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Biomedical subjects

J J Green

Publications and source records attributed to J J Green.

18 recordsLinked to original sources
PubMed2001

Xerosis in hypothyroidism: a potential role for the use of topical thyroid hormone in euthyroid patients.

Xerosis is an extraordinarily common problem in dermatology. Despite the knowledge of well recognized aggravating factors, its etiology is an enigma, and the management of the condition is often suboptimal. Dry skin may be a manifestation of hypothyroidism. The nature of this association is reviewed, culminating in the speculation that topical thyroid hormone may represent a useful modality in euthyroid patients with xerosis or other disorders of keratinization.

Administration, Topical↗
PubMed2001

Pseudoporphyria.

Pseudoporphyria is the term used to describe a photodistributed bullous disorder with clinical and histologic features of porphyria cutanea tarda, but without accompanying biochemical porphyrin abnormalities. Medications, chronic renal failure/dialysis, excessive sun exposure and UVA radiation have all been reported to cause pseudoporphyria. Recognition, diagnosis, and appropriate management of pseudoporphyria are discussed.

Adolescent↗
PubMed2000

Localized whirlpool folliculitis in a football player.

Pseudomonas aeruginosa folliculitis occurs in patients exposed to contaminated water. Most out-breaks are associated with whirlpools. The infection is characterized by follicular, erythematous papules and pustules located on immersed body surfaces. Most reported cases are the result of recreational water use, occur in a diffuse pattern, and are devoid of green pustular pigment changes. The case described occurred in a football player after whirlpool treatment for an ankle strain. Green pustules and a localized affected area are unusual aspects of this case.

Adult↗
PubMed1996

Postmortem MR imaging of lobar cerebral infarction with pathologic and in vivo correlation.

Postmortem magnetic resonance (MR) imaging features of different types of lobar cerebral infarction are correlated with the findings in gross and histologic specimens. The postmortem findings are also correlated with in vivo findings in similar cases selected from teaching files. In acute infarction, white matter vasogenic edema leads to high signal intensity on T2-weighted images and blurring of the gray-white matter junction. Petechial hemorrhage in the cortex results in inhomogeneous signal intensity on T2-weighted images. In laminar necrosis, the hyperintense cortex on T1-weighted images is due not to hemorrhage but possibly to necrosis and the presence of lipid-laden macrophages. In subacute infarction, cortical edema and necrosis may cause the gyral pattern of enhancement. Meningeal inflammation and early fibrosis are probably responsible for meningeal enhancement. In chronic infarction, gliosis and cystic malacia are responsible for the increased signal intensity of white matter on T2-weighted images. Knowledge of the pathologic features of cerebral infarction helps in understanding the MR imaging findings.

Acute Disease↗
PubMed1995

Ultrasonography in the detection of aneuploidy in the first trimester.

Ultrasonography has been used increasingly in the first trimester to identify fetal anomalies as early as possible in gestation. First trimester sonographic screening may detect a greater proportion of aneuploid fetuses than sonography performed later in pregnancy, and it may allow determination of potential markers for prediction of chromosomal anomalies.

Aneuploidy↗
PubMed1990

Diagnosis and significance of cystic hygroma in the first trimester.

Thirty cases of cervical cystic hygroma were diagnosed in the first trimester of pregnancy. Karyotype analysis was available in 29 (97 per cent). Fifteen (52 per cent) had a chromosomal abnormality. The ultrasound appearance was described as posterior cervical, lateral cervical, or cervical hygroma with hydrops. Of the 14 euploid embryos, six were electively aborted, two are undelivered, and six have been delivered as phenotypically normal infants. In cases in which the chromosomes were normal and the pregnancy continued, all lesions resolved by 18 weeks.

Aneuploidy↗
PubMed1990

Saphenous vein rupture pressure, rupture stress, and carotid endarterectomy vein patch reconstruction.

Early postoperative patch rupture is a catastrophic complication of carotid endarterectomy reconstruction with greater saphenous vein. Mechanical determinants of saphenous vein rupture were identified by structural measurements and the results applied to carotid endarterectomy patch geometry. Diameter and rupture pressure was measured in fresh saphenous vein segments from the ankle, knee, or thigh in 157 patients undergoing bypass operations. Circumferential hoop rupture stress was calculated and the results were applied to 157 carotid endarterectomy reconstructions. All vein ruptures were in the cylindric axis. The mean vein diameter was 4.58 mm. The mean vein rupture pressure was 2873 mm Hg (3.78 atm). Vein diameter was larger in the thigh than in the ankle or knee (p less than 0.01), but there was no significant difference in rupture pressure between veins from the three locations. Women had a smaller vein diameter than had men at all locations (p less than 0.01). There was a positive linear correlation between vein diameter and rupture pressure. The mean maximum diameter of curvature of 157 carotid endarterectomy reconstructions with a vein patch was 13.3 mm. Multiple random applications of the 157 veins to 157 carotid diameters predicted a mean patch rupture pressure of 1087 mm Hg (1.43 atm), 1163 mm Hg (1.53 atm) for men, and 866 mm Hg (1.14 atm) for women. Predicted vein patch rupture pressures less than 300 mm Hg were found in 5.7% of cases (8.8% women and 1.2% men). Only 0.6% of patients (1.8% women and 0% men) had a predicted rupture pressure less than 200 mm Hg. No veins with a diameter greater than or equal to 4.0 mm had a predicted patch rupture pressure less than 300 mm Hg. These results suggest that small-diameter saphenous veins have a higher risk of rupture when used as a carotid patch.

Blood Pressure↗
PubMed1989

Pulsed Doppler flow-velocity waveforms in the prediction of fetal hematocrit of the severely isoimmunized pregnancy.

We previously reported a significant relationship between the hematocrit levels of anemic fetuses and information derived from ultrasonographic and Doppler flow-velocity waveforms. In this study we prospectively tested two formulas for the prediction of hematocrit values, by use of gestational age, presence or absence of hydrops, and Doppler indices. Although one of the two formulas predicted hematocrit values significantly, the only component of the formula that made a significant contribution was fetal hydrops. We conclude that currently available fetal Doppler measurements are unable to be applied in the prospective prediction of hematocrit values in anemic fetuses of isoimmunized pregnancies.

Blood Flow Velocity↗
PubMed1989

Fetal cardiac output in the isoimmunized pregnancy: a pulsed Doppler-echocardiographic study of patients undergoing intravascular intrauterine transfusion.

The mechanism of development of hydrops fetalis in severe isoimmunization has been subject to speculation. We performed pulsed Doppler assessment of cardiac output in 13 severely isoimmunized fetuses before and after intravascular transfusion and compared the results with 37 control fetuses between 20 and 34 weeks' gestation. The cardiac index of the anemic fetuses was significantly greater than that of the control group. A significant (right ventricle, p less than 0.01; left ventricle, p less than 0.02) increase in indexed output was noted from both ventricles and in the combined ventricular output (mean +/- SEM 644 +/- 35.3 ml/kg/min in control fetuses versus 879 +/- 86.0 ml/kg/min in anemic fetuses, p less than 0.006). An increase in cardiac output was also noted when anemic fetuses were compared with gestational age-specific norms. We conclude that severely anemic fetuses of isoimmunized pregnancies tend to have significantly higher cardiac output than do unaffected fetuses and that this high output state may play a part in the development of hydrops fetalis.

Blood Transfusion, Intrauterine↗
PubMed1989

In utero intravesicular pressure and the prune belly syndrome.

The pathogenesis of the prune belly syndrome is unclear. The proposed etiologies include a distal obstructive uropathy or a mesodermal defect of the anterior abdominal wall and urinary tract. Detection of increased intravesicular pressure might identify those fetuses with an obstructive etiology who, therefore, would benefit from shunting.

Adult↗
PubMed1989

Evaluating the effectiveness of a school drug and alcohol prevention curriculum: a new look at "Here's Looking at You, Two".

The article reports on the results of an evaluation of a school drug and alcohol prevention curriculum marketed under the title, "Here's Looking at You, Two." Previous evaluations, unreported in the literature and having unresolved methodological problems, have found that while the program appears effective at transmitting information regarding drug and alcohol abuse, it has not been effective at changing the underlying attitudes and behaviors that, in part, explain substance abuse. Employing a more rigorous methodology, our examination of a relatively large sample across five school districts provides support for previous findings. Over the short-term of one year, the program was particularly effective at transmitting substance information to primary and middle school students. The program, however, produced very little of the expected effect on the underlying attitudes that are critical to changing substance abuse behaviors.

Adaptation, Psychological↗
PubMed1989

A comparison of transvaginal and abdominal ultrasound in visualizing the first trimester conceptus.

Ultrasound visualization of the first trimester embryo was compared using abdominal and transvaginal sonography. The parameters evaluated included the ability to obtain biometry, the ability to visualize detailed internal anatomy, and a subjective assessment of the overall image clarity. In 120 patients studied, transvaginal sonography was superior to abdominal sonography in obtaining biometric measurements in 51 cases (43%) and for visualizing internal anatomy in 45 cases (38%); also the image clarity of transvaginal sonography was subjectively better in 75 cases (63%). Vaginal sonography was superior to abdominal sonography in gestations less than or equal to 10 weeks, in obese patients, and in patients with retroverted uteri. The major difficulty encountered with transvaginal sonography was the limited maneuverability of the probe to generate specific views. Vaginal sonography can be a valuable tool in imaging the first trimester fetus, complementing, not replacing, abdominal sonography.

Abdomen↗
PubMed1988

The frequency of aneuploidy in prenatally diagnosed congenital heart disease: an indication for fetal karyotyping.

The frequency of chromosomal abnormalities in infants with congenital heart disease has been estimated from postnatal clinic data to be 5% to 10%. Over an 18-month period we performed fetal echocardiograms on 502 fetuses and found cardiac anomalies in 34. Eleven of these fetuses (32%) had abnormal chromosomes. This marked discrepancy from the data found in the pediatric literature may relate to nonviable fetuses identified in utero, who escape pediatric case identification. We conclude that in cases of fetal heart disease the workup should include either amniocentesis or fetal blood sampling for chromosome analysis. The information can be used for complete parental counseling and for managing delivery and neonatal care.

Aneuploidy↗
PubMed1988

Abdominal ultrasound examination of the first-trimester fetus.

The first-trimester fetus can now be comprehensively studied with ultrasound. Various biometric measurements correlate well with gestational age, such as crown-rump length (r2 = 0.938) and cranial apex to ear diameter (r2 = 0.983). On the other hand, yolk sac diameter (r2 = 0.129) and abdominal perimeter (r2 = 0.58) correlate poorly with gestational age. By 10 weeks' gestation, kidneys can be visualized in 60% of cases; 98% will be seen at 11 weeks; and 100% of cases will be visible by 12 weeks. The bladder appears later, and by 12 weeks' gestation this organ can be identified in 50% of cases. It is likely that renal agenesis can be diagnosed (or excluded) reliably in the first trimester. With improving technology, prenatal diagnosis of some fetal anomalies is now possible in the first trimester.

Abdomen↗
PubMedDate not supplied

Linear childhood discoid lupus erythematosus following the lines of Blaschko: a case report with review of the linear manifestations of lupus erythematosus.

Seventeen cases of childhood discoid lupus erythematosus (DLE) have been previously reported in the literature. We describe the first reported case of childhood linear DLE following the lines of Blaschko. The clinical and histologic characteristics of childhood DLE are discussed and a review of the linear manifestations of childhood LE is presented.

Biopsy↗