Biomedical subjects
Publications and source records attributed to K Morris.
In summary, the data suggest that the traditional role of the radiologist as an expert consultant who provides an accurate written report is still the dominant perception. This study emphasizes the importance of development of communication skills and communication standards, with particular emphasis on written data as the single most important factor in keeping a strong clinician referral base.
A twenty year old girl was referred to the surgical out-patients clinic with a history of intermittent epigastric pain and vomiting of five months duration. The patient enjoyed good health prior to this and her past medical history was uneventful. Findings on physical examination included pallor, patchy alopecia and a soft mobile, non-tender mass in the epigastrium and left upper quadrant of the abdomen. When questioned she admitted to a history of trichophagia for as long as she could recall. A provisional diagnosis of gastric trichobezoar was made. Radiological investigations included an abdominal ultrasound which showed a large ill-defined mass lesion with poor transonic features, situated in the upper abdomen and extending from the left upper quadrant across the midline to the liver margin. Barium meal revealed that the greater part of the lumen of stomach was occupied with material of an indeterminate nature. Her haematological investigations showed Haemoglobin 9.5 gm/dl and Leucocyte Count 9.0 x 10(9)/L. Her Urea and Electrolytes were within normal range. At laparotomy a large hair ball extending from the Stomach into the duodenum and proximal jejunum was removed through a vertical gastrotomy incision. The patient had a satisfactory post-operative convalescence and was discharged two weeks later.
Five french (5F) catheters are being widely promoted for use in patients undergoing day case angiography including coronary angiography. Although there are theoretical advantages to this practice there are also potential disadvantages. We reviewed various performance parameters of four different brands of 5F coronary catheter and compared them with performance of the six (6F) and eight french (8F) coronary catheters used in routine coronary angiography. All the 5F catheters performed significantly less satisfactorily than the 6F and 8F catheters. 5F coronary catheters cannot be recommended for routine transfemoral coronary angiography.
1. Rapidly growing broiler chickens fed ad lib. until 56 days, but feed restricted until 60 days of age, had higher arterial oxygen saturations, lower respiratory frequencies, total ventilations that were not different, and higher tidal volumes compared to those fully fed for 56 days. 2. Arterial oxygen saturation correlated negatively with respiratory frequency, but was not related to total ventilation or tidal volume. 3. Hypoventilation appeared not to be the cause of arterial oxygen desaturation. 4. Arterial oxygen desaturation correlated with the degree of right ventricular hypertrophy.
Using an in vitro cochlear preparation from postnatal hamsters, spiral ganglion cells (SGCs) were labeled retrogradely following extracellular injections of HRP into the cochlear nerve. In 24 cochleae from hamsters between postnatal days (P) 0 and 10, the neuronal morphology of 201 SGCs and their peripheral axons were analyzed. From P 0 to 3, labeled SGCs had few distinguishable features. Although SGCs could be traced separately to inner hair cells (IHCs) and outer hair cells (OHCs), they all had roughly bipolar-shaped cell bodies. Approximately half of the labeled SGCs had peripheral axons that spiraled some distance before entering radial fiber bundles. From P 3 to 7, SGCs increased in size by nearly 30% and the number of SGCs with spiraling peripheral axons decreased to near zero. At P 10, the central axon diameter to peripheral axon diameter ratios distinguished two populations of SGCs. The hair-cell innervation patterns of SGCs also changed morphologically as a function of postnatal age. At P 0, radial fiber (RF) terminals of peripheral axons contacted as many as 8 IHCs; by P 3, RFs contacted typically one or two IHCs. The terminal portions of peripheral axons contacting OHCs did not show any appreciable spiral until P 2. By P 5, individual outer spiral fibers (OSFs) had greater spiral lengths underneath row-3 OHCs and the number of OHC contacts was also greatest for row-3 OSFs. These data suggest that SGCs undergo a systematic maturational process. Furthermore, the morphological differentiation of SGCs occurs after they have established separate inner and outer hair cell innervations.
A series of 151 patients with 154 acoustic schwannomas have been operated upon in Manchester Royal Infirmary by a joint Otological and Neurosurgical team, employing either the translabyrinthine or the suboccipital approach. The perioperative mortality rate was 3 per cent. Anatomical preservation of the facial nerve was achieved in 89 per cent of tumour removals and a good to normal functional result in 79 per cent of cases. Attempts at hearing preservation have been unsuccessful, largely because of the small number of patients in the series in whom useful hearing was present preoperatively. Complications included major brain stem ischaemia (1.2 per cent), CSF fistula (5 per cent) and facial dysaesthesia (7 per cent). The incidence of mortality and morbidity is directly related to tumour size and to the experience of the surgeons. A number of patients experienced an unusual type of post-operative dreamlike state which appeared to be a form of hypnagogic hallucination, and the possible neurophysiological mechanism responsible for this phenomenon is discussed. The continuing failure to attain the ideal of early diagnosis is lamented, and the importance of a flexible bidisciplinary surgical approach emphasized.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Some studies suggest that home use of wood-burning stoves is an independent risk factor for lower respiratory tract infection in young children. To test this hypothesis in a population with a high prevalence of wood-burning stove use, we studied Navajo children with diagnosed pneumonia or bronchiolitis. We matched each case (less than or equal to 24 months of age) with a child of identical sex and age who was seen for well-child care or a minor health problem, and we interviewed an adult caretaker about family history and environmental exposures. Analyzing 58 case-control pairs, we found that home wood-burning stove use, recent respiratory illness exposure, family history of asthma, dirt floors, and lack of running water in the home increased the risk of lower respiratory tract infection. On multiple logistic regression analysis, however, only wood-burning stove use and respiratory illness exposure were independently associated with higher risk.
The enteric adenovirus type 40 (strain Dugan) grows well in tissue culture only when the E1B 55K protein of Ad5 or Ad12 is supplied in trans, either constitutively expressed in an established cell line or by coinfection with an appropriate helper virus (V. Mautner, N. Mackay, and V. Steinthorsdottir, 1989, Virology 171, 619-622). The synthesis of Ad40 E1B mRNAs and proteins has been examined under permissive and nonpermissive conditions: At late times postinfection in permissive cells, E1B-specific mRNA species of 22 and 13-14 S are made, as well as 15 and 9 S messages for the late IVa2 and ppIX proteins. None of these are detected before the onset of DNA replication and none of them accumulate in the presence of a cytosine arabinoside block to DNA replication. The failure to detect cytoplasmic mRNAs as early times cannot be attributed to a failure of mRNA transport from the nucleus as there is no accumulation of nuclear E1 RNA. In nonpermissive Hela cells only traces of E1B- and ppIX-specific mRNAs are detectable, at very late times postinfection. Antibodies raised to synthetic oligopeptides corresponding to the N- and C-terminal domains of the putative E1B 19K and 55K proteins show a high titer against the cognate peptide by ELISA, but only the E1B 19K C-terminus-specific sera have detected a unique polypeptide in Ad40-infected cells, at late times postinfection. There is no shut-off of host protein synthesis in permissive cells, despite the expression of Ad2 55K protein.
1. At 6 weeks of age, the time of most rapid body growth, fast growing broiler chickens showed more right ventricular hypertrophy than slower growing chickens. 2. The degree of right ventricular hypertrophy was directly related to blood haematocrit and indirectly related to arterial oxygen saturation (estimated in the chickens using an ear oximeter designed for man). 3. When oxygen saturation was estimated sequentially from 6 to 17 weeks of age, mean oxygenation improved with age, partly due to the death of the chickens with the worst saturations, but also because of an improvement in oxygenation of the survivors.
Explore the source record for details and available documents.
Very fast-growing (VFG) broiler chickens tend to have marked right ventricular hypertrophy when compared with slower growing chickens. We hypothesized that, in the setting of rapid growth, a hypoxic stimulus would cause greater pulmonary hypertension and right ventricular hypertrophy (RVH). We have studied the relationship between artial oxygenation (SaO2), RVH, and pulmonary artery pressure (Ppa) in 28 awake VFG chickens. We found that the hypoxemic chickens had pulmonary hypertension and that the Ppa was linearly related to the SaO2. The relationship between Ppa and RVH, however, was best described by a broken line (p less than 0.05). Thus, at higher pressures, the RVH seemed excessive for a given Ppa. We have also studied the effects of reducing FIO2 on Ppa, systemic pressure, cardiac output, and calculated total pulmonary resistance (TPR) in lightly anesthetized fast-growing and normal chickens. We found that normal chickens and fast growers had similar TPR in room air, but that the fast growers had a greater increase in TPR than did the normal chickens in response to hypoxia (p less than 0.05). Finally, we placed 2-wk-old normal and VFG chicks in a hypobaric chamber set at "10,000 feet" for 2 wk and found that the VFG but not the normal chickens developed marked RVH in response to the hypoxia. However, the RVH in the fast-growing chickens could be prevented by restricting their diet, and hence their growth. We conclude that hypoxemia probably caused the pulmonary hypertension and RVH in the fast-growing chickens, but that the rapid growth appeared to act as an important amplifier of this response.
The growth in the use of small portable analysers outside hospital laboratories has been a cause of concern to laboratory practitioners. This has been partly because of a perceived threat to laboratory careers and partly because of fears that the quality of testing would be poor, with a consequent danger of patients being placed at risk. The evidence in this paper indicates that the use of equipment outside laboratories is still increasing in many areas. Despite the fears which have been expressed, little attention is being given to operator training, service costs, safety and many other aspects; only rarely has responsibility for the quality of results been accepted.
Hypoglycemia may develop in patients with severe untreated malaria and can complicate the course of treatment with parenteral quinine as a result of quinine-induced hyperinsulinemia. Intravenous quinine is used increasingly as the therapy of choice in patients with severe malaria, most of whom are children. To assess the importance of both pretreatment and quinine-related hypoglycemia in children in an area in which the disease is endemic, we prospectively studied 95 Malawian children with falciparum malaria and altered consciousness who were treated with intravenous quinine. Nineteen patients had hypoglycemia before treatment. Seven (37 percent) died, and five of the survivors (26 percent) had neurologic sequelae. The corresponding values for patients who were initially normoglycemic were 4 percent and 4 percent, respectively (P less than 0.0001). Hypoglycemia was associated with low plasma insulin concentrations and with elevated plasma concentrations of lactate, alanine, and 5'-nucleotidase--a finding that suggests that impaired hepatic gluconeogenesis but not hyperinsulinemia contributes to the pathogenesis of pretreatment hypoglycemia. All patients were given quinine dihydrochloride in a 5 percent dextrose infusion, and those with hypoglycemia received 50 percent dextrose. Hypoglycemia recurred in seven of the patients with pretreatment hypoglycemia, but these episodes were also not associated with hyperinsulinemia. Of the 76 children who were initially normoglycemic, none became hypoglycemic during the course of treatment with intravenous quinine. We conclude that hypoglycemia is a frequent complication of falciparum malaria in children and that it reflects severe disease and is associated with a poor prognosis. We did not find it to be a complication of quinine treatment.
Explore the source record for details and available documents.
Explore the source record for details and available documents.