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Biomedical subjects

J R Thompson

Publications and source records attributed to J R Thompson.

At least 343 records · Page 19Linked to original sources
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Actinomycetoma masquerading as an abdominal neoplasm.

Despite the fact that infection accompanying actinomycotic organisms is relatively rare, the possibility of such infection should be kept in mind because the organism is known to be commensal in the oral cavity, lungs, and intestinal tract. Abdominal lesions may mimic a neoplasm in many ways--physical findings, clinical course, and roentgenographic changes. Since the bacterium is anaerobic and difficult to grow on culture, one may have to rely on histologic confirmation for diagnosis. The infection can usually be eradicated by large doses of antibiotic (penicillin) over an extended period of time.

Abdominal Neoplasms↗
PubMedDate not supplied

CBF and CBF/PCO2 reactivity in childhood strangulation.

Four children with self-inflicted strangulation injuries had cerebral blood flow determined by stable xenon computed tomography (XeCTCBF) within 24 hours of admission. All had suffered a severe hypoxic-ischemic cerebral injury; 3 initially had fixed pupils, all were apneic with varying bradyarrhythmias, and the initial mean arterial pH was 7.26 (+/- 0.18). The initial blood glucose values were greater than 300 mg/dl (334 and 351 mg/dl) in the 2 patients who died compared to the 2 who survived (104 and 295 mg/dl). The cardiac index was depressed during the first several days of hospitalization in the 2 patients who died (less than 2.0 L/min/m2) compared to the 2 who survived. Total CBF was normal (63 +/- 8 ml/min/100 gm) and local variations in CBF were present. PCO2 reactivity was determined by hyperventilating the 4 patients for 20 min from an end tidal PCO2 of 39 +/- 3 torr to 29 +/- 1 torr and then repeating the XeCTCBF study. Marked regional variability in the CBF/PCO2 response was observed, ranging from 0.5-5.5 ml/min/100 gm/torr PCO2. In the 2 patients who died, the CBF/PCO2 was decreased (1.2 ml/min/100 gm/torr PCO2) compared to the 2 patients who survived (2.1 ml/min/100 gm/torr PCO2). Although CBF was normal in these 4 children, the hyperventilation response was depressed, variable, and even paradoxical which may be important in the evolution of further brain injury and is a critical factor in deciding whether hyperventilation may be of clinical benefit.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMedDate not supplied

High-resolution proton nuclear magnetic resonance spectroscopy in the detection and quantitation of ethanol in human serum.

A precise, accurate, and nondestructive method for the detection and quantitation of serum ethanol in humans using proton (1H) nuclear magnetic resonance spectroscopy (MRS) was developed. The 1H MRS method was linear within the range of 30-1500 mg/L. The lowest detectable ethanol concentration was 15 mg/L, with 30 mg/L being the lowest level reproducibly quantitated. Within-run and day-to-day coefficients of variation (CV) ranged from 0.6 to 2.7% and 0.5 to 3.5%, respectively. The excellent day-to-day CVs indicate a negligible loss of ethanol due to volatilization during analysis. Fifteen human serum samples found to be negative for ethanol by headspace gas chromatography (HSGC) had no ethanol as detected by 1H MRS. Twenty-eight human serum samples with ethanol concentrations (determined by HSGC) ranging from 370 to 4440 mg/L were accurately reproduced by 1H MRS. The 1H MRS method required no pretreatment and was nondestructive, thereby allowing for further analysis by confirmatory methods.

Ethanol↗
PubMedDate not supplied

Computed tomography of local complications of temporal bone cholesteatomas.

The preoperative temporal bone CT scans of 13 patients with surgically proven acquired cholesteatoma were retrospectively reviewed for bony erosions and for extension beyond the temporal bone. A correlation with the clinical and surgical findings was also carried out. The CT findings are discussed and illustrated as well as some pitfalls in the evaluation of bony erosions. The appearance of "autoantrectomy" caused by a dry, self-cleaning, well ventilated cholesteatoma is also discussed and illustrated.

Adolescent↗
PubMedDate not supplied

Computed tomography of children and adolescents with suspected spinal stenosis.

Spinal stenosis in children and adolescents is a rare condition that should be considered in patients with appropriate clinical signs and symptoms. We describe and discuss four cases of spinal stenosis in children and adolescents diagnosed by CT. In all these cases, CT was beneficial at demonstrating and defining the nature and location of suspected spinal stenosis.

Adolescent↗
PubMedDate not supplied

Xenon-CT cerebral blood flow evaluation of cerebral ischemia in children and young adults.

Xenon-CT cerebral blood flow determinations in 20 children and young adults (age less than 40) who presented with cerebral ischemia were retrospectively reviewed for evidence of unifocal or multifocal ischemic disease. These results were compared with the findings of conventional CT and magnetic resonance (MR) examinations in the same patients. Xenon-CT revealed additional lesions or added significant pathophysiological information in 80% of patients scanned by noncontrast CT, 89% scanned by postcontrast CT, and 58% scanned by MR. Xenon-CT is a useful adjunct to MR and conventional CT in the evaluation of cerebral ischemia in children and young adults.

Adolescent↗
PubMedDate not supplied

A cross-over trial comparing once daily levobunolol with once and twice daily timolol.

The intraocular pressure (IOP) lowering efficacy of once-daily levobunolol 0.5% was compared with timolol 0.5% twice-daily and timolol 0.5% once-daily in 20 chronic open angle glaucoma and 5 ocular hypertensive patients. The design used was a randomised double blind cross-over trial with three periods each of 8 weeks separated by 2 weeks of no treatment. We found that following levobunolol a two week washout was not sufficient for the IOP to return to its original baseline level suggesting that levobunolol is a longer acting drug than timolol. Adjusting for this carryover effect, we found on significant difference in the IOP lowering effect among the three regimes (p = 0.53). Reduced cost, less ocular discomfort and better compliance are the main potential advantages of the once daily treatments.

Adrenergic beta-Antagonists↗
PubMedDate not supplied

Factors affecting treatment compliance in amblyopia.

Amblyopia is the most common form of visual disability in children. Successful treatment by patching depends on compliance, but evidence of factors affecting compliance is limited and contradictory. Because there is a well established relationship between social deprivation and access to health care, we hypothesized that social deprivation might be associated with noncompliance. Data from a historical cohort of 961 children from seven English orthoptic clinics starting treatment for amblyopia in 1983 were used to study factors affecting compliance with amblyopia treatment. Children were classified as noncompliant if they failed to attend all appointments prescribed during the first year of treatment. There was a significant difference in compliance between centers (P = .0001). Overall, children with anisometropic amblyopia were more compliant than those with strabismus but this varied significantly between centers. A relationship between social deprivation and compliance was also found (P = .00001). Only 41% of children from the most deprived wards were compliant compared with 61% in the least deprived wards. Compliance was not found to be related to age at starting treatment.

Amblyopia↗
PubMedDate not supplied

Draconian buyers and Spartan suppliers: the harsh realities of a managed care world.

In this article, authors Robert Hurley, Ph.D.,and Jon Thompson, M.S.P., report results of a survey involving interviews with employee benefits managers. The results are notable in that they reveal purchasers in the process of challenging many of the fundamental assumptions regarding buying medical benefits and the services of medical professionals.

Administrative Personnel↗
PubMedDate not supplied

The bright choroid plexus on MR: CT and pathologic correlation.

Fourteen patients studied with MR imaging were found, incidentally, to have unusually bright, large choroid plexus glomera on T2-weighted sequences. A group of 167 patients was then examined retrospectively for size and intensity of the choroid plexus glomera on T2-weighted images. In the latter group of 167 patients, 66 (39.5%) had bright choroid plexus glomera. Of those who had bright choroid plexus glomera, eight of the 14 initial group and 11 of the 66 patients studied retrospectively had previous CT scans. The typical CT appearance of these bright glomera consisted of nonenhancing central regions of low (but not negative) attenuation with peripheral calcifications in the majority. The remainder showed noncalcified glomera. Fifty-two glomera were obtained at autopsy and examined retrospectively. Eight showed small, variably sized masses with lipid deposits, neuroepithelial microcysts, and peripheral psammoma body calcifications. One patient who died had a bright choroid plexus glomus on MR, and his glomera showed the same pathologic findings. The autopsy findings were believed to be typical pathologically for early xanthogranulomata formation. These early xanthogranulomatous changes appear to be of little clinical significance but must be differentiated from other lesions that can produce bright or enlarged choroid plexus glomera on MR.

Adolescent↗