Biomedical subjects
Publications and source records attributed to J S Huff.
A 53-year-old man arrived at the emergency department after the onset of progressive hemiballismus. This movement disorder was the only manifestation of his hyperglycemic state. Prompt recognition of the association of unusual movement disorders with nonketotic hyperglycemia will allow for prompt treatment.
A previously healthy 32-year-old man presented to the ED in complete heart block. Ischemic, infectious, and inflammatory conditions were considered in the differential diagnosis. Management options for complete heart block, the etiology of heart block in young adults, and treatment guidelines are reviewed.
A 41-year-old man rapidly developed quadriparesis moments after injecting cocaine. Investigation discovered a cervical spinal epidural hematoma. This complication of cocaine abuse has not been previously reported.
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A young, previously healthy patient with multiple trauma mistakenly received 400 grams of mannitol over a 3-hour period. The laboratory report of hyponatremia prompted treatment with hypertonic saline before the hyperosmolar state was recognized. The osmolal gap was 118. Mannitol intoxication in a patient without preexisting renal failure is unusual. Identification of an abnormal osmolal gap and recognition of the hyperosmolar state is discussed.
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Explore the source record for details and available documents.
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A study was undertaken to evaluate high-frequency jet ventilation (HFJV) as an adjunct for the treatment of heatstroke. Eleven mongrel dogs were anesthetized, shaved, and externally heated until core temperature reached 43 C (109.4 F). Control animals (n = 6) were cooled passively in room air. Treatment animals (n = 5) were cooled with the addition of HFJV using a flow-interrupter, high-frequency jet ventilator with a rate of 200, a driving pressure of 40 psi, and an inspiratory to expiratory ratio of .5 to deliver room air. Temperatures were measured in brain, pulmonary artery, rectum, and subcutaneous tissue of the chest wall. Serial arterial blood gases, cardiac outputs, and mean arterial pressures were measured at baseline, maximal heating, and at .5, 1, 2, and 12 hours after heating. Animals were sacrificed 12 hours after heatstroke induction. Cooling rates for brain, pulmonary artery, and rectum achieved in the HFJV group were 1.7 times faster than those for the control group (P less than .05), although slower than previously reported cooling rates with gastric and peritoneal lavage. A higher PO2, a lower PCO2, and a more physiologic pH was maintained in the HFJV group than in the control group at 30 and 60 minutes after onset of cooling (P less than .05). Gross and histopathologic examination showed characteristic changes of heatstroke in both groups; no deleterious findings could be attributed to the use of HFJV itself. HFJV warrants clinical investigation as an adjunct for treatment of hyperthermia.
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We describe a case of a granular cell tumor (GCT) of the suprasellar region with an 11-year history in a 26-year-old woman. The computed tomographic scan showed a midline, contrast-enhancing, noncalcified mass. The biopsy was diagnosed as GCT. The tumor was treated with radiation therapy. At necropsy, a large, homogeneous GCT surrounded by gliosis was found. The tumor cells were filled with granules positive for periodic acid-Schiff, diastase-resistant. The cells did not contain glial fibrillary acidic protein or S-100 protein. Electron microscopy showed tumor cells filled with innumerable lysosomal structures. No intermediate filament was found within the cytoplasm. The tumor cells were not surrounded by a basement membrane. Based on this study and on our review of the literature, the suggestion that GCT has a multicellular origin is upheld.
Depressed PMN chemotactic responsiveness was observed in 17.5% of 97 patients studied, depressed PMN bactericidal activity in 23.3% of 30 patients, and depressed PMN chemiluminescence activity in 15.8% of 19 patients. Depressed chemotactic
One hundred forty-four serous and mucoid effusions were cultured for aerobic bacteria, Mycoplasma pneumoniae, and virus. Thirty percent of all effusions yielded an unequivocally positive culture for aerobic bacteria. Although serous effusions were culture positive as often as mucoid effusions, Haemophilus influenzae was isolated predominantly from serous effusions and Staphylococcus epidermidis predominantly from mucoid samples. Only one of 73 effusions yielded a viral isolate (Herpesvirus hominis). None of 33 effusions yielded M pneumoniae, and only one of 17 effusions yielded an anaerobe (Propionibacterium). These findings suggest that aerobic bacteria may play a role in the pathogensis of serous and mucoid otitis media.
A syndrome compatible with an X-linked trait is described, affecting four male cousins in three sibships. The body had skeletal anomalies, including short stature, ridging of the metopic suture, fusion of cervical vertebrae, thoracic hemivertebrae, scoliosis, sarcral hypoplasia and short middle phalanges. In addition, they had moderate developmental retardation, and abducens palsies. Three of the four had glucose intolerance, and one was born with an imperforate anus. Of five female obligate carriers studied, three had fusion of cervical vertebrae, three had some shortening of the middle phalanges and three had glucose intolerance. The syndrome in this family was compared to previously reported syndromes, and the conclusion was reached that it represents a previously unreported X-linked syndrome with minor manifestations in carrier females.
Activities of various oxidative (LDH, MDH) and hydrolytic (LAP, alkaline- and acid phosphatase, and lysozyme) enzymes in serous middle ear effusions (MEE) and serum from patients with serous otitis media were studied. The ratio of enzyme activity between MEE and serum (MEE/serum) was greater than one for all enzymes studied indicating a higher activity of these enzymes in MEE than in serum. These findings are consistent with a hypothesis suggesting the release of enzymes from inflammatory processes in the middle ear cavity. These enzymes presumably originate from 1) enzymes normally present in blood, 2) release of enzymes from inflamed middle ear mucosa, 3) release of enzymes from inflammatory cells present in the effusions.
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