Biomedical subjects
Publications and source records attributed to C Wood.
Studies on in vitro fertilization were begun at Monash University in 1970. A review is presented summarizing developments since then, culminating in pregnancy rates of 18% in 1980, 22% in 1981, and 19% in 1982.
Between 1973 and 1981 1000 successful studies involving ambulatory monitoring of intra-arterial blood pressure were performed using percutaneous cannulation of the brachial artery. We have reviewed the clinical effects of these studies and 35 other cases where attempted cannulation was unsuccessful. One major complication occurred, when an infected haematoma arising at the cannulation site led to the formation of a false aneurysm. In only one other case was distal pulsation diminished following the study. There were 157 reported "minor" complications in 122 studies, including haematoma, haemorrhage, transient paraesthesiae in median nerve territory, and evidence of micro-emboli. A limited study using pulsed wave Doppler ultrasound revealed no significant alteration in arterial lumen size or flow in 20 subjects. The procedure was therefore associated with a much smaller incidence of clinical problems than has been reported with other investigations involving cannulation of the brachial artery.
Measurements of weight, head circumference, crown-heel length, crown-rump length, rump-heel length and limb lengths were made in 514 neonates. From these measurements the differences in trunk and limb growth and their relations with head growth and body weight were examined in small-for-gestation (SGA) and appropriate grown (AGA) infants, and in different ethnic groups. We found that Asian infants had different body proportions from blacks and whites, with shorter trunks and forearms. SGA infants as a whole showed little difference in proportions from AGA infants except in their ponderal indices and the ratio of head size to body weight. However there was a preponderance of thin, relatively well-grown infants among them. When very short SGA infants were compared with AGA infants significant differences emerged, the short infants of all ethnic groups having shorter trunks and forearms in relation to their other measurements. We found no evidence of relative sparing of head growth. The results suggest that infants with prolonged intrauterine growth retardation are most likely to have disturbed skeletal proportions.
A case of toxic shock syndrome presenting with macular erythema and subepidermal bullae is described. The patient meets the Centers for Disease Control criteria for toxic shock syndrome. A biopsy of the bullae and macular erythema revealed, respectively, subepidermal bullae and superficial perivascular infiltration. This case demonstrates the potential difficulty in differentiating between toxic shock syndrome and toxic epidermal necrolysis.
Frying of ground beef at 250 degrees C results in the formation of a series of mutagenic heterocyclic amines, possibly as many as 10 distinct compounds. In this study, the mutagens are separated by aqueous/acid extraction from the beef, XAD adsorption, acid/neutral/base-liquid/liquid extraction, preparative reverse phase h.p.l.c., normal phase h.p.l.c., and analytical reverse phase h.p.l.c. Identification is by low and high resolution mass spectrometry, u.v. absorption spectroscopy and nitrite sensitivity assays. More than 30% of the mutagenic material is identified as 2-amino-3,8-dimethylimidazo[4,5-f]quinoxaline (MeIQx). The previously described beef mutagen, 2-amino-3-methylimidazo[4,5-f]quinoline (IQ) contributes less than 12% of the total mutagenicity at high temperatures (300 degrees C) and less than 4% at lower temperatures. In addition to MeIQx major mutagens are seen with molecular ions at m/z 227 (C12H13N5), 209 (C13H11N3), and 176 (C9H12N4). Two very polar and two non-polar peaks making a relatively minor contribution to the total mutagenicity (less than 16% total) have not yet been identified. Estimates of the mass of these mutagens in the original cooked beef were made from the mass spectral analysis and the mutagenic recoveries. From one kilogram of cooked ground beef, 1.0 micrograms MeIQx, 0.02 micrograms of IQ, and up to 1.5 micrograms of additional mutagens are formed.
The aetiology of idiopathic infertility largely appears to lie within the female genital tract. The causes may be related to psychological, hormonal or biological factors that could influence sexual behaviour or function of the cervix, uterus, tubes or ovaries. Carefully controlled prospective studies are needed to evaluate diagnoses and therapy. Management of cases of long-standing idiopathic infertility in an IVF programme is indicated if the pregnancy rates of the programme are greater than 10%, as it will aid in both diagnosing the underlying cause as well as offering a significantly higher chance of pregnancy than either expectancy or other treatments.
The use of donor eggs and embryos is indicated in those infertility cases where the recipient's eggs are either absent, unavailable or inappropriate for in vitro fertilization (IVF) and embryo transfer (ET) programmes. Donor eggs may be fertilized by either the sperm of the recipient's husband (donor egg programme) or by donor sperm (donor embryo programme), in vitro or in vivo and may be transferred as either fresh or frozen-thawed embryos. Human pregnancies and livebirths have recently been reported following the donation of embryos fertilized both in vitro and in vivo. The development of this new technique will allow the achievement of normal pregnancy in infertile women who hitherto had no possible chance of pregnancy.
Microcystic adnexal carcinoma is a distinct clinicopathologic entity with combined pilar and eccrine differentiation. Clinically it resembles other adnexal neoplasms, but it tends to be deeply invasive and locally aggressive. A 47-year-old man with microcystic adnexal carcinoma of the left cheek with deep dermal and subcutaneous invasion was successfully treated by microscopically controlled excision. The possible etiologic association with teenage radiation therapy is discussed.
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A second case of eccrine ductal proliferation of the scalp which presented as cicatricial alopecia is reported. Histopathology is compatible with a diagnosis of eccrine sweat duct hamartoma. This case seems to establish a rare clinical occurrence of sweat gland cyst formation which microscopically resembles syringoma.
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In vitro fertilisation after stimulation of the ovulatory cycle has led to successful pregnancy. If more oocytes are recovered than are needed they may be left unfertilised, preserved, or donated to a recipient couple from whom oocytes cannot be obtained. A case of human pregnancy initiated by transfer of a donated embryo fertilised in vitro is reported. The donor was a 42 year old woman with primary infertility from whom six follicles were aspirated after stimulation of the ovulatory cycle. The recipient was a 38 year old infertile woman who had undergone several unsuccessful attempts for artificial insemination from a donor. Five oocytes were recovered from the donor's six follicles, four of which were inseminated with spermatozoa of the donor's husband and the fifth with a frozen sample of semen. Three of the four embryos fertilised by her husband were returned to the donor and the fifth was transferred to the recipient. No pregnancy was recorded in the donor, but pregnancy was confirmed in the recipient, though spontaneous abortion occurred after 10 weeks. This case will give useful information for further study of in vitro fertilisation, but also raises many ethical issues.
Depletion of noradrenaline from the locus coeruleus system was effected by intraperitoneal injection of 6-hydroxydopamine to neonatal rat pups. Spontaneous, and two paradigms of rewarded alternation behaviour were examined in a T-maze. No change was seen in spontaneous alternation but marked impairment in acquisition of one of the two rewarded alternation tasks was found. It is concluded that powerful support is offered to previous results using intracerebral adult 6-hydroxydopamine administration.
The ultrasound results in 141 patients through 203 cycles stimulated with clomiphene citrate prior to oocyte collection and in vitro fertilization are analyzed. A wide range in the size and number of follicles was seen. Bivariate analysis of the size of the largest follicle, compared with the time of the spontaneous luteinizing hormone (LH) surge, has shown a highly significant correlation (r = 0.720; P less than 0.001) between these two variables, but the accuracy of prediction of the LH surge in a specific cycle, as expressed by the standard error of estimate, was 34.3 hours. As an isolated observation, ultrasound results are no better than the menstrual history in predicting the time of the LH surge in stimulated cycles. Multiparameter assessment of follicular development is required.
We have mapped 12 diversity (D) gene segments of mouse Ig heavy chains between 80 and 1 kilobases 5' to the four joining (JH) gene segments by molecular analysis of DNA clones isolated from recombinant phage and cosmid libraries. All identified D and JH segments are in the same 5'-3' orientation. The significance of these findings with respect to the joining mechanism for Ig gene segments is discussed.
A case is reported of deep cutaneous mycosis in an immunosuppressed patient who, after heart transplantation, developed a solitary blue-black skin nodule that was excised. No cultures were taken. The nodule, in the dermis, was a granuloma with microabscesses containing a few pale yellowish-brown fungal spores that were found after much searching in hematoxylin- and eosin-stained sections. Stains for melanin showed numerous spores and septate branching hyphae that also stained with P.A.S. Melanin staining indicated that the fungi were dematiaceous and that the lesion was a phaeomycotic cyst. Staining of stock cultures of fungi for melanin showed good correlation between the amount of pigment in cell walls of fungi and the accentuation of staining when a melanin stain was incorporated.