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Biomedical subjects

T Hodgson

Publications and source records attributed to T Hodgson.

At least 19 recordsLinked to original sources

MRI of perineural extramedullary granulocytic sarcoma.

Granulocytic sarcoma is an extramedullary solid tumour consisting of myelogenous leukaemic blast cells, usually seen in acute myeloid leukaemia and less commonly in patients with chronic myeloid leukaemia or myeloproliferative disorders. Blast cells have a predilection for periosteal and perineural regions and rarely precede evidence of systemic disease. We present two patients, aleukaemic on peripheral blood counts, both at presentation and during subsequent treatment. We present the MRI features of this rare but important condition.

Adolescent↗

Pulse rate over pressure evaluation (ROPE) is useful in the assessment of compensated haemorrhagic shock.

OBJECTIVE: To evaluate a calculation of pulse rate over pulse pressure as a method of predicting decompensation in patients with compensated haemorrhagic shock. METHODS: A retrospective cohort study was undertaken enrolling 184 adult victims of major road trauma who were not shocked on presentation to the emergency department. A pulse rate over pressure evaluation was calculated at presentation and vital signs were observed during the first 2 h of emergency department management. RESULTS: Thirty-one patients became shocked during their first 2 h. A ROPE value of greater than 3.0 had a positive predictive value of 53% and a value less than 3.0 had a negative predictive value of 86% for the development of decompensated shock. CONCLUSIONS: ROPE is an easily applied and useful clinical tool with a ROPE of less than 3.0 being predictive of a patient remaining well and a ROPE of above 3.0 being predictive of the patient developing decompensated shock.

Adolescent↗

Oral lesions indicative of plasminogen deficiency (hypoplasminogenemia).

BACKGROUND: Gingival overgrowth with ulceration has recently been recorded in 4 reports: (1) our report of a British patient with ligneous conjunctivitis in whom the gingival lesions appeared to be related to tranexamic acid-an antifibrinolytic agent; (2) a report of 2 Turkish patients and an Italian patient with mainly gingival lesions; (3) our report of 5 Turkish patients with mainly gingival lesions; and (4) a report of 3 new Turkish cases, which also were associated with gingival lesions and alveolar bone loss. These patients all had gingival swellings, and a minority had conjunctival involvement similar to ligneous conjunctivitis, although the etiology was unclear in all. Nevertheless, fibrin exudation was fundamental because the hyaline or amyloidaceous material seen on the gingival biopsy stained for fibrin but failed to stain for amyloid. METHODS: We have examined 6 more patients who exhibited gingival swelling caused by amyloidaceous deposits that stained only for fibrin, and we assayed their plasminogen levels. RESULTS: The plasminogen functional activity assayed in these 6 additional patients, and in 2 of the 5 patients previously reported by us, was significantly reduced. CONCLUSIONS: Gingival overgrowth with ulceration appears to be a new complication caused by plasminogen deficiency; it also appears to be related to ligneous conjunctivitis in some cases.

Adolescent↗

Impaired spatial working memory across saccades contributes to abnormal search in parietal neglect.

Visual neglect of left space following right parietal damage in humans involves a lateral bias in attention, apparent in many search tasks. We hypothesized that parietal neglect may also involve a failure to remember which locations have already been examined during visual search: an impairment in retaining searched locations across saccades. Using a new paradigm, we monitored gaze during search, while simultaneously probing whether observers judged they had found a new target, or judged instead that they were re-fixating a previously examined target. A patient with left neglect following focal right parietal infarction repeatedly re-fixated right locations. Critically, he often failed to remember that these locations had already been searched, treating old targets as new discoveries at an abnormal rate. In comparison, healthy age-matched control subjects rarely re-fixated targets, and mistook old targets as new targets even more rarely. The frequency of such mistakes in the parietal patient, for different conditions, correlated with the severity of his neglect. Control experiments indicated no perceptual localization deficit in non-search tasks. These results suggest a deficit in retaining searched locations across saccades in parietal neglect, in addition to the lateral spatial bias. Moreover, the former deficit exacerbates the latter, such that patients do not realize that the rightward locations favoured by their bias have already been examined during previous fixations and, for this reason, they saccade back to them repeatedly. The combination of the two deficits (a lateral bias plus a deficit in retaining locations already searched) may thus explain the pathological pattern of search that characterizes parietal neglect: why stimuli on the right are re-examined recursively, as if being searched for the first time, and hence why stimuli on the left continue to be ignored even with unlimited viewing time. These proposals accord with recent electrophysiological and functional imaging data, demonstrating posterior parietal involvement in the retention of target locations across saccades.

Aged↗

Localization to the nucleolus is a common feature of coronavirus nucleoproteins, and the protein may disrupt host cell division.

The subcellular localization of transmissible gastroenteritis virus (TGEV) and mouse hepatitis virus (MHV) (group I and group II coronaviruses, respectively) nucleoproteins (N proteins) were examined by confocal microscopy. The proteins were shown to localize either to the cytoplasm alone or to the cytoplasm and a structure in the nucleus. This feature was confirmed to be the nucleolus by using specific antibodies to nucleolin, a major component of the nucleolus, and by confocal microscopy to image sections through a cell expressing N protein. These findings are consistent with our previous report for infectious bronchitis virus (group III coronavirus) (J. A. Hiscox et al., J. Virol. 75:506-512, 2001), indicating that nucleolar localization of the N protein is a common feature of the coronavirus family and is possibly of functional significance. Nucleolar localization signals were identified in the domain III region of the N protein from all three coronavirus groups, and this suggested that transport of N protein to the nucleus might be an active process. In addition, our results suggest that the N protein might function to disrupt cell division. Thus, we observed that approximately 30% of cells transfected with the N protein appeared to be undergoing cell division. The most likely explanation for this is that the N protein induced a cell cycle delay or arrest, most likely in the G(2)/M phase. In a fraction of transfected cells expressing coronavirus N proteins, we observed multinucleate cells and dividing cells with nucleoli (which are only present during interphase). These findings are consistent with the possible inhibition of cytokinesis in these cells.

Animals↗

Detection of subarachnoid haemorrhage with magnetic resonance imaging.

OBJECTIVES: To measure the sensitivity and specificity of five MRI sequences to subarachnoid haemorrhage. METHODS: Forty one patients presenting with histories suspicious of subarachnoid haemorrhage (SAH) were investigated with MRI using T1 weighted, T2 weighted, single shot fast spin echo (express), fluid attenuation inversion recovery (FLAIR), and gradient echo T2* sequences, and also by CT. Lumbar puncture was performed in cases where CT was negative for SAH. Cases were divided into acute (scanned within 4 days of the haemorrhage) and subacute (scanned after 4 days) groups. RESULTS: The gradient echo T2* was the most sensitive sequence, with sensitivities of 94% in the acute phase and 100% in the subacute phase. Next most sensitive was FLAIR with values of 81% and 87% for the acute and subacute phases respectively. Other sequences were considerably less sensitive. CONCLUSIONS: MRI can be used to detect subacute and acute subarachnoid haemorrhage and has significant advantages over CT in the detection of subacute subarachnoid haemorrhage. The most sensitive sequence was the gradient echo T2*.

Adult↗

Allergic reactions.

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Anesthesia, Dental↗

Aetiological factors for oral manifestations of HIV.

OBJECTIVES: Describe the oral diseases in HIV-infected individuals in London, UK and identify social and medical factors related to the presence of specific oral diseases. DESIGN: Dental clinics. SUBJECTS: Consecutive sample of 456 patients with HIV infection. METHODS: Social and medical history and clinical examinations. Univariate and logistic regression analysis. OUTCOMES: Presence of HIV-associated oral disease. RESULTS: 80% of patients with AIDS and 50% of patients with HIV had a specific oral disease. The most common diseases were hairy leukoplakia (30%), erythematous candidiasis (24%), pseudomembranous candidiasis (14%), angular chielitis (6%), necrotising periodontal disease (8%) and non-recurrent ulceration (6%). CONCLUSIONS: The presence of erythematous candidiasis was not related to advanced HIV disease. Pseudo-membranous candidiasis, hairy leukoplakia and mucosal ulceration were significantly associated with advanced HIV disease. Smoking was also identified as a strong aetiological factor in oral diseases. Longitudinal studies are required to further explore the prognostic significance of oral diseases in HIV infection.

Acquired Immunodeficiency Syndrome↗

A preliminary study into the sensitivity of disease activity detection by serial weekly magnetic resonance imaging in multiple sclerosis.

Long TR and gadolinium enhanced spin echo brain MRI was performed weekly for three months in three patients with relapsing-remitting or secondary progressive multiple sclerosis. During the study, 38 new enhancing lesions were seen; 11 showed enhancement for less than four weeks, and two enhanced on only one scan. All 16 new lesions seen on long TR scans showed initial enhancement. When only every fourth (monthly) scan was analysed, a total of 33 new enhancing lesions were seen. Subject to confirmation in a larger cohort, the results suggest: (a) that blood brain barrier leakage is an invariable event in new lesion development in relapsing-remitting and secondary progressive multiple sclerosis; (b) the small increase in sensitivity of weekly scanning does not justify its use in preference to monthly scanning when monitoring treatments.

Adult↗

Case report: Extra-hepatic biliary cystadenoma in association with adenomyomatosis of the gall-bladder.

Biliary cystadenoma is a rare cystic tumour of biliary origin. We report on the ultrasound, CT and angiographic appearances of an extra-hepatic biliary cystadenoma arising from the left main hepatic duct with compression of the quadrate lobe. We also describe the histological finding of adenomyomatosis of the gall-bladder in association with the cystadenoma, an association not previously reported.

Angiography↗

The nervus terminalis ganglion in Anguilla rostrata: an immunocytochemical and HRP histochemical analysis.

Immunocytochemistry and retrograde horseradish peroxidase (HRP) transport were used to study the ganglion of the nervus terminalis in the American eel, Anguilla rostrata. Luteinizing hormone releasing hormone (LHRH) like immunoreactivity was found in large, ganglion-like cells located ventromedially at the junction of the telencephalon and olfactory bulb and in fibers within the retina and olfactory epithelium. HRP transport from the retina demonstrated direct connections with both the ipsi- and contralateral populations of these ganglion-like cells. Given the well-documented role of both olfaction and vision during migratory and reproductive phases of the life cycle of eels, the robust nature of a nervus terminalis system in these fish may present a unique opportunity to study the behavioral correlates of structure-function organization in a discrete population of ganglion-like cells.

Anguilla↗

Possible savings with appropriate antibiotic prophylaxis.

Antibiotic utilization was studied for one month in 52 patients from two surgical wards and one urology ward in an 835 bed teaching hospital. The use of antibiotics was classified as prophylaxis or treatment and the cost of each regimen was determined. The appropriate antibiotic for prophylaxis was chosen according to the surgical procedure and as a result of a literature review. Using cefazolin as the drug of choice in suitable general surgery cases resulted in a justifiable cost for prophylaxis of $17.64 per patient and a possible saving of up to $67.01 per patient (possible total saving of up to $670.05 for the study population). It was concluded that appropriate antibiotic prophylaxis in surgical patients could lead to significant cost savings. Some techniques for improving antibiotic prescribing are reviewed.

Anti-Bacterial Agents↗