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Biomedical subjects

J Ludwig

Publications and source records attributed to J Ludwig.

At least 289 records · Page 16Linked to original sources
PubMed1978

Pneumothorax in a large autopsy population. A study of 77 cases.

Postmortem chest roentgenograms in approximately 3,500 cases of a random autopsy population were reviewed. Pneumothorax was found in 77 cases (2.2%). Simple pneumothorax was present in 38 cases, and tension pneumothorax or combined simple and tension pneumothorax was present in 39 cases. Only 40 of the 77 patients had been clinically diagnosed as having pneumothorax. Pulmonary conditions most often present in cadavers with pneumothorax were bacterial pneumonia, pulmonary emphysema, and pulmonary embolism, with or without infarcts and infarct abscesses. Procedures most frequently associated with pneumothorax were mechanical ventilation and attempts at cardiorespiratory resuscitation. Rib fractures (iatrogenic and noniatrogenic) were found in 23 of the 77 cases.

Adult↗
PubMed1978

Bilateral renal loss resulting from intravesical formalin instillation.

A patient was referred for evaluation of obstructive uropathy after treatment with 10% formalin to control recurrent hemorrhagic radiation cystitis. Progressive bilateral ureteral, pelvic, and renal parenchymal destruction occurred despite ileal ureteral replacement. This complication of therapy reinforces the concept that vesical instillation of formalin should be done only in extreme cases and then only in low concentrations.

Female↗
PubMed1978

Asymptomatic primary biliary cirrhosis. Presentation, histology, and results with D-penicillamine.

Of 103 patients with the syndrome of primary biliary cirrhosis (chronic, nonsuppurative destructive cholangitis) who entered a double-blind, randomized, controlled treatment trial with either D-penicillamine or placebo, 21 (20%) were asymptomatic with respect to their liver disease. Study of these 21 patients revealed that (1) 43% of patients with asymptomatic primary biliary cirrhosis had advanced histologic lesions (fibrosis or cirrhosis); (2) asymptomatic patients with advanced histologic lesions likely have had their disease for 10 years or more; (3) stage of primary biliary cirrhosis may remain unchanged for years; and (4) most asymptomatic patients receiving D-penicillamine, when compared with patients given placebo, had improved liver function tests at 1-year follow-up. However, the incidence of major toxicity with D-penicillamine for primary biliary cirrhosis in a maintenance dose of 1 g approximates 20%. Furthermore, one of our patients who was asymptomatic but who had advanced histologic changes died recently from D-penicillamine-associated bone marrow suppression. It remains to be determined whether the benefit-to-risk ratio of D-penicillamine in primary biliary cirrhosis justifies its use.

Adult↗
PubMed1977

A review of lobular, portal, and periportal hepatitis. Interpretation of biopsy specimens without clinical data.

This representation, in which a recently adopted terminology is used, represents a compilation of clinical diagnoses that must be considered whenever a morphologic diagnosis of lobular, portal, or periportal hepatitis has been made. Also described are the morphologic findings that may enable the pathologist to list, without knowledge of clinical data, the suspected clinical conditions in an order of likelihood.

Acute Disease↗
PubMed1977

Mucosal iron-binding proteins in mice with X-linked anaemia.

The mouse with X-linked anaemia [sla] has a defect in iron absorption which can be temporarily reversee by feeding a low iron diet. Duodenal non-haem iron was significantly higher in the sla than in the normal mouse on an iron supplemented diet but non-haem iron was reduced to minute amounts when the mice were fed a low iron diet. Gel chromatography on Sephadex G-200 of th partial-free supernatant of pooled mucosal homogenates revealed the presence of three proteins binding 59Fe. Fraction I [mol wt 450 000] resembled ferritin and was present in both normal and sla mice fed an iron supplemented diet. Fraction II [mol wt 78 ooo] eluted in a similar position to transferrin and was evident in both normal and sla mice fed an iron deficient diet. Fraction III [mol wt less than 15 000] contained equivalent amounts of radioiron in normal and sla mice fed the iron deficient diet, whereas this fraction contained less radioactivity in sla animals in two of three experiments in which the animals were fed an iron supplemented diet. The iron transport defect in sla mice does not appear to reside in the iron-binding proteins in the supernatant fraction of the intestinal mucosa and the cause of the defect in iron absorption remains to be elucidated.

Anemia, Hypochromic↗
PubMed1977

Esophageal carcinoma in Olmsted County, Minnesota, 1935-1971.

In order to estimate the incidence rate of esophageal carcinoma in a defined populat;on, all cases in bona fide residents of Olmstead County, Minnesota, newly diagnosed from 1935 through 1971 were identified and reviewed. There were 33 confirmed cases. The mean annual incidence was 2.6/100,000 men and 0.8/100,000 women. The age-adjusted incidence rates in this population are lower than those reported recently from other populations. Of the 27 patients whose disease was diagnosed before death, only 1 survived more than 6 years after initial diagnosis of the esophageal carcinoma, and all had died before the end of the study.

Adult↗
PubMed1977

The Student Response System. A 5-year Mayo Medical School Experience.

The Student Response System is a commercially available electronic communication system applicable to many teaching and testing situations. At rather short intervals during a programmed course, the instructor projects on a screen multiple-choice questions that the student should have learned to answer during one or two previous teaching steps. Correct and incorrect responses are indicated on a panel on the desk of the instructor. If students fail to give the correct answer, the teaching step is repeated. Recurrent incorrect answers indicate that explanations had been inappropriate or that test slides were poorly designed. Thus, the system allows the instructor to monitor his own performance. Students are kept alert and attention spans are prolonged; communication is increased and personal embarrassment is minimized. Only the instructor has access to the individual student's response. Most learning takes place in the classroom rather than during subsequent private study. This system is quite versatile and offers potential uses hitherto untested in medical education at all levels.

Audiovisual Aids↗
PubMed1976

Serum ferritin and the iron status of Canadians.

Serum ferritin concentration was determined in 1105 Canadians aged 1 to 90 years. Geometric mean values (ng/ml) were as follows: children 1 to 4 years old, 12; children 5 to 9 years old, 15; adolescent girls, 17; adolescent boys, 18; women 20 to 39 years, 23; women 65 years and older, 52; men 20 to 39 years, 93; and men 40 and older, 92. Ranges were side in all age groups, reflecting variations in size of body iron stores. From analysis of the ferritin values it is highly probably that iron stores were greatly reduced in approximately 25% of children, 30% of adolescents, 30% of menstruating women, 60% of pregnant women and 3% of men. Iron-deficiency anemia was noted in only 2% of subjects. If "normality" requires more than small amounts of storage iron to meet physiologic demands, the study results suggest a high probability of iron deficiency in 60% of the pregnant women and in 19% of the other subjects; but if normality is defined as maintenance of adequate iron stores for erythropoiesis, the prevalence of iron deficiency was zero in the pregnant women and 2% in the other subjects.

Adolescent↗
PubMed1975

Serum ferritin, cobalt excretion and body iron status.

Serum ferritin concentration was measured by immunoradiometric assay in 64 subjects. It was closely related to the size of body iron stores measured by hemosiderin content of bone marrow in all subjects and by the deferoxamine test in 10 patients with iron overload. Urinary cobalt excretion, an indirect measure of iron absorption, was inversely related to hemosiderin content of bone marrow in 34 patients aged 18 to 72 with or without liver disease, but this relation did not hold in a group of 20 student volunteers aged 17 to 30, indicating that the test is unreliable in young people. A strong inverse correlation was demonstrated between values for cobalt excretion and serum ferritin in the 34 patients and between those for iron absorption and serum ferritin in the 20 students. Serum ferritin concentration appears to reflect accurately the iron status of the healthy individual but high values in liver disease must be interpreted with caution.

Adolescent↗
PubMed1975

Hemangiosarcoma of the liver. Spectrum of morphologic changes and clinical findings.

Analysis of four cases of hemangiosarcoma of the liver and review of the literature indicate that these tumors are either predominantly cystic and fairly well differentiated or are more solid and poorly differentiated. Well-differentiated hemangiosarcomas may resemble peliosis hepatis or other benign conditions. The tumor was associated disseminated intravascular coagulation and fibrinolysis syndrome in one of our cases. One of our patients had received thorium dioxide (Thorotrast) but none seemed to have been exposed to arsenicals or to vinyl chloride.

Adult↗
PubMed1975

Distribution of storage iron as body stores expand in patients with hemochromatosis.

The relative distribution of storage iron between bone marrow and liver has not been adequately studied in patients with iron-loading disorders. To help clarify this we assessed iron metabolism in patients with iron overload and in control subjects with cirrhosis but no excess body iron. In 4 patients with advanced iron overload studied late in the course of their illness, excess hemosiderin was present in both bone marrow and liver, as expected. In contrast, 2 patients with idiopathic hemochromatosis whose excess iron had been depleted by phlebotomy subsequently developed progressive hepatic parenchymal and reticuloendothelial (RE) deposition of iron, yet marrow hemosiderin remained sparse. Moreover, surface radioactivity over the liver after an oral dose of 59Fe. These results suggest that during the initial stages of hemochromatosis there is a dissociation in the rate of iron accumulation between the bone marrow and liver. Excess hemosiderin appears to be deposited predominantly and preferentially in hepatic storage sites until the later stages of the disease.

Aged↗
PubMed1975

Calcified mixed malignant tumor of the liver.

Two adult patients died from mixed hepatic tumors of the liver with metastasis. The outstanding findings in both patients were a long clinical course, roentgenologically identifiable calcification of the tumors, and, in one, hypertrophic osteoarthropathy and spider angiomas. Mixed hepatic tumors are rare in adults, only 14 possible previous cases have come to our attention. The mixed hepatic tumors of adults are morphologically different from the more common mixed hepatoblastomas of infancy and childhood. Calcification in a slow-growing tumor in an adult without cirrhosis may indicate a mixed hepatic tumor.

Autopsy↗