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Biomedical subjects

M B Johnson

Publications and source records attributed to M B Johnson.

At least 37 records · Page 2Linked to original sources

Electromyographic response of peroneal muscles in surgical and nonsurgical injured ankles during sudden inversion.

Because the peroneal muscles are thought to act as a safeguard against lateral ankle injury, it is important to study their function. This study was undertaken to electromyographically assess the latency between sudden unexpected ankle inversion and the start of peroneal muscle activity. Three groups participated in the study, including subjects with lateral ankle sprain rehabilitated nonsurgically (N = 7), sprains rehabilitated following surgery (N = 6), and injury-free ankles (N = 11). Peroneal latency was assessed by dropping the subjects into inversion from a special platform. The platform was designed so that either ankle could be inverted to 35 degrees without warning. The ANOVA revealed no significant latency differences (p > .05) between the three groups. The study suggests that bilateral peroneal latency is unaffected by injury. Although it has been thought that healthy muscles provide a defense against ankle sprain, their latency is not permanently affected by ankle injury or by surgery performed to correct defects from injury. It appears that mechanoreceptor impairment may be rehabilitated and that it is not a factor in ankle injury.

Adolescent↗

Hepatic focal nodular hyperplasia: findings with color Doppler sonography.

Color Doppler sonographic images of five patients with a total of six lesions of FNH were reviewed. All cases were confirmed pathologically. All six lesions showed increased intralesional flow in comparison to surrounding liver parenchyma on color Doppler sonography. Four of the six lesions showed significant peripheral flow; two of the six lesions showed central flow radiating peripherally from a central vessel. We conclude that increased color Doppler flow may be a characteristic feature of FNH. Increased internal flow has also been reported in HCC and hepatic metastatic disease. Considerable overlap is seen in color Doppler flow patterns. However, in patients clinically at low risk for malignancy, detection of a liver mass with increased color Doppler flow should suggest the diagnosis of FNH.

Blood Flow Velocity↗

Familial omphalocele: considerations in genetic counseling.

Nonsyndromal omphalocele is generally regarded as a sporadic malformation. Recurrence risk is considered negligible. We report on a patient in whom 5 consecutive pregnancies (by 2 separate nonconsanguineous partners) were complicated by omphalocele as an isolated defect. Neither the patient nor her partners had history of relatives with omphalocele, although the patient's brother and his son had large umbilical hernias requiring repair in infancy. Some familial cases of nonsyndromal omphalocele have been previously reported; most such pedigrees suggest vertical transmission, although there are a few cases with only a single generation involved. In our case, the multigenerational finding of ventral wall hernias makes an autosomal dominant mechanism with variable expressivity a tenable explanation. The collected instances of familial nonsyndromal omphalocele emphasize omphalocele heterogeneity and caution in counseling recurrence risks.

Female↗

Uncomplicated amebic liver abscess: prospective evaluation of percutaneous therapeutic aspiration.

The performance of therapeutic aspiration in the treatment of amebic liver abscess, advocated and practiced in many centers, is controversial. Previously, this practice has been evaluated in retrospective analyses. To test the potential benefit of therapeutic aspiration, the authors undertook a prospective randomized trial in 57 patients admitted for suspected amebic liver abscess during a 15-month period. Sixteen patients were excluded from the trial. The remaining 41 patients were randomly included in one of two study groups to receive amebicidal therapy alone or amebicidal therapy coupled with image-guided percutaneous therapeutic aspiration. All patients in the trial recovered. No statistically significant benefit was demonstrated in the aspiration group for the two objective parameters evaluated: length of hospitalization and duration of time to becoming afebrile. Subjective improvement in symptoms after aspiration was greater in the aspiration group at a marginally statistically significant level. These data do not support the adjunctive performance of percutaneous therapeutic aspiration in the treatment of uncomplicated amebic liver abscess. Amebicidals alone were equally efficacious in treating the group studied.

Humans↗

Budd-Chiari syndrome: detection with color Doppler sonography.

The value of color Doppler sonography in evaluating newly diagnosed Budd-Chiari syndrome in five patients was studied. Hepatic venous findings included absence of vessels (one patient), flow reversal (two patients), narrowing (four patients), and tortuosity (three patients). Detected collaterals included hepatic venous to hepatic venous (four patients), hepatic venous to subcapsular systemic venous (two patients), and portosystemic (three patients). Hepatic venous spectral Doppler waveforms were flat and essentially aphasic in four patients, indicative of distal hepatic venous compression. The inferior vena cava was markedly compressed in two patients and slightly compressed in one. Color Doppler sonography allowed more reliable and confident identification of irregular, compressed, or otherwise abnormal hepatic veins than did conventional sonography. Color Doppler sonography also showed collateral vessels that were undetected with conventional sonography or other imaging techniques. Our results suggest that color Doppler sonography may be a valuable tool in the initial diagnosis and evaluation of suspected Budd-Chiari syndrome.

Budd-Chiari Syndrome↗

A review of overtraining syndrome-recognizing the signs and symptoms.

Overtraining syndrome is common in athletes. It manifests itself with both physiological and psychological symptoms, and can adversely affect an athlete's performance. This article reviews the physiological and psychological signs and symptoms of overtraining syndrome in order to help the athletic trainer recognize the condition. With an understanding of overtraining syndrome, the athletic trainer can better aid coaches and athletes in preventing and treating this phenomenon, and thus maintain the athlete's optimal performance level.

Journal Article↗

Splenic salvage vs splenectomy. Care of the trauma patient.

Because of the incidence of overwhelming postsplenectomy sepsis that occurs after splenectomy, there is an increased incentive to try to salvage the spleen in patients with splenic injury. Even though operative time is increased by this technique, the advantage of immunologic competence is well worth the added operative time. In hemodynamically unstable patients, however, splenectomy remains the method of choice.

Hemostatics↗

Portal venous system after portosystemic shunts or endoscopic sclerotherapy: evaluation with Doppler sonography.

We sought to determine the usefulness of duplex Doppler sonography in the assessment of blood flow and clot formation in the portal vein in 44 patients with portal hypertension and bleeding esophageal varices who had undergone either endoscopic sclerotherapy (28 cases) or portosystemic shunt procedures (16 cases). The main, left, and right portal veins (collectively referred to as intrahepatic portal veins), superior mesenteric vein, splenic vein, and shunt were assessed for flow direction, presence of thrombi, and collaterals. Patent shunts were visualized in 12 (75%) of the 16 cases. Clot was detected in 27 (69%) of 39 intrahepatic portal veins in patients with end-to-side shunts, in six (67%) of nine intrahepatic portal veins in patients with distal splenorenal shunts, and in five (5%) of 92 intrahepatic portal veins in patients who had had endoscopic sclerotherapy. Flow in the main portal vein was hepatopetal in two (15%) of 13 patients with patent shunts (one end-to-side portacaval shunt and one distal splenorenal shunt). Flow in the main portal vein was hepatopetal in 26 (93%) of 28 patients who had had endoscopic sclerotherapy. Our data suggest endoscopic sclerotherapy preserves antegrade portal flow and results in fewer portal vein clots than surgical portosystemic shunts do. Patterns of thrombosis and flow direction vary unpredictably from patient to patient. Shunt patency should not be inferred without direct visualization of the shunt.

Esophageal and Gastric Varices↗

Color Doppler sonographic findings in renal vascular lesions.

Three patients with renal vascular lesions, one congenital arteriovenous (AV) fistula and two renal pseudoaneurysms, were assessed with color Doppler sonography. The AV fistula was detected initially by color Doppler after having been missed by both real-time sonography and computed tomography. High frequency shift blood flow within a hypoechoic lesion noted by color Doppler characterized the AV communication. Both renal pseudoaneurysms had detectable bidirectional swirling blood flow within an anechoic portion of a complex mass. Findings in all three cases were confirmed by angiography or pathology. Color Doppler sonography seems potentially useful in the evaluation of renal vascular pathology.

Adult↗

Color Doppler sonography in hepatocellular carcinoma.

Sixteen patients with hepatocellular carcinoma (HCC) were assessed with color Doppler sonography (CDS) for flow compared to normal hepatic parenchyma. Nine showed moderate increased flow, and two revealed marked increased flow. In most instances, the increased flow was peripheral. Color Doppler was also useful in assessing seven patients with portal vein invasion. In two instances, venous invasion was not detected on preliminary grayscale images. In another patient, hepatic venous invasion was suspected on grayscale images, but was shown to represent extrinsic compression only by color Doppler.

Carcinoma, Hepatocellular↗

Color Doppler sonography of the scrotum.

Color Doppler sonography is a noninvasive, rapidly performed, and relatively inexpensive imaging technique for use in the diagnosis of scrotal pathology. Its major and proven role is in the evaluation of patients with acute scrotal pain, for which it is likely to become the primary imaging modality. Further work is needed to determine whether color Doppler is a useful diagnostic adjunct in evaluating patients with varicoceles and scrotal masses.

Doppler Effect↗

Color Doppler sonography in acute epididymitis and orchitis.

Clinical diagnosis of patients with acute scrotal pain is frequently imperfect. Imaging, using nuclear medicine scintigraphy and hand-held continuous-wave Doppler ultrasound devices, has been used in these patients. We retrospectively analyzed 28 consecutive patients referred for scrotal sonography, all of whom had been imaged using color Doppler sonography. Of 22 patients with confirmed diagnoses, 11 had acute epididymitis/orchitis and 11 had another diagnosis. Ten of 11 patients with acute epididymitis/orchitis had increased epididymal flow. Eight also had increased testicular flow. None of the 11 patients without acute epididymitis/orchitis had increased flow. Our data suggest that color Doppler sonography may be useful in establishing the diagnosis of acute epididymitis/orchitis. This might decrease the need for scrotal exploration. No distinction could be made among scrotal lesions in the nonacute epididymitis/orchitis group. Sensitivity was inadequate to reliably detect flow in normal testicles, a prerequisite to accurately diagnose torsion. Newly improved sensitivity may enhance the utility of color Doppler sonography in assessing patients with acute scrotal pathology.

Acute Disease↗

The holistic paradigm in nursing: the diffusion of an innovation.

Nursing today is affected by challenges to the beliefs and values underlying the delivery of health care services. Results of a bibliometric analysis of the nursing literature since 1966 revealed a process of paradigm change in which a scientific medical model is being replaced by a model based on the concept of holism. Key ideas representing a holistic paradigm of health appear with increasing frequency in the journals of the nursing field, demonstrating the diffusion of a new and different perspective in the practice of nursing.

Bibliometrics↗

The effects of prior exposure to silicone on capsule formation, histology, and pressure.

Investigations into the effects of prior silicone exposure on subsequent capsule formation around silicone implants assume particular relevance in light of the exponential increase in the medical application of polymers such as silicone. The inert nature of silicone has been in question with regard to its effects on the immune system, specifically whether or not it may act as a hapten or antigen. The present study analyzes the effects of prior silicone exposure on subsequent capsule formation, histological consistency, and pressures when an animal is reexposed to a silicone implant. Twelve female Lewis rats (body weight 250 g) were randomly divided into two groups. Group 1 (n = 6) rats were subcutaneously injected with 2.5 ml of Freund's Complete Adjuvant, Group 2 (n = 6) rats were injected with an equal volume of adjuvant sonicated with silicone gel. At 4 weeks a gel-filled silicone implant was placed subcutaneously in each animal. Capsule pressures were obtained at 4 months and the capsules from 3 rats from Group 2 were excised and examined microscopically. Pressures were measured again at 8 months and all remaining capsules were excised and examined. No statistically significant differences were noted when comparing two profiles over time between silicone-exposed and nonexposed animals in regard to capsule thickness or capsule pressure. However, capsule pressures were significantly lower at 8 months than at 4 months in both groups (p less than 0.034). In this model, significant reductions in capsule pressure were noted in both groups over time, but prior exposure to silicone did not appear to alter capsule histology, thickness, or pressure.

Animals↗