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Biomedical subjects

J H Morris

Publications and source records attributed to J H Morris.

At least 55 records · Page 3Linked to original sources

Septation and focal dilatation of ventricles associated with cryptococcal meningoencephalitis.

A 35-year-old woman developed temporal lobe seizures. Isolated dilatation of the right temporal horn was demonstrated by computed tomography. She was asymptomatic for the next 10 months while on anticonvulsants before severe headaches, vomiting, and mental confusion prompted hospitalization. Both temporal horns were now dilated, there was marked periventricular edema, and cryptococci were cultured from the ventricular fluid. She succumbed after prolonged systemic and intrathecal antifungal therapy, having developed isolation and dilatation of both frontal horns and third and fourth ventricles. Cryptococcal or other fungal meningoencephalitis should be considered in the differential diagnosis of isolated dilatations of the ventricular chambers as noted in the present case.

Adult↗

Effects of acute nerve compression on conduction of impulse trains of increasing frequency.

The acute effect of localized nerve compression has been detected electrophysiologically in isolated rat tail nerve by utilizing a special stimulus pattern, a STIF (Stimulus Train of Increasing Frequency), which shows the highest frequency that the most sensitive axons in a compound potential can transmit through the compressed region. The same method also detected recovery after release of compression. Overlap of waveforms at high frequencies of stimulation required special techniques to permit unequivocal measurements. The best endpoint at which to detect the acute nerve compression in these experiments was found to be that frequency at which only a few fibers were blocked. The method was also effective when part of the nerve was completely blocked by the compression, and was more sensitive than measure of change in latency of a single response.

Acute Disease↗

Effects of storage temperature and pH on the stability of eleven beta-lactam antibiotics in MIC trays.

Microdilution MIC test trays containing 11 beta-lactam antibiotics in Mueller-Hinton broth at pH 7.31 or 6.80 were prepared and stored at 4, -10, -25, and -70 degrees C. The drugs tested were ampicillin, ticarcillin, mezlocillin, piperacillin, azlocillin, cefazolin, cefotaxime, moxalactam, cefoperazone, ceftriaxone, and imipenem. MICs for Staphylococcus aureus ATCC 29213, Escherichia coli ATCC 25922, and Pseudomonas aeruginosa ATCC 27853 were determined at weekly intervals for up to 1 year. The data from the MIC determinations showed the stability of antimicrobial activity over time to be -70 degrees C greater than -25 degrees C approximately 4 degrees C much greater than -10 degrees C. The relative stability at 4 degrees C as compared with that at -10 degrees C cannot be explained by desiccation, as determined by changes in broth sodium concentrations. The relative instability at -10 degrees C may have been caused in part by a temperature fluctuation, resulting in intermittent freezing and thawing of the antibiotics. Some of the drugs appeared to be more stable when diluted in broth at pH 6.80, but endpoints were more difficult to read. Cefazolin and cefoperazone were stable at all four storage temperatures. Cefotaxime, moxalactam, and ceftriaxone also were relatively stable. The other drugs showed moderately rapid to rapid deterioration at each temperature except -70 degrees C. Storage at -25 degrees C is suitable for up to 3 months for many, but not all, beta-lactams; -10 degrees C appears to be unsuitable. Storage at -70 degrees C is recommended.

Anti-Bacterial Agents↗

Candidal infection in the central nervous system.

Candida has become the most prevalent cerebral mycosis at autopsy, indicating a significant incidence coupled with inadequate eradication. Of 29 patients with systemic candidiasis, 48 percent (14 of 29) also had central nervous system involvement. Of these patients, however, only 21 percent (three of 14) had antemortem diagnosis, and only one of these three patients remains alive; the two patients with antemortem diagnosis who died had a meningeal form that, although easier to document on the basis of cerebrospinal fluid examination, is now distinctly rarer than other forms of the disease in adults. The lone surviving patient was treated with amphotericin B for endocarditis and mycotic aneurysms of the cerebral vessels. One clue to central nervous system candidal infection was the striking correlation between cardiac and cerebral involvement; 80 percent of patients with myocardial or valve infection also had central nervous system candidiasis. Most forms of immunosuppression represent a risk factor for both the systemic and cerebral mycoses. Neuropathologically, there is a spectrum of disease entities associated with Candida, including two previously unrecognized lesions reported herein: fungus balls of both white and gray matter and mycotic aneurysms secondary to Candida parapsilosis. Other parenchymal presentations include thrombosis, vasculitis, abscess, hemorrhage, and demyelination. For drug therapy such as amphotericin B to be more effective, earlier diagnosis of these parenchymal infections must be sought.

Adolescent↗

Cervical chordoma presenting with intervertebral foramen enlargement mimicking neurofibroma: CT findings.

A cervical chordoma, confirmed at surgery, presented on plain spine films as a focal enlargement of the intervertebral foramen and mimicked the characteristic appearance of cervical neurofibroma. Computed tomography (CT) of the cervical spine was obtained immediately following metrizamide myelography; it demonstrated a soft-tissue mass in the enlarged intervertebral foramen that extended posteriorly to compress the spinal cord and anteriorly to compress the hypopharynx. The mass was sharply demarcated, inhomogeneous, and low in attenuation; CT density measured between those of cerebrospinal fluid and muscle. Although this CT appearance is not specific for cervical chordoma, it is unusual for neurofibroma. Cervical chordoma should be considered in the differential diagnosis of focal enlargement of cervical intervertebral foramina.

Adult↗

Polymyalgia rheumatica: an arthroscopic study of the shoulder joint.

A careful selection of 19 patients fitting the classical description of polymyalgia rheumatica have been examined by arthroscopy and thoroughly screened and followed up to exclude rheumatoid arthritis and other disease processes. Synovitis of the shoulder joint has been observed through the arthroscope in 17 and synovitis of varying degrees noted histologically, 4 of whom were studied by immunofluorescence. Five patients had radioactive joint scans.

Aged↗

Intrasellar gangliocytoma and syndromes of pituitary hypersecretion. Case report.

Syndromes of hypersecretion of pituitary hormone and sellar enlargement may on occasion be caused by a gangliocytoma instead of a pituitary adenoma. At least some of these rare tumors are apparently independent of and separable from the pituitary gland, its stalk, and the hypothalamus, and are therefore surgically removable without incurring further endocrine deficit. The authors report such a case, with successful removal of the tumor via a frontal craniotomy. The associated hypersecretion of pituitary hormone was corrected without disturbing normal pituitary function.

Acromegaly↗

An analysis of conservative (non-surgical) management of thoracolumbar fractures and fracture-dislocations with neural damage.

The cases of thirty-four patients with thoracolumbar lesions were reviewed. The neural recovery rate was substantially the same as in comprehensive reviews of surgical and conservative methods by Dickson et. al. and Burke and Murray. We suggest that reduction and maintenance of vertebral body displacement is the single most important factor in the treatment of such fractures and fracture-dislocations. The loss of correction of an angular deformity, however, does not prejudice neural recovery or physical performance during and after rehabilitation. The results of non-surgical methods in achieving reduction and maintenance of displacement were comparable with the results of surgical methods. The immobilization and hospitalization times were longer than in series that used surgical methods.

Fractures, Bone↗

Chemistry in line.

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Chemical Phenomena↗