Opthalmologic effect of ultrasound at diagnostic intensities.
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Biomedical subjects
Publications and source records attributed to K Harris.
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The purpose of this study was to compare the ultrasound appearance of the uterus immediately after the placenta was delivered with the gross and histologic findings obtained by manual exploration and sponge curettage. One hundred thirty-one patients underwent a sonographic assessment of the uterus within 5 minutes of placental delivery. A manual exploration and sponge curettage were performed with 2 minutes of the ultrasound examination, and the specimens were assessed for gross and histologic evidence of retained products of conception. Twenty-four (18.8%) of the patients had documented evidence of retained products of conception either by gross inspection or histologic assessment. Nineteen (15%) of the patients had what appeared to be retained products on ultrasound examination. Using our sonographic description of retained products of conception, the sensitivity, specificity, positive predictive value, and negative predictive value of ultrasound in detecting retained products was 44%, 92%, 58%, and 87%, respectively. The ultrasound findings in patients with retained products of conception were: a normal endometrial cavity in 9 (37.5%), echogenic mass in 6 (25%), heterogenous mixed density mass in 5 (21%), and fluid only in 4 (16.6%). Of the 6 cases with an echogenic mass, all were associated with retained products of conception. The ultrasound appearance of retained products of conception in the immediate time period after placental delivery is highly variable.
Historical, physical, cognitive, and cytogenetic data were documented in 105 heterozygous fragile X [fra(X)] females and 90 controls in a prospective fashion. For comparisons, we divided heterozygotes and controls into those with cognitive impairment (IQ less than 85) and normal IQ (IQ greater than or equal to 85). The only finding that was significantly more frequent in impaired heterozygotes compared with impaired controls chi 2 analysis was shyness. Features that were more frequent in normal IQ heterozygotes compared with normal controls were voluntary thumb dislocation and hyperextensible metacarpal-phalangeal (MP) joints. Comparisons among heterozygotes demonstrated more math problems, hand biting, strabismus, high-arched palate, hyperextensible finger joints, and flat feet in impaired heterozygotes than in normal heterozygotes. Premature menopause was present in 8 of 61 normal heterozygotes and in none of the impaired heterozygotes. A multiple regression analysis demonstrated a significant inverse correlation between the percent fragility and IQ for the heterozygotes as a group. However, no correlation existed between IQ and fragility when the percent fragility was 2% or greater. However, a higher percentage of fragility was positively correlated with the total number of physical findings present.
In three experiments with nondysarthric agrammatics, we explored the association between phonology and morphosyntax. (1) Contrasting phonological and nonphonological factors on inflectional-affix production of English verbs across three tasks in eight agrammatics, longer stem-syllabic length and stem-final-CC status resulted in poorer affix-production. (2) Studying verb inflections in six agrammatic Spanish-speakers, affix-length and affix-stress correlated with poorer repetition, as did low affix frequency. (3) Four English-speaking agrammatics read aloud and repeated derived words varying in syllable-length and stem-stress reassignment; both contributed independently to word-production difficulty. Phonological complexity of affixes and stems appears to reduce resources for morphological processing in nondysarthric agrammatics.
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The seroprevalence of hepatitis C virus was evaluated in blood donors and antenatal clinic attenders in Kumasi, Ghana and seropositive subjects were tested for hepatitis C virus ribonucleic acid by the polymerase chain reaction (PCR). The overall seroprevalence among Ghanaians was 2.8% but there was a significantly higher prevalence in males (4.6%) than in females (1.0%). No risk factor for infection was identified by a questionnaire. Among those who showed evidence of active infection with a positive PCR, the most common genotype was type 2 but the subtype could not be specifically determined; these type 2 hepatitis C viruses may be indigenous to Africa.
In the United Kingdom, as elsewhere, mental health services are becoming increasingly aware that existing services may not meet the needs of different minority groups. This paper outlines the model used to set up a project focusing specifically on refugee mental health needs in Waltham Forest, in north-east London. Funding was available for one sole mental health worker and careful consideration was therefore given as to how her time should be used. A thorough needs assessment of refugees living in Waltham Forest determined that the provision of therapy or counselling alone would not be the most appropriate means of addressing refugees' needs. The intervention model developed therefore included awareness raising and community mobilization, in addition to one-to-one clinical sessions. The empowerment, training and support of refugee community groups became a central part of the work, which helped to establish and then consolidate links between mainstream services and individual refugees.
Quantitative proton MR spectroscopy (MRS) and proton-decoupled phosphorus MRS were applied in the parietal cortex of 13 schizophrenic subjects (11 drug-treated and 2 neuroleptic-naive) and 15 normal control subjects. Significantly increased concentrations of glycerophosphorylcholine (1.18 +/- 0.16 vs. 0.93 +/- 0.14 mmol/kg brain; p < 0.001), glycerophosphoethanolomine (0.70 +/- 0.19 vs. 0.59 +/- 0.07 mmol/kg; p < 0.04), and phosphocreatine (3.73 +/- 0.39 vs. 3.41 +/- 0.13 mmol/kg; p < 0.007), but no differences in N-acetylaspartate, total creatine, or myo-inositol, were determined in treated schizophrenic subjects. Identical abnormalities were found in two neuroleptic-naive patients. These results provide new evidence of disordered cerebral membrane and high energy phosphate metabolism in schizophrenia.
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The physiologic effects of 12-hour lung preservation were assessed in six mongrel dogs studied for 20 hours after double-lung allograft implantation. Donor animals were pretreated with allopurinol (30 mg/kg) and methylprednisolone (500 mg) intravenously at anesthesia induction. Heart-lung blocks were harvested after cardioplegic arrest, and a simple pulmonary artery flush of 4 degrees C modified Collins' solution was administered at 15 ml/kg/min. The lungs were ventilated with 100% nitrogen during flushing and inflation. Recipient animals received an infusion of deferoxamine (20 mg/kg) during implantation and were pretreated with methylprednisolone (500 mg) intravenously. All six implantations were technically successful. Two animals died of cardiac standstill 12 and 24 hours postoperatively. Gas exchange deteriorated after implantation compared with donor levels but remained in a range compatible with survival, and at 20 hours arterial oxygen tension (FiO2 0.4) was 138 +/- 91 mm Hg. Similar changes were seen in alveolar-arterial oxygen gradients and arterial-alveolar oxygen tension fraction. Elimination of carbon dioxide was satisfactory. Pulmonary venous shunt fraction rose significantly at the end of the study. Hemodynamic changes consisted of a gradual increase in pulmonary vascular resistance and a reduction in cardiac output. Lung mechanics also deteriorated, with a gradual rise in airway resistance and a fall in compliance. The double-lung model allows detailed assessment of the early effects of preservation and may have certain advantages over heart-lung models of preservation. The preservation technique warrants further study.