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Biomedical subjects
Publications and source records attributed to L Morris.
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3 patients with histologically proven hepatocellular carcinoma in whom ultrasound demonstrated portal vein thrombosis are presented. Sonography is a simple, noninvasive method of screening patients with primary hepatocellular carcinoma for the presence of portal vein thrombosis.
The case of a neonate with heart failure and myocardial ischaemia due to a large coronary artery fistula is reported. ECG monitoring and Thallium - 201 imaging indicated pre-operative myocardial ischaemia. The diagnosis was confirmed by cardiac catheterization. Successful surgical ligation of the fistula was performed at the age of 10 days and to our knowledge is the first successful ligation in the neonatal period. Follow up Thallium - 201 imaging was normal. Repeat cardiac catheterization demonstrated complete closure of the fistula and normal left ventricular function.
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In 1977, the parents of 1,043 births recorded for 15 to 19 year old women in Fulton County, Georgia, were classified as married. However, only 36 per cent of these births could be linked with marriage certificates. An analysis of the unlinked birth certificates showed that the overwhelming majority of teenage parents did not appear to be legally married. The absence of a specific statement regarding marital status on birth certificates results in inaccuracies in the reporting of births according to marital status of parents.
Since November 1980 we have diagnosed 11 cases of severe autoimmune thrombocytopenic purpura in homosexual men; their mean platelet count (+/- SE) was 16 000 +/- 3000/mm3. All patients have been sexually active with multiple partners and exposed to numerous viruses and drugs. During this period, we also have diagnosed 20 cases of classic autoimmune thrombocytopenic purpura in heterosexual persons, with a normal women to men ratio of 3:1. Eight of nine homosexual patients had elevated platelet IgG compared with normal values in eight of 10 homosexual control subjects having normal hemograms (p less than 0.01). All responded moderately or completely to steroids. The three patients who had splenectomy had excellent responses. Four of five patients had a decreased helper/suppressor T cell ratio compared to healthy controls (p less than 0.001). Circulating immune complexes and total gamma globulin levels were elevated and lymphocytes relatively decreased in homosexual patients compared with homosexual controls (p less than 0.05). Thus, some sexually-active homosexual men seem to have an increased incidence of an immune regulation disorder directed against platelets.
During the 1970s, El Salvador had one of the most active communication programmes for family planning (FP) of any Latin American country. The current study, carried out nationwide among women of reproductive age in El Salvador, indicates that over 90% of women have been reached FP messages via mass or interpersonal channels. Levels of exposure were found to be relatively lower among women who live in rural areas, who work at home or not at all, who have little education, who are not married or live in union, and who are under 19 or over 40. The study was completed at a time of political stability in the country, and these data were to be used as a guideline for designing future communication programmes with respect to content, target population, and channels. With regard to communication research, this study yielded findings which usefully supplement those already recorded through a number of investigations of the subject.
Mononuclear cells from the blood of 26 patients with the 'autoimmune' connective tissue disorder cryptogenic fibrosing alveolitis (CFA) were examined in Chang cell cytotoxicity assays for their capacity to mediate antibody-dependent cell-mediated cytotoxicity (ADCC). The results showed an impairment for the group by comparison with a group of 45 normal healthy controls (P less than 0.01). The impairment was greater in patients with associated connective tissue disorders of other systems (CFA+CT) than in those having the lung disorder alone (lone CFA); (P less than 0.001). The reduction in ADCC showed a correlation with reducing counts of cells bearing Fc gamma G surface receptors (P less than 0.05), and with increasing levels of soluble immune complexes in the blood of these patients by C1q binding (P=0.05). Non-specific esterase staining indicated that the Fc gamma G rosetting cells were subpopulations of lymphocytes not monocytes. We therefore suggest that the observed ADCC impairment may be due to impairment of lymphocyte Fc receptor function, and we speculate that this may influence immune regulation.
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To test the hypothesis that preoperative head computed tomography scans could be used to predict the likelihood that a patient with a supratentorial brain tumor would develop intracranial hypertension during surgery before the cranium was opened, intraoperative intracranial pressure and blood pressure records of 60 patients undergoing craniotomy were compared with the appearance of their preoperative computed tomography scans. The scans were interpreted by a neuroradiologist who was unaware of the clinical events in each case. A positive correlation was found between the amount of preoperative brain edema observed surrounding tumors (on an arbitrary 0 to 3 + scale) and subsequent increases in intracranial pressure greater than base line values. No such correlation could be found with regard to tumor size, shift of midline structures, or effacement of the lateral ventricles. When preoperative brain edema seen on computed tomography scan was taken into consideration, increases in intracranial pressure during craniotomy also correlated with simultaneous increases in blood pressure. It is concluded that patients with large amounts of preoperative brain edema surrounding supratentorial tumors should be considered at risk for developing intraoperative intracranial hypertension and may benefit from preoperative insertion of an intracranial pressure monitor before general anesthesia is induced.
Panama has a high prevalence of contraception, with surgical sterilization being the dominant method. Use of contraception is fairly high even in rural areas. Seventy-one percent of users named a public sector source for their contraception. High use of contraception is part of an overall program of public sector maternal and child health services that also shows substantial penetration of rural areas. The high reliance on public sector sources in panama distinguishes it from other Latin American populations with comparable levels of contraceptive use, such as Sao Paulo state, Brazil, and Costa Rica. These populations also differ in that oral contraceptives are the most prevalent method of contraception. The survey results indicate that the risk of unplanned pregnancy is greatest for unemployed married women who have children. It is particularly important to expand program coverage in rural areas, where two-thirds of those at risk of unplanned pregnancies reside; risk of an unplanned pregnancy for rural women is more than twice that for urban women. While unmarried teenage women do not appear to constitute an important group by this definition, there are other compelling reasons, some supported by other results of the survey, for a special effort oriented toward teenagers. The experience of Panama may be unique in many ways. It shows that an integrated MCH-FP public sector program can meet a high demand for surgical contraception and achieve a fairly high level of contraceptive use. Finally, the results illustrate the value of periodic surveys to gauge the impact of public health programs by monitoring trends in contraceptive use, fertility, breastfeeding, and other aspects of reproductive health.
The 1978 Contraceptive Prevalence Survey for Guatemala provides an opportunity to examine fertility levels and a number of determinants of fertility for three broad segments of the country: the Department of Guatemala and, in the remainder of the country, the Ladino and Indian populations. While Ladinos had a much higher rate of contraceptive use than did Indians, the two groups had similar birth rates. The lack of difference in fertility appears to be due to the pattern of prolonged breastfeeding among Indians and perhaps to differences in the rate of conception due to nutrition, coital frequency, or other factors.
The intrinsic innervation of the anterior two thirds of the tongue in adult dogs of both sexes was studied in paraffin sections stained with Bodian, Holmes, cholinesterase and other stains. In all the sections, a subepithelial plexus of nerve fibres and cells was always seen on the dorsum of the tongue. Nerve endings were seen extending in between the epithelial cells on the dorsum of the tongue. The nerve cells were usually spindle-shaped and collected to form numerous ganglia in the submucosa. There were other ganglia in the tongue whose structure was very much similar to terminal autonomic ganglia. The significance of the ganglia consisting of biopolar nerve cells is being discussed.
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One hundred and twenty-two patients with intrinsic asthma, extrinsic atopic asthma, or asthma with allergic bronchopulmonary aspergillosis were tissue typed for the HLA A, B, and C loci. No associations were found with any of the clinical groups, or with serum total IgE concentrations. Sixty-eight members of 10 families where more than one member was affected by asthma were studied. The segregation of haplotypes in siblings of the propositi who were or were not affected by asthma did not differ from the predicted segregation, and there were no differences when atopy or serum total IgE were considered. No biologically important association between HLA and asthma has been shown.