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Biomedical subjects

D M Jenkins

Publications and source records attributed to D M Jenkins.

At least 19 recordsLinked to original sources
PubMed1996

Benign cervical leiomyoma leading to disseminated fatal malignancy.

A case study is reported of incomplete excision of a sessile leiomyoma of the posterior cervix followed by rapid tumor growth of the same region in a pregnancy commencing 2 months later. Cesarean section for placenta previa was followed 10 days later by hysterectomy for massive hemorrhage. The tumor was considered, following multiple review, to be a leiomyoma of the cervix with mitosis consistent with recent pregnancy. Widespread peritoneal recurrence occurred within 3 months requiring further laparotomy for excision of widespread tumor and ligation of internal iliac arteries. Death occurred 4 weeks later with widespread peritoneal occurrence. No postmortem was performed. The case emphasizes the rare potential for malignant change in histologically benign leiomyomas with no indications to this potential apart from biological behavior.

Adult↗
PubMed1995

The effect of intermittent steroid therapy on anti-sperm antibody levels.

Sperm-bound antisperm antibody levels were measured in 10 males in subfertile partnerships who were treated with high dose intermittent prednisolone therapy over a period up to 9 months. Antibody levels fell in all patients during therapy, although a transient rise occurred after 2-4 months. There were low treatment complication rates. Four pregnancies occurred during the treatment of the 10 patients. There was no correlation between pregnancy and change in antibody.

Adult↗
PubMed1993

Postlaparoscopic small bowel obstruction.

Laparoscopic surgery continues to grow in popularity as a technique for approaching a variety of clinical problems. With an increase in the number of these procedures performed, unique complications, both early and late, will be identified. Optimal management of complications may differ significantly from the conventional approach. We describe the course of a patient who develops a high-grade partial small bowel obstruction 2 days after an uneventful laparoscopic cholecystectomy for acute cholecystitis. The patient had a history of laparoscopic pelvic surgery 7 years previously. Findings at exploration included a Richter's hernia through a midline fascial defect unrelated to our procedure. This defect, approximately 5 cm below the umbilicus, was most likely secondary to her previous laparoscopic procedure. This finding supports routine fascial closure of 10-mm or greater trochar sites and early, aggressive investigation and intervention in postlaparoscopic bowel obstructions.

Cholecystectomy, Laparoscopic↗
PubMed1992

Does incourse assessment and counselling improve exist performance?

Based on an incourse MCQ test in obstetrics and gynaecology, 60 final year medical students were individually advised, according to their performance, whether or not they needed to work harder at the subject to avoid the risk of failure at the final medical examination. Nobody who performed well at the MCQ failed or was borderline at the final examination. Half of those who were advised to work harder occupied the lowest marks at the final examination. The incourse MCQ was sensitive in selecting out those candidates at risk in their final examination but the advice they were given failed to deal with the deficiencies in half of the students involved. After graduating, these doctors will presumably need special help to maintain their knowledge as they are either incapable of self-motivation or are otherwise deficient. The incourse assessment feedback may have helped another small groups of students to work harder but this study cannot confirm that. The exercise seems worthwhile in that the outlay in time is small, there may be a positive advantage for some students and the medical teacher can feel free of any guilt for failing to advise those students who were at risk of poor performance in the final examination.

Clinical Clerkship↗
PubMed1991

Atheroembolism.

Atheroembolism is an underdiagnosed and often preventable cause of acute arterial insufficiency. The patients suffering from atheroembolism require aggressive evaluation for a source of emboli and frequently surgical excision or exclusion of the source. The Keesler Air Force Base experience with atheroembolism over the past four years was reviewed. Fifteen patients representing 0.03 per cent of hospital admissions were diagnosed with atheroembolism. The embolic source as confirmed by arteriography was aortoiliac in eight patients (57%), femoropopliteal in six patients (43%), and unknown in one patient. Nine patients (60%) were treated surgically or with angioplasty. Three patients had toe amputations and one required a below-the-knee amputation. Only one death occurred that was secondary to unrelated disease.

Adult↗
PubMed1989

Intra abdominal rupture of first trimester cervical pregnancy.

A case of cervical pregnancy resulting in intra abdominal rupture in the first trimester is reported. The clinical features of this rare cause of uterine rupture are outlined. Pathological examination of the uterus showed placenta percreta.

Cervix Uteri↗
PubMed1987

Redistribution of plasma zinc between albumin and alpha 2-macroglobulin in pregnancy.

A cross sectional study involving 12 non-pregnant and 71 pregnant women was undertaken to determine the effect of pregnancy on the concentration in the plasma of zinc and copper and the binding of zinc to plasma proteins. The results confirmed the relationship observed by others between reduced zinc and increased copper concentrations in the plasma of pregnant women. These changes occurred during the first and second trimesters of pregnancy. The concentrations of plasma albumin-bound zinc and alpha 2-macroglobulin-bound zinc were observed to decrease 27.5% and 52.1%, respectively, during the second and third trimesters of pregnancy. During the second and third trimesters of pregnancy a redistribution of zinc occurred within the total plasma zinc pool between albumin and alpha 2-macroglobulin. In the process, the contribution of albumin-bound plasma zinc pool was increased 16.2%, whereas the contribution of alpha 2-macroglobulin-bound plasma zinc was decreased 31.6%. The former is considered more "dynamic" than the latter and the observed shift of zinc within the plasma pool to the albumin-bound state, during pregnancy, may represent an adaptive response designed to offset any adverse effects of reduced maternal plasma zinc concentrations on the developing fetus.

Copper↗
PubMed1983

HLA-DR-positive cells in the human amniochorion.

Human amniochorion has been studied by indirect immunofluorescence using a monoclonal antibody to a monomorphic determinant of HLA-DR antigens. Positive staining was noted only on significant numbers of large cells with irregular cytoplasmic processes in the mesenchymal connective tissue layer of the membranes. These cells resemble the dendritic-type, strongly HLA-DR-positive cells described by Steinman [3] and may be particularly relevant in immunobiological events at this important materno-foetal interface.

Amnion↗
PubMed1983

Plasma copper and zinc concentrations and infertility.

Plasma copper concentration was significantly lower in 48 infertile women than in 35 control subjects and somewhat lower in women with secondary rather than primary infertility. Plasma zinc concentration was not appreciably different in infertile and fertile women. Low plasma copper concentration may influence normal human female fertility.

Adolescent↗
PubMed1983

Degenerative changes and detection of plasminogen in fetal membranes that rupture prematurely.

Amniochorion obtained at caesarean section and vaginal delivery, at 34-36 weeks gestation and at term, have been studied by electron microscopy and immunofluorescence for evidence of amniotic epithelial degenerative changes and the presence of plasminogen. When delivery was by caesarean section between 34-36 weeks, electron microscopy revealed no degenerative changes in four cases, but in two cases they were widespread. All but one membrane obtained at term showed only minimal amniotic epithelial cell degenerative changes, but extensive change was seen when delivery was premature after premature membrane rupture. Plasminogen was seen in amniotic epithelium proportional to the degree of cell degeneration; it was absent from healthy membranes. These findings demonstrate that degenerative changes are extensively present in membranes that rupture prematurely, particularly before the onset of premature labour, and suggest a role for plasminogen in membrane rupture.

Epithelium↗
PubMed1982

Maternal and fetal plasma zinc concentration and fetal abnormality.

Plasma zinc concentration was significantly lower in the maternal blood of 54 women giving birth to congenitally abnormal babies either within 24 h or 24 months previously when compared with control mothers. Cord blood zinc concentrations in 20 congenitally abnormal babies were also lower than in the control babies. We conclude that low plasma zinc may be an associated factor in the aetiology of fetal abnormality.

Congenital Abnormalities↗