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Biomedical subjects

P M O'Reilly

Publications and source records attributed to P M O'Reilly.

17 recordsLinked to original sources
PubMed1996

Graft loss following liver transplantation in patients with chronic hepatitis C.

Liver disease due to hepatitis C (HCV) is an increasingly frequent indication for orthotopic liver transplantation (OLT). The aim of the current study was to analyze the causes of graft loss following OLT for chronic hepatitis C and the longterm outcome following retransplantation in a large university program. Between January 1990 and December 1995, 1183 patients underwent primary OLT at our center. In 304 patients, HCV was diagnosed by seropositivity and/or polymerase chain reaction. Fifty-six (18.4%) of these patients underwent retransplantation. The 36 patients retransplanted for primary non-function were excluded from further analysis. The other indications for regrafting (>30 days following primary transplant) included hepatic artery thrombosis (5), chronic rejection (4), severe HCV recurrence (5), and other etiologies (6). The cumulative survival rates for the 248 patients who received 1 OLT (group 1) were 84% after one year and 75% after three years. The corresponding rates for the 20 non-PNF patients who were retransplanted (group 2) were 60% and 43%, respectively (P<.0001). Moreover, logistic regression analysis confirmed that patients in group 2 were more than 4 times likely to die than patients in group 1 (P<.0034; risk ratio, 4.2; 95% confidence interval 1.61 to 11.37). Patients undergoing retransplantation had a high incidence of serious infectious complications leading to mortality. Two additional patients with severe recurrent HCV died awaiting liver retransplantation. Eight of the 304 total patients (2.6%) transplanted for chronic HCV developed graft failure secondary to HCV recurrence and 6 of the 8 were retransplanted; 3 of the 6 patients retransplanted are alive without evidence of histologic recurrence (mean follow-up less than 1 year). In summary, despite the high frequency of recurrent histologic evidence of HCV following primary OLT (70% at 3 years), graft loss attributable solely to HCV is an infrequent finding. Retransplantation per se is a risk factor for a fatal outcome, and the indication for reOLT does not appear to impact ultimate outcome. Serious infectious complications were the leading cause of mortality in patients retransplanted. Furthermore, given the indolent natural history of HCV, longer follow-up is necessary to determine the ultimate rate of graft loss due to HCV recurrence.

Biopsy↗
PubMed1996

The radiological features of primary small-cell carcinoma of the esophagus.

Primary small cell carcinoma of the esophagus is a rare neoplasm. The incidence was 2% in our series. A primary lung tumor must be excluded before the diagnosis can be made. Two cases of primary small-cell carcinoma of the esophagus are presented. The radiological features of this tumor are nonspecific. Its unusual histological appearance is described. One patients had received radiotherapy for breast carcinoma 21 years earlier and the possible relationship of this type of cancer to radiotherapy has not been previously described in the literature. Each patient had a short-term response to therapy.

Aged↗
PubMed1996

Medicolegal aspects of breast cancer in U.S. federal medical facilities: analysis of 80 claims.

Eighty malpractice claims were taken against the U.S. government alleging negligence and delay in the diagnosis of breast cancer in federal medical facilities during the period from 1980 to 1989. Medical records and claim documents were reviewed together with the opinions of expert witnesses, journal articles, and opinions of the Department of Legal Medicine of the Armed Forces Institute of Pathology. The radiology and pathology reports were reviewed. Of the 80 claims, 68 were closed; compensation amounts ranged from $6,000 to $1 million. There was no correlation between the length of delay in diagnosis and the amount of compensation paid. The reasons for delayed diagnosis are considered in detail, and recommendations are made in an attempt to minimize the number of such claims in the future.

Adult↗
PubMed1996

A painful shoulder.

A case is outlined of a patient presenting with a painful shoulder. Metastatic malignant melanoma was diagnosed. The sites of origin of melanotic lesions as well as metastatic sites are described. Both gross and radiological appearances of such lesion are not uniform, varying from osteolytic to osteoblastic forms. Treatment is for the most part ineffective. The outcome is rapid and invariably fatal.

Aged↗
PubMed1995

Neonatal herpes simplex type 2 encephalitis: its appearances on ultrasound and CT.

We report the ultrasound findings in a 28-day-old infant with encephalitis due to herpes simplex type 2. To date less than ten such cases have appeared in the world literature. Asymmetric ventricular dilatation was seen sonographically with widespread parenchymal hyperechoic areas which corresponded to areas of low attenuation on CT. Cranial ultrasound has a distinctive appearance which, if recognised, and suggested, can lead to an early definitive diagnosis.

Encephalitis, Viral↗
PubMed1991

Temporal influences on relapses of multiple sclerosis.

A 5-year retrospective study (January 1981-December 1985) of 87 patients with a known diagnosis of MS who were admitted to the University College Hospital, Galway, Ireland, was carried out. The duration of disease relapse was correlated with the following meteorological factors prevailing about the period of relapse: (a) temperature--mean daily, absolute maximum, absolute minimum; (b) rainfall; (c) relative humidity, and (d) sunshine and global radiation. Highly significant positive correlations were found between relapse duration and temperature variables, total number of sunshine hours and global radiation. Negative correlations were found between relapse duration and both rainfall and relative humidity. Relapses were of longer duration in the middle months of the year.

Adolescent↗
PubMed1990

Structural and radiographic evaluation of four cases of tooth fusion.

Four cases of tooth fusion are presented. Three of the patients were female and one male. Radiographic examination revealed union of calcified tissues with discrete root canals and a common pulp chamber in Case 3 and the converse in Case 4. The finding of fused mandibular incisors and canines in both the deciduous and permanent dentitions is described in Case 1, while in two others unilateral fused tooth masses are described which are not repeated in the permanent dentition. The dentist should be aware of the possibility of finding fused teeth on routine dental inspection and once diagnosed the patient should be informed of the potential hazards as regards plaque accumulation and varied root canal morphology.

Adult↗
PubMed1990

Fibre composition of the hypoglossal nerve in the rat.

The fibre composition of the hypoglossal nerve of the rat has been investigated by means of (a) retrograde neuronal labelling following application of fluorescent dyes to the XII nerve and/or to the ansa cervicalis, lingual nerve and facial nerve; and (b) anterograde fibre degeneration in silver-impregnated sections of the tongue following interruption of one or more of these nerves. A search for neuromuscular spindles was carried out in coronal paraffin sections of eight control tongues. The ansa cervicalis was found to make three significant contributions to the distal XII trunk: one set of axons originated in the medial subnucleus of the ventral tier of the XII nucleus and contributed to the motor innervation of intrinsic lingual muscles: a second set originated in the lateral subnucleus of the ventral tier and contributed to the motor innervation of the posterior part of the geniohyoid muscle. A third set, having cell bodies in the two uppermost cervical ganglia, provided proprioceptive afferents to the tongue and geniohyoid. A small number of somata in the caudal end of the facial nucleus contributed axons to the XII nerve prior to its emergence from the medulla oblongata. The salivatory nucleus (pons) also contributed pre-emergence fibres, which supplied autonomic ganglia destined for the supply of small arteries in the tongue. The fibre composition of the XII trunk was completed by an afferent contribution from the jugulo-nodose ganglion complex of the vagus nerve, and by sympathetic fibres from the superior cervical ganglion. In control material, eight neuromuscular spindles were detected in five out of eight tongues. Six occupied the longitudinalis inferior, one the hyoglossus, and one the genioglossus. All eight were close to the surface of the tongue base.

Amidines↗
PubMed1990

The effects of hetero-reinnervation within the rat tongue.

This study centred on the effects of hetero-reinnervation within the rat tongue. Lingual, greater auricular and vagus nerves were used. Proximal segments of each of these nerves were joined to the distal hypoglossal stump using 10/0 nylon suture. Histological sections of the tongue were examined. In lingual hypoglossal cross-union, histological evidence indicated that neuromuscular junction (nmj) reinnervation was present to some degree in all intrinsic tongue muscles and within geniohyoid. Lingual nerve fibres were also found within the dorsal keratinised lingual epithelium, reinnervating taste buds and intralingual ganglia. Greater auricular nerve fibres were unable to make contact with nmjs, nor were they found to any appreciable degree within the lingual mucosa. Vagal nerve fibres were found close to, but not innervating, nmjs, but did reinnervate taste buds, lingual vasculature and intralingual ganglia. It was concluded that nodose cells are unable to reinnervate vacated nmjs, but like lingual fibres can reinnervate lingual mucosa, intralingual ganglia and vasculature.

Animals↗
PubMed1989

A structural and ultrastructural study of a fused tooth.

A fused mandibular lateral incisor and canine tooth were examined histologically at various levels. A composite reconstruction of the fused mass was compiled and the vascular supply indicated. Light microscopic examination revealed a common pulp chamber and discrete root canals. In the interstitium between the root canals an irregular type of secondary dentin was found. This was characterized by numerous vascular spaces and was termed "vasodentin." A notable feature of the histological examination was the paucity of odontoblasts in the interstitial root canal wall of the minor root canal, while the odontoblast layer was continuous throughout the remainder of the tooth. A theory is presented for the formation of fused teeth.

Child↗
PubMed1989

The behaviour of sensory ganglia in relation to their environment.

The nodose ganglion was removed from rats and transplanted into the denervated tongue and into the denervated or innervated sternocleidomastoid muscle. In another procedure the ganglion was sutured to the distal hypoglossal or sciatic nerve. The ganglia failed to develop motor end-plates on denervated muscle. They did, however, induce formation of taste buds on the lingual epithelium. The regenerated nerve fibres ramified extensively within the connective tissue, invading perivascular tissue and lingual epithelium. At a cellular level some ganglion cells were covered with a meshwork of axonal material while others were found outside the confines of the implanted ganglion. The latter cell group are thought to achieve their location by a process of migration.

Anastomosis, Surgical↗
PubMed1985

Management of a vertically fractured endodontically treated tooth.

The case of a vertically fractured endodontically treated tooth in which an amalgam platform was constructed on the root face is presented. A modified post crown was erected on this base. No exploratory endodontic surgery was performed. Over a 2-year follow-up period, neither the clinical nor the radiographic appearance of the tooth had deteriorated.

Aged↗
PubMed1985

Internodal segments in human laryngeal nerves.

The laryngeal nerves of a recently deceased patient were examined in order to determine whether the prenatal elongation of the recurrent nerves (especially of the left) is accompanied by significant elongation of internodal segments among their myelinated fibres. No evidence was found to support this notion. In the nerve roots of the cauda equina, internodal elongation is known to accompany ascent of the spinal cord during fetal life. The difference in behaviour in the two cases seems to lie in the fact that the laryngeal nerves reach their final positions before myelination commences, whereas the spinal nerve roots elongate later, at a time when Schwann cell multiplication has largely ceased.

Humans↗