Elder abuse, Arkansas law, and dental professional responsibility--Part 2.
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Biomedical subjects
Publications and source records attributed to W E Martin.
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Experimental infections of Cloacitrema michiganensis were established in chicks by inoculation per cloaca with excysted metacercariae. Ovigerous adults were present 20 days later with eggs containing ocellate miracidia after 21 days. The eggs hatch in utero; the miracidium contains a fully developed redia. Rediae of 2 size groups were present in the digestive gland of the brackish-water snail, Cerithidea californica. Megalurous cercariae are released and encyst on submerged objects. The stages of C. michiganensis resembled those of Parorchis acanthus, a philophthalmid also infecting C. californica, except for differences in the epidermal plate count of their miracidia and in their cercarial stage which was larger in P. acanthus and had a spinuous tegument with a collar of spines.
A superficial shave biopsy is described as a simple, essentially painless, more reliable method for the demonstration of the scabies mite, eggs, and feces in human skin.
The cardiovascular effects of total hip placement were evaluated in 10 surgical patients, aged 55 to 82, while receiving fluroxene-N2O-O2 anesthesia. The anesthetic regimen caused mild cardiovascular depression. The placement of the acrylic cement into the acetabulum and femoral shaft also induced mild cardiovascular depression, but these changes were not significant at p less than 0.05. In one 67-yr-old woman, there were significant reductions of cardiac output and stroke volume 2 min after the insertion of acrylic into the femoral shaft, despite careful replacement of intravascular loss and careful anesthetic management. Methylmethacrylate (1 X 10(-6) to 1 X 10(-4), v/v) was administered to 24 isolated perfused rabbits hearts. These concentrations of methylmetacrylate are of the same order as measurable blood levels in surgical patients. There was a dose-dependent depression of left ventricular dP/dt correlated with a depression of the spontaneous heart rate. When the bradycardia was prevented by electrically pacing the hearts or the administration of atropine, the depressed dP/dt rose to control levels. Reduction in myocardial temperature and heart rate by means of reduction in perfusate temperature of the isolated hearts reduced the myocardial depressant effect of methylmethacrylate.
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Recent evidence suggests a genetic mode of transmission of Parkinson's disease. A multifactorial mechanism is likely, but autosomal dominance with reduced penetrance has not been excluded. The distribution of ancestral second-degree relatives with Parkinson's disease was evaluated in 12 families. Affected relatives were bilaterally distributed more often than would be expected for autosomal dominance. The distribution of ancestral secondary cases suggests a multifactorial etiology for most cases of Parkinson's disease. The possibility of dominant gene inheritance in some families is not entirely ruled out.
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Serial determinations of plasma dihydroxyphenylalanine (dopa) in 16 Parkinson's disease patients receiving levodopa showed a negative correlation between plasma dopa levels and disability scores among patients who exhibited daily fluctuations of signs and symptoms. This suggests that the amount of levodopa delivered to the brain from the periphery is of major importance in the production of the "on-off" phenomenon. A close relationship between plasma dopa levels and abnormal involuntary movements was present in six patients. In three a striking dissociation between control of Parkinson's disease and abnormal involuntary movements was present, suggesting that in some patients these two effects are mediated through different underlying mechanisms. Administration of levodopa in such a way as to prevent both high and low levels of dopa in plasma minimizes disability in Parkinson's disease and may lessen abnormal involuntary movements in patients with the "on-off" effect.
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Forty patients from a group of seventy elected to participate in a prospective randomized clinical study designed to evaluate the systemic effects of polymethylmethacrylate implanted with a Charnley total hip replacement, utilizing patients treated with a Ring total hip prosthesis ad controls. Intraoperative alterations in cardiovascular function were related to use of methylmethacrylate, but postoperative changes in pulmonary function, erythrocyte sedimentation rate, serum lactic acid dehydrogenase, serum glutamicoxalacetic transaminase, and alkaline phosphatase were not. Charnley total hip replacements were associated with more ectopic-bone formation twelve months postoperatively. The two "latent" infections recognized during the thirty-four months of the study were in hips without acrylic fixation.
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