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Biomedical subjects

M J Robinson

Publications and source records attributed to M J Robinson.

At least 145 records · Page 8Linked to original sources

Aortic dissection complicating aortocoronary saphenous vein bypass.

A high autopsy incidence, 7 of 50 cases (14%), of aortic dissection as the major cause of death in patients who died following aortocoronary saphenous vein bypass is reported. The patients ranged in age from 45 to 61 years, and all had moderately severe aortic atherosclerosis. None was hypertensive, and no significant predisposing aortic medial disease was recognized. Trauma during surgical cannulation with retrograde perfusion through atherosclerotic femoral or iliac arteries was considered the initiating event leading to ileo-aortic dissection in five of the seven patients. Damage secondary to aortic cross-clamping is suggested as the pathogenetic mechanism leading to dissection in the other two patients. In six patients, the dissection was Type I of DeBakey, and in one patient, Type II. Dissection was recognized intra-operatively in five of the seven patients. In older patients, particularly those likely to have atherosclerosis of the aorta and its main branches, vigilance regarding the possibility of aortic dissection developing during the course of cardiopulmonary bypass must be constant.

Animals↗

Significance of abnormal echoes in left ventricular outflow tract.

We have observed abnormal echoes in the left ventricular outflow tract in 4 patients: 3 of the subjects had bacterial endocarditis and the fourth patient had myxomatous degeneration of the aortic valve (floppy aortic valve). A single diastolic echo with fine high frequency fluttering was seen in the patient with the floppy aortic valve, whereas the patients with endocarditis had associated infection of the mitral valve and an aneurysm of the anterior mitral leaflet, which was represented by dense systolic echoes on the proximal part of the mitral valve...

Adult↗

Cerebral malformation associated with metabolic disorder. A report of 2 cases.

A clinical and neuropathological study is presented of two cases each of which showed neuronal heterotopia. Microgyria was also present in one case. One patient was suffering from a degenerative disorder affecting the white matter. The other was a case of Menkes' disease. It is suggested that the antenatal damage may have been caused by an imbalance of the maternal metabolism, the predisposing factor being the mother's carrier state for a metabolic defect. This is the first report of teratogenesis in a case of Menkes' disease. It is also noted that in this case there is interference with the postnatal as well as the antenatal development of the brain.

Brain↗

Chlorpropamide-induced granulomas. A probable hypersensitivity reaction in liver and bone marrow.

Anicteric hepatitis, associated with fever and exfoliative dermatitis, developed in a diabetic patient two weeks after intake of a long-acting sulfonylurea, chlorpropamide (Diabinese). Granulomas showing heavy infiltration with eosinophils were found in the liver and bone marrow. These were interpreted as manifestations of an allergic reaction. The clinical signs, abnormal laboratory findings, and hepatic lesions subsided spontaneously on withdrawal of the drug. Bone marrow changes, however, persisted seven months after cessation of the drug. To our knowledge, this is the first report of a patient with liver and bone marrow inflammation characterized by granulomas with eosinophilic infiltration following intake of chlorpropamide.

Biopsy↗

Rifamycin in neonatal flavobacteria meningitis.

Three newborn infants with meningitis due to Flavobacterium meningosepticum were treated with rifamycin administered parenterally and directly into the cerebral ventricles. Antibiotic concentrations of blood and cerebrospinal fluid (CSF) were monitored during treatment. There was rapid sterilization of the CSF after this antibiotic. Jaundice was the only toxicity noted. All 3 infants developed hydrocephalus and are shunt dependent. Two of them are otherwise free of neurological complications and are developing normally. Rifamycin is a safe and effective antibiotic in this form of neonatal meningitis.

Female↗

Therapeutic evaluation of oxantel pamoate (1, 4, 5, 6-tetrahydro-1-methyl-2-[trans-3-hydroxystyryl] pyrimidine pamoate) in severe Trichuris trichiura infection.

The efficacy of oxantel pamoate (1, 4, 5, 6-tetrahydro-2-[trans-3-hydroxystyryl]-1-methyl pyrimidine pamoate) was evaluated in 25 children with severe Trichuris infection. The presence of chronic dysentery and sigmoidoscopic demonstration of whipworms in the intestinal mucosa were the criteria for inclusion in the trial. Most of these patients had severe anemia, rectal prolapse, digital clubbing, hypoproteinemia, and growth retardation. There were a high incidence of concomitant parasitism with other intestinal helminths and with Entamoeba histolytica and Giardia lamblia. Sigmoidoscopic grading of Trichuris load and egg count in the feces were carried out prior to treatment and 2 days after each course of oxantel therapy. Oxantel was administered at a dose of 10 mg/kg body weight twice daily for a 3-day course. Satisfactory response, as judged by relief of dysentery and absence of whipworms from the mucosa at sigmoidoscopy, was achieved in 17 patients after the first course and in the remaining 8 patients after a second course of oxantel. The drug was well tolerated and no side effects were noted during or after treatment. It is concluded that oxantel is a safe and effective anthelmintic for severe clinical trichuriasis.

Child↗

Mebendazole in treatment of severe Trichuris trichiura infection in Malaysian children.

Children with severe Trichuris trichiura infection pose significant social, clinical, and therapeutic problems in Malaysia. Thirty such children were investigated, and mebendazole was found to be safe and effective in the treatment of severe trichuriasis but it had to be given for a longer period than currently recommended. A poor correlation was found between egg load and worm burden in these children. Direct visualization of the rectal and colonic mucosa was the most reliable method of assessing severity in untreated cases, and response to treatment. The eggs of Trichuris that had been exposed to mebendazole were morphologically altered and not viable when incubated. This may be of considerable epidemiological importance.

Adolescent↗

The clinical presentation of mesenteric vascular disease.

The clinical presentation of 17 patients with mesenteric vascular disease admitted to Mount Sinai Medical Center was reviewed. The signs and symptoms were similar in most cases. However, the acute onset of the symptom triad of abdominal pain, diarrhea, and bloody stools in an elderly patient should make one suspect the possibility of mesenteric vascular disease. The gross and light microscopic appearance of the intestinal tract was characterized by hemorrhagic infarcts regardless of the cause of the bowel ischemia. Mortality from this disease remains high, with only four of our 17 patients alive four months after operation.

Acute Disease↗