Biomedical subjects
Publications and source records attributed to M Freeman.
Bone imaging was performed in a patient with a rapidly expanding parietal bone lesion. The findings on the nuclear medicine study showed a doughnut type lesion. The underlying abnormality was found to be an angioblastic meningioma causing local bone destruction.
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High school students filled out reports on their experiences at random times during their daily lives, including 48 occasions when they were using alcohol or marijuana. Alcohol use was reported primarily in the context of Friday and Saturday night social gatherings and was associated with a happy and gregarious subjective state. Marijuana use was reported across a wider range of situations and was associated with an average state that differed much less from ordinary experience.
Nongranulomatous ulcerative jejunoileitis is a rare cause of small intestinal ulceration. Clinical features include fever, pain, steatorrhea, and protein-losing enteropathy with an unremitting downhill course. Some cases have shown similarities to gluten-sensitive enteropathy. However, the small bowel barium study of these two diseases shows markedly divergent patterns.
Little is known of the outcome of pregnancy in women denied abortions in the United States. To address this question, we studied the pregnancy outcomes in 316 low-income women who were denied second-trimester abortion at a large, metropolitan teaching hospital in the Southeast between August, 1978, and July, 1979. Follow-up information was available on 82%. One in five women denied an abortion managed to obtain one elsewhere. Earlier gestational age at the initial abortion request, higher education level, and higher income were the best predictors of whether a woman subsequently obtained an abortion. For the women who continued their pregnancies, neither the rate of serious maternal complications nor the neonatal death rate was increased when compared with that of the rest of the hospital's population.
The development of quantitative techniques to assist in the analysis of planar thallium-201 stress-redistribution scintigrams has led to improved abilities of this modality to detect the presence of and to localize significant coronary artery disease (CAD). This fact has encouraged the reevaluation of its capabilities relative to other types of scintigraphic data collection, including seven-pinhole tomography. We have undertaken a comparison of planar scintigraphy and seven-pinhole tomography to detect in 40 exercised patients (23 with angiographically demonstrated CAD, eight with normal coronary angiograms, and nine with less than or equal to 1% likelihood of having CAD) the presence of significant CAD and to localize it correctly to an individual coronary artery. Emphasis was placed on similar imaging conditions and on analysis of images by the same quantitative program of TI-201 distribution and washout. Both techniques were found to be highly sensitive and specific for disease detection and localization. Importantly, seven-pinhole tomography did not significantly improve results.
The relationship between the severity of coronary artery stenosis and the time to completed redistribution of thallium 201 (TI-201) defects following maximal exercise was investigated in 59 patients undergoing stress-redistribution TI-201 scintigraphy, coronary angiography, and contrast ventriculography. Multiple view TI-201 scintigrams were obtained, beginning 6 minutes (immediately post stress), less than 1 hour (early), 3 to 5 hours (average), and 18 to 24 hours (late) following intravenous TI-201 injection at peak exercise. Angiographic lesions were grouped into five levels of severity by percent stenosis. In the 107 defects which were seen on the immediate post stress images, early redistribution was noted in 15 (14%) and late redistribution was found in 23 (21%). In addition, there was a correlation (r = 0.56) between the time to completed redistribution and the severity of the coronary artery stenosis (p = 0.001). In comparison to defects with early and average redistribution, the segments contralateral to those with defects showing late redistribution more often had a critical stenosis supplying that segment. The frequency of myocardial infarction on ECG and the number of segments with akinetic and dyskinetic wall motion were less in defects undergoing late rather than no redistribution. Thus the time to completed TI-201 redistribution following stress appears to be related to the severity of stenosis in the coronary artery supplying the defect. Also, late redistribution is associated with the presence and early redistribution with the absence of a significant stenosis in the coronary artery to the contralateral segment.
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Forty-three squirrel monkeys were raised on either naturally tough or artificially softened foods. Significant differences were found in craniofacial and occlusal development between hard and soft diet animals: The latter exhibit maxillary arch narrowing, palatal arching, rotated and displaced teeth, crowded premolars, and retarded cranial bone mineralization. The correlates in results between soft diet squirrel monkeys and American children suggest that dietary consistency may be an important factor in human craniofacial growth.
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Visual evoked potentials were measured in eight exteriorized near-term fetal lambs prior to and during 8 minutes of asphyxia and during 1 hour of newborn survival. Four of the lambs were then extubated, and measurements were continued while the lambs were observed for behavior and gross motor function. Early in the asphyctic period, marked changes in the visual evoked potential occurred in association with a fall in Po2, whereas during the postexposure period the visual evoked potential appeared to recover independently of cardiovascular or arterial blood gas values. Moreover, early wave components of the visual evoked potentials were more resistant to asphyxia than were later components and responded more quickly to resuscitative efforts. During the survival period the visual evoked potential did not correlate with gross motor function when animals were exposed to moderate acidosis. After severe acidosis abnormal visual evoked potentials were seen during periods of clinical deterioration.
A method is described for the analysis of chromosomes in prophase and early metaphase. It involves culturing the lymphocytes in medium RPMI-1640, supplemented with 10% autologous plasma instead of fetal bovine serum. Living cells are treated with actinomycin D and colcemid for 1 h prior to harvest and harvested early at 65 h of incubation, using a hypotonic solution formulated by Ohnuki (1968). The method has been tested on several hundred clinical samples on a routine basis. On average, 30% of the dividing cells were in prometaphase.
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The visual evoked potential (VEP) of five healthy, near-term exteriorized fetal lambs was compared with the VEP obtained from the same animals during the first hour after ventilation. Characteristics of the individual wave components and their relationship to blood pressure, heart rate, and arterial blood gas measurements concomitantly obtained were examined. Results show that the VEP of the healthy fetus is a stable, reproducible signal consisting of four basic components, and that the latencies (msec) and the amplitude (mu V) of the individual components of the VEP are similar to those of the newborn. In two related experiments, fetal asphyxia of unknown duration was encountered during fetal exteriorization an instrumentation. In the first case, neonatal, acidosis persisted despite aggressive resuscitation efforts and was accompanied by an atypical VEP. In the second case, the neonatal VEP obtained after 15 min of resuscitation was markedly depressed despite restoration of acid-base balance but gradually recovered during the remainder of the 1-hr newborn period. In conclusion, the VEP is a reproducible measure of cortical function in the healthy fetus and neonate and may reflect the acute status of cerebral function during fetal asphyxia and neonatal resuscitation.
Approximately 200 children aged 8, 12 and 16 years with poliovirus neutralising antibody titres of less than 1/45 to at least one type were given a single dose of oral or inactivated polio vaccine. Almost all children given IPV responded with high levels of neutralising antibody to all 3 types. The response to the oral vaccine was less dramatic. The relationship between pre-existing antibody and the further response and the implications for susceptibility to reinfection will be discussed.
The group B streptococcus carrier status of pregnant women appears to be relatively unstable. By using multiple low vaginal and rectal samples cultured on 2 or more media, an overall carrier rate of 38% was found in 187 women. Sequential samples commonly showed changes in the nature of the carrier status with time. More carriers were detected late in pregnancy; women giving negative results early in pregnancy often produced positive cultures later and there was a significant tendency towards rectal positivity.