Biomedical subjects
Publications and source records attributed to M B Harris.
Abdominal pregnancy is an uncommon occurrence, and diagnosis by conventional means is often difficult. A case is presented in which a 29-week viable abdominal pregnancy was diagnosed by magnetic resonance imaging.
A cardiovascular health education curriculum was designed and pilot-tested with 218 fifth grade students from rural New Mexico. The program incorporated materials, examples, and exercises relevant to the Navajo and Pueblo American Indian and Hispanic cultures of the students. Significant increases in knowledge about the cardiovascular system, exercise, nutrition and obesity, tobacco use, and habit change were found, suggesting a culturally oriented program may help promote a healthy lifestyle in minority group children.
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gamma-Glutamyltranspeptidase (GGT) activity (per mg protein) in blood lymphoid cells of 27 children with acute lymphoblastic leukemia (ALL) (1.05 +/- 0.15) was significantly below that of controls (2.25 +/- 0.30), became normalized during chemotherapy-induced remission (2.47 +/- 0.26), and was low again (1.59 +/- 0.62) in relapsed subjects. Individual variations in the GGT activity of the blood lymphoid cell fraction (per mg protein) bore a significant inverse correlation to the number of white blood cells (WBC) as well as of blasts per ml blood. Blasts had minimal GGT activity; however, partial GGT deficiency was also exhibited by the microscopically normal circulatory lymphocytes of several patients prior to treatment and in relapsed subjects whose blood was still devoid of blasts. Significantly diminished GGT activity (per mg protein) was found in the blood granulocytes of ALL subjects. This deficit, restored during remission and present again at relapse, varied in magnitude but showed no statistically significant correlation to the different patients' degree of neutropenia. In about one-third of the newly diagnosed or relapsed pre-B ALL children, the circulatory granulocytes' GGT activity was only 10-20% of normal. The results suggest that 1) the presence or absence of this sign of functional maldifferentiation in granulocytes is a factor in the heterogeneity of disease manifestation among subjects with apparently the same type of ALL and that 2) measurement of GGT in the circulatory granulocytes, as well lymphocytes, may be useful for monitoring the efficacy of chemotherapy.
The activity of thymidine kinase (TK) and the proportion of its isozymes (TK1/TK2) were studied in peripheral lymphoid cells of 37 children with acute lymphocytic leukemia (ALL). The high TK in 25 untreated subjects (31.5 +/- 8.9) decreased during chemotherapy-induced remission to uniformly low (5.3 +/- 0.4) normal values, and rose again during relapse to a mean of (24.8 +/- 8.1). The proportion of isozyme 1 followed the same pattern but TK was a more sensitive indicator of disease state. The lymphocyte fractions' TK (per mg protein) correlated with the number (per ml blood) of WBCs, blasts and lymphocytes. Although the higher TK of blasts than of apparently normal lymphocytes was confirmed in cases permitting clean physical separation, the lymphocyte fraction of several untreated subjects with minimal blast counts also exhibited elevated TK. Moreover, this elevation was also seen in relapsed cases even if their blood (unlike bone marrow) was devoid of blasts. The results indicate that quantification of TK can reveal a subpopulation of maldifferentiated lymphocytes which are microscopically normal and that it may provide an objective parameter of prognostic differences between ALL subjects with similar hematological characteristics.
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In a review of 432 children with newly diagnosed acute lymphoblastic leukemia (ALL), we identified a new nonrandom translocation, tdic(9;12)(p1?1;p1?2), in the leukemic marrow cells of eight patients. Seven had hypodiploid karyotypes that lacked chromosomes 9 and 12 and contained a der(12), tdic(9;12); the eighth had a pseudodiploid karyotype with two normal 9 chromosomes, one normal 12 and the der(12), tdic(9;12). Abnormalities involving chromosomes other than 9 and 12 were noted in four of the eight patients. All cells with the tdic(9;12) expressed both the common ALL antigen and HLA-DR. Cytoplasmic immunoglobulin, a marker of pre-B ALL, was detected in one case with the tdic(9;12) but was absent in the other seven. Our results suggest that the tdic(9;12)(p1?1;p1?2) rearrangement is specifically associated with leukemic B cell precursors.
Five families with concurrent von Willebrand's disease (VWD) and classic hemophilia (hemophilia A) are described. Three were ascertained through women undergoing hemophilia carrier testing, one through an obligate carrier who also has VWD, and one through the affected father of a hemophiliac. The VWD probands exhibited Type I VWD with reduced Factor VIII-related antigen (VIIIR:Ag) and/or von Willebrand factor on more than one occasion, normal VIIIR:Ag on crossed immunoelectrophoresis, and mild symptoms. No male had both disorders, but two obligate hemophilia carriers also had VWD. Neither was detectable as a carrier by discriminant analysis. Four possible carriers of hemophilia had VWD and would also be classified as noncarriers statistically. These findings suggest that the presence of VWD may invalidate hemophilia carrier testing by conventional methods. The independent entry into the family of the two genes by mating of a hemophilia carrier and a VWD male is documented in two cases and probable in two. The observed frequency of such matings supports the hypothesis that VWD is a common disorder.
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A 15-yr-old male hemophiliac developed the acquired immune deficiency syndrome (AIDS). His terminal illness was characterized by rapidly progressive respiratory failure with intermittent wheezing, nonresponsive to bronchodilator and steroid therapy. Postmortem examination revealed a pseudomembrane covering the mucosa of the lower trachea and bronchi of both lungs. This pseudomembrane was composed predominantly of fungal hyphae speciated as Aspergillus niger. There was widespread transmural necrotizing bronchitis and fungal invasion that extended to involve a narrow zone of peribronchial tissues. The intervening lung parenchyma was free of fungal disease. This unique form of bronchitis is a distinct variant of invasive aspergillosis and merits recognition because of its clinical and prognostic implications.
Unlike previous studies that examined specialized populations or were completed some years ago, this survey collected information from a cross-section of patients who were currently receiving various kinds of dental treatment. Although the study disclosed that patients' preferences and perceptions of dentists' performance might vary within and between demographic groups, a more important finding was that, in general, most patients in all demographic groups held common beliefs about how they would like to be treated by their dentists. However, according to the reports of these patients, the dentists did not always behave in ways that were congruent with the patients' preferences. The study showed that patients are sensitive to dentists' behaviors. It should also be noted that dentists are sensitive to patients' behaviors and that dentist-patient relationships may be a source of stress for both patients and dentists. Nevertheless, the responsibility for setting the tone of these relationships rests primarily with the dentist rather than with the patient. Therefore, it is important for dentists to be aware of the needs and preferences of their patients so that they can act in ways that will make patients comfortable and dental treatment a positive experience. The potential that appears to be inherent in good, satisfying dentist-patient relationships for minimizing patient stress and making dentistry a less stressful profession has yet to be fully realized. Dentistry is a two-way street: whatever benefits the patient should in turn benefit the dentist as well.
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Primary undifferentiated sarcoma of the liver is a rare tumor with survival reliant on total excision of the tumor. The authors report such a tumor, initially nonresectable, in a 7-year-old girl whose tumor was successfully excised following treatment with cisplatin and Adriamycin (doxorubicin). The light and electron microscopic details of this patient's tumor are presented.
We applied quantitative methods of analysis to all blood cultures drawn during the course of treatment in 28 children with Broviac catheters in a central vein. Thirty febrile episodes in 14 of these patients were evaluated. Samples of blood obtained from a peripheral vein and through the central catheter were cultured quantitatively on agar plates and nonquantitatively in standard broth media. Catheters were judged to be a source of septicemia nine times in seven children. In all nine positive catheter samples, the concentration of pathogens was 10 times as great as that observed in the peripheral venous sample. The blood drawn through the Broviac catheter contained greater than or equal to 2000 colony-forming units per milliliter in six cases. Quantitative cultures in two patients with septicemia not attributable to the catheter yielded low colony counts in the catheter sample. Cultures of blood samples drawn through the catheter when a child was well were not helpful in predicting subsequent septicemia. The technique of inoculating blood directly onto agar plates is easily performed and superior to standard broth cultures, because it detected pathogens within 16 hours and identified infections with multiple organisms.
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Male and female Anglo, Hispanic and Native American adolescents from urban and rural areas were given a chance to ask anonymous questions about sex. These questions were then used as the bases for subsequent presentations on sex education. The most popular categories of questions were reproduction, sexuality, and contraception, followed by anatomy, venereal disease, pregnancy, abortion, vocabulary, hygiene, and other diseases. Younger adolescents asked significantly more questions in most categories than older ones. Girls asked significantly more total questions and ones concerning pregnancy, contraception, and anatomy than boys. Students attending rural schools asked more questions about venereal disease than those in urban schools, but no other main effects of urban-rural location were found. There were no ethnic differences found. The adolescents' questions ranged from sophisticated to poignantly ignorant, suggesting that the strategy of adapting sex education sessions to fit the concerns of the specific adolescents involved might be valuable.