Biomedical subjects
Publications and source records attributed to R Lynch.
Rhabdomyolysis is an unusual complication following infection with influenza B virus. We recently managed a young boy who presented with severe rhabdomyolysis and bilateral lower extremity compartment syndrome due to infection with influenza B virus.
Explore the source record for details and available documents.
Four cases of patients in whom graft vs. host disease developed after liver transplantation are described. The clinical course of each patient was similar with fever, pancytopenia, diarrhea and a skin rash developing 1 or 2 mo after liver transplantation. The clinical diagnosis was made from skin or colon biopsy specimens. Liver dysfunction did not occur in the patients at the time of diagnosis. Extrahepatic donor DNA was identified in the three patients it was tested for. Three patients died from the complications of the disease primarily related to sepsis. The other patient recovered from the graft vs. host disease but died from lymphoproliferative disease.
Explore the source record for details and available documents.
The North American opossum Didelphis virginiana was used as a model for fetal urinary obstruction. In this animal the fetus develops on a teat in a pouch and, therefore, it is accessible to surgical intervention. Unilateral ureteral obstruction was created at a mid trimester developmental equivalent in 8 pups, late ureteral obstruction was created in a similar fashion in 6 pups at a full-term equivalent and unobstruction of 9 pups was accomplished with a ureteroneocystostomy at a full-term equivalent. After early intervention 6 pups were found to have only partial ureteral obstruction as measured by mild dilatation and probe patency of the ureter. The control group consisted of 11 unoperated animals. The animals were maintained until adulthood when they were harvested after obtaining creatinine clearances from both kidneys. All dilated urinary systems were cultured for bacteria and they were sterile.
Complete urethral atresia is an anomaly that previously was incompatible with life. We report on a surviving infant with this anomaly. As a fetus urinary decompression was accomplished with a vesicoamniotic shunt. Peritoneal dialysis was initiated shortly after birth and at 9 months supramembranous scrotal inlay urethroplasty was performed to provide for egress of urine from the bladder. A maternal renal allograft was performed when he was 12 months old. When the patient was 3 1/2 years old he had normal renal function and emptied the bladder to completion through the reconstructed urethra. Although mildly delayed, he continues to progress with all developmental milestones.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
The effects of pregnancy on neurosurgical disease are complex and require a detailed knowledge of physiology, anatomy, and pharmacology. The following article details the pathophysiology and treatment of the more common disorders of the nervous system seen during pregnancy.
Male infertility can affect up to one in ten couples attempting a pregnancy. Careful history taking and thorough physical examination, supplemented by laboratory and clinical measurements, are important in reaching an accurate diagnosis of this increasingly complex subject. Available treatment options are outlined for a range of clinical conditions and their anticipated success rates are discussed.
Evidence to support the contention that avoidance of testicular hyperthermia (due to hot baths and/or tight clothing) will improve fertility is, in the main, anecdotal. Semen samples derived from 128 infertile men were analyzed before and after a 3-month conservative treatment regimen. Six seminal characteristics were studied. Clinical evaluation included normal bath temperature, types of underwear worn, and past history of hernia repair, orchiopexy, or varicocelectomy. The patients were divided into three groups (A to C) according to sperm density and then subclassified on the basis of progressive motility status. The results show that a significant, or approaching significant, improvement in seminal characteristics occurs in certain groups of oligospermic individuals with pretreatment progressive motility of less than 40%. In clinical trials, it should be recognized that any improvement in seminal quality following pharmacologic or surgical intervention may include a contribution from conservative treatment.
Explore the source record for details and available documents.
The sensitivity and specificity of magnetic resonance (MR) imaging and computed tomography (CT) were compared in blinded readings of images of a consecutive series of patients with subsequently proved diagnoses. Overall, MR imaging was less sensitive than CT because of its lower sensitivity in detecting benign tumors. With a similar experimental protocol, the effects of technical refinements or contrast media on the sensitivity of MR imaging can be determined.
Explore the source record for details and available documents.
The topographical representation of the masticatory muscles of the rat was investigated by studying retrograde transport of horseradish peroxidase (HRP) from individual muscles. Contrary to the classically accepted scheme, the temporalis and masseter are separately represented dorsolaterally, the pterygoids dorsomedially and the jaw-opening mylohyoid and anterior belly of digastric ventrally within the motor nucleus, corresponding to the arrangement of the muscles on the head. Phylogenetic and ontogenetic justifications for this organization are adduced.
Comparison between computed tomography and nuclear magnetic resonance imaging in 17 patients with intracranial hematomas indicates a distinct role for NMR in evaluating the stable patient with hematoma. NMR is useful for delineating the extent of the hematoma, the relationship of the hematoma to brain anatomy, and the presence of hematoma at a time when the hematoma is isodense on CT.
A survey of alcohol use among 217 Black and Haitian migrant agricultural workers was conducted in 13 camps in three counties of upstate New York. The orienting hypothesis stated that older, unattached men account for much of the drinking on migrant camps and that older, unattached men have experienced a variety of personal troubles as a result of their drinking. The results of the survey were found to support the initial hypothesis. In camps composed primarily of family groups, social control mechanisms were found to be more highly developed than in camps composed primarily of unattached, isolated men. It was also found that this difference in degree of social control was reflected in differences of drinking behavior. It is suggested that the mechanization of agriculture has become a self-reinforcing process that results in a proportional increase in the use of the homeless and troubled as a source of low-cost agricultural labor.
Sixty-nine patients with 91 separate abnormal findings were studied by both intra-arterial digital subtraction arteriography (ADSA) and conventional film screen subtraction arteriography (CFSA) in the same projection, with the same magnification. Digital subtraction arteriography has distinct advantages over CFSA in the form of reduced contrast utilization, better patient tolerance of arteriography because of reduced contrast concentration, superior contrast resolution, and rapid, on-line visualization of the abnormalities. Digital subtraction arteriography is limited by its availability in only a single plane, by decreased spatial resolution which affected the image quality for intracranial blood vessels at an image intensifier (I.I.) field of 12 inches, and by relatively limited field of view both intracranially and extracranially for I.I. fields of 6 and 9 inches.