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Biomedical subjects

J L Carpenter

Publications and source records attributed to J L Carpenter.

At least 73 records · Page 4Linked to original sources
PubMed1987

Idiopathic periadnexal multinodular granulomatous dermatitis in twenty-two dogs.

A distinctive periadnexal multinodular granulomatous dermatitis of unknown cause was diagnosed over a 6-year period in 22 dogs (13 males and nine females) aged 8 months to 10 years, purebred as well as mixed-breed. Nodules, usually more than two, started on the face and were often unaccompanied by signs of irritation. All dogs were otherwise healthy except a Viszla with bilateral anterior uveitis and a Basset hound with nasal congestion and sneezing. Microscopically, cutaneous lesions occurred in a periadnexal pattern, replaced sebaceous glands, coalesced, and extended into the subcutis and in more advanced cases through the panniculus carnosus. Infectious agents were not demonstrated by aerobic, anaerobic, or fungus cultures or by light or electron microscopy, nor were ectoparasites seen. Immunofluorescence and peroxidase-antiperoxidase techniques gave negative results for intraepidermal and basement membrane deposits of IgA, IgG, IgM, and C3. Lesions were unresponsive to a variety of antibiotics; they regressed spontaneously in two untreated dogs and rapidly in dogs given only corticosteroid therapy. Continuous low-dose corticosteroids were necessary in a few dogs to prevent recurrence.

Animals↗
PubMed1987

Modulation of carbohydrate residues in regenerative nodules and neoplasms of canine and feline pancreas.

The glycoconjugates of regenerative acinar cells, acinic cell carcinomas, islet cell tumors, and normal canine and feline pancreas were studied. The authors used biotinylated lectins as probes and avidin-biotin-peroxidase complex as visualant to identify and to compare the distribution of carbohydrate residues on paraffin sections from 74 cases. The findings demonstrate a difference in the staining pattern between normal acinar, islet, and ductal cells in each species and small differences in the staining pattern between the species. It is shown that in nodules of regenerative acinar cells and acinic cell carcinomas there is an increased staining intensity with Concanavalia ensiformis agglutinin, Ricinus communis agglutinin-I, and wheat germ agglutinin. The pattern of lectin staining in regenerative cells and malignant acinar cells reflects the degree of cellular differentiation. Intensive apical staining characterizes a higher degree of differentiation, while dispersed staining is a major feature of poor differentiation. These findings suggest that malignant transformation of pancreatic acinar cells is associated with enhanced expression of glycoconjugates, which resembles that seen in a normal immature acinar cells.

Animals↗
PubMed1987

Functional assessment of the elderly. A comparison of standard instruments with clinical judgment.

Using specific instruments and scales to measure mental status, nutritional state, visual acuity, gait, and activities of daily living, we studied 79 medical inpatients aged 70 years or older. We then interviewed the patients' primary physicians and nurses and asked them to rate their patients. The prevalence of functional impairment was high: 25 (32%) of the 79 patients were mentally impaired, 31 (39%) were malnourished, 18 (23%) were visually impaired, 31 (39%) had impaired gait, and 23 (29%) had problems with continence. Although clinicians recognized severe impairments, the sensitivity of their clinical judgment was poor in detecting moderate impairment in four categories: mental status sensitivity was 28% (5/18); nutrition, 54% (14/26); vision, 27% (4/15); and continence, 42% (5/12). With clinical judgment alone, physicians and nurses correctly identify severe impairment, but the more prevalent moderate impairments in mental status, nutrition, vision, and continence are poorly recognized. Comprehensive functional assessment instruments can detect these moderate impairments, which may be remediable through early intervention.

Activities of Daily Living↗
PubMed1986

Factors affecting compliance for general medicine consultations to non-internists.

For a general medicine consultation service to be effective, compliance with recommendations is essential, as is an understanding of the factors that improve compliance. Residents in a general medicine consultation service attempted prospectively to improve their skills as consultants and to enhance compliance by implementing the following steps, reported to influence compliance: identify critical recommendations; make early, direct oral contact with the referring surgeon; limit the number of recommendations; and render definite recommendations. At the end of the study period, recommendations were tabulated and categorized as to whether each was diagnostic or therapeutic and critical or noncritical, and the time of contact with the referring surgeons was noted when applicable. Multivariate analysis of the factors, in relation to the type of recommendation, demonstrated that compliance can be improved, especially if a consultant clearly identifies the critical recommendations and makes contact with the referring physician within 24 hours.

Education, Medical, Graduate↗
PubMed1986

Medical house staff performance in physical examination.

One hundred twenty patients admitted to the medical service and presented at one of two teaching conferences were examined to evaluate the nature of errors made in physical examination by house officers. The overall mean error rate per patient was 5.8% +/- 0.6% for residents and 6.4% +/- 0.6% for interns. The mean error rate for cardiac examination was significantly worse than for respiratory, abdominal, or thyroid examinations. An additional 40 patients selected for abnormal cardiac or neurologic findings were found to have a significantly higher mean error rate in those areas than did the first group of patients with less abnormal findings. Agreement in physical findings between investigators was significantly better than between investigators and house officers. Resident performance in physical examination correlated with estimates of relative time spent by attending physicians at the bedside reevaluating physical findings, but not with class-ranking and inservice examination scores. Educational implications are discussed.

Diagnostic Errors↗
PubMed1985

Tuberculosis. Cause of death in antibiotic era.

A five-year review (1979 to 1983) of 41 patients with active tuberculosis at the time of death was performed to determine the cause of death. Twenty deaths (49 percent) were directly attributed to tuberculosis. Overwhelming tuberculous disease was the cause of death for seven patients, and among them the majority had strikingly low serum levels of albumin. Ten patients died of either massive hemoptysis or respiratory failure. Only two patients died due to progressive drug-resistant disease in an area where drug resistance is common. The majority of patients (21/41; 51 percent) died of common medical problems unrelated to tuberculosis. Eleven patients died from cardiopulmonary disease (five pulmonary emboli, one respiratory failure due to chronic obstructive pulmonary disease, two acute myocardial infarctions, and two primary dysrhythmias). Three deaths were the result of gastrointestinal bleeding, and three patients died as a result of bacterial superinfection. Our data indicate that patients still die of tuberculosis in the era of effective antituberculosis therapy. It is imperative that clinicians are aware that pulmonary emboli, arteriosclerotic heart disease, bacterial superinfection, and gastrointestinal bleeding cause approximately 50 percent of the deaths among patients who have tuberculosis and that prompt recognition and treatment of those diseases might decrease the mortality from tuberculosis.

Adolescent↗
PubMed1985

Morning report. A successful format.

Morning report can function as an instructive teaching conference capable of providing a broad coverage of topics in internal medicine. A format at our institution that utilizes brief case presentations by on-call interns, followed by an in-depth discussion of key points among representative subspecialty staff, provided coverage of 85.6% of material present in three major medical references. An internal monitoring system used to guide case selection assures a broader coverage of topics. In addition, preconference preparation to delineate major teaching points, timely follow-up of previously discussed cases, and the generation of a pertinent bibliography are significant features of a format for morning report that provides a conference for exposing house staff to a wide variety of internal medicine problems.

Data Collection↗
PubMed1984

Water intake of weaned piglets from three to seven weeks old.

One hundred and two large white cross landrace piglets weaned at 21 (+/- 1) days old were randomly allocated to one of two commercial early weaning diets for a four week growth trial. The piglets were housed in groups of between six and 10. After initial moderate restriction the piglets were fed ad libitum. Food intakes and weight gains were recorded weekly. Water consumption of individual pens of piglets was recorded daily. Dietary treatment had no significant effect on mean daily feed intake, daily liveweight gain or food conversion ratio. The relationship between water and food intake, piglet weight and daily gain was examined using regression and multiple regression analyses. Water intake was related to all these parameters, with daily feed intake being the best single predictor of water intake. The relationship was described by the equation: water intake (litres/day) = 0.149 + 3.053 feed intake (kg/day).

Animal Feed↗
PubMed1984

Clinical and pathologic features of thymoma in 15 dogs.

Thymoma was diagnosed in 15 dogs at Angell Memorial Animal Hospital between 1972 and 1983. All thymomas developed in the cranial portion of the mediastinum. An autoimmune paraneoplastic syndrome was observed in 10 (67%) of the dogs and included myasthenia gravis, nonthymic neoplasms, and polymyositis. Clinical signs were variable and inconsistent, depending on whether they were attributable to the cranial mediastinal mass or to the paraneoplastic syndrome. Eleven dogs were necropsied. Two thymomas had gross characteristics of malignancy. In 3 cases, a cell consistent with a subclass of mast cell was found and in 1 thymoma, melanocytes were observed.

Animals↗
PubMed1984

Disseminated disease due to Mycobacterium chelonei treated with amikacin and cefoxitin. Absence of killing with either agent and possible role of granulocytes in clinical response.

Disseminated disease due to rapidly growing mycobacteria is manifested by positive blood cultures and multiple skin and subcutaneous abscesses. A patient had T-cell lymphoma and disseminated disease; he also had neutropenia intermittently. Single-agent therapy with amikacin sulfate or cefoxitin sodium was not adequate during periods of neutropenia, and combination therapy was necessary to control the infection. Clinical response correlated with detectable serum inhibitory levels of the antimicrobial agents. Surprisingly, the organism was not killed by either amikacin or cefoxitin, a finding that correlated with the absence of serum bactericidal levels. This case suggests that granulocytes may play a role in the host's response to this organism, and determination of serum inhibitory and possible bactericidal levels may be useful in monitoring therapy.

Adult↗
PubMed1984

Fibrodysplasia ossificans in three cats.

A disseminated disorder of epimysial connective tissue characterized by hyperplasia and ossification causing atrophy and displacement of skeletal muscles, entrapment of vessels and nerves, and progressive immobility is described in three domestic cats. The condition has some features in common with fibrodysplasia ossificans progressiva in man.

Animals↗
PubMed1984

The insulin receptor of a human monocyte-like cell line: characterization and function.

Most clinical studies of the insulin receptor in man have been carried out in circulating cells, mainly monocytes. It is important to establish whether the function of the insulin receptor in blood cells reflects that of the major target tissues. Since peripheral monocytes do not divide, they cannot be studied under continuous cell culture conditions. We, therefore, studied the insulin receptor of a monocyte-like human cell line (U-937) to determine whether it could serve as a model for further investigation of the function of the insulin receptor. We found that the U-937 cells bind [125I]insulin specifically and in a time-, temperature-, concentration-, and pH-dependent fashion, similar to circulating monocytes. In addition, they internalize the hormone-receptor complex rapidly and extensively at 37 C in a fashion analogous to that of blood monocytes and hepatocytes. U-937 cells show a similar affinity for insulin as monocytes. Unlike hepatocytes, these cells do not appear to release extensive insulin-degrading activity and do not degrade cell surface-associated ligand during initial incubations. [125I] Insulin extracted or dissociated spontaneously from the cell surface shows full rebindability to fresh cells. The insulin receptor of the U-937 cells can be down-regulated as in the major target cells. As in cultured human lymphocytes, preincubation of U-937 cells with prednisolone results in significantly increased insulin binding. Incubation with a phorbol ester tumor promoter, in contrast, inhibits the extent of specific [125I]insulin binding to U-937 cells by altering the receptor affinity. The insulin receptor of the U-937 monocyte-like cell line mirrors the insulin receptor of blood monocytes and target cells; it is a useful tool for further in vitro studies of the insulin receptor.

Cell Line↗