Spontaneous migration of a Hickman catheter.
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Biomedical subjects
Publications and source records attributed to R Goldberg.
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We reviewed the ocular findings in 57 consecutive patients with the facioauriculovertebral sequence (Goldenhar-Gorlin syndrome). Epibulbar choristomas were detected in 18 cases (32%), a much lower occurrence than reported previously. Various motility disorders (11 cases, 19%), blepharoptosis or narrow palpebral fissures (seven cases, 12%), eyelid colobomas (six cases, 11%), and lacrimal drainage system anomalies (six cases, 11%) were more frequent than previously noted. These ocular findings were more common in the patients with epibulbar choristomas. Of the various features of the Goldenhar-Gorlin syndrome (skin tags, microtia, hemifacial microsomia, and vertebral anomalies), only skin tags correlated positively with the laterality of epibulbar choristomas. Preauricular and facial tags represent choristomas, explaining their association with epibulbar choristomas and the laterality they share.
Double labeling and color microradioautography were used in a new method of hybridization in situ to identify different genes in individual cells. The method is based on the unequal penetration of 3H and 35S into two layers of nuclear track emulsion separated by a thin barrier film. Hybridization of a 35S-labeled probe specific for one kind of gene results in silver grains over cells in both layers of emulsion; a 3H-labeled probe for a second gene provides grains only in the first layer of emulsion. Silver grains are converted to magenta-colored grains in the first layer and to cyan-colored grains in the second to facilitate enumeration of grains in each layer. This technique should be widely applicable in analyses of differential gene expression in single cells or in discrete populations of cells.
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Risk factors for local-regional recurrence of breast cancer were analyzed in a retrospective review of 117 patients treated with adjuvant CMF (Cytoxan [Mead Johnson & Co, Evansville, Ind], methotrexate, 5-fluorouracil) after radical or modified radical mastectomy at the Vincent T. Lombardi Comprehensive Cancer Center (Washington, DC). The median follow-up time was 50 months after mastectomy. The median time to recurrence was 23 months. The actuarial local-regional failure rate was 19% at five years. Risk of local failure correlated with size of primary (27% for T3 v 15% for T1) and axillary node status (36% for four or more positive nodes v 9% for three or fewer positive nodes). These findings suggest a rationale for the addition of postoperative radiation therapy in high-risk patients treated with adjuvant chemotherapy.
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A case of cecal adenocarcinoma with the typical histopathologic features of collagenous colitis throughout the resected colon is described in a 67-year-old woman. Collagenous colitis has not previously been reported in association with adenocarcinoma of the colon and the relationship of these findings appears to be unprecedented. A review of 100 randomly selected Duke's B adenocarcinomas of the colon revealed no similar case.
Accident reports and medical statements (a total of 719) concerning chain-saw injuries were evaluated. Chain-saw wounds can be found in all parts of the body, especially the thighs and fingers. The typical chain-saw wound is a multiple superficial laceration, soft tissue wounds are usually heavily bruised and jagged , and bone lesions are rare and superficial. Among 188 finger injuries, only 15 slight bone lesions were seen. The frequency of all injuries decreases as one progresses from the thumb to the little finger and from the finger tip to the finger. The more proximal the isolated finger injury, the more frequently is it diagonal or even longitudinal. Incomplete or complete finger amputations were not observed.
Using a prospective study design, we compared the incidence rates in 807 patients of phlebitis, malfunction, cellulitis, and septicemia for short-term Teflon catheters with dressings changed every 24 or 48 hr, or using a polyurethane dressing changed every 48 hr. The study utilized either a standard dressing, which consisted of a small piece of dry sterile gauze, or a polyurethane dressing. The risk of phlebitis at 48 hr was significantly greater in the daily dressing change group as compared with the group that had dressings changed every 48 hr or with those using the polyurethane dressing (p less than 0.05). At 72 hr, there was also significantly less phlebitis using the standard dressing changed every 48 hr (p less than 0.05). The risk of malfunction was significantly greater at 24 hr for the polyurethane dressing compared with the other two groups (p less than 0.05). These findings indicate that adoption of a 48-hr dressing change interval using a standard dressing could result in less phlebitis and significant cost savings to a university-based institution.
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The authors report a rare complication of intravenous pyelography: namely "iodide mumps". A review of the literature is undertaken.
The life-style of adolescents attending a Seventh-Day Adventist boarding school was evaluated as it related to cardiovascular risk factors. The diet contained 34% calories as fat, with 11% derived from saturated fat. Total serum cholesterol levels were low (mean, standard deviation=138+/-15 mg per dl), and apolipoprotein B level was low as well (46+/-9 mg per dl). The high-density lipoprotein cholesterol level was within the usual range (52.4+/-13.3 mg per dl). Mean blood pressures were also low (systolic, 104.1+/-9.6 mm of mercury; diastolic, 65.7+/-9.7 mm of mercury). There was no self-reported use of cigarettes. If this life-style were to continue through adulthood, the incidence of premature atherosclerotic disease, particularly coronary artery disease, for this group might well be reduced, compared with other North Americans, as suggested by findings from previous studies of adult Seventh-Day Adventists.
A cross-over study using 11 male subjects and a closely controlled diet, investigated the effect of alcohol on serum high density lipoprotein (HDL) components. Smoking status and body weight remained essentially constant and exercise changes were adjusted for in the analysis. As compared to sucrose, alcohol consumption was associated with a significant elevation in serum apolipoprotein A-I (0.37 mg/dl/g/day of alcohol) with similar effects for serum HDL cholesterol (0.14 mg/dl/g/day of alcohol) and serum apolipoprotein A-II (0.11 mg/dl/g/day of alcohol) achieving borderline levels of statistical significance.
Rabbit antibody produced in response to the purified mitogenic glycoprotein lectin from Wistaria floribunda seeds (WFM) contains anti-carbohydrate antibody. This antibody, which represents 25% of the total antibody precipitated by the homologous antigen cross-reacts with the glycoprotein hemagglutinating lectins from Sophora japonica (SJL), W. floribunda (WFA) and the glycoprotein bromelain, but not the protein lectin from Maclura pomifera seeds. The cross-reactive reaction is totally abolished by the presence of glycopeptides obtained from SJL. Utilization of a fluorometric binding assay employing fluorescein derivatized glycopeptides from SJL, bromelain, fetuin and ovalbumin, it was found that the total anti-carbohydrate antibody population best reacts with the following carbohydrate structure: MAN alpha 1 leads to 6 MAN alpha 1 leads to 6 MAN beta 1 leads to 4 GLCNAC beta 1 leads to 4 GLCNAC beta 1 leads to Asn. Substitution of the beta-mannosyl moiety at position 3 results in structures not capable of binding to the anti-carbohydrate antibody. This antibody appears to distinguish between those glycan moieties of glycoproteins commonly found in animals from those lacking 3-O-substitution of the beta-mannosyl residue as found in some plant glycoproteins.
A nonconcurrent prospective study was conducted in the metropolitan Baltimore, Maryland, area to examine the influence of marital status on the in-hospital and long-term survival rate of 1401 patients who experienced an acute myocardial infarction. Patients were classified as "married" or "unmarried" at the time of their myocardial infarction and any later change in the marital history was not considered. For married males the adjusted in-hospital case fatality rate was 19.7 per cent, whereas for unmarried males the rate was 26.7 per cent (p less than 0.05); similarly, the case fatality rate for married and unmarried females was 23.3 per cent and 37.4 per cent, respectively (p less than 0.05). A 10-year follow-up of 888 subjects who were discharged alive after an acute myocardial infarction also showed a significantly better survival rate for the married compared to the unmarried for both males (p less than 0.0001) and females (p less than 0.025). The results of this study indicate that married men and women who experience an acute myocardial infarction have a significantly better survival prospect, both in-hospital and after discharge, independent of other factors.
Dictyosomelike structures (DLS) are organelles unique to male mammalian germ cells and occur in large numbers in spermatocytes of the guinea pig. Selective staining of DLS with phosphotungstic acid at low pH was used to identify DLS in cell fractions prepared by combined sucrose gradient and differential centrifugation procedures. This staining property was retained in homogenates and permitted DLS to be distinguished from cisternae of Golgi apparatus and most other spermatocyte membranes. DLS were resistant to the homogenization and isolation stresses, at least in regard to their structural integrity. The purity of the DLS fractions was proportional to the purity of spermatocytes derived in the initial cell separation steps. Cell separation and the attainment of good spermatocyte fractions appear critical to the isolation of DLS by these procedures.
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