Management of hyperlipidaemia: a consensus statement.
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Estrogen Replacement Therapy↗
Biomedical subjects
M Webster
Publications and source records attributed to M Webster.
Changing etiology of iliopsoas abscess.
Over a 5-year period, iliopsoas abscesses were found in 11 patients. Although the most common underlying condition was Crohn's disease (3 of 11 patients), 5 abscesses resulted from hematogenous spread from a distant site. Each of these five patients was elderly, severely malnourished, or had an underlying chronic disease. Fever was a presenting sign in 8 of 11 patients, whereas all 4 patients who presented with back pain had nontuberculous lumbar osteomyelitis or disk space infections. No patient presented with the classic triad of fever, back pain, and anterior thigh or groin pain. Computed tomographic (CT) scans accurately established the clinical diagnosis in 10 of 11 patients. Two of the patients died. One patient was an intravenous drug abuser, whereas the other patient was being treated with steroids for systemic lupus erythematosus. Elderly patients, diabetics, and patients with chronic disease are susceptible to this kind of occult infection and may present with minimal clinical findings. Aggressive diagnosis using CT scanning and treatment with resection of involved bowel, complete drainage of the abscess, and prolonged antibiotics are required to salvage these patients.
Abscess↗
Supernova (spno), a new maternal mutant producing variable-sized cleavage nuclei in Drosophila.
This paper describes a new recessive maternal lethal which disrupts normal nuclear division and migration during cleavage in Drosophila. We have named this gene locus supernova. Deletion mapping and in situ hybridization have located this gene to 88 F9/89 A1 on the polytene chromosome map. The terminal mutant phenotype is characterized by the presence of many variable-sized nuclei scattered throughout the cytoplasm of the unhatched egg. Following fertilization, the initial cleavage divisions appear delayed and are often accompanied by the formation of ring-like association of chromosomes and/or chromosome bridges. Although the polymerization of tubulin into spindles occurs during the initial cleavage divisions, there appears to be both a spatial and temporal uncoupling of DNA replication from the formation and proper functioning of spindles. Eventually no functional spindles are formed, but nuclei continue to increase in size and number with increasing age of the embryo following fertilization.
Animals↗
Clinical trials with purified platelet releasate.
Clinical trials of PDWHF are ongoing and the final results are not yet available; however early lessons learned have allowed us to modify these trials. It is anticipated that the patient accrual will be completed within the next six months, and the last patient will complete the trial within the next year. At that time, we hope to have new insight into the role of PDWHF in the treatment of lower extremity ulcers. At this time, we are encouraged by the early improvement seen in patients entering the PDWHF versus saline trial. Preliminary results suggest that PDWHF improves the healing of diabetic ulcers of the lower extremity.
Blood Platelets↗
Clonal deletion: a mechanism of tolerance in mixed bone marrow chimeras.
The mechanism of antigen-specific immunologic unresponsiveness which results from lethal irradiation and mixed (syngeneic-allogeneic) bone marrow cell (BMC) reconstitution is unknown. To determine whether clonal deletion is the mechanism of tolerance in this model, monoclonal antibody (Mab) RR-4-4, specific for a T-cell receptor (V beta 6) reactive against the minor alloantigen MLsa, was employed. Six-week-old B10 mice (H-2b, Mlsb, Thyl.2) were tolerized to AKR antigens (H-2k, Mlsa, Thyl.1) by whole body irradiation (950 R) and iv infusion of T-cell-depleted (TCD) B10 BMC + non-TCD AKR BMC. Chimerism and antigen-specific tolerance were documented by flow microfluorometry (FMF), skin grafting, mixed lymphocyte reaction, and cell-mediated lympholysis. When tolerant B10 mice (n = 15) had accepted AKR skin grafts for greater than 100 days, these animals were studied for the presence of host V beta 6+ T cells using Mab RR-4-4. FMF revealed that 0-5% of host (B10) lymph node and spleen cells from chimeras were V beta 6+ while 15-20% of lymph node and spleen cells from control B10 mice expressed V beta 6. These data demonstrate that clonal deletion occurs in the lethal irradiation-mixed reconstitution model as evidenced by the near total elimination of Mlsa-reactive V beta 6+ T cells and suggest that it maybe a mechanism responsible for tolerance in adult mice.
Animals↗
The child with chronic or debilitating illness.
Children with chronic diseases face particular problems at school. Early recognition of these difficulties and appropriate management should enable most of these children to participate fully in school life.
Adaptation, Psychological↗
Hepatitis B infections after gynaecological surgery.
When acute hepatitis B developed in 3 patients who had had gynaecological surgery, the surgeon was found to be a carrier of hepatitis B e antigen. Of 268 patients operated on by this surgeon in one hospital, 247 were screened for markers of recent or current hepatitis B. 22 (9%) had such markers, associated with symptoms in 5. The operations carrying greatest risk of infection were hysterectomy (10/42) and caesarean section (10/51). These findings strengthen the case for vaccination of all surgeons and medical students against hepatitis B.
Acute Disease↗
Cryopreserved venous homografts as vascular conduits in canine carotid arteries.
In this study we evaluated the histologic condition, prostacyclin production, and compliance of morphologically intact cryopreserved venous homografts (CVH) and autografts 3, 6, and 9 months after arterial implantation. Eighteen external jugular veins were cryopreserved and implanted into the carotid arteries of mongrel dogs. All grafts were patent at the time of excision. Electron microscopy documented a disrupted endothelium in the homografts at 3 months that was intact at 9 months. The cellular infiltrate, suggestive of rejection, in the 3-month homografts resolved by 9 months. Prostacyclin production at 3 months was 8.7 +/- 3.2 pg/ml/cm2 compared with 24.1 +/- 9.6 pg/ml/cm2 (p less than 0.025) in the adjacent carotid artery. The prostacyclin production in the 6-month homografts was 21.7 +/- 12.4 pg/ml/cm2, not significantly different from the adjacent carotid artery. The return of prostacyclin paralleled the return of an intact endothelium. Compliance of fresh vein was diminished by cryopreservation, from 1.57 +/- 0.39% radial change/mm Hg (10(-2] to 0.79 +/- 0.21% radial change/mg Hg (10(-2] (p less than 0.02). The compliance of CVH at 3 months (1.7 +/- 1.0) and at 6 months (1.1 +/- 0.42) was not significantly different from cryopreserved veins. These data showed that CVH remained patent in dogs for 9 months, without loss of compliance for 6 months, and developed a morphologically intact and functional endothelium that paralleled the resolution of the inflammatory infiltrate.
Animals↗
A nail in the head: report of a clinico-pathological conference.
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Craniocerebral Trauma↗
Gentamicin-resistant Klebsiella aerogenes in a urological ward.
A gentamicin-resistant strain of Klebsiella aerogenes was isolated from the urine of 17 patients out of 237 admitted to a male urological ward between Jan. 21 and May 9, 1977. The factors most frequently associated with K. aerogenes in the urine were catheterisation and antibiotic therapy. Often the epidemic strain (type K16) was found not only in the patients' faeces but also on more remote skin sites such as hands, knees, groins, and the umbilicus. Resistance to gentamicin and many other antibiotics was R-factor mediated. Barrier nursing of colonised patients, stringent staff handwashing with chlorhexidine, and the use of disposable aprons seemed to contain the outbreak. Hand carriage was demonstrated in one nurse 62 days after she had left the ward.
Bacteriuria↗
Neonatal sound deprivation affects brain stem auditory nuclei.
CBA/J mice deprived of airborne sound stimulation during postnatal development have smaller globular cells in the ventral cochlear nucleus and smaller neurons in the medial nucleus of the trapezoid body than do normal control mice. The sound deprivation in these mice is similar to that experienced by persons with pure congenital conductive hearing losses. Even more profound central neural changes were found in auditory nuclei in the brain stem of a congenitally sensorineural deaf human.
Acoustic Stimulation↗
Auditory systems of heteromyidae: cochlear diversity.
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Animals↗
Dr. Wilhelm Gilges.
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History, 20th Century↗
Auditory systems of Heteromyidae: functional morphology and evolution of the middle ear.
Middle ears (515) from 26 species of the rodent family Heteromyidae - genera Dipodomys, Microdipodops, Perognathus, and Liomys - were studied both grossly and histologically, for qualitative and quantitative comparisons. Middle ear modifications characteristic of each genus are qualitatively described. Quantitative comparisons are made among the 26 species in the study. Some correlations between middle ear size and other measurements are discussed. The middle ear is an acoustical transformer that for best efficiency must match the impedance of the cochlea to the impedance of the air in the external auditory meatus. It accomplishes this by a pressure increase and a velocity decrease through the combined effects of the lever and areal ratios; however, because the important consideration is a matching of two impedances rather than an absolute pressure increase, the pressure transformer ratio is a less informative measure of the middle ear's efficiency than is the impedance transform ratio. The impedance transformer mechanism is explained (from a morphological point of view), and equations are presented. Dipodomys, Microdipodops, and Perognathus have a theoretical transmission (at the resonant frequency) of 94-100% of the incident acoustical energy; Liomys, 78-80%. The areal ratio of stapes footplate to 2/3 tympanic membrane is remarkably constant among the species, varying only from 0.04 to 0.07: in Dipodomys and Microdipodops this small ratio is due to the very large tympanic membrane; in Perognathus and Liomys it is due to the extremely small stapes footplate. The lever ratio of incus to malleus varies from 0.28 to 0.33 in Dipodpmys and Microdipodops, from 0.37 to 0.46 in Perognathus, and from 0.55 to 0.60 in Liomys. In addition, the middle ear volumes and the morphology of tympanic membrane, ossicles, ligaments, and muscles, all combine to minimize both mass and stiffness. All these data suggest middle ear mechanisms which are very efficient over a broad frequency range. The middle ear modifications found in heteromyids are adaptive in predator avoidance, especially in areas of little natural cover; nevertheless, contrary to expectations, there is no firm relationship between habitat and the extent of these modifications in the 26 species. However, environment did apparently plan an important role in the evolution of the family, and this is discussed.
Acoustics↗
Databases, quality control and interpretation of DNA profiling in the Home office Forensic Science Service.
The history of DNA profiling in the Home Office Forensic Science Service began with the introduction of multilocus probes into casework in 1986. The use of single-locus probes was introduced in 1990, supported by databases of three ethnic groups; interpretation is backed up using a Bayesian approach. Databases were compiled using an image analysis computing system. Quality control systems are described, detailing requirements before a sample can be included in the database.
DNA Fingerprinting↗
Effects of neonatal conductive hearing loss on brain stem auditory nuclei.
Both postnatal auditory deprivation and experimentally produced conductive hearing losses in mice result in incomplete maturation of most brain stem auditory neurons. The affected groups are: octopus cell, globular cell, small spherical cell, and large spherical cell groups in ventral cochlear nuclei; and the lateral superior olive and medial nucleus of the trapezoid body of the superior olivary complex. When 45 days of auditory deprivation are followed by 45 days of normal acoustic stimulation, there is incomplete maturation of neurons in: multipolar cell, globular cell, small spherical cell, and large spherical cell groups in ventral cochlear nuclei; lateral superior olive and medial nucleus of trapezoid body in superior olivary complex; and central nucleus of inferior colliculus. A critical period exists when adequate sound stimulation is needed for full development of these neurons.
Acoustic Stimulation↗
Cochlear nerve projections following organ of corti destruction.
Experimental organ of Corti destruction results in (1) secondary loss of all type I spiral ganglion neurons, (2) development of type III spiral ganglion neurons, (3) degeneration of most cochlear nerve myelinated fibers, and (4) terminal degeneration in the ventral and dorsal cochlear nuclei. The first signs of degenerative changes occur by eight days after organ of Corti destruction and degeneration debris remains until 28 weeks after destruction.
Animals↗