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Biomedical subjects

G W Mitchell

Publications and source records attributed to G W Mitchell.

At least 19 recordsLinked to original sources
PubMed1991

Class II antigen expression in peripheral neuropathies.

The expression of class II antigen was studied in sural nerve biopsies from patients with peripheral neuropathies. These included patients with chronic demyelinating polyradiculoneuropathy (CIDP), non-immune mediated neuropathies of diverse etiologies and controls without evidence of neuropathy. The major finding in CIDP was a marked increase in class II expression on Schwann cells. Endoneurial Schwann cell staining to the same degree as in CIDP was seen in diabetic symmetric proximal motor neuropathy, neuropathies associated with monoclonal gammopathies and hereditary sensory and autonomic neuropathy type 1. In the control nerves and the other non-immune mediated neuropathies class II expression was mainly restricted to endothelial and perineurial cells. Increased endoneurial expression of class II antigen was found to correlate with elevated cerebrospinal fluid (CSF) protein levels but not with other clinical variables or demyelination as defined by electrophysiologic criteria or teased fiber analysis. The increased expression of class II antigen on Schwann cells may be indicative of a breakdown in immunological tolerance but should not be used as a diagnostic marker for dysimmune neuropathies due to overlap with non-immune mediated neuropathies.

Adult↗
PubMed1991

Rapid onset of severe heat illness: a case report.

Aviators flying extended periods in hot environments are known to be at risk for heat-related illness. The risk when wearing chemical individual protective equipment (IPE) is increased even at relatively warm temperatures and light workloads. In this paper, we report the physiological responses of an aviator who had been flying a UH-1H helicopter up to 6 h/d clothed in full IPE on 6 consecutive days prior to the sudden onset of heat illness. His performance during the study was normal, and no clear physiological derangements were noted prior to his symptoms. The rapid evolution of his symptoms after voicing no complaints provides a graphic illustration of the difficult predictability and initial central nervous system effects of this condition.

Adult↗
PubMed1979

Bicornuate uterus and partial atresia of the fallopian tube.

Partial atresia of the fallopian tube was discovered in two patients with double uteri of the bicornuate variety. The abnormal tube in each case was ipsilateral to a noncommunicating, nonfunctioning, rudimentary uterine horn. A normal fimbriated end led to a short, patent ampullary portion that ended blindly in the mesosalpinx. Realization of the potential for the coexistence of congenital malformation of the fallopian tubes with various uterine malformations suggests that extreme caution be exercised during adnexal surgery in patients with anomalous development of the müllerian ducts.

Adolescent↗
PubMed1979

Premature rupture of the membranes: a conservative approach.

A conservative approach was followed in 188 patients with premature rupture of the membranes (PROM) over a 2 year period. There were no neonatal deaths from sepsis, and only one infant showed a positive central bacteriologic culture. Fifty-seven percent of all patients less than 37 weeks' gestation had a latent period of 24 hours and 19% went beyond 7 days before labor began. Patients less than 34 weeks' gestation who received antepartum steroids for lung maturation showed no increased infectious morbidity or mortality. A conservative approach to patients with PROM seems reasonable when either prematurity and/or a cervix unfavorable for induction further complicates the pregnancy.

Delivery, Obstetric↗
PubMed1979

Chylous metrorrhea.

Chylous is an extremely unusual cause of leukorrhea. The diagnosis is established by verification of the chylous nature of the discharge, documentation of its uterine origin, and lymphangiographic demonstration of dilated pelvic lymphatics with uterine reflux. Surgical excision of the incompetent lymphatic channels is the treatment of choice.

Child↗
PubMed1979

Practical aspects of full-time liaison psychiatry in gynecology.

A full-time liason psychiatrist can work within a department of obstetrics and gynecology. The full-time position described here includes administrative, clinical, teaching and research aspects within a general hospital affiliated with a medical school. The liason role can be established within a department outside psychiatry where medical and psychologic treatment can be rendered to patients simultaneously and the mediating role between psychiatry and medicine is truly a viable phenomenon.

Ambulatory Care↗
PubMed1978

Positive correlation of optical density at 650 nm. with lecithin/sphingomyelin ratios in amniotic fluid.

In this study, we have attempted to correlate optical density measurements of amniotic fluids with L/S ratios. We may conclude, with over a 98 per cent accuracy, that fluids having optical density readings of 0.15 and above, at 650 nm. will have an L/S ratio over 2.0. Fluids having optical density readings up to 0.05 will have L/S ratios of about 1.3. Finally, amniotic fluids having optical densities greater than 0.05 and less than 0.15 will have L/S ratios of approximately 1.5.

Amniotic Fluid↗
PubMed1978

Surgery for congenital absence of the vagina.

The Counsellor modification of McIndoe's procedure was used to create a vagina in 12 of 15 patients who presented with Rokitansky-Kuster-Hauser syndrome. Eighty percent of these patients, followed postoperatively from 4 months to 8 years, report satisfactory coital function. Our experience suggests that a malleable stent fashioned to conform to the surgically created neovagina is superior to a preformed, nonmoldable stent to which the endopelvic fascial dissection must conform.

Adolescent↗
PubMed1978

Diagnostic evaluation of hirsutism in women by selective bilateral adrenal and ovarian venous catheterization.

To determine the most significant secretory source of their androgens, 13 hirsute nonvirilized women underwent selective bilateral adrenal and ovarian venous catheterization to obtain effluent blood for the assay of testosterone and delta4-androstenedione. In three patients the testosterone and delta4-androstenedione gradients were significantly greater in the adrenal venous effluents. Testosterone and delta4-androstenedione gradients were significantly greater in the ovarian venous effluents in four patients. In six patients there were no significant differences in the testosterone gradients between the adrenal and ovarian venous effluents. The delta4-androstenedione gradients were greater in the adrenal venous effluents in three of these patients, greater in the ovarian venous effluents in one, and not significantly different in two of these patients. The fact that the measurement of urinary 17-ketosteroid excretion, the suppressibility of peripheral plasma androgens with dexamethasone, and the stimulation of peripheral plasma androgens with human chorionic gonadotropin correlated poorly with the selective catheterization data suggests that the former modalities are imprecise in the diagnostic evaluation of hirsutism in women.

17-Ketosteroids↗
PubMed1977

Cancer patients: knowledge and attitudes.

Fifty patients undergoing treatment were interviewed on what they knew about radiotherapy and their attitudes towards their disease and those treating their disease. Ninety-four percent used the word "cancer" or "malignant tumor" to describe the reason for being treated. All patients were told their diagnosis by the physician who referred them for therapy. Nineteen patients remembered feeling frightened by the equipment at first, but all had a lessening of anxiety with time. All patients perceived the role of the radiation technologist as that of operating the treatment machine and spoke only about trivialities to them. Eighty percent felt that the radiotherapist gave them satisfactory information about their treatment before commencing treatment. In contrast, the referring physician was thought to have been of no help in preparing for the experience of undergoing radiotherapy by 52% of those interviewed. Eighty-two percent of the patients expressed the opinion that both the referring physician and therapist were not the people to whom they would bring emotional problems. Therefore, mental health professionals could make a major contribution in the total program if they were involved in the day to day care of patients receiving radiotherapy.

Adult↗