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Biomedical subjects

J Corbett

Publications and source records attributed to J Corbett.

At least 55 records · Page 3Linked to original sources

Development, disintegration and dementia.

It has been argued that there is an important group of conditions, seen for the first time in late infancy and early childhood, which are both remarkably persistent and pervasive in their influence on cognitive and social development. They combine features of childhood autism, mental retardation and cognitive deterioration and the term 'disintegrative' most precisely characterizes their impact on development. The term 'psychosis' is only usually appropriate in describing the severity of the psychiatric symptoms. In order to avoid confusion with the psychoses or dementia of adult life, the term 'disintegrative disorder of development' may be preferred. While specific pathology is being identified in an increasing number of cases, the combined use of psychiatric and physical diagnostic categories perhaps best serves to draw attention to this important group of disorders. It is likely that, with increasing knowledge, the need for such an interim diagnostic category may become unnecessary.

Autistic Disorder↗

Basilar migraine: polarity-dependent alteration of brainstem auditory evoked potential.

We studied serial brainstem auditory evoked potentials (BAEPs) in a patient who had episodic basilar migraine. During migraine attack, significant alteration of wave IV-V was revealed only by rarefaction clicks. The alteration remained unchanged throughout the headache and reverted to normal when the headache subsided. In contrast, BAEPs with condensation clicks were normal during and after the headache.

Adult↗

Early positive technetium-99m stannous pyrophosphate images as a marker of reperfusion after thrombolytic therapy for acute myocardial infarction.

Fourteen patients with transmural acute myocardial infarction (AMI) were treated with intravenous streptokinase a mean of 4 +/- 1 hours after chest pain and underwent technetium-99m stannous pyrophosphate (Tc-99m-PPi) imaging 7 +/- 2 hours after the onset of chest pain. The early Tc-99m-PPi images were obtained to test the hypothesis that an early, strongly abnormal Tc-99m-PPi image suggests reperfusion. Eleven of 14 patients had early peaking (within 16 hours) serum creatine kinase isoenzyme levels (CK-B) at a mean of 11 +/- 3 hours. Ten of 14 patients had 3+ or 4+ acute Tc-99m-PPi images. Eight of 11 patients had patent infarct-related vessels at cardiac catheterization 15 days after AMI. One patient who had both an early positive Tc-99m-PPi image and CK-B peak level had an occluded infarct-related artery at catheterization. Acute left ventricular (LV) ejection fraction (EF) by radionuclide ventriculography was compared with LVEF on day 15, and improved from 0.37 +/- 0.13 to 0.50 +/- 0.16 (p = 0.004) in the 10 patients with strongly positive acute Tc-99m-PPi images. LVEF also improved from 0.37 +/- 0.12 to 0.49 +/- 0.15 (p = 0.003) in the 11 patients with early peaking serum CK-B values. Three patients without evidence of reperfusion failed to improve the LVEF from the initial value to the one obtained at hospital discharge. Six control patients had acute Tc-99m-PPi images 10 +/- 2 hours after chest pain; none had strongly positive acute Tc-99m-PPi images, and the mean time to peak CK-B was 19 +/- 5 hours.(ABSTRACT TRUNCATED AT 250 WORDS)

Cardiac Catheterization↗

Prescriptive authority for nurse practitioners: a comparative study of professional attitudes.

We assessed the attitudes of Wyoming physicians, pharmacists, nurses, and nurse practitioners about granting prescriptive authority to nurse practitioners. Support for the issue was mixed, with physicians expressing the strongest disagreement. All groups supported limitation of authority to a specific drug formulary, collaborative regulation, and mandatory certification and continuing education if prescriptive authority is granted to nurse practitioners.

Attitude of Health Personnel↗

Bilateral internuclear ophthalmoplegia reversed by naloxone.

We encountered an apparent bilateral internuclear ophthalmoplegia (INO) in a stuporous patient who used narcotics and benzodiazepines and had taken phenytoin sodium for drug-withdrawal seizures. The INO was promptly reversed by administration of the narcotic antagonist naloxone, which binds opiate receptors. This suggests the INO resulted from a specific toxic effect of narcotics, but opiate receptors have not been anatomically demonstrated within the medial longitudinal fasciculus or associated structures. Stimulation of inhibitory GABA-ergic (alpha-aminobutyric acid) vestibulo-ocular fibers may have been related to INO in this case.

Adult↗

Churg-Strauss syndrome (allergic granulomatous angiitis). Neuro-ophthalmologic manifestations.

Two patients with severe bronchial asthma, hypereosinophilia, and peripheral neuropathy were initially observed with neuro-ophthalmologic signs and symptoms that included amaurosis fugax, superior oblique palsy, ischemic optic neuropathy, and scattered areas of retinal infarction. Clinical investigation led to the diagnosis of Churg-Strauss syndrome (allergic granulomatous angiitis). As in other collagen vascular diseases, ocular signs or symptoms may occasionally be the most prominent manifestation of the disease. Recognition of this systemic disorder by the ophthalmologist may minimize systemic and ocular complications.

Asthma↗

Childhood nocturnal enuresis: factors associated with outcome of treatment with an enuresis alarm.

A study was carried out to assess the factors that may affect the outcome of a single course of treatment for childhood nocturnal enuresis by use of an enuresis alarm. 113 children were treated and followed up; those showing failure of initial arrest of wetting, relapse and longterm successful outcome were analysed separately. Emphasis is placed on the need for the adoption of clear criteria regarding the definition of these three groups, and for an adequate follow-up of treated cases. Unsatisfactory housing conditions and circumstances giving rise to family difficulties were significantly associated with a less favourable rate of initial arrest. In the long term, family difficulties again were found to be significantly related to poor outcome. Behavioural deviance, as revealed by a teacher's behavioural questionnaire also adversely affected long-term success, although less significantly so. Family difficulties emerged as the most important predictor for outcome of treatment and adversely influenced the rate of initial arrest of wetting, the relapse rate and the long-term success rate.

Adolescent↗

Neuro-ophthalmologic signs in the angiitic form of neurosarcoidosis.

We studied eight patients with CNS sarcoidosis, including two patients with postmortem evidence of sarcoid granulomatous angiitis. Neuro-ophthalmologic findings included perivenular sheathing of retinal veins resembling the dripping of candle wax, vitreous cells, anterior uveitis, optic disk edema or granulomas, and conjunctival granulomas. Perivenous sheathing in the retina and the perivascular meningeal lesions in sarcoid angiitis were identical.

Adult↗

Myocardial rupture after myocardial infarction. Detection by multi-gated image-acquisition scintigraphy.

Myocardial rupture following infarction usually is an acute and dramatic event. Rarely, it may take a subacute course, allowing surgical treatment. We report herein a case of subacute rupture of the heart in a 54 year old patient with acute myocardial infarction. The rupture was diagnosed by the appearance of a radiopaque halo around the heart during radionuclide ventriculography. The patient subsequently underwent surgical resection of a large anterolateral aneurysm and a 2 inch long rupture of the myocardium and survived. Clinical suspicion, prompt diagnosis, and surgical intervention are important in the management of this relatively unusual complication of infarction.

Heart Aneurysm↗

The relationship between metabolism of 2,3,4,5,3',4',5'-heptachlorobiphenyl and its ability to induce both cytochromes P-448 and P-450.

Male CD rats received i.p. injections of 2,3,4,5,3',4',5'-heptachlorobiphenyl (7CB) under conditions resulting in induction of both benzphetamine demethylase (cytochrome P-450-dependent) and ethoxyresorufin deethylase (cytochrome P-448-dependent) activities. To test the possibility that one class of induction (P-450) was due to the parent compound and the other (P-448) to a metabolite, liver, adipose, bile, urine and feces were analyzed for the presence of 3,4,5,3',4',5'-hexachlorobiphenyl (6CB) (the major photolysis product of 7CB) and/or 3-hydroxy-3,4,5,3',4',5'-hexachlorobiphenyl (OH-6CB), another known P-448 inducer. To allow for the possibility that 6CB might be a transient intermediate. The results supported the hypothesis that 7CB is a true 'mixed inducer', nor requiring metabolic alteration for its dual activity.

Adipose Tissue↗

The effect of dimethylsulfoxide on the mutagenicity of the hair dye p-phenylenediamine.

Published data on the mutagenicity of the oxidative hair dye intermediate p-phenylenediamine in the Ames test are conflicting. The work reported here resolves the discrepancies, showing that the activity of p-phenylenediamine in the Ames Salmonella/microsome test is markedly influenced by the use of dimethylsulfoxide as solvent, and by the age of the solution prior to plating. Thus, aqueous solutions of p-phenylenediamine are non-mutagenic; fresh solutions in DMSO are equally non-mutagenic, but become highly active on standing at room temperature for 4 hr. These results suggest the need for caution in the choice of solvents and tight controls in the execution of the test.

Dimethyl Sulfoxide↗

Relationships between sensory stimulation and stereotyped behaviour in severely mentally retarded and autistic children.

The reinforcing properties of four sensory stimuli (continuous and flashing light, vibration and sound) which were under the subject's control, were examined and the effect on stereotyped behaviour observed. The subjects were 24 severely retarded children in three diagnostic groups; Down's, Rubella and a group which included neither of these diagnoses. Duration of stimulation with continuous light was significantly lower than the other three stimuli, but there were no differential effects on stereotypy, nor diagnostic group differences.

Adolescent↗

Effect of verapamil and nifedipine on left ventricular function at rest and during exercise in patients with Prinzmetal's variant angina pectoris.

To assess the effects of verapamil and nifedipine on left ventricular function at rest and during exercise in patients with Prinzmetal's variant angina pectoris, 10 patients (6 men and 4 women with a mean age of 52 years) with variant angina were each treated for 2 months periods with placebo, verapamil (400 +/- 80 mg/day, mean +/- standard deviation [SD]) and nifedipine (82 +/- 31 mg/day). During the final week of each 2 month treatment period equilibrium gated blood pool scintigraphy was performed at rest and during exercise. At rest, heart rate during verapamil therapy was lower than during treatment with nifedipine; systolic blood pressure and left ventricular volumes and ejection fraction were similar for the three interventions. The maximal work load achieved was similar during placebo, verapamil and nifedipine therapy. At the maximal work load common to all three exercise studies, heart rate and systolic blood pressure were lower with verapamil than with placebo and nifedipine; ventricular volumes and ejection fraction were similar with the three agents. Thus, in patients with variant angina and a wide range of left ventricular function at rest, neither verapamil nor nifedipine significantly alters left ventricular volumes or ejection fraction at rest or during exercise.

Angina Pectoris↗

Pathophysiologic considerations and clinicopathological correlates of technetium-99m stannous pyrophosphate myocardial scintigraphy.

99mTc-PYP myocardial scintigrams represent a means to detect and localize acute myocardial necrosis. These scintigrams are expected to be abnormal with acute myocardial infarcts of at least 3 grams in weight if serial imaging is utilized and proper attention to technique is provided. Any etiology of myocardial necrosis may produce abnormal 99mTc-PYP scintigrams if the damage is relatively localized and includes at least 3 grams of tissue. It is possible to accurately size acute anterior and anterolateral transmural myocardial infarcts using area or 2 dimensional measurements. Further development in imaging cameras and computer techniques allowing three dimensional reconstruction of myocardial infarcts with this and similar imaging techniques may allow relatively precise quantitation of other types of myocardial infarcts. The "doughnut" and "persistently abnormal" 99mTc-PYP scintigrams appear to have anatomic and prognostic significance at least in subsets of patients studied, but larger numbers of individuals need to be evaluated before final conclusions regarding their ultimate prognostic significance can be reached.

Animals↗