Standarization in hospital design--investment and payback.
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Biomedical subjects
Publications and source records attributed to R Moss.
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Ceruminoma is a catch-all term that has caused much confusion both in the literature and in clinical practice in regard to the specific histologic diagnosis and proper treatment for tumors arising from the ceruminous glands of the external ear canal. The term ceruminoma has been used in the past to refer to both benign and malignant lesions. To clarify the terminology and better determine appropriate treatment, two cases of benign adenoma of the ceruminous glands along with their histopathologic findings will be presented. The specific characterization of the individual types of ceruminous gland neoplasms, their clinical manifestations, histopathology, and recommended treatment will then be discussed. Finally, suggestions for the appropriate nomenclature for these rare tumors will be reviewed.
Cells of K2M rat sarcoma and their descendants (RP, RPS) form tumours in syngeneic inbred rat strain LEW/CUB. Thirty to fifty per cent of tumour-bearing rats develop metastases, preferentially in the lung. In vitro, a quasi-stellate dynamic morphotype was characteristic of K2M cells and their descendants (RP, RPS): a highly changeable round or spindle-shaped or multipolar rather thick cell body with two or more protrusions of various length, often branching, and broadened at the tips, where vivid membrane activity was observed. Changeability of appearance and directionality of locomotion were stimulated in medium of pH 6.5. The enhanced expression of this morphotype correlated with the increased metastatic potential. In vitro, in poor, slightly acid medium metastasizing cells preserved the quasi-stellate dynamic morphotype and survived longer than non-metastasizing cells. It is likely that the observed combination of traits, viz. the quasi-stellate dynamic morphotype and, under unfavourable conditions, prolonged survival, increased migratory activity and decreased mitotic rate could be of significance in the metastatic cascade, mainly for the escape from the primary site.
Paper disc-based solid phase radioimmunoassays are widely used in vitro diagnostic test kits for measuring total IgE (Phadebas PRIST) and specific IgE antibodies (RAST). Recently, these kits have been modified by the substitution of an enzyme-linked immunosorbent assay detection system (Phadezym PRIST/RAST). We studied the performance characteristics of Phadezym PRIST and RAST kits. Phadezym PRIST was sensitive to 0.5 IU/mL IgE. Reproducibility was excellent in the range of 5 to 200 IU/mL IgE and adequate in the range of 5 to 1000 IU/mL using 1:10 serum dilutions (average inter-assay coefficient of variation = 19%). Phadezym RAST was specific, but sensitivity was limited by absorbances in the RAST class 1/0 range indistinguishable from background values. Average inter-assay coefficient of variation was 29% for the semi-quantitative 'Phadezym RAST Unit' (PRU) reporting system. We modified the test kit procedure by disc incubations in microtiter plate wells with rotational agitation and use of ELISA-dedicated spectrophotometer and computer software. These microplate accelerated computerized assays ('MacPRIST' and 'MacRAST') were shown to perform similarly to the conventional Phadezym procedures with advantages in speed, ease, and handling of data.
Organic illness in the elderly can often present with psychiatric signs and symptoms such as anxiety, agitation, depression, mania, paranoia, delusions, hallucinations, and changes in cognitive function. The prototypes of three such diseases--B12 deficiency, hypothyroidism, and normal pressure hydrocephalus are discussed. Specifically addressed are the neuropsychiatric manifestations of these diseases and the need for a thorough and continuing evaluation of patients presenting with mental dysfunction, in order to ensure an accurate and timely diagnosis. It is only through the recognition that these symptoms may represent non-psychiatric organic disease that early treatment can be implemented and symptoms potentially reversed.
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Results of previous investigations indicate that muscular prostaglandins (PG) E2 and F2 alpha are biosynthesized during changes in muscular activity and stimulate protein degradation and synthesis, respectively. The results of the present investigation demonstrates a reduction by indomethacin of soleus hypertrophy, which occurred during a one week recovery period following rat hindlimb suspension. While this hypertrophic model evoked significant, rapid increases in soleus myosin and weight in control groups, continuous systemic release of indomethacin (3.5 mg/Kg/day) reduced the gain in soleus weight, Type I and II hypertrophy. Body weights of all groups were not significantly different. Additional analysis found a selective reduction in phosphatidylethanolamine (PE) during soleus atrophy and hypertrophy which were elicited by hindlimb suspension and recovery from suspension, respectively. Indomethacin enhanced PE recovery. Data from previous and present studies support a hypothesis that a change in soleus activity elicits PE catabolism, changes in cytosolic and muscular calcium, in calcium-dependent phospholipase activity, in PG biosynthesis, and in soleus size.
The protective effect of breast-feeding in allergy prophylaxis remains controversial despite many epidemiologic studies. One reason for confusion could be heterogeneity of breast milk with regard to its protective capacity. To clarify this issue, we studied 57 mother-infant pairs where breast-feeding was the sole source of infant nutrition. Family history and infant symptom scores suggestive of allergic disease were noted. The presence and quantity in breast milk of a prominent food allergen (beta-lactoglobulin), total IgA, and IgA antibodies to whole cow's milk and casein were measured serially. Eleven infants had symptom scores highly suggestive of allergic disease. The breast milk from mothers of these 11 infants was found to have lower total IgA (p less than 0.01) and IgA antibodies to both whole cow's milk and casein (p less than 0.001 and p less than 0.005, respectively) than milk from mothers whose infants had few or no symptoms. Beta-lactoglobulin was detectable in 45% of breast-milk specimens at concentrations up to 6.4 ng/ml and persisted up to 3 days after maternal dietary milk exclusion but was unrelated to antibody levels or symptom scores. Inadequate quantities of maternal IgA antibodies to food allergens appear to play a permissive role in development of infantile allergic disease in breast-fed infants and are more closely associated with symptoms than parental atopic history.
Changes in aromatase activity in the neuroendocrine tissues of captive male and female red grouse (Lagopus lagopus scoticus) were measured during a photo-induced breeding cycle. The gonads enlarged and subsequently regressed, as a consequence of the development of long-day refractoriness, within 84 days of transferring photoinsensitive birds from a non-stimulatory to a stimulatory daylength. The object of the study was to determine whether long-day refractoriness is related to an increase in aromatase activity in the neuroendocrine tissues which might result in a greater inhibitory action of locally produced oestrogens on the release of LH-releasing hormone. Aromatase activity was measured and found to be present in the anterior pituitary gland, the anterior/preoptic hypothalamus, the posterior hypothalamus and the hyperstriatum dorsale. It was higher in the hypothalamus than in the hyperstriatum dorsale and higher in the posterior than in the anterior/preoptic hypothalamus. Aromatase activity in the posterior hypothalamus was higher in males than in females in short-day photosensitive and reproductively active birds, but not in long-day refractory birds. A similar sex difference was also observed in the anterior/preoptic hypothalamus in reproductively active birds. Hypothalamic aromatase activity in both sexes was directly related to gonadal function, being highest in reproductively active birds and lowest in long-day refractory birds. It is concluded that the development of long-day refractoriness is not related to an increase in aromatase activity in the neuroendocrine tissues. The decrease in aromatase activity in the neuroendocrine tissues in long-day refractory birds parallels a decrease in aggressive and territorial behaviour.
Constipation and its complications, particularly meconium ileus equivalent, may become management problems in patients with cystic fibrosis. The medical records of 168 patients with cystic fibrosis were reviewed for the prevalence of constipation and meconium ileus equivalent. Of 168 patients, 54 (32%) had experienced at least one episode of constipation which responded to oral or rectal laxative therapy. In 16 of the study group (9%) meconium ileus equivalent developed. Patients younger than 5 years of age had a lower prevalence and those older than 30 years of age had a much higher prevalence of both conditions. Those with prolonged histories of inadequately controlled steatorrhea appeared to be at higher risk for the eventual development of meconium ileus equivalent. Recurrences and complications of constipation may be avoided by instituting early and aggressive therapy.
We have studied some aspects of the morphological and biochemical differentiation of the foetal guinea-pig colonic epithelium. At day 40 the epithelium was organised in ridges and appeared pseudo-stratified. Folding of the epithelium, followed by villus formation, occurred between days 45 and 55, and by day 50 mucus-secreting goblet cells appeared at the bases of the colonic villi. By day 55 most epithelial cells, including goblet cells, possessed numerous microvilli which, by day 65, had become organised into well developed brush-borders. Between day 55 and term (day 65-68) mucosal depth increased markedly and the colon attained its final glandular morphology. Biochemical studies showed the specific activities of the microvillar hydrolases to be much lower in the washed colon than in either foetal meconium or small intestine at all times during development. Furthermore, a membrane fraction highly enriched in microvillus hydrolase activities was prepared from foetal colonic meconium using techniques originally devised to isolate the foetal small intestinal microvillus membrane. This meconial subfraction was almost identical in polypeptide composition to the highly-purified foetal small intestinal microvillus membrane. Identification of the colonic microvillus membrane was hampered by the absence of reliable membrane markers. Nevertheless, a fraction 14-fold enriched in aminopeptidase activity was prepared from day 40 foetal colon and its polypeptide composition compared by SDS-PAGE to that of the small intestinal microvillus membrane at the same age.
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Louping-ill virus was injected into the tarsal pads of four black grouse and the course of infection monitored. All developed viraemia of low intensity that lasted for four days and thereafter produced high titres of haemagglutination inhibiting antibody. No clinical signs were detected and mild neuropathological changes were present in only 1/4 brains collected on day 17 after inoculation. The mild response of black grouse to infection with louping-ill virus is thus similar to that found in other woodland and forest birds and contrasts with the generally fatal response of moorland and tundra grouse species. These findings give further support to the concept that louping-ill has been introduced to the moorland habitat only in the relatively recent past.
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A patient is described in whom cutaneous lesions were the initial manifestation of hairy-cell leukemia. Touch preparations made immediately on removal of a 3-mm punch biopsy specimen of the cutaneous lesions revealed acid-phosphatase positive, tartrate-resistant staining in the leukemic cells, and helped to establish the diagnosis. Specific eruptions occur in approximately 7% of patients with hairy-cell leukemia, appearing grossly as disseminated, erythematous maculopapules, with a perivascular mononuclear leukemic cell infiltrate seen microscopically. A review of the English literature indicates that cutaneous manifestations are not generally recognized as a diagnostic source in individuals with hairy-cell leukemia, and biopsy is seldom undertaken.
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It has been shown that gluten powder stained for one minute and forty-five seconds in a 0.192% solution of fast green FCF and then washed repeatedly with distilled water can be detected both by visible light and fluorescence microscopy when incorporated into doughs. Evidence that the functional properties of the gluten are not affected by this treatment suggested that the technique may be useful for following the incorporation of other proteins into various food systems.