Biomedical subjects
Publications and source records attributed to S Hamilton.
A 32-year old woman was found at surgery to have an esophageal leiomyoma arising within an epiphrenic diverticulum. These uncommon conditions may rarely occur together, causing difficulty in diagnosis of the leiomyoma. Other neoplasms may also arise in an epiphrenic diverticulum and should be borne in mind in this situation.
Medial talo-calcaneal coalition is an uncommon developmental anomaly consisting of a bony projection arising from the postero-medial aspect of the sustentaculum tali, which may articulate with another bony projection from the medial aspect of the talus. Fibrous, cartilaginous or bony ankylosis may occur. It usually presents in adolescents, and causes pain following exercise. It may cause a lump, and can predispose to flat foot and early osteoarthrosis. This condition is easily overlooked on routine views of the ankle, and may require oblique views and tomography for its detection and clarification.
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Primary non-obstructive megaureter is rarely first diagnosed in adult life. The clinical and radiographic findings in 11 adults presenting with this condition are reviewed. The commonest complaint was pain. In all cases the diagnosis was suggested by intravenous urography, which was usually the initial diagnostic test. Confirmation was aided chiefly by micturating cystography and retrograde pyelography. Cystoscopy was normal. The radiologist can make an early diagnosis in this condition, which requires no treatment, in the absence of complications.
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The return of fluid and protein to the bloodstream by the lymphatic circulation may play an important role in reconstituting intravascular volume following hemorrhage. In this study, we have defined the lymph-flow changes that occur in cannulated mesenteric lymphatics following a 25% blood loss in anesthetized sheep and investigated the effects of hemorrhage on the intrinsic contractile activity (lymph pumping) of these vessels in vivo using a new model system. The removal of 25% of the calculated blood volume resulted in increases in lymph flow over a 6-hour period, with peak changes to 3.5 times the prebleed levels. Systemic arterial pressures dropped to roughly 50% of control values immediately following the bleed and returned to control in 3 hours. To directly assess the effects of hemorrhage on lymphatic pumping, a segment of intestinal lymphatic was isolated from all lymph input and supplied with fluid from a reservoir. While there was no net pressure driving fluid through the duct, a transmural distending pressure was applied to the vessel, which stimulated resting lymphatic contractions and fluid pumping. A 25% blood loss resulted in increased activity of the lymph pump; up to 6 times more fluid was propelled through this "isolated" vessel in vivo than in similar preparations in sheep that were not bled (p less than 0.01). Measurements of fluid pulse pressures in this preparation indicated increased pumping frequency and/or force after hemorrhage compared with prebleed levels. We conclude that lymphatic contractile activity is stimulated after a blood loss independent of changes in lymph formation and speculate that this mechanism may play an important role in the reexpansion of the vascular space.
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Dermatologists and their plastic surgical colleagues treating acne vulgaris and its sequelae have an effective arsenal of anti-acne preparations to inhibit and avoid many of the long-term, cosmetically deforming effects of severe inflammatory acne. It is incumbent upon the physician participating in the care of the early and late sequelae of acne vulgaris to provide timely surgical therapy for those lesions requiring surgical drainage, extraction, or scar revision, while maintaining appropriate medical therapy for those areas of the skin still at risk to develop active disease.
Proper understanding of the cause, nature, and treatment of diseases affecting the skin requires an intimate knowledge of the anatomy and physiology of normal as well as pathologic skin. This article thus lays the groundwork for the discussions of specific pathologic conditions that follow in this issue.
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The etiology, diagnosis, and treatment modalities of common and not so common vascular malformations of the head and neck are discussed in this article.
Receptor binding, electrophysiological, and inotropic effects of the pure dihydropyridine enantiomers (+)S202-791 and (-)R202-791 were studied in cardiac preparations. The KI for (+)S202-791 binding correlated with the ED50's for an increase in contractile force and an increase in calcium current, the latter effect occurring at depolarized as well as resting holding potentials. The KI for (-)R202-791 binding was much lower than the IC50's for inhibition of calcium current measured at holding potentials of -80 or -90 mV and a negative inotropic effect, but correlated closely with the IC50 for inhibition of calcium current measured at -30 mV. Thus, (+)S202-791, is a voltage independent calcium channel activator and (-)R202-791 is a voltage dependent calcium channel inhibitor.
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Interventional postoperative manipulation of the common bile duct is usually performed for removal of retained calculi via T-tube or surgical cholecystostomy tracks. The removal of foreign bodies from the gallbladder and common bile duct in dogs via cholecystostomy tracks using interventional radiology techniques is described as an alternative to surgery.
Rupture of the pulmonary artery is a potential complication of the use of a Swan-Ganz catheter. We report a single case in which the site of rupture was visualized on a postmortem arteriogram, but was not apparent on a contrast radiograph performed prior to death, presumably due to inadequate filling of the arterial tree with contrast. Awareness of the value of a properly performed arteriogram may allow a lifesaving lobectomy or pneumonectomy.
Rheumatoid arthritis is generally a symmetrical polyarthritis characteristically involving small joints. Unilateral disease may occur when limbs are protected by a neurologic defect. Unilateral rheumatoid arthritis occurring in a patient with hemiplegia is here described.