Transient neurologic symptoms after epidural analgesia.
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Adult↗
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Aggressive ulcerative necrobiosis lipoidica associated with venous insufficiency, giant-cell phlebitis and arteritis.
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Arteritis↗
Hereditary monocyte esterase deficiency.
An inherited cytochemical staining abnormality of monocytes is described, affecting members of three generations of one family. alpha-Naphthyl acetate and alpha-naphthyl butyrate esterase staining reactions have been consistently negative in 95% of the monocytes of the propositus and her son and in 60-70% of the monocytes in two of four grandchildren.
Aged↗
Hemorrhage from esophageal varices after placement of the LeVeen shunt.
Transient bleeding from esophageal varices was noted in a patient with alcoholic cirrhosis and a patent end-to-side portacaval shunt after placement of a LeVeen shunt for unmanageable ascites. Pressure measurements of the portal systemic gradient, obtained at the time of bleeding and 12 days later, suggest that the variceal hemorrhage was induced by the rapid infusion of ascitic fluid into the systemic circulation. Principles of management for variceal hemorrhage after LeVeen shunt placement are discussed.
Ascites↗
Management of chronic pain with epidural steroids.
Perioperative nurses need to be aware of the multiple treatment modalities associated with chronic back problems. Patients who undergo back surgeries often have been and may continue to be pain therapy patients. In addition, many conditions other than back problems are treated in pain clinics. Perioperative nurses may be in a position to refer patients for pain therapy and are encouraged to do so. Patients may look to nurses for guidance when making decisions about using pain therapy clinics. Pain management programs vary from small single-discipline or modality clinics to large multidisciplinary centers. Regardless of the type of clinic, team members should place a strong emphasis on assessing patients' physical, mental, and psychosocial statuses so that coherent treatment plans can be developed. Patients should be encouraged to participate in all decision making because they have much of the responsibility for their treatment. Patients also should be cautioned not to expect miracles but to look for significant improvement and the opportunity to lead more effective and satisfying lives with minimal pain.
Anesthetics, Local↗
Successful remission induction with deoxycoformycin in elderly patients with T-helper prolymphocytic leukaemia.
Two elderly patients with prolymphocytic leukaemia (PLL) of T helper phenotype were treated with the adenosine deaminase inhibitor--deoxycoformycin--and achieved remission. The first patient has remained in an unmaintained remission for over a year. The second patient, treated with a regime which produced less side effects, subsequently relapsed in skin and lymph nodes and died. In view of the rarity of this condition a multi-centre assessment of the effectiveness of deoxycoformycin is indicated. T-lymphocyte colony formation in both cases was found to be reduced. Co-culture of the patients' lymphocytes with nonadherent mononuclear cells from normal individuals also showed inhibition of T-colony formation indicating that lack of nutrients or accessory cells was not responsible for low T-colony forming capacity.
Aged↗
Etiology of body dissatisfaction and weight concerns among 5-year-old girls.
Among adolescent girls and women, higher weight status is associated with greater body dissatisfaction and weight concerns. This study investigated the etiology of body dissatisfaction and weight concerns among 5-year-old girls by assessing associations among girls' and parents' weight status, body dissatisfaction, and weight concerns. Weight status, body dissatisfaction, and weight concerns were assessed for 197 5-year-old girls and their parents, and relationships among these variables were investigated using multiple regression in the form of path analysis. For girls and parents, higher weight status was associated with greater body dissatisfaction, which in turn was associated with higher weight concerns. No direct relationship was found between girls' weight status and girls' weight concerns. Girls' body dissatisfaction and mothers' weight concerns, however, were independently and positively associated with higher weight concerns among girls. In conclusion, relationships among weight status, body dissatisfaction, and weight concerns for 5-year-old girls parallel those reported among adults. In addition, results suggest that the etiology of weight concerns in young girls may be linked to girls' subjective evaluations of their weight status (body dissatisfaction) in combination with weight concerns expressed by their mothers.
Body Image↗
Chronic Parkinsonism secondary to intravenous injection of meperidine analogues.
Abuse of 4-propyloxy-4-phenyl-N-methylpiperidine, a meperidine congener, produced parkinsonism in a 23-year-old man. Unlike other drug-induced motor disturbances, the syndrome persisted for 18 months and responded to drugs that stimulate dopamine receptors. Biogenic amines and metabolites in the cerebrospinal fluid and microscopic evaluation of the brain at necropsy were consistent with damage to aminergic neurons in the substantia nigra.
Adult↗
Myeloperoxidase deficiency in a patient with rheumatoid arthritis: oxygenation and radical activity by phagocytic cells.
Complete functional deficiency of the phagocytic cell enzyme, myeloperoxidase, is described in a patient with rheumatoid arthritis. Measurement of oxygenation and free radical activity by blood monocytes and polymorphonuclear leucocytes shows gross reduction in myeloperoxidase-dependent chemiluminescence. Implications of these data for theories linking reactive oxygen species to inflammatory tissue damage in rheumatoid arthritis are discussed.
Adult↗
Human macrophages convert L-tryptophan into the neurotoxin quinolinic acid.
Substantial increases in the concentrations of the excitotoxin and N-methyl-D-aspartate-receptor agonist quinolinic acid (QUIN) occur in human patients and non-human primates with inflammatory diseases. Such increases were postulated to be secondary to induction of indoleamine 2,3-dioxygenase in inflammatory cells, particularly macrophages, by interferon-gamma. To test this hypothesis, human peripheral-blood macrophages were incubated with L-[13C6]tryptophan in the absence or presence of interferon-gamma. [13C6]QUIN was quantified by gas chromatography and electron-capture negative-chemical-ionization mass spectrometry. [13C6]QUIN was detected in the incubation medium of both unstimulated and stimulated cultures. Exposure to interferon-gamma substantially increased the accumulation of [13C6]QUIN in a dose- and time-dependent manner. The QUIN concentrations achieved exceeded those reported in both cerebrospinal fluid and blood of patients and of non-human primates with inflammatory diseases. Macrophages stimulated with interferon-gamma may be an important source of accelerated L-tryptophan conversion into QUIN in inflammatory diseases.
Carbon Isotopes↗
Substrate specificity of Xenopus matrix metalloproteinase stromelysin-3.
The matrix metalloproteinase stromelysin-3 (ST3 or MMP11) was initially identified as a breast carcinoma associated protease and has since been shown to be highly expressed in diverse carcinomas and in developmental processes that involve extensive cell death (apoptosis) and tissue remodeling. Unlike other MMPs, purified ST3 has little activity toward known extracellular matrix (ECM) proteins in vitro but cleaves strongly a few non-ECM, extracellular proteins, including human alpha1-proteinase inhibitor (alpha1-PI). To investigate the possibility of alpha1-PI as a conserved physiological substrate for ST3 during vertebrate development, we analyzed the ability of Xenopus laevis ST3 catalytic domain to cleave frog alpha1-PI. Surprisingly, we found the ST3 failed to recognize the site in alpha1-PI equivalent to the major cleavage site in human alpha1-PI by mammalian ST3. Sequence and mutagenic analysis revealed that multiple substitutions at P2-P3' positions between human and Xenopus alpha1-PI contributed to the inability of Xenopus alpha1-PI to be cleaved by ST3. Our studies showed that (A)(G/A)(A)(M)(F/A)(L) (P3-P3') as a preferred cleavage site for ST3. We further demonstrated that mutations in the cleavage sites affected cleavage by ST3 differently from several other MMPs. These findings, together with earlier reports on ST3, showed that ST3 has distinct substrate specificities compared to other MMPs. Our results further suggest that alpha1-PI is unlikely to be a physiological substrate for ST3, at least with regard to evolutionarily conserved developmental processes.
Animals↗
A longitudinal examination of patterns in girls' weight concerns and body dissatisfaction from ages 5 to 9 years.
OBJECTIVE: To examine the development of girls' weight concerns and body dissatisfaction from ages 5 to 9 years and how change and continuity in these constructs from age 5 to 7 years is associated with girls' eating attitudes, dietary restraint, and dieting status at age 9. METHODS: Weight concerns, body dissatisfaction, and weight status were assessed for 182 girls when they were 5, 7, and 9 years old, and their eating attitudes, dietary restraint, and dieting status were assessed when they were 9. RESULTS: Girls tended to maintain their rank in weight concerns and body dissatisfaction across ages 5 to 9 years, and associations among girls' weight concerns, body dissatisfaction, and weight status increased with age. In addition, positive associations were found between changes in girls' weight concerns, body dissatisfaction, and weight status across ages 7 to 9. Finally, girls' who reported high weight concerns or high body dissatisfaction across ages 5 to 7 reported higher dietary restraint, more maladaptive eating attitudes, and a greater likelihood of dieting at age 9, independent of their weight status. CONCLUSION: Girls' reported weight concerns and body dissatisfaction across middle childhood showed consistency over time, were systematically related to their weight status, and predicted their dietary restraint, eating attitudes, and the likelihood of dieting at age 9. These results reflect patterns identified among adolescent girls and women.
Body Image↗
Methicillin-resistant Staphylococcus aureus (MRSA) isolated from animals and veterinary personnel in Ireland.
Reports of methicillin-resistant Staphylococcus aureus (MRSA) in animals have become more frequent in recent years. This paper documents the recovery of MRSA from animals with respiratory, urinary tract or wound infection and from animals subjected to surgical procedures following treatment in one veterinary hospital and 16 private veterinary clinics in different geographical locations throughout Ireland. MRSA was recovered from 25 animals comprising 14 dogs, eight horses, one cat, one rabbit and a seal, and also from 10 attendant veterinary personnel. Clinical susceptibility testing suggested that the 35 isolates fell into two different groups. One group of isolates (Group 1) was resistant to one or more of the following classes of antimicrobials: macrolides, lincosamines, tetracyclines and/or fluoroquinolones. The second group (Group 2) was resistant to macrolides, aminoglycosides, tetracyclines and trimethoprim/sulphamethoxazole and variably resistant to fluoroquinolones, lincosamines and rifampicin. One isolate in Group 2 was susceptible to trimethoprim. Epidemiological typing by antibiogram-resistogram (AR) typing, biotyping and by chromosomal DNA restriction fragment length polymorphism analysis using SmaI digestion followed by pulsed field gel electrophoresis (PFGE), confirmed these two major clusters. PFGE analysis showed that most isolates from non-equine animals were indistinguishable from each other and from the isolates from personnel caring for these animals. MRSA was isolated from eight horses which attended six different veterinary practices before referral to an equine veterinary hospital. Isolates from the eight horses and from their attendant personnel had PFGE patterns that were indistinguishable and were unlike the patterns obtained from the other isolates. Comparison of PFGE patterns of isolates from veterinary sources with patterns from MRSA recovered in human hospitals showed that the most frequently occurring pattern of MRSA from non-equine animals was indistinguishable from the predominant pattern obtained from the most prevalent MRSA strain in the human population in Ireland. However, the patterns of the isolates from horses were unlike any patterns previously reported in Irish studies of human isolates. This study shows that transmission of two strains of MRSA is occurring in veterinary practices in Ireland and that one strain may have arisen from human hospitals. The source of the second strain remains to be determined.
Animal Technicians↗
Autologous fat grafting: comparison of techniques.
BACKGROUND: Despite more than a century of reporting in the medical literature, controversy still surrounds both the efficacy and longevity of autologous fat transplantation in subcutaneous soft tissue augmentation. OBJECTIVE: To summarize the existing literature relating to the effectiveness of this procedure and to highlight differences in technique that may play a role in reported treatment successes and failures. METHODS: Review of the literature and reporting of authors' observations and results. CONCLUSION: Autologous fat transplantation can be a gratifyingly effective treatment for subcutaneous augmentation that may produce permanent results in some cases. This article aims to clarify some of the differences in technique employed by doctors in this field and aims to enable the reader to better see the subtle, but sometimes important differences in methods used.
Adipose Tissue↗
Intraneuronal generation of a pyridinium metabolite may cause drug-induced parkinsonism.
The compound 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) induces an irreversible neurological syndrome in man and monkey which is similar to idiopathic Parkinson's disease in its clinical, pathological, neurochemical and pharmacological response properties. MPTP is selectively neurotoxic to the dopaminergic regions of the brain, destroying neurones in the substantia nigra (A8 and A9 cells, nigrostriatal system) but not the ventral tegmental area (A10 cells, mesolimbic system). Selective dopamine depletion and nigral cell loss after MPTP treatment has also been reported recently in the mouse. The mechanism by which a peripherally administered, low-molecular weight compound exerts permanent but selective toxic effects on dopamine systems in the brain may be relevant to parkinsonian syndromes induced by other toxins and to the disease process in idiopathic Parkinson's disease. We report here that MPTP is oxidized in the brain to a pyridinium species (a compound with potent herbicidal activity) and, in the monkey, is trapped intraneuronally. Furthermore, we demonstrate that this enzymatic oxidation is blocked in vivo in the mouse by a monoamine oxidase inhibitor, a condition which also blocks the neurotoxicity, indicating that the oxidative metabolism of MPTP is required for its neurotoxic effect.
1-Methyl-4-phenyl-1,2,3,6-tetrahydropyridine↗
Simultaneous measurement of imipramine and desipramine by selected ion recording with deuterated internal standards.
A gas chromatographic mass spectrometric method for the quantitative determination of imipramine and its N-demethylated metabolite desipramine in plasma samples at the nanogram level is reported. The method involves derivatization of the extracted drugs with trifluoroacetylimidazole, a mild derivatizing reagent. Specificity is provided by selected ion recording of the [M + H]+ ions, formed upon chemical ionization with methane as reagent gas. Quantitation is achieved by stable isotope dilution techniques, using deuterium labeled analogs, prepared by acid-catalyzed exchange, as internal standards. Data on patient samples are presented.
Chemical Phenomena↗
THE EFFICACY AND TOXICITY OF ISO-, HYPO-, AND HYPERTONIC SODIUM SOLUTIONS IN THE TREATMENT OF BURN SHOCK IN MICE.
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Animals↗
An aetiopathological study of chronic bronchopneumonia in lambs in Ireland.
Chronic bronchopneumonia in lambs, also known as 'atypical' or 'chronic, non-progressive' pneumonia is a common, frequently sub-clinical disease affecting animals under 12-months-old in intensive production systems. Infection with both Mycoplasma ovipneumoniae and Mannheimia haemolytica have been implicated in the aetiology of this condition and a variety of pulmonary lesions can result. In this study, detailed laboratory examination of 30 abattoir-derived lungs with the characteristic gross features of atypical pneumonia (AP) was carried out with a view to refining and correlating the histopathological and microbiological criteria required for the diagnosis of this disease. For the first time a broad range of laboratory detection techniques including bacterial and virus isolation, fluorescent antibody tests and immunohistochemistry were used in parallel to identify potential causative pathogens such as M. ovipneumoniae, M. haemolytica, parainfluenza type-3 (PI3) virus and respiratory syncytial virus (RSV) in AP lesions. The most consistent finding was the association of gross AP lesions with M. ovipneumoniae, identified by either culture or immunohistochemistry in 27 (90%) of the 30 cases. However the presence M. ovipneumoniae organisms or antigen did not consistently correlate with particular histopathological changes. Furthermore, peri-airway lymphoid hyperplasia, intra-alveolar exudation and nodular 'hyaline scars', which are all previously reported microscopic lesions of AP, were not identified in 12 (40%) of the cases and isolation of M. haemolytica was over-represented in lungs exhibiting suppurative lesions. These findings illustrate the complex aetiopathogenesis of this disease and highlight the requirement to use a combination of diagnostic criteria in its laboratory diagnosis.
Abattoirs↗