Charles N. Luttrell

Bio: Charles N. Luttrell is an academic researcher from Johns Hopkins University School of Medicine. The author has contributed to research in topics: Hypernatremia & Osmotic concentration. The author has an hindex of 6, co-authored 6 publications receiving 388 citations.

Mass accidental salt poisoning in infancy. A study of a hospital disaster.

Abstract: In the first known incidence of a mass salt poisoning of infants, the case fatality rate was 6 of 14 exposed. Five died before the situation was recognized. All five whose brains were examined at autopsy showed hemorrhagic encephalopathy consistent with previous reports of salt poisoning in humans and animals. Eleven of 14 of these infants manifested neurological symptoms. Peritoneal dialysis was attempted in four patients, three of whom survived despite severe illness in two of them. The technique proved feasible under ordinary hospital conditions and may be instrumental in the recovery of patients. Some suggestions for improvement have come from the experience.

Hemorrhagic Encephalopathy Induced by Hypernatremia: II. Experimental Observations on Hyperosmolarity in Cats

Abstract: Hypernatremia as a cause of acute neurological disorder is being recognized with increasing frequency.1-11Common clinical and metabolic features in infants with fatal outcome were described in the previous paper.12At autopsy, extensive venous occlusion and subarachnoid, subdural, and intracerebral bleeding were prominent findings. Mechanisms for production of these vascular changes and their relative importance in the clinical picture were not clear. It was not known, for example, to what degree hemorrhagic encephalopathy was an integral manifestation of the underlying metabolic disturbance, or whether these vascular lesions merely represented nonspecific, secondary results of transiently disturbed intracranial-pressure relationships. Hyperosmolarity, of order of magnitude similar to that encountered in patients (375-400 mOsm/L.), produces comparable clinical alterations in experimental animals.13,14Within 30 minutes after intraperitoneal injection of hypertonic solutions, cats develop marked tremor, ataxia, muscle twitching, stupor, and occasional convulsions. One cat in three dies within a few hours. In

Hemorrhagic Encephalopathy Induced by Hypernatremia: I. Clinical, Laboratory, and Pathological Observations

Abstract: Hyperosmolarity is characterized by an increase in the solute concentration of body fluids brought about by loss of water, inadequate water intake, or administration of large amounts of hypertonic solutions. When the osmolar concentration of the extracellular fluid is increased, transfer of water from cells to extracellular fluid exceeds that in the opposite direction. Net water movement is thus out of the cells, with resultant dilution of extracellular fluid and concentration of the fluid within cells themselves. If the solute which increases the extracellular fluid osmolarity is one which is in the main excluded from intracellular fluid, such as sodium and chloride ions, this disturbance in water distribution cannot be mitigated by movement of solute into cells. Hence, the ultimate effect of hypernatremia is dehydration of cells. This physicochemical disorder is most frequently encountered in infants and children with severe diarrhea and vomiting, but it also occurs in adults. Schmidt,

Factors in the pathogenesis of virus diseases.

Abstract: Publisher Summary This chapter discusses the pathogenesis of virus infection on the basis of the organs affected. This basis becomes somewhat modified in consideration of some viral groups or genera, such as myxoviruses and poxviruses. Because susceptibility to infection depends both upon environmental factors and upon the physiologic status of the host, these must be regarded as important facets of virus disease. The two components of any study of virus pathogenesis are the virus and the host. In the host, virulence is manifest as the degree of the effect of virus on susceptible cells. Organ pathogenicity develops when a threshold number of cells are damaged. Virulence, thus, has an ecological character and can be defined as the capacity of a given virus strain to destroy certain cell types. In natural disease, the portals of virus entry into and exit from a host may have no correlation. Variola virus, for example, may enter via the lungs and exit through the skin while foot-and-mouth disease seems to enter via the respiratory tract and exit from lesions it has produced in the mouth.

Newcastle Disease Encephalomyelitis in Cats: II. Physiological Studies on Rhythmic Myoclonus

Abstract: The term myoclonus is used clinically to describe a wide variety of suddenly appearing involuntary movements or jerks not otherwise readily classified. 1-18 These myoclonic movements may be generalized, segmental, or even limited to one muscle or muscle group. They vary in force and complexity from mere muscular twitches to coordinated movements sufficiently violent to displace one or more limbs, or throw the subject to the ground. They may be isolated, intermittent, and of short duration, as in the myoclonus accompanying certain epileptic states. On the other hand, they may continue repetitively over prolonged periods of time. The movements, when widespread, frequently appear synchronously throughout many parts of the body, or present first in one region before bursting forth successively in others. In some instances the explosive outbursts seem to follow a definite rhythm; in others they are rather irregular in time. It seems evident, therefore, that clinical patterns implied

Development of food preferences

Abstract: Using a developmental systems perspective, this review focuses on how genetic predispositions interact with aspects of the eating environment to produce phenotypic food preferences. Predispositions include the unlearned, reflexive reactions to basic tastes: the preference for sweet and salty tastes, and the rejection of sour and bitter tastes. Other predispositions are ( a) the neophobic reaction to new foods and (b) the ability to learn food preferences based on associations with the contexts and consequences of eating various foods. Whether genetic predispositions are manifested in food preferences that foster healthy diets depends on the eating environment, including food availability and child-feeding practices of the adults. Unfortunately, in the United States today, the ready availability of energy-dense foods, high in sugar, fat, and salt, provides an eating environment that fosters food preferences inconsistent with dietary guidelines, which can promote excess weight gain and obesity.

Differential facial responses to four basic tastes in newborns.

Abstract: The distinctiveness and recognizability of taste-elicited facial expressions in newborns were examined in 2 studies. Sucrose, sodium chloride, citric acid, and quinine hydrochloride solutions were presented to 12 infants at 2 hours of age. In Study 1, the anatomically based Facial Action Coding System adapted for infants (Baby FACS) was used to obtain detailed, objective descriptions of the infants' videotaped facial responses to each solution. Facial responses to sucrose were characterized primarily by facial relaxation and sucking. The responses to salty, sour, and bitter solutions shared the same hedonically negative upper- and midface components but differed in the accompanying lower-face actions: lip pursing in response to sour and mouth gaping in response to bitter. There was no distinctive facial expression for sodium chloride. These findings demonstrate that newborns differentiate sour and bitter from each other and from salt, as well as discriminating sweet versus nonsweet tastes. In Study 2, untrained adults viewing videotapes of the infants' facial reactions made forced-choice judgments identifying the stimuli presented and rated the hedonic tone of the infants' responses. While the judges accurately identified the newborns' responses to sucrose, there were systematic errors in their judgments of the 3 nonsweet stimuli. The judges' hedonic ratings, on the other hand, clearly differentiated between the infants' responses to the bitter stimulus and the other 3 tastes. The findings are discussed in terms of the possible functional origins and communicative value of taste-elicited facial expressions in infants.

Osmotic opening of tight junctions in cerebral endothelium.

Abstract: Hyperosmotic solutions of 3 M urea, either infused into one internal carotid artery or applied topically to the pia mater of rabbits, results in the opening of endothelial tight junctions through which horseradish peroxidase passes from blood to extracellular fluid of the brain. The evidence for this opening of the blood-brain barrier to protein is the entry of peroxidase into the extracellular pools between successive tight junctions. In animals not receiving 3 M urea, the interjunctional pools are inaccessible to proteins. Having passed through the endothelial junctions, the peroxidase spreads along the extracellular channels of the perivascular neuropil for approximately 100 μ in 90 seconds. Most of the affected vessels are capillaries, though larger vessels are rendered leaky as well. Calyciform cisterns, that lie beneath shallow notches in the endothelium of untreated rabbits, appear to be enlarged after the administration of 3 m urea. It is undetermined whether these few endothelial cisterns and vesicles are involved in carrying protein from blood to the cerebral extracellular fluid.