Spectrum of bacterial pathogens transmitted by Pharaoh's ants.
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Biomedical subjects
Publications and source records attributed to J Gregory.
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Primary ciliary dyskinesia is thought to be caused by a primary defect of ciliary ultrastructure and function. However, atypical cilia have also been described in humans with and without acquired respiratory tract disease. With few exceptions, these abnormalities have not been quantified. Ciliary ultrastructure was therefore studied in 21 specimens of bronchial mucosa from patients with a variety of respiratory problems and in five specimens of nasal mucosa from asymptomatic nonsmokers. The incidence of microtubular abnormalities and compound cilia was generally less than 10 per cent, and there was no correlation between the incidence of these abnormalities and the presence of lung carcinoma or smoking habits. Transposition of ciliary microtubules and radial spoke defects, specific microtubular abnormalities thought to be pathognomonic for primary ciliary dyskinesia, were observed in a number of specimens, and visualization of dynein arms, particularly inner dynein arms, was extremely difficult. It is concluded that ultrastructural abnormalities of cilia should be carefully quantified in patients with primary ciliary dyskinesia and control subjects before it can be assumed they have pathologic significance.
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The case of a 7-year-old boy born with exstrophy of the bladder is presented. Biofeedback and behavioral therapy were employed in the treatment of anal incontinence, which occurred following ureterosigmoidostomy diversion. After 19 treatment and follow-up sessions over a period of 12 months, there was significant decrease in fecal/urinary incontinence. The patient was soiled 29% of waking hours over the first 4 weeks of treatment. This figure dropped to 9.7% over the last three sessions. Subjective satisfaction of parent, child, and teachers was high. These gains were maintained over a 12-month follow-up period. Given the design of the present study, it is not possible to determine whether the biofeedback per se had a specific treatment effect. The case demonstrates the usefulness of a broad-based behavior therapy in the management of fecal/urine soiling, which is a frequent, refractory complication of ureterosigmoidostomy.
Tissues from five cases of angiofollicular lymph node hyperplasia have been studied. All had the histological structure of the hyaline-vascular type of lesion; large numbers of very compact lymphoid follicles were distributed evenly throughout a highly vascular tissue. The follicles were characterized by their small size, a vascular poorly cellular and frequently hyalinized centre, and a 'tight' concentric mantle of small lymphocytes arranged in layers producing an 'onion-skin' appearance. The interfollicular tissue was characterized by the large numbers of small vessels mainly hyalinized capillaries and a few high endothelial venules and the presence of variable numbers of lymphocytes, plasma cells, immunocytes and immunoblasts. The immunoperoxidase method demonstrated polytypic cytoplasmic immunoglobulin in the small numbers of centroblasts and plasma cells within the follicle centres and in the plasma cells and immunocytes in the interfollicular tissue. Large numbers of suppressor T cells were present in the interfollicular areas and only scattered helper T cells were seen within the lymphocyte mantles. A strong reaction for factor VIII-related antigen was seen in the endothelium of the interfollicular high endothelial venules but only a weak reaction in the vessels in the follicle centres. A concentric distribution pattern of the dendritic reticulum cells was seen with the metalophil impregnation method of Marshall and with the enzyme histochemical methods for acid alpha-naphthyl acetate esterase and 5'-nucleotidase. This pattern differs from the zonal distribution of these cells seen in reactive lymphoid follicles. The nature and possible pathogenesis of AFLNH are discussed and contrasted with reactive hyperplasia.
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Of 67 patients with penetrating neck wounds admitted to the hospital between 1969 and 1979, 22 (32.8%) were taken to the operating room and 14 (63.6%) were found to have major structural damage. Three patients died (4.4%), all as a direct result of their associated head injuries and none as a result of their neck wounds, regardless of management. Five patients (7.4%) had complications. The average hospital stay for patients undergoing surgery was 4.9 days; for those observed with multiple injuries, 4.6 days; and for those observed with isolated neck wounds, 2.4 days. Indications for selective exploration are presented.
Real-time sonography of the scrotal veins was performed in 13 subjects with clinically obvious or small varicocele and in 10 normal controls. In normals, the vessels were 0.5-1.5 mm in caliber and a main draining vein up to 2 mm often was seen. In all varicoceles, numerous dilated, tortuous, branching vessels of uniform size were observed. Vessels of different lesions varied in caliber from 2 to 5 mm. Blood flow was seen in some normal vessels, and sluggish flow was observed in all varicoceles. The direction of visualized flow and the influence on flow of the upright position and Valsalva maneuver were shown with confidence only in large and medium-sized lesions. In these the findings were consistent with incompetence of the internal spermatic venous system. The cystic spaces in multiloculated spermatoceles or epididymal cysts varied more in size, were not tubular or branching, and no flow phenomenon was seen at high gain settings. Sonography provides an alternative to other noninvasive tests for detection of a small varicocele, especially in the infertile patient.
To assess how well results by different methods for urinary oxalate determinations agree with each other in a clinical setting, we compared six different assays: Hodgkinson and Williams (Clin Chim Acta 36:127-132, 1972), enzymatic, modified Hodgkinson and Williams, gas chromatography, ion chromatography, and "high-pressure" liquid chromatography. For the entire group of samples, the mean value by each method agreed relatively closely, although the enzymatic procedure produced a somewhat higher value. All six methods had large coefficients of variation within (8-58%) and between (15-88%) assays. In addition, analytical recovery by most assays was more than 100% of the added oxalate. Analytical recovery of 10 micrograms of oxalate added per milliliter of urine specimen ranged from 86 to 237%; for 20 micrograms/mL it was 83 to 320%. Thus for the six methods evaluated, no single method appeared to be superior to the others.
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The ability of 7 "oxalate-rich" foods to enhance urinary oxalate excretion was measured in 8 normal volunteers. The analyzed value for oxalate was high for spinach (1,236 mg.), moderate for chocolate (126 mg.) and tea (66 mg.), and for low vegetable juice, cranberry juice, pecans, and orange juice (2 to 26 mg.). The urinary oxalate increased by 29.3 mg. during eight hours after ingestion of spinach. However, it rose by less than 4.2 mg. from consumption of other food items. The bioavailable oxalate (per cent of total appearing in urine) was much less from food items of high or moderate oxalate content (spinach and chocolate) than from standard solutions of sodium oxalate (2.4 to 2.6 versus 6.5 to 7.3 per cent). Thus, only spinach among food items tested was capable of causing hyperoxaluria in normal subjects.
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A number of fixatives were tested to determine their suitability for use with the unlabelled antibody peroxidase-antiperoxidase (PAP) method for demonstrating immunoglobulin in paraffin sections of tonsil and trephine samples of bone marrow. It was found that tonsil fixed in 'isotonic' solutions of formaldehyde reacted with the PAP method only after the sections had been trypsinised. Several other fixatives, including Bouin's fluid, Carnoy's fluid, and solutions containing mercuric chloride, gave tissues which reacted without trypsinisation of sections, and particularly good results were obtained with formol saline to which acetic acid (2-10%) had been added. A combination of acetic acid (10%)-formol saline and formol sublimate also gave excellent results with bone marrow. The influence on the PAP method of a number of steps in the processing of tissues and sections was also examined.
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We describe a simple, rapid method for determining urinary oxalate: isolation by precipitation with calcium chloride and conversion to dimethyl oxalate, which then is measured by gas chromatography. To each sample, tracer amounts of 14C-labeled oxalic acid are added, to determine the analytical recovery of urinary oxalate. Analytical recovery of [14C]oxalic acid added to urine specimens ranged from 15 to 95% (mean, 80%), and corrected recovery, based on calculation isotope-dilution techniques, ranged from 98 to 100%. The urinary excretion of oxalic acid by 18 normal men, ages 23 to 43 years, ranged between 9 and 23 mg/24h, with a mean value of 16 mg; that by 68 patients with small-bowel bypass ranged from 60 to 210 mg/24 h, with a mean of 127 mg.