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PubMed2001

Reossification of the orbital wall following ventral translocation of the fronto-orbital bar and cranial vault remodeling.

The purposes of this study were to determine the extent of ossification of the orbit following ventral translocation of the fronto-orbital bar and to find out whether age at the time of the procedure and presence of a concomitant syndrome adversely affect ossification. A retrospective review of 27 patients with craniosynostosis was conducted at the St. Louis Children's Hospital and the Children's Hospital of Oklahoma. Patients with preoperative, perioperative, and postoperative three-dimensional computed tomography scans were included. Eighty-eight percent of the lateral orbital wall defects and 92 percent of the defects within the roof of the orbit ossified completely in the postoperative period. When syndromic patients were compared with nonsyndromic patients (based on clinical findings only), three of the 19 syndromic defects and three of the 30 nonsyndromic defects demonstrated incomplete ossification in the lateral orbital wall (p > 0.05). Similarly, two of the 19 syndromic defects and two of the 30 nonsyndromic defects demonstrated incomplete ossification within the roof of the orbit (p > 0.05). With respect to age at the time of the procedure, four of the 37 defects and two of the 12 defects demonstrated incomplete ossification in the lateral orbital wall for age at the time of the procedure less than 12 months and greater than 12 months, respectively (p > 0.05). Similarly, two of the 37 defects and two of the 12 defects had incomplete ossification within the roof of the orbit for age at the time of the procedure less than 12 months versus more than 12 months, respectively (p > 0.05). Ossification of the orbital wall and roof is complete in the majority of cases within 1 year after the procedure, and neither age at the time of the procedure nor presence of a concomitant syndrome adversely affects ossification of the orbit after ventral translocation of the fronto-orbital bandeau.

Bone Transplantation↗

PubMed1987

Hyperpyrexia in children: clinical implications.

A prospective study was done to determine the incidence of serious illness in children under two years of age with hyperpyrexia (temperature of 41.1 degrees C [106 degrees F] or greater). Nineteen children were seen and followed in the emergency department of Oklahoma Children's Memorial Hospital over a one-year period. The final clinical diagnoses included acute otitis media, pneumonia, acute gastroenteritis, roseola, and cellulitis of the leg. In the entire group there was no meningitis or subsequent death. One child was hospitalized. The statistical analysis (binomial test at the 0.05 level) confirms that the incidence of serious illness manifested only by high fever is no higher than 0.15. The mere presence of very high fever does not necessarily indicate a serious illness. Laboratory and other diagnostic work-up and hospitalization should be based on clinical evaluations, rather than done routinely.

Acute Disease↗

PubMed1976

Genitourinary complications of abdominoperineal resection.

The genitourinary complications of 86 consecutive cases of abdominoperineal resection at the University of Oklahoma Health Sciences Center are described. Vesical dysfunction was the most common problem, occurring in 11 patients in our series. Eight required prostatectomy for urinary retention. The significance and treatment of vesical dysfunction is somewhat controversial, but an attempt to document the cause should be made in every case. Voiding symptoms and results of intravenous urogram with postvoiding films, cystogram, cystometrogram, and cystoscopy are diagnostically pertinent. Accordingly, preoperative urologic evaluation is indispensable to proper treatment of rectosigmoid carcinoma.

Abdomen↗

PubMed1977

Hereditary (familial) renal disease: clinical and genetic studies.

Four or more generations of three Oklahoma-Kansas families in which multiple members have been found to have glomerulonephritis or interstitial nephritis have been studied. Twenty-five of 146 members in kindred A, 16 of 50 members in kindred B, and 33 of 156 members in kindred C were identified as probably to definitely afflicted. Renal tissue from members of the first two families showed an acute or chronic glomerulonephritis. Renal failure often appeared by the third decade. The lesions were less frequent but more rapidly lethal in the male members. Renal tissue from members of the third kindred showed an interstitial nephritis. This appeared later in life and followed a more chronic course. Hearing loss was common in both groups. The hereditary studies are consistent with the hypothesis that the disease is transmitted by an autosomal dominant gene with imcomplete penetrance (not all members carrying the gene develop renal disease) and variable expressivity. Male-to-male transmission was present in all three families but less frequently than would be predicted, suggesting a reduced clinical expression of the disease in males who receive the mutant gene from their father.

Adult↗

PubMed1979

Group III atypical mycobacterial infections.

We retrospectively and prospectively examined the clinical presentation, course of disease, and response to therapy in 63 patients whose mycobacterial isolates were identified as Runyon group III atypical mycobacteria. All of the patients except four had pulmonary disease similar to typical pulmonary tuberculosis. The others had scrofula or abxcess. There was a male predominance and whites were slightly more frequently infected in our series. Forty-six percent of the patients were from rural Oklahoma. Skin testing and chest roentgenography were important, but culture of the organism appeared to be the only productive method of distinguishing the atypical disease from typical tuberculosis. Eighty-one percent had an associated disease. The isolates showed a very high rate of primary drug resistance, and this was reflected in the difficulty in controlling the infection.

Adolescent↗

PubMed1998

Correlation of gallbladder ejection fraction with pathologic grade for chronic inflammation.

BACKGROUND: The purpose of this study is to define the sensitivity and specificity of the gallbladder ejection fraction (GBEF) for identifying patients with various grades of histologically proven chronic cholecystitis. METHODS: Of 693 consecutive patients who had a scintigraphic GBEF determination at Baptist Medical Center of Oklahoma, 161 subsequently had a cholecystectomy at the same institution. Pathologic material was reassessed by one outside blinded reviewer, who graded the intensity of the inflammation present on a 0 (absent) to 3 (most severe) scale. RESULTS: The least square mean maximum GBEF was 23.7% for those with grade 0, 9.6% for those with grade 3, and 13.9% for those with cholesterolosis. If a normal value for GBEF is set at > 30%, the sensitivity for detecting grade 1, 2, or 3 disease was 84%, and the specificity was 26%. For grade 3 disease alone, the sensitivity was 100%, and the specificity was 26%. CONCLUSIONS: The GBEF is sensitive but not specific for chronic inflammation of the gallbladder. The GBEF appears to be useful as a screening examination in the appropriate clinical setting.

Cholecystitis↗

PubMed1976

Rentran. An on-line computer-based regional kidney transplant matching system.

An interactive on-line computerized renal transplant matching system called RENTRAN which serves the Southwest Kidney Transplant Region is described. The region consists of one transplant center in Arkansas, two in Oklahoma, and six in Texas. The computer used is the DECsystem-10 located in the Medical Computing Resources Center at Dallas. RENTRAN participants have remotely located standard interactive computer terminals and gain access to the computer by dialing over normal telephone lines. Functions provided by RENTRAN include obtaining instructions, performing a donor-recipient match, obtaining a list of potential recipients, making a user comment or adding, updating or deleting a potential recipient record. Either long or short formats for dialog with the computer system are available for inexperienced and experienced and users, respectively. In the time period from August 1,1973, when the system went into production on February 1, 1976, there have been in excess of 232 matches attempted and approximately 142 kidneys have been transplanted according to RENTRAN results. There are about 361 recipients currently on the data base. The system was developed with funds provided by the Texas Regional Medical Program. Expenses of maintaining the system as well as occasional programmed improvements as deemed appropriate by the Southwest Kidney Transplant Region Registry Committee on the basis of user comments are provided through a $25 per year charge to patients for being listed on the data base.

ABO Blood-Group System↗

PubMed1986

Improved nuclear fluorescence screening technique.

Three separate screening studies have tested the sensitivity and specificity of quantitative fluorescence image analysis for detecting bladder cancer. Nuclear intensity (NI) measurements of fluorescent dye-stained epithelial cells from voided urine and bladder washings were compared with routine Papanicolaou (Pap) cytology results, and findings were verified against pathological biopsy diagnoses. The NI cytology method detected the pathologically confirmed tumors earlier and with greater specificity than did conventional cytology. In the study of 140 clinically symptomatic patients in Oklahoma, the NI method detected 91.1% (31 of 34) of the pathologically confirmed grades 1 and 2 tumors and 100% of 18 grades 3 and 4 tumors. Pap cytology detected only 47% (16 of 34) of low-grade and 78% (14 of 18) of high-grade tumors. Comparable results were obtained in a study of symptomatic patients in Mississippi and the method has been employed in the screening of a high-risk occupationally exposed cohort in Georgia.

2-Naphthylamine↗

PubMed2004

Organizing the orthopaedic trauma association mass casualty response team.

Physicians and surgeons in the United States have become increasingly aware of the requirement for an organized response to mass casualty and disaster situations. This has not always been the case. The terrorist acts in Oklahoma City in 1995 and at the World Trade Center in 1993 and 2001 showed the inefficiencies and confusion of the civilian managed disaster response. Trauma surgeons are uniquely suited to play a leadership role in the planning and coordination of disaster care because of their integration in prehospital emergency medical systems and trauma centers. The Orthopaedic Trauma Association has developed strategies to facilitate the orthopaedic response to mass casualties and to develop an educated approach to disaster management. The current initiatives include the establishment of a link with the American College of Surgeons Committee on Trauma in addition to the development of training programs for orthopaedic surgeons as responders to disaster and mass casualty situations. A team of volunteer orthopaedic traumatologists also has been credentialed to become part of the National Disaster Medical System's International Medical-Surgical Response Team.

Association↗

PubMed2006

Magnetic resonance imaging compatibility and safety of the SOUNDTEC Direct System.

OBJECTIVE/HYPOTHESIS: The purpose of this study was to evaluate magnetic resonance imaging (MRI) compatibility and safety of an electromagnetic implanted hearing device (the SOUNDTEC Direct System; SOUNDTEC, Inc., Oklahoma City, OK) implant during a 0.3-Tesla open MRI imaging examination of the head and neck and to develop an MRI protocol that maximizes patient safety while minimizing the need for implant removal. The current literature regarding MRI compatibility of implantable hearing devices was reviewed. STUDY DESIGN: Linear and torsional forces, heating, and implant magnetization were evaluated in vitro. Implanted fresh-frozen human temporal bones were used to evaluate image distortion. A prospective study of 11 volunteers previously implanted with the SOUNDTEC Direct System was conducted to evaluate MRI compatibility and safety. A MEDLINE search of the literature between 1980 and July 2005 was reviewed to summarize MRI compatibility testing of implantable hearing devices. METHODS: Torsional and linear forces experienced by eight implant magnets were measured using calibrated neurologic Von Frey Hairs and compared with finite element analysis predictions as well as forces required to separate the incudostapedial joints of 12 fresh-frozen human temporal bones. Implant heating was determined by measuring the temperature change of eight implant vials compared with saline controls immediately after a head MRI scan. Implant magnetization was evaluated after repeated exposure to a 0.3-Tesla magnetic field. An 11-patient prospective study was performed to evaluate MRI compatibility in a 0.3-Tesla open MRI environment using adult volunteers previously implanted with the SOUNDTEC Direct System. A modified MRI protocol was developed to maximize patient safety. Each individual underwent an audiometric and otologic examination immediately before and after MRI. RESULTS: Peak linear force at the MRI entry measured 0.5 g +/- 0.2 standard deviation (SD). Maximum torque occurred at isocenter and measured 11.4 g-cm +/- 1.2 SD. The mean torque required to separate the incudostapedial joint was 33.8 g-cm +/- 20.4 SD. The average increase in temperature of the eight implant vials was 0.45 degrees C +/- 0.11 SD, whereas the increase in temperature of the three saline controls measured 0.47 degrees C +/- 0.11 SD. The average change in magnetic flux density of the 14 implant magnets tested was 22.0 gauss. Maximum image distortion occurred during the gradient echo sequence and measured 8.6 cm in diameter with a volume of 5,096 mm. Eleven patients completed a total of 12 head, one shoulder, and three lumbar 0.3-Tesla open MRI scans without patient- or device-related complications other than degradation of the MR image. There was no report of discomfort, tinnitus, dizziness, change in hearing, or change in device performance. All post-MRI changes in pure-tone thresholds, speech discrimination, soundfield thresholds, and aided soundfield thresholds were within the range of test-retest variability. CONCLUSION: When considering MRI of implantable ferromagnetic hearing devices, issues related to mechanical forces, implant heating, current induction, implant demagnetization, image degradation, and acoustic trauma must be considered. The SOUNDTEC Direct System is both MRI-compatible and safe in a 0.3-Tesla open MRI environment when a modified protocol is used. Degradation of the head MRI image may impair visualization of the ipsilateral temporal bone and adjacent structures within a 2.5- to 4.3-cm radius of the implant and is minimized by using a fast spin echo sequence.

Adult↗

PubMed1983

Causative factors responsible for femoral fractures in infants and young children.

The causative factor responsible for producing a femoral fracture was determined in 74 children 5 years of age or younger admitted to Oklahoma Children's Memorial Hospital over a 5-year period. Almost one-half of the fractures (34/74) were sustained as a result of suspected or confirmed abuse; most (17/26) of the fractures in infants less than 1 year of age were a result of abuse. Seven automobile-pedestrian accidents were causative in children 2 years or older. An accurate history, good record keeping, common sense, and awareness of the incidence of abuse will assist the orthopedist in recognizing abuse when it is likely, and sparing the family when it is not.

Accidents, Traffic↗

PubMed1983

Cast brace management of the femoral shaft fracture in children and young adults.

Seventy-two children and adolescents, 5-19 years of age, sustaining femoral fractures were treated with immediate cast bracing at Oklahoma Children's Memorial Hospital. Ambulation was started an average of 3 days after fracture when there were no associated injuries. The average length of hospitalization was 18.7 days; the average length of immobilization in plaster was 67.4 days. Results were generally comparable to those of more standard methods of treating a fractured femur in this age group. Proximal as well as middle and distal fractures were treated, but varus and anterior angulation was not well controlled in proximal fractures. No patient had a clinically significant deformity. Sixty-one percent of the entire group healed with less than 6 mm discrepancy. Middle-third fractures showed more tendency toward shortening. All six fractures that healed with more than 1.5 cm of shortening were middle third. No injured femur was longer than the uninjured femur at a 6-month follow-up. Immediate cast bracing can provide an opportunity for early ambulation and avoid the sequelae of immobilization. Weekly assessment for the first 4 weeks is mandatory to monitor length and angulation. The adolescent male with a midshaft fracture was most difficult to manage, and in this situation, closed intramedullary nailing is recommended.

Adolescent↗

PubMed1999

Haloanaerobium kushneri sp. nov., an obligately halophilic, anaerobic bacterium from an oil brine.

Three strains, designated VS-751T, VS-511 and VS-732, of a strictly anaerobic, moderately halophilic, Gram-negative, rod-shaped bacterium were isolated from a highly saline (15-20%) brine from an oil reservoir in central Oklahoma, USA. The optimal concentration of NaCl for growth of these three strains was 2 M (12%), and the strains also grew in the presence of an additional 1 M MgCl2. The strains were mesophilic and grew at a pH range of 6-8. Carbohydrates used by all three strains included glucose, fructose, arabinose, galactose, maltose, mannose, cellobiose, sucrose and inulin. Glucose fermentation products included ethanol, acetate, H2 and CO2, with formate produced by two of the three strains. Differences were noted among strains in the optimal temperature and pH for growth, the maximum and minimum NaCl concentration that supported growth, substrate utilization and cellular fatty acid composition. Despite the phenotypic differences among the three strains, analysis of the 16S rRNA gene sequences and DNA-DNA hybridizations showed that these three strains were members of the same genospecies which belonged to the genus Haloanaerobium. The phenotypic and genotypic characteristics of strains VS-751T, VS-511 and VS-732 are different from those of previously described species of Haloanaerobium. It is proposed that strain VS-751T (ATCC 700103T) be established as the type strain of a new species, Haloanaerobium kushneri.

Bacterial Typing Techniques↗

PubMed1998

Ultrastructural differentiation of the genogroups in the genus Ehrlichia.

Ultrastructural characteristics of 15 strains and isolates of ehrlichiae belonging to three genogroups, or clades of genetically related organisms united in the genera Ehrlichia, Cowdria, Anaplasma, Neorickettsia and a strain of Wolbachia pipientis which represents a fourth genogroup in this cluster of species, were studied in continuous cell culture or in vivo: E. canis (Oklahoma strain and VHE isolate), E. muris (AS 145), E. chaffeensis (Arkansas, 91HE17 and Sapulpa), human granulocytic ehrlichiae (HGE)(BDS, 96HE27, 96HE37, #54, #55 and #72), E. equi (MRK), E. sennetsu (Miyayama), E. risticii (HRC-IL). Wolbachia pipientis was studied in the naturally infected Aedes albopictus mosquito cell line Aa23. All organisms were similar in the normal ultrastructure of individual cells and in the ability to form abnormal, pathological ehrlichial cells of the same type irrespective of the species. Normally all ehrlichiae studied in cell culture existed in two morphological forms - reticulate and dense-cored cells, both of which could divide by binary fission. Most alterations were related to their membranes, especially the cell wall. Differences in the structure of intravacuolar microcolonies (morulae) of ehrlichiae and their inter-relations with the host cells allowed differentiation of the genogroups: the E. canis-E. chaffeensis-E. muris genogroup formed large morulae, with many ehrlichiae, often suspended in a fibrillar matrix, and the host cell mitochondria and endoplasmic reticulum usually aggregated near the morulae and were in contact with the morula membrane; the E. phagocytophila-E. equi-HGE group morulae had no fibrillar matrix, no contacts with host cell mitochodria, and they did not aggregate around the morulae; E. sennetsu-E. risticii group usually developed in small individual vacuoles that did not fuse with each other and divided along with the ehrlichiae.

Animals↗

PubMed2005

Databases and information integration for the Medicago truncatula genome and transcriptome.

An international consortium is sequencing the euchromatic genespace of Medicago truncatula. Extensive bioinformatic and database resources support the marker-anchored bacterial artificial chromosome (BAC) sequencing strategy. Existing physical and genetic maps and deep BAC-end sequencing help to guide the sequencing effort, while EST databases provide essential resources for genome annotation as well as transcriptome characterization and microarray design. Finished BAC sequences are joined into overlapping sequence assemblies and undergo an automated annotation process that integrates ab initio predictions with EST, protein, and other recognizable features. Because of the sequencing project's international and collaborative nature, data production, storage, and visualization tools are broadly distributed. This paper describes databases and Web resources for the project, which provide support for physical and genetic maps, genome sequence assembly, gene prediction, and integration of EST data. A central project Web site at medicago.org/genome provides access to genome viewers and other resources project-wide, including an Ensembl implementation at medicago.org, physical map and marker resources at mtgenome.ucdavis.edu, and genome viewers at the University of Oklahoma (www.genome.ou.edu), the Institute for Genomic Research (www.tigr.org), and Munich Information for Protein Sequences Center (mips.gsf.de).

Base Sequence↗

PubMed1973

Indoleacetic Acid and abscisic Acid antagonism: I. On the phytochrome-mediated attachment of mung bean root tips on glass.

The phytochrome-mediated attachment of mung bean (Phaseolus vulgaris L., var. Oklahoma 612) root tips on glass is quickly affected by indoleactic acid and abscisic acid at concentrations of 10 nm or less. Indoleacetic acid induces detachment, whereas abscisic acid induces attachment. Both plant regulators rapidly antagonize the action of the other. None of several cytokinins, gibberellins, and ethylene tested over a wide range in concentration had any effect on either attachment or detachment of root tips. It is postulated that phytochrome could control the endogenous levels of indoleacetic acid and abscisic acid and perhaps other hormones under certain circumstances, that this action is the first process initiated by phytochrome, and that indoleacetic acid and abscisic acid act on the plasmalemma to bring about opposing changes in the surface electric charges of plant cells.

Journal Article↗

PubMed1974

Boron-induced Bioelectric Field Change in Mung Bean Hypocotyl.

Low concentrations of boron were found to affect the bioelectric field potentials of hypocotyls excised from 4-day-old mung bean (Phaseolus aureus cv. Oklahoma 612) seedlings grown in darkness and irradiated with red light. The significance of this effect is discussed in relation to the possible role of boron in some membrane function.

Journal Article↗

PubMedDate not supplied

Doris Wagner Ferguson, still waters run deep: an oral history.

Doris Wagner Ferguson, MS, RN, FAAN, an original member of the journal of Public Health Nursing editorial board, is now retired in Oklahoma after a 50-year career in public health nursing. She has been a staff nurse, an administrator, and an educator in several states and, in each instance, was instrumental in effecting change and improvement for the practice of her specialty. Her story informs us of earlier struggles and challenges, which we may take for granted today. Those of us currently working in public health nursing acknowledge that we stand on the shoulders of nurses like Doris Wagner Ferguson.

Aged↗