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Biomedical subjects

R L Anderson

Publications and source records attributed to R L Anderson.

At least 55 records · Page 3Linked to original sources
PubMed1998

Neurochemical distinction between skeletal muscle vasodilator neurons and pelvic vasodilator neurons in guinea-pigs.

This study sets out to compare the combinations of potential vasodilator transmitters expressed by sympathetic and pelvic vasodilator neurons of guinea-pigs. Triple-labelling fluorescence immunohistochemistry was used to examine immunoreactivity (IR) to vasoactive intestinal peptide (VIP), nitric oxide synthase (NOS) and calcitonin gene-related peptide (CGRP) in lumbar sympathetic ganglia, and in perivascular axons supplying hindlimb skeletal muscles or pelvic viscera. Only 0.2% of VIP-IR nerve cell bodies in lumbar sympathetic ganglia (n = 4632 VIP-IR nerve cell profiles) contained NOS-IR, and one VIP-IR neuron contained CGRP-IR. The VIP-IR perivascular axons along the common and external iliac arteries, femoral artery and arteries to hindlimb muscles lacked NOS-IR and CGRP-IR. In contrast, all VIP-IR perivascular axons projecting from pelvic ganglia to the main uterine artery, and half of the VIP-IR axons along the internal iliac artery, contained NOS-IR and CGRP-IR. Thus, the neurochemical content of sympathetic vasodilator neurons to skeletal muscle arteries was clearly distinguishable from that of pelvic vasodilator neurons to the uterine vasculature. Furthermore, the autonomic dilation in each vascular bed is likely to be qualitatively different, and matched to the functional requirements of each target organ.

Animals↗
PubMed1998

Sarcoidosis with orbital tumor outside the lacrimal gland: initial manifestation in 2 elderly white women.

Two elderly white women (aged 72 and 87 years) were first seen with painless, unilateral orbital swelling. Orbital scanning revealed masses infiltrating the soft tissue around the eye. Biopsy results showed nodular, noncaseating granulomas consistent with sarcoidosis. One patient's workup revealed systemic manifestations of sarcoidosis at the time of examination with hilar lymphadenopathy noted on gallium scan; the other refused a complete systemic workup. The orbital tumors resolved with systemic prednisone therapy. To our knowledge, our 87-year-old patient is the oldest to be seen with orbital sarcoidosis. These 2 patients demonstrate that this diagnosis must be considered with orbital tumors in the elderly and in unusual locations, such as these which occurred outside the lacrimal gland.

Aged↗
PubMed1998

Cutaneous malignant melanoma and oculodermal melanocytosis (nevus of Ota): report of a case and review of the literature.

A 29-year-old white man, with oculodermal melanocytosis, had a rapidly enlarging, erythematous, painful nodule over his left brow, within the nevus. The lesion was excised and diagnosed as a malignant melanoma. Systemic evaluation showed no evidence of distant disease. This is the tenth case reported of a cutaneous melanoma developing in a nevus of Ota. Melanoma arising in the choroid, brain, orbit, iris, ciliary body, or optic nerve in association with a nevus of Ota is well documented. Careful observation is necessary in patients with a nevus of Ota, particularly in white patients, in whom malignant degeneration seems to occur with a disproportionate frequency.

Adult↗
PubMed1998

Sanitary care and maintenance of ice-storage chests and ice-making machines in health care facilities.

In response to a reported hospital outbreak traced to the use of contaminated ice in 1968, the Centers for Disease Control and Prevention (CDC) developed an advisory regarding the sanitary care and maintenance of ice-storage chests and ice-making machines. CDC has revised this unpublished advisory several times during the years to respond to requests for guidance from infection control professionals. Because CDC continues to receive inquiries about this topic from infection control professionals, this advisory is being published.

Centers for Disease Control and Prevention, U.S.↗
PubMed1998

Ruptured globe during orbital decompression surgery.

A 74-year-old patient sought treatment for visual obscuration and clinically had signs of Graves orbitopathy. Past medical history was unremarkable except for the use of antihypertensive medication. During the hospital admission, a fluorescent treponemal antibody absorption test was reactive, indicating infection with syphilis at some time in the past. Visual deterioration despite oral corticosteroid therapy prompted orbital decompression. At the time of surgery, she sustained a globe rupture. Presumably, syphilitic scleritis was responsible, in part, for scleral thinning and weakening, predisposing her to this complication. To the authors' knowledge, globe rupture has not been previously reported during orbital decompression.

Aged↗
PubMed1998

Blepharospasm: past, present, and future.

To investigate causes, associations, and results of treatment with blepharospasm, 1,653 patients were evaluated by extensive questionnaires to study blepharospasm and long-term results of treatment with the full myectomy operation, botulinum-A toxin, drug therapy, and help from the Benign Essential Blepharospasm Research Foundation (BEBRF). The percent of patients improved by the BEBRF was 90%, full myectomy 88%, botulinum-A toxin 86%, and drug therapy 43%. The patient acceptance rate for the BEBRF was 96%, full myectomy 82%, botulinum-A toxin 95%, and drug therapy 57%. Blepharospasm is multifactorial in origin and manifestation. A vicious cycle and defective circuit theory to explain in origin and direct treatment rather than a defective specific locus is presented. All four forms of therapy evaluated are useful and must be tailored to the patient's needs. Mattie Lou Koster and the BEBRF have helped blepharospasm sufferers more than any other modality, and all patients should be informed of this support group. The full myectomy is reserved for botulinum-A toxin failures, and the limited myectomy is an excellent adjunct to botulinum-A toxin.

Blepharospasm↗
PubMed1997

Five inhibitory transmitters coexist in pelvic autonomic vasodilator neurons.

Here we describe the localization of a potent vasodilator, calcitonin gene-related peptide (CGRP), in pelvic autonomic neurons containing four other inhibitory transmitters: vasoactive intestinal peptide (VIP), neuropeptide Y, nitric oxide and acetylcholine. These neurons mediate endothelium-independent vasodilation by releasing nitric oxide and one or more neuropeptides. Sixty percent of nerve cell bodies in guinea-pig paracervical ganglia with immunoreactivity (IR) for VIP, choline acetyltransferase (ChAT) and nitric oxide synthase (NOS), also contained IR for CGRP. Furthermore, many VIP-IR varicose nerve terminals at the adventitia-medial junction of the guinea-pig uterine artery contained IR for CGRP, ChAT and NOS. Both alpha-hCGRP and beta-hCGRP were potent dilators of the uterine artery (pD2 values 8.1, 8.3, respectively), but 1 microM hCGRP(8-37) did not antagonize dilations produced by either agonist. Dilations produced by alpha-hCGRP were unaffected by removal of the endothelium. Taken together with results of our previous studies, we propose that CGRP can contribute directly to autonomic vasodilation, possibly via CGRP2 receptors on smooth muscle cells, and that CGRP is the fifth inhibitory transmitter co-existing in pelvic vasodilator neurons.

Animals↗
PubMed1997

Comparison of dimercaptosuccinic acid and calcium disodium ethylenediaminetetraacetic acid versus dimercaptopropanol and ethylenediaminetetraacetic acid in children with lead poisoning.

OBJECTIVES: To compare the response to dimercaptopropanol (BAL) and calcium disodium ethylenediaminetetraacetic acid (EDTA) versus orally administered meso-2,3-dimercaptosuccinic acid (DMSA) and EDTA in children with lead poisoning. METHODS: Retrospective review of medical records of children admitted to MetroHealth Medical Center with a whole blood lead (BPb) concentration of 2.17 mumol/L (45 micrograms/dl) or more (or less than 2.17 mumol/L and not a candidate for outpatient oral chelation) and treated with BAL + EDTA or DMSA + EDTA. In each group, the mean BPb values at the end of therapy and at 14 and 33 days after chelation were compared with pretreatment BPb by the Wilcoxon signed-rank test, whereas the Mann-Whitney U test was used to compare percentage change from pretreatment at each follow-up day between the two groups. RESULTS: Twenty-three children received BAL + EDTA and 22 received DMSA + EDTA. The BPb values (mean +/- SD) at the end of therapy and at 14 and 33 days after chelation were significantly lower than pretreatment in both groups (BAL + EDTA: 17 +/- 10, 34 +/- 7, 36 +/- 11 vs 58 +/- 14 micrograms/dl, p < 0.02, 0.01, 0.001, respectively; DMSA + EDTA: 10 +/- 4, 30 +/- 10, 30 +/- 14 vs 50 +/- 10 micrograms/dl, p < 0.01, 0.001, 0.01, respectively). The percentage reduction (mean +/- SD) in BPb from pretreatment at the end of therapy and on days 14 and 33 after chelation did not differ between the groups (BAL + EDTA: -71.2% +/- 19.8%, -40.2% +/- 13.8%, -37.1% +/- 17%; DMSA + EDTA: -79.9% +/- 8.7%, -38.3% +/- 21.6%, -37% +/- 32%; p > 0.20). Elevation of alanine aminotransferase and vomiting during therapy were observed more frequently in the BAL + EDTA group compared with the DMSA + EDTA group. CONCLUSIONS: Treatment with DMSA or BAL combined with EDTA results in a comparable reduction in BPb.

Alanine Transaminase↗
PubMed1997

Transcanalicular neodymium: YAG laser for revision of dacryocystorhinostomy.

BACKGROUND: Laser-assisted dacryocystorhinostomy (DCR) has failed to match the success rates of external DCR. It has been suggested that this technology may be best suited for revision of failed DCR cases. The authors prospectively evaluated the efficacy of transcanalicular laser-assisted revision DCR (TCLARDCR). METHODS: A neodymium:YAG (Nd:YAG) laser was used for transcanalicular revision of 24 failed DCRs. Failure had followed one (n = 15), two (n = 7), or three (n = 2) previous external DCRs. RESULTS: Mean duration of the surgery was 78.2 minutes. Success was achieved in 11 cases (46%; mean follow-up, 20 months). There was no correlation between early loss of stents and failure. Three cases had partial relief of symptoms. Three of the failures unsuccessfully underwent further TCLARDCR. CONCLUSIONS: The authors' success rate of 46% with TCLARDCR compares poorly with the 85% success for external revision DCR. With TCLARDCR, specific anomalies like the sump syndrome cannot be addressed adequately. There is a theoretical risk of canalicular injury. Laser lacrimal surgery also is equipment dependent and more costly than external DCR. The TCLARDCR cannot be recommended for revision DCR using the Nd:YAG laser (Lasersonics, Milpitas, CA).

Adult↗
PubMed1997

Atypical lymphoid hyperplasia of the eyelids manifesting as xanthelasma-like lesions.

We describe a patient who had bilateral, yellow papules of the upper eyelids. This proved to be the clinical manifestation of an atypical lymphoid hyperplasia of the orbits. We describe this clinical presentation as a new sign of this condition. This finding serves to broaden the differential diagnosis of yellow papules on the eyelids. Atypical lymphoid hyperplasia of the orbits poses a challenging problem. Their benign or malignant nature cannot usually be determined by clinical and radiologic criteria. Most of these infiltrates result in extraocular lymphoma. We describe a patient with bilateral, yellow papules of the upper eyelids that proved to be a manifestation of an atypical lymphoid hyperplasia of the orbits.

Adult↗
PubMed1997

Resistance to heat radiosensitization and protein damage in thermotolerant and thermoresistant cells.

Recently, randomized phase III trials have indicated that hyperthermia combined with radiation leads to significantly better tumour control of certain malignancies than does radio-therapy alone. Yet, the full capacity of such combined treatments might not have been optimally exploited as in vitro data indicate that repeated beating of cells can result in either the development of a transient heat resistance (thermotolerance) and/or the selection/induction of a stable heat resistant cell population. Although the mechanism of thermotolerance and its effect on thermo-radiotherapy has been studied extensively, little data are available on the mechanism of stable heat resistance and its impact on combined heat and radiation treatments. In the current study, a comprehensive analysis was made of the differences and similarities between thermotolerance (TT) and stable heat resistance (TR) in terms of the mechanism of resistance to the direct toxic action of heat and in terms of the impact on the extent of thermal radiosensitization. Using heat resistant mutants previously derived from a murine radiation-induced fibrosarcoma (RIF-1), it was observed that these cells were resistant to protein denaturation and aggregation in the cytoplasmic/membrane compartment (measured by ESR (electron spin resonance) analysis and by in situ thermal denaturation of the foreign firefly luciferase targeted to the cytoplasm) but not in the nuclear compartment (measured by TX-100 insoluble nuclear proteins and by in situ thermal denaturation of luciferase targeted to the nucleus). RIF-1-TT cells, in contrast, were resistant for a 1 end-points tested. The lack of protection of nuclear heat damage in the RIF-TR cells could not be explained by a failure of one or more of the HSP70 isoforms to enter the nuclei of these cells. In relation to the absence or presence of heat resistance in the nucleus, the extent of heat radiosensitization was reduced in RIF-1-TT but not RIF-TR cells. This implies that resistance for heat killing is not necessarily accompanied by a reduction in the ability of heat to enhance the cellular radiosensitivity. The data indicate that the mechanism leading to permanent resistance after repeated heating and the mechanism causing thermotolerance may share common features but are in part different.

Animals↗
PubMed1997

Susceptibility of vancomycin-resistant enterococci to environmental disinfectants.

OBJECTIVE: To determine the susceptibilities of vancomycin-resistant and -sensitive enterococci (VRE and VSE) to various concentrations of commonly used, commercial, hospital-grade disinfectants. DESIGN: A microbial suspension test using inocula of 10(8) cells per mL in a disinfectant test dilution was used to determine inactivation kinetics of the test strains. In each test, 1-mL aliquots were removed from the cell-disinfectant mixtures at 15 and 30 seconds and then at 1-minute intervals for 5 minutes and neutralized. Appropriate serial dilutions were plated on agar medium for enumeration of survivors. RESULTS: VRE and VSE challenge inocula (in the absence of any additional protein or serum challenge) were below the limit of detection (5 colony-forming units/mL) after 15 seconds' exposure to the manufacturers' suggested use-dilutions of quaternary ammonium, phenolic, or iodophor germicidal detergents. In subsequent tests, when the disinfectants were diluted far beyond-the recommended use-dilutions (extended dilution), no differences were demonstrated between the susceptibilities of VRE and VSE. CONCLUSIONS: VRE and VSE are sensitive to a spectrum of commonly used environmental disinfectants and have parallel inactivation rates when challenged with extended dilutions of these products. Our findings did not demonstrate a relationship between antibiotic and germicide resistance. Routine disinfection and housekeeping protocols presently used in hospitals need not be altered due to concerns about the potential for environmentally mediated transmission of antibiotic-resistant microorganisms.

Anti-Bacterial Agents↗
PubMed1997

The universal implant for evisceration surgery.

The Universal implant is a quasi-integrated buried orbital implant designed to provide the same motility advantages as does an Iowa implant, but is simpler to implant and associated with fewer complications. The protruding mounds on the implant are keyed to corresponding indentations on the posterior prosthetic surface, allowing more life-like motility. We describe a straight-forward technique for its use as an evisceration implant and report the results in 24 patients. The Universal implant is simple to use and the lock-and-key mechanism obtained between implant and prosthesis provides the patient with a high degree of life-like motility. Its cost is significantly lower than the more popular hydroxyapatite implant and it does not require a drilling procedure for coupling.

Adult↗
PubMed1997

Management of postblepharoplasty lower eyelid retraction with hard palate grafts and lateral tarsal strip.

Lower eyelid malposition is the most common long-term complication following transcutaneous lower eyelid blepharoplasty. The malposition may include rounding of the lateral canthal angle, lower eyelid retraction with inferior scleral show, or frank ectropion. The result is cosmetically unacceptable and may be associated with tearing, irritation, and other exposure keratitis symptoms. Multiple factors, including lower eyelid laxity, shortage of skin, and scarring of the middle lamella, may be responsible for this malposition. A systematic examination of the lower eyelid, as presented, helps to assess the degree to which each of these factors is responsible for the malposition. Patients with the most severe degree of lower eyelid malposition generally have middle lamella scarring. If this abnormality is not addressed, lower eyelid procedures aimed at correcting the malposition are doomed to failure. In the presence of significant middle lamella scarring, a spacer is required to provide vertical height and stiffness to support the lower eyelid following release of the cicatrix. A systematic approach aimed at addressing the underlying abnormalities was developed. In patients with significant middle lamella scarring, hard palate mucosa grafts were used as spacers in 29 eyelids (17 patients). A lateral canthotomy and transconjunctival incision allow access to the scarring in the lower eyelid retractors and septum. After careful release of all cicatrix, a hard palate mucosa graft is inserted between the lower border of the tarsal plate and the recessed conjunctiva, lower eyelid retractors, and septum. Horizontal lower eyelid laxity, when present, is corrected by performing a lateral tarsal strip. Most patients do not have a true deficiency of the anterior lamella (skin and orbicularis oculi muscle). When a moderate amount of anterior lamella deficiency is present with significant scarring of the middle lamella, the technique we describe allows correction of the lower eyelid malposition without a skin graft. After a follow-up interval of 6 to 30 months (mean 14 months), excellent results were obtained in all eyelids. Complications included corneal abrasions in two eyes before routine use of bandage cornea contact lenses at the end of surgery and a secondary bleed from the roof of the mouth in one patient. Palate mucosa closely resembles tarsus and provides excellent vertical support to the eyelid. It is stiff enough to maintain eyelid contour without causing a cosmetically unacceptable bump. Tissue can be obtained with ease. The technique, as described, addresses the underlying causes of lower eyelid malposition and gives excellent functional and cosmetic results.

Adult↗