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Biomedical subjects

J E Carter

Publications and source records attributed to J E Carter.

At least 73 records · Page 4Linked to original sources
PubMed1990

Hyperacute T-wave criteria using computer ECG analysis.

Hyperacute T waves (HATWs) have been described as tall-amplitude, primary T-wave abnormalities sometimes seen in the early phases of transmural myocardial infarction. Despite numerous human and animal studies addressing the presence and significance of HATWs, there are no widely held, reliable ECG criteria for their accurate identification. Using a specially designed computer program on a Hewlett-Packard Realm ECG analysis system, we screened 13,393 adult ECGs to identify those having T-wave amplitudes greater than accepted standards (limb leads, greater than 0.5 mV; precordial leads, greater than 1.0 mV). Patients with other known causes of primary and secondary tall T waves were excluded from the study sample. Patients with tall-amplitude T-waves who then developed clinically verifiable myocardial infarction were labeled the HATW group. The HATW group (21) represented 4.1% of the tall T wave group (513) and 0.16% of the entire sample. The remaining patients, who did not meet HATW criteria, were called the early repolarization variant (ERV) group (51). Both groups underwent comparative computer morphology analysis. Nine parameters were statistically significant in discriminating HATWs from early repolarization variants. A combination of J-point position/T-wave amplitude of more than 25%, T-wave amplitude/QRS amplitude of more than 75%, J-point position of more than 0.30 mV, and age of more than 45 years predicted HATWs from a control group with a specificity of 98.0% and a sensitivity of 61.9% and with positive and negative predictive values of 92.9% and 86.2%, respectively. We conclude that HATWs have characterizable discriminating ECG morphology as determined by computer ECG analysis compared with a control group.

Electrocardiography↗
PubMed1990

Dental maturity in children with chronic renal failure assessed from dental panoramic tomographs.

Children with chronic renal failure are known to lag behind normal children for both height achievement and bone age. In the present study, dental maturity was assessed by scoring dental panoramic tomographs using two methods. The method of Dermirjian gave closer estimates of the chronological age than that of Leinonen. With the former method, dental maturity was found to be slightly delayed in children with chronic renal failure, although this was not statistically significant.

Adolescent↗
PubMed1990

Static and dynamic differences among five types of skinfold calipers.

Thirty-eight skinfold calipers were compared in terms of dial accuracy, downscale force, and pressure at jaw openings of 10, 20, 30, 40, and 50 mm. Dynamic measures were made on four thicknesses of foam rubber. Foam rubber was used to simulate the compressibility of skinfolds and to eliminate subject and tester variability. Five caliper types were tested: 10 Harpenden (HRP), 9 Lange (LNG), 12 Slim Guide (85SG), 4 Skyndex (SKN), and 3 Lafayette (LF). Within-type variation was small and consistent across openings for dial accuracy, force, pressure, and foam rubber compressed thickness. Between-type pressures differed (p less than 0.01), with the HRP and LNG calipers having the highest but similar pressures and the SKN, LF, and 85SG calipers having the lowest but similar pressures. LF and LNG calipers (which differed from each other) had higher compressed foam rubber means than HRP, SKN, and 85SG calipers (p less than 0.01), which were similar to each other at three of four thicknesses. When average pressure was used as the covariate, differences between types were still large, with 97.5-99.3% of the variation explained by type. Compressibility of foam rubber was shown to be caliper specific. It is concluded that there are static and dynamic differences between the five major types of skinfold calipers. When measurer error is eliminated, the HRP, 85SG, and SKN calipers are similar to each other, but they give lower values than the LNG or LF calipers by approximately 50-100%, depending on compressed thickness. These differences should be noted when comparing skinfolds measured with dissimilar calipers.

Anthropometry↗
PubMed1989

Renal vein thrombosis and response to therapy in a newborn due to protein C deficiency.

A newborn infant was diagnosed as having renal vein thrombosis due to heterozygous protein C deficiency and no other predisposing factor for thrombosis. He responded adequately to treatment with streptokinase, fresh frozen plasma and subsequent anticoagulation with heparin and warfarin (Coumadin). Four years from diagnosis he remains well with no recurrence of thrombosis and with normal renal function.

Drug Therapy, Combination↗
PubMed1989

DNA determinants of structural and regulatory variation within the murine beta-glucuronidase gene complex.

The murine beta-glucuronidase (GUS) gene complex, [Gus], encompasses the GUS structural element, Gus-s, and a set of regulatory elements which serve to modulate Gus-s expression. Three common GUS haplotypes representing virtually all inbred strains of laboratory mice have been compared with respect to GUS mRNA sequence. Results of such comparisons revealed sequence variations which target the location of one of the GUS regulatory elements to sequences within Gus-s and which account for known electrophoretic and heat stability differences among GUS allozymes of the three common GUS haplotypes.

Alleles↗
PubMed1989

Gastric emptying during prolonged cycling exercise in the heat.

Eight trained male cyclists (age 20-33 yr) completed four 3-h bouts of cycling at 60% peak VO2 in the heat (33 degrees C) drinking either water (W), 5% glucose (G), 5% glucose polymer (GP), or 3.2% glucose polymer + 1.8% fructose (GP/F) at a rate of 350 ml every 20 min (3.15 l total volume). Similar changes in heart rate, sweat rate, rectal and mean skin temperatures, and plasma [Na+], [K+], and osmolality were observed during all trials. Mean changes in plasma volume, although not significantly different between trials, were lowest for the GP/F drink (-2.6%) and greatest for the G (-8.1%) drink. Plasma volume decreased (P less than 0.05) below pre-exercise control values during the W, G, and GP trails but was maintained at control values during the GP/F trials. In contrast to water ingestion, G, GP, and GP/F ingestion maintained plasma glucose and respiratory exchange ratios throughout the 3-h exercise bouts. Gastric residual volume (GRV) obtained at the end of exercise was similar for the W, GP, and GP/F trials. The G trials yielded greater (P less than 0.05) GRV than W trials. For all drinks ingested, over 90% of the 3.15 l consumed was emptied from the stomach during the 3-h exercise bouts. At a mean sweat rate of 1.2 l.h-1, cyclists replaced 73% of fluid lost and experienced only a 1.6% loss in body weight. This study demonstrates that, during prolonged (3-h) cycling exercise in the heat, large volumes of W and 5% carbohydrate can be emptied from the stomach to help minimize the effects of dehydration.

Adult↗
PubMed1989

Preoperative diagnosis of Lhermitte-Duclos disease by magnetic resonance imaging. Case report.

Lhermitte-Duclos disease is a benign, presumably hamartomatous lesion of the cerebellum which presents clinically as a mass lesion. Pathologically, it consists of thickening of both the molecular and granular cell layers of the cerebral cortex which enlarges the folia but allows for preservation of the gyral pattern of the cerebellar cortex. Preoperative diagnosis with computerized tomography and other studies has not been possible, and even at surgery the diagnosis may be missed because of the preservation of the gyral pattern. The sensitivity of magnetic resonance imaging allows recognition of the cortical nature of the mass lesion, and especially the gyral pattern within the mass lesion, providing a diagnostic image which is unlikely to be confused with any other pathological process in the cerebellum. Preoperative diagnosis of Lhermitte-Duclos disease allows surgeons to plan an appropriate decompressive procedure.

Adult↗
PubMed1989

Pseudodrusen of the optic disc. Papilledema simulating buried drusen of the optic nerve head.

The distinction between true papilledema and pseudopapilledema rests on characteristics of the optic disc when examined ophthalmoscopically. Buried disc drusen frequently simulate papilledema and often result in misdirected diagnostic maneuvers in search of a cause for presumed intracranial hypertension. When an elevated optic disc exhibits an irregular, "lumpy, bumpy" border, a diagnosis of buried drusen of the optic nerve is usually made. We report a case with papilledema secondary to increased intracranial pressure in which the margins of the swollen optic disc presented this lumpy, bumpy border characteristic of buried drusen. The lumpy character of the disc border disappeared with resolution of the papilledema, and ultrasonography demonstrated the absence of any buried drusen. Other characteristics of papilledema, including extension of the disc swelling into the peripapillary nerve fiber layer, telangiectasia of the superficial vessels of the optic disc, and obscuration of the retinal vessels as they crossed the margins of the optic disc, provided strong evidence of true papilledema and remain the most reliable findings allowing a distinction between true papilledema and pseudopapilledema.

Adult↗
PubMed1989

Fluid replacement during and after exercise in the heat.

This study sought to determine whether ad libitum drinking of a carbohydrate-electrolyte (CE) beverage would minimize the physiological disturbances associated with prolonged (3 h) continuous exercise in the heat (Tdb = 31.5 degrees C, percent RH = 22.3). Seven male subjects performed two bouts of cycle exercise (60% VO2max) drinking either a CE beverage (4.85% polycose, 2.65% fructose) or distilled water. Subjects continued to drink ad libitum for 3 h during recovery in the heat. No significant differences were observed between drinks for rectal temperature, heart rate, or sweat rate during exercise. Subjects tended to drink more (P less than 0.0565) water than the CE beverage during exercise, but plasma volume (percent PV) decreased less (P less than 0.0253) and plasma [( glucose], P less than 0.0001 and [K+], P less than 0.0047) were higher when subjects drank the CE solution. At the end of exercise, plasma osmolality and [Na+] were also higher (P less than 0.05) when subjects drank the CE beverage rather than water. Rating of perceived exertion was higher (P less than 0.0001) when drinking water. In recovery, ingesting the CE beverage, 1) subjects drank more (P less than 0.0012); 2) plasma volume increased to a higher level (P less than 0.0017); 3) plasma osmolality (P less than 0.0001), [Na+] (P less than 0.0001), glucose (P less than 0.0001), and [K+] (P less than 0.0015) were greater; and 4) body weight increased more (P less than 0.0422) than when water was ingested. Thus, in terms of minimizing physiological disturbances, ad libitum drinking of the CE beverage was as effective as drinking water during exercise but was more effective in recovery.

Adult↗
PubMed1988

Ollier's disease and Maffucci's syndrome: distinct entities or a continuum. Case report: enchondromatosis complicated by an intracranial glioma.

A patient with the diagnosis of enchondromatosis (Ollier's disease) presented with seizures. CT examination showed an avascular right frontal lobe lesion. Surgery revealed a histologically verified grade II astrocytoma. This case is consistent with recent evidence that questions the distinction between the two forms of enchondromatosis (Ollier's disease and Maffucci's syndrome). Maffucci's syndrome is associated with a high rate of malignancy, including intracranial gliomas. Ollier's disease has not been associated with malignant change, other than sarcomatous transformation of the enchondromas. However, Ollier's disease and Maffucci's syndrome may be a spectrum of the same disease process, and therefore patients with diagnosed Ollier's disease are at a higher risk for malignancy than has been previously recognized.

Adult↗
PubMed1988

Faculty and house staff members as role models.

In the fall of 1986 approximately 100 faculty members, community physicians, house staff members, and students associated with Indiana University School of Medicine participated in a conference on "Teachers as Role Models: The Impact on the Learning Process." Small-group discussions allowed the participants to define and discuss the impact of role-modeling in medical education. It was anticipated by the organizers that after the conference the participants would be more cognizant of their influence as role models and would be motivated to become better role models and support good role-modeling. A synopsis of the conference indicates that the participants identified both the positive and negative impact of role-modeling and concluded that medical educational programs should use positive role-modeling as a teaching tool to instill within students the desire to gain new knowledge and to apply that knowledge as medical professionals.

Education, Medical, Undergraduate↗
PubMed1988

Role modeling.

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Education, Medical↗