Coccidioidomycosis of prostate gland.
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Aged↗
Biomedical subjects
M J Price
Publications and source records attributed to M J Price.
Simultaneous assessment of human sperm motility and morphology by videomicrography.
Videotapes were analyzed to assess sperm motility and morphology in the semen of 5 fertile donors and 20 infertile patients. The slow motion playback control of the video recorder allowed simultaneous assessment of the motility and morphology of individual sperm cells. Similar values were obtained with this method for abnormal morphology more often were immotile or weakly motile than were the normal sperm in the same ejaculates. Normal oval sperm in the semen of infertile men were less likely to be motile and tended to swim more slowly than did morphologically normal sperm in the semen of fertile men.
Adult↗
Tapioca melanoma of the iris: clinicopathological correlation with results of fluorescein angiography.
A tapioca melanoma in a 75-year-old Caucasian man was shown by light microscopy to consist of spindle B cells with abundant vesicular cytoplasm, minimal pigmentation and surface nodularity that correlated with the gross appearance. Electron microscopy showed spindle shaped cells with multiple premelanosomes and melanin granules. Iris angiography demonstrated an irregular crisscrossing vascular network with a papillary configuration and fluorescein leakage confined to the tumour. The clinical appearance of the lesion and the angiographic findings are characteristic of this unusual variant of iris melanoma and help distinguish it from granulomatous iritis and from neurofibroma, leiomyoma and metastatic carcinoma of the iris.
Adult↗
Diagnosis of the empty sella with intrathecal metrizamide computed tomography.
The empty sella syndrome can be diagnosed with high resolution computed tomography. The addition of intrathecal metrizamide defines the degree of extension of the subarachnoid space into the sella turcica, demonstrates the relationship of surrounding structures, and differentiates the empty sella from other isodense or hypodense intrasellar lesions. Photographs from a case of primary empty sella demonstrate the details of anatomy seen with metrizamide computed tomography combined with sagittal reconstruction.
Adult↗
Use of hydroxyethyl starch to improve granulocyte collection in the Latham blood processor.
This report describes a practical, relatively inexpensive system of leukapheresis and plateletpheresis, utilizing the Haemonetics blood processor. The results of 236 phereses of normal donors are reported, with particular attention to an evaluation of five different anticoagulant mixtures: ACD, 2 per cent citrate in saline, and three different combinations of citrate and hydroxyethyl starch (HES). These mixtures were compared with respect to their effectiveness in the harvesting of granylocytes and platelets, respectively. The best harvest of granulocytes (3.5 X 10(9) cells per liter of blood processed) was with 6 per cent HES anticoagulated with trisodium citrate. All solutions gave about the same platelet yields (a mean of 1.6 X 10(11) per liter of blood processed). Because of its higher citrate content, ACD caused three times as many donor reactions as the other solutions. The use of HES thus permits this widely available plateletpheresis system to be used for leukapheresis with only minimal procedural modification.
Anticoagulants↗
Leukapheresis of patients with chronic granulocytic leukemia (CGL), using the Haemonetics blood processor.
By the use of citrated hydroxyethyl starch (HES) as anticoagulant, the Haemonetics blood processor can be used to obtain large numbers of granulocytes from patients with CGL. This report is of 67 leukaphereses on 11 different patients. A median of 1.14 x 10(11) granulocytes was obtained per 6-cycle pheresis (3.4 x 10(10) per liter of blood processed), or eight to ten times the number obtained from comparable leukaphereses of normal donors. High yields of platelets were also obtained, although not in proportion to granulocytes, since some of the patients used as donors have normal or even low platelet counts. The patients tolerated the procedure well, and no adverse reactions to HES were observed. The patients experienced a mean 35 per cent drop in the postleukapheresis WBC count, but in no case was this drop sustained for more than a few days, and no lasting effect on the disease process was observed.
Adolescent↗
Citrate anticoagulants for plateletpheresis.
In 112 plateletphereses done by the Haemonetics blood processor, the comparative effectiveness of ACD formula A, ACD formula B, and 2 per cent citrate in saline was evaluated. With respect to yields of platelets and white blood cells (e.g., lymphocytes), ACD-B was significantly better than the other two. Both ACD-B and 2 per cent citrate gave a much lower incidence of citrate reactions in the donors than were encountered with ACD-A.
Anticoagulants↗
Qualitative analysis of the patient-provider interactions: the patient's perspective.
This qualitative analysis of videotaped patient-provider interviews focuses attention on the patient's experience of diabetes. Excerpts from the videotaped interviews are examined from the framework of a diabetes management trajectory identified from a qualitative research study of 19 insulin-managed adults. It is suggested that providers need to become sensitive to the experience of illness-as-lived in order to more accurately assess patient responses to management and to promote sustained efforts toward diabetes self-care.
Diabetes Mellitus↗
X-linked congenital stationary night blindness with myopia and nystagmus without clinical complaints of nyctalopia.
Seven of eight patients presented initially or were followed for decreased acuity and nystagmus without complaints of night blindness. The diagnosis of congenital stationary night blindness was established with electroretinogram and dark adaptation testing. Careful electrodiagnostic testing is needed to provide accurate genetic counseling. Two patients showed pupillary constriction to darkness which is a sign of retinal disease in young patients.
Adolescent↗
A population-based approach to diabetes management in a primary care setting: early results and lessons learned.
OBJECTIVE: To determine the effect of a multifaceted program of support on the ability of primary care teams to deliver population-based diabetes care. DESIGN: Ongoing evaluation of a population-based intervention. SETTING/PARTICIPANTS: Group Health Cooperative of Puget Sound, a staff model HMO in which more than 200 primary care providers treat approximately 15,000 diabetic patients. INTERVENTION: A program of support to improve the ability of primary care teams to deliver population-based diabetes care was implemented. The elements of the program are based on an integrated model of well-validated components of delivery of effective care to chronically ill populations. These elements have been introduced since the beginning of 1995, and some aspects of the program were pilot-tested in a few practice sites before being implemented throughout the organization. The program elements include 1) a continually updated on-line registry of diabetic patients; 2) evidence-based guidelines on retinal screening, foot care, screening for microalbuminuria, and glycemic management; 3) improved support for patient self-management; 4) practice redesign to encourage group visits for diabetic patients in the primary care setting; and 5) decentralized expertise through a diabetes expert care team (a diabetologist and a nurse certified diabetes educator) seeing patients jointly with primary care teams. MAIN OUTCOME MEASURES: Patient and provider satisfaction through existing system-wide measurement processes; process measures, health outcomes, and costs are tracked continuously. RESULTS: Patient and provider satisfaction have improved steadily. Interest in and use of the electronic Diabetes Registry have grown considerably. Rates of retinal eye screening, documented foot examinations, and testing for microalbuminuria and hemoglobin A1c have increased substantially. CONCLUSIONS: Providing support to primary care teams in several key areas has made a population-based approach to diabetes care a practical reality in the setting of a staff model HMO. It may be an important mechanism for improving standards of care for many diabetic patients.
Community Health Planning↗
Glaucoma screening.
The ability to screen for any disease is based on several factors (established natural history, high prevalence rates, effective treatment, and available screening tests); however, the earliest psychosocial, clinical, or electrodiagnostic changes in glaucoma are presently unknown. Public awareness of glaucoma must be increased. Mass screenings not only aid in the detection of disease, but through their promotion by the local media, they also assist in augmenting the general public's awareness of eye health. The future of more effective screening may lie in more objective or automated testing that could be performed by lesser trained personnel.
Glaucoma↗
High-resolution computed tomography of the basilar artery: 1. Normal size and position.
Normal high-resolution computed tomographic (CT) scans of 126 patients were reviewed to define the diameter, height of the bifurcation, and transverse position of the normal basilar artery. The mean diameter of the normal basilar artery is 3.17 mm at the level of the pons. In 92% of normal subjects, the basilar bifurcation is located in the interpeduncular cistern adjacent to the dorsum sellae or in the suprasellar cistern below the level of the floor of the third ventricle. In 98% of normal individuals, the basilar artery courses in the midline or in a paramedian position, medial to the lateral margins of the clivus and dorsum sellae.
Adolescent↗
High-resolution computed tomography of the basilar artery: 2. Vertebrobasilar dolichoectasia: clinical-pathologic correlation and review.
To better define the clinical significance of vertebrobasilar dolichoectasia, the clinical signs and symptoms and basilar artery parameters of diameter, height, and transverse position were evaluated in two groups of symptomatic patients. Ten patients had isolated involvement of the third, sixth, or seventh cranial nerves. The other 10 patients had multiple neurologic deficits including combinations of compressive cranial nerve deficits, both ischemic and compressive central nervous system deficits, and hydrocephalus. Although significant differences for mean basilar artery diameter and height exist between these two groups, the symptomatology and basilar artery parameters present as a spectrum. A symptomatic patient with a normal-caliber, but tortuous, basilar artery is more likely to have isolated cranial nerve involvement. Conversely, the patient with marked basilar artery dilatation (ectasia) is far more likely to present with multiple compressive or ischemic neurologic deficits. Conventional angiography in patients with dilated basilar arteries carries a significant risk for brainstem ischemia. Most authors agree that when vertebrobasilar dolichoectasia has been demonstrated by computed tomography, additional angiography, if required at all, should be performed by digital subtraction techniques.
Adult↗
Tarsal conjunctival appearance in contact lens wearers.
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Conjunctiva↗