Biomedical subjects
Publications and source records attributed to J L Thomas.
Four patients evaluated for obstructive jaundice had an ultrasonic examination without evidence of biliary dilatation. Subsequent percutaneous transhepatic cholangiographic examinations demonstrated an obstructive etiology without dilatation of the biliary system. Findings in these patients emphasize that the absence of sonographic biliary dilatation does not exclude the diagnosis of obstructive jaundice.
The computed tomographic and clinical findings of five patients with segmental biliary dilatation are presented. The difference between segmental and complete biliary obstruction is emphasized. In patients with isolated segmental biliary obstruction, there is minimal total bilirubin elevation. Primary therapeutic efforts should be directed at controlling patient's primary lesion and hepatic metastases. Awareness of this entity should avoid unnecessary biliary drainage procedures.
The attitudes of second-year medical students were measured to determine if positive attitude changes could be obtained in a human sexuality course that de-emphasized small group activities. Students were given a semantic differential instrument and were asked to rate four concepts related to human sexuality: (a) my sexuality, (b) masturbation, (c) homosexuality, and (d) my role in understanding sexual problems. Significant changes in student attitudes were reported at the 0x05 level for the concept, my sexuality; at the 0x01 level for the concept, my role in understanding sexual problems; and at the 0x001 level for the concepts, homosexuality and masturbation. Females had more positive attitudes (P < 0x001), pre and post, towards homosexuality than did males. No significant differences were found between married and single students.
The computed tomographic (CT) findings in 10 patients with pheochromocytoma are presented. Three of 10 patients had multiple endocrine adenomatosis, all with bilateral adrenal masses. One other patient had bilateral adrenal masses, four had right, and one had left sided adrenal masses. One tumor was extraadrenal. CT, when used as the initial imaging study, correctly identified nine of nine pheochromocytomas in six patients. In another four patients, recurrent or metastatic disease was identified. CT findings of use in diagnosis were mass lesions, some with areas of decreased attenuation indicating hemorrhage, and metastases identified in liver, mediastinum, lung, and spine. CT differentiation of benign from malignant lesions is facilitated by demonstration of local invasion or metastasis. CT is recommended as the initial radiographic procedure in the evaluation of patients with clinical or biochemical suspicion of pheochromocytoma, and for follow-up examination in patients with evidence of recurrent disease.
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Most cases of ventral hernias are easily diagnosed by palpation, but palpation is a subjective examination that may be difficult or even misleading, especially in obese patients. In cases of diagnostic uncertainty, ultrasonic examinations offer an objective means of distinguishing between a mass in the abdominal wall and one actually deep to the peritoneum. In addition, if such a mass is detected, these studies provide information that can characterize its physical nature.
Infantile polycystic disease (IPCD) is an uncommon pathologic entity involving the kidneys and liver. Gray scale echography can detect this pathologic process within the kidneys, despite the presence of renal failure. In addition, the sonic study may detect associated hepatic abnormalities even though isotopic liver scan is normal. These capabilities make the ultrasonic examination uniquely suited for evaluating patients with IPCD.
Radionuclide angiography and static whole body imaging performed with technetium-99m-labeled particulates can clearly demonstrate differential shunting in patients with patent ductus arteriosus (PDA) with Eisenmenger physiology. The anatomic arterial relationships in this condition which direct deoxygenated blood into the lower body (differential cyanosis) produce specific radionuclide images characterized by differential shunting of the technetium-99m-labeled particulates into the abdomen and lower extremity.
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Four dairy cows were stressed by exposure to hot and cold environments in tests to determine the effect of environment on milk yield, somatic cell counts, and California mastitis test scores of milk from all mammary quarters and on bacterial counts of milk from infected quarters. Two cows were held in temperature-controlled rooms for successive 5-day periods at moderate (21 to 28 C), cold (-16 C), moderate, hot (36 to 37 C), and moderate environments. The cold and hot sequences were reversed for the other 2 cows. Temperature transmitters were surgically implanted in the skeletal muscles of the loin and gluteal regions; however, only one of these transmitters (gluteal region) functioned continuously throughout the experiment. At the end of this experiment, a transmitter was implanted in the gland cistern of a rear quarter of 1 cow, and the sequence of holding in the cold before the hot environment was used. Mean body temperature was approximately 1 degree higher (39.2 C) in the hot room (1 cow) and 3 to 4 degrees lower (35 C and 33 C), respectively, for 2 cows) in the cold room than that during the moderate temperature periods. A similar comparison showed that the mean intramammary temperature was 1 to 2 degrees higher (39.5 C) in the hot room and approximately 9 degrees lower (29.4 C) in the cold room. Exposure of the cows to hot and cold environments caused a greater loss in milk production in the 2 medium-yielding cows (23 to 28 kg/day) than in the 2 low-yielding cows (9 to 13 kg/day). The effect of the extreme temperatures on the somatic cell counts in uninfected quarters was limited to only a few quarters and was inconsistent (mean counts increased and decreased at both temperatures). The California mastitis test reactions showed no consistent changes during periods of heat and cold stress. Also, the effect of the environmental temperature on the intramammary infections also was inconsistent. The effect on bacterial counts appeared to vary with the type of organism. Some mean counts decreased in the heat and cold (Streptococcus agalactiae, Micrococcus sp), some increased (Pseudomonas sp), and another seemed independent (Streptococcus uberis) of the environmental temperature at which the cow was held.
Radionuclide imaging with I-131 rose bengal and orally administered Tc-99m colloid was successfully used to show the presence of an afferent loop that was not visualized by radiographic, endoscopic, or ultrasonic procedures.
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