Medicine and Health Sciences Commons^™

The Emerging Clinical Usefulness Of Complement Measurements, Shaun Ruddy

MCV/Q, Medical College of Virginia Quarterly

Not many years ago the main purpose of “complement” seemed to be to drill holes in sheep erythrocytes. In the classic experiment which was part of every medical student’s microbiology laboratory experience, a magic stuff called complement, somewhat mysteriously obtained from guinea pigs, was either “fixed” or not “fixed” and the sheep cells either not lysed or lysed accordingly. That was about all there was to know about complement, and all one needed to know. Today the term "complement" embodies a group of plasma proteins which react in a complex sequence to mediate a variety of inflammatory effects, including changes …

Immunology And Disease Of Connective Tissue, Robert Irby

MCV/Q, Medical College of Virginia Quarterly

Since immune responses play a major role in the development of connective tissue diseases, it is not surprising that a number of laboratory studies reflect these responses. Prior to the 1940s when rheumatoid and LE factors became widely known, one relied mainly on erythrocyte sedimentation rate and serum electrophoresis to identify protein abnormality. Elevated sedimentation rate depends on rouleaux formation, and rouleaux formation is dependent upon large asymmetric molecules of fibrinogen and gamma globulin in plasma. The demonstration of gamma globulin has become the cornerstone of the immunologist’s edifice. It is amazing to see how the subspecialty of immunology has …

Contents

MCV/Q, Medical College of Virginia Quarterly

Table of contents for MCV/Q, Medical College of Virginia Quarterly, 1977, Volume Thirteen, Number Three.

Introduction, John R. Taylor

MCV/Q, Medical College of Virginia Quarterly

This issue of the MCV Quarterly is devoted to a review of some of the problems in clinical neurology that present soon after onset and often require urgent evaluation and care. Problems such as seizures and headache are regular features of many types of practice. Others such as acute ophthalmoplegias are infrequently seen outside the field of neurology. Still others, for instance, head injury, are commonly seen but often require the attention of physicians with specialized training, such as Dr. Miller of the MCV Division of Neurosurgery. While every acute neurologic problem cannot be reviewed in a single issue, the …

Acute Bilateral Ophthalmoplegias, John B. Selhorst

MCV/Q, Medical College of Virginia Quarterly

Bilateral ophthalmoplegia is that condition of weakness or paralysis involving one or more ocular muscles in each eye. Its sudden appearance due to an acute ocular myopathy is indeed unusual. Swash reported a single patient with acute necrotizing orbital myositis and carcinomatosis neuromyopathy. The more common bilateral ocular muscle diseases, such as dysthyroid exophthalmopathy, orbital myositis, and progressive external ophthalmoplegia, develop insidiously and are restricted to the orbit.

Indications For Antenatal Genetic Diagnosis, Fay Redwine, Robert E. Petres

MCV/Q, Medical College of Virginia Quarterly

The future of antenatal genetic diagnosis is an exciting one. Recent advances include the application of chromosal banding techniques to identify subtle abnormalities and rearrangements; ultrasonography, using high resolution gray scale equipment to permit delineation of fetal soft tissue and skeletal anomalies; and fetoscopy, using a small fiberoptic instrument to view the fetus directly and observe its development. With these advances in technology, it should be possible to enable even more women at high risk for genetically diseased offspring to bear healthy children.

Recent Advances In Cytogenetic Technology For Antenatal Genetic Testing, Judith A. Brown, Anna Carr, Elizabeth S. Cooper, Deborah W. Heritage

MCV/Q, Medical College of Virginia Quarterly

The examination of human chromosomes has been a part of the physician’s laboratory armamentarium since the correct diploid number of human chromosomes was established and a method was developed for the in vitro growth of peripheral blood leukocytes to yield metaphase chromosomes. The discovery that on ultraviolet microscopy (UV), metaphase chromosomes stained with fluorochrome dyes displayed a characteristic pattern of bright and dull bands unique for a given pair of homologous chromosomes, was a major technological breakthrough in human cytogenetics; for the first time, every chromosome in the karyotype could be unequivocally identified. Although the short storage life of fluorochrome-stained …

The Genetic Counseling Program At Mcv, Phyllis Winter, Peter Mamunes, Walter E. Nance

MCV/Q, Medical College of Virginia Quarterly

The Genetic Counseling Clinic at the Medical College of Virginia, established by Drs. Peter Mamunes and R.B. Young in 1973, has been supported since its inception by a clinical service grant from the National Foundation – March of Dimes; it is one of 83 genetic counseling programs in the United States and one of three in Virginia that receive support from the Foundation. The Clinic provides counseling and diagnostic services for a variety of genetic disease and is the focus of clinical teaching and research activities of the Department of Human Genetics. The Clinic is staffed by member of the …

The Virginia Sickle Cell Anemia Awareness Program: Education, Screening, And Counseling, Florence N. Cooper, Robert B. Scott

MCV/Q, Medical College of Virginia Quarterly

In 1968, a program of screening for sickle trait carriers was begun as part of the work of the Hematology Division, Department of Medicine, at the Medical College of Virginia. It was felt that sickle cell anemia was more of a public health problem than was generally recognized, and in addition to instituting screening and education programs, data were collected to document the relative neglect of the problem.

The Genetic And Somatic Effects Of Radiation: A Balance Between Benefits And Risks, Timothy Merz

MCV/Q, Medical College of Virginia Quarterly

The present clinical interest in mutagenic agents in general and radiation in particular can be seen in the current proliferation of popular articles and reports on the effect of mutagens and radiation on biological systems. In spite of the continuing controversy over the effects of radiation from environmental sources, the most significant problem today is the increasing x-ray exposure of individuals due to the increasing radiological diagnostic capability and the expanding importance of radiographic procedures in medical diagnosis.

Syndrome Identification [Case Reports], Peter Mamunes

MCV/Q, Medical College of Virginia Quarterly

What’s in a name? This question is often asked of a genetic counselor when a syndrome is newly delineated. The brief case reports that follow demonstrate the importance of establishing precise diagnoses. They also emphasize that many of these syndromes are recognizable only after careful physical examination of the proband and family members, consultation with other subspecialties (for example, neurology, radiology, orthopedics, dentistry, pathology), and a review of the medical literature.

A Report Of Familiar Ring (9) Chromosome [Case Study], Robin J. Caldwell, Judith A. Brown, Reuben B. Young

MCV/Q, Medical College of Virginia Quarterly

Ring chromosomes originate in the simultaneous occurrence of two breaks at opposite ends of the chromosome and the subsequent reuniting of the free ends to form a ring. They may be compatible with normal life, as only a fractional loss of genetic material has occurred, or they may lead to spontaneous abortion or to an offspring with severe physical and mental handicap attributable to significant genetic alterations.

A Case Of Saethre-Chotzen Syndrome, Catherine Mckeon-Kern, Peter Mamunes

MCV/Q, Medical College of Virginia Quarterly

Saethre-Chotzen syndrome was described independently by the Norwegian psychiatrist, Saethre, and the German psychiatrist, Chotzen, in the 1930s; since that time many cases have been reported, some using the terms acrocephalosyndactyly, type III, and craniooculodental syndrome. Clinically, the syndrome is characterized by premature closure of the cranial sutures, low-set hairline, nasal septum deviation, brachydactyly, and ptosis. It is inherited as an autosomal dominant with complete penetrance and great variability in expression. Because of this variable in expressivity, the syndrome is difficult to diagnose in the less severe form without a positive family history.

The Bulletin, School Of Nursing Alumnae Association, 1977, Margaret Summers, Francis J. Sweeney, Doris E. Bowman, Terrie Metzger, Carmen Russo, Carol M. Hutelmyer, Charlotte E. Voss, Elizabeth J. Sweeney, Joy Roff Mara, Harriet K. O'Connor, Janet Hindson, Jeanette Plasterer, Dolores Heckenberger, Betty Piersol, Julia T. Mccracken, Martha E. Riland, Elizabeth S. Miller, Ruth Thorp Craven, Beverly Rupp, Peter A. Herbut

Nursing Alumni Bulletins

A Letter from the President

Progress - The New Jefferson Hospital/Clinical Teaching Facility 1977

School of Nursing

A Comprehensive Approach to Hand Rehabilitation

Parking Garage

Your Sesquicentennial Campaign

Social Report

Scholarship Report

Sick and Welfare Committee

Program Committee

Resource Committee of the Board of Trustees

Bulletin

Administration

Ways and Means Committee Report

Resume of Minutes of Alumnae Association Meetings

Duke University Distinguished Alumna Award to Col. Catherine T. Betz (Ret.)

Patient Representatives

The Joys and Sorrows of a Director of Geriatric Nursing

Highlights 1976 P.N.A Convention

Class News

Marriages

Births

In Memoriam

A Letter from the Former President

Help Us …

Professional Writing And Lectures: "Brief History Of The Osteopathic Hospital Of Maine," 1977, Undated, Lowell M. Hardy Do

Personal and Professional Papers

No abstract provided.

The Polymorphonuclear Neutrophilic Phagocyte, Gerald L. Mandell

MCV/Q, Medical College of Virginia Quarterly

Patients who have too few functioning mature polymorphonuclear neutrophils frequently develop fatal bacterial or fungal infections despite our best efforts to prevent and treat those infections. Recently new facets of white cell function which enable us to better understand both normal and abnormal states have been found. Several review articles about polymorphonucler neutrophils (also called neutrophils and granulocytes – the latter term includes eosinophils and basophils) have been published recently and the reader is referred to these for more comprehensive coverage of the field.

The Relevance Of Genetics To Medicine [Introduction], Walter E. Nance

MCV/Q, Medical College of Virginia Quarterly

This issue of the MCV Quarterly focuses on the explosion of knowledge in the field of human genetics. The activities of the new Department of Human Genetics at the Medical College of Virginia encompass the traditional medical school triad of teaching, patient care, and research, and an active graduate program has been developed with curricula leading to masters and doctorate degrees. The program is supported by a recently awarded National Institutes of Health predoctoral training grant as well as State and local funds from the A.D. Williams Foundation.

Population Screening For Genetic Disease, Peter Mamunes

MCV/Q, Medical College of Virginia Quarterly

Recent advances in genetics and laboratory techniques have raised difficult issues for both the medical and lay communities. The desirability of initiating population screening programs is an example of one such issue that has engendered considerable confusion concerning is intent – so much so that the National Academy of Sciences recently reviewed this subject and in 1975 published a book entitled, Genetic Screening – Programs, Principles and Research. This presentation will describe the four major forms of population screening for genetic disease and, from the Virginia experience with some of them, demonstrate their strengths and shortcomings.

Influence Of Duration Of Homograft On Humoral Responses In Man, Marion Waller, James C. Pierce, Gerardo Mendez-Picon, Hyung M. Lee

MCV/Q, Medical College of Virginia Quarterly

Elevated titers of natural antibodies have been demonstrated in the sera of patients following transplantation. These humoral responses were thought to be associated with rejection. This concept was challenged by investigators whose studies associated these responses with infection or with injection of heterologous serum. Nevertheless, the possible prognostic significance of these relatively simple tests has continued to evoke interest. This study was undertaken to compare the humoral responses in three different groups of patients with organ transplants in order to evaluate the influence of duration of the homograft and the attendant immunosuppression.

Brain Death, Cary Suter

MCV/Q, Medical College of Virginia Quarterly

Until recently determination of death was simple. The heart stopped. There was no pulse, no recordable blood pressure, and no heart sounds. There was no breathing. Now, methods of cardiopulmonary resuscitation are common knowledge, both to the layman and to the physician. Hospitals have special “Code Blue” teams; emergency rooms and intensive care units are superbly equipped for life support; hearts that stop are started again. Machines do an excellent job of respiration. Nevertheless, the patient’s brain may be dead and damaged beyond recovery, either in whole or in part. When the whole brain is seriously damaged, including the cerebral …

Immunology And Disease Of The Kidney, William F. Falls Jr.

MCV/Q, Medical College of Virginia Quarterly

The emphasis of this paper is the review of several aspects of renal disease which have immunologic overtones and clinical relevance. The pathogenesis of several subtypes of glomerulonephritis will be discussed, the immunologic implications of amyloidosis will be noted, and the relation between immune mechanisms and tubulointerstitial disease will be mentioned. The discussion will then be completed by an analysis of the prognosis of the aforementioned renal disease, and by an attempt to place contemporary therapeutic modalities in a proper perspective.

Genetics And Cancer, John M. Mueller, Robert B. Diasio

MCV/Q, Medical College of Virginia Quarterly

The existence of a relationship between cancer and heredity has been recognized for years, but only recently has emerging knowledge in this area enabled physicians to detect and treat cancer earlier in affected individuals and to prevent its occurrence in others.

The Search For Optimal Management Of Head Injury, J. Douglas Miller

MCV/Q, Medical College of Virginia Quarterly

Head injuries of sufficient severity to bring the patient to a hospital occur in more than one per hundred of the population every year. The toll in death and disability is staggering: the majority of patients are young wage-earners with families so that the total socio-economic burden can hardly be guessed at. Much emphasis is laid on the concept that physical disruption of neurons in the brain is not a reversible process and that regeneration within the nervous system to the point of functional recovery does not occur; however, this rather dismal view of head injury is at variance with …

New Approaches To The Use Of Twins In Biomedical Research, Walter E. Nance

MCV/Q, Medical College of Virginia Quarterly

Human geneticists are often accused of being preoccupied with exotic syndromes that are of marginal relevance to the general population. Brilliant success has been achieved during the past two decades in defining the nature and function of the genetic material, the molecular pathology of a large number of metabolic diseases, the phenotype of more than 2,000 Mendelian traits, and more recently the chromosomal location of a rapidly expanding number of human gene pairs. In contrast, relatively little progress has been made in the genetic analysis of quantitative traits such as blood pressure, serum cholesterol, intelligence quotient, skin color, height, birth …

Dominantly Inherited Amyotrophic Lateral Sclerosis (Motor Neuron Disease), Louise E. Wilkins, Robin M. Winter, Edwin C. Myer, Walter E. Nance

MCV/Q, Medical College of Virginia Quarterly

The term amyotrophic lateral sclerosis was first introduced by Charcot to describe cases with mixed upper and lower motor neuron signs without sensory impairment. Later the syndromes of progressive bulbar palsy (PBP) and progressive muscular atrophy (PMA) were recognized to be variations of the same pathological process, and ALS was used as an inclusive term to refer to these syndromes as well. Although some authors reserve the term ALS for the specific syndrome of mixed upper and lower motor neuron lesions and use the term “motor neuron disease” to refer to the constellation of syndromes, most of the literature on …

A New Familial Chondrodystrophy Simulating Parastremmatic Dwarfism, Wendy L. Golden, Peter Mamunes, Michael B. Kodroff

MCV/Q, Medical College of Virginia Quarterly

Recent developments in tissue culture and enzyme analysis have made it possible to classify more precisely some of the skeletal dysplasias and to understand their pathophysiology; thus almost all seven clinical types of mucopolysaccharidoses are due to separate single enzyme deficiencies – one type, the Sanfilippo syndrome, has three subtypes, each with a different enzyme deficiency. The majority of the skeletal dysplasias have no definable biochemical abnormality and are classified on the basis of clinical and radiological findings and the mode of inheritance. The purpose of this report is to present a family with an apparently new type of chondrodystrophy.

Mcv/Q, Medical College Of Virginia Quarterly, Vol. 13 No. 4

MCV/Q, Medical College of Virginia Quarterly

No abstract provided.

Mcv/Q, Medical College Of Virginia Quarterly, Vol. 13 No. 2

MCV/Q, Medical College of Virginia Quarterly

No abstract provided.

Somatostatin: Diverse Physiological Roles And Therapeutic Implications, Gordon C. Weir, S. Bonner Weir

MCV/Q, Medical College of Virginia Quarterly

In its brief lifetime as a known peptide, somatostatin has provided a truly remarkable story filled with surprising developments from unexpected quarters. The foundation was set in 1969, when Krulich and McCann reported that fractions of a crude hypothalamic extract inhibited the secretion of growth hormone. In 1973, Guillemin's laboratory reported the sequence and synthesis of a fourteen amino acid peptide with the same inhibitory effect. It occurs in both a cyclic and linear form, each displaying equal biological activity. Somatostatin was assigned as its name, but it is also commonly referred to as growth hormone release inhibitory factor (GHRIF) …

Differential Diagnosis Of Progressive Generalized Or Symmetrical Flaccid Paralysis, Edward R. Isaacs

MCV/Q, Medical College of Virginia Quarterly

Progressive flaccid paralysis occurring over a period of hours or days is usually associated with the Landry-Guillain-Barré-Strohl syndrome. This symptom complex is often accompanied by a history of previous flu-like illness, antecedent myalgias, and subjective sensory complaints of tingling or simply a “tight” sensation in hands and feet. The paralysis that ensues either ascends from the feet and legs or descends from the facial muscles to involve all or most of the voluntary skeletal musculature. Along with paralysis of the intercostal and diaphragmatic musculature, severe cases may also involve other cranial nerves as well as the autonomic nervous system. In …