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Biomedical subjects
Publications and source records attributed to M Finlayson.
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Hemangiopericytomas are uncommon soft tissue tumors. While their occurrence in sinuses and soft tissues around the ear is well documented, there are no reports of primary involvement of the temporal bone. This article discusses the case of a 21 year old patient who had a right temporal angioblastic meningioma resected and presented two years later with a hemangiopericytoma that extensively involved the right temporal bone and external auditory canal. In review, the "meningioma" had the same histological features as the auditory tumor and it was evident that both lesions resulted from the growth of a hemangiopericytoma arising from the intracranial aspect of the temporal bone. Electron microscopic examination of the tumor proved useful in making the diagnosis and in evaluating the cytological features that influence prognosis and treatment. Temporal bone involvement was a major problem and the opportunity is taken to document this rare occurrence and to discuss the biological behavior, pathological characteristics, and differential diagnosis of these neoplasms.
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Left ventricular endocardial fibroelastosis developed in two patients whose mitral valves were replaced by tilting disk prostheses. The distribution of the lesions was compatible with their being caused by a hemodynamic effect of the prosthetic valves. The fibroelastosis appeared to have been of no clinical importance in one patient, but in the other, the endocardial thickening was greater and was probably a factor in causing cardiac decompensation.
Atypical endothelial proliferation and continuing growth of small vessels were found to be the main features of two benign soft tissue tumors. Lack of history of injury and insidious onset suggested neoplasia, but the morphology was that of a reactive rather than neoplastic process. Ultrastructural study of the relationship of the endothelial cells to one another and to perithelial cells was helpful in making this distinction. The process appeared to have begun in an organizing thrombus or hematoma, in one case in relation to an occluded artery, and in the other in an abnormally vascular area of skeletal muscle. It is known that endothelial hyperplasia can occur in reparative reaction of this type. The prominent muscular development of small vessels in the cases reported here suggests that abnormal flow or intraluminal pressure could have been a stimulant to atypical growth.
Two adult patients receiving immunosuppressive therapy experienced toxoplasma cerebritis. In one, the brain findings were typical of this form of the disease in adults, but the clinical features and brain lesions of the other were atypical, and had some resemblance to those seen in congenital toxoplasmosis. It is suggested that two patterns of encephalitis can occur in opportunistic toxoplasma infections, a common form with random foci of gland necrosis associated with numerous intracerebral organisms, and another with vascular lesions and periventricular necrosis. The latter has morphologic features in common with congenital encephalitis, and may also have a similar pathogenesis.
A patient with disseminated coccidioidomycosis initially had pulmonary and skin manifestations and survived for 14 years before dying of meningitis due to Coccidioides immitis. In addition to several courses of amphotericin B therapy the patient received injections of transfer factor derived from appropriate donors and miconazole nitrate therapy. The immunologic defence mechanisms of the patient during the course of his disease were studied and the possibility of a cell-mediated immunologic defect, potentially reversible by transfer factor, was demonstrated.
The effect of chlortetracycline fed at concentrations of 10 or 20 grams per ton on the antibiotic resistance of fecal coliforms from weaned pigs from four different farms was studied. At admission to experimental quarters, coliforms resistant to at least one antibiotic predominated in all groups of animals. In pigs from three farms, chlortetracycline caused a reduction in the proportion of sensitive coliforms excreted, the extent of reduction depending on feeding practices on the farm of origin. In another experiment using pigs from a fourth farm, almost all coliforms isolated were resistant. Of all resistant strains isolated, those carrying resistance to a multiplicity of antibiotics predominated, and resistance to tracycline unaccompanied by that to other agents was relatively infrequent. Special studies of hemolytic coliforms from pigs from one farm identified two particular antibiotic sensitive types. No further isolations of these types were made once chlortetracycline administration began although 21 additional isolates were made from littermates receiving unsupplemented ration. These findings suggest that the elimination of sensitive strains resulting from chlortetracycline administration was due to a replacement of these strains by different resistant types rather than by acquisition of resistance by previously sensitive strains.
Four Salmonella strains were used. With two, S. canada and S. enteritidis, establishment of infection in pigs was poor. Although improved establishment was achieved with two strains of S. typhimurium, no infections were extensive. No significant difference was detected between excretion of infecting strains by pigs receiving chlortetracycline at levels of ten gm per ton of feed and that by control counterparts. Comparable establishment of S. typhimurium S192 was achieved in pigs receiving 20 or 40 gm of chlortetracycline per ton. Resistant variants were isolated from some animals in all experiments using S. typhimurium S192. Almost without exception such variants were isolated only after specimen enrichment. The numbers of specimens from test animals yielding resistant variants were more than twice those of control counterparts. Numbers of such variants in material from the former were much greater. In vitro transfer of resistance to S. typhimurium S192 was demonstrated both in waters from drinking troughs and during specimen enrichment. The former, indicating the risk of transfer in pigs' environments and packing houses, has disturbing implications for public health. The latter emphasizes the difficulties of determining antibiotic sensitivity of pathogens as they occur in the animal body.
OBJECTIVE: The purpose of this review was to identify the major findings of published research on the factors influencing older adults' use of adaptive equipment. METHOD: Fourteen studies involving an older adult sample were selected from major electronic bibliographic databases searched with a series of key words related to aging and equipment use. Results of these studies were compared to determine the most common factors influencing the use of adaptive equipment among older adults. RESULTS: Although the reviewed studies varied in their sampling strategies and designs, many results were similar. Between 47% and 82% of prescribed equipment continues to be used by older adults, with use decreasing over time. Findings from published studies show that equipment suitability, adequate training, and pre-prescription home visits contribute to these rates of use. Lack of fit among the person, his or her environment, and the equipment was the primary reason identified for nonuse. CONCLUSION: The results of the published research provide practicing occupational therapists with a range of factors to consider when prescribing adaptive equipment to older adults. Although the findings of this review demonstrate remarkable consistency across existing research findings, future research is needed to identify what constitutes optimal device use, what factors provide personal motivation for using assistive devices, and how home visits influence use.
OBJECTIVE: This study describes the types of assistive devices in the possession of persons with multiple sclerosis (MS) and identifies factors that best predicted the probability of possessing these devices. METHOD: A secondary analysis using frequency distributions and logistic regression of existing cross-sectional data was completed. Data were from an anonymous mail survey of members of the Multiple Sclerosis Society of Canada (Atlantic Division) (N = 906). RESULTS: Mobility aids and grab bars were the most commonly reported assistive devices. Seeing an occupational therapist, not working, having a progressive type of MS, having more activity limitations and more symptoms, and having MS for a longer period were found to increase the probability of possessing assistive devices. CONCLUSION: The descriptive results of this study are similar to studies of assistive technology use by older adults and persons with other chronic conditions. Type of MS and seeing an occupational therapist were the two strongest predictors of possessing assistive devices among respondents.
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