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Biomedical subjects

G A Machin

Publications and source records attributed to G A Machin.

86 records · Page 5Linked to original sources
PubMed1979

Follicular carcinoma in a thyroglossal duct.

The case of a 24-year-old woman with follicular carcinoma arising de novo in a thyroglossal duct is reported. A review of the literature disclosed seven case reports of thyroglossal duct carcinoma with a mixed papillary-follicular pattern. There are three criteria for the diagnosis of follicular carcinoma of a thyroglossal duct: presence of a thyroglossal duct, absence of carcinoma within the thyroid gland and angioinvasion. A plan of treatment, based on the literature survey, should include Sistrunk excision of the tumour if possible, and subtotal thyroidectomy should be performed to eliminate the presence of a primary thyroid carcinoma.

Adenocarcinoma↗
PubMed1978

Urinary tract malformation in the XYY male.

Phenotypic expression of the 47,XYY chromosome complement in man has been investigated mostly in terms of the central nervous system. Evidence is presented here to suggest that urinary tract malformation may be a component of the XYY syndrome; this should be taken into account when counselling parents of children with this chromosome anomaly, and in making decisions when an affected foetus is diagnosed antenatally.

Abnormalities, Multiple↗
PubMed1978

Nephroblastomatosis and multiple bilateral nephroblastomata. Histologic, therapeutic, and theoretical aspects.

A hemihypertrophic girl had multiple sequential bilateral Wilms' tumors over a period of five years. Diagnostic biopsy and resected specimens showed also the presence of nephroblastomatosis, presumably the substrate from which these multiple tumors arose. The patient died of complications of chemotherapy and dialysis after bilateral nephrectomy, but also had residual tumor. The relationships between nephroblastomatosis, Wilms' tumor, bilateral Wilms' tumor, and teratogenic disorders are discussed, and the therapeutic implications of the nephroblastomatosis/nephroblastoma complex are considered.

Child↗
PubMed1976

Hyaline-membrane disease, alkaline buffer treatment, and cerebral intraventricular halphaemorrhage.

In 55 preterm infants dying from hyaline-membrane disease (H.M.D.) in 1971-74, infants with associated cerebral intraventricular haemorrhage (H.M.D./I.V.H.) had been given more intravascular sodium-bicarbonate solution, but the same proportions of cases with H.M.D. and H.M.D./I.V.H. received bicarbonate at the time of birth. Much of the sodium-bicarbonate solution given to H.M.D./I.V.H. infants was injected in response to the clinical effects of I.V.H. Maximum serum-sodium concentrations correlated with sodium-bicarbonate dosage but not I.V.H. The incidence of I.V.H. in preterm infants in 1971-74 was unchanged from 1956-59 when alkaline buffer treatment was not used. These findings do not suggest that sodium-bicarbonate therapy plays a major part in the pathogenesis of I.V.H.

Bicarbonates↗
PubMed1975

A perinatal mortality survey in south-east London, 1970-73: the pathological findings in 726 necropsies.

The primary necropsy finding are presented for 726 perinatal deaths; the classification of the 1958 British Perinatal Mortality Survey is used, and results of the two surveys are compared. Lethan malformation has replaced intrapartum hypoxia as the most common cause of perinatal death. There has been substantial reduction in intracranial trauma but an increase in intraventricular haemorrhage and, possible, extrapulmonary infection. Chromosome abnormalities occurred in 28 of 500 karyotyped infants (5-6 per cent). Indications for genetic counselling, and antenatal diagnosis in any subsequent pregnancy, were apparent in 10 per cent of cases.

Autopsy↗
PubMedDate not supplied

Abnormal umbilical cord coiling is associated with adverse perinatal outcomes.

The normal umbilical cord coil index is one coil/5 cm, i.e., 0.2 +/- 0.1 coils completed per cm. We report the frequency and clinical correlations of abnormally coiled cords among 1329 cases referred to our placental pathology services. Twenty-one percent of cords were overcoiled and 13% were undercoiled. Abnormal cord coiling was seen at all gestational ages. Principal clinical correlations found in overcoiled cords were fetal demise (37%), fetal intolerance to labor (14%), intrauterine growth retardation (10%), and chorioamnionitis (10%). For undercoiled cords, the frequencies of these adverse outcomes were 29%, 21%, 15%, and 29%, respectively. Abnormal cord coiling was associated with thrombosis of chorionic plate vessels, umbilical venous thrombosis, and cord stenosis. Thus, abnormal cord coiling is a chronic state, established in early gestation, that may have chronic (growth retardation) and acute (fetal intolerance to labor and fetal demise) effects on fetal well-being. The cause of abnormal cord coiling is not known. Its effects on neurological status of survivors are also unknown. Antenatal detection of abnormal cord coil index by ultrasound could lead to elective delivery of fetuses at risk, thereby reducing the fetal death rate by about one-half. We recommend that the cord coil index become part of the routine placental pathology examination.

Chorioamnionitis↗
PubMedDate not supplied

Twin-twin transfusion syndrome: the 'Select' procedure.

OBJECTIVES: Twin-twin transfusion syndrome (TTTS) is associated with a high risk of perinatal morbidity and mortality. The condition results from intertwin vascular connections in the shared placenta. We report here a case of early, severe TTTS that failed to respond to serial amniocenteses and that was successfully treated by means of superselective laser coagulation. METHODS: A causative arteriovenous anastomosis was identified by means of prenatal obstetrical sonography, using color and spectral Doppler techniques. At fetoscopy, performed at 23 weeks' gestation, laser occlusion of only this connection was achieved. RESULTS: This therapeutic intervention resulted in rapid resolution of all evidence of TTTS and a successful pregnancy outcome, with subsequent delivery of 2 healthy infants at 33 weeks' gestation. CONCLUSIONS: The potentially fatal pathophysiology of TTTS was reversed by interruption of a single arteriovenous connection. We have termed this the sonographically evaluated, laser-endoscopic coagulation for twins ('Select') procedure.

Adult↗
PubMedDate not supplied

Perinatally acquired neonatal tuberculosis: report of two cases.

Perinatally acquired neonatal tuberculosis occurs rarely, is difficult to diagnose, may be the indicator of untreated tuberculosis in the mother, and could result in nosocomial transmission to neonatal patients, visitors to neonatal intensive care units, and health care workers. The disease may be more common in certain ethnic and social groups. Neonatal mortality approaches 30%. We report two cases with different outcomes. A neonate was treated for clinical miliary tuberculosis and survived; Mycobacterium tuberculosis was cultured from bronchoscopic washings, maternal genital fluids, and tissues. A second infant died at age 46 days, and autopsy disclosed miliary tuberculosis of lungs, mediastinal and mesenteric nodes, liver, spleen, and bone marrow. The lungs were most severely affected, but the placenta and central nervous system were not involved. The histopathology was not granulomatous. After the diagnosis in the infant, the mother was ascertained to have pulmonary and genital tuberculosis. Fetal and neonatal tuberculosis could be acquired transplacentally as prenatal tuberculous chorioamnionitis, perinatally through aspiration and ingestion of infected maternal genital tissues and fluid, or postnatally through droplet spread from cases of active tuberculosis. These two neonates probably acquired the disease perinatally from maternal genital tuberculosis.

Antitubercular Agents↗
PubMedDate not supplied

Angiosarcoma of the heart.

A 17-year-old boy presented with severe chest pain which partially subsided on anti-inflammatory medication. Five week later he was admitted with fully developed cardiac tamponade. Within five days surgical exploration revealed an nonresectable right atrial tumour. Management of angiosarcoma of the heart is discussed.

Adolescent↗