New medical tool for submarine corpsmen: computer ready for sea trials.
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Biomedical subjects
Publications and source records attributed to K Robinson.
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A child with amebic colitis, liver abscess and hepatitis A is reported. Speculation as to why these two infectious agents have rarely been associated is presented. Diagnosis of hepatitis was not suspected in this case until physicians caring for the patient developed clinical hepatitis. The importance of suspecting hepatitis A in all patients with unexplained liver enzyme elevations is stressed.
A nosocomial outbreak of hepatitis A occurred after hospitalization of a 21-month-old girl with amebic liver abscess and unsuspected, anicteric hepatitis A. The index patient, who had an acute diarrheal illness prior to enzyme elevations, seroconverted from IgM hepatitis A antibody to IgG hepatitis A antibody. Of the 103 hospital personnel with known or potential exposure, three physicians (2.9%) contracted clinical hepatitis A, 27 to 29 days after their initial contact with the source patient. A fourth physician developed subclinical infection. Two of the three clinical cases occurred in two of the three primary care physicians of the source patient. Hepatitis A should be considered in any patient with acute, unexplained liver enzyme abnormalities. Diarrhea occurring in a fecally incontinent child incubating hepatitis A may increase the risk of transmission.
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The properties of a new cell line derived from a human retroperitoneal liposarcoma are described. The cells do not grow at low cell concentrations and contain in their cytoplasm large numbers of droplets that stain with Oil Red O. No indication of the presence of endogenous virus particles could be found. The mean chromosome number per cell is 36, with several constant markers, the most conspicuous of which is a large submetacentric marker due to a translocation between chromosomes 4 and 11, which is present in every cell. The liposarcoma cells show an enhanced uptake of [14C]acetate compared to normal human fibroblasts.
Post-heparin lipoprotein lipase (PH-LPL)-high density lipoprotein cholesterol (HDL-C) interrrelationships were assessed in 9 subjects with documented familial hyperalphalipoproteinemia (FHA) and in 8 controls to focus on potential biochemical etiologies of FHA and relationships of HDL-C to triglyceride hydrolysis and PH-LPL. FHA subjects had mean HDL-C and HDL2-C levels > twice controls; their PH-LPL levels (mean +/- SEM) (3.14 +/- 2.3 mumol FFA/h/ml) were also > twice that of controls (15.0 +/- 1.6) (P < 0.01), but post-heparin hepatic lipase levels (PH-HL) in the FHA and control subjects did not differ (18.1 +/- 1.6 vs 26.6 +/- 4.3, P > 0.1). For all subjects (FHA and controls) PH-LPL was positively correlated with HDL-C (r = 0.79, P < 0.01) and with HDL2-C (r = 0.90, P < 0.01), but not with HDL3-C (r = --0.02). There were no significant PH-HL and HDL-C interrelationships, P > 0.1. The amount of apo CII (the primary activator of PH-LPL) in HDL2 was greater in the FHA (mean +/- SEM) (16.1 +/- 2.5 microgram/ml plasma) than in control subjects (4.7 +/- 0.9, P < 0.01). There were strong positive correlations between HDL2 apo CII and both PH-LPL (r = 0.79, P < 0.01) and HDL2-C (r = 0.80, P < 0.01). Apo CII as a percentage of HDL2 protein was higher in FHA than control subjects (mean +/- SEM) (1.2 +/- 0.3% vs 0.5 +/- 0.2%, P < 0.01). Apo CII as a percentage of HDL3 protein was similar in FHA and control subjects. We postulate that increased turnover rate of triglyceride-rich lipoproteins due to high LPL activity may be an important factor leading to the elevation of HDL-C in FHA. The highly significant positive correlation between HDL2-C and PH-LPL provides strong clinical evidence for the theory that HDL2 is formed during the hydrolysis of triglycceride-rich lipoproteins. The high concentration of HDL2 apo CII in FHA subjects may be caused by increased catabolism of triglyceride-rich lipoproteins in the presence of high endothelial LPL, with transfer of apo CII from very low to high density lipoproteins.
Auditory evoked potentials, both early and middle components, were recorded from 227 patients with a variety of conditions including multiple sclerosis, brain stem vascular disease, intracranial tumours and Arnold-Chiari malformation. Abnormalities were found in a substantial proportion of patients with definite multiple sclerosis and a smaller proportion of those in the less definite clinical categories of this condition. There was a high correlation between clinical evidence of brain stem involvement and an abnormal auditory evoked potential in multiple sclerosis. Abnormalities were also found in a few patients presenting with an isolated episode of central nervous system dysfunction involving the brain stem. The auditory evoked potential was abnormal in other patients with known diagnoses including half of those with Arnold-Chiari malformation. Tumours involving the brain stem caused abnormalities of the brain stem evoked potentials in some cases and more frequently distortion of the middle components. The specificity of these auditory evoked potential abnormalities to multiple slcerosis is discussed.
The elimination of artefact during the preparation of cell cultures for scanning electron microscopy is difficult. Collapse of cellular projections, cytoplasmic cracks, perforations and fracturing of cell-cell processes and cell-substrate attachments occur during fixation, dehydration and critical point drying. Coating and storage may cause further artefact. A specimen holder which serves to minimize turbulence in the critical point dryer and which allows for the simultaneous processing of up to five coverslips, as well as a reproducible technique for the preparation of cell cultures are described.
Four benzodiazepine radioimmunoassays are described, the most sensitive of which can detect sub-therapeutic levels of bromazepam, chlordiazepoxide, clobazam, demoxepam, desalkylflurazepam, desmethyldiazepam, diazepam, flunitrazepam, lorazepam, medazepam, nitrazepam, oxazepam, prazepam, temazepam and triazolam. The standard curve for diazepam has a concentration range of 0-2.5 ng ml-1. The assay is particularly applicable to blood samples of forensic interest that may be haemolysed or decomposing. A 75 microliter sample is required. The antiserum and [3H]flunitrazepam used are commercially available.
The management of vascular amputees in the Roehampton Limb Surgery Unit since its opening in 1975 is outlined and the results in 167 cases presented. Of the 35 patients over the age of 80, 57% were walking independently at the time of their discharge from the unit.
When total protein in very low density lipoprotein samples is measured by the method of Lowry et al. (1951. J. Biol. Chem 193:265-275), turbidity remains in the final color reaction. Addition of 0.1 ml of 2.5% (v/v) solution of Triton X-100 removes this turbidity immediately and effectively. This simple modification is faster, less cumbersome, and more economical than removing turbidity with ethyl ether or chloroform. Addition of 0.1 ml of 2.5% (w/v) sodium dodecyl sulfate to the final reaction mixture is also effective in removing turbidity and can be used as an alternative method.
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Sequential records of the early and middle components of the auditory evoked potential in response to a click stimulus have been obtained over a period of 2.5 years in normal subjects and in patients with multiple sclerosis. The latencies of all the components were highly consistent in the control subjects and in the patients who were clinically stable throughout the period of study. In constrast, in some of the patients who had clinical relapses during the study there was variation in the latency and amplitude of some of the components. The significance of this variation is discussed and the poor correlation between the sites of the new lesions as determined clinically and the auditory evoked potential variability is emphasised.
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Fascia obtained from the abdominal wall of a rat was transplanted to the oral cavity of five dogs as a graft material for vestibular extension. In all five dogs the grafted fascia remained in place as the surgical defects were covered with epithelium, which transpired within a period of 4 weeks. After 6 months, the vestibular depth was increased significantly and the vestibule was smooth and regular.
Nonhealing palatal ulcerations in two white male patients, one 50 and another 58 years of age, were clinically suspected of being malignant, even after the initial biopsies were negative. Second biopsies in each case confirmed the original opinions, but the lesions were diagnosed specifically as "necrotizing sialometaplasia". This is an interesting condition of uncertain etiology that can mimic cancer, both clinically and microscopically. The condition heals spontaneously. It should be considered in a differential diagnosis of suspicious lesions of the palate.
Fifteen components of the auditory evoked potential can be recorded within 300 ms of a click stimulus and these can be classified by latency in early (0-8 ms), middle (8-60 ms) and late (greater than 60 ms) components. Follwing a click stimulus of high intensity these components have been studied in 45 normal subjects and in 88 patients with definite multiple sclerosis. Component V, thought to arise from brain-stem structures, was the most consistently abnormal in patients and there was a correlation between the abnormalities and clinical evidence of a brain-stem lesion. Thus in 79 per cent of patients with definite evidence of a brain-stem lesion and in 51 per cent of those without clinical signs related to the brain-stem, component V was abnormal. Abnormalities were also detected for components Pa, Nb and P1 of the middle components, and in 12 per cent of these the early components were normal. The late components were normal in all but 3 patients. Evidence is presented to show that pairs of click stimuli, 5 ms apart, presented at a fast stimulus rate, stress the auditory system in normal subjects. Using this technique abnormalities of component V in patients became more marked and the proportion of abnormalities detected was increased. The contribution of the reflex muscle responses to the click to the middle components of the auditory evoked potential has also been studied. It is concluded that components Pa, Nb and P1 are independent of these reflexes.