Acute volvulus of the right colon: an analysis of 69 patients.
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Biomedical subjects
Publications and source records attributed to J R Anderson.
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The involvement of the entire colon in an ischemic process is unusual because of the dual source of blood supply to the large bowel. Three cases of total ischemic colitis are presented. A precipitating cause to account for the distribution of ischemia was identified in each patient.
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An enzyme-linked immunoassay urine pregnancy test was used on a group of patients suspected of having an ectopic pregnancy. Patients were seen in the county hospital emergency department and had the urine test correlated with a serum beta-hCG level determined by radioimmunoassay. There were 884 patients with urine ICON-serum beta-hCG correlations. The ICON was positive in each of the 247 patients whose serum value was over 50 mIU/mL, and was negative in each of the 619 patients whose serum level was below 5 mIU/mL. Eighteen patients had a serum level between 10 and 50 mIU/mL and the ICON was positive in 13. The five patients with a low serum beta-hCG level and a negative ICON had dilute urine when tested. Using a modified testing procedure, each of these produced a positive ICON. Of the 27 patients with an ectopic pregnancy the urine ICON was positive in 26. The urine ICON is an improved assay for hCG in patients suspected of having an ectopic pregnancy, and is ideally suited for ED use.
Lambornella clarki (Ciliophora: Tetrahymenidae), an endoparasite of Aedes sierrensis (Diptera: Culicidae), is dispersed by infected adult mosquitoes. Invasion of the ovaries induces parasitically castrated females to exhibit oviposition behavior and thereby actively disperse ciliates through deposition into water. Oviposition behavior of infected females is prolonged and mimics that of normal gravid females in their first gonotropic cycle. Adults of both sexes also passively disperse ciliates by dying on water surfaces, and infected adults are more likely to die on water than uninfected adults. Ciliates dispersed by infected adults can infect larvae and form desiccation-resistant cysts. Parasite-induced dispersal by hosts, desiccation-resistant cysts, an active host-seeking infective stage, and high infection and mortality rates all indicate significant biological control potential for these and related ciliates against container-breeding mosquitoes.
Herpes simplex virus-specific DNA sequences have been detected by Southern hybridization analysis in both central and peripheral nervous system tissues of latently infected mice. We have detected virus-specific sequences corresponding to the junction fragment but not the genomic termini, an observation first made by Rock and Fraser (Nature [London] 302:523-525, 1983). This "endless" herpes simplex virus DNA is both qualitatively and quantitatively stable in mouse neural tissue analyzed over a 4-month period. In addition, examination of DNA extracted from human trigeminal ganglia has shown herpes simplex virus DNA to be present in an "endless" form similar to that found in the mouse model system. Further restriction enzyme analysis of latently infected mouse brainstem and human trigeminal DNA has shown that this "endless" herpes simplex virus DNA is present in all four isomeric configurations.
Small bowel is the commonest site of gastrointestinal metastases from cutaneous malignant melanoma. Five patients with malignant melanoma involving the small bowel are reported. One patient was operated on for suspected acute appendicitis, two patients for gastrointestinal bleeding and two patients for small bowel obstruction. Two patients remain well 4 and 5 years after surgery.
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A randomized clinical trial of combination chemotherapy for patients who relapsed following primary radiation therapy for Hodgkin's disease was conducted from 1975 to 1981 by the Cancer and Leukemia Group B (CALGB). One hundred thirteen patients were prospectively randomized to receive 12 cycles of either CVPP (CCNU, vinblastine, procarbazine, and prednisone), ABOS (bleomycin, vincristine [Oncovin; Lilly, Indianapolis], doxorubicin [Adriamycin, Adria Laboratories, Columbus, Ohio], and streptozotocin), or alternating cycles of CVPP and ABOS. The median length of observation for patients in this report is 4 years. Toxicities of the three treatment programs were primarily hematologic. Frequencies of complete response were 72% for CVPP, 70% for ABOS, and 82% for CVPP/ABOS (P = .37). Females and patients who had nodular sclerosing disease at initial diagnosis had significantly higher complete response rates. The 5-year disease-free survival for the complete responders was 55%; the 5-year overall survival was 60%. There were no significant differences among the treatments on disease-free survival (P = .78) or overall survival (P = .18). Age under 40 years was the only significant positive prognostic factor for disease-free survival (P = .095) and overall survival (P = .003). This study demonstrates no statistically significant advantage for alternating cycles of combination chemotherapy in affecting complete response frequency, disease-free survival, or overall survival as compared with therapy with CVPP or ABOS alone. However, the power to detect differences in these outcome parameters is somewhat limited by the sample sizes.(ABSTRACT TRUNCATED AT 250 WORDS)
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Octomyomermis troglodytis was found infecting Aedes sierrensis larvae in 14.5% of 165 tree holes sampled between 1982 and 1986. Mermithid infections were detected in tree hole waters that ranged in pH from 6.5 to 9.3 and electrical conductivities between 0.10 and 5.11 mmhos/cm. Third and fourth instar larvae were most frequently infected, and most immatures that succumbed to infections died while in the fourth instar. Most hosts contained only one nematode. Infected adults were obtained from emergence traps over tree holes, from field-collected immatures reared in the laboratory, and from mosquito collections from sentinel humans. Octomyomermis troglodytis escaped from adults into water vials in the laboratory, suggesting that infected adult mosquitoes serve as dispersal agents for this parasite.
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Thirty-nine patients with acute pancreatitis have been assessed using a prognostic factor grading system, abdominal ultrasound, and autologous leukocyte imaging. Both prognostic factor grading and leukocyte imaging can accurately assess the severity of the disease early in its course. All patients with a negative indium-labeled leukocyte image recovered without sequelae, whereas five of the 12 patients with a positive image developed complications, including two deaths. Abdominal ultrasound is of no value in assessing severity, but is a useful method of detecting those patients with gallstone-associated disease. In patients with suspected abscess formation following acute pancreatitis, indium leukocyte imaging does not differentiate between fat necrosis and abscess formation. In this situation, computerized tomography should be carried out before laparotomy is undertaken.
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