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Biomedical subjects

M Fowler

Publications and source records attributed to M Fowler.

At least 37 records · Page 2Linked to original sources
PubMed1986

Beta 1- and beta 2-adrenergic-receptor subpopulations in nonfailing and failing human ventricular myocardium: coupling of both receptor subtypes to muscle contraction and selective beta 1-receptor down-regulation in heart failure.

We used radioligand binding techniques and measurement of beta-agonist-mediated positive inotropic responses in isolated cardiac tissue to examine beta-adrenergic-receptor subpopulations in nonfailing and failing human left and right ventricular myocardium. In tissue derived from 48 human hearts the receptor subtypes identified in nonfailing ventricle by radioligand binding were beta 1 (77%) and beta 2 (23%), with no evidence of an "atypical" beta-adrenergic receptor. In failing left ventricle the beta 1:beta 2 ratio was markedly different, i.e., 60:38. This decrease in the beta 1 proportion and increase in the beta 2 proportion in the failing ventricles were due to a 62%, "selective" down-regulation of the beta 1 subpopulation, with little or no change in beta 2 receptors. In muscle bath experiments in isolated trabeculae derived from nonfailing and failing right ventricles, both beta 1- and beta 2-adrenergic receptors were coupled to a positive inotropic response. In nonfailing myocardium, beta 1 responses predominated, as the selective beta 1 agonist denopamine produced a response that was 66% of the total contractile response of isoproterenol. In heart failure the beta 1 component was markedly decreased, while the beta 2 component was not significantly diminished. Moreover, in heart failure the beta 2 component increased in prominence, as the contractile response to the selective beta 2 agonist zinterol increased from a minority (39%) to a majority (60%) of the total response generated by isoproterenol. We conclude that failing human ventricular myocardium contains a relatively high proportion of beta 2 receptors, due to selective down-regulation of beta 1 receptors. As a result, in the failing human heart the beta 2-receptor subpopulation is a relatively important mediator of inotropic support in response to nonselective beta-agonist stimulation and is available for inotropic stimulation by selective beta 2 agonists.

Adrenergic beta-Agonists↗
PubMed1985

Sonographic findings in leiomyoma of postorchiectomy scrotum.

Leiomyomas of the scrotum are unusual testicular masses and a case report reviewing the ultrasonographic findings of this entity comprises this report. The ultrasonographic characteristics of leiomyoma have not been reported previously. The purpose of this case report is to discuss the findings of ultrasound in evaluation of leiomyoma in the area of the scrotum.

Castration↗
PubMed1985

Tenckhoff catheter obstruction resulting from invasion by Curvularia lunata in the absence of peritonitis.

A 60-year-old black woman on continuous ambulatory peritoneal dialysis (CAPD) presented with Tenckhoff catheter malfunction. She exhibited no signs or symptoms of acute peritonitis. Darkly pigmented plaques were adherent to the inner wall of the catheter and exchange tubing focally throughout its length. Similar material was adherent to the protein coagulum in the dialysis bag. The Tenckhoff catheter and tubing were removed, and hemodialysis was initiated. Cultures of the catheter and the dialysate protein coagulum grew the saprophytic soil fungus, Curvularia lunata. Histologic examination of the catheter and tubing demonstrated penetration of each by hyphae. Catheter removal alone was sufficient to eradicate the fungus since recurrence of colonization or peritonitis has not occurred following the resumption of CAPD. Peritonitis produced by opportunistic pathogens especially fungi is increasingly common. Although Curvularia species have been implicated in pulmonary and cerebral mycetomas, allergic bronchoalveolar disease, and keratitis, they have not been reported previously to cause peritonitis or catheter malfunction in CAPD patients. Fungal invasion of CAPD catheters can produce mechanical obstruction even in the absence of peritonitis. Such colonization does not preclude resumption of chronic peritoneal dialysis at a later date.

Catheters, Indwelling↗
PubMed1984

People and dollars: the experience of one hospice.

The Hospice of the North Shore (HONS) provides home hospice care, using local hospitals when inpatient care is essential. The actual cost of 4,779 patient days of care delivered from May 1, 1980 through Dec 31, 1981 was $14.26 per patient day. The median length of service was 31.5 days, with a mean of 66.4 days. Care was provided to 22.3% of all those dying of cancer during 1981 within the service area of the HONS. It is estimated that each patient receiving hospice care avoids 11.05 days of traditional inpatient care, resulting in a saving of $3,167.06 during the index period of this study. If this saving were extrapolated to a national scope, it is conservatively predicted that approximately $266,000,000 could be saved annually. The experience of the HONS strongly supports further development of outpatient, home care hospice organizations.

Adolescent↗
PubMed1983

Specific terminal DNA replication sequence of X chromosomes in different tissues of a live-born triploid infant.

Using the thymidine pulse method, DNA replication kinetics were studied on cells derived from cartilage, gonad, lymphocytes, and skin of a live-born triploid (69,XXY) infant with typical clinical findings. Replication studies showed that 3% of the lymphocytes had one early and one late replicating X, and 97% of the lymphocytes, and cartilage, gonad, and skin cells had two early replicating X's. Asynchronous DNA replication between the two early replicating X's was observed in all tissues (range 25-40%). The predominant terminal replication sequence of X chromosomes from chondrocytes, gonad, and skin fibroblast differed from that of the lymphocytes. Thus, a tissue-specific DNA replication pattern of the early-replicating X chromosome may be present. In every tissue, the last band to complete DNA replication was Xq21. Polymorphisms of metaphase chromosomes of parents and the patient were studied by Q-banding. The possible origin of the extra haploid set of chromosomes is discussed.

DNA Replication↗
PubMed1983

The Pena-Shokeir syndrome: report of five cases and further delineation of the syndrome.

We report on five cases of lethal Pena-Shokeir syndrome from three families with affected sibs. In addition to multiple anklyoses, camptodactyly, facial anomalies, and pulmonary hypoplasia, one fetus had pterygia of the neck and axillae and cardiac hypoplasia. Radiographic changes are nonspecific and probably are related to a lack of intrauterine movement. Our data and review of the literature suggest that pterygium formation is one of the manifestations of the Pena-Shokeir syndrome. A recently described lethal form of the recessively inherited multiple pterygium syndrome may represent a severe form of the Pena-Shokeir syndrome.

Abnormalities, Multiple↗
PubMed1979

Wegener granulomatosis. Unusual cause of necrotizing urethritis.

We report a case of Wegener granulomatosis presenting as a destructive urethral mass. The initial clinical impression was carcinoma, and a urinary diverting procedure was considered before the correct diagnosis was established. The importance of recognizing this unusual disease and its dramatic response to appropriate therapy are emphasized.

Cyclophosphamide↗
PubMed1979

Identification of specific antibodies to extractable nuclear antigens by passive immunodiffusion.

Extractable nuclear antigens have been identified in a number of systemic rheumatic diseases and may be useful in differentiating those with overlapping clinical features. A number of detection systems have been described but technical feasibility and sensitivity have limited widespread application. We describe a simple immunodiffusion method to identify extractable nuclear antigens with high specificity and sensitivity that compares favorably with parallel hemagglutination studies. This method can be applied easily to routine analysis of antinuclear antigens.

Antibodies, Antinuclear↗
PubMed1979

Carcinosarcoma of the prostate: report of a case with ultrastructural observations.

A carcinosarcoma of the prostate was examined by light and electron microscopy. The epithelial component was comprised of adenosquamous carcinoma. The stromal component demonstrated osseous and cartilaginous differentiation, and appeared mesenchymal by fine structure analysis. Despite aggressive therapy the patient died with disseminated disease 5 months after diagnosis.

Aged↗