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Biomedical subjects

N M Robinson

Publications and source records attributed to N M Robinson.

50 records · Page 3Linked to original sources

Azotobacter keratitis.

Ten cases of Azotobacter keratitis were identified at the Baylor College of Medicine and Cullen Eye Institute, Houston, from 1972 to 1980. Azotobacter are large, pleomorphic, aerobic, Gram-negative rods of the family Azotobacteraceae. The genus comprises four species (A beijerinckii, A chroococcum, A paspali, and A vinelandii) that are found in soil and water throughout the world. To our knowledge, Azotobactger species have not previously been recognized as causing human, animal, or plant disease. On the basis of the similarity of the organisms, other cases of Azotobacter keratitis may have been identified erroneously as Moraxella species.

Adolescent↗

Spastic diplegia in premature infants. Etiologic and diagnostic considerations.

To investigate the etiology of spastic diplegia (SD) of prematurity, we compared the prenatal, perinatal, and neonatal course of 18 preterm infants with SD to that of a control group of preterm infants without SD. No significant differences between the group with SD and the control group were found in most of the perinatal and neonatal factors analyzed. Significant differences were found in birth weight, birth head circumference, and the one-minute Apgar score. Controlling for gestational age, infants with SD weighed less at birth, had smaller heads, and were more often briefly neurologically depressed. Intracranial hemorrhage and neonatal seizures occurred significantly more often in infants with SD. Fifteen infants with SD were believed to be neurologically normal at the time of nursery discharge. These findings suggest the importance of prenatal factors in optimally treated preterm infants in whom SD develops.

Apgar Score↗

Bacterionema matruchotii ocular infections.

One case of endophthalmitis and two cases of corneal ulceration, each occurring in a structurally altered eye, were associated with Bacterionema matruchotii, a gram-positive filamentous bacillus.

Actinomycetales↗

Isolation, identification, and biological characterization of Acanthamoeba polyphaga from a human eye.

Trophozoites and cysts of an Acanthamoeba were repeatedly isolated from the corneal scrapings of a patient suffering from acute ulceration of the right eye. The ameba was cloned and cultivated axenically in a proteose peptone-yeast extract-glucose medium. At a later date the organism was identified as A. polyphaga on the basis of its morphologic characteristics, especially those of cysts. Experimental studies on the in vitro interaction of this organism with monkey kidney tissue culture (Vero line) and its pathogenicity to mice indicated that it was a low virulent strain. When large numbers of amebae (25,000+) were inoculated into Vero cell cultures, cytopathic effects (CPE) were noticed within 5 to 6 days. The CPE consisted of cell shrinkage, nuclear pyonosis, and discontinuity of cell sheet, and the cell culture was totally destroyed in 8 to 10 days. When 20,000+ amebae were instilled intranasally into each of 20 2-week-old mice, only 1 mouse died, on the 28th day. Amebae were isolated from the brain of the dead mouse, and trophozoites and cysts were also demonstrated in the brain sections. When amebae isolated from the brain were intranasally instilled into mice, they failed to kill the mice for at least 1 month; however, when 10,000+ amebae were inoculated intracerebrally, the mice died within 5 to 8 days, exhibiting symptoms of primary meningoencephalitis.

Amebiasis↗

The value of transthoracic echocardiography during percutaneous balloon mitral valvuloplasty.

Percutaneous balloon mitral valvuloplasty is a standard alternative to surgery in a selected group of patients with symptomatic dominant rheumatic mitral stenosis. With careful transthoracic and transesophageal echocardiographic selection of patients, there is a low complication and high success rate. Echocardiography has also been established as extremely useful in the long-term follow-up of patients. We present four cases that highlight our view that transthoracic echocardiography should be performed during the procedure, after each balloon inflation, and before and after the intervention. In our experience transthoracic echocardiography during balloon mitral valvuloplasty is invaluable in assessing commissural separation, increasing mitral valve area, new mitral regurgitation, and occasional unexpected anatomic sequelae of balloon inflation.

Adult↗

In vitro evaluation of antimicrobial compounds for cysticidal activity against Acanthamoeba.

Amebic keratitis presents a therapeutic dilemma because Acanthamoeba, unlike Naegleria, encysts in infected tissues. To date, the results of medical therapy have been disappointing, and the optimal medical regimen for acanthamoeba keratitis is yet to be defined. Clinical cure necessitates eradication of the encysted amebae with medications known to have ocular toxic effects in combination with surgical maneuvers. Antiinfective agents possessing in vitro cysticidal activity include paromomycin, neomycin, ketoconazole, natamycin, and ciclopirox olamine, but no agent has been shown to be uniformly effective against all isolates of Acanthamoeba. Treatment of amebic cysts with propamidine isethionate plus either paromomycin or neomycin has produced slightly additive cysticidal effects. Multiple factors, including the varied clinical presentation and the lack of standardized in vitro techniques for the assay of cysticidal activity, account for the lack of correlation between in vitro activity and in vivo efficacy.

Acanthamoeba↗

Comparison of clinical outcome after elective and "bail out" coronary stent insertion.

BACKGROUND: Coronary stents may be used electively during percutaneous transluminal coronary angioplasty (PTCA) or as a "bail-out" device to treat abrupt or threatened vessel closure following PTCA. OBJECTIVE: To compare the clinical outcome of elective and "bail-out" coronary stent insertion. DESIGN: A retrospective analysis of all patients receiving coronary stents. SETTING: Tertiary referral center performing over 400 PTCA procedures a year. PATIENTS: Fifty-six patients (42 male), mean age 57 (range = 32 to 78) years received 67 Palmaz-Schatz coronary stents. Forty-nine stents were deployed as "bail-out" in 41 patients (abrupt vessel closure in 15 and threatened vessel closure in 26) and 18 stents were deployed electively in 15 patients. MAIN OUTCOME MEASURES: Myocardial infarction, repeat angiography, coronary artery bypass graft surgery and death. RESULTS: Stents were successfully deployed in 56/62 (90.3%) patients. In-hospital events were significantly more common in the "bail-out" group compared to the elective group. The in-hospital events, comparing the "bail-out" group versus the elective group, were as follows: Death 2/41 (4.9%) vs 0/15 (0%), coronary artery bypass graft surgery (CABG) 8/41 (19.5%) vs 0/15 (0%), stent thrombosis 3/41 (7.3%) vs 0/15 (0%), and myocardial infarction 6/41 (14.6%) vs 1/15 (6.7%) respectively. After discharge no patient died or had CABG. One patient in the "bail-out" group had a myocardial infarct (late stent thrombosis). Two patients from each group had repeat angiography because of recurrent angina in the 6 month follow up period. CONCLUSION: "Bail-out" stenting has an increased incidence of in-hospital complications compared to elective procedures. If these short-term problems can be overcome however, the clinical events in the first 6 months after leaving hospital are low and similar to patients under-going elective procedures.

Angioplasty, Balloon, Coronary↗