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Biomedical subjects

R E Morris

Publications and source records attributed to R E Morris.

At least 199 records · Page 11Linked to original sources
PubMed1990

Vitrectomy in asteroid hyalosis.

Asteroid hyalosis (AH), a condition in which calcium-lipid complexes form in the collagen meshwork of the vitreous, affects from 0.5% to 0.9% of the general population. In patients with dense AH and visual loss, obscuration of fundus detail on ophthalmoscopy and even on fluorescein angiography may complicate the diagnosis and treatment of underlying posterior segment disease. To evaluate the usefulness of vitrectomy in AH, we reviewed 7 cases of dense AH in 6 patients who underwent vitrectomy in the setting of decreased visual acuity of uncertain cause. Additional diagnoses made following surgery included age-related macular degeneration (ARMD) in 2 eyes, ARMD with associated epiretinal membrane in one eye, and the staging of diabetic retinopathy as proliferative in one eye. Although no major surgical complications occurred in this series, the potential for serious complications exists, and pars plana vitrectomy (PPV) should be considered only after less invasive diagnostic evaluations and therapeutic approaches have been exhausted.

Adult↗
PubMed1989

Why teenagers put rocks in their ears. Hidden drugs and confidentiality.

Just before and during the arrest procedure, juveniles may hide drugs within the body, an act called "body stuffing." The type and quantity of drug, its container, and the hiding place modify the potential toxicity of the contraband drug. The discovery of drug contraband by medical personnel raises an ethical issue regarding confidentiality. Responsibility for prison security rests primarily with the correctional staff, not with the medical staff. The need for trust between the physician and the adolescent in the detention setting is important. Appropriate medical and psychologic intervention can only be instituted if the detainee trusts and cooperates with the physician.

Adolescent↗
PubMed1989

Some difficulties encountered in teaching physician-parent communication in a pediatric emergency department.

In an attempt to increase physician-parent communication in cases of a child's emergency hospitalization, an informational protocol was developed with 10 topics to be discussed and checked off by the physician. Compliance was sporadic, with only 130 protocols completed during the first month, despite measures to improve its use. During the seven-month study period there were 2161 admissions, but only 466 protocols completed (21.5%). We excluded 143 forms because of errors in completion. The remaining 323 forms were analyzed for educational level of the physicians, topics omitted, patient diagnosis, and physician's rating of parent sophistication. Compliance in discussing each topic ranged from 77 to 93%. Attending physicians discussed all topics less than trainee physicians. All physicians discussed guilt feelings least (P less than 0.001). Guilt was discussed 55 and 62% of the time when the diagnosis was poisoning or chronic disease, respectively. Topics discussed were unrelated to parental sophistication. This protocol was unhelpful in improving communication.

Child↗
PubMed1989

Binding and uptake of pulmonary surfactant protein (SP-A) by pulmonary type II epithelial cells.

A glycoprotein of Mr 26-36,000 (SP-A) is an abundant phospholipid-associated protein in pulmonary surfactant. SP-A enhances phospholipid reuptake and inhibits secretion by Type II epithelial cells in vitro. We have used two electron microscopic cytochemical methods to demonstrate selective binding and uptake of SP-A by rat pulmonary Type II epithelial cells. Using an immunogold bridging technique, we showed that SP-A binding was selective for Type II cell surfaces. Binding was dose dependent and saturable, reaching maximal binding at approximately 10 ng/ml. On warming to 23 degrees C, SP-A binding sites were clustered in coated pits on the cell surface. To characterize the internalization and intracellular routing of SP-A, we used the biotinyl ligand-avidin-gold technique. Biotinyl SP-A was bound by rat Type II epithelial cells as described above. On warming, biotinyl SP-A was seen in association with coated vesicles and was subsequently located in endosomes and multivesicular bodies. Biotinyl SP-A-gold complexes were seen in close approximation to lamellar bodies 10-60 min after warming. Binding of biotinyl SP-A was inhibited by competition with unlabeled SP-A. These results support the concept that Type II epithelial cells bind and internalize SP-A by receptor-mediated endocytosis. This newly described uptake system may play a role in the recycling of surfactant components or mediate the actions of SP-A on surfactant phospholipid secretion.

Animals↗
PubMed1989

In vivo evaluation of the effects of altered cyclosporine metabolism on its immunosuppressive potency.

The dose-response and plasma concentration-response relationships of cyclosporine after both inducing and inhibiting its metabolism were studied in a mouse heart transplant model. The metabolism of cyclosporine was altered by coadministering phenobarbital and cimetidine as metabolism inducing and inhibiting agents, respectively. We found that phenobarbital depressed the immunosuppressive potency of cyclosporine by enhancing its metabolism resulting in lower cyclosporine blood levels. On the other hand, when cimetidine was administered concurrently with cyclosporine, the immunosuppressive effect was enhanced due to inhibition of the metabolism of cyclosporine which produced higher cyclosporine blood levels. When graft survival was evaluated relative to blood cyclosporine concentrations, however, it appeared that cimetidine had a direct negative effect on the survival of transplanted organs independent and contrary to its effect on the accumulation of cyclosporine. The immunosuppression produced by cyclosporine at these elevated blood levels was less than expected. The accrued data support the conclusion that cyclosporine and not its metabolites are primarily responsible for its immunosuppressive activity in the mouse.

Animals↗
PubMed1989

Ocular self-mutilation.

A 32-year-old paranoid schizophrenic man repeatedly stabbed both his eyes with a sharpened wire coat hanger. The patient underwent vitrectomy on each eye approximately 2 1/2 weeks after injury, with multiple retinal defects noted OU. None of the posterior wounds involved the macula or optic disc, and final vision was 20/70 OD and 20/50 OS. Ocular self-mutilation, deliberate and severe self-injury which threatens visual function, is a rare occurrence most often described in acutely psychotic patients. Psychosis may be due to schizophrenia, drug abuse, manic phases of bipolar mood disorders, and depression. A striking number of these patients have delusions with religious and sexual content. They are prone to repeated attempts during the acute psychotic phase and must be monitored closely at this time.

Adult↗
PubMed1988

'AIDS and dentistry'.

Explore the source record for details and available documents.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Differential effects of glucocorticoid on expression of surfactant proteins in a human lung adenocarcinoma cell line.

Synthesis of pulmonary surfactant-associated glycoproteins of Mr 28,000-36,000 (SP-A) and Mr 42,000-46,000 (proSP-B) has been identified in a continuous cell line derived from a human lung adenocarcinoma. SP-A was detected by immunoblot analysis, ELISA assay and by [35S]methionine labelling of the cells. SP-A was secreted into the media as an endoglycosidase F sensitive glycoprotein which co-migrated with the isoforms of SP-A identified in human lavage fluid by 2D-IEF-SDS-PAGE. Hybridization of cellular RNA with SP-A-specific cDNA identified an abundant 2.2 kb mRNA species, identical to that observed in human lung. SP-A RNA and protein content were markedly inhibited by dexamethasone in a dose-dependent fashion. Under identical culture conditions, synthesis of a distinct surfactant protein, SP-B, was markedly stimulated by the glucocorticoid. The SP-B precursor was secreted into the media as heterogeneous Mr 42,000-46,000 protein, pI 4.6-5.1, and was sensitive to endoglycosidase F. Synthesis of proSP-B was enhanced by the glucocorticoid in a dose-dependent fashion and was associated with increased SP-B mRNA of 2.0 kb detected by Northern blot analysis. The cell line secreted proSP-B as Mr 42,000-46,000 glycosylated protein and did not process the precursor to the Mr 7000-8000 surfactant peptide. In summary, a human adenocarcinoma cell line has been identified which synthesizes and secretes two surfactant-associated proteins, SP-A and proSP-B. Glucocorticoid enhanced SP-B but inhibited SP-A expression in this cell line. The identification of a continuous cell line secreting surfactant proteins may be useful in the study of synthesis and secretion of these important proteins and for production of the proteins for clinical uses.

Adenocarcinoma↗
PubMed1988

Evolving techniques in the treatment of macular detachment caused by optic nerve pits.

Fourteen patients with macular detachments caused by optic nerve pits were treated for progressive visual loss, cystoid macular changes, or atrophy of the macular retinal pigment epithelium. Photocoagulation of the temporal disc border alone was unsuccessful in two cases but promptly reattached the macula of two patients immobilized after laser surgery. Vitrectomy and gas tamponade improved vision and flattened the macula of three patients over various periods. The detachment recurred in one patient. Prompt and sustained macular reattachment with improved vision was noted after photocoagulation, vitrectomy, and gas tamponade in eight patients, although four required second operations. The prompt reattachment and visual recovery noted in these eight patients surpasses the reported 25% rate of spontaneous resolution.

Bed Rest↗