Pathological case of the month. Spinal chordoma.
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Adolescent↗
Biomedical subjects
M Norris
Publications and source records attributed to M Norris.
Subclinical central nervous system infection with JC virus in patients with AIDS.
Immunocompromised patients, particularly those with AIDS, develop progressive multifocal leukoencephalopathy (PML) due to central nervous system infection with JC virus (JCV). It is unknown whether JCV infection in the central nervous system can occur in the absence of PML symptoms. To address this question, autopsy specimens from patients with AIDS were examined. The brains of a group of patients without AIDS or central nervous system disease were also examined. JCV DNA was detected by the polymerase chain reaction in brain tissue from 4 (31%) of 13 human immunodeficiency virus (HIV)-positive patients. JCV was also detected in 1 elderly HIV-negative patient but not in the 11 other control brains. JCV was not detected in 22 myocardial specimens obtained at autopsy from HIV-negative patients nor 10 peripheral blood specimens from HIV-positive patients. The presence of JCV in brains of patients without clinically evident PML suggests that JCV may be present in the central nervous system without clinical disease.
Acquired Immunodeficiency Syndrome↗
Uptake and incorporation of inositol by preimplantation mouse embryos.
The uptake of myo-inositol by preimplantation mouse embryos was investigated using [3H]myo-inositol. Uptake increased about 12-fold between one- and two-cell stages and increased again at the blastocyst stage (> 6-fold compared with the two-cell stage). Uptake at the blastocyst stage was time and temperature dependent; it was stimulated by sodium, inhibited by glucose and appeared to take place mainly via a saturable mechanism. Uptake in the presence of 6.25 mmol inositol l-1 was 1424 fmol inositol per blastocyst per h. About 10% of the [3H]inositol taken up by blastocysts during 8 h in culture was incorporated into lipid. Thin layer chromatography of the lipid showed that most of this inositol was incorporated into lipid material co-migrating with phosphatidylinositol with a small proportion co-migrating with phosphatidylinositol 4-phosphate.
Analysis of Variance↗
Implementation of the three-field electron wraparound technique for extensive recurrent chest wall carcinoma: dosimetric and clinical considerations.
Treatment of extensive recurrent chest wall carcinoma is a challenge for the radiation oncologist as well as the physics team responsible for setup, computer planning, and daily reproducibility. While electron arc therapy is desirable, unfortunately, most sites do not have this capability. The alternative method of treatment discussed here involves the use of a three-field electron wraparound technique for the chest wall when electron arc therapy is not available. This technique yields an excellent alternative treatment modality with flexibility to accommodate multiple electron energies to compensate for varying chest wall thickness. An additional anterior photon beam is used when skin lesions extend superiorly to the clavicle and along the proximal aspect of the arm. Computerized tomography (CT) interfaced radiotherapy computer planning is used to precisely calculate the sequential gantry angles, skin gaps for adjacent electron fields, and the appropriate junction moves to create a feathering effect of all overlap areas. Treatment aids include extensive shaping of electron and photon fields and the application of bolus material on all four fields. A Smithers Medical Products' Alpha Cradle is used to make this intricate setup possible, providing patient comfort and daily reproducibility for a more efficient treatment.
Breast Neoplasms↗
The tangential breast match plane: practical problems and solutions.
The three-field breast set-up, in which tangential oblique opposed fields are joined to an anterior supraclavicular field, has been the method of choice for treatment of breast cancer for many years. In the last several years many authors have suggested refinements to the technique that improve the accuracy with which fields join at a match plane. The three-field breast set-up, using a rotatable half-beam block is the technique used at our institution. In instituting this procedure, several practical problems were encountered. Due to the small collimator rotation angles used it is possible to clinically reverse the collimator angle without observing an error noticeable on fluoroscopy. A second error can occur when the table base angle is used to compensate for the incorrect collimator rotation. These potential sources of error can be avoided if a programmable calculator or computer program is used to assist the dosimetrist during the simulation. Utilization of fluoroscopy, digital table position displays and a caliper provide accurate input for the computer program. This paper will present a hybrid procedure that combines practical set-up procedures with the mathematical calculation of ideal angles to result in an accurate and practical approach to breast simulation.
Breast Neoplasms↗
Bullous systemic lupus erythematosus.
Two patients with bullous systemic lupus erythematosus are reported. In one, the disease appears to have been caused by hydralazine. The cutaneous lesions of bullous SLE have not been previously reported in drug-induced lupus.
Adult↗
Localization of urinary tract infection in elderly, institutionalized women with asymptomatic bacteriuria.
We determined the site of urinary tract infection in 51 elderly, institutionalized women (mean age, 80.5 years) with asymptomatic bacteriuria by using the Fairley bladder washout technique. Thirty-four (67%) infections were localized in the kidney and 17 (33%) in the bladder. Women with renal infection were older than those with bladder infection (81.9 vs. 77.6 years of age; P = .04). The antibody-coated bacteria test had a sensitivity of 58%, specificity of 71%, positive predictive value of 82%, and negative predictive value of 43% for upper-urinary-tract infection. A quantitative urinary leukocyte count of greater than or equal to 20 leukocytes/mm3 had a positive predictive value of 80% and a negative predictive value of 88% for upper-urinary-tract infection. This study suggests that the majority of elderly, institutionalized women with asymptomatic bacteriuria have upper-urinary-tract infection. Both the antibody-coated bacteria test and the quantitative urinary leukocyte count may be useful as noninvasive tests for localization of urinary tract infection in this population.
Age Factors↗
En bloc hemicolectomy with anterior abdominal wall resection for colon carcinoma: immediate reconstruction with rectus femoris myocutaneous flap: a case report.
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Abdominal Muscles↗
Provision of the immunoglobulin heavy chain enhancer downstream of a test gene is sufficient to confer lymphoid-specific expression in transgenic mice.
To test whether the immunoglobulin heavy chain enhancer is sufficient to direct lymphoid specific gene expression in vivo, we have incorporated into the mouse germ line a test gene (chloramphenicol-acetyl transferase) whose transcription is potentiated by the enhancer. Analysis of transgenic mice bearing single-copy integrations of the injected DNA indicates that provision of the enhancer downstream of the test gene (beyond the polyadenylation site) is sufficient to direct lymphoid-specific expression. The tissue specificity is considerable as judged by the fact that transgene expression is at least one thousandfold higher in spleen than in liver. Within the lymphoid family, expression of the transgene is much higher in surface IgM+ spleen cells than in thymocytes high in Thy-1 expression, suggesting that the enhancer preferentially directs expression to cells of the B lineage.
Acetyltransferases↗
Attentional vulnerability indicators, thought disorder, and negative symptoms.
Deficits on two continuous performance test versions and the forced-choice span of apprehension task, which are potential vulnerability factors for schizophrenic disorders, were examined in relationship to particular symptoms of schizophrenic disorders, with emphasis on hypothesized relationships to formal thought disorder and negative symptoms. These interrelationships were determined concurrently within a group of 40 schizophrenic patients at an inpatient point. In addition, 32 of these patients were retested at a stabilized outpatient point to address the extent to which continued attentional deficits were associated with specific symptomatology during the hospitalized period. Signal-discrimination deficits on the three tasks were consistently associated with inpatient negative symptoms of schizophrenia as measured by the Anergia factor of the Brief Psychiatric Rating Scale (BPRS), across both the inpatient and outpatient assessments. The outpatient signal-discrimination deficits also showed significant, but less consistent, correlations with inpatient schizophrenic modes of thinking measured by the Rorschach Thought Disorder Index and with formal thought disorder measured by the BPRS Conceptual Disorganization rating. In contrast, no relationship with inpatient hallucinations or delusions was found. Combined with previous findings from high-risk samples, these results are consistent with the view that signal-discrimination deficits in situations demanding high levels of effortful processing are enduring vulnerability factors for schizophrenic negative symptoms and possibly for certain schizophrenic forms of thought disorder.
Adolescent↗
[An unusual protodiastolic bruit: the click of an aberrant mitral cord].
An asymptomatic adult woman without clinical cardiac disease had an unusual early diastolic heart sound. All usual causes of this finding were excluded: it was not a delayed pulmonary component of the second heart sound, a mitral or tricuspid opening snap, an early diastolic third heart sound or a pericardial vibration. The only apparent cause was a left ventricular false tendon extending from the septal endocardium to the left ventricular free wall, demonstrated by 2D echocardiography. This type of aberrant intracardiac band has already been described but the possibility of early diastolic stretching of this structure giving rise to an abnormal early diastolic sound does not seem to have been previously reported.
Female↗
Pseudomelanosis duodeni: a clinicopathologic entity.
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Aged↗
Testicular detorsion using Doppler ultrasound monitoring.
In one year's time, eight of 11 cases of torsion of the testicle were successfully untwisted in the emergency room. The doppler ultrasound was used to document return of blood flow after detorsion. Subsequent fixation of both testes may be done on a less urgent basis.
Adolescent↗
Aeromonas hydrophila gastroenteritis.
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Aeromonas↗
Changes in patients during treatment at the Henderson Hospital therapeutic community during 1977-81.
This study is the third in a series which has used repertory grids to evaluate changes in people in various 'treatment' milieux. In this paper findings are reported for 70 men and 33 women patients at the Henderson Hospital. Significantly more patients in the hospital changed in desired directions ('benefited') than in previous milieux studied. Grid interpretation of 'benefit' seemed to have face value for therapist when compared with clinical impressions. Association of 'benefit' with attendance at meetings is discussed and so are differences in results for men and women. Changes in self-esteem compare favourably with such changes in the other milieux and for theoretical reasons this suggests that desired changes will be maintained. The hospital did seem to achieve measurable benefit in patients often regarded as unamenable to treatment.
Adolescent↗
A clinical trial of a bead bed system for the prevention of pressure sores in elderly orthopaedic patients.
This paper summarizes the results of the trial of the Beaufort Bead Bed system designed to reduce the incidence and severity of pressure sores. Elderly orthopaedic admissions were allocated alternately to the Beaufort system and to the usual trolley, table and bed surfaces, and followed from admission to hospital until separation. The incidence of pressure sores was 15.6% in the 32 'trial' patients, which was significantly less than the 48.8% in the 43 'control' patients, as was the mean maximum diameter of the pressure sores incurred: 6.4 mm for the 'trials' as against 29.5 mm for the 'controls'. In particular the trial group were free from pressure lesions to the heel, which affected 32.6% of the control group. The groups were well matched on a variety of criteria on admission, and we conclude that the Beaufort system successfully reduces the incidence and severity of pressure sores for elderly orthopaedic patients. The system--renamed recently the 'Neumark-Macclesfield Support System'--is now in regular and satisfactory use.
Aged↗
Natural processes in the phonologies of four error-rate groups.
Processes involved in the misarticulations of 97 children were used to identify patients associated with error rate. Results indicated that while no processes are unique to subjects with higher error rates, the moderate and high error-rate children either used more processes in unusual ways or overused a few, less-differentiated processes. Groups of intercorrelating processes were determined by factor analysis.
Articulation Disorders↗