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Biomedical subjects

J M Morris

Publications and source records attributed to J M Morris.

At least 19 recordsLinked to original sources

Sonographic evaluation of intrauterine growth retardation.

The prenatal recognition of the growth-retarded fetus is important because of the associated increased perinatal morbidity. Clinical methods of assessing fetal growth are disappointing and necessitate that a high-risk group be identified for more intensive surveillance. This review discusses the role of ultrasound biometry in establishing whether a fetus is small. Behavioral characteristics of the fetus may also be assessed using real-time ultrasound. The realization that not all small fetuses are a result of growth failure has led to the development of Doppler ultrasound to identify the fetus at risk. This paper focuses on the evidence supporting the selected use of Doppler ultrasound to investigate high-risk pregnancy.

Female

Membranoproliferative glomerulonephritis in dogs with a genetically determined deficiency of the third component of complement.

Renal disease is a common clinical manifestation of genetically determined deficiencies of the complement system in man. Like their human counterparts, dogs with a genetically determined complete deficiency of C3 also develop renal disease. Five of 20 C3-deficient dogs developed clinical evidence of renal failure. However, 14 of the 15 remaining dogs had histological evidence of type I membranoproliferative glomerulonephritis. The lesions were characterized by mesangial cell proliferation, an increase in the mesangial matrix, thickening of the glomerular capillary wall, electron-dense deposits in the mesangium and subendothelial space, and the presence of IgG and IgM. In order to determine the effect of treatment with C3 on the renal disease of C3-deficient dogs, two C3-deficient dogs were infused with normal canine plasma twice weekly for 3 weeks. Their urinary protein excretion rose progressively from less than 200 mg/24 hr to greater than 1000 mg/24 hr; renal function remained normal. Renal biopsies performed 1 week after the last infusion revealed more severe glomerulonephritis and the presence of C3. As controls, a C3-deficient dog was given C3-deficient canine plasma and a normal dog was given normal canine plasma; neither control animal developed proteinuria or changes in their renal biopsy. These observations suggest that renal disease may be more common in humans with complement deficiencies than would be suspected based on clinical assessment. Furthermore, these results suggest that treatment with complement-containing blood products may worsen preexisting renal disease in complement-deficient individuals.

Animals

Pancreatic adenocarcinoma with osseous metaplasia in a ferret.

A poorly differentiated pancreatic adenocarcinoma with regional lymphatic, hepatic, enteric and pulmonary metastases was diagnosed in an adult European ferret (Mustela putoris furo). The ferret showed clinical signs including a progressive, marked abdominal enlargement owing to ascites. Microscopic findings included intralesional osseous metaplasia. Exocrine pancreatic neoplasms in ferrets are rarely reported compared with neoplasms with endocrine differentiation.

Adenocarcinoma

Lumbar spinal fusion. Assessment of functional stability with magnetic resonance imaging.

Segmental spinal instability was evaluated with magnetic resonance (MR) imaging, computed tomography (CT), and conventional radiography in 33 patients who had undergone surgical spinal fusion. In 16 of the 19 patients who had a diagnosis of solid fusion, the immobilized vertebral bodies demonstrated areas of high signal intensity on images with short repetition time (TR) and echo time (TE). The signal intensity of these areas was either less intense or normal on images with long TR and TE. In 10 of the 14 patients with segmental instability at the fusion site, subchondral vertebral bands of low signal intensity were shown on short TR/TE images, which demonstrated high signal intensity on long TR/TE images. All but two of the patients showed vertebral signal changes 12 or more months past fusion or onset of clinical symptoms. The vertebral MR signal intensity in solid lumbar fusions might be related to marrow composition changes resulting from decreased biomechanical stress, while the vertebral signal intensities in patients with unstable fusions might be related to reparative granulation tissue, inflammation, edema, and hyperemic changes. Magnetic resonance imaging appears to be unique in its assessment of functional fusion stability. Magnetic resonance may be most useful in patients symptomatic of fusion pseudarthrosis in whom conventional radiography and CT fail to demonstrate anatomic disruption.

Female

Changes in neuronal size and neurotransmitter marker in hereditary canine spinal muscular atrophy.

Hereditary canine spinal muscular atrophy (HCSMA) is a dominantly inherited motor neuron disease that produces muscle weakness and atrophy. Immunocytochemical and computer-imaging morphometric methods were used to compare early changes that occurred in dogs with HCSMA (n = 4) versus controls (n = 2). The size and number of neurons in the ventral horn and the number of motor neurons expressing choline acetyltransferase were quantitated. The density of all ventral horn neurons per micrometer squared in dogs with HCSMA was greater than controls, and there were more small neurons than in controls. Immunocytochemical methods revealed more small cholinergic neurons and fewer large cholinergic neurons in HCSMA than in controls, suggesting growth arrest in HCSMA or a shift in size class from large cholinergic neurons to small ones. The density of cholinergic neurons per micrometer squared was not significantly different between the two groups. Analysis of predicted distributions of cholinergic and noncholinergic neurons revealed that HCSMA cholinergic neurons were smaller and that, in some size classes, fewer neurons expressed choline acetyltransferase. These observations indicate that in HCSMA the motor neuron fails to achieve normal size and/or undergoes atrophy.

Animals

[3-dimensional computed tomography and multiplanar CT-reformations in lumbar spondylodesis].

Three-dimensional computed tomography (3-D-CT) and multiplanar CT reformations were performed in 42 patients who were clinically suspected of spinal instability following posterior lumbar fusion. Sagittal and coronal CT reformations demonstrated fusion pseudarthrosis more frequently than axial CT or conventional radiography. Three-dimensional CT cuts through the fusion revealed pseudarthrosis in most patients with positive 2-D images. In 5 patients, however, fusion appeared to be artifactually stable or unstable on 3-D cuts contrasting the 2-D images. Three-dimensional surface reconstructions demonstrated the complex anatomy of the fusion and showed superficial breaks. They were helpful in preoperative planning as well as intraoperative localization. 3-D-CT is a clinically useful adjunctive imaging method.

Adult

The semiconstrained total shoulder arthroplasty.

In a two-year follow-up on sixteen total shoulder arthroplasties done with the semiconstrained Stanmore prosthesis, we found that patients with rheumatoid arthritis or osteoarthritis of the glenohumeral joint noted a greater relief of pain, were more satisfied with their surgery, used fewer analgesics, and had a greater increase in range of motion than patients with traumatic arthritis. Patients with irreparable rotator-cuff injury demonstrated the poorest range of motion postoperatively. Younger patients gained significantly more motion than older patients. All patients continued to have difficulty with lifting heavy loads. Complications consisted of one patient with a chronically dislocating prosthesis, one patient with a deep wound infection, and one with a postoperative wound dehiscence. The average follow-up was 31.4 months, ranging from twenty-four to fifty-three months.

Adult

Complications of water-soluble contrast lumbar myelography. Review of the literature and case report.

A historic review of the development of water-soluble contrast materials for lumbar myelography is presented. This is followed by a discussion of their advantages and complications, as well as a case report of convulsive segmental myoclonus, hypotension, and death after myelography associated with the use of dimeglumine locarmate (Dimer-X). A new nonionic material, metrizamide (Amipaque), is discussed, and its current clinical status is summarized.

Aged

A pneumatically driven pump for constant perfusion manometry.

Syringe pumps are almost universally used for constant perfusion oesophageal manometry, despite important technical limitations. A pneumatically driven perfusion pump has been designed specifically for oesophageal manometry. This pump requires less than one third the flow setting of a syringe pump to achieve a given rate of pressure rise. It is simple to operate and needs infrequent refilling. Nearly two years' practical experience with this pump has confirmed its superiority over the syringe pump for constant perfusion manometry.

Air Pressure

A formula for selective lymphadenectomy. Its application to cancer of the vulva.

A statistical formula can be applied to aid clinical judgment in decisions regarding the advisability of lymphadenectomy in gynecologic cancer. If benefit (B) factors in a given case do not exceed debit (D) factors, the procedure is ill-advised. In unilateral vulvar cancer, for example, if the ipsilateral inguinal nodes are negative, the risks from routine contralateral or deep pelvic node dissection appear to exceed the benefits.

Adult

Routine use of hysterography in endometrial carcinoma and postmenopausal bleeding.

Unexpected hysterographic findings were encountered in 42 of 105 patients with postmenopausal bleeding or endometrial carcinoma. These included the extent and location of tumor, size and position of the uterus, uterine perforations or fistulas, and undetected myomas, congenital defects, or adnexal pathology. The findings proved of sufficient value in clinical management that hysterography, using water soluble medium, has been adopted as a routine procedure in such cases, especially if radium or cesium packing is employed. There was no statistically significant correlation between the histologic grade of the tumor and the hysterographic appearance of well-circumscribed or diffusely infiltrating lesions. Intravasation of contrast media occurred in 9 patients, lymphatic uptake was observed in 8, and peritoneal spillage of dye in 31 patients. There was no significant morbidity, and results to date show no evidence of tumor spread from the procedure.

Adenocarcinoma