this group was 16%. Follow-up was 3.5 years. Physical therapy and occupational therapy evaluations were done preoperatively and postoperatively at 2- and 5-year intervals. Information was gathered in three categories: 1) ambulation, 2) equipment use, and 3) functional activities. After fusion, sitting tolerance was maintained but additional use of mobile arm supports, lapboards, and reaching aides was necessary for all patients. The ability to perform activities such as drinking, self-feeding, and self-hygiene declined during the 2 years immediately following surgery but improved by 5 years. Surgical patients never approached their preoperative skill levels. Therapy evaluations further demonstrated that there were no difference in function between either operative group.
Adolescent↗
Functional activities in spinal muscular atrophy patients after spinal fusion.
Spinal muscular atrophy patients present with weakness, greater in the proximal muscles, leading to scoliosis and limited upper extremity function. The purpose of this study is to identify unique aspects of these patients and to understand how spinal fusion affects their function. Forty patients underwent Harrington or Luque rod instrumentation with functional evaluations preoperatively and 2 and 5 years postoperatively. Biomechanical assessment of function is important. Flexibility of the spine is functionally advantageous because distal strength is used to align weaker proximal segments. Postoperatively, lack of spinal flexibility resulted in a decline in gross motor function and increased use of UE aids due to a change in the trunk position in the weaker patients. The stronger patients' activities were maintained. Earlier mobilization in patients with Luque procedures did not improve postoperative function.
Activities of Daily Living↗
Lateral electrical surface stimulation in idiopathic scoliosis. Experience in two private practices.
One hundred twenty-six patients with idiopathic scoliosis were treated by lateral electrical surface stimulation. Of these, 39 patients satisfied a strict set of protocols and were evaluated as a group. In this subgroup, curves averaged 28 degrees (range, 20-38 degrees). Thirty-eight percent exhibited initial curves greater than 30 degrees. Thirty percent of patients had a Risser sign of 0. Follow-up was from 6 months to 6 years. Progression was greater than 5 degrees in 48% and greater than 10 degrees in 35%. The final curve was greater than 40 degrees in 30%. Twenty-eight required fusion. Compared with natural history studies, these results are acceptable, and the authors continue to offer lateral electrical surface stimulation as a method of nonoperative care for progressive idiopathic scoliosis.
Bone Development↗