Fibromyalgia: misdiagnosed, mistreated and misunderstood?
Explore the source record for details and available documents.
Adult↗
Biomedical subjects
R C Jones
Publications and source records attributed to R C Jones.
Stereotactic breast biopsy as an alternative to open excisional biopsy.
BACKGROUND: Health care cost continues to play a dominant role in our society. Technological advances are expensive, with the possible exception of stereotactic breast biopsy. We must learn other alternatives that give the same diagnostic accuracy at lower cost. The intention of this study was to find other acceptable alternatives to open excisional breast biopsies. METHODS: Patients were referred to Baylor University Medical Center between May 1990 and June 1992 for stereotactic breast biopsy of nonpalpable mammographic abnormalities. Before stereotactic biopsy, lesions were categorized into low or high suspicion for malignancy based on screening mammography. Slides were reviewed by a pathologist and the histological diagnosis was compared with mammographic characterization. Benign histology confirming the low-suspicion mammographic abnormality demonstrated mammographic and histologic correlation. Mammographic follow-up was recommended. RESULTS: Two hundred twenty-five women underwent 250 stereotactic breast biopsies. Malignancy was diagnosed in 47 patients; the remaining 203 lesions were benign on pathological examination and are being followed regularly. Seventy-eight percent of the lesions were characterized as low suspicion for malignancy, and 22% were characterized as high suspicion. The average cost savings per lesion using stereotactic biopsy was $1,629. CONCLUSION: Stereotactic breast biopsy is an acceptable, less expensive alternative to open excisional biopsy for diagnosing nonpalpable mammographic findings.
Adult↗
Development of the gonads in the triploid (ZZW and ZZZ) fowl, Gallus domesticus, and comparison with normal diploid males (ZZ) and females (ZW).
Gonadal development in fowls aged from 1 day to more than 4.5 years was studied in 63 ZZW and 16 ZZZ triploid crossbreds and compared with normal diploid males (ZZ) and females (ZW). In the ZZW fowl, the right gonad developed into a testis (although this occurred earlier in the ZZ genotype), and a structurally-abnormal excurrent duct system containing some malformed spermatids and spermatozoa was associated with the gonad of young adults. The left gonad was an ovotestes at hatching and no excurrent ducts were associated with it. The ovarian component was much less developed than that in the ZW genotype-it started to degenerate by 1 week of age, and most of the oocytes had disappeared by about 3 weeks of age. The seminiferous tubules developed in the medullary region, but only abnormal spermatozoa were produced. Leukocytes infiltrated both gonads at about 9 months of age and the seminiferous epithelium had degenerated in most fowls over 1 year old. In ZZZ fowl, gonadal and excurrent duct development was normal, but occurred earlier than in the ZZ genotype. However, meiosis and spermiogenesis were abnormal and malformed spermatozoa were produced. The heads of spermatozoa from the ducts deferens were about 1.4-times longer in the ZZZ genotype than in the ZZ genotype, indicating that the former may be producing some diploid spermatozoa.
Animals↗
Continuous nitric oxide inhalation reduces pulmonary arterial structural changes, right ventricular hypertrophy, and growth retardation in the hypoxic newborn rat.
Breathing low oxygen levels for several weeks produces progressive pulmonary artery hypertension and smooth muscle hypertrophy and hyperplasia in many species. Because nitric oxide (NO) is an important regulator of pulmonary vascular tone, we examined whether the continuous inhalation of low levels of NO gas would attenuate pulmonary arterial structural changes in hypoxic rat pups. Nine-day-old rat pups and their mothers continuously breathed at FIO2 0.21 or 0.10 with or without adding 20 ppm (by volume) NO for 2 weeks. Lung tissue was obtained for vascular morphometric analysis, and the hearts were dissected to measure right ventricular weight and levels of mRNA encoding rat atrial natriuretic factor (rANF). In addition, femur and skull length were radiographically determined. Breathing at FIO2 0.10 for 14 days increased pulmonary arterial wall thickness and the proportion of muscular arteries in the lung periphery. Right ventricular weight and right ventricular rANF gene expression increased, whereas body weight and skeletal growth were reduced (all P < .05). Continuous inhalation of 20 ppm NO at FIO2 0.10 for 2 weeks decreased hypoxic pulmonary vascular structural changes and somatic growth retardation and prevented the increase of right ventricular weight and right ventricular rANF mRNA levels. These observations suggest that chronically breathing NO attenuates pulmonary vascular smooth muscle hypertrophy and/or hyperplasia and extension into distal arterial walls, right ventricular hypertrophy, and growth retardation of newborns breathing at a low oxygen level.
Administration, Inhalation↗
Multiple personality disorder in an intellectually disabled man: a case report.
The case of a young man with the dual diagnoses of severe intellectual handicap (IQ 30 and mental age 4 years) and Multiple Personality Disorder is presented. The intellectual handicap is probably due to hypoxia in infancy and the Multiple Personality Disorder follows prolonged physical and sexual abuse. The patient frequently switches between any of nine discrete but incompletely formed identities. Although some personalities seem more capable than others, all have similar levels of disability on testing. The diagnosis of psychiatric disorders coexistent with the intellectual handicap is hindered by the difficulty in separating psychiatric phenomena from the behavioural disturbances associated with the disability. Differential diagnosis and management are discussed.
Adult↗
Electron microscopy of the seminiferous epithelium in the triploid (ZZZ and ZZW) fowl, Gallus domesticus.
The ultrastructure of cells of the seminiferous epithelium is described in both triploid ZZZ and ZZW fowls, especially cytological aberrations influencing the development of morphologically abnormal spermatids and spermatozoa. Mitotic divisions in triploid fowls are similar to those in diploid fowls, but meiosis in both the ZZZ and ZZW triploid fowl is abnormal and many defective gametes are produced. The majority of spermatids have structural abnormalities and this is attributed to the aneuploidy expected from meiotic chromosome pairing in a triploid. Some spermatids were observed to possess an irregularly shaped head, 2 centriolar complexes, 2 acrosomes and 2 tails and this type differentiated into large-headed spermatoza. Such spermatids and spermatozoa are suggested to be near diploid due to their large nuclear size and 2 sets of organelles. Other spermatids, observed with only 1 centriolar complex, 1 acrosome and 1 tail, are suggested to be near haploid. Differentiation of these spermatids is similar to the process observed in diploid fowls except that there is a high percentage of abnormally shaped heads. The fact that morphologically normal spermatozoa were rare is consistent with the expectation that very few spermatozoa would be exactly haploid. In both ZZZ and ZZW triploid fowls, triple pairing of chromosomes is observed in synaptonemal complexes (SC) during meiosis and recombination nodules are distributed at random in the central regions of the triple pairing SC. In ZZW triploid fowls gamete formation is more severely affected than in ZZZ triploid fowls and it is suggested that many of the degenerative changes occurring in ZZW fowls could be attributed to those spermatids that possess a W sex chromosome, since normal male fowls are the homogametic sex (ZZ) and normal spermatids and spermatozoa contain only a Z sex chromosome.
Animals↗
Intracellular signal transduction mechanisms of rat epididymal spermatozoa and their relationship to motility and metabolism.
The role of intracellular signal transduction mechanisms in regulating the motility and metabolism of rat spermatozoa in undiluted caudal epididymal fluid (CEF) was examined. Samples of CEF containing immotile spermatozoa were exposed to drugs and other agents that either stimulate signal transduction pathways or mimic the action of their second messengers. Under these conditions, sperm motility in 25-30 nl of CEF was stimulated by calcium ions (Ca2+), N2,2'-O-dibutyrylguanosine 3':5'-cyclic monophosphate (dibutyryl cGMP), cyclic adenosine 3':5'-monophosphate (cAMP), N6,2'-O-dibutyryladenosine 3':5'-cyclic monophosphate (dibutyryl cAMP), 8-bromoadenosine 3':5'-cyclic monophosphate (8-bromo cAMP), caffeine, theophylline and bicarbonate ions (HCO3-). Other agents such as magnesium ions (Mg2+), veratridine, phospholipase C (PLC), ionophore A23187, 1,2-dioctenoyl-sn-glycerol (DAG), phorbol 12-myristate 13-acetate, phospholipase A2 (PLA2), arachidonic acid, and melittin did not significantly influence motility. In the presence of radiolabelled energy substrates, untreated (immotile) spermatozoa in samples of CEF utilised D-[U-14C]glucose and [1-14C]acetate as exogenous energy sources for oxidative metabolism. No detectable 14C-lactate was produced, and none of the drugs altered the rate of glycolytic or oxidative metabolism. The findings suggest that the motility of rat caudal epididymal spermatozoa is regulated by Ca2+ and the guanylate cyclase and adenylate cyclase pathways, but not through the PLC and PLA2 pathways. Also, their metabolism of exogenous substrate was uncoupled from the induction of motility, and their oxidative capacity exceeded the rate of flux of glucose-carbon through the glycolytic pathway.
Animals↗
Surface area of apical and basolateral plasmalemma of epithelial cells of the ductuli efferentes testis of the rat.
Serial sectioning was used to determine the occurrence of ciliated cells, and a morphological technique was used to estimate the relative and absolute surface areas of apical and basolateral membrane of the epithelial cells lining the ductuli efferentes of the rat. It was found that the ciliated cells constitute 15% of the epithelial cells and occur as groups of mainly 1-3 cells which are distributed at random in the duct epithelium. For the non-ciliated cells it was estimated that the formation of microvilli by the apical membrane increased the surface area of that border by a factor of 37-fold. The average surface density of the basolateral membrane was 76% the surface density of the apical membrane. However, there was a 3-fold increase in surface density along the apical-basal axis of the basolateral plasmalemma. In the Discussion, the ductuli efferentes are compared to their homologue, the proximal tubules of the kidney, in the rates of fluid transport and membrane adaptations of their epithelium.
Animals↗
A comparison of single and repeated oral infection of chicks with two avian reoviruses.
Groups of specific pathogen-free light hybrid chicks were inoculated with one dose or repeated doses on alternate days of avian reovirus strain R2 isolated from tenosynovitis, or strain 49/82, isolated from infectious stunting. Strain 49/82 induced significant reductions in weight gain after infection by either method, as did strain R2 after repeated doses. Neither virus induced clinical signs or gross lesions of stunting or tenosynovitis in the five weeks of observation. Both viruses and methods of infection induced similar microscopic changes of reovirus tenosynovitis in the hock joints. Repeated doses caused a more prolonged persistence of virus in the intestine than a single dose. Cloacal swabbing indicated that strain 49/82 was more persistent in the gut after repeated doses than virus R2. For both strains, the persistence of virus in the liver was short-lived and the proportions of birds with virus in the hock joints were similar after both methods of infection. Repeated inoculations did not exacerbate the joint lesions or heighten the neutralising antibody response. However, for certain studies of reovirus infections, repeated inoculations with the virus may give a more accurate simulation of a natural infection.
Animals↗
Demonstration of a virulent subpopulation in a prototype live attenuated turkey rhinotracheitis vaccine.
A prototype live attenuated turkey rhinotracheitis (TRT) vaccine, which was known to cause occasional disease in young poults following multiple back passage, was tested for the presence of a virulent subpopulation by a novel combined in vitro and in vivo screening technique. When vaccine was inoculated at high titres into chick embryo tracheal organ cultures, 17% of aliquots were found to cause ciliostasis, and when these aliquots, in turn, were inoculated into 1-day-old poults, approximately one-quarter caused clinical disease. Removal of the subpopulation by plaque purification led to viruses which had reduced tendency to revert to virulence but remained protective. The technique proved valuable in identifying virulent subpopulations in specific prototype TRT vaccines. The principle may have more general application.
Animals↗
Interactions of sperm and the reproductive ducts of the male tammar wallaby, Macropus eugenii (Macropodidae: Marsupialia).
This review compares sperm production in the tammar wallaby and eutherian mammals, particularly the rat. The capacity of sperm to fertilize an ovum when they leave the testis and the changes they undergo in the epididymidis are considered. The structural differentiation and regulation of the extratesticular duct system is assessed and related to the reabsorption and secretion of water, inorganic ions and proteins, and the interaction of sperm and proteins synthesized and secreted by the epididymidis. Adaptations of the cauda epididymidis for storing spermatozoa are also considered. It is suggested that the tammar may be a good animal model to study the suppression of sperm motility and metabolism in the cauda epididymidis as it is possible to collect from them luminal samples of sperm which are initially immotile and then spontaneously activate during incubation in vitro.
Animals↗
Micropuncture and cannulation studies of fluid composition and transport in the ductuli efferentes testis of the rat: comparisons with the homologous metanephric proximal tubule.
Luminal fluids were collected in vivo by micropuncture and cannulation from the rete testis, efferent ducts and ductus epididymidis of the rat to determine the composition of efferent duct fluids and the rates of reabsorption of water and solutes by the efferent ducts. The concentration of spermatozoa increased by a factor of about 25 from 2.42 x 10(4) microliters-1 in the fluid from the rete testis to 6.00 x 10(5) microliters-1 in fluid at the end of the efferent ducts, indicating that 96.2% of the fluid leaving the testis is reabsorbed from the lumen of the efferent ducts. Most of this reabsorption (70.9% or 33.4 microliters h-1) occurs in the region between the rete testis and the middle of the coni vasculosi, with only 25.1% (11.8 microliters h-1) occurring between the coni and the beginning of the ductus epididymidis. However, reabsorption across the epithelium occurs at about the same rate in both regions, with the proximal region reabsorbing 17.2 microliters cm-2 h-1 (70.9% of fluid entering the region) and the distal region reabsorbing 12.2 microliters cm-2 h-1 (86.1% of fluid entering the region). Consequently, the fluid reabsorption rate for the whole efferent duct system (15.6 microliters cm-2 h-1) is similar to the values for individual regions. The principal solutes in luminal fluids from the efferent ducts are Na+ (137-144 mM) and Cl- (113-130 mM). The estimated sum contribution of Na+, Cl- and K+ to the osmotic pressure of luminal fluids was approximately 80% at each site sampled in the efferent ducts. The osmotic pressure of luminal fluid samples (301-307 mosmol kg-1) did not vary significantly along the ducts or differ significantly from that of blood plasma. The results demonstrate that there is a net reabsorption in the efferent ducts of nearly all the testicular output of water and inorganic electrolytes, and most of the protein, and that, in comparison, the ductus epididymidis is a negligible site of net fluid reabsorption. The results indicate that the ductus epididymidis, rather than the efferent ducts, is the site of accumulation of high concentrations of specific organic compounds like inositol. The efferent ducts are similar to the homologous proximal tubules of the metanephric kidney in that the luminal electrolyte composition (principal solutes Na+ and Cl-) and osmotic pressure remain relatively stable and that fluid reabsorption is close to isotonic and occurs at the same rate as the reabsorption of Na+.
Absorption↗
Studies on the epizootiology of canine coronavirus.
The seroprevalence and, or, incidence of canine coronavirus infection was determined in several dog populations in the UK. Seroprevalence ranged from 76 per cent for a rescue kennel to 100 per cent in a commercial breeding colony. In the rescue kennel there was no difference in seroprevalence of the virus between dogs less than or more than four months of age. In the breeding colony, subclinical seroconversion occurred between six and 10 weeks of age. The virus was isolated from faecal samples from 45 of 100 dogs in the rescue kennel; it was isolated from 73 per cent of the dogs with diarrhoea and from 43 per cent of those which did not have diarrhoea. In field cases of acute, mainly haemorrhagic diarrhoea in pet dogs, eight of 32 were positive for canine coronavirus. No canine coronavirus was isolated from either clinically healthy pet dogs in a boarding kennel or from non-diarrhoeic pet dogs examined at the University of Liverpool Small Animal Hospital. It would appear that although canine coronavirus is widespread, the role of the virus in canine enteritis is still equivocal.
Animals↗
Isolation of infectious laryngotracheitis virus from proximal femora of lame broiler chickens.
Two herpesviruses previously isolated from seven of 19 affected joint/bone samples in an earlier survey of lameness in broilers were identified. They were characterised as infectious laryngotracheitis (ILT) virus using serum neutralisation, immunofluorescence, restriction enzyme analysis and polymerase chain reaction techniques. In experimentally infected chicks, one of the isolates caused mild ILT and intranuclear inclusion bodies were present in the tracheal epithelium after four days. It is considered unlikely that these viruses were involved in the pathological changes in the affected legs. The possibility that ILT pathogenesis and epidemiology are more complex than currently understood is discussed.
Animals↗
New horizons in the diagnosis and treatment of breast cancer using magnetic resonance imaging.
A new nuclear magnetic resonance imaging (MRI) technique, Rotating Delivery of Excitation Off-resonance (RODEO), has been developed to assist surgeons in the diagnosis and treatment of breast cancer. A nonrandomized, prospective study of 100 patients with a high suspicion of breast cancer was conducted; these patients were examined by RODEO and conventional breast imaging, including mammography. Forty-one breasts were removed by mastectomy; each pathologic specimen was examined by sectional analysis. This study was undertaken to determine the extent that RODEO can aid in detecting breast tumors (including multicentric disease) and in evaluating candidates for conservative breast surgery. RODEO detected 85 pathologically confirmed lesions, 64 of which proved to be malignant. RODEO had a sensitivity of 95%, compared with a sensitivity of 58% for conventional imaging. More study is needed to determine distinguishing MRI characteristics that are suspicious for malignancy. RODEO may be used clinically to assess multicentricity and response to chemotherapy.
Breast Neoplasms↗
Major hepatic trauma.
The intraoperative management of complex liver injuries can be extremely challenging. During the past two decades, there have been some changes in philosophy regarding the optimal techniques for controlling hemorrhage and decreasing mortality and morbidity rates. An overview of these techniques is presented.
Debridement↗
Autologous graft-vs-host disease: mechanisms and potential therapeutic effect.
Administration of the immunosuppressive drug cyclosporine (CsA) after autologous or syngeneic bone marrow transplantation (BMT) elicits an autoimmune syndrome with pathology identical to graft-vs-host disease (GVHD). This syndrome can be induced both in man and in rats and is associated with the development of cytolytic autoreactive T cells that recognize MHC class II determinants. Studies in a rat model suggest that there are two essential components necessary for the induction of an autologous/syngeneic GVHD and include the inhibition of thymic dependent clonal deletion of autoreactive T lymphocytes by CsA and the elimination of a peripheral regulatory mechanism by the preparative regimen. The absence of peripheral autoregulation creates a permissive environment for the activation of the autoreactive T cells. Based on our understanding of the immunobiology of this autoimmune syndrome, we have utilized the induction of autologous/syngeneic GVHD in an attempt to provide an antitumor therapeutic effect after autologous BMT. Interim analyses of our clinical trials suggest that this approach is quite promising.
Animals↗
Spermiogenesis and spermiation in the Japanese quail (Coturnix coturnix japonica).
The ultrastructure of 12 steps of spermatid development and the process of spermiation are described for the Japanese quail in order to clarify the classification proposed for determining the stages of the cycle of the seminiferous epithelium (Lin et al. 1990) and to assess disagreements in the literature about sperm development in birds. It was concluded that acrosomal development involves the formation of proacrosomal granules which do not contain dense granules like the mammalian acrosome. Material which forms the perforatorium initially accumulates as a nuclear granule before appearing in the subacrosomal space. A circular and longitudinal manchette develop sequentially during nuclear elongation. Microtubules of the circular manchette initially form around several parts of the spherical nucleus of step 4 spermatids and subsequently occur most frequently around the narrowest regions of the elongating nucleus. Fibrous sheath development starts in step 2 spermatids indicating that it forms much earlier in the quail than in mammals. Spermiation differs from the process described in mammals in that the residual body is released from near the rostral end of the sperm nucleus leaving no cytoplasmic droplet in quail spermatozoa.
Animals↗