Biomedical subjects
Publications and source records attributed to J Carlson.
We evaluated the potential of obtaining ECG signals from electrodes attached to an endotracheal tube. Tests during surgery using a 2-electrode system with 3 pediatric patients produced recordings suitable for rate monitoring and arrhythmia detection.
The lentiviruses, caprine arthritis-encephalitis virus (CAEV) and progressive pneumonia virus (PPV) of sheep, cause major diseases in their respective hosts; however, the infectivity of these viruses for closely related species has not been determined. Experiments were conducted to determine whether CAEV would infect sheep and whether PPV would infect goats. Upon inoculation with CAEV, lambs developed a nonsuppurative arthritis and antibody to CAEV, and the virus was isolated up to 4 months later. Exposure of 3 lambs to CAEV-infected adult goats did not lead to demonstrable infection after 18 months. Young goats inoculated with PPV replicated the virus and developed arthritis and antiviral antibody. These results demonstrate that these distinctly different lentiviruses may infect and cause diseases in species other than their accustomed host. Presently used techniques may not be effective in differentiating which lentivirus is responsible for infection of sheep and goats. Our results also indicate that mixing sheep and goats may adversely influence attempts to eradicate lentiviruses from these species.
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Mouse neuroblastoma cells (Clone NIR-115) were grown in serum-free (defined) medium, defined medium supplemented with serum, and control medium to determine whether serum-free medium could substitute for serum-containing medium in our studies of the histamine H1 and muscarinic acetylcholine receptors of these cells. The function of these receptors as determined by measurement of receptor-mediated cyclic [3H]GMP formation was absent in cells grown in serum-free medium and increased as the percentage of serum was increased in the defined medium, but never attained the levels found with control cells. Muscarinic receptor number for cells grown in defined medium was 60% above that found for control cells with no change in the affinity of the receptor for the radioligand (--)[3H]quinuclidinyl benzilate. Guanylate cyclase and acetylcholinesterase activities for cells grown in defined medium were 23 and 66% of those found in control cells, respectively. This marked reduction of guanylate cyclase activity in large part explains the lack of function of these receptors.
The rates of admissions in 1976-78 to all hospitals in Western Australia, both psychiatric and non-psychiatric, of patients with a primary psychiatric diagnosis were analysed specifically for country of birth and whether they lived in Perth or in country areas. Eastern European migrants had the highest hospitalization rates, and Southern European migrants the lowest. Rates for schizophrenia were high in the Eastern Europeans, and for alcoholism low in Southern European and Asian females and high in Northern European males. The United Kingdom migrants were most like the Australian born in regards to admission rates, diagnostic composition, and in the distribution of hospitalization patterns between psychiatrists and non-psychiatrists. Women, especially Southern European, in the country areas are at special risk to be admitted for neurosis/personality disorder.
Data are presented of all patients with a primary psychiatric diagnosis who were admitted to all psychiatric and non-psychiatric hospitals, in Western Australia during 1976-78. Patients resident in the country were compared with those resident in Perth, the capital city of Western Australia. A high proportion of both Perth and country residents were admitted under non-psychiatrists. Age standardised admission rates were highest for female country residents, the excess rate being mainly due to their very high rates of neurosis/personality disorder. The higher male admission rates for Perth compared with country residents were mainly due to higher Perth rates for alcoholism. The implications of these findings are discussed.
In a prospective series of 205 patients undergoing liver biopsy, fasting plasma total bile acid (TBA) levels were compared with 11 different histological features. The TBA level was found to correlate positively (P less than 0.001) with the extent of total hepatic damage. In both alcoholic (no. = 93) and non-alcoholic disease (no. = 112) TBA levels correlated better with characteristics consistent with inflammation and Kupffer cell activity than with connective tissue changes. The degree of steatosis had no effect on TBA levels. Of 117 patients with greater than or equal to 5 of 33 possible biopsy score points, 44, or 38%, had normal TBA levels. All patients with biopsy scores greater than or equal to 12 had abnormally high TBA. Although an elevated fasting TBA level is specific for hepatobiliary disease, the test is insensitive and is not appropriate for screening purposes. This applies equally to alcoholic and non-alcoholic liver disease.
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The medical justification for many postconcussive hospital admissions (one fourth of all trauma admissions) is unsettled, as are the potential legal consequences of nonadmission. Three hundred thirty-three patients with Class I level of consciousness (9) (alert, responsive to questions and complex commands, may be disoriented and/or confused) were admitted during a 6-month period. Seventy-nine per cent had sustained loss of consciousness. Eighty-one per cent were admitted solely for neurologic observation. Thirteen per cent of the patients had skull fractures. Patients admitted with localized neurologic findings were most likely to have skull fractures (8/16). Thirty per cent of the confirmed skull fractures occurred in patients without 'high yield' criteria for skull roentgenograms. No deaths and no neurologic sequelae occurred among the patients without skull fractures. In contrast, among the 43 patients with skull fractures, one patient died of neurologic injuries, seven patients developed major neurologic sequelae, and eight patients required neurosurgical intervention. In our series, only the presence of a skull fracture was of grave prognostic significance among patients with Class I level of consciousness following closed head injuries. No benefit was derived from the precautionary admission of patients with Class I level of consciousness following closed head injuries who did not sustain skull fractures.
In order to study the relation between intra- and extrahepatocellular alpha 1-antitrypsin (alpha 1-AT) concentrations in patients with various Pi phenotypes, a prospective series of needle liver biopsies was stained with both periodic acid-Schiff (PAS) and a specific immunoperoxidase technique to demonstrate intracellular alpha 1-AT. Concomitant blood samples from all patients were analysed for alpha 1-AT. Pi phenotypes were determined by isoelectric focusing. Non-globular intrahepatocellular alpha 1-AT can be seen in biopsies from Pi M patients with increased plasma alpha 1-AT concentrations and active liver disease. No evidence was found in this study of 250 patients (including 22 controls) for predisposition toward liver disease in any phenotypic group. PAS or immunoperoxidase staining (or both) for alpha 1-AT demonstrated characteristic globular inclusions in 11 of 15 cases having the Z allele, one case being diffusely positive and three negative. Biopsies from 3 of 207 patients with liver disease and lacking the Z allele had globular inclusions seen with both PAS and immunoperoxidase techniques. alpha 1-AT globules in absence of the Z allele are most often found in elderly patients with severe disease and high plasma alpha 1-AT concentrations.
The plasma acute phase reactant pattern was studied in 124 patients with liver disease and 16 healthy individuals undergoing liver biopsy, alpha 1-Antitrypsin levels were found to correlate positively with the extent of hepatocellular damage, inflammatory activity and total biopsy score. Haptoglobin levels correlate negatively with these parameters and particularly with characteristics conducive to portal hypertension. Orosomucoid and fibrinogen were unaffected by extent of disease and activity. These changes result in a typical acute phase reactant pattern, seen most frequently in viral hepatitis and chronic active hepatitis and less frequently in alcoholic liver disease. When present, it has a high specificity and predictive value for detection of liver disease.
The peripheral axons of lower motor and spinal ganglion neurons were permanently transected and not allowed to regrow to target tissue in adult cats by amputation of the hind limb at the hip. The number and sizes of L-7 lower motor neurons at two levels (cell bodies of lateral group motor neurons and myelinated fibers [MFs] of ventral root) and of L-7 spinal ganglion neurons at two levels (cell bodies of L-7 spinal ganglion and MFs of dorsal root) were morphometrically evaluated in groups of cats at 3 months, 9 months, and 18 months after amputation and compared with the number and sizes of neurons in controls or with those on the opposite side. The number of neurons decreased only minimally after amputation. The diameter of neuron cell bodies was only equivocally reduced. By contrast, the median diameter and the peak diameter of both large and small MFs of dorsal and ventral nerve roots were significantly (approximately 30%) less than those of controls. This reduction in diameter of MFs is judged to be related to chronic axonal atrophy rather than to selective loss of large fibers. Permanent transection of distal axons should therefore prove to be a good model of chronic axonal atrophy.
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Seventeen food colours were tested as inhibitors of the simultaneous uptake of labelled o-iodohippurate and iodipamide into slices of rat renal cortex. The results have been interpreted in terms of inhibition of two different aniontransport systems: the hippurate of H-system and the liver-like L-system. No clearcut relation was found between inhibition ability and system specificity on the one hand and moleculr weight or structure on the other. However, most disulphonic azo dyes and quinoline yellow show an L-system affinity while tri-and tetra-sulphonic azo dyes, triarylmethanes and erytrosine show very little predilection for either of the two systems.
The hospital course of 144 consecutive patients with pulmonary embolism (PE) demonstrated by pulmonary angiography was reviewed to determine the mortality of patients with treated PE. Twelve patients (8%) died of PE, and eight died of causes other than PE; 124 (86%) survived. Pulmonary embolism was the primary cause of death in only four of the 12 patients who died of PE. Pulmonary embolism contributed to the death of eight other patients, each of whom had associated potentially lethal disease, particularly heart disease. The most important factor affecting mortality was shock due to acute right ventricular failure secondary to massive PE (mortality, 32%). Mortality was not related to magnitude of PE per se; the mortality of patients with massive PE without shock (6%) was the same as that for patients with submassive PE (5%. Patients with PE who survive long enough to have the diagnosis established and appropriate prophylactic therapy begun have an excellent prognosis, unless they have associated severe medical disease.
The distribution and excretion of different body burdens of methylmercury (MeHg) have been investigated in the squirrel monkey. In monkeys given weekly 0.8 mg/kg doses, orally, of 203-MeHg, a linear correlation was observed between the concentrations of radioactive Hg in the blood and brain to as much as a blood concentration of 1 mug/gm. Above this level, the ratio of concentration in the brain and blood was increased. The total Hg concentration in bile collected from the bile duct was 10% to 30% of that in blood, while the concentration in bile from the gallbladder approached that in the blood. The total Hg concentration in feces was always more than ten times that in urine. Biotransformation of MeHg to inorganic mercury has been demonstrated; in the liver about 20% of the total mercury was inorganic, in the kidney 50%, and in the bile 30% to 85%. In the brain less than 5% of the total mercury was inorganic. After a single 0.8 mg/kg dose, orally, of 203-MeHg, the halftime for total Hg in blood was 49 plus or minus 2.8 days, and in the whole body 134 plus or minus 2.7 days. During the first four days after dosing, the decrease in blood concentration was more rapid than that occurring later, due to a redistribution within tissue compartments. A differential distribution of MeHg within the brain has been demonstrated in animals that showed clinical signs of intoxication.
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