Diagnosis of a posttraumatic arteriovenous fistula by dynamic scintigraphy.
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Biomedical subjects
Publications and source records attributed to M Gordon.
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The effect of clinical pharmacy services on the quality and economy of health care provided to psychiatric patients at a Veterans Administration outpatient clinic was evaluated. Twenty-one patients were selected from the Day Treatment Center, of these, 19 patients completed the study. In providing health care to these psychiatric patients, the clinical pharmacist used a systemized approach including data gathering, evaluation, plan of action, and follow-up. In addition, medication groups and weekly staff meetings were incorporated into the patient treatment plan. Following a 3-month study period, the impact of clinical pharmacy services was evaluated. The provision of allied health care to psychiatric patients by clinical pharmacists resulted in a decreased incidence and severity of adverse drug effects, fewer drug use problems, a reduction in the total number of drugs prescribed, improved patient drug knowledge, and reduced expenditures for health care without compromising the patient's mental functioning.
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We present two cases, each with a small meningioma arising from the sheath of an optic nerve in the canal. Both cases demonstrate the paucity of clinical and radiographic signs occurring with these tumors. The diagnosis must be strongly suspected when a middle aged white woman slowly and progressively loses vision in one eye in the absence of remission or other neurological findings. We review similar cases reported in the literature that have been proven by biopsy.
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Guinea pig epididymal sperm, incubated for ATPases at pH 7.0 or pH 9.0, localize reaction product on both the periacrosomal segment of the plasmalemma and the outer acrosome membrane. In other species, e.g., rabbit, Ca++-ATPase is identified with the outer acrosome membrane. It may transport Ca++ into the acrosome for activation of enzymes released during the acrosome reaction. The neutral ATPase is demonstrable on the periacrosomal plasmalemma and possibly modifies Ca++ concentration in the fluid around the acrosome. In guinea pig sperm, Ca++-ATPase is sensitive to centrifugation or washing of sperm which indicates that the ductal fluid has unusual properties for preservation of the acrosome. Inhibition of the enzyme by these treatments suggests that conditions on the plasmalemmal surface affect the acrosome membrane. Inability to separate reaction product on the plasmalemma from that on the acrosome membrane may be due to migration of reaction product across the periacrosomal space. However, the ATPases are elicited in the guinea pig under the same conditions as in other species. The pH 9.0 enzyme requires Ca++ while the enzyme at pH 7.0 has no ion specificities. Demonstration of these enzymes indicates that mechanisms of acrosome activation, similar to those in other sperm, are relevant to the guinea pig.
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Protein status of alcoholics admitted to a detoxification center was investigated with a view to adapting a hair root test for use in screening for protein deficiency. Hair root volume and hair root diameter had previously been shown to correlate well with hair root protein and to be sensitive indicators of protein deficiency. Hair root volumes in this study correlated well with mean maximum hair root diameters (n = 35, r = 0.9), which were simpler to measure, so diameter measurements were used. Mean maximum hair root diameters (range 0.02 to 0.19 mm) correlated with plasma RNase concentrations (range 6000 to 14,000 units/ml; n = 17, r = -0.7). Mean hair diameters of 84 alcoholics averaged 0.0864 +/- 0.0366 mm; those of 25 nonalcoholics were significantly greater: 0.100 +/- 0.0254 mm (P less than 0.05). Frequency of occurrence of hair root diameters of 0.06 mm or less was significantly higher in 71 alcoholics (29.5%) than in 23 nonalcoholics (8.6%) matched by age. Mean hair root diameters of 0.06 mm or less therefore can be used to signify protein deficiency where more expensive or technically demanding tests are not feasible. Protein deficiency occurs extensively in non hospitalized alcoholics. This method enables staff to single out those clients most likely to be in need of nutritional counseling and therapy.
A 93-year-old woman who presented with cardiac and gastrointestinal symptoms was found to have transient hyperthyroidism due to "silent" thyroiditis. The diagnosis was supported by the appropriate correlation between serum thyroid hormone levels and the thyroidal I-131 uptake and scan.
Sixteen elderly patients with occult cardiac arrhythmias presented with signs of neurologic dysfunction that often had led to traumatic falls. Holter electrocardiographic monitoring was a valuable tool in defining the arrhythmia for which specific treatment was successful.
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