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Biomedical subjects

A Palmer

Publications and source records attributed to A Palmer.

17 recordsLinked to original sources

Magnetic resonance angiography of renal transplants.

Stenosis of the artery of transplanted kidneys is an important cause of graft dysfunction. Diagnosis and follow-up of this condition normally requires intra-arterial digital-subtraction angiography (IADSA), which is invasive and may cause complications. A possible alternative to IADSA is magnetic resonance angiography (MRA), and we have assessed this technique in 50 renal transplant patients who were referred for investigation of possible renal arterial stenosis. In every patient, MRA was compared prospectively with conventional IADSA. Compared with IADSA, MRA had a sensitivity of 83% and a specificity of 97%, and when all images were graded retrospectively for severity of stenosis, the two techniques showed a significant correlation (r = 0.74, p less than 0.001). MRA can provide an accurate image of the renal transplant artery in a non-invasive manner with a high sensitivity and specificity.

Angiography, Digital Subtraction

Early teenage pregnancies in Hull.

OBJECTIVES: To determine the pattern, obstetric outcome and factors that predispose to pregnancies in young teenagers in Hull. DESIGN: Retrospective study of case records of pregnancies from 1977 to 1988 in girls aged 16 years or less and in a control group of nulliparous women aged 20-24 years. SETTING: Hull health district hospitals. SUBJECTS: 1,660 pregnant teenagers and 3,576 nulliparas aged 20-24 years. MAIN OUTCOME MEASURES: Ages at pregnancy, number of pregnancies per year, gestational age at booking and delivery, antenatal complications, mode of delivery, utilization of contraceptives and some social factors. RESULTS: Of the 1,660 pregnancies in the young adolescents, 59-6% were terminations. The youngest girl was 11. The average annual incidence of early teenage pregnancies was 10.5 per 1,000 girls aged 10-16 compared to 6.4 per 1,000 in England and Wales. Physical characteristics and pattern of antenatal care were similar in the study and control groups. Anaemia was 2.53 times as common in teenagers (95% CI 2.19-2.9; P < 0.0001) while hypertension alone was 1.7 times as frequent (95% CI 1.28-2.4; P = 0.002). Pre-eclampsia and proteinuric disorders were similar in the two groups. Apart from prolonged pregnancy, which was significantly less common in the index group, other gestational ages at delivery and birthweights were the same in both groups. The caesarean section rate in the index group was 0.56 times that in the control group (95% CI 0.4-0.75; P < 0.0001) but forceps deliveries were 2.37 times as common in the index group (95% CI 1.80-3.12; P < 0.0001). The uncorrected perinatal mortality rates were 13.6/1000 and 15.7/1000 in the index and control groups respectively. CONCLUSION: Early teenage pregnancies are common in Hull and, contrary to previous reports, are physically well tolerated by the early adolescents who book early and attend antenatal clinics regularly. Ineffective utilization and ignorance of contraceptive methods are contributory factors. We recommend that emphasis should be placed on providing contraceptive services for teenagers and adopting a more purposeful and holistic approach to sex education.

Abortion, Legal

The efferent cardiac lymphatic pathways in the macaque monkey.

In ten postmortem hearts of the Macaque monkey (M. mulatta), the coronary lymphatics were visualized using an India ink suspension in 2% gelatin. The left coronary lymphatic initially passed to the dorsal surface of the aortic arch. In five hearts, this lymphatic went directly to the cardiac lymph node, whereas in the others, it first ascended to the left superior tracheobronchial node and then interconnected with the cardiac lymph node. The right coronary lymphatic usually passed in front of the ascending aorta and common arterial (brachiocephalic) trunk and entered the cardiac lymph node. In two hearts, however, the right coronary lymphatic first ascended to an anterior transverse mediastinal node and from here lymphatics joined the cardiac lymph node. Those lymphatics that passed cephalad from the cardiac lymph node to the right anterior mediastinal nodes and the right paratracheal nodes ultimately emptied into the right venous angle. Those lymphatics that passed cephalad from the cardiac lymph node to the anterior transverse mediastinal nodes ultimately emptied into the left venous angle. In five other Macaque monkeys (M. mulatta and M. fascicularis) after marker injection (T1824 blue dye and micropulverized barium sulfate) into the living heart or pericardium, lymphatic drainage beyond the base of the heart could not be demonstrated. Whereas postmortem morphologic studies suggest that the monkey coronary lymphatic system is amenable to obstruction by removal of the cardiac lymph node and interruption of its adjacent lymphatic connections, effective methods for visualizing the mediastinal lymphatic collecting system in the living monkey must be developed before experimental cardiac lymphatic ablation can be accomplished in this species.

Animals

The principles of tomographic positioning with particular reference to skull tomography.

Because the principles of tomography relating to positioning have not been clearly understood it has generally been the practice to employ only basic positions when undertaking tomographic studies. The purpose of this paper is to outline tomographic positioning principles, and to integrate them in a simple positioning system for common usage. This has given rise to the need for a completely new set of technical terms which pertain to positioning for skull tomography. It is hoped to establish an understanding which will enable the radiographer to devise methods of demonstrating structures for which there are no text book references to act as a guide, and to assist the radiologist in the recognition of pseudo-shadows.

Ear, External

Byssinosis and chronic respiratory disease in U.S. cotton gins.

A pilot study of cotton gin workers was undertaken in the ginning industry so as to determine if a definitive study could be undertaken and to make some first order estimates of byssinosis and chronic respiratory disease and to compare the findings to those reported in the African and European gins. Baseline medical data were collected on 203 gin workers and 260 controls, consisting of a medical symptom questionnaire, a chest x-ray and the forced expiratory spirogram pulmonary test. Results revealed a prevalence of functional reactors equal to that found in the textile industry and other gin studies (44%) as determined by spirometric testing, without any association to smoking history. The major reaction group within the ginning population was those working in the baling press area. These same workers demonstrated evidence of chronic depressions in their spirometry data. No excess of chronic respiratory disease as determined by the questionnaire was detected within the gin worker population.

Byssinosis

Colposcopic examination of the cervix of cebus monkeys.

A total of 410 colposcopic examinations were performed on 188 female cebus monkeys that were under study to determine the oncogenic potential of herpes simplex virus type 2 in this genus. A split-cone vaginal speculum was developed that permitted good observation of the vaginal cervix in the cebus monkey. The cervical anatomy of cebus monkeys was found to differ from that of humans in that the surface of the animal cervix was more papilliform, with thinner squamous epithelium, and the squamocolumnar junction lay within the endocervical canal. Therefore, the ability to detect abnormalities in the cervical epithelium by colposcopic examination in the cebus monkey was restricted to vascular changes in the squamous epithelium. After 100 examinations, several vascular patterns were distinguishable and interpretations of these patterns were compared with cytologic findings on the same animals. Findings by both cytology and colposcopy were mild in nature; no carcinoma was detected. Colposcopic and cytologic findings correlated at a level of 84%. More abnormalities were detected with colposcopy than with use of cytologic techniques.

Animals

The prevalence and clinical diagnosis of vaginal candidosis in non-pregnant patients with vaginal discharge and pruritus vulvae.

Two hundred and thirteen nonpregnant female patients complaining of vaginal discharge or pruritus vulvae were recruited to the study by 45 general practitioners in the Yorkshire region. Of these patients, 102 (48 per cent) were found to have demonstrable vaginal mycosis on an initial swab and a further 10 to be swab positive after one week of placebo treatment. The total prevalence in this population of women consulting their practitioner was thus 52.6 per cent.Analysis of symptomatology and of physical findings showed that a clinical diagnosis of vaginal mycosis cannot be made with acceptable reliability.The occurrence of spontaneous swab conversion is noted, and its possible origins are discussed.

Female

Phenylalanine inhibited p-nitrophenyl phosphatase activity in the serum as an indication of intestinal cellular disruption in the horse.

Examination of tissues obtained from thoroughbred horses showed that the 'intestinal' phosphatase activity could be differentiated from other phosphatases by analysis at a pH of 9-5 and inhibition with 15 mM L-phenylalanine. A simple method for the measurement of 'intestinal' phosphatase in heparinised plasma or serum is described. Application of the technique to serum or plasma from normal and diseased horses indicates that the increase in the activity of 'intestinal' phosphatase is associated with cases showing clinical, biochemical and haematological evidence of intestinal damage.

4-Nitrophenylphosphatase

A critical review of intrauterine fetal transfusion.

A critical review of 142 intrauterine fetal transfusions performed in 99 patients during 107 pregnancies raised doubts about the absolute benefit of the procedure. Two main problems emerged: the diagnostic criteria upon which decisions were based were inadequate and the fetal mortality associated with transfusion was high, especially when this was performed before 28 weeks. We measured amniotic fluid bilirubin concentration by a biochemical method but the results following intrauterine fetal transfusion were similar to those observed by others using spectrophotometric examination of amniotic fluid.

Abortion, Spontaneous

Vaginitis.

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Adult