Biomedical subjects
Publications and source records attributed to J T Morris.
We have presented a case of M chelonei subsp abscessus in an immunocompromised patient. The patient was given antimicrobial therapy, to which the organism appeared sensitive for 4 weeks, but he died because of other medical problems. Repeated negative blood cultures for mycobacteria after the initiation of therapy and a careful postmortem examination suggested that the antimicrobial therapy was effective.
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Pulmonary tuberculosis is found predominantly in the lung apices. In diabetics it has been suggested that tuberculosis tended to occur predominantly in the lower lobes. A retrospective chart review was performed of all patients with a diagnosis of diabetes and pulmonary tuberculosis admitted to a health care facility to determine the presenting chest roentgenographic location of tuberculosis. Multiple lobe involvement was the predominant chest roentgenographic finding in both diabetics and nondiabetics with pulmonary tuberculosis. Since tuberculosis and diabetes frequently coexist in the population at risk for tuberculosis, clinicians should suspect tuberculosis in the diabetic with an abnormality on chest roentgenogram. Aggressive diagnostic measures and specific chemotherapy should be given and monitored to treat pulmonary tuberculosis.
Drug-resistant tuberculosis was found in 21 percent of homeless individuals in New York City between 1982 and 1987. To see if this relationship existed in south Texas, we evaluated all admissions to a Texas Health Department facility with culture-proven tuberculosis. Four hundred forty-three patients were admitted between September 1987 and October 1990. Twenty-six, (5.9 percent) of these patients were identified as homeless. Alcoholism, tobacco abuse, divorce, and unemployment were common demographic characteristics. Six male patients and one female patient (27 percent) had Mycobacterium tuberculosis resistant to one or more antituberculosis drugs. Five were Hispanic, one was white, and one was black. The six male patients had resistance to only one drug, either rifampin or ethambutol. The female patient had resistance to streptomycin, isoniazid, and rifampin. These findings illustrate that drug-resistant tuberculosis exists among homeless individuals in south Texas. As the number of homeless people increases, physicians need to recognize that pulmonary tuberculosis is a frequent infection in this population and that the causal mycobacteria may well be resistant to one or more antituberculosis agents.
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Higher pressure, up to several hundred pascal relative to ambient, is generated by hygrometric pressurization within the central hollow space of the stem in Spartina alterniflora. Dilution of oxygen and nitrogen by water vapor within the plant's internal gas space results in an influx of nitrogen and oxygen from the air and a net increase in the internal gas pressure at steady state. The nature of the pressure gradient suggests that small pores exist in the plant tissues. Moreover, the compact arrangement of leaf mesophyll cells creates a high resistance for the mass flow of gases and contributes to the higher pressure within leaves. After experimentally venting the internal pressure, outside air diffused through the basal area of the adaxial side of the leaves into the internal space and elevated pressure was restored.
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The accuracy of drawing up insulin was tested in a group of randomly selected insulin requiring diabetics. The mean error between patients of drawing up rapid acting insulin was + 5.6%, of intermediate acting insulin, + 4.9% and of a mixture of rapid and intermediate acting insulin, + 1.8%. There was no correlation in percentage error in drawing up insulin the age of patient, duration of diabetes, dosage of insulin nor quality of diabetic control.
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Use of electrosurgery or laser surgery in the presence of metallic implants has been implicated in generating heat-induced injury to peri-implant bone, with the subsequent loss of osseointegration. Studies involving lasers offer conflicting results, while in the case of the electrosurg, little research has been published supporting or refuting these claims. This study measured local heat effects created by use of a unipolar electrosurgical unit, a bipolar electrosurgical unit, and a neodymium:yttrium-aluminum-garnet (Nd:YAG) laser. Absolute temperature increase was measured during an in vitro uncovering surgical procedure performed with each unit. Analysis of variance for repeated measures was performed. Second, absolute temperature increase for each unit was compared with a theoretical clinical limit of a 10 degrees C increase. The findings suggest that use of the unipolar electrosurgical unit should be avoided, while judicious use of both the bipolar unit or the laser unit should produce temperature profiles well within clinical limits.
Milwaukee brace treatment for patients with idiopathic scoliosis very rarely accomplishes improvement approaching that of successful surgery. Prpgression of small and medium-sized curves (60 degrees or less) has been routinely halted. Few curves progress with adequate brace treatment. Occasionally, improvement in deformity and curve measurement is significant, but loss of improvement seems to be gradual and almost uniformly present to some degree after cessation of treatment. A much longer follow-up period will be necessary if the improvement seen with Milwaukee brace treatment can be considered "permanent." Milwaukee brace treatment is effective in skeletally immature patients with small, flexible and nondeforming curves. Corrective surgery is recommended for deforming curves in all patients for whom permanent improvement is the goal.