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Biomedical subjects

R J Lane

Publications and source records attributed to R J Lane.

104 records · Page 6Linked to original sources

An evaluation of some carrier detection techniques in Duchenne muscular dystrophy.

Some recently described abnormalities in the serum and red cell membranes in Duchenne dystrophy have been examined as methods of carrier detection in a single-blind controlled study. Twelve carriers (4 definite, 3 probable and 5 possible carriers previously found to have raised creatine kinase levels) and 12 normal female controls of the same age, were examined on 3 separate occasions at approximately two-weekly intervals. Analysis of age-dependent red cell shape changes, serum haemopexin levels, red cell K+ efflux rate, sensitivity of red cell ghost membrane ATPase to ouabain, membrane protein phosphorylation studies and lactate dehydrogenase isoenzyme profiles on agarose gel electrohoresis all failed to distinquish carriers from controls. The carriers suffered muscle cramps more frequently than the controls and all but one carrier and two control subjects were correctly identified by manual muscle strength testing, certain proximal muscles in paricular being consistently weaker in carriers than in the control group subjects. Scalar electrocardiography revealed higher values for the R/S ratio in Leads V1 and V2 and the sum (R-S) in V2.

Adenosine Triphosphatases↗

Operative ultrasonic bile duct scanning.

The concept of operative echography is introduced. A technique of operative ultrasonic bile duct visualization is presented as an alternative to contrast cholangiography during surgery. The technique is rapid, sensitive, provides immediate results, and does not involve the use of ionizing radiation.

Aged↗

Epsilon aminocaproic acid (EACA) myopathy.

Two female patients developed a severe, painful proximal myopathy after taking 18--30 g of epsilon-aminocaproic acid daily for 5 weeks. Marked elevations of serum aminotransferases, creatine kinase and aldolase levels were found and the first patient had electromyographic and muscle biopsy changes of an acute monophasic, necrotising myopathy at the height of the illness. Resolution occurred in both cases on stopping the drug and the second patient had no electromyographic or muscle biopsy abnormalities 3 weeks later. Only 2 recognized cases of the condition have been reported previously but a review of the literature revealed several other possible examples.

Aged↗

Drug-induced myopathies in man.

Drug-induced diseases constitute up to 5% of hospital admissions,a figure which almost certainly understates the total morbidity due to drugs1. Sever drug-induced myopathies are uncommon, but milder forms may be more prevalent than is generally appreciated, since skeletal muscle constitutes some 45% of total body-weight and has a major metabolic role in addition to its mechanical function2. Knowledge of possible effects of drugs on the neuromuscular system is of increasing importance both because the range of therapeutic agents continues to expand and because the resulting syndromes, through usually reversible at the outset, may progress and lead to grave consequences if the drug responsible is not stopped. Drug-induced neuropathies3 will not be considered here, but it will be appreciated that muscle weakness may also be feature of such disorders and that some drugs may cause both a neuropathy and a myopathy. The features of the main drug-induced syndromes are summarised in the table. To these one could justifiably add the unwanted effects of srugs given for the treatment of central-nervous-system or neuromuscular disorders per se-e.g., the cholinergic block which may be produced by anticholinesterases alone or with corticosteroids in the myasthenic,4 and the profound weakness which may supervene after relief of spasticity with dantrolene sodium5.

Acute Disease↗

Oxyphenbutazone-induced goitre.

A woman who had taken oxyphenbutazone for 4 years because of back pain presented with goitre and hypothyroidism. This was shown to be due to an organification defect, caused or aggravated by oxyphenbutazone.

Back Pain↗

Percutaneous control of a portacaval H-graft: description of a new device and its initial clinical application.

A percutaneously-controlled inflatable cuff which can change the diameter of a portacaval H-graft has been developed and used in 10 patients. When inflated, the cuff narrows the H-graft to increase portal pressure and reduce shunting. Use of the cuff has been of clinical significance in 3 of 7 long-term surviving patients. Narrowing the shunt improved the clinical state in 2 patients with encephalopathy, and reopening a closed shunt improved ascites in the third patient. Duplex ultrasound and deep Doppler have demonstrated an alteration of hepatic portal blood flow following inflation of the cuff after 6 months. It is concluded that further development of this controlled portacaval H-graft is warranted.

Adult↗

Aneurysm of the internal carotid artery at the base of the skull: an unusual cause of cranial neuropathies.

Aneurysms of the cervical portion of the internal carotid artery are relatively rare and can present difficult diagnostic problems. Signs and symptoms of cerebral ischemia are common, but isolated cranial neuropathies are unusual. A patient with hypoglossal and glossopharyngeal cranial nerve palsies secondary to an extracranial internal carotid artery aneurysm is the subject of this case report and discussion.

Aneurysm↗

Pediatric infectious cervical lymphadenitis.

Infectious cervical lymphadenitis is a frequently encountered problem in the pediatric population. The recent experience with infectious cervical lymphadenitis at the Children's Hospital of Philadelphia was reviewed. The most common etiologic agent was Staphylococcus aureus. beta-Hemolytic streptococcus and mycobacterium were found in 15% and 6% of cases respectively. Other agents included pneumococcus, cat scratch, Toxoplasma gondii, actinomycosis, and mixed bacteroides and peptostreptococcus. Most patients responded to high-dose intravenous antistaphylococcal penicillin. Needle aspiration proved successful in identifying the casual agent in a high percentage of cases. Aspiration was also beneficial in draining small abscess cavities. Surgical drainage was rarely necessary.

Adolescent↗