Biomedical subjects
Publications and source records attributed to J B Askew.
Monostotic Paget's disease of bone is an uncommon disease, reported in the hand in only a few instances. We have described an additional case involving a metacarpal bone in a 43-year-old man. We believe this disease should be considered in the radiological differential diagnosis of lytic expansile, subchondral lesions of the hand.
Injectable silicones have been applied to an undetermined number of men for penile augmentation. The practitioners of this art, whether lay or medical, have allegedly long discontinued treating penile size. In the literature to date, four men have been identified as having complications from this mode of therapy; three have had excisions of granulomatous masses secondary to the silicone; the third refused surgery. This paper reports an additional case of silicone granuloma of the penis, documented by biopsy, which necessitated two excisions to obtain a satisfactory size for copulation. Moreover, because of impotence, a Dow-Corning (Gerow design) penile prosthesis was inserted. The inflammatory response in this new case is identical to that found in other parts of the body, namely, multiple silicone droplets surrounded by multinucleated giant cells and chronic inflammatory cells.
Percutaneous needle biopsy specimens of the liver from three elderly persons (aged 77, 71, and 66) demonstrated eosinophilic intracytoplasmic globules within hepatocytes, particularly in the periportal and periseptal areas. These globules were periodic acid-Schiff positive and diastase resistant, and were identified as alpha-1-antitrypsin by immunofluorescence technics. Two of the patients had cirrhosis, and identification of protease inhibitor (Pi) type by acid starch electrophoresis and crossed immunoelectrophoresis demonstrated SZ and MZ genotypes. The patient with SZ genotype also had a long history of chronic obstructive pulmonary disease. Pi-typing was not performed for the third patient, who did not have cirrhosis. The morphologic identification of alpha-1-antitrypsin disease in liver biopsies of persons of any age is important because of (1) possible multisystem involvement (hepatic and pulmonary), (2) increased frequency of hepatocellular carcinoma, and (3) implications for genetic counseling for other family members.
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Blood lead levels were measured by atomic absorption spectrophotometry in 86 San Diego policemen to see if they would reflect the known high atmospheric lead levels in San Diego. The mean blood lead for the entire group was 27.0 microgram per dl, a level very similar to that found in the general population of other cities. Work exposure to heavy traffic, area of residence, work shift and smoking did not significantly influence blood lead. Thus, an ambient atmospheric lead load ranging from 2 to 5 microgram per cubic m does not demonstrably cause higher blood lead levels in persons exposed to such air. Surprisingly, the youngest group, 21 to 25 years, had the highest mean (32.2 microgram per dl) while the oldest, 46 to 55 years, had the lowest mean (20.9 microgram per dl), a difference statistically highly significant. However, length of work as a policeman per se did not influence blood lead levels. Exposure to other known high-risk factors (hobbies, ceramics, old dwellings) was associated with higher levels (mean 30.6 microgram per dl).