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Biomedical subjects

R Parrish

Publications and source records attributed to R Parrish.

At least 19 recordsLinked to original sources
PubMed2000

Fracture of the occipital condyle: the forgotten part of the neck.

A case of occipital condylar fracture in a multiply injured and unconscious motorcyclist is reported. This injury was clinically unsuspected but found on the lowest cuts of head computed tomography. It is shown that this site is often inadequately imaged when scanning the head and neck in victims of trauma. The Anderson and Montesano classification of occipital condylar fracture is described. It is noted that types 1 and 2 are stable injuries but type 3 is potentially unstable. A retrospective analysis of 30 head computed tomography scans in trauma cases revealed that in only 16 were the occipital condyles adequately imaged. It is emphasised that vigilance is required to detect fractures of the occipital condyle and that it should be standard practice to include this area when performing computed tomography of the head in trauma victims.

Adolescent↗
PubMed1996

Identification and treatment of children's mental health problems by primary care providers: a critical review of research.

This article critically reviews research studies on the identification and treatment of children's mental health problems by primary care providers. Using a valid and reliable instrument to guide the review, the investigators examined the methods and findings of all 13 studies published on the topic from 1979 to 1994. Overall, primary care providers appeared to underidentify mental health problems among children and adolescents, especially those whose emotional impairments were not overtly severe. Large proportions of youngsters identified as having mental health problems did not receive needed treatment.

Adolescent↗
PubMed1996

Partially mismatched related donor transplants as salvage therapy for patients with refractory leukemia who relapse post-BMT.

Patients who relapse post-ABMT are usually resistant to conventional therapy, and a potentially curative therapy with allogeneic BMT is limited due to availability of a matched donor. To assess whether such patients can be salvaged using partially mismatched related donors (PMRD), eight patients age 6-50 years old underwent PMRD-BMT. All patients ALL (n = 3) and AML (n = 5) were in relapse 7-31 months after first BMT. Donors (1-3 Ag mismatch) were selected from family members. Conditioning included TBI, etoposide, Ara-C and cytoxan (n = 3), or busulfan, thiotepa, and etoposide (n = 5). GVHD prophylaxis consisted of partial T cell depletion followed by systemic immunosuppression. All evaluable patients established sustained engraftment by day 18. Severe regimen-related toxicity was evident in the gastrointestinal and hepatic systems (6/8 and 4/8, respectively), the latter associated with poor outcome (P < 0.014). Acute but not chronic GVHD, grade > or = II occurred in 3/7 patients. Four of eight patients are disease-free, maintaining longer remission than following their first BMT (14 vs 9 months). In conclusion, our data shows that PMRD-BMT is a feasible option for patients who relapse post-BMT and use of such alloreactive grafts may be appropriate earlier in the disease course of high risk patients.

Adolescent↗
PubMed1984

Estrogen and progesterone receptors in head and neck cancer.

The existence of hormone receptors on or within neoplastic tissue has potential diagnostic, therapeutic, and prognostic importance. It was the purpose of this study to measure estrogen and progesterone receptors in a large group of patients with head and neck cancer to determine their frequency. Sixty-five patients with head and neck tumors underwent a total of 75 estrogen and 50 progesterone receptor assays. In this group, 87.7% were squamous cell carcinoma. In the estrogen receptor assays, 89.3% (67/75) were negative, 8% (6/75) were borderline, and only 2.7% (2/75) were positive. In the progesterone receptor assays, 78% (39/50) were negative, 22% (11/50) were borderline, and there were no positive results. There were no changes in assays of tissue removed at biopsy v tissue removed during surgery. There was no impact with chemotherapy. In conclusion, head and neck cancers do not appear to possess estrogen or progesterone receptors and can be considered to be hormonally independent.

Adenocarcinoma↗
PubMed1984

Intraoperative imaging with a therapeutic computed tomographic scanner.

A therapeutic computed tomographic (CT) scanner uniquely dedicated to surgical usage allowed intraoperative CT imaging during precise resections of glial brain tumors in three patients. Intraoperative CT scanning provided accurate tumor localization, superior contrast and spatial resolution of the lesion, and cross sectional anatomy of the entire brain. Further development of intraoperative CT guidance will allow safer or even complete removal of some previously unresectable brain tumors.

Adult↗
PubMed1983

Eyes with end-stage neovascular glaucoma. Natural history following successful modified filtering operation.

A modified filtering operation for neovascular glaucoma provided control of intraocular pressure after 12 to 23 months in ten of 13 eyes. After long-term follow-up, 23 to 54 months, seven of ten eyes still had controlled IOP. Two eyes were receiving no medication, two required miotics, and three required maximal medical therapy, including carbonic anhydrase inhibitors. One eye had undergone cyclocryotherapy four years after trabeculectomy. Four of seven eyes with diabetic neovascular glaucoma retained ambulatory vision. The eye with neovascular glaucoma from central retinal vein occlusion lost useful vision. The underlying disease process is an important determinant of surviving visual function.

Adult↗
PubMed1982

Iridectomy in the surgical management of eight-ball hyphema.

The complete absorption of blood in patients with eight-ball hyphema and medically uncontrollable intraocular pressure occurred after iridectomy. No intra-operative complications were noted. Six of the seven patients maintained normal IOPs without medical therapy for at least six months postoperatively. Pupillary block by the clotted blood and the tamponade effect exerted by the total hyphema on the outflow pathway are possible mechanisms of the secondary glaucoma.

Adolescent↗
PubMed1982

Outer retina ischemic infarction--a newly recognized complication of cataract extraction and closed vitrectomy. Part 2. An animal model.

Intraocular pressure was artificially elevated above systolic blood pressure in 40 owl monkey eyes. Diffuse retinal whitening of the posterior pole and subsequent retinal pigment epithelial disruption were produced in nine of ten eyes with high pressure for 90 minutes or longer, but also in a few eyes with high pressure for a shorter duration. Fluorescein angiography and histologic examination demonstrated damage of the photoreceptors and retinal pigment epithelium with sparing of the inner retinal layers. This animal model duplicates the acute visual loss due to outer retinal infarction that sometimes occurs after closed vitrectomy or after continuous external ocular compression in preparation for surgery.

Animals↗
PubMed1982

Outer retinal ischemic infarction--a newly recognized complication of cataract extraction and closed vitrectomy. Part 1. A case report.

This report describes a peculiar syndrome occurring as a complication of cataract extraction. The syndrome is characterized initially by (1) acute loss of central and paracentral vision discovered usually on the first postoperative day; (2) diffuse and patchy whitening of the outer retinal layers in the posterior fundus; (3) normal angiographic retinal and choroidal appearance and circulation time; (4) a peculiar polygonal pattern of fluorescein staining of the pigment epithelium and outer retina in the area of retinal whitening, and followed later by (5) clearing of the retinal whitening and mottled changes in the pigment epithelium; (6) partial recovery of the central visual field; and (7) preservation of normal optic disc and retinal vessel caliber. Prolonged elevation of the intraocular pressure sufficient to obstruct choroidal blood flow occurring during the use of intraocular volume-reducing devices before surgery, during phakoemulsification or closed vitrectomy is postulated as the major cause of this complication.

Adolescent↗
PubMed1982

Ocular involvement in lupus erythematosus profundus (panniculitis).

Lupus erythematosus profundus (panniculitis) is a rare clinical variant of lupus erythematosus. It has not been implicated previously as a cause of lid edema or proptosis. In this report, three patients who had eyelid edema as the initial manifestation of lupus erythematosus profundus are presented. The ocular manifestations improved with antimalarial therapy.

Adult↗
PubMed1979

Reaction of the purple membrane with a carbodiimide.

Purple membrane was reacted with 1-ethyl-3-(3-dimethylaminopropyl)carbodiimide at pH 4.5 and 8.0. At pH 4.5, the reaction yields cross-linked bacteriorhodopsin. The cross-linking is inhibited by pretreatment of the membrane with papain, or by the presence of carbohydrazide or glycine ethyl ester in the reaction mixture. The product of the pH 8.0 reaction is not cross-linked, but it displays altered properties. Two measures of photochemical activity (light-induced change in proton binding (delta h) and decay of photointermediate M) show changes indicative of slowed proton uptake. The delta h is increased by ethyl dimethylaminopropylcarbodiimide. This increase is unaffected by pretreatment of the membrane with papain, and it is not reversed by NH2OH. However, the reaction is inhibited by millimolar concentrations of CaCl2. The altered delta h is not apparent in detergent-solubilized membranes. Ethyl dimethylaminopropylcarbodiimide does not appear to cause a large alteration in the membrane surface charge, as measured by Ca2+ binding. We conclude that (1) at acid pH, ethyl dimethylaminopropylcarbodiimide can be used for cross-linking or for attachment of specific probes to the C-terminal region of bacteriorhodopsin, and hence to the cytoplasmic side of the purple membrane, and (2) at alkaline pH, ethyl dimethylaminopropylcarbodiimide reacts at a diffent type of site and appears to inhibit the proton pump.

Bacteriorhodopsins↗