Search PubMed⌕ Search

Biomedical subjects

R Fisher

Publications and source records attributed to R Fisher.

At least 217 records · Page 12Linked to original sources

Rheoencephalographic and other studies of betahistine in humans. III. Improved methods of diagnosis and selection in arteriosclerotic dementia.

Thirty-six institutionalized geriatric patients with particularly severe and longstanding dementia were selected by chart review and were studied neurologically. Criteria for clinical diagnosis are derived, and it is shown that arteriosclerosis had caused or contributed to their dementias in 33 patients (91.7%) and probably did so in two others (97.2%). Arteriosclerotic dementia may not be rare and may be much more prevalent than may now be considered the case. As 23 patients (63.9%) showed evidence of carotid and/or vertebrobasilar involvement, large-vessel disease also may be more prevalent in geriatric dementia than is now thought and should be considered in all such patients. The results further confirm that careful review of ward records without reference to psychiatric diagnoses of etiology is a simple, rapid, and reliable method of screening a large institutionalized population for possible arteriosclerotic dementia. The selectees should then be surveyed appropriately to confirm the presence of the disease. Since a careful review of the complete hospital records and a thorough neurologic examination proved sufficient, more definitive but more dangerous invasive diagnostic procedures may not be necessary for clinical pharmacologic and similar investigations.

Aged↗

Sarcoma of the kidney: angiographic features.

Sarcomas of the kidney are highly malignant neoplasms. Abnormal vascularity can be detected in almost all types of sarcomas, but arteriovenous shunting, pooling of contrast material, and tumor staining are seldom present. Extension to renal vein and inferior vena cava may occur. While angiographic findings in our seven cases of renal sarcomas were nonspecific, this diagnosis should be considered in a relatively hypovascular neoplasm especially when the capsular arteries contribute considerably to the vascular supply. Nevertheless, statistically the most likely diagnosis of a hypovascular mass is renal cell carcinoma. Angiographic studies do not alter the management of the patient but merely suggest the diagnostic possibility of sarcoma. Angiographic diagnosis of different histologic types of sarcomas is not possible.

Adult↗

Carotid body in the sudden infant death syndrome.

Sixty-three percent of victims of the sudden infant death syndrome had a subnormal volume and 23 percent an enlarged volume of glomic cells in their carotid bodies. Evidences of antecedent chronic alveolar hypoxia and hypoxemia were found in both groups but were more severe in the victims with enlarged glomic tissue.

Age Factors↗

Hypothalamic-pituitary-gonadal function in men with cirrhosis of the liver.

Hypothalamic-pituitary-gonadal function was studied in 37 cirrhotic males, 25 of whom were alcoholic. Irrespective of aetiology, cirrhotic patients had significantly reduced free testosterone concentrations. Despite low free testosterone concentrations and reduced or absent spermatogenesis, basal levels of luteinizing hormone (LH) and follicle stimulating hormone (FSH) were normal in nearly all patients, suggesting impaired function of the hypothalamic-pituitary-gonadal axis. In 14 cirrhotic men, seven of whom had gynaecomastia, the ability of the pituitary to secrete LH and FSH in response to exogenous gonadotrophin releasing-hormone (LH/FSH-RH) was asssessed. A normal LH response to LH/FSH-RH was obtained in patients without gynaecomastia. An exaggerated LH response was found in four of seven with gynaecomastia, suggesting Leydig cell failure. The Leydig cell response to exogenous gonadotrophin in eight consecutive cirrhotic patients was probably abnormal but difficult to interpret as all but one were within conventionally accepted limits of normality. The patients without gynaecomastia gave a normal or minimally exaggerated FSH response to LH/FSH-RH. Six of seven with gynaecomastia gave a markedly exaggerated response suggesting failure of spermatogenesis, and all tested were either azoospermic of oligospermic. The single patient with a normal FSH response had a normal sperm count. The pituitary cells can therefore respond to LH/RSH-RH and the Leydig cells of the testes show some response to exogenous gonadotrophin. Similar abnormalities in hypothalamic-pituitary-gonadal function have recently been described in patients with normal liver function on chronic oestrogen therapy.

Adult↗

Parental correlates of Rorschach human movement responses in children.

The meaning of the human movement response (M) to inkblot stimuli was explored in terms of correlations between children's M productions and the attributes of their parents in 119 familes. M scores were available for the family members; and for each parent there were also measures of personality, values, and childrearing attitudes. A number of the parent-child correlational patterns were congruent with Rorschach's theories concerning the significance of M.

Adolescent↗

[Reaction of inhibition of macrophage electrophoretic mobility in differential diagnosis of carcinomas].

The reactivity of the lymphocytes from 40 carcinoma patients and 19 patients without detectable malignancies was tested by means of the macrophage-electrophoresis-mobility (MEM) test exposing lymphocytes from one individual to a large spectrum of antigenic preparations. Besides the encephalitogenic protein (EP) and the carcino-embryonic antigen (CEA) hypertonic KCl-extracts from human cancer and normal tissues were used as antigens to be tested. When performed in such a complex manner, the MEM-test resulted in characteristic reaction patterns allowing one not only to discriminate between cancer and noncancer, but also to draw a conclusion in which organ a carcinoma has arisen. The characteristic "immunological tumor profiles", thus obtained, are obviously due to the existance of common antigens in carcinomas of the same tissue origin. The CEA seems to be another antigen of high diagnostic value in that system, since the lymphocyte response to CEA was restricted to patients with tumors of the colon, rectum and stomach. The results show for the first time that lymphocytes of the tumor patients mentioned are able to react to CEA. The human lymphocyte response to CEA seems to be far more cancer- and (or embryo-specific than the reactions obtained with xenogenic hyperimmune sera) which areused for the detection of CEA in human sera or plasma samples. The "immunological tumor profile" opens a new step of quality among the attempts to develop immunological tumor tests.

Adenocarcinoma↗

Cardiac and other abnormalities in the sudden infant death syndrome.

Many victims of the sudden infant death syndrome (SIDS) have abnormally heavy cardiac right ventricles. The degree of this abnormality is directly proportional to: a) the mass of muscle about small pulmonary arteries, b) the amount of brown fat retention about adrenal glands, and c) the presence of hepatic erythropoiesis. The pulmonary arterial abnormality is probably the result of chronic alveolar hypoventilation, while brown fat retention and hepatic erythropoiesis are likely consequences of chronic hypoxemia. These abnormalities are found in both SIDS victims who die with and those who die without mild respiratory tract infections. However, there are some differences between the two SIDS groups. Infected victims die at an older age and have smaller thymus glands and larger spleens; there is a greater proportion of males in the infected victims than in the noninfected victims.

Adipose Tissue, Brown↗

[The distribution of B-lymphocytes in lymphoepithelial tissues as well as in tumors of the neck-, nose-, and throat region derived from lymphoreticular and lymphoepithelial tissues (author's transl)].

B-Lymphocytes carrying IgG-, IgM,- and IgA-surface receptors were estimated by fluorescence microscopy in the palatine tonsil of 50 patients aged 3 to 18 years as well as in 44 patients with various types of malignant lymphoms and lymphoepithelial carcinomas. Hyperplastic tonsillartissue contains large numbers of B-cells with a marked variability in concentration (4-30% IgG-cells, medium 12,9%;6-36 IgM-cells, medium 23.4%;3-38% IgA cells, medium 20.8%). There appears to exist an age-dependent increase in IgM-cells and an increase in IgG-and IgA-cells in patients with numerous recurrent infections of the upper respiratory tract. Malignant lymphomas can be grouped into three main categories: Such with a predominance of one B-cell line (above 75-80% of one immunological cell type); these include primarily malignant lymphomas of the well differentiated lymphocytic type (IgM and IgA receptors). Secondly, such with a significant decrease in B-cells (below 10%) which include primarily malignant lymphomas of the poorly differentiated lymphocytic type. Thirdly, such with an increased B-cell content but with more than one cell line participating in cell proliferation. The latter ones comprise certain cases of Hodkin's lymphomas. Lymphoepithial carcinomas are charactersized by a significant decrease in total B-cell content, except for IgE- and IgD-cells which were not investigated. The results show that the immunologic classification of malignant lymphomas correlates only to a certain degree with the morphologic classification; i.e. the same morphologic type of tumor may possess different immunologic characteristics. Since the immunologic characteristics may reflect a certain functional potential of these tumors as well as probably a certain kind of immunologic incompetence prior to tumor development, it is suggested, that future morphologic investigations of malignant lymphomas and lymphoepithelial carcinomas are combined with immunologic classifications.

Adolescent↗

Alcohol intoxication and serum osmolality.

The relation between serum osmolality and blood-alcohol was studied prospectively in 565 acute trauma patients. The two measurements were closely correlated. It is therefore possible to estimate the blood-alcohol from serum osmolality to assist in the clinical management of acutely injured patients.

Accidents↗

Carbon monoxide and heart attacks.

A study of the relationship between carbon monoxide exposure and heart attacks was conducted in Baltimore. There was no evidence of clustering of either myocardial infarction or sudden ASHD on a specific day, nor was there correlation between the number of cases per day and ambient CO levels. Postmortem HbCO levels were slightly higher in ASHD sudden deaths than in sudden deaths due to other causes. Any differences were probably primarily due to cigarette smoking. Cigarette smokers who died suddenly due to ASHD had substantially higher postmortem HbCO levels than nonsmokers. Practically all of the elevated HbCO levels could be related to cigarette smoking or specific environmental exposure. There were no differences between HbCO levels in ASHD sudden death patients and in living controls. There was also no relationship between cardiac pathologic findings and postmortem HbCO levels among patients dying suddenly of ASH.

Adult↗

Post-traumatic aneurysms of the thoracic aorta.

Nineteen patients with histologically proved post-traumatic aneurysm of the thoracic aorta were reviewed. Only seven aneurysms were detected at the time of hospitalization for trauma. Eight of 12 patients with chronic aneurysms either became symptomatic or showed enlargment during a period of observation. Surgical excision was the recommended method of therapy.

Accidents, Traffic↗

Foetal respiratory movements, electrocortical and cardiovascular responses to hypoxaemia and hypercapnia in sheep.

1. Foetal breathing movements, electrocortical activity, arterial pressure and heart rate were recorded continuously in chronically catheterized sheep, 97-145 days pregnant.2. With increasing gestational age there was a fall in heart rate of 0.67 beats/day and a rise in arterial pressure of 0.46 mmHg/day.3. Hypoxaemia in the foetus was induced by allowing the ewe to breathe low oxygen mixtures, 9% O(2) with 3% CO(2) in N(2). In the younger foetuses there was an initial rise in heart rate whereas in the older foetuses there was a fall. After the end of hypoxia there was a persistent tachycardia in both groups. In the older foetuses there was a rise of arterial pressure.4. Two vagotomized older foetuses showed cardiovascular responses similar to those of the younger foetuses.5. Foetal breathing movements were abolished by hypoxaemia in twenty-two of twenty-five experiments. In the three exceptional experiments there was a small rise in P(a, CO2).6. The proportion of time occupied by low voltage electrocortical activity in the foetus was reduced by hypoxaemia.7. Hypercapnia was induced by giving the ewe 4-6% CO(2) with 18% O(2) in N(2) to breathe. After an initial slight fall the foetal heart rate increased and there was a small rise in foetal arterial pressure.8. The proportion of time occupied by low voltage electrocortical activity and breathing movements was increased by hypercapnia.9. Maternal hyperoxia, induced by giving 50% O(2) in N(2), did not significantly increase foetal breathing movements unless the ewe was in labour. In labour the foetuses had lower P(a, O2) values initially and a reduced incidence of foetal breathing, both of which were increased by maternal hyperoxia.

Animals↗