Biomedical subjects
Publications and source records attributed to K A Murray.
In an anatomical study of fresh cadavers, 25 arms were dissected. The arcade of Struthers was found to be present in 17 arms (68%). Atypical features of the arcade of Struthers were observed in seven specimens. The anatomical features and clinical implications of the variants are discussed.
A recently developed technique used in the estimation of age at death is based upon the metamorphosis of the auricular surface of the ilium. This technique was designed to be used in seriation to estimate the age distribution of a skeletal sample. However, the technique has also been used in forensic science cases, which must be analyzed on a case-by-case basis. The present study examines the use of the auricular surface technique as the single aging factor. Two hypotheses are tested using a sample of 189 individuals drawn from the Terry Collection, housed at the Smithsonian Institution. The hypotheses are (1) is the method equally applicable across race and sex, and (2) how well does the method perform as the single aging factor? The results indicate that the amount of degenerative change in the auricular surface is not dependent upon race or sex in any given age category. However, the rate of degenerative change is too variable to be used as a single criterion for the estimation of age; the range of estimation error is simply too large for forensic science purposes.
Two clones, pOA1 and pOA5, have been isolated from a genomic DNA library prepared from pools of Onchocerca armillata adults in the plasmid vector pUC12. In dot-blot hybridisations, these two clones do not cross-hybridise significantly with total genomic DNA from O. volvulus, O. gutturosa, O. ochengi, O. gibsoni, O. lienalis, bovine, human, Culicoides nubeculosus, Simulium species or Brugia pahangi, but do hybridise with as little as 100 pg of DNA from two separate geographic isolates of O. armillata. The sequence of pOA1 and pOA5 has been determined and found to contain a repetitive DNA sequence 147 bp in length. These clones can be used as specific and sensitive DNA probes for the identification of O. armillata capable of identifying a single L3 larva.
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An experimental model was designed to evaluate the course of healing and the changes in bacterial concentrations of infected forelimb wounds with devascularized bone in dogs. Infected leg wounds were allowed to heal by secondary intention or were covered with a full-thickness or split-thickness skin graft, an epigastric skin/fat flap, or a gracilis musculocutaneous flap. All skin grafts failed. Gracilis muscle flaps were superior to epigastric skin/fat flaps in decreasing soft-tissue bacterial concentrations. Quantitative bone cultures, however, were positive at reexploration 6 weeks later in 33% of all legs covered with a flap. X-ray films were successful in predicting the presence or absence of bone infection in 70% of all legs. Postmortem arteriograms of legs covered with muscle flaps showed neovascularity to bone. This study suggests muscle flap coverage of wounds debrided of contaminated, necrotic, or infected bone and soft tissue to be an excellent method of providing well-vascularized soft tissue promoting healing and resolution of infection.
Pasteurella multocida was isolated in pure culture from the optic chiasm of a rabbit that was euthanatized subsequent to acute development of neurological signs. Histopathologically, there was meningoencephalomyelitis, bilateral otitis interna, retrobulbar cellulitis, optic neuritis and iritis. The ocular involvement, severity of the spinal lesions and the lack of otitis media was unusual.
This study is presented as both a follow-up and an extension of previous work on storage techniques for the preservation of skin by refrigeration. Rabbit skin grafts were used to compare the merits of various storage media. One of the media, McCoy's 5A plus serum, gave improved skin graft take and storage half-life. The ability to improve skin graft storage techniques is most beneficial to all aspects of plastic and reconstructive surgery where skin grafting is required. Prolonged graft viability and improved graft quality are of major clinical importance.
A 62-year-old woman, who lived in an area of the United States nonendemic for leprosy, was seen for an enlarging anesthetic lesion that involved the entire left breast. Microscopic examination of skin biopsy specimens taken from the edge of the lesion disclosed chronic perineural inflammation and neural proliferation, with an acid-fast bacillus demonstrable in one nerve. Granulomas, giant cells, epithelioid cells, nerve abscesses, or other characteristics of tuberculoid leprosy were not seen. This woman had a skin lesion of leprosy in an atypical site. It appeared to be indeterminate on pathologic examination and was accompanied by an unusual degree of neural proliferation.
The pharmacokinetics and bioavailability of prednisolone after doses of oral prednisone and intravenous prednisolone were determined in seven patients receiving corticosteroids for treatment of inflammatory bowel disease in active disease and remission. Prednisone absorption and conversion to the active form of prednisolone was complete in both disease phases. Pharmacokinetic parameters for total and free (unbound) prednisolone did not differ significantly between disease phases. Differences in protein binding were observed between active disease and remission with the fractional binding of prednisolone to plasma proteins decreased in active disease. This may be accounted for by decreased plasma albumin concentrations in active disease. Alpha 1-acid glycoprotein concentrations were significantly higher in active disease but did not contribute to the overall binding of prednisolone.
A modification of the original inferior flap reduction mammaplasty is presented using a dermal pedicle based on the inferior flap to support the nipple and areola complex. The technique is extremely versatile, and the breast contour is excellent. The nipple shows excellent projection and generally improved sensation over the preoperative state.
Between 1975 and 1979, 630 patients with leprosy of Hansen's disease (HD) were examined clinically and screened for syphilis using both the rapid plasma reagin (RPR) and fluorescent treponemal antibody absorption (FTA-ABS) tests. Seropositive syphilis was found more frequently than in the general population; 10% were true positive reactors with a reactive RPR, a reactive FTA-ABS, and historical, clinical, and/or postmortem evidence of syphilis. Only 8% exhibited false positive tests for reagin with a negative FTA-ABS and neither historical nor clinical evidence of treponemal infection. Among those with FTA-ABS test reactivity, highly positive FTA-ABS immunofluorescence (+3, +4) was highly predictive for syphilis (94.7%). Seropositive HD patients with both RPR and FTA-ABS reactivity should be seriously evaluated for syphilis and, if not yet treated, they should be treated.
Zomepirac sodium, a new, nonnarcotic analgesic agent, was compared with the combination of propoxyphene/acetaminophen in a placebo-controlled, double-blind, single-dose study in 196 hospitalized postsurgical patients with pain severe enough to require a prescription analgesic. Patients received 100 mg zomepirac sodium, 50 mg zomepirac sodium, 100 mg propoxyphene napsylate with 650 mg acetaminophen, or placebo. Total pain relief during the 6-hour observation period showed that 100 mg zomepirac sodium was significantly more effective than the propoxyphene combination. All active drugs were superior to placebo. Percentages of patients requiring remedication before the end of the study were: 77 per cent for placebo, 48 per cent for propoxyphene/acetaminophen, 43 per cent for 50 mg zomepirac sodium, and 29 per cent for 100 mg zomepirac sodium. The numbers of patients reporting side effects were not significantly different among the treatment groups. These results confirm those of other single-dose pain studies which showed 100 mg zomepirac sodium significantly more efficacious than the propoxyphene/acetaminophen combination.
Two cases of Klebsiella ozaenae septicemia from the National Hansen's Disease Center, Carville, La., are discussed: one fatal and one nonfatal. Although both patients had nasal complications of Hansen's disease (leprosy), the organism was grown initially from spinal fluid, blood, and wound cultures. This report confirms the potential pathogenicity of the K. ozaenae species and its widening disease spectrum.
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Codeine, a relatively weak oral narcotic agent, is the most frequently prescribed oral opiate drug. It is also frequently utilized as a control drug in comparative analgesic efficacy studies. These studies are often single dose analysis of pain relief following surgery or childbirth. We conducted a single dose, post-operative analysis of 116 patients who were randomly assigned to receive codeine 60 mg, acetaminophen 600 mg, the combination of codeine and acetaminophen at these doses, or a placebo. Only the combination agent was uniformly superior to placebo. Codeine 60 mg was not consistently superior to placebo in this post-operative single dose analysis. A review of the literature confirms the difficulty in unequivocally establishing the value of codeine as an analgesic, in acceptable oral doses, in the single dose setting. Previous reports, however, suggest that the multiple doses of codeine may afford adequate analgesia. Interpretation of single dose studies with extrapolation to repeated dosing in the practice setting is difficult.
The effects of different dosages of ethanol on respiration were determined by evaluating arterial blood PCO2, PO2 and pH in rats. Adult, male Sprague Dawley rats were treated per os with either 2, 4 or 6 g/kg of ethanol; controls received deionized water. Blood was sampled from an indwelling femoral artery catheter before treatment and 15, 30, 60, 120, 180 and 240 min posttreatment. Serum ethanol levels and body temperature was measured concurrently on all animals. This study demonstrates that ethanol ingestion results in a dose-dependent metabolic acidosis and hypothermia in rats. In addition, the highest dose of ethanol, 6 g/kg, resulted in hypoxia.