Biomedical subjects
Publications and source records attributed to R I Miller.
The pathogenesis, clinical characteristics, screening protocol, and dental management of the patient with sickle cell anemia or sickle cell trait are discussed. Treatment modalities are presented to aid the practitioner in caring for the patient with a sickle cell disorder.
Seasonal changes in density and spatial distribution of Onchocerca cervicalis microfilariae were studied in ventral-midline skin of 15 infected pony mares in southern Louisiana. Triple running mean analysis of data over a 13-mo period indicated that a distinct pattern exists in total microfilariae population density and in microfilariae occurrence in different levels of the dermis. Microfilariae density reaches peak levels in the spring followed by a 58% decrease in the summer, a 19% increase in the fall, and a decrease to the lowest numbers in the winter. Microfilariae were found in all levels of the skin during the spring, summer, and fall but were not found in the superficial layers of the dermis during the winter months. The population density of Culicoides variipennis, a demonstrated vector of O. cervicalis, appeared to have seasonal fluctuations similar to the changes in microfilarial density. Harmonic wave analysis of microfilariae density data in individual ponies showed that all individuals did not follow the population trend.
An unusual case of bilateral condylar fractures in a child with extensive remodeling of the condyles is described. The case was complicated by the delay in diagnosing the fractures and the severity of the apertognathia, limited mandibular opening, and deviation of the mandible. Conservative therapy allowed remodeling of the condyles.
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Oral candidiasis and bacterial septicemia were diagnosed in 8 foals that had laboratory and/or pathologic evidence of immunodeficiency. Two foals suffered solely from complete failure of passive transfer of colostal immunoglobulins. Six foals had evidence of immune defects but did not meet the criteria for diagnosis of any of the currently recognized primary equine immunodeficiency syndromes. All six of these foals died or were euthanatized due to bacterial infections. One foal with failure of passive transfer recovered and the other died of a mesenteric torsion before the effect of treatment could be evaluated.
A horse had severe granulomatous lesions of the upper airways that were attributable to Conidiobolus coronatus. Therapeutic success was documented by clinical examination of the horse 4 years after treatment by surgical extirpation and intralesional and topical use of amphotericin B.
Six Brahman and Brahman-cross calves less than or equal to 9 months old were examined because of ulcerative swellings of the fetlocks (5 calves) or numerous focal ulcerated cutaneous lesions (1 calf). Biopsies revealed focal cutaneous granulomas around regular, thick-walled branching hyphae, 4 to 9 micron in diameter. In all cases, portions of the hyphae were surrounded by granular encrustations, which ultrastructurally were composed of amorphous material comparable to antigen-antibody complexes. The protist Pythium sp was isolated from 2 calves.
Basidiobolus haptosporus was isolated from a horse with a rapidly progressive ulcerative lesion of the ventral midline. The pathologic findings of an irregular line of yellow material composed of hyphae, eosinophils, and granulomatous inflammation between the superficial edematous tissue and the underlying muscle, and hyphae in tissue sections intimately surrounded by granular eosinophilic cuffs were considered diagnostic for this and one other case diagnosed retrospectively. Both horses were successfully treated by surgery and potassium iodide.
In a study of 63 cases of canine gastrointestinal phycomycosis, 60 were determined to have pythiosis and 3 to have entomophthoromycosis. In pythiosis, male, large-breed dogs less than or equal to 3 years old were most commonly affected. Clinical signs usually included vomiting and weight loss and these were associated with lesions of the stomach and small intestine. Histologically, the causative organisms were found in necrotic regions of diffuse or discrete granulomas in the submucosa or muscularis mucosae. Entomophthoromycosis was diagnosed by finding wide eosinophilic sleeves intimately surrounding thin-walled hyphae. Less than 5% of the dogs were alive 3 months following diagnosis.
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This article has reviewed the disease process and oral manifestations of AIDS. Specifically, dentists should review the medical history and perform an overall health assessment for all dental patients before treatment is rendered. Attention should be directed to the prodromal signs and symptoms of AIDS. If dental treatment of a patient with AIDS is required, strict infection control guidelines are mandatory.
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We have used intra-arterial (i.a.) 1,3-bis(2-chloroethyl)-1-nitrosourea (BCNU) either alone or as part of adjuvant chemotherapy in patients with malignant brain tumors over a 3 year period (1979-1982). The i.a. BCNU technique was used 111 times to infuse 134 arteries in 37 patients. These patients, 28 cases with glial tumor and 9 cases with brain metastasis, received i.a. BCNU in combination with Vincristine and Procarbazine every 6 weeks. Complications encountered were transient and included: periorbital erythralgia or occipital-nuchal pain in 23 (62%), mild confusion and disorientation in 14 (38%), and ipsilateral conjunctival edema in 10 (27%). Reversible myelosuppression was not found. Our findings suggest that BCNU (100 mg/M2) may be given by i.a. infusion in combination chemotherapy without persistent severe untoward effects with a cumulative dose of 700 mg/M2.
Bilateral complete mature alveolar clefts with oronasal fistulae were surgically created in dogs to directly compare the rate and quantity of bone formation between autogenous particulate bone and cancellous marrow, undecalcified freeze-dried allogeneic bone, and controls of repaired clefts without bone graft material. This study demonstrated autogenous particulate bone and marrow to be the superior graft material, although the allogeneic bone demonstrated bone formation through inductive mechanisms. The bone formation through induction was delayed compared with the autogenous graft system, and was quantitatively insufficient to support eruptive or orthopedic forces.
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