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Biomedical subjects

A J Kaufman

Publications and source records attributed to A J Kaufman.

At least 37 records · Page 2Linked to original sources

Isotopic compositions of carbonates and organic carbon from upper Proterozoic successions in Namibia: stratigraphic variation and the effects of diagenesis and metamorphism.

The carbon isotope geochemistry of carbonates and organic carbon in the late Proterozoic Damara Supergroup of Namibia, including the Nama, Witvlei, and Gariep groups on the Kalahari Craton and the Mulden and Otavi groups on the Congo Craton, has been investigated as an extension of previous studies of secular variations in the isotopic composition of late Proterozoic seawater. Subsamples of microspar and dolomicrospar were determined, through petrographic and cathodoluminescence examination, to represent the "least-altered" portions of the rock. Carbon-isotopic abundances in these phases are nearly equal to those in total carbonate, suggesting that 13C abundances of late Proterozoic fine-grained carbonates have not been significantly altered by meteoric diagenesis, although 18O abundances often differ significantly. Reduced and variable carbon-isotopic differences between carbonates and organic carbon in these sediments indicate that isotopic compositions of organic carbon have been altered significantly by thermal and deformational processes, likely associated with the Pan-African Orogeny. Distinctive stratigraphic patterns of secular variation, similar to those noted in other, widely separated late Proterozoic basins, are found in carbon-isotopic compositions of carbonates from the Nama and Otavi groups. For example, in Nama Group carbonates delta 13C values rise dramatically from -4 to +5% within a short stratigraphic interval. This excursion suggests correlation with similar excursions noted in Ediacaran-aged successions of Siberia, India, and China. Enrichment of 13C (delta 13C> +5%) in Otavi Group carbonates reflects those in Upper Riphean successions of the Akademikerbreen Group, Svalbard, its correlatives in East Greenland, and the Shaler Group, northwest Canada. The widespread distribution of successions with comparable isotopic signatures supports hypotheses that variations in delta 13C reflect global changes in the isotopic composition of late Proterozoic seawater. Within the Damara basin, carbon-isotopic compositions of carbonates provide a potentially useful tool for the correlation of units between the Kalahari and Congo cratons. Carbonates depleted in 13C were deposited during and immediately following three separate glacial episodes in Namibia. The correspondence between ice ages and negative delta 13C excursions may reflect the effects of lowered sea levels; enhanced circulation of deep, cold, O2-rich seawater; and/or the upwelling of 13C-depleted deep water. Iron-formation is additionally associated with one of the glacial horizons, the Chuos tillite. Carbon-13 enriched isotopic abundances in immediately pre-glacial carbonates suggest that oceanographic conditions favored high rates of organic burial. It is likely that marine waters were stratified, with deep waters anoxic. A prolonged period of ocean stratification would permit the build-up of ferrous iron, probably from hydrothermal sources. At the onset of glaciation, upwelling would have brought 13C-depleted and iron-rich deep water onto shallow shelves where contact with cold, oxygenated surface waters led to the precipitation of ferric iron.

Carbon↗

Clinical comparison of polyglactic acid (Vicryl) and polytrimethylene carbonate (Maxon) suture material.

Over a 1-year period, 584 repairs of surgical defects were completed using two different synthetic absorbable sutures, polyglactic acid (Vicryl) and polytrimethylene carbonate (Maxon). No difference in scar width or postoperative complications were found between the two sutures, but polytrimethylene carbonate (Maxon) demonstrated preferable handling and tying characteristics.

Cicatrix↗

Variation in the size and number of stone fragments after gallbladder lithotripsy.

Ninety-four gallbladder ultrasound examinations were carried out in 11 patients at intervals for the first 40 days after lithotripsy. No dissolution or other active therapy was carried out during this time. Fragment size and number were measured to determine the postlithotripsy variability. Analysis of variance (ANOVA) showed no significant changes in fragment size or number over time. The changes in fragment size and number compared to the previous measurements were then evaluated. Again, ANOVA showed no significant changes between times. The average change in absolute size was 3.1 +/- 0.6 mm, and the average change in absolute number was 1.4 +/- 0.5. We conclude that fragment size and number as determined by ultrasound do not vary significantly with time during the first 40 days. The absolute size change measured to the nearest millimeter should be at least 4 mm to surpass the 95% confidence interval. Similarly, the absolute change in number should be at least 2 to be regarded as significant.

Analysis of Variance↗

Pathophysiologic effects of biliary shockwave lithotripsy in a canine model.

At least 10 extracorporeal shockwave lithotripters are under investigation in the United States for treatment of biliary stone disease. Few reports, however, have documented the potential side effects of this new treatment method. In this study, we performed a series of acute and chronic studies in dogs exposed to varying numbers of shockwaves directed at the gallbladder wall via a transthoracic or transabdominal targeting approach. When shockwaves were directed transthoracically, pulmonary hemorrhagic contusions were found which were sometimes large in size. When a transabdominal approach was used, however, only focal areas of hemorrhage were found in the gallbladder wall and adjacent liver with no alterations in postlithotripsy pancreatic or liver enzymes, and normal cholecystokinin-octapeptide stimulated oral cholecystograms were obtained 6 days after treatment. Biliary shockwaves appear to cause few side effects under normal conditions but should be used with caution in patients with potential bleeding disorders. Until further studies are performed, lung tissue should be avoided in the shockwave beam path during treatment.

Abdomen↗

Ioversol for intravenous urography: a comparison study.

A new nonionic, low-osmolar iodinated contrast media, ioversol, was compared with another low-osmolar, nonionic contrast media, iohexol, in 80 patients undergoing intravenous urography. There were 40 patients in each contrast group. Patients were assessed for changes in vital signs, patient tolerance (heat and pain), and other adverse effects. Double-blind evaluation was also performed for comparison of the urogram image quality. There were no severe, life-threatening reactions for either contrast group. Ten patients (25%) receiving ioversol and seven (17.5%) receiving iohexol perceived body heat related to the injection of contrast material. Two patients (5%) in each group experienced mild nausea. Two patients (5%) of each group experienced noted unpleasant taste, and two patients (5%) of the iohexol group complained of headache. Vital signs remained stable without significant change in both groups, and image quality was considered equivalent. The results indicate that the two contrast agents are equivalent in image quality, safety, and incidence of adverse effects.

Adult↗

Adenocarcinoma in a sigmoid conduit: case report.

The increased risk of developing adenocarcinoma in the sigmoid colon after ureterosigmoidostomy has been acknowledged for some time. Development of adenocarcinoma in colonic conduits isolated from the fecal stream is rare. We report a case of adenocarcinoma arising in a sigmoid conduit that probably represents a metachronous adenocarcinoma of the colon.

Adenocarcinoma, Mucinous↗

Primary and diagenetic controls of isotopic compositions of iron-formation carbonates.

Mineralogic, chemical, and isotopic compositions have been determined for 97 carbonate microbands in five core segments from the early Proterozoic (2.5 Ga) Dales Gorge Member of the Brockman Iron Formation, Hamersley Basin, Western Australia. Samples were obtained both from banded iron-formation (BIF) macrobands 9-12 at Paraburdoo, on the southern margin of the basin, and from BIF macroband 13 at Wittenoom, 130 km NW. At Paraburdoo, oxygen-isotopic compositions of coexisting chert and magnetite microbands were measured and indicated final equilibration temperatures ranging from 60-160 degrees C. This range is consistent with observed mineral assemblages and indicates a considerable temperature gradient across the basin (cf. T approximately 300 degrees C at Wittenoom; BECKER and CLAYTON, 1976). Carbon-isotopic compositions of carbonates are near -7% vs. PDB at Paraburdoo and -10.5% at Wittenoom, but the greater isotopic depletion at Wittenoom appears related to primary or diagenetic processes, not metamorphism. Contents of organic carbon are consistently low. Isotopic depletion is roughly correlated with iron abundance and, together with petrographic observations and chemical balances, is consistent with the model of BIF deposition introduced by BEUKES et al. (1990): primary siderite (delta approximately -5%) precipitated from an anoxic water column depleted in 13C; additional depletion of 13C is associated with coprecipitation of iron oxides and organic carbon. Oxygen-isotopic abundances of microbanded carbonates are similar to those under- and overlying massive marine carbonates, ranging from 17.6 to 21.0% vs. SMOW (-9.6 to -12.9% vs. PDB). Millimeter-scale variations in abundances of 13C and 18O are associated with diagenetic replacement of primary siderite by secondary ankerite and/or magnetite. It is shown that these isotopic variations cannot result from mineral-dependent fractionations, metamorphism, or the influence of large volumes of water in an open system.

Carbon↗

American Cancer Society's Breast Cancer Detection Awareness Program: the 1988 middle Tennessee experience.

In an effort to augment public awareness of the benefits of screening mammography and to encourage the use of screening mammograms, the Tennessee Division of the American Cancer Society initiated the Breast Cancer Detection Awareness Program in March 1988. As a result of the initiative, 3,473 women telephoned for information, and 3,123 were found to be eligible for a screening mammogram. Of the 2,248 mammograms actually obtained, 1,764 (78%) were interpreted as normal, whereas 484 (22%) were classified as abnormal. Of the 484 women with abnormal mammograms, 277 (57%) were advised to have follow-up mammograms and 57 (12%) had excisional biopsy. The 55 biopsies reported showed benign changes in 83.6% and malignancy in 16.4%. Thus, nine malignancies were discovered from 2,248 screening mammograms (four malignancies per 1,000 mammograms). No malignancies were found in women between 35 and 39 years old.

Adult↗

Pemphigus, myasthenia gravis, and pregnancy.

A 27-year-old woman with active but stable myasthenia gravis developed pemphigus while she was pregnant. Therapeutic abortion performed for personal reasons was followed by clinical and serologic improvement in her immunobullous disease. Both autoimmune conditions, pemphigus and myasthenia gravis, may be adversely affected by pregnancy. As with another immunobullous disease, herpes gestationis (bullous pemphigoid of pregnancy), hormonal factors appear to induce pemphigus. Although myasthenia gravis and pemphigus have been reported during pregnancy, this is the first instance of coexisting myasthenia gravis and pemphigus in a pregnant woman.

Abortion, Therapeutic↗

Magnetic resonance imaging of ischemic bowel in rabbit model.

Acute mesenteric ischemic bowel disease is a common yet complex disorder with high morbidity and mortality rates predominantly caused by delayed diagnosis. We examined the role of magnetic resonance imaging (MRI) in the early detection of small bowel ischemia using the rabbit model. Surgical ligation of the appropriate arterial vascular supply to the ileum of 10 rabbits produced the ischemic compromise. The animals were imaged at different time intervals after the arterial occlusion. Multislice, T1 and T2-weighted images were obtained in axial and coronal planes. Abnormal findings of the dearterialized segment of bowel were visualized as early as 45 minutes after vascular occlusion. The findings consisted of: (1) bowel wall thickening, (2) two- to three-fold increase in signal intensity from bowel on T2-weighted images, and (3) isointensity or slightly increased signal intensity within the bowel wall on T1-weighted images. MRI appears to be a sensitive, noninvasive technique for the early detection of bowel ischemia in the rabbit animal model.

Animals↗

Efficacy of computerized tomography in the preoperative staging of pancreatic carcinoma.

The increasing use of nonoperative methods for the diagnosis and palliative treatment of pancreatic cancer has placed greater emphasis on computerized tomography (CT) in staging of this malignancy. The present study was done to review our experience with CT in staging pancreatic cancer, specifically its efficacy in predicting lesions amenable to curative versus noncurative surgical treatment. Sixty six consecutive patients with pancreatic cancer who were considered potential candidates for surgical resection and who had preoperative CT scans over the 4-year period from 1982 through 1986 were studied. Preoperative CT scans were reviewed by a radiologist without knowledge of patients' surgical management. CT criteria for unresectable disease include hepatic and distant metastasis as well as evidence of locally advanced disease, including peripancreatic fascial extension, extension of tumor to locally contiguous structures, vascular encasement/invasion, and local lymphadenopathy. CT predicted resectability with a sensitivity of 75 per cent and a positive predictive value of 38 per cent. Unresectability was predicted with a sensitivity of 72 per cent and positive predictive value of 93 per cent. CT incorrectly predicted unresectable disease in three patients who had a curative resection. CT was most reliable when it predicted unresectability due to the presence of hepatic and/or distant metastasis. CT predicted unresectability with least sensitivity using criteria for locally advanced disease. Therapeutic decisions for nonoperative management of patients with pancreatic cancer based upon CT predictions of unresectable disease, especially predictions of unresectability solely on the basis of locally advanced disease, can not be recommended at this time.

Adenocarcinoma↗

Secular variation in carbon isotope ratios from Upper Proterozoic successions of Svalbard and East Greenland.

Analyses of stratigraphically continuous suites of samples from Upper Proterozoic sedimentary successions of East Greenland, Spitsbergen and Nordaustlandet (Svalbard) provide an approximation to the secular variation in carbon isotope ratios during a geologically and biologically important period of change from around 900 million years ago to the beginning of the Cambrian period. Late Riphean carbonates and organic material show a stratigraphically useful pattern of enrichment in 13C relative to Phanerozoic or earlier Proterozoic samples. Isotopic compositions of isolated samples from other localities are consistent with a worldwide extended interval of enhanced organic burial and consequent net survival of oxidized material, probably O2, just before the initial radiation of metazoans.

Animals↗

Ureteral abnormalities in women with endometriosis.

High-volume intravenous urography was performed in 63 women with surgically proven endometriosis. Subtle abnormalities were found in 15.9% of these women. No patient had urologic symptoms, and there was no evidence of hydroureter or ureteral obstruction on the IVP. Long-term follow-up study will be required to determine whether or not these lesions will progress and cause ureteral obstruction.

Adult↗

Dermatologic features of the fat embolism syndrome.

Fat embolism syndrome is a life-threatening disease with cutaneous manifestations that occur most commonly after fractures of a long bone. The syndrome consists of a triad of dermatologic, pulmonic, and neurologic involvement. Because no major dermatologic journal has reviewed this syndrome in more than five years, we present a case and discuss the current approaches to the pathogenesis, diagnosis, and treatment of this often overlooked syndrome.

Adult↗

Breast sonotomography and high-frequency, hand-held, real-time sonography: a clinical comparison.

The diagnostic quality of breast sonography as performed with a dedicated tomographic unit (ST) and a hand-held, high-frequency, real-time transducer (RT) was evaluated in 76 patients. In 38 per cent of cases, ST was found to be of equal diagnostic quality to RT. The number of instances in which ST was judged to be better than RT was slightly greater than those in which RT was considered better than ST (34 vs. 24 per cent) (P less than or equal to 0.10). In 3 per cent of cases, the diagnostic quality of both ST or RT was considered to be poor. The majority of instances when the diagnostic quality of ST was judged to be better than RT occurred in establishing a negative diagnosis, whereas RT seemed to have greater diagnostic quality than ST in the evaluation of a palpable mass.

Adult↗

Separated chorioamnion and elevated chorion: sonographic features and clinical significance.

The clinical presentation and outcome of pregnancy was analyzed in thirteen patients in whom a free-floating intrauterine membrane was found on sonography. The cases were divided into two groups: those with elevated chorion and those with chorioamniotic separation. Five of seven patients with chorioamniotic separation progressed normally to term and delivered normal infants. In the two pregnancies with chorioamniotic separation that did not progress to term, one was associated with a placental chorioangioma and the other had a dead fetus that had a cystic hygroma indicative of Turner's syndrome. Of the six patients with elevated chorion, all presented with an episode of vaginal bleeding in the early second trimester. Five of six patients with elevated chorion progressed to term with the delivery of normal infants. One patient with extensive elevation of the chorion aborted. Three patients with elevated chorion had a subchorionic clot, whereas this was not present in patients with separated chorioamnion. Follow-up sonographic examination of patients with separated chorioamnion and elevated chorion revealed that most (11 of 13), but not all pregnancies in which an intrauterine membrane was found progressed to term without complications.

Abortion, Spontaneous↗

Current perspectives on medical imaging.

Advances in biomedical technology have expanded the potential of medical imaging. Selected aspects of developments in sonography, nuclear medicine, nuclear magnetic resonance and digital imaging are addressed, stressing the wide scope permitted by these newer modalities.

Angiography↗