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Biomedical subjects

R E Erb

Publications and source records attributed to R E Erb.

At least 19 recordsLinked to original sources
PubMed1995

Traumatic anterior dislocation of the hip: spectrum of plain film and CT findings.

Traumatic anterior dislocation of the hip represents 11% of all hip dislocations and is classified into superior and inferior types [1]. Whereas inferior anterior hip dislocation is easily recognized on an anteroposterior radiograph of the pelvis, the radiographic appearance of superior anterior hip dislocation is less straightforward, often leading to an initial misdiagnosis of posterior hip dislocation. Misdiagnosis of the direction (anterior versus posterior) of a hip dislocation can result in failed closed reduction or an improper surgical approach to open reduction. In addition, recognition of associated impaction fractures is important, as patients with this finding have a greater tendency to develop traumatic arthritis [2, 3]. This pictorial essay, which is based on our experience with 20 cases of anterior hip dislocation, including five of the rare superior type, illustrates the spectrum of radiographic findings and distinguishing features associated with anterior hip dislocation.

Adult↗
PubMed1994

Magnetic resonance imaging of Carney's triad.

Carney's triad, a rare disorder affecting young females, is characterized by the presence of at least two of the three following neoplasms: gastric epithelioid leiomyosarcoma, extra-adrenal paraganglioma, and pulmonary chondroma. Diagnosis and follow-up evaluation of cases of Carney's triad may require an approach that uses a combination of modalities, including magnetic resonance imaging (MRI), metaiodobenzyl-guanidine (MIBG) I 131 scintigraphy, and computed tomography. MRI is as effective as MIBG scintigraphy in detecting functioning paragangliomas. In the evaluation of suspected cases of Carney's triad in which there is clinical and biochemical evidence of a paraganglioma, MRI is the modality of choice for screening and follow-up. We report a case of gastric leiomyosarcoma and extra-adrenal paraganglioma in a young woman whose initial presentation was at 7 years of age. To our knowledge, this is the earliest presentation of this disorder.

Adult↗
PubMed1990

Adenocarcinoma in a sigmoid conduit: case report.

The increased risk of developing adenocarcinoma in the sigmoid colon after ureterosigmoidostomy has been acknowledged for some time. Development of adenocarcinoma in colonic conduits isolated from the fecal stream is rare. We report a case of adenocarcinoma arising in a sigmoid conduit that probably represents a metachronous adenocarcinoma of the colon.

Adenocarcinoma, Mucinous↗
PubMed1990

Early detection of acute myocardial infarction in patients presenting with chest pain and nondiagnostic ECGs: serial CK-MB sampling in the emergency department.

STUDY OBJECTIVES: Patients presenting to the emergency department with chest discomfort are a difficult problem for emergency physicians. Nearly 50% of patients with acute myocardial infarction (AMI) will initially have nondiagnostic ECGs on ED presentation. The purpose of this study was to determine if patients with AMI having nondiagnostic ECGs could be identified using new immunochemical assays for serial CK-MB sampling in the ED. DESIGN: Chest pain patients, more than 30 years old, with pain not caused by trauma or explained by radiographic findings, were eligible for the study. Serial serum samples were drawn on ED presentation (zero hours) and three hours after presentation, then analyzed for CK-MB using four immunochemical methods and electrophoresis. Standard World Health Organization criteria were used to establish the diagnosis of AMI, including new Q-wave formation or elevation of standard in-hospital serum cardiac enzyme markers. SETTING: A tertiary cardiac care community hospital. MEASUREMENTS AND MAIN RESULTS: The serum from 183 patients hospitalized for possible ischemic chest pain was collected and analyzed. Thirty-one of 183 patients (17%) were found to have AMI by standard in-hospital criteria. Sixteen of the 31 patients (52%) with AMI had nondiagnostic ECGs on presentation. Immunochemical determination of serial CK-MB levels provided a sensitive and specific method for detecting AMI in patients within three hours after ED presentation compared with standard electrophoresis. The four immunochemical methods demonstrated a range in sensitivity from 50% to 62.1% on ED presentation versus 92% to 96.7% three hours later. The immunochemical tests demonstrated specificities ranging from 83.0% to 96.4% at three hours, with three of the four tests having specificities of 92% or greater. Electrophoresis had a sensitivity of 34.5% on ED presentation, increasing to 76.9% at three hours, with a specificity of 98.6%. CONCLUSIONS: Immunochemical CK-MB methods allowed rapid, sensitive detection of AMI in the ED. Early detection of AMI offers many potential advantages to the emergency physician. Early detection of AMI, while the patient is in the ED, could direct disposition of this potentially unstable patient to an intensive care setting. Such information may prevent the ED discharge of patients with AMI having nondiagnostic ECGs. The diagnosis of AMI within a six-hour period after symptom onset may allow thrombolytic therapy to be given to patients with AMI not having diagnostic ECGs. This study served as a pilot trial for a multicenter study of the Emergency Medicine Cardiac Research Group, which is currently ongoing.

Adult↗
PubMed1989

Massive hemoperitoneum following rupture of hepatic metastases from unsuspected choriocarcinoma.

Spontaneous massive hemoperitoneum in a reproductive-aged woman is usually associated with ectopic pregnancy. An unusual cause of intraperitoneal hemorrhage is presented: spontaneous rupture of hepatic metastases from unsuspected choriocarcinoma in a 29-year-old woman 4 weeks postpartum. Although choriocarcinoma is known to have the potential for subsequent hemorrhage of secondary sites, massive hemoperitoneum due to rupture of hepatic metastases is rare. In this case report, the presentation, prognosis groups, and treatment modalities are presented.

Adult↗
PubMed1983

Factors associated with edema of the mammary gland in primigravid dairy heifers.

The severity and anatomical extent of mammary edema (edema) of 73 primigravid Holstein heifers was scored, and certain hormones in peripheral blood plasma were quantified. The objective was to obtain by least-squares analysis of covariance independent estimates of the association of each hormone and other factors with edema scores around first calving. Mammary edema prepartum increased with age of heifer and gestation length, decreased as calf birthweight increased, but was unrelated to seasonal fluctuations in temperature and photoperiod. The increase in edema during the last week of pregnancy was accounted for by associations with prepartum concentrations of hormones in plasma. The independent estimates of hormonal relationships to edema score prepartum were positive for plasma estrone and estradiol-17 alpha and were negative for plasma estradiol-17 beta and progesterone. Plasma prolactin was not related to edema score. After parturition, estradiol-17 beta was the only independent variable associated (negatively) with edema. The results indicate a complicated interaction among the sex steroids of late pregnancy wherein some steroids may promote edema and other steroids may inhibit edema in heifers.

Age Factors↗
PubMed1982

Variables associated with peripartum traits in dairy cows. IX. Relationship of season and other factors to blood plasma concentrations of progesterone and the estrogens.

Least-squares associations of month, average daily temperature, photoperiod (h daylight/24 h) and other factors with plasma concentrations of hormones during the prepartum period were examined in 172 Holstein cows and heifers. The data were summarized and expressed as values for prepartum d 7, 4 and 1, which represented the means for d 8 to 6, 5 to 3, and 2 to 0. respectively. All animals calved during a period of 19 consecutive months. Across days, least-squares means for plasma hormones were 4.0 ng/ml for progesterone (P4), 232 pg/ml for estradiol-17 beta (E beta), 478 pg/ml for estradiol-17 alpha (E alpha), 1,970 pg/ml for estrone (E1) and 2,680 pg/ml for total estrogen (TE; sum of E beta, E alpha and E1). Variations in plasma concentrations of certain steroids were associated (P less than .05 to P less than .01) with diet group (E beta), calf sex (TE), prepartum day (all hormones), month (E beta, E alpha) and linear covariates of cow weight (E beta, E alpha) calf birth weight (E beta, E alpha, E 1, TE), temperature (P4, E beta) and photoperiod (P4, E beta). The independent linear regressions for temperature and for photoperiod in prediction equations for each plasma hormone were always inversely related. The combined use of these regressions only partially accounted for fluctuations in the least-squares monthly means for hormones. Changes in least-squares monthly means for P4, E beta and E alpha tended to be only partially paralleled during the year. Nonparallel trends among hormones were most apparent during May to July (decreasing P4 but increasing E beta and E alpha), September to November (decreasing P4 and E beta but increasing E alpha) and January and February (only E alpha elevated). We hypothesize that seasonal differences in parturient traits reported for cows may be explained in part by the seasonally associated nonparallel changes in plasma concentrations of P4, E beta and E alpha.

Analysis of Variance↗
PubMed1982

Relationships of hormones, temperature, photoperiod, and other factors to voluntary intake of dry matter in pregnant dairy cows prior to parturition.

Voluntary intake of dry matter per 100 kg body weight (defined as intake) was quantified in 86 pluriparous Holstein cows which calved during 19 consecutive mo. Least squares techniques were used to examine the association of intake during the last 8 days before calving with numerous independent variables representing seasonal and physiological factors. The data were summarized as prepartum days 7, 4, and 1 (means of days 8 to 6, 5 to 3, and 2 to 0, respectively). Intake was lowest on prepartum day 1. Main effects of diet-group, health status, and month were not related significantly to intake when covariates were included in the statistical model. Intake decreased with increasing age of cows, but it was not related independently to body condition score. There were seasonal variations in intake which could be accounted for statistically by either month as a main effect or by quantitative indices of seasonality (temperature, photoperiod, plasma prolactin). Intake was lowest in February, June, and July and highest in October. Calf birthweight was related to intake in an unexpected manner. Intake was lowest in dams carrying either small or large calves. Prolactin of plasma was associated independently with intake, but this hormone may be just another measure of seasonal variation. All variables accounted for 58% of the total variance in intake. When seasonal variations in intake were accounted for statistically by other variables, none of the steroid hormones (progesterone, estrone, estradiol-17 beta, and estradiol-17 alpha) were associated independently with variation in voluntary intake. Associations of cow age and of climatic indices with intake were greater during days 7, 4, and 1 prepartum as compared to day 250 of gestation, days .5 to 2.5 postpartum, and days 3 to 30 of lactation.

Animal Feed↗
PubMed1980

Variables associated with peripartum traits in dairy cows. VII. Hormones, calf traits and subsequent milk yield.

Independent effects of certain partum and peripartum traits on subsequent milk yields (Y) during days 1 to 27 (Y27), 28 to 60 (Y60) and 1 to 200 (Y200) of lactation were estimated from data on 167 Holstein cows and first-calf heifers. The variables were health status, calf sex and covariates (linear, quadratic and cubic) of calf birth weight (CBW), cow age (CA), month of calving code (season) and the peripartum blood plasma concentrations (means of three samples taken from 48 hr prepartum to within 2 hr postpartum) of prolactin (PRL), progesterone (P4), estrone (E1), estradiol-17 beta (E beta) and estradiol-17 alpha (E alpha). Except for Y200 values, the measures of milk yield were positively correlated (P < .01) with each other and with CA, CBW, plasma PRL and plasma E beta. Plasma PRL, E beta and E1 were positively correlated with each other and with CA (PRL and E beta) and CBW (E1 and E beta). Covariates prominently and independently related to increases in Y were CA, CBW and plasma PRL (P < .01). Predicted Y27, Y60 and Y200, calculated with equations of the cubic model, increased by 12.4, 6.5 and 3.7%, respectively, between CBW of 37 and 50 kg, and by 16.6, 15.9 and 14.8% between plasma PRL concentrations of 50 and 195 ng/ml. Season of calving, calf sex and health status were associated with changes in Y27 but not Y60 or Y200. Within the health status group, only infectious disorders (metritis or mastitis) decreased (P < .025) milk yield adjusted for CA and cow weight (adjusted Y60 and Y200). Among all other cows, including those with dystocia alone, adjusted yields were increased by heavier calves (P < .07, Y60), high plasma PRL (P < .025, Y60) and below average plasma E1 (P < .025, Y200). It may be practical to increase milk yield by providing supplemental light prepartum to increase plasma PRL and by selecting sires to maintain CBW above average.

Animals↗
PubMed1979

Variables associated with peripartum traits in dairy cows. IV. Seasonal relationships among temperature, photoperiod, and blood plasma prolactin.

Concentrations of prolactin in plasma were measured in 176 dairy cows and heifers from 13 days before calving to 2.5 days after calving over 21 mo. Prolactin averaged 35.1, 115.0, and 34.4 ng/ml prepartum (days -13 to -2), peripartum (days -1.0 to +.5), and postpartum (days +1.5 and +2.5). Season of the year affected prolactin in all periods. The linear covariate of daily photoperiod (hours of daylight per 24 h) accounted for as much variation in prolactin prepartum and postpartum as did linear covariates of both photoperiod and average daily temperature. However, it was possible to account for additional seasonal variation in prolactin peripartum by addition of the temperature covariate to the photoperiod covariate. Although photoperiod was related either directly or indirectly more than temperature to factors affecting prolactin seasonally, these statistical inferences cannot prove that prolactin is more dependent on photoperiod than on temperature because the two metereorological measures were correlated (r = .84). When the data were grouped for correlation analysis by months, correlations between temperature and prolactin among prepartum samples collected in the spring and in the fall were positive, small but significant.

Animals↗
PubMed1979

Effect of sexual experience, location, malnutrition, and repeated sampling on concentrations of testosterone in blood plasma of Gallus domesticus roosters.

Five studies were conducted with mature White Leghorn roosters to study variables associated with concentrations of testosterone in blood sampled from a wing vein. Testosterone in blood plasma was unchanged 15, 30, or 45 min after collection of semen artificially whether or not roosters were trained for collection of semen. Likewise, cohabitation with hens for 7 to 8 hr was without effect. However, trained roosters had higher (P less than .05) plasma testosterone concentrations after 7 to 8 hr in a new location than untrained roosters. Furthermore, both groups in the new location had higher testosterone concentrations than the controls not translocated. Plasma testosterone was decreased (P less than .01) about 50% within 2 weeks by feeding a diet low in crude protein (2%) which decreased feed intake 33% and caused weight loss; those fed 12% crude proteins were unchanged. Variations in concentrations of testosterone among sequential samples of blood collected at 45 min intervals for 3 hr indicated random pulsatile releases of testosterone as reported for mammals. Sequential sampling at 15 min intervals for 1 to 2 hr revealed that the testosterone increases (up to 10 ng/ml) lasted for about 1 hr and that the returns to basal concentrations required about 1 to 1.5 hr. The interval between pulsatile releases may be as long as 3 hr in some roosters. These results indicate that roosters have spontaneous and pulsatile releases of testosterone as expected, because roosters release luteinizing hormone episodically during both light and dark cycles of the day.

Animals↗