Biomedical subjects
J B Walsh
Publications and source records attributed to J B Walsh.
Cotton-wool spots as a sign in leptospirosis (Weil's disease).
A 44-year-old black male presented with fever, myalgia and weakness. He had elevated blood urea nitrogen, creatine phosphokinase and serum glutamic-oxaloacetic transaminase. During the first 6 days of this undiagnosed illness azotemia increased, a pericardial friction rub occurred, and hematuria was present. On the 7th day bilateral subconjunctival hemorrhages, anterior uveitis, and peripapillary cotton-wool spots were noted. This combination of findings suggested leptospirosis, which was subsequently confirmed by specific antibody titers. Therapeutic response was achieved with high-dose systemic steroids.
Ethanol-induced disordering of membranes from different age groups of C57BL/6NNIA mice.
In previous studies, we have shown that many of the pharmacological effects of ethanol administered in vivo are greater in older mice compared to younger mice. This study determined if there are age-related differences in membrane order when ethanol is administered in vitro. Synaptic plasma membranes, brain microsomal membranes and erythrocyte membranes were isolated from young (3-5 month), middle (11-13 months), and old (22-24 months) C57BL/6NNIA mice. The order parameter of each age group was measured using a 5-nitroxide stearic acid spin label in the presence of 0, 250 and 500 mM ethanol added in vitro. No age-related differences in order parameter were seen in the absence of ethanol. However, membranes from young animals were disordered to the greatest degree by ethanol. The synaptic plasma and erythrocyte membranes from young mice were disordered by both 250 and 500 mM ethanol. Membranes from old mice were disordered significantly by 500 mM ethanol only and the disordering was not as great as was seen in the membranes from the young mice. In the microsomal membrane preparation, 500 mM ethanol significantly disordered the membranes from the young animals, but it had no effect on membranes from old animals. Age differences were also observed generally for cholesterol and total phospholipid which both increased with increasing age for synaptic plasma and brain microsomes. Membrane disorder induced by ethanol differs with age and is associated with cholesterol and phospholipid content of membranes.
Vitelliform macular dystrophy and butterfly-shaped epithelial dystrophy: a continuum?
We report the case of 22-year-old white female who presented for a routine ocular examination and displayed Best's disease in her right eye and butterfly-shaped macular dystrophy in her left eye. These diagnoses were confirmed by fluorescein angiography, EOG, and ERG. The fact that these 2 disorders are present in one person suggests that they are only different manifestations of the same underlying disease process.
Hypertensive retinopathy. Description, classification, and prognosis.
In 1898 Marcus Gunn described the changes in retinal vessels noted with hypertension. Arteriolar narrowing, caliber irregularity, alterations of the light reflex, and hiding of the arterial blood column were noted. Arteriovenous crossing changes and capillary bed abnormalities, such as cotton-wool spots, retinal hemorrhages, and retinal edema were also mentioned, as well as blurred discs. In the 83 intervening years, little has been added to the description of hypertensive retinopathy, but our understanding has increased. Retinal vessels respond to elevations of systemic blood pressure by generalized arteriolar constriction. This can lead to arteriolar necrosis, retinal edema, cotton-wool spots, hemorrhage, and disc edema. If the blood pressure is controlled, or slow rising, or if arteriolar sclerosis is present in the retinal arteries, then a picture of arteriolar irregularity will be noted and, depending upon the ability of the retinal vessels to contract, segmental constriction will be seen. In separating hypertensives from nonhypertensives, the most consistent ophthalmoscopic finding is arteriolar narrowing with focal irregularity. In prognosticating for survival, the best method available is the Keith-Wagener-Barker classification. However, the difficulty in separating Groups 1 and 2 of this classification has lead to numerous modifications that make comparisons from one study to another difficult.
The ankle and subtalar joints.
Explore the source record for details and available documents.
Measurement of urinary loss in elderly incontinent patients. A simple and accurate method.
A simple method which uses beam balance scales, a portable timer, a large plastic-backed absorbent pad, and tight fitting pants has been developed to measure urinary loss in incontinent patients. Complete collection of all the urine lost was achieved in 220 (94%) of 234 incontinent episodes in patients from three long-term-care wards. The attendant's subjective assessment of "wetness", as used in other methods, was shown to be an extremely crude indicator of the degree of incontinence since the weight-gain in pads judged subjectively as being "wet" was anything from 0.7 to 341 g and there was considerable overlap between the weights of pads judged to be "dry", "damp", or "wet". In 6 healthy volunteers the mean weight-gain per pad caused by perspiration was 1.2 g/2 h and the mean change due to evaporation/leakage, determined by means of pre-wetted pads, was 1.0 g.
A grading system for iris neovascularization. Prognostic implications for treatment.
A retrospective study of 34 eyes of 30 patients who had neovascularization of the anterior segment and who received panretinal photocoagulation (PRP) and/or panretinal cryotherapy was performed. The eyes were all classified preoperatively and postoperatively as to the grade of neovascularization of the iris and the anterior chamber angle according to the system devised by Weiss and Gold. The grading system of Weiss and Gold was useful in predicting the response to treatment of iris neovascularization. Almost all eyes in angle grades 0 through 2 did well. Eyes with angle grade 3 had an intermediate response. Eyes in angle grade 4 almost uniformly did poorly. Eyes with iris neovascularization secondary to central retinal vein occlusion (CRVO) or hemiretinal branch vein occlusion (HBVO) had a more rapidly progressive disease than that of eyes with rubeosis secondary to diabetes alone. The patients with the most advanced rubeosis initially, however, were those diabetics with ischemic-type CRVO.
Idiopathic preretinal macular gliosis.
Explore the source record for details and available documents.
Diurnal variations in intraocular pressure. Chronic open angle glaucoma: preliminary report.
Human beings have a diurnal variation in their intraocular pressure and this variation is related to the sleep-wake cycle. Patients with chronic open angle glaucoma have a similar fluctuation in intraocular pressure and, even without medication, may achieve a "normal" intraocular pressure several hours into their sleep period. Two patients with chronic open angle glaucoma, maintained on their usual miotic therapy, also maintained a normal diurnal fluctuation in intraocular pressure as did one patient with a unilaterally transected optic nerve and another with a surgically divided trigeminal nerve.
Diurnal variations in intraocular pressure. Chronic open angle glaucoma. Preliminary report.
Explore the source record for details and available documents.
Retinal vascular anomalies. Pathogenesis, appearance, and history.
Retinal vascular anomalies may be classified as congenital or acquired. The natural history, frequency, and significance of such lesions is outlined, and a guideline for management is provided. Most retinal vascular anomalies can be accurately diagnosed and appropriately managed by careful consideration of the patient's history and the funduscopic appearance, and by appropriate use of fluorescein angiography.
Previously unrecognized treatable illness in an Irish elderly population.
Explore the source record for details and available documents.
Repetitive subthreshold synaptic excitation and transmitter depletion.
Explore the source record for details and available documents.
Choroidal folds.
We documented the presence of choroidal folds in a series of 59 eyes. Fifteen separate conditions were established as causes of the choroidal folds. Hyperopia was the most common cuase, although no definite etiology could be established in ten cases.