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Biomedical subjects

A Gunn

Publications and source records attributed to A Gunn.

At least 55 records · Page 3Linked to original sources

Evidence for surface-coat localisation of a monoclonal antibody-isolated merozoite antigen of Babesia divergens.

The localisation of monoclonal antibody-derived merozoite antigens of Babesia divergens was examined using immunogold electron microscopy and immunoprecipitation of the monoclonal antibody with both biosynthetically and surface-labelled parasites. Immunogold labelling provided evidence that the antigens are components of the surface coat of the merozoite. Immunoprecipitation with biosynthetically labelled parasites showed the antigens to be of parasite origin, whereas surface labelling confirmed that the antigens form part of the surface coat.

Animals↗

Long-term weight changes in treated hyperthyroid and hypothyroid patients.

To compare the effect of three treatments for thyrotoxicosis on subsequent body weight, a retrospective survey of 65 patients was performed. The effect of thyroxine replacement on body weight in 25 patients with primary hypothyroidism was also examined. In one year after starting therapy 21 patients treated with carbimazole gained a mean of 5.4kg (95% confidence interval 3.6 to 7.2kg); 20 patients after thyroidectomy gained a mean of 6.3kg (95% c.i. 3.4 to 9.2kg); and 24 patients given radioiodine gained a mean of 7.4kg (95% c.i. 5.2 to 9.6kg), p less than 0.001 in all three groups. The weight gain in the three groups was not significantly different. 54-67% of the weight gain occurred in the first three months. The patients treated for hypothyroidism had lost an insignificant amount of weight 12 months after starting therapy--mean change was -0.6kg (95% c.i. -2.2 to +1.1kg) p greater than 0.1. This data suggests that all patients treated for thyrotoxicosis will gain body weight irrespective of the treatment used, but patients treated for primary hypothyroidism will not lose an appreciable amount of weight. Therefore dietary advice should be given, where appropriate, at the onset of any treatment of thyroid dysfunction.

Adolescent↗

Congenital hypertrophy of retinal pigment epithelium: a sign of familial adenomatous polyposis.

Families of people known to have familial adenomatous polyposis are screened for signs of the disease by yearly examination of the bowel. Multiple areas of congenital hypertrophy of the retinal pigment epithelium have been described in patients with familial adenomatous polyposis. To assess the reliability of this marker 40 patients with familial adenomatous polyposis, representing all 25 pedigrees with living affected members in the Northern region's polyposis registry, were examined for hypertrophy of the retinal pigment epithelium. All had multiple lesions, ranging in number from two to over 40. None of the 35 controls had more than two lesions. Ocular examination is valuable for detecting carriers of the gene for familial adenomatous polyposis before their symptoms develop.

Adenomatous Polyposis Coli↗

Parathyroid hyperplasia associated with thymoma.

The case of a 65 year old female with myasthenia gravis and hypercalcaemia is presented. Failure of medical control of the myasthenia necessitated thymectomy at which time parathyroid exploration was also carried out. This revealed parathyroid hyperplasia and a thymoma. This association has not been previously documented in the literature.

Aged↗

Parotid tumours: a review of parotid tumour surgery in the Northern Regional Health Authority of the United Kingdom 1978-1982.

A review of inpatients treated for parotid tumours during the 5-year period 1978 to 1982 in the Northern Regional Health Authority of the United Kingdom revealed 376 new parotid tumours and 28 recurrent tumours. The incidence of new parotid tumours was 2.4 per 100,000 and of pleomorphic adenomas 1.5 per 100,000 per annum. Local excision was the most common operation and was employed to remove 156 (67.2 per cent) of the 232 pleomorphic adenomas but there was evidence of incomplete excision in 60 (38.5 per cent) of these tumours. Incomplete excision also occurred in 12 (15.8 per cent) of the 76 pleomorphic adenomas removed by conservative parotidectomy. Global temporary facial nerve palsy was more common after conservative parotidectomy for benign tumours (21.8 per cent) than after local excision (3.7 per cent) but global permanent nerve palsy only occurred after local excision (0.9 per cent). The widespread use of local excision resulted in its use in 12 (27.3 per cent) of the 44 malignant tumours. The low incidence of parotid tumours and their treatment by a relatively large number of surgeons resulted in limited experience for surgeons and few opportunities for training in parotid surgery.

Adenoma↗

Fluoroscopic peroperative cholangiography: technique and associated radiation hazards.

The techniques specific to peroperative fluorocholangiography are discussed based on an experience of 632 cholangiograms and an estimation has been made of the associated radiation doses to staff and patients. Rapid and accurate information can be obtained during fluorocholangiography using appropriate techniques with acceptably low radiation hazards.

Bile Duct Diseases↗

Neonatal death: grieving families.

This paper examines the stress on a family after a neonatal death. Sixty-seven families who experienced 63 neonatal deaths and four post-neonatal deaths were studied during an interview held eight weeks after the death. Predominant support for the parents was provided by each other (63%), their parents (33%), friends, many of whom had experienced a similar loss (16%), neighbours (15%) and religion (13%). Grief reactions were more commonly reported by mothers than by fathers and included: sleep disturbances (51%); depression or fits of crying (34%); anorexia or weight loss (33%); nervousness and anxiety (19%); social withdrawal (18%); morbid preoccupation (9%); and guilt, anger or hostility (9%). Grief reactions were graded on a scale of I (physically, psychologically and emotionally settled) to IV (serious symptoms that disturbed day-to-day functioning). Pathological grief reactions occurred in 21 families and correlated with a lack of parental support and contact with their critically ill infant and a severe initial grief state (P less than 0.05). There was no correlation with the type of initial grief reaction; the attachment to the baby; the age of the baby; the comprehension of the cause of death; the hospital care or the way that they were informed of the death. The loss of a newborn infant had a major pathological effect on 31% of the families that were studied. This was probably an underestimate as eight weeks is too soon to assess unresolved grief.

Death↗

The clinical and metabolic responses to early surgical treatment for hyperthyroid Graves' disease: a comparison of three pre-operative treatment regimens.

We have compared the clinical and metabolic responses of three groups of patients undergoing subtotal thyroidectomy for hyperthyroid Graves' disease. These patients were prepared for surgery with propranolol alone, propranolol plus potassium iodide or the long acting beta-adrenoceptor antagonist nadolol plus potassium iodide. Pre-treatment with potassium iodide reduced serum T4 to normal or subnormal in all patients. Patients in the propranolol group had significantly higher pulse rates and temperatures after operation and one patient developed an exacerbation of the hypermetabolic state. The perioperative rise in serum cortisol and blood glucose was delayed in patients in the propranolol group and this was also noted in one severely hyperthyroid patient on propranolol + potassium iodide. Nadolol was administered once daily as compared to multiple daily doses with propranolol. Despite this, plasma nadolol levels were consistently higher throughout the perioperative period while propranolol levels in patients on both propranolol alone and propranolol + potassium iodide were highly variable and sometimes undetectable. We conclude that, in the rapid preparation of patients with hyperthyroid Graves' disease for surgery, the combination of nadolol + potassium iodide has significant advantages over the other two regimens.

Adult↗

Cycle accidents.

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Accidents↗

Lindau's disease and familial hyperparathyroidism.

A case of medullary hemangioblastoma is described occurring in association with familial hyperparathyroidism. The possibility that this combination may represent a previously unreported variant of Lindau's disease is discussed.

Brain Neoplasms↗