Biomedical subjects
Publications and source records attributed to M Guy.
This report describes a large adrenal cortical tumor with a significant component of mature adipose tissue in a 40 year old woman. No bone marrow elements were identified in multiple sections. This lesion, representing most likely an adrenal cortical adenoma with extensive fat cell metaplasia, has not been previously reported and must be differentiated from adrenal myelolipoma.
Schistosomiasis intercalatum in known to exist in Saõ Tomé since 1988, (Corachan et al.). It is transmitted by Bulinus forskalii, (Brown et al., 1989). Stool, blood and urine specimens have been collected from 380 inhabitants of all age groups living in the small town of Guadalupe close to the Agua Traź river and Agua Polino. The prevalence of schistosomiasis by detection of S. intercalatum eggs in a 10 mg stool thick smear (Kato technique) is 25.5%. An excreted Schistosoma polysaccharide antigen, detected by means of a monoclonal antibody (Ripert et al., 1992), is found in 49.1% of the urine samples. Patients voiding S. intercalatum eggs in stools have been treated with praziquantel (40 mg/kg body weight), as recommended by WHO Expert Committee on Schistosomiasis, but it might be wise to also treat persons excreting antigen in urine. The prevalence of intestinal helminthiasis, ascariasis (73.7%), trichuriasis (73.7%) and necatoriasis have been measured.
Stool, blood and urine specimens have been collected from 380 inhabitants of all age groups living in the small town of Guadalupe in May 1992. The seroprevalence of Falciparum malaria (96%), toxoplasmosis (73.3%), have been measured.
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BACKGROUND: This study examines the limitations and complex management problems associated with the use of tiered-therapy, implantable cardioverter-defibrillators (ICDs). METHODS AND RESULTS: The study group comprises the first 154 patients undergoing implantation of tiered-therapy ICDs at our institution. Pulse generators from three different manufacturers were used. In 39 patients, a complete nonthoracotomy lead system was used. The perioperative mortality was 1.3%. Of these 154 patients, 37% experienced late postoperative problems. Twenty-one patients required system revision within 36.5 months (mean, 8.57 +/- 11.3) of surgery. Reasons for revision were spurious shocks due to electrode fractures (3) or electrode adapter malfunction (2), inadequate signal from endocardial rate-sensing electrodes (3), superior vena cava or right ventricular coil migration (5), failure to correct tachyarrhythmias due to a postimplant rise in defibrillation threshold (5), or pulse generator failure (3). One of these patients required system removal for infection after revision of an endocardial lead. A further 32 patients received inappropriate shocks for atrial fibrillation with a rapid ventricular response or sinus tachycardia. Two of these patients also received shocks for ventricular tachycardia initiated by antitachycardia pacing triggered by atrial fibrillation. Ventricular pacing for bradycardia was associated with inappropriate shocks due to excessive autogain in 2 patients. CONCLUSIONS: Despite the major diagnostic and therapeutic advantages of tiered-therapy ICDs, a significant proportion of patients continue to experience hardware-related complications or receive inappropriate shocks.
3 chronic paranoid schizophrenic men, aged 29, 30 and 37 years, respectively, developed retrograde ejaculation, a rare side-effect of clozapine. It disappeared after the dose was lowered in 1 of the patients and after stopping the drug in the other 2. On rechallenging with the drug, retrograde ejaculation recurred.
Retinol-binding protein (RBP) is a low molecular weight protein freely filtered at the glomerulus. The fractional tubular reabsorption of RBP is 99.97% and increased excretion is therefore a sensitive marker of tubular dysfunction. We obtained early-morning urine specimens from 151 well children, from newborn to 16 years of age. RBP was measured using an enzyme-linked immunosorbent assay, albumin by a radioimmunoassay and creatinine by a modified Jaffé reaction. Protein excretion was assessed by calculating the protein:creatinine ratio for early-morning urine samples. We found a fall in both RBP and albumin excretion with increasing age, particularly in the 1st year of life, with a much wider variation in values from the infants studied. The mean excretion of RBP for children aged 0-6 months [51.4 (0.6-4,719) micrograms/mmol] was significantly higher (P < 0.001) than the mean for children aged 6 months to 16-years [15.0 (3.8-60) micrograms/mmol]. It has been shown that measurement of tubular proteinuria using the RBP: creatinine ratio is useful in the assessment of children with renal disease and we propose a value two standard deviations above the geometric mean for the age of the patient as an upper limit of normal.
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A 29-year-old bachelor had immigrated from Uzbekistan to Israel 2 years before to improve his economic situation. He began drinking at the age of 20, and increased to 1-1.5 bottles of vodka a day. He was unable to keep a job more than a few months. When called up for limited military service, he thought that the army might be a solution for his employment problem. However, he felt that he would not be able to integrate into the army, and later into Israeli society, unless he was circumcised. The Ministry of Religion deferred his request for a religious circumcision because they did not consider him Jewish. Since he could not afford to pay for the operation, he read up on the procedure, drank a bottle of vodka as premedication, and tried to circumcise himself with a razor blade. Since he was unable to control bleeding, he applied to the hospital emergency room half an hour later, where the circumcision was completed and sutured. The psychiatric diagnosis was an unspecified personality disorder with psychopathic but not psychotic features.
Primary tuberculosis of the glans penis is extremely rare. We report a case in a 70-year-old man who presented with a deep ulceration of the ventral surface of the glans which mimicked malignancy. The diagnosis of tuberculosis was confirmed by biopsy, culture, and response to antituberculous chemotherapy. There was no coexisting tuberculous infection elsewhere.
Thiol reagents have been shown to increase cytosolic Ca2+ in several cell types. In non-muscle cells, these agents induce Ca2+ spikes by increasing the sensitivity of the intracellular Ca2+ stores to D-myo-inositol-1,4,5-trisphosphate (InsP3). We have investigated the effects of thimerosal and oxidized glutathione on the binding properties of the InsP3 receptor in permeabilized hepatocytes and liver and cerebellar membranes. Thimerosal, at the maximal concentration of 100 microM, decreased the KD for the InsP3 binding to permeabilized hepatocytes and cerebellar membranes from 16 to 3 nM and from 25 to 8 nM, respectively, without affecting the maximal binding capacities. On liver membranes, both thimerosal and high Ca2+ concentrations increased the affinity for InsP3 binding. The Ca2+ and the thimerosal effects were differentiated by kinetic experiments. In low Ca2+ media, two kinetic components were identified and thimerosal decreased the rate of dissociation from both these components without affecting the rate of association. In the high Ca2+ medium, a single kinetic component was found with a very slow rate of dissociation. These data suggest that the InsP3 receptor exists in different states. The high-affinity inactive state induced by high Ca2+ concentrations displays slow rates of association and dissociation. The binding properties of the receptor in its active state can be regulated by thiol reagents which increase the affinity by decreasing the dissociation rate constants. At a resting concentration of 100-200 nM, Ca2+ has two effects: it increases the affinity of the active state of the receptor as thiol reagents do and transforms part of the receptors into the inactive high-affinity state.
Postgraduate training is one of the core functions of every specialty. The Trainee Members Committee of the Faculty of Public Health Medicine audited the quality of training in public health medicine according to guidelines set by the Education Committee of the Faculty. The survey identified several weaknesses in training which need to be remedied by Faculty Members. This audit model would prove useful to other specialties and the benefit of trainee involvement in the Committee structure of the Faculty is highlighted.
A testicular mass is a diagnostic challenge, as it may include both benign and malignant processes. Due to the difficulty in diagnosis and the need to prevent complications, it is sometimes necessary to perform orchiectomy. We present an unusual case of brucellosis in which the presenting features were persistent cough for 6 months and a right testicular mass. The clinical picture and ultrasound findings suggested malignancy. Orchiectomy and medical treatment resulted in rapid resolution of symptoms.
The authors have analyzed the characteristics of menstrual cycles during the post-partum without breastfeeding, according to the nature of the first period. 172 women gave the thermal curve from childbirth to the first period. Among them, 118, 111, 98 and 54 women gave the self-observation data concerning, respectively, the first, second, third and the fourth cycle after the first period. They have noticed more short luteal phases and delays in ovulation after an anovulatory first period than after an ovulatory first period. The hormonal studies in the post-partum without breastfeeding seem not to explain the whole of these anomalies ascertained beyond twelve post-partum weeks. Most authors admit that the gonadotropin axis returns to a normal state within the fifth post-partum week. Because of the peculiar kinetics of follicle development, the ovary could be an important component of the "remnant effect of gestation", that is to say, of the delay of return to post-partum ovulation following the gestation state.
Evaluation of self-observation signs noted during post-partum, enables to study the physiology of this period. The signs analyzed in this study are: discharge of vaginal secretions, temperature discrepancy and bleeding. The originality of the study lies in the comparison of successive post-partum periods: 2 to 6 post-partum periods were studied in 163 women; in addition, we studied 38 cases including breast feeding time details and children reactions. The authors described especially the retention effect of the pregnancy and the inhibiting effect of breast feeding on the return of the fertility, by progressively escaping these two effects, and the part of the woman's reaction.
The uptake of [(36)Cl]chlorate by the 14U variant of the XD cell line of Nicotiana tobaccum L. cv Xanthi was investigated to examine the use of chlorate as a nitrate analog in transport studies. The kinetics of chlorate uptake against concentration was complex. Evidence was obtained, e.g., by means of nitrate competition, that these kinetics could be resolved into two components indicating the existence of two influx mechanisms: a saturable high affinity transport system (HATS) and a low affinity transport system (LATS) that showed first order kinetics. HATS has an apparent K(m) for chlorate of 0.3 millimolar, and a marked pH dependence. The V(max) dropped about fivefold as the pH was changed from the optimum pH (5.5-6.5), while the K(m) remained virtually unchanged. The activity of HATS was completely inhibited by 15 millimolar nitrate and was less sensitive to chloride. LATS was inhibited by chloride and showed some inhibition by nitrate. It was concluded that [(36)Cl]chlorate can be used as an analog for nitrate uptake studies only in a limited low concentration range where HATS is the main route for chlorate influx.