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Biomedical subjects

J M Costello

Publications and source records attributed to J M Costello.

10 recordsLinked to original sources

Severe aortic regurgitation as a late complication of temporal arteritis.

Two patients with a remote history of pathologically documented giant cell arteritis developed severe regurgitation. The first patient developed severe aortic regurgitation five years after the pathologic documentation of giant cell arteritis of the temporal arteries. Giant cell arteritis involvement of the aortic root was confirmed. The second patient developed aortic regurgitation seven years after pathologic documentation of giant cell arteries of the temporal arteries. Although pathologic confirmation of the aortic root process was not obtained, this case strengthens the clinical association between giant cell arteritis of the temporal arteries and subsequent aortic root dilatation and severe aortic regurgitation. Observation for signs of de novo severe aortic regurgitation is indicated in follow-up of patients with temporal arteritis.

Aged

The response to treatment with pituitary growth hormone: the New Zealand experience.

Ninety-four growth hormone deficient New Zealand children were treated with thrice weekly intramuscular injections of human pituitary growth hormone (GH) from 1979 to 1985 and the results from 43 children were analysed in detail. Their height velocity was mean (SD) 4.0 (1.9) cm/yr immediately prior to treatment and 8.5 (3.1) cm/yr in the first year of treatment. In each of the first three years of treatment the height velocity was significantly increased (p less than 0.001), but there was a significant decline in height velocity between the first and second, and second and third years. Nevertheless each year of treatment gave a highly significant gain in relative height. Bone age did not advance more rapidly than chronological age during the first two years of treatment, but did so subsequently. The response to GH, as assessed by the increase in relative height, was negatively correlated with the relative height at the start of treatment and with the maximum pretreatment plasma GH response to insulin hypoglycaemia. There was no correlation with pretreatment relative height velocity or aetiology of GH deficiency. Height velocity improved in five of 14 children treated with thyroxine after starting GH. Discontinuation of GH for one year in 34 children resulted in a highly significant reduction in growth rate from 7.5 (2.4) cm/yr to 2.5 (2.0) cm/yr, however four prepubertal children continued to grow at a rate exceeding 4 cm/yr.

Age Determination by Skeleton

Neonatal hypopituitarism: a neurological perspective.

Twelve patients presented with evidence of hypopituitarism in the neonatal period, but only four were correctly diagnosed at that time. Craniofacial, optic and neurological features were common. Optic hypoplasia occurred in six cases, large anterior and posterior fontanelles in four, wide sutures in four, depressed nasal bridge in three, facial palsy in three, and one infant had an asymmetrical, crying facies. Seizures occurred in three during the neonatal period and in eight at a later age. All 12 had hyperbilirubinaemia, 11 had hypoglycaemia, and micropenis occurred in five of the seven boys. This survey suggests that the incidence of neonatal hypopituitarism may have increased.

Female

Stuttering and speech naturalness: some additional data.

Thirty listeners used the 9-point speech naturalness rating scale described by Martin, Haroldson, and Triden (1984) to score 1-minute spontaneous speaking samples from 15 normally fluent speakers and 15 stutterers who had completed the initial phases of a prolonged speech treatment program. The same listeners were later asked to judge whether each sample was from a stutterer or from a normal speaker. Reliable listeners identified almost identical numbers of samples from both speaker groups as "normal speakers," but the stutterers received significantly higher scores on the rating scale, indicating that their speech was judged more unnatural sounding. The speech samples incorporated those used in a related study by Ingham and Packman (1978), thus permitting a reevaluation of the findings of that study.

Humans

Drug reaction simulating malignant lymphoma: a case due to pyrimethamine.

A 9 1/2-year-old boy who had been treated with pyrimethamine and sulphadimidine presented with generalised lymphadenopathy, fever, and an unusual sun-tanning. He was found to have mild anaemia, severe leucopenia and thrombocytopenia. The bone marrow was megaloblastic. Lymph node biopsy was initially interpreted as showing malignant lymphoma. No treatment for neoplasia was given and he was well 4 1/2 years later. We consider that the seemingly malignant changes were due to pyrimethamine.

Child

Programmed instruction.

This report presents a description of the principles of programmed instruction and an explanation of all major components of a program. No attempt is made to review or critique all available speech and language programs, but certain programs are discussed in some detail in order to illustrate adequate application of programming principles.

Behavior Therapy

46, X,X-X terminal rearrangement/45, X mosaicism in a child with short stature.

A phenotypically female child, investigated because of short stature, had abnormally large, often bipartite Barr bodies and a mosaicism of 45, X cells and cells with 46 chromosomes which included an exceptionally large metacentric chromosome (Xp+). G- and C-banding established that the chromosome was derived from two substantially entire X chromosomes joined short arm-to-short arm, and was likely to be an isodicentric X with functional inactivation of one centromere.

Body Height