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Biomedical subjects

B T Green

Publications and source records attributed to B T Green.

11 recordsLinked to original sources
PubMed2001

Myroides odoratus cellulitis and bacteremia: case report and review.

A case of Myroides odoratus cellulitis with bacteremia in an apparently immunocompetent man is presented. Although common in soil and water, this agent is a rare clinical isolate and is often not considered pathogenic. The virulence of M. odoratus may be greater than is currently believed and it should be considered in bacteremias from cutaneous sources in immunocompetent patients.

Adult↗
PubMed2001

Splenic abscess: report of six cases and review of the literature.

Splenic abscesses are rare but appear to be increasing in frequency. Recent advances in radiologic techniques have affected the diagnosis and management. The purpose of this study was to evaluate these effects. The medical records of one institution were retrospectively reviewed and six cases of splenic abscesses seen between 1989 and 1999 were identified. All patients had predisposing conditions with metastatic hematogenous infection in three and one each with trauma, immunodeficiency, and a contiguous site of infection. Fever was present in all patients with chills and vomiting in five and three patients, respectively. Left upper quadrant tenderness appeared in four patients and leukocytosis was found in every patient except one with the acquired immunodeficiency syndrome. Chest roentgenograms were abnormal in five patients with a left pleural effusion most common. Ultrasound revealed the defect in both patients it was utilized in and computed tomography was diagnostic in all cases. The causative organisms were anaerobes in two cases and Candida albicans, Streptococcus viridans, Escherichia coli, and Citrobacter freundii each present in one case. Radiology guided percutaneous drainage was attempted in four patients but was only successful in one. Splenectomy with antibiotics was curative in the remainder with a 100 per cent survival. These data suggest that percutaneous drainage may be appropriate for certain patients initially, but the high failure rate demonstrates that splenectomy remains the standard treatment.

Abdominal Abscess↗
PubMed2001

Strangulated obturator hernia: still deadly.

The case of an elderly, emaciated female patient with recurrent lower abdominal and hip pain associated with nausea and vomiting due to an incarcerated obturator hernia is described. The presence of a Howship-Romberg sign and a tender mass on digital rectal examination in this thin, elderly woman with a small bowel obstruction led to the rapid diagnosis of an obturator hernia by computed tomography (CT). The high mortality rate associated with this most lethal of all abdominal hernias requires a high index of suspicion to facilitate rapid diagnosis and surgical intervention if the survival rate is to be improved.

Abdominal Pain↗
PubMed2000

In vitro evaluation of intraluminal factors that may alter intestinal permeability in ponies with carbohydrate-induced laminitis.

OBJECTIVES: To study the in vitro effects of cecal contents incubated with corn starch on colonic permeability in horses. ANIMALS: 4 healthy adult ponies. PROCEDURE: Mucosal specimens were obtained from the right ventral colon and mounted in Ussing chambers. Changes in short circuit current, conductance, and large-molecule permeability in response to addition of cecal contents and cecal contents incubated with corn starch were evaluated for 120 minutes. RESULTS: Incubation of cecal contents with corn starch for 8 hours resulted in a decrease in cecal content pH and an increase in lactic acid concentration. These changes were similar to those reported in vivo for ponies given corn starch. Exposure of colonic mucosa to cecal contents incubated with corn starch resulted in an increase in tissue conductance and permeability of technetium Tc 99m pentetate, compared with mucosa exposed to cecal contents alone. CONCLUSIONS AND CLINICAL RELEVANCE: In vitro exposure of colonic mucosa to cecal contents incubated with starch resulted in increased paracellular permeability. Fermentation of excessive amounts of carbohydrate in the intestinal lumen of horses may directly induce increased intestinal permeability associated with carbohydrate-induced laminitis.

Animals↗
PubMed2000

Amniotic fluid embolism.

Amniotic fluid embolism is a rare occurrence, with no single pathognomonic clinical or laboratory finding. Diagnosis is based on clinical presentation and supportive laboratory values. We describe the case of a 17-year-old nulliparous woman at 27 weeks' gestation who had uterine bleeding, hematuria, hemoptysis, hypotension, dyspnea, and hypoxemia within 30 minutes of vaginal delivery. Laboratory values revealed diffuse intravascular coagulation. Chest films were consistent with adult respiratory distress syndrome. Pulmonary artery catheterization revealed moderately increased pulmonary capillary wedge pressure. Supportive measures, including oxygenation, fluid resuscitation, and plasma, were administered. Central hemodynamic monitoring and inotropic support were necessary. Our patient recovered uneventfully and 6 weeks later was living an unrestricted life-style.

Adolescent↗
PubMed2000

Intestinal type 2 proteinase-activated receptors: expression in opioid-sensitive secretomotor neural circuits that mediate epithelial ion transport.

Trypsin and mast cell tryptase cleave within the extracellular N terminus of proteinase-activated receptor-2 (PAR-2), exposing a tethered ligand (SLIGRL) that binds and activates the cleaved receptor. We examined the neuronal expression of PAR-2 and its role in intestinal ion transport. Short-circuit current elevations in response to trypsin or the receptor-activating peptide SLIGRL-NH(2) were measured in sheets of mucosa-submucosa from porcine ileum. SLIGRL-NH(2) or trypsin rapidly elevated short-circuit current after their contraluminal application with respective 50% effective concentrations of 184 and 769 nM. Their actions were attenuated after contraluminal administration of the neuronal conduction blocker saxitoxin (0.1 microM); the cyclooxygenase inhibitor indomethacin (10 microM); or the Na(+)/K(+)/Cl(-) cotransport inhibitor furosemide (10 microM), but not by atropine (0.1 microM), a muscarinic cholinergic antagonist. In addition, soybean trypsin inhibitor (5 microgram/ml) reduced mucosal responses to trypsin. The delta-opioid agonist [D-Pen(2,5)]-enkephalin (0.1 microM) inhibited trypsin action, an effect that was prevented by naltrindole (0.1 microM), a delta-opioid antagonist. PAR-2 immunofluorescence was localized in the mucosa using a receptor-specific antibody. PAR-2-like immunoreactivity was detected in myenteric and submucosal neurons, nerve fibers innervating ileal smooth muscle and mucosa, and in enteroendocrine cells. Some neurons coexpressed PAR-2- and choline acetyltransferase-like immunoreactivity. These results indicate that PAR-2 is expressed on cholinergic and noncholinergic submucosal neurons in porcine ileum. PAR-2 agonists stimulate active anion secretion by a neurogenic mechanism that is modulated by prostanoids and opioids. These receptors may have a potentially important role in intestinal neuroimmunomodulation.

Animals↗
PubMed1996

Production of an autoinducer of growth by norepinephrine cultured Escherichia coli O157:H7.

Escherichia coli O157:H7 were cultured in the presence of norepinephrine to generate conditioned media. The presence of a growth-inducing factor(s) in the conditioned media was examined by measurements of the ability of conditioned media to support the growth of fresh cultures of E coli O157:H7. Supplementation of fresh cultures with as little as 0.024% (v/v) norepinephrine conditioned medium resulted in increased growth as compared to controls, thereby indicating the presence of an autoinducer of growth. Analysis of the production kinetics for the autoinducer during the generation of conditioned media indicates that it differs from other more well characterized autoinducers. It is proposed that the neurohumoral environment of the host may contribute to the production of bacterial growth factors.

Bacteriological Techniques↗
PubMedDate not supplied

Duodenal somatostatinoma presenting with complete somatostatinoma syndrome.

Somatostatinomas are the rarest pancreatic endocrine tumors and can arise in the pancreas or duodenum. Duodenal somatostatinomas are less common than, and are distinguished from, their pancreatic counterparts by a frequent association with type I neurofibromatosis, the presence of psammoma bodies, the less frequent presence of metastatic disease, and the absence of somatostatinoma syndrome (diabetes mellitus, steatorrhea, and cholelithiasis). We report a case of somatostatinoma with metastases and psammoma bodies presenting with all three features of the syndrome in a patient with neurofibromatosis. Although several reports have documented portions of the syndrome in patients with duodenal somatostatinomas, to our knowledge, this is the first report of the complete syndrome associated with a duodenal lesion.

Ampulla of Vater↗