Americans with Disabilities Act: big impact on small business.
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Biomedical subjects
Publications and source records attributed to J McCarthy.
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Hyperornithinaemia gyrate atrophy (HOGA) is a rare autosomal recessive disorder in which chorioretinal degeneration occurs with cataracts, myopia, and hyperornithinaemia. We report the case of an 18-year-old female who presented with the typical features of HOGA, including posterior subcapsular cataracts and elevated plasma ornithine. She later developed distorted vision in both eyes owing to wrinkling of the anterior lens capsules. Histological examination following lens extraction showed the wrinkling was caused by focal distortion from capsular fibrosis (anterior subcapsular plaque cataract). This specific lens change has not been linked previously with HOGA.
Case reports of three patients with cerebellar infarction causing brain stem dysfunction and obstructive hydrocephalus as seen in computed tomography are presented. Surgical treatment, either ventricular puncture with drainage or suboccipital craniectomy and resection of the necrotic cerebellar tissue, was carried out. Indications for surgical treatment of space-occupying cerebellar infarction and post-operative follow-up of 4 1/2 years are discussed.
Survival after acute lung injury (ALI) depends on prompt alveolar repair, a process frequently subverted by the development of granulation tissue within the alveolar airspace. Immunohistochemical examination of the intraalveolar granulation tissue confirmed that capillaries as well as myofibroblasts were the principal cellular constituents. We therefore hypothesized that angiogenesis factors would be present on the air-lung interface after ALI. To evaluate this hypothesis, bronchoalveolar lavage fluid from patients with ALI (n = 25) and patient controls (n = 8) was examined for angiogenesis bioactivity by its ability of induce endothelial cell migration. While lavage fluid from controls had no bioactivity, lavage fluid from 72% of patients with ALI promoted endothelial cell migration. Heparin affinity, ion exchange, and gel filtration chromatography resolved the bioactivity into at least two moieties. One appeared identical to the well characterized endothelial cell growth factor, basic fibroblast growth factor. The other was a 150-kD non-heparin binding protein that mediated endothelial cell migration and attachment in vitro, and the growth of new vessels in vivo. These data are consistent with the hypothesis that the growth of capillaries into the alveolar airspace results from angiogenesis factors present on the alveolar surface of the lung after ALI.
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Ecologically relevant stimuli were developed as an alternative to Munsell color chips. Colored pictures of familiar objects were used to study color memory. We investigated the typicality of color to particular objects. Contextually typical colors were remembered more accurately than atypical colors were. Moreover, this variable had a stronger effect on memory than focality did. We concluded that memory for ecologically relevant material is more impressed by a color's relation to experience than by its intrinsic properties.
Three children with ectopic ureteroceles were examined with ultrasound, intravenous urography and cystography. In all cases the ultrasound studies outlined the ectopic ureterocele within the fluid-filled bladder and in one case added additional information regarding the non-functional portion of the duplication and its ureter.
A 53-year-old white woman developed diabetes mellitus, migratory erythema, and anemia, clinical features suggesting the presence of a "glucagonoma." Ten years earlier, after laparotomy and pancreatic biopsy, she had been told that she had an inoperable pancreatic carcinoma. Review of that biopsy together with current hormonal assay now confirms the diagnosis of glucagonoma. The recurrent peptic ulcer in this patient despite high levels of glucagon, a gastric inhibitory agent, is noted but not explained. An enhanced amylase-creatinine clearance ratio supports the notion that glucagon increases the clearances of amylase.
The effects of injection site, age, and body position on cervical venous reflux during carotid radionuclide angiography were studied. Adults injected via the left arm while supine were more likely to show reflux; neither the position nor the side injected was important in children. Right arm injection is preferred for adults; adults injected via the left arm should be erect if possible.
The mode of sensory integration of differentiated perceptions of exertion from the legs and chest was determined during sub-maximal cycle ergometer exercise. 50 male subjects performed three separate cycle ergometer tests. Power output was held constant at 840 kpm/min., while pedalling rate was randomly set at 40, 60, or 80 rpm. The over-all rating of perceived exertion was significantly lower than the rating for the legs and higher than that for the chest at each pedalling rate. Local signals from the legs dominated the sensory process. Central signals were less pronounced. The mean of the ratings for the legs and chest was slightly but significantly higher than the over-all rating at each pedalling rate. Therefore, the integration process at the superordinate level of sensory processing appeared as a weighted average of the involved regional signals.
Differentiated ratings of perceived exertion in the legs and chest were compared to local and central physiological adjustments during submaximal cycle ergometer exercise. 50 male subjects performed three separate cycle ergometer tests. Power output was held constant at 840 kpm/min., while pedalling rate was randomly set at 40, 60, or 80 rpm. Differentiated reports of exertion from the legs were considered to be local signals and reports from the chest to be central signals. Ratings of exertion for the legs, chest and over-all body were each significantly higher at 40 rpm than 60 or 80 rpm. Heart rate, oxygen uptake, ventilation and respiratory rate were also higher at 40 rpm. Lactic acid, pH, and pCO2 were similar between pedalling rates. Lactic acid did not operate differentially to influence local perceptual signals from the legs. Central measures of respiratory and aerobic metabolic adjustments were consistent with the more intense regional report of chest exertion at 40 rpm.
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Cerebral myeloma in a 49-year-old white man took the form of diffuse arachnoid infiltration, intracerebral perivascular cuffing, and frank intracerebral invasion.
Some chronic renal failure patients maintained on dialysis have uncontrollable hypertension. Those with elevated renin levels require bilateral nephrectomies prior to kidney transplant to avoid nephrosclerosis. The morbidity and mortality from surgical nephrectomies are high. In 2 such patients we embolized the renal arteries with gelfoam and successfully occluded all the major vessels. One patient became normotensive. The second remained hypertensive and had increased renin levels, probably on the basis of ischemia. Subsequent surgical nephrectomies demonstrated completely occluded segmental branches but only focal areas of infarction. Collateral blood supply determines the success of the procedure.
Perceived exertion responses were compared between field-independent and field-dependent perceivers at three cycle-ergometer pedalling rates. 50 male subjects were classified according to mode of field approach on the basis of their performance on an embedded-figures test. Power output was held constant at 840 kpm/min., while pedalling rate was randomly set at 40, 60, or 80 rpm. Significant differences between the field-independent and -dependent groups were not found at the three pedalling rates for any of the physiological variables or for over-all, legs and chest ratings of perceived exertion. The extent of differentiated psychological functioning did not account for individual differences in perceptual reactance during muscular exertion.