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Biomedical subjects

J L Weissman

Publications and source records attributed to J L Weissman.

At least 19 recordsLinked to original sources

Lifestyle Differentiation Among Marine Denitrifying Microorganisms.

Microorganisms carrying out denitrification in marine anoxic zones drive bioavailable nitrogen loss. Sequencing datasets have demonstrated the modularity of denitrification, with most populations having the genetic capability for only a subset of the pathway (NO3-➔NO2-➔NO➔N2O➔N2). Although previous work provided ecological explanations for this diversity among the functional modules, large trait variations exist within each functional module, and this within-module diversity and its biogeochemical implications remain unexplored. Here, we combine genomic data and modeling to explore how metabolic "lifestyle" strategies influence denitrifier community structure. We build a comprehensive genomic database of marine denitrifiers, and identify lifestyle differentiation among denitrifier functional groups. We then extend a mathematical ecosystem model by resolving two microbial functional types for each module representing a metabolic trade-off: a copiotroph, optimized for fast growth, and an oligotroph, optimized for high nutrient affinity. In the model, as the supply of organic matter relative to nitrate increases, the degree of copiotrophy among the community increases and then decreases. This suggests that oligotrophs are associated with either organic-matter- or nitrate-limiting conditions, whereas copiotrophic lifestyles are associated with an intermediate regime. Our model further associates NO2- reducers with oligotrophy and NO3- reducers with copiotrophy, particularly those producing greenhouse gas nitrous oxide (N2O), linking N2O production to substrate-replete conditions, which is consistent with our genome-based lifestyle estimates. Results provide insight into denitrifier ecological niches and thus the biogeochemical conditions that are associated with the production of intermediates, such as N2O, improving our understanding of how nitrogen cycling will change in a warming ocean.

Marine denitrifiers

Head and neck space infections in infants and children.

A retrospective study was performed in 117 children with head and neck space infections treated at the Children's Hospital of Pittsburgh from January 1986 through June 1992. Peritonsillar space infections were the most common (49%), followed by retropharyngeal (22%), submandibular (14%), buccal (11%), parapharyngeal (2%), and canine (2%) space infections. The most common pathogens isolated (N = 78) were the aerobes beta-hemolytic streptococcus (18%) and Staphylococcus aureus (18%), the anaerobes Bacteroides melaninogenicus (17%) and Veillonella (14%), and the gram-negative organism Haemophilus parainfluenzae (14%). beta-Lactamase production by aerobic pathogens was detected in 22% of cultures. Computed tomography scans (N = 16) were reviewed in blinded fashion and compared with operative findings. The sensitivity of computed tomography scan in detecting the presence of an abscess vs. cellulitis was high (91%), whereas the specificity was rather low (60%). Treatment of head and neck space infections in children should consist of accurate physical diagnosis aided by imaging studies, empiric antibiotic therapy that covers gram-negative and beta-lactamase--producing organisms as well as gram-positive organisms and anaerobes, and timely surgical intervention, when indicated.

Abscess

Replacement of a malpositioned tracheoesophageal catheter in the radiology department.

This article describes a safe and easy method to position a tracheoesophageal catheter correctly. The procedure is carried out under fluoroscopic guidance and requires neither general nor local anesthesia. The only modification necessary was removal of the tip of the hollow rubber catheter, to create an opening through which the guide wire could be passed.

Aged

Enlarged anterior chamber: CT finding of a ruptured globe.

A deep anterior chamber of the globe is a clinical sign of posterior scleral rupture, an ophthalmologic emergency. On axial CT, the depth of the anterior chambers of ruptured globes was greater than the depth of the anterior chambers of normal globes. The discrepancy between the depth of the two anterior chambers in any patient can also suggest posterior scleral rupture.

Anterior Chamber

Advances in treatment of tumors of the cranial base. Advances in imaging.

Imaging has facilitated aggressive skull base surgery by allowing precise preoperative delineation of the extent of lesions. Continued advances providing even better resolution on imaging studies may in turn facilitate the development of new surgical approaches to the skull base.

Adipose Tissue

Condylar canal vein: unfamiliar normal structure as seen at CT and MR imaging.

PURPOSE: The vein of the posterior condylar canal is often seen (and occasionally misinterpreted) at computed tomography (CT) and magnetic resonance (MR) imaging. The CT appearance of the canal and the vein on a skull specimen was compared with the CT and MR appearance in patients. MATERIALS AND METHODS: One condylar canal of the skull specimen was marked with a wire that also indicated the course of the vein beneath the skull base. Axial and coronal CT images of the specimen were compared with CT or MR images of six patients, studied for various clinical indications, in whom the vein was apparent. RESULTS: In all six patients, the location of the vein beneath the skull base corresponded to the location predicted by the wire on the specimen. The normal vein may be prominent or diminutive. CONCLUSION: Recognition of the normal vein of the posterior condylar canal may prevent misinterpretation of the vein as a neoplasm or an abnormal lymph node at CT or MR imaging.

Adult

Thrombosed aneurysm of the cervical carotid artery: avoiding a retrospective diagnosis.

Two patients with neck masses were evaluated, one with computed tomography (CT) and the other with magnetic resonance (MR) imaging. Each mass was correctly identified within the carotid sheath. The correct diagnosis-thrombosed cervical carotid aneurysm--was not considered, necessitating unexpected repair of the aneurysm or artery. Although rare, aneurysm of the cervical carotid artery should be considered in the differential diagnosis of a carotid sheath mass between the jugular vein and carotid artery. Peripheral calcification or enhancement on CT scans and a peripheral signal void on MR images are especially suggestive of the diagnosis.

Aged

Imaging of ossicular prostheses.

The prostheses available for reconstruction of the ossicular chain have expanded to include a variety of synthetic materials. Hydroxyapatite contains the inorganic constituents found in human living bone and is currently being incorporated into many new prostheses. This study demonstrates the computed tomography and magnetic resonance image characteristics of eight middle ear prostheses, a block of dense hydroxyapatite, and a human incus. Imaging of ossicular prostheses is more informative with computed tomography.

Bone Substitutes

Computer-assisted frontal sinusotomy.

An osteoplastic frontal sinus flap with flat obliteration is the "gold" standard for the management of chronic frontal sinus inflammatory disease caused by obstruction of the nasofrontal duct. Frontal sinusotomy, with an osteoplastic technique, call for osteotomies, guided by a template obtained from a Caldwell radiographic view taken at a distance of 6 feet. The reliability of the template depends on the position of the patient, distance at which the radiograph is taken, penetration of the x-rays, and other technical aspects. Therefore the template is a potential source of error. We present the use of a computer-assisted frontal sinusotomy as a method to corroborate the shape and margins of the frontal sinus in six patients undergoing obliterative frontal sinus surgery. In our hands, this technique has proved more reliable than the radiographic template to corroborate the positioning of the osteotomies.

Ethmoid Sinus

Congenital perilymphatic fistula: computed tomography appearance of middle ear and inner ear anomalies.

Congenital perilymphatic fistula is an abnormal communication between the inner ear and middle ear. Inner ear anomalies have been described on computed tomography scans. Middle ear anomalies have been found at surgery; the most frequent are anomalies of the stapes and round window. This retrospective study describes the appearance of the inner and middle ear on computed tomography scans, and of the middle ear at surgery, in 10 patients (15 ears) in whom perilymphatic fistula was found at surgery. Twelve of 15 stapes were abnormal at surgery; 4 of these 12 (33%) could be seen on computed tomography scans. Two stapes normal at surgery were normal on computed tomography. Three round windows were abnormal at surgery; none of these was seen on computed tomography scans. There were also four dysplastic cochleas, four dysplastic vestibules, and three dilated vestibular aqueducts. Computed tomography scans identified an abnormal inner ear, middle ear, or both in 8 (53%) of the 15 ears with perilymphatic fistula. An inner ear or middle ear anomaly on computed tomography may heighten clinical suspicion of congenital perilymphatic fistula.

Adolescent