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Biomedical subjects

D Robinson

Publications and source records attributed to D Robinson.

At least 325 records · Page 18Linked to original sources
PubMed1991

Leukaemia as a manifestation of large cell lymphoma.

A leukaemic phase is uncommon in large cell lymphoma, particularly at presentation of the disease, and very few cases have been reported since immunological markers became available. We have studied 24 cases presenting over a period of 15 years. 16 were B-lineage and eight T-lineage. In five patients the large cell lymphoma represented a transformation of a preceding low grade, small cell lymphoproliferative disease. Three other patients with T-lineage large cell lymphoma presented with skin infiltration (two cases) or lymphoma-associated nephrotic syndrome (one case) 3-9 months before leukaemia occurred. The other 16 patients (12 B-lineage and four T-lineage) presented with de novo large cell leukaemia/lymphoma. With the exception of skin infiltration, clinical features did not differ between T and B-lineage cases. Prognosis was generally poor although a minority of patients lived 1-2 years. Median survival was 7 months. In the B-cell lymphomas immunological markers were those expected but among the T-cell cases there were many unusual immunophenotypes with frequent failure to express markers which are usually positive in peripheral T cells. Without the availability of immunological markers diagnosis would have been difficult, with acute myeloid leukaemia being the most important differential diagnosis. T-lineage and B-lineage cases could not be distinguished on cytological features. In the majority of cases the cells were very pleomorphic with nuclear lobulation, prominent nucleoli and marked cytoplasmic basophilia being commonly observed. Marked nuclear lobulation was not confined to T-lineage cases but was seen also in seven of 12 cases of de novo B-lineage leukaemia/lymphoma; it was readily apparent in histological sections and on ultrastructural examination.

Adolescent↗
PubMed1991

Within-individual variation in serum cholesterol levels: association with DNA polymorphisms at the apolipoprotein B and AI-CIII-AIV loci in patients with peripheral arterial disease.

We have examined the association between variation at the apolipoprotein (apo) B gene and apo AI-CIII-AIV gene cluster and within-individual variation in serum cholesterol levels. Annual measurements were available over a period of 5-10 years in a group of 117 male patients with peripheral arterial disease. The overall within-individual coefficient of variation in cholesterol levels over time was 13.9%. For all patients, Restriction Fragment Length Polymorphism (RFLP) genotype at the apo B gene (XbaI and EcoRI) and apo AI-CIII-AIV gene cluster (XmnI, PstI and PvuII-CIII) had previously been determined. At the apo B locus, individuals heterozygous for either the XbaI or EcoRI RFLP showed significantly greater within-individual variability over time compared to individuals of other genotypes. At the apo AI-CIII-AIV gene cluster, individuals homozygous for the common allele of either the PstI or PvuIIA RFLPs showed the greatest within-individual variability over time but there was no difference in this estimate associated with XmnI genotype. Our observations suggest that variation at both the apo B and apo AI-CIII-AIV loci interacts with unidentified environmental factors to determine individual variability in serum cholesterol levels over time.

Apolipoprotein A-I↗
PubMed1991

Molecular and cytogenetic analysis of a familial microdeletion of Xq.

Cytogenetic analysis of a male infant referred for poor neurological development and failure to thrive showed a microdeletion of the X chromosome, his karyotype being 46,Y,del(X)(pter----q21.1:: q21.2----qter). His mother and grandmother were also found to carry the deletion. DNA probes were used to define the deletion molecularly and it was shown to span intervals 2 to 6 of Cremers et al, a portion of Xq that contains the TCD gene and genes whose absence is associated with deafness and mental retardation. RFLP analysis together with X inactivation studies using the probe M27 beta verified the carrier status of the female relatives and showed non-random X inactivation in the heterozygous females.

Chromosome Banding↗
PubMed1991

Massive chloroquine overdose--a survivor.

Large chloroquine overdoses are almost inevitably fatal. We describe the presentation and management of a patient with such an overdose who survived, due to general supportive care and new specific treatment.

Adult↗
PubMed1991

Active knee joint subluxation: its influence on the prognosis of ligament reconstruction.

Voluntary subluxation of the knee, known as active pivot shift, can be observed in a minority of patients with anterior cruciate ligament deficiency knees. We compared a group of 7 patients exhibiting voluntary subluxation of the knee joint with a group of 61 patients undergoing a similar operative procedure who did not demonstrate this sign. Despite similar age and similar operative procedures, the former group remained handicapped and regained the ability to subluxate the knee. We conclude that patients who exhibit voluntary subluxation of the knee joint are poor candidates for knee-ligament reconstruction.

Adult↗
PubMed1990

Cholinergic REM sleep induction in atypical depression.

The arecoline REM induction test, a measurement of central cholinergic sensitivity, was performed in 10 patients with atypical depression. Arecoline induced REM sleep significantly more rapidly than placebo. Atypical depressives without evidence of anxiety, in particular those without panic attacks, had a more rapid REM induction response to arecoline than atypicals with anxiety symptoms. We compared our atypical depressives with normal controls and affectively ill patients studied in other laboratories. The rapid REM induction response observed in atypical depressives without anxiety was comparable to that seen in endogenous depressives and euthymic bipolars. Previous studies have demonstrated the presence of cholinergic supersensitivity in the latter two groups of patients. Our results suggest that atypical depressives may be distinguished in their response to arecoline based on their anxiety history, and that cholinergic supersensitivity is present in atypical depressives without anxiety. Additional studies with larger samples and simultaneously studied control groups are necessary to test these preliminary findings.

Adolescent↗
PubMed1990

Chorionic villus sampling for prenatal diagnosis in Wales using DNA probes--5 years' experience.

Chorionic villi were sampled from 125 women who requested prenatal diagnosis, either for genetic disorder or because of advanced maternal age. Of these, 105 samples were obtained by the transcervical route and 20 were obtained by the transabdominal approach. The sampling success rate was 97 per cent (122/125). The mean maternal age of the patients was 31 years (range 17-44) and the mean gestational age at which the chorionic villus sampling was performed was 10 weeks (range 7-13 weeks). Seventy-four of these diagnoses involved the use of DNA markers. The minimal size of the sample used for DNA diagnosis was 5 mg. Maternal contamination was detected in two samples. A diagnosis was provided on all but two samples. The fetal loss rate was high initially but fell to 1.9 per cent in 1988.

Adolescent↗
PubMed1990

Regenerating hyaline cartilage in articular defects of old chickens using implants of embryonal chick chondrocytes embedded in a new natural delivery substance.

Partial and full thickness defects were created mechanically in articular cartilage and subchondral bone of the tibiotarsal joint condyles of 3-year-old chickens. The wounds were then repaired using embryonal chick chondrocytes embedded in a new biocompatible, hyaluronic acid-based delivery substance. Controls were similarly operated on but received either no treatment or implants of the delivery substance only. Animals were killed from 1 week to 6 months postoperatively. Sections from the two groups were examined and compared macroscopically, histologically, and histochemically. Results of 6-month follow-up showed that only the defects of the experimental chickens were completely filled with reparative hyaline cartilage tissue, with no signs of inflammation or immunologic rejection. Initially the entire defect cavity, whether partial thickness or full thickness up to the deep regions in the subchondral bone, was filled with cartilaginous reparative tissue. Relatively rapid maturation occurred under the tidemark; chondrocytes hypertrophied, were invaded with vascular elements and ossified. In the superficial areas, the reparative tissue remained cartilaginous and matured as typical hyaline cartilage tissue. These results indicate that aged chicken cartilage and its accompanying thin and spongy osteoporotic bone offer a favorable host environment for embryonal cell implants.

Animals↗
PubMed1990

Purification of genomic sized herpesvirus DNA using pulse-field electrophoresis.

A new method for the separation of genomic sized herpesvirus DNA was developed. This method utilizes the improved separation of extremely high molecular weight DNA molecules by pulse-field electrophoresis. This method has allowed us to separate and purify herpesvirus DNA (greater than 100 kbp) free of cellular DNA, directly from infected cells. In the case of cell associated herpesviruses (such as Marek's disease herpesvirus), this method is more efficient than present isolation procedures. The DNA obtained is able to be restriction enzyme digested and used in cloning experiments.

DNA, Viral↗
PubMed1990

Effect of intrauterine growth retardation on renal function on day one of life.

We measured inulin clearance per kilogram, fractional sodium excretion per kilogram, osmolality, and urinary prostaglandin concentration in seven growth-retarded neonates and six appropriately grown neonates matched for gestational age during the first 24 hours of life to determine the effect of fetal growth retardation on renal function. There was a nonsignificant reduction in inulin clearance per kilogram in the growth-retarded neonates (p = 0.11). Inulin clearance correlated with gestational age in both groups. It was significantly correlated with birthweight in the growth-retarded group (p less than 0.05) but did not reach significance in the control group (p less than 0.06). Fractional sodium excretion was significantly higher in the growth-retarded fetuses (p less than 0.05). This increase was not explainable by differences in mean blood pressure and intravenous fluid intake, although differences in urinary prostaglandin concentrations during the study interval may be involved. In conclusion, we have demonstrated that growth retardation is associated with impaired renal maturation, which during the first 24 hours of life is manifest as decreased glomerular filtration rate and increased sodium excretion.

Fetal Growth Retardation↗
PubMed1990

Spontaneous intramural rupture of the oesophagus.

The clinical, endoscopic, and radiological features of seven patients with an uncommon oesophageal injury characterised by long lacerations of the oesophageal mucosa with haematoma formation but without perforation are reported. The injuries were not related to forceful vomiting or any other definable cause but were similar to those previously described as intramural oesophageal rupture. Upper gastrointestinal endoscopy undertaken to identify the cause of haematemesis in six patients proved safe and useful. When dysphagia and odynophagia occurred early in the clinical course to alert the clinician to possible oesophageal injury, radiological contrast studies were used to exclude perforation. One patient in this study had oesophageal cavernocapillary haemangiomatosis which may have caused intramural oesophageal bleeding and submucosal dissection but in the remainder the aetiology of intramural oesophageal rupture remains uncertain. Conservative management was successful in all patients.

Aged↗
PubMed1990

Mycobacterial infection in patients infected with the human immunodeficiency virus.

Of 207 homosexual or bisexual patients with the acquired immune deficiency syndrome (AIDS), 24 with the AIDS related complex, and 39 with asymptomatic HIV infection, 32 patients were found to have mycobacterial infection. Mycobacterium tuberculosis was found in 13 patients with AIDS and in two with the AIDS related complex. M avium-intracellulare was found in 15 patients with AIDS and was disseminated in 12. One patient was infected with M kansasii and one with M ulcerans. Invasive procedures were frequently required to obtain positive bacteriological results. Subclinical carriage of M avium-intracellulare and other mycobacteria thought to be nonpathogenic was common in patients seronegative for the human immunodeficiency virus and at all stages of human immunodeficiency virus infection. All but one isolate of M tuberculosis were fully sensitive to standard antimycobacterial antibiotics. Response to treatment was usually rapid. M avium-intracellulare isolates were all resistant to first line agents in vitro, and antibiotics such as ansamycin and amikacin were required to obtain a clinical response.

AIDS-Related Complex↗
PubMed1990

Intravenous injection of propylene glycol causes pulmonary hypertension in sheep.

Propylene glycol (30%) is the carrier base for pentobarbital sodium in preparations often used in research laboratories. It has caused pulmonary hypertension in calves, and we found it caused pulmonary hypertension in sheep as well. To investigate the mechanism of pulmonary hypertension with propylene glycol, we injected an average loading dose of 30% propylene glycol (0.5 ml/kg) into adult sheep, which was followed by a rise in thromboxane levels (P less than 0.05) in systemic arterial plasma and lung lymph and by a dramatic increase in pulmonary arterial pressure (17 +/- 1 to 35 +/- 4 mmHg, P less than 0.05) and a fall in cardiac output (2.7 +/- 0.5 to 1 +/- 0.2 l/min). Indomethacin pretreatment blocked the rise in thromboxane in lung lymph and arterial plasma and substantially, although not entirely, blocked the rise in pulmonary arterial pressure. Pulmonary intravascular macrophages (PIMS), which are present in sheep and calves, can release thromboxane in response to a stimulus. To test whether PIMS might be the source of the thromboxane and pulmonary hypertension, we injected propylene glycol into guinea pigs and dogs, which are reported to have no PIMS, as well as into newborn lambs, which are not believed to develop many PIMS until the 2nd wk of life. In dogs and guinea pigs there was no response to propylene glycol. In lambs there was a rise in pulmonary vascular resistance but significantly less than in adult sheep; indomethacin blocked this response.(ABSTRACT TRUNCATED AT 250 WORDS)

15-Hydroxy-11 alpha,9 alpha-(epoxymethano)prosta-5↗
PubMed1990

Role of sulfidopeptide leukotrienes in synthetic smoke inhalation injury in sheep.

Acute lung injury with smoke inhalation results in significant morbidity and mortality. Previously we have shown that synthetic smoke composed of carbon and acrolein, a common component of smoke, causes delayed-onset noncardiogenic pulmonary edema. To study the possible role of the vasoactive and edemagenic sulfidopeptide leukotrienes (SPLT) in smoke inhalation injury, we measured pulmonary hemodynamics, lung lymph flow, and SPLT and leukotriene (LT) B4 in lung lymph before and after 10 min of synthetic acrolein smoke exposure. After smoke exposure there was a significant rise in pulmonary vascular resistance caused by a rise in pulmonary arterial pressure, a fall in cardiac output, and no change in pulmonary capillary wedge pressure. This was accompanied by an increase in total systemic vascular resistance (P less than 0.05), lung lymph flow (P less than 0.05), and extravascular lung water-to-lung dry weight ratio (P less than 0.05). Both SPLT and LTB4 clearance rose significantly (P less than 0.05), but there was a 10-fold increase in SPLT over LTB4 clearance. In sheep pretreated with FPL55712, a SPLT antagonist, the early rise in pulmonary vascular resistance was attenuated, and the rise in systemic vascular resistance was blocked. This was associated with an attenuated and delayed fall in cardiac output. FPL55712 had no effect on lung lymph flow or extravascular lung water-to-dry weight ratio. SPLT, and especially LTD4, may have a role in increased pulmonary and systemic vascular resistance after smoke inhalation injury but does not appear to affect vascular permeability.

Acrolein↗