Biomedical subjects
Publications and source records attributed to D Hunter.
We report a case of a recurrent perirenal cyst after 4 previous attempts to obliterate the cyst by more conventional means percutaneously and by open surgery. Endocystolysis, a technique for the internal marsupialization of a cyst into the renal collecting system, was used successfully to obliterate the cyst. This case and the technique of endocystolysis are described in detail.
Annual age-standardised rates for first contacts with psychiatric services in the Aberdeen area from 1969 to 1984 were calculated for schizophrenia, paranoid states, reactive psychoses, all affective psychoses, mania, and depressive neuroses. Highly significant declines occurred in the diagnosis of schizophrenia and of depressive neuroses. No concomitant increase occurred. It is concluded that these results probably indicate that there has been a fall in the incidence of schizophrenia in North-East Scotland. This may have arisen due to changes in the mode of expression and/or the severity of all functional psychoses.
We report a case of acute portal vein thrombosis that occurred 1 week after orthotopic liver transplantation in a patient with sclerosing cholangitis. Unlike other patients reported in the literature who were first seen with variceal bleeding or acute hepatic failure, this patient initially had mild clinical signs, consisting of an abnormal prothrombin time, an increase in liver function test values, and enlarging but nonbleeding gastroesophageal varices. Whereas patients with more extreme symptoms often die or require retransplantation, this patient was managed nonoperatively. Spontaneous lysis of the portal vein thrombus occurred over the ensuing 2 weeks. The diagnosis and management of this milder form of early, acute portal vein thrombosis are discussed.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Group B streptococcal disease is the most frequent infectious cause of morbidity and mortality of newborns in North America. There is evidence that vertical transmission, the major route of neonatal acquisition, may be interrupted by administration of antibiotics during the intrapartum period. A modified starch serum medium has been developed that will allow the rapid identification of group B streptococci, by observation of a color change, in vaginal and rectal swabs. This medium was compared to a "gold standard" of routine culture. The sensitivity and specificity of the test were found to be 100% and 99%, respectively, in 237 specimens from women attending different clinics who submitted vaginal swabs. All color changes occurred within 6 hours. Vaginal and rectal carriage of the organism were found in 8% and 12%, respectively, of women in preterm labor. In this population the sensitivity and specificity of the test for vaginal specimens were 97% and 98%, respectively. The corresponding values for rectal swabs were 94% and 100%. The test can potentially select carrier mothers who could benefit the most from intrapartum antibiotics. This medium may also be used for transport to enhance detection of colonization.
Explore the source record for details and available documents.
Between 1979 and 1986 an abnormality of the urinary tract was diagnosed by prenatal ultrasound examination in 93 fetuses. Postnatal investigation at a large teaching hospital showed a definite abnormality in 85 infants, 66 of whom were boys. An obstructed urinary tract, usually requiring surgery, was present in 46 infants. Other abnormalities included a multicystic kidney (in 15 infants), vesicoureteric reflux (in 9), prune-belly syndrome (in 5) and polycystic kidneys (in 5). Early recognition and treatment of urinary tract disorders in infants should be accompanied by informed prenatal counselling to minimize parents' anxiety.
Three patients with lower urinary tract fistulas after multiple operations and radiation therapy for pelvic cancer were treated with percutaneous ureteral fulguration and nephrostomy tube drainage. This technique occluded the ureter and allowed for maintenance of a dry fistula site in all 3 patients. There were no complications. The longest followup in these patients was 21 months. The procedure is simple technically and it can be performed with the patient under local anesthesia. The technique of percutaneous ureteral fulguration is described and other techniques for nonoperative occlusion of the ureter are discussed.
Macronuclear chromosomes in Oxytricha fallax, a hypotrichous ciliate, are very short. They often belong to small families of cross-hybridizing chromosomes of two or three different sizes. For example, the 81-MAC family consists of three sizes of macronuclear chromosomes (4.9, 2.9, and 1.6 kbp) (Cartinhour and Herrick 1984). We show that the family actually consists of two closely related sets of three each and that the two sets are independently created by alternative processing of two separate precursor (micronuclear) versions. Chromosomes of a set share a common 1.6-kbp region, which contains a transcribed gene coding for a 25-kD protein. Different-sized macronuclear chromosomes of a set result from alternative choices of positions for telomere formation. All six members of the family are reproducibly generated in each developing macronucleus, and their copy numbers are stably maintained during vegetative replication of the macronucleus (Herrick et al. 1987). Here we argue for the existence of three distinct copy control elements in the 81-MAC family chromosomes. A model is discussed in which, following polytenization of the micronuclear chromosomes, different chromatids are processed differently, and, subsequently, replication-competent macronuclear chromosome products are amplified under the influence of the vegetative copy control elements.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
The results of an examination of the 238 cases of anorexia nervosa on the Aberdeen Psychiatric Case Register for the period 1965-82 are reported. A highly significant increase in the number of cases over time was found. The average annual incidence rate for the period 1978-82 was 4.06 per 100 000 population. The case notes of every second patient on the register were inspected to assess diagnostic reliability, to define patient characteristics further and to look for changes in these over time. The diagnosis was highly suspect in 5% of cases. A social class bias was found, with an over-representation of classes I and II but an under-representation of social class III. Few significant changes were noted in the patients over time. The utilization of services was also examined, and it was found that 24% of the patients remained in contact for 4 years or more.
Twenty known cases of X;autosome translocations with breakpoints at Xp21 associated with Duchenne or Becker muscular dystrophy in girls are reviewed. The variable severity described for different persons may reflect differences in X inactivation or in the nature of the genomic target disrupted. High resolution cytogenetic studies on 12 cases indicate breakpoints on the X chromosome at Xp21.1 or Xp21.2. Translocation chromosomes from several of these cases have been isolated in human/mouse somatic cell hybrids. Molecular heterogeneity in the breakpoint positions has been established by probing DNA from these hybrids with a range of cloned sequences known to be located within, or closely linked to, the Duchenne region. The minimum separation between the most distal and the most proximal breakpoints is 176 kb suggesting that, if a single gene is involved, it must be large. Alternatively, the translocations may affect different genes, or confer alterations to regulatory sequences which operate at a distance.
Of 46 liver transplantations performed, 15 patients are alive at follow-up intervals from 2 to 50 months. The most common indications for liver transplantation were biliary atresia, cirrhosis, and neoplasia. About 50% of the patients had pre- and/or postoperative angiograms. Additional material was available from pretransplant workups in patients subsequently shown to be unsuitable for transplantation. Of 13 preoperative angiographic studies, portal vein patency was confirmed in two, inferior vena caval (IVC) patency was confirmed in two, and diffuse neoplasm was identified in three. These patients subsequently had transplants. Conditions precluding liver transplantation in six patients were inadequate portal vein size (less than 5 mm) in two, occluded IVC or portal vein in one each, nonvisualized portal vein in one, and neoplasm localized to one lobe in one. Postoperatively 18 vascular studies identified hepatic arterial compromise in nine, postbiopsy arteriovenous fistula in two, and bleeding from a right adrenal artery in one. Postoperative venography showed thrombosis or occlusion of the IVC in five, portal vein thrombosis in one, and splenic vein thrombosis in one. Of the 18 postoperative angiograms, 12 demonstrated findings considered threatening to the transplants' survival. Six of 18 studies demonstrated findings considered compromising to the transplant. Of the nine postoperative cholangiographic studies, six diagnoses were considered threatening to transplant survival: obstruction of the biliary-enteric anastomosis in four, leakage from the biliary-enteric anastomosis in one, and an abscess from biliary leakage in one.