Biomedical subjects
Publications and source records attributed to J L Angel.
Acute abdominal and shoulder pain in association with a pneumoperitoneum are common signs and symptoms of perforation of a hollow viscus. We report a case that describes the development of a postcoital pneumoperitoneum in an otherwise healthy postpartum patient. The literature is discussed, and supports this case as pneumoperitoneum in association with vigorous coital activity.
Skeletal evidence exists for life stresses of 120 Black individuals from 25 sites in Maryland, Virginia, and the Carolinas. Periods for statistical comparison are eighteenth century, 1690-1770; Catoctin Furnace, Maryland industrial slaves, 1790-ca.1820; 1800-ca.1860, nineteenth century; and a twentieth-century Black sample compiled from forensic (accidental deaths) cases. From these archaeological sources, skeletal age at death shifts from 36 years, female, and 30 years, male in eighteenth century (N = 29) to 34.8, female, and 36.3, male in nineteenth century (N = 56). Catoctin Furnace slaves' longevity may reflect special conditions for skilled males (34.6 years, female; 41.2 years, male (N = 16). Nutritional stresses are indicated by dental lesions, hypoplasias, stature, and skull base height and pelvic brim index. Occupational stress occurs in some adolescents and in many adults as exaggerated development of lifting muscles (deltoid and pectoral crests) and early vertebral and shoulder breakdown. Lead content of bone may reflect site of occupation. The most common pathology is anemia or sicklemia; parietal depressions and ulna fractures ("parry") indicate violence-related trauma.
The congregation of the Reverend Henry Simmons (First African Baptist Church at 8th & Vine, Philadelphia) from 1823 to 1841 used a cemetery rediscovered through subway expansion which was carefully excavated by M. Parrington and S. Pinter in 1983-1984; currently 75 adults were available for study. As an overall health indicator, longevity at 38.9 years (N = 39) female and 44.8 (N = 36) male indicates more stress on females. Probable causes of stress are inadequate nutrition for the performance of arduous labor, pregnancy, and childrearing, unsanitary living conditions, limited exposure to sun, and extensive exposure to infectious diseases. Nutritional indicators of stature, dental lesions, skull base height, and pelvic brim index scarcely advance over 1790-1820 Catoctin Furnace, Maryland, slaves' indicators. Disease evidence includes limb-distorting rickets in one child who died at age 8, anemia, and arthritis; but the incidence of arthritis was less than at Catoctin. Genetic traits are chiefly African. Family links show in details: os acromiale in about 30%. This plus less violence (fewer fractures) suggests community strength developing.
Retroplacental blood flow requires inhibition of coagulation in the absence of an endothelial lining. We confirmed that trophoblast releases an inhibitor of platelet aggregation which functions via degradation of adenosine diphosphate. This inhibitor appears to be deficient in some pregnancies with abruptio placentae and intrauterine growth retardation. Unimpeded retroplacental blood flow may depend upon the local inhibition of platelet aggregation. Placental tissue contains an inhibitor of platelet aggregation which appears to be an adenosine diphosphatase distinct from heat-stable alkaline phosphatase. Placental tissue from patients with abruptio placentae contains abnormally low amounts of this enzyme.
The importance of geographical distance as a determining factor of the population's biological and socio-cultural structure was studied on the island of Korcula, Yugoslavia. Migrational kinship coefficients, biological and linguistic distances were analysed in respect to isolation by distance, using Malecot's model. The fit of the model is highly significant for migrational kinship, linguistic, anthropometrical and physiological distances, while for morphometrical distances of metacarpal bones and dermatoglyphic distances, it is not adequate. The major conclusions reached through this analysis are in concordance with the known historical events in the entire region.
Parents experiencing perinatal death have health care needs beyond the physical needs of the postpartum woman. Health care providers must direct their attention to the emotional needs of the couple. Parents can be offered the opportunity to participate in decisions regarding their care and thereby regain a sense of control over a situation that frequently produces frustration and anger. Appropriate care, offered within a variety of structures, will more likely be provided when the health care professional addresses the needs of the grieving couple in an open, sensitive manner.
Blood infusion through standard 20- and 22-gauge spinal needles, with varying hematocrit and rates of 1-6 mL/minute, did not result in significant amounts of erythrocyte hemolysis.
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Lead content was determined in the skeletal tissue of 82 individuals representing two black and two white Colonial American populations: Catoctin Furnace, College Landing, Governor's Land, and Irene Mound. Group and individual differences in bone lead concentrations were used to assess behavioral, social and occupational characteristics. Variations in skeletal lead content suggested that the white owners of the Catoctin iron furnace shared little of their food and beverage with their black, male, industrial slaves, but that some of these workers' women had access to the owners' food sources--probably via domestic duty assignments. A broad range of lead concentrations in bones of the free blacks at College Landing implies a wide range of economic success among these tradesmen. Bone lead content of the white populations at Governor's Land and Irene Mound helped confirm family relationships that had been assigned on an archaeological and osteological basis, and also suggested that the social and functional status of the white tenant farmers' white servants frequently differed little from that of black slaves. These findings suggest that, when applied in appropriate circumstances, lead studies of archaeological skeletal tissue may provide information supplemental to that derived from historical, archaeological, or other conventional sources.
Cystic dilatation of the common bile duct is rare and dangerous during pregnancy. We have described a case of a twin gestation and a concomitant choledochal cyst. Surgical release of the dilatation is urgent in light of the overdistended uterus. A conservative surgical approach in the antepartum period is supported by the successful outcome of this case.
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The syndrome of puerperal ovarian vein thrombosis is often a diagnostic enigma. In the past, laparotomy has been the most frequent modality used to establish the diagnosis. The clinical picture and characteristic mass have not accurately predicted the presence of this syndrome, resulting in potentially dangerous and unnecessary surgery. The use of computed tomography is suggested as a noninvasive ancillary method.
Strong multiple reactions often occur with the Phadebact Streptococcus test when the culture contains blood. These reactions interfere with the identification of the Lancefield groups of streptococci. Group B streptococci from the vagina of pregnant women are difficult to identify by slide coagglutination because of the frequent presence of blood on culture swabs. Elimination of these multiple reactions caused by blood would permit rapid identification of group B streptococci in pregnant women. Vaginal broth cultures were examined to determine the cause of multiple reactions with slide coagglutination and to eliminate them from the testing procedure. Of 245 maternal broth cultures, 135 (55%) yielded multiple reactions when tested by coagglutination. Such reactions were either eliminated or greatly diminished by heating the broth sample to 90 degrees C for 10 min. It was also found that globulins in the serum may be responsible for multiple reactions with blood. This heating protocol will permit vaginal broth cultures to be rapidly tested for group B streptococci by slide coagglutination.
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Skull base height increases significantly with better nutrition and health conditions, as seen in comparing 163 nineteenth to twentieth century dissecting-room skeletons (Terry Collection) with 237 modern American middle-class adults (forensic and willed skeletons). The increase parallels the change in pelvic inlet depth index, known to respond sensitively to nutrition, and in stature, and is over six times greater than the general skull size change. Skull base height (porion-basion) is easy to measure with depth gauge and sliding caliper, or by subtraction, and is in adult a sensitive indicator of childhood growth stress.
In the nineteenth century, accurate descriptive studies, often dealing with pre-Columbian "syphilis," were made by Virchow, J. Jones, and Putnam. Hrdlicka, Moodie, Ruffer, and others in the early twentieth century carried out research on subjects ranging from trephination to schistosomiasis. However, it was not until Hooton, Williams, Stewart, Wells, and others (1930 to 1965) that paleopathology was combined with paleodemography to get a population perspective on health as an equilibrium with disease. Not until recently, with the creative summaries of Jarcho and Brothwell, have we had bone pathologists (Lent Johnson and especially Putschar) and others (Moseley in blood, Cockburn and Allison in epidemiology and mummies) working actively with physical anthropologists and historians. This cooperation has triggered a major revival in the study of bone physiology and responses to disease (Ortner), disease ecology, demography and health, and paleonutrition (Goldstein, Laughlin, Cook and Buikstra, Ubelaker, Angel). New techniques range from histology to immunochemistry and now involve a host of young investigators.
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Eighty-two people dating from 1975 to 1879 compared with 182 modern middle-class White and Black skeletons test the myths of radical changes produced by improved diet, less disease, and nineteenth century immigration. Longevity increases and health and growth improvement is clearest in reduced juvenile deaths (census data) and deepening of true pelvis. Stature increase is minimal (though seventeenth century Londoners and modern West Africans are shorter than Colonial to Modern Americans); teeth deteriorate and for cultural reasons fractures increase. Clavicles and forearms elongate. From Old to New World Colonial samples there is a noticeable skull change (and a greater Old World to Modern contrast) but White Colonial to Modern shows strong continuity surprisingly, the key changes being increasing head height, and retraction of face with increasing nose projection, and longer mastoids, resulting from selection and mixture. Blacks change more, possibly from Indian and White mixture. Variabilities are above average. Change is much less than expected, and apparently involves heterosis and selection as well as the obvious health advance and mixtures.