Americans with Disabilities Act: big impact on small business.
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Biomedical subjects
Publications and source records attributed to J McCarthy.
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Hyperornithinaemia gyrate atrophy (HOGA) is a rare autosomal recessive disorder in which chorioretinal degeneration occurs with cataracts, myopia, and hyperornithinaemia. We report the case of an 18-year-old female who presented with the typical features of HOGA, including posterior subcapsular cataracts and elevated plasma ornithine. She later developed distorted vision in both eyes owing to wrinkling of the anterior lens capsules. Histological examination following lens extraction showed the wrinkling was caused by focal distortion from capsular fibrosis (anterior subcapsular plaque cataract). This specific lens change has not been linked previously with HOGA.
Three children with ectopic ureteroceles were examined with ultrasound, intravenous urography and cystography. In all cases the ultrasound studies outlined the ectopic ureterocele within the fluid-filled bladder and in one case added additional information regarding the non-functional portion of the duplication and its ureter.
A 53-year-old white woman developed diabetes mellitus, migratory erythema, and anemia, clinical features suggesting the presence of a "glucagonoma." Ten years earlier, after laparotomy and pancreatic biopsy, she had been told that she had an inoperable pancreatic carcinoma. Review of that biopsy together with current hormonal assay now confirms the diagnosis of glucagonoma. The recurrent peptic ulcer in this patient despite high levels of glucagon, a gastric inhibitory agent, is noted but not explained. An enhanced amylase-creatinine clearance ratio supports the notion that glucagon increases the clearances of amylase.
The effects of injection site, age, and body position on cervical venous reflux during carotid radionuclide angiography were studied. Adults injected via the left arm while supine were more likely to show reflux; neither the position nor the side injected was important in children. Right arm injection is preferred for adults; adults injected via the left arm should be erect if possible.
The mode of sensory integration of differentiated perceptions of exertion from the legs and chest was determined during sub-maximal cycle ergometer exercise. 50 male subjects performed three separate cycle ergometer tests. Power output was held constant at 840 kpm/min., while pedalling rate was randomly set at 40, 60, or 80 rpm. The over-all rating of perceived exertion was significantly lower than the rating for the legs and higher than that for the chest at each pedalling rate. Local signals from the legs dominated the sensory process. Central signals were less pronounced. The mean of the ratings for the legs and chest was slightly but significantly higher than the over-all rating at each pedalling rate. Therefore, the integration process at the superordinate level of sensory processing appeared as a weighted average of the involved regional signals.
Differentiated ratings of perceived exertion in the legs and chest were compared to local and central physiological adjustments during submaximal cycle ergometer exercise. 50 male subjects performed three separate cycle ergometer tests. Power output was held constant at 840 kpm/min., while pedalling rate was randomly set at 40, 60, or 80 rpm. Differentiated reports of exertion from the legs were considered to be local signals and reports from the chest to be central signals. Ratings of exertion for the legs, chest and over-all body were each significantly higher at 40 rpm than 60 or 80 rpm. Heart rate, oxygen uptake, ventilation and respiratory rate were also higher at 40 rpm. Lactic acid, pH, and pCO2 were similar between pedalling rates. Lactic acid did not operate differentially to influence local perceptual signals from the legs. Central measures of respiratory and aerobic metabolic adjustments were consistent with the more intense regional report of chest exertion at 40 rpm.
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Cerebral myeloma in a 49-year-old white man took the form of diffuse arachnoid infiltration, intracerebral perivascular cuffing, and frank intracerebral invasion.
Some chronic renal failure patients maintained on dialysis have uncontrollable hypertension. Those with elevated renin levels require bilateral nephrectomies prior to kidney transplant to avoid nephrosclerosis. The morbidity and mortality from surgical nephrectomies are high. In 2 such patients we embolized the renal arteries with gelfoam and successfully occluded all the major vessels. One patient became normotensive. The second remained hypertensive and had increased renin levels, probably on the basis of ischemia. Subsequent surgical nephrectomies demonstrated completely occluded segmental branches but only focal areas of infarction. Collateral blood supply determines the success of the procedure.
Perceived exertion responses were compared between field-independent and field-dependent perceivers at three cycle-ergometer pedalling rates. 50 male subjects were classified according to mode of field approach on the basis of their performance on an embedded-figures test. Power output was held constant at 840 kpm/min., while pedalling rate was randomly set at 40, 60, or 80 rpm. Significant differences between the field-independent and -dependent groups were not found at the three pedalling rates for any of the physiological variables or for over-all, legs and chest ratings of perceived exertion. The extent of differentiated psychological functioning did not account for individual differences in perceptual reactance during muscular exertion.
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This paper applies the techniques of multiple decrement life tables to marriage histories collected as part of the 1973 National Survey of Family Growth, in an attempt to examine differences in pattern and level of marriage dissolution by marriage order. The paper considers the process of marriage dissolution in two stages--marriage to separation and separation to divorce--in addition to considering the composite of these two, marriage to divorce. Second marriages are more likely to reamin intact only for blacks. For all subgroups of whites, second marriages are either as likely or more likely to dissolve than first marriages. For both first and second marriages, blacks are considerably less likely to obtain a divorce after separation.
The effect of aminophylline on lung function was studied in 14 premature infants with apnea (gestational age, 30.2 weeks; birth weight, 1.052 gm). The infants showed compromised pulmonary function with a large difference in alveolar-arterial PO2 gradient (83.9 mm Hg), a low normal lung compliance of 1.1 ml/cm H2O . kg, and a normal inspiratory resistance of 45.3 cm H2O/liter/sec. Aminophylline therapy did not change these functions significantly, but it decreased the incidence of apneic episodes from 29.7 to 4.4 per day. The effectiveness of aminophylline in treating apnea in premature infants must be related to its central stimulating effect and not to an improvement in lung function and oxygenation.
A case of multiple cystic adenomas is described and their histological characteristics discussed. Review of the literature showed no previous publication of multiple tumours from labial salivary glands.