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Biomedical subjects

M L Turner

Publications and source records attributed to M L Turner.

At least 109 records · Page 6Linked to original sources
PubMed1991

Pudendal neuralgia.

We call attention to a group of patients with chronic vulvar burning (vulvodynia), who do not have apparent infections or easily discernible abnormal physical findings, but who on simple sensory testing have allodynia, hyperalgesia, hyperpathia, and hypoesthesia in varying permutations within the areas innervated by the pudendal nerve. We propose that pudendal neuralgia (pain along the pudendal nerve) is one of the causes of idiopathic vulvodynia. In those patients in whom a neurologic, metabolic, infectious, traumatic, or malignant cause for neuralgia is not found, medical management with tricyclic antidepressants, antiepileptic agents, or both may prove helpful. Awareness of this entity will lead to earlier diagnosis, treatment, and reassurance of patients with chronic vulvar burning.

Acyclovir↗
PubMed1991

Repair of Achilles tendon ruptures with a polylactic acid implant: assessment with MR imaging.

An investigational tendon repair device composed of a polymer of lactic acid (PLA) is currently undergoing multicenter clinical trials for use in repairing rupture of the Achilles tendon. The advantages of the PLA device include high tensile strength and the induction of a rapid proliferative tissue response resulting in a shorter rehabilitation period than with conventional surgical repair. We reviewed 16 MR examinations performed in 10 patients 3-35 months after repair to characterize the MR appearance. All 16 T1-weighted sagittal images revealed a thickened fusiform tendon with streaks of moderate signal within the tendon corresponding to the PLA device and its surrounding collagenogenic response. The double-echo T2-weighted axial images at the mid tendon level demonstrated progressive changes in the signal pattern of the central portion of the tendon that reflected the maturation of the healing tendon. All tendons repaired with PLA implants were uniformly hypertrophied relative to the contralateral normal side because of the induced proliferative collagenogenic ingrowth. Two follow-up MR examinations were performed in six patients and showed mean reductions in tendon caliber of 24% and 30% at the mid and inferior levels. MR imaging of the Achilles tendon repaired with PLA implants shows a diffusely thickened tendon with streaks of signal within the tendon that distinguish it from tendons repaired by conventional techniques.

Achilles Tendon↗
PubMed1990

Vancomycin-induced toxic epidermal necrolysis.

We have reported a patient who had had renal transplantation for end-stage renal disease; she was treated for fever and presumed sepsis with intravenous tobramycin and vancomycin, with subsequent development of persistent fever, eosinophilia, and a maculopapular rash that progressed to linear bullae. Findings on skin biopsy were consistent with a diagnosis of toxic epidermal necrolysis. Sustained measurable serum concentrations of vancomycin, the temporal response to drug exposure, and the response to steroid therapy suggest vancomycin as the causative agent.

Adult↗
PubMed1990

Evaluation of the lacrimal apparatus with digital subtraction macrodacryocystography.

Patients who suffer from epiphora can benefit from reconstructive surgery in many cases of obstructive and nonobstructive lesions of the lacrimal apparatus. We describe our technique of digital subtraction macrodacryocystography (DSM) and discuss its efficacy in the evaluation of various abnormalities involving the lacrimal drainage pathway. A variety of pathologic conditions of the lacrimal apparatus are portrayed. DSM is an accurate, easy to perform, but relatively unrecognized method of anatomic localization of obstructive lesions within the lacrimal drainage system.

Dacryocystitis↗
PubMed1989

Odontoma in an African elephant (Loxodonta africana).

The first known case of an odontoma in an African elephant (Loxodonta africana) is described. The tumour was fused with the coronal cementum of the sixth right mandibular molar tooth, thus preventing its eruption.

Animals↗
PubMed1989

Granulomatous perioral dermatitis in children.

Five children, aged 3 to 11 years, developed a distinctive perioral, perinasal, and periorbital rash, consisting of tiny, closely spaced, flesh-colored "micronodules." Histopathologic examination in all five cases revealed upper dermal and perifollicular granulomas admixed with lymphocytes. There were no associated systemic abnormalities. The lesions resolved after months to years, leaving no scars. We propose that this condition is a form of perioral dermatitis with granulomatous histologic features, which can be distinguished from sarcoidosis and other facial eruptions in childhood both on clinical and histologic grounds.

Age Factors↗
PubMed1988

Bipolar femoral endoprosthesis: a study correlating component movement with clinical outcome.

Fifty-five bipolar femoral hemiarthroplasties performed between January 1979 and February 1986 were reviewed to correlate component movement with clinical outcome. Fourteen of these patients were examined clinically using the Harris Hip Score and radiographically by the method of Drinker and Murray to determine the per cent of total motion in abduction present at the inner bearing surface. The average followup was 19.7 months. The data demonstrate that the clinical result is related to inner bearing motion. The inner bearing motion is significantly decreased by weight bearing and may be influenced by the size of the femoral component.

Aged↗
PubMed1988

Association of human papillomavirus with vulvodynia and the vulvar vestibulitis syndrome.

Seven women presenting with longstanding introital dyspareunia and burning in the vulvar area were demonstrated, with DNA hybridization techniques, to harbor human papillomavirus (HPV). Three of the seven had intermittent, culture-negative dysuria coincident with the vulvar complaints. All the patients had mild to marked erythema of the openings of the minor vestibular glands, with exquisite tenderness on palpation with a cotton-tipped applicator. A regular histologic examination was equivocal for evidence of HPV infection in four of the seven cases. The clinical picture prior to acetic acid application exhibited three variations: (1) smooth epithelial surfaces devoid of papillations; (2) patchy papillations of the vestibular and adjacent structures; and (3) florid, fine papillomatosis of the vestibule and adjacent structures. We propose that HPV infection is one of the causes of vulvodynia and the vulvar vestibulitis syndrome.

Adult↗
PubMed1988

Active specific immunotherapy with an autologous tumor cell vaccine in patients with resected non-small cell lung cancer.

Eighteen postoperative patients with non-small cell lung cancer were actively immunized with a vaccine that included autologous cryopreserved irradiated tumor cells admixed with bacillus Calmette-Guerin. Patients received three weekly intradermal immunizations beginning 1-3 months after surgery (15 patients) or after completion of postoperative radiotherapy (3 patients). There was marked heterogeneity in the relative proportion of tumor cells versus host infiltrating cells within individual vaccines (range of percent tumor cells 7-75%). Five patients exhibited positive delayed cutaneous skin test reactivity (DCR) to autologous irradiated tumor cells prior to immunization, whereas 8 of 13 converted from skin test negative to positive. There were no correlations between DCR reactivity and in vitro lymphoproliferative responses to autologous tumor cells or to clinical outcomes, i.e., freedom from relapse. Possible explanations for the heterogeneity of the lung cancer vaccine and approaches for improving its immunogenicity are discussed.

BCG Vaccine↗
PubMed1986

Progressive nodular fibrosis of the skin: altered procollagen and collagenase expression by cultured fibroblasts.

A 33-year-old man presented with a spontaneous progressive cutaneous tumor-like fibrosis involving the right leg and buttock. Histologically the deep dermis was composed of numerous fibroblasts and dense bands of collagen, suggesting that the lesion might be related to an abnormality in collagen metabolism. Fibroblast cultures were established from the affected and normal-appearing skin. The growth rate of the lesional cells was essentially equal to that of control cells. The synthesis of procollagen was approximately 3.5-fold increased in the cells derived from the nodules when compared with control fibroblasts (p less than 0.001). The increase in procollagen synthesis was reflected by an approximate 6-fold increase in both type I and type III procollagen mRNA abundance in the lesional fibroblasts (p less than 0.001), thus suggesting an aberration in the pretranslational level of procollagen gene expression. In contrast, the synthesis of collagenase, the enzyme required for the initiation of collagen degradation, was decreased to approximately 25% of control values (p less than 0.0025), although the enzyme was catalytically normal. The data indicate that these cells are characterized by an increased synthesis of procollagen and decreased synthesis of collagenase, 2 phenotypic characteristics that could account pathophysiologically for the lesions. The unusual reciprocal nature of these biochemical parameters in 2 proteins important in connective tissue homeostasis suggests that this progressive tumor-like condition may have resulted from the expansion of a clonal population of cells.

Adult↗
PubMed1986

Hypersensitivity to vaginal candidiasis or treatment vehicles in the pathogenesis of minor vestibular gland syndrome.

Minor vestibular gland syndrome is a specific clinical entity found in young women with a previous history of vaginal candidiasis. The criteria for diagnosis include introital dyspareunia, absence of active infection, erythema around orifices of the minor vestibular glands and exquisite tenderness to point palpation with a cotton-tipped applicator over these glandular openings. The histopathology shows a mixed inflammatory infiltrate in the subepithelium as well as around the glands. The etiology of this clinical syndrome is unknown. It is unlikely that a delayed hypersensitivity reaction to Candida is the cause. It is also unlikely that an irritant or allergic reaction to Monistat-7 vaginal cream or the vehicles in other vaginal creams contributes to this problem.

Adult↗
PubMed1984

Skin changes after forty.

Skin changes in the middle years are relatively minor but are often regarded as major problems. Wrinkles, skin dryness and hair loss are sources of great concern for some individuals. Little can be done to prevent hair loss, since it is primarily determined by genetic factors. Wrinkles and thinning of the skin can best be prevented by avoiding sun exposure. Seborrheic keratoses, skin tags, hyperplastic sebaceous glands and angiomas appear more often in patients over age 40 and must be distinguished from malignant lesions.

Adult↗