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Biomedical subjects

J R MacKenzie

Publications and source records attributed to J R MacKenzie.

At least 37 records · Page 2Linked to original sources
PubMed1989

Intrarenal duplication.

We report the anomaly of intrarenal duplication seen during the course of investigation of urinary tract infection in 6 children. The anomaly and its embryological basis are described.

Child↗
PubMed1989

A prospective study of children with first acute symptomatic E. coli urinary tract infection. Early 99mtechnetium dimercaptosuccinic acid scan appearances.

Between 1985 and 1987 102 children, age 0-14 years, presented with a first acute symptomatic E. coli urinary tract infection. Investigations included early 99mtechnetium dimercaptosuccinic acid (DMSA) scan (which was performed at a median of 27 days), ultrasonography, micturating cysto-urethrography and indirect voiding radionuclide cystography using 99mTc DTPA. Follow-up DMSA scan was carried out after 6 months. Twenty-one of 102 of initial DMSA studies showed diminished uptake of radionuclide and 12 showed cortical scarring. Twenty-nine patients had significant vesicoureteral reflux (VUR). The finding of diminished uptake on the initial scan was significantly associated with fever, systemic upset, length of symptoms and a peripheral blood leucocytosis, (p less than 0.05). In addition the finding was associated with fever and loin pain in the older child. Both diminished uptake and scarring were more common in refluxing kidney units. We propose that, in children with UTI, diminished uptake on early DMSA scan localises infection in the renal parenchyma.

Acute Disease↗
PubMed1989

Physeal widening in children with myelomeningocele.

We report five examples of physeal widening in four children with myelomeningocele. In all cases there was rapid clinical resolution with the use of the patients' normal orthoses and minor limitation of activity, and there was no evidence of early epiphyseal closure or growth disturbance. We suggest that recognition of the pathological process before fracture occurred may explain the rapid return to normal.

Child↗
PubMed1989

The prevalence of peripheral neuropathy in patients with anorexia nervosa.

A prospective, controlled study was conducted to determine the prevalence of peripheral neuropathy (PN) in patients with anorexia nervosa (AN). Fifty-one patients (49 females, 2 males) between the ages of 12 and 47 (means = 22.5) who met the criteria for AN of the Diagnostic and Statistical Manual of Mental Disorders, Third Edition, were randomly selected from an inpatient eating disorders unit during 15 months. Fifty healthy volunteers (41 females, 9 males) between the ages of 17 and 50 (means = 26.5) served as controls. After a neurologic history, all patients were evaluated by physical examination and standardized electrodiagnostic testing. Chi-square contingency testing was used to assess data. Four study group patients (8%) had electrodiagnostic evidence of a sensorimotor PN compared with none in the control group. This is approaching statistical significance (p = 0.13). Three of four patients with AN for at least ten years were among those with PN. The prevalence of subjective symptoms among the study group (65%) as compared to the control group (4%) was of marked significance (p = 5.62 x 10(-10]. In addition, three anorexic patients were found to have an isolated peroneal nerve palsy. We conclude that PN is a notable complication of AN, particularly in long-standing cases. The PN is most likely a product of chronic malnutrition rather than a specific nutrient deficiency. Patients with AN also appear to be at increased risk for developing localized compression neuropathies secondary to subcutaneous tissue loss.

Adolescent↗
PubMed1989

Anatomic observations in carpal tunnel syndrome as they relate to the tethered median nerve stress test.

The Tethered Median Nerve Stress Test (TMNST) has proved to be a reliable clinical tool in the diagnosis of chronic, low-grade carpal tunnel syndrome (CTS). The TMNST consists of hyperextending the index finger at the distal interphalangeal joint with the wrist maintained in a supinated position. Proximal volar forearm pain radiation is experienced by patients with chronic CTS during this maneuver. This investigation shows that significant distal excursion of the median nerve occurs with hyperextension of the index finger and to a greater degree than with hyperextension of the adjacent digits. Pain experienced during the TMNST appears to be vascular in origin and its severity is directly related to the duration of testing. This finding emphasizes the important role of ischemia in chronic entrapment neuropathies.

Adult↗
PubMed1987

Renal scarring secondary to vesicoureteric reflux. Critical assessment and new grading.

One hundred and fifty children with proven urinary tract infection who were assessed by renal ultrasound (U/S), intravenous urography (IVU) and dimercaptosuccinic acid (99mTc DMSA) scan, were studied to identify the sensitivity of each examination and the pick-up rate of renal scarring secondary to vesicoureteric reflux. Sixty-three of these children who had the examinations carried out within a 6-month period were assessed in detail. A DMSA scan is the most accurate method of detecting early renal scars in the young age group (0-2 and 2-5 years), followed by ultrasound. The examinations are equally sensitive over the age of 5. A new grading system of the severity of renal scarring is presented.

Adolescent↗
PubMed1987

Serial quantitative 99mTc DTPA imaging in CMV-associated renal allograft dysfunction.

Two cases of cytomegalovirus associated renal allograft dysfunction were monitored by serial 99mTc DTPA imaging and cytomegalovirus specific fluorescent antibody tests. One case of primary cytomegalovirus disease associated with pneumonitis, hepatitis and pyrexia occurred 25 days after transplantation. The second case, due to cytomegalovirus reactivation/reinfection had fewer symptoms and occurred 78 days following transplantation. 99mTc DTPA perfusion index at the height of the cytomegalovirus associated illness remained unaltered in both cases, and did not suggest the presence of acute rejection. This non-reactive response was associated with a rapid return of graft function. The combined use of these rapid diagnostic tests during suspected rejection episodes may be useful in indicating cytomegalovirus associated allograft dysfunction and preventing the addition of further potentially harmful immunosuppressants.

Antibodies, Viral↗
PubMed1983

Positioning of umbilical arterial catheters with ultrasound.

Fifty six infants were studied by ultrasound, 22 during the placement of the umbilical artery catheter. The descending aorta, bifurcation, common iliac arteries, and the intra-arterial catheter could be clearly seen. We recommend that the catheter tip be placed 5-10 mm above the aortic bifurcation thus avoiding the major branches of descending aorta.

Aorta, Abdominal↗
PubMed1982

Leukocytosis in peritoneal lavage effluent after selected abdominal organ injury in an experimental model.

Elevation of the corrected leukocyte count (Cwbc) in peritoneal lavage effluent has been reported by us in association with colon perforation. We have extended this study in order to investigate systematically the nature of the stimuli to, and the timing, magnitude, and consistency of this response in the presence of other occult abdominal injuries associated with trauma. This has been done by subjecting an anesthetized canine model to a variety of isolated intra-abdominal injuries and then measuring sequential peritoneal lavage leukocyte counts up to six hours after injury. A rising lavage leukocyte count gave Cwbc-positive lavages in 94% of animals with jejunal, ileal, and colonic wounds by six hours. In animals with isolated peritoneal penetration alone, or simple liver or spleen wounds, an elevated Cwbc count was unusual. In stomach, gallbladder, and urinary bladder perforation, a positive lavage was an inconsistent finding. Peritoneal lavage leukocyte counts corrected on the basis of red cell count can enhance the accuracy and utility of lavage for abdominal trauma, especially when gastrointestinal perforation is present as an isolated injury, by detecting an early peritoneal inflammatory response which appears independently from simple hemorrhage. [Mueller GL, Burney RE, MacKenzie JR: Leukocytosis in peritoneal lavage effluent after selected abdominal organ injury in an experimental model.

Abdominal Injuries↗
PubMed1982

Are ligand assay methods specific for cobalamin? A survey report.

To determine whether or not laboratories participating in the ligand assay survey of the College of American Pathologists can measure cobalamin (vitamin B-12) in the presence of cobalamin analogues, either cobalamin or cobinamide (a model for the non-physiological analogues of cobalamin) was added to pooled human serum, and aliquots of the various samples were submitted to the participants. Nine hundred and nineteen results that represented 13 commercially available methods were analyzed. For a sample containing 412 pg/mL. of cobalamin, the mean interference produced by 400 pg/mL of cobinamide, expressed as the apparent increase in the cobalamin concentration, was 26.5 pg/mL with a range of 18 to 42 pg/mL. The mean recovery of added cobalamin was 104% of the expected value.

Humans↗
PubMedDate not supplied

Indications for aortography. Radiography after blunt chest trauma: a reassessment of the radiographic findings associated with traumatic rupture of the aorta.

Indications for aortography in truncal trauma patients have expanded as reports of radiographic findings associated with traumatic rupture of the aorta (TRA) have proliferated. By studying to what extent these findings also occurred in trauma patients without TRA, we determined the utility of these findings in selecting patients for aortography. The detection of nine radiographic findings associated with TRA was tabulated in 173 patients undergoing arch aortography to rule out TRA from 1975 to 1980. Twenty-five of these had TRA. All patients with TRA under age 65 had a widened mediastinum (WM); this was the only finding that taken alone correlated significantly with TRA (P = 0.001). Only two of six patients with TRA over 65 had a WM. Other findings such as hemothorax, fracture of ribs 1 or 2, pulmonary contusion, or multiple rib fracture were more likely to be found in patients without TRA. Formal radiographic interpretation by staff radiologists detected more radiographic abnormalities than physicians caring for the patient emergencly, who had access to a junior radiology resident. However, these physicians were as successful as staff radiologists in detecting WM when it was associated with TRA. A widened mediastinum is the best single criterion for aortography in young trauma patients; all elderly persons with severe truncal trauma should probably have aortography even in the absence of mediastinal widening. Radiologic consultation is important for complete detection of thoracic pathology in trauma patients, but in this study late interpretation of more subtle findings did not detect additional patients with TRA.

Adolescent↗