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Biomedical subjects

G C Mason

Publications and source records attributed to G C Mason.

At least 19 recordsLinked to original sources
PubMed2005

Outcomes of severe pre-eclampsia/eclampsia in Yorkshire 1999/2003.

OBJECTIVE: To establish the risk of serious complications from severe pre-eclampsia and eclampsia in a region using a common guideline for the management of these conditions. DESIGN: A five-year prospective study. SETTING: Sixteen maternity units in Yorkshire. POPULATION: All women managed with severe pre-eclampsia and eclampsia. METHODS: A common guideline was developed for the management of women with these conditions. A network of midwives prospectively collected outcome data. MAIN OUTCOME MEASURE: Incidence of the conditions and serious complication rates. RESULTS: A total of 210,631 women delivered in the 16 units between 1 January 1999 and 31 December 2003. One thousand eighty-seven women were diagnosed with severe pre-eclampsia or eclampsia (5.2/1000). One hundred and fifty-one women had serious complications including 82 women (39/10,000) having eclamptic seizures and 49 women (23/10,000) requiring ICU admission. There were no maternal deaths but 54 out of 1145 babies died before discharge, giving a mortality rate of 47.2/1000. Of the 82 cases of eclampsia, 45 occurred antenatally (55%), 18 before admission to the maternity unit. Eleven cases occurred in labour (13%), including 1 during a caesarean section, and 26 cases occurred following delivery (32%). Twenty-five women developed pulmonary oedema (2.3% of cases) and six women required renal dialysis (0.55% of cases). One hundred and sixty-five (15%) required no antihypertensive therapy and 489 (53%) of the remainder required only oral therapy. Two hundred and one (18.5%) required more than one drug. CONCLUSION: A regional guideline for severe pre-eclampsia and eclampsia can be developed and implemented. Its use may contribute to a low rate of serious complications.

Anticonvulsants↗
PubMed2000

Preliminary experience with twenty perineal repairs using Indermil tissue adhesive.

OBJECTIVE: To assess the use of Indermil tissue adhesive for perineal repair. SETTING: Leeds General Infirmary, a teaching hospital with 4500 deliveries annually. METHOD: Over a period of five months, 20 women who sustained either a second degree tear or who had an episiotomy at vaginal delivery had their perineal skin repaired with Indermil tissue adhesive. They were followed up prior to discharge and then by telephone once discharged. RESULTS: Ten repairs followed normal vaginal deliveries, six were after ventouse deliveries, three after midcavity forceps delivery and one after a rotational forceps delivery. Three women noticed a burning sensation during application of adhesive. At follow up, 13 women were completely without problems, two complained of a sharp sensation from excess adhesive, one had silver nitrate applied at the six week check, two had small defects in the skin which healed well and in two women the skin edges broke down completely but did not need resuturing. CONCLUSION: Indermil tissue adhesive appears to be a safe and effective method of skin closure for episiotomies and second degree tears. The skin closure is quick and painless.

Delivery, Obstetric↗
PubMed2000

A randomised controlled pilot study of the management of gestational impaired glucose tolerance.

OBJECTIVE: To determine whether a study of a less intensive form of management for impaired glucose tolerance in pregnancy is feasible and whether women would accept randomisation. DESIGN: Prospective randomised controlled study. SETTING: A large district general hospital and a large teaching hospital in West Yorkshire. SAMPLE: Seventy women with impaired glucose tolerance in pregnancy. METHODS: One group monitored plasma glucose up to four times daily. The other group did not monitor plasma glucose at all. MAIN OUTCOME MEASURES: The number of women recruited of those approached and neonatal admissions to special care baby units in each group. RESULTS: Sixty-eight of 70 women approached entered the study. There were no statistically significant differences between the groups in neonatal outcome measures. The median number of plasma glucose measurements in the monitored group was 118 (range 0-500), and 19% of women in the monitored group were treated with insulin. CONCLUSIONS: This study fails to demonstrate any benefit from intensive management of impaired glucose tolerance in pregnancy with additional maternal inconvenience. This pilot study has shown that a large randomised controlled study of the management of impaired glucose tolerance in pregnancy is not only feasible but necessary.

Adult↗
PubMed2000

Hyperechogenic fetal bowel: a prospective analysis of sixty consecutive cases.

A two year prospective analysis of all second trimester fetuses (16-22 weeks of gestation) with hyperechogenic bowel was undertaken. Hyperechogenic fetal bowel (sonographic echogenicity similar to or greater than that of surrounding fetal bone) was diagnosed using strict criteria. Outcome of affected fetuses was ascertained from hospital records, health care workers and autopsy reports, up to six months of age. Sixty consecutive fetuses were identified, of which 48 (80%) were liveborn. Six pregnancies were terminated, four ended with an intrauterine fetal death and two died at birth. The incidence of cystic fibrosis and aneuploidy were each 5%, and there were no cases of congenital infection. Intrauterine growth retardation was recorded in six fetuses (10%), four of whom died perinatally. Eighty-two percent of fetuses (28/34) with isolated hyperechogenic bowel had a normal outcome.

Abortion, Induced↗
PubMed2000

An unusual case of trisomy and triploidy in a chorion villus biopsy.

A case is reported of a 35-year-old woman who underwent a chorion villus biopsy (CVB) at 17 weeks' gestation after intrauterine growth retardation and oligohydramnios were diagnosed by ultrasound scan. Chromosome analysis of the CVB direct preparations showed a 47,XX,+6 karyotype in all cells. The pregnancy was terminated and subsequent analysis of cultured cells from both the CVB and the post-mortem placenta showed three cell lines: 46,XX, 47,XX,+6 and 69,XXX, while fetal skin and muscle were entirely 69,XXX. An explanation is proposed for the origin and distribution of the three cell lines.

Adult↗
PubMed1998

Case report: cerebellar hemi-hypoplasia.

Cerebellar hypoplasia is a prominent feature of fetal brain pathology. The lesion is rarely isolated or asymmetric. Various aetiological factors have been proposed. The frequency of cerebellar hypoplasia as a congenital defect in humans is unknown. A single case is described of unilateral cerebellar hypoplasia with intact vermis that was detected on prenatal ultrasound examination. Changes in the appearance of the abnormality over the course of the pregnancy raised the possibility of a disruptive vascular aetiology with destruction of normally formed structures. Prenatal ultrasound, post-delivery cranial ultrasound, and MRI images are presented to support the hypothesis.

Adult↗
PubMed1997

The efficacy of intrapartum fetal surveillance when fetal pulse oximetry is added to cardiotocography.

OBJECTIVE: To determine if oxygen saturation measurement with pulse oximetry (SpO2) in combination with cardiotocograghy (CTG), improves the assessment of the intrapartum fetal condition. STUDY DESIGN: Four expert obstetricians individually evaluated 119 cases that were monitored during labor: during the first session the CTG data were available, and in the second session CTG and SpO2 data were evaluated. They were instructed to indicate the need for intervention and to estimate the umbilical artery pH. RESULTS: In the non-acidotic group (umbilical artery pH > or = 7.15, n = 112) the average(+/-S.D.) number of interventions decreased from 27(+/-17) to 16(+/-9) when SpO2 was available. This reduction in number of interventions resulted in an significantly increased specificity for two referees. In the acidotic group (n = 7) the average number of interventions also decreased, from 6(+/-2) to 4(+/-2), and as a consequence the sensitivity decreased. The pH estimate based on CTG + SpO2 was higher in both acidotic and non-acidotic fetuses than the estimated pH based on CTG alone. CONCLUSION: In this study all referees intervened less frequently when SpO2 was used as an adjunct to CTG. This resulted in fewer unnecessary operative interventions, but may also lead to unidentified fetal acidosis. The number of acidotic newborns (n = 7) was too small, however, to draw definite conclusions. Larger studies should address the efficacy of SpO2 in detecting fetal compromise before clinical use can be advocated.

Cardiotocography↗
PubMed1993

Randomised comparison of routine versus highly selective use of Doppler ultrasound in low risk pregnancies.

OBJECTIVE: To help answer the question: should Doppler ultrasound of the umbilical circulation be made available to all pregnant women as part of their routine antenatal care? DESIGN: A randomised trial. SETTING: St James's University Hospital, Leeds. SUBJECTS: 2025 low risk primigravid women. MAIN OUTCOME MEASURES: Obstetric intervention rates and short term neonatal morbidity. RESULTS: The incidence of abnormal Doppler was low (1.7%) with complete absence of end diastolic flow in only 0.3% of cases. No significant differences could be demonstrated between control and study women in any of the outcomes measured. CONCLUSION: This study did not demonstrate any benefit or harm from Doppler ultrasound as a routine screening test for all low risk women, whereas our previous studies have suggested that it is useful in high risk pregnancies. Any marginal returns on extending access to Doppler ultrasound from high risk to all women must be small. Since this test has excellent performance characteristics (sensitivity and specificity) for the prediction of fetal hypoxia and acidosis our results call into question the cost to benefit ratio of all tests designed to predict these outcomes in low risk women.

Female↗
PubMed1988

Poor maternal weight gain between 28 and 32 weeks gestation may predict small-for-gestational-age infants.

In a retrospective analysis of 158 women considered to have had normal, low-risk pregnancies, 30 gave birth to infants with a birthweight less than the 10th centile for gestation. These 30 women had a significantly poorer mean increase in weight (0.99 kg) between 28 and 32 weeks gestation than the other 128 women (1.95 kg) who gave birth to infants with birthweights above the 10th centile for gestation. There was no statistically significant difference in booking weight, overall weight gain or other variables associated with low birthweight between the two groups of women which suggests that poor maternal weight gain specifically between 28 and 32 weeks gestation may predict small-for-gestational-age infants.

Adult↗
PubMed1986

Accuracy and reproducibility of a new contrast clearance method for the determination of glomerular filtration rate.

A new method for determining the glomerular filtration rate was analysed prospectively. The method uses an x ray fluorescence technique to measure disappearance from the plasma of injected non-ionic iodinated contrast media. Eighty seven patients were studied. Fifty four had an intravenous dose of 100 ml iohexol (Omnipaque) and 33 had 50 ml iohexol. Clearances of chromium-51 labelled edetic acid (51Cr-EDTA) were measured simultaneously. In the patients given 100 ml iohexol there was excellent correlation with 51Cr-EDTA clearance (r = 0.90). The correlation using 50 ml iohexol was also good (r = 0.85). Correlation between creatinine clearance and clearance of 51Cr-EDTA in 33 patients was less satisfactory (r = 0.69). There were no adverse reactions to the contrast media. The equipment used for measuring contrast clearance was robust and simple to operate. Freezing plasma samples in 10 studies and re-examining them weekly for six weeks showed no significant variation in results; hence reproducibility was good. This new and accurate method for determining the glomerular filtration rate merits further study and might find a useful place in routine clinical practice.

Adolescent↗
PubMed1986

Studies on the stimulation of the bacterial, collagenolytic enzyme clostridiopeptidase A by cobalt (II) ions.

Co(II) ions increase the Vmax of clostridiopeptidase A, producing a maximum stimulation of overall enzymic activity of 120%. Co(II) does not displace Zn(II) from the active site, nor Ca(II) from its binding site on the enzyme. There appears to be an additional transition metal-binding site on clostridiopeptidase A, accepting Zn(II), which is inhibitory (Ki = 550 microM), or Co(II), which is stimulatory (Kact = 200 microM).

Cobalt↗
PubMed1986

High pressure chronic retention. Incidence, aetiology and sinister implications.

A prospective analysis of 36 consecutive cases of high pressure chronic retention presenting over a 3-year period is described. Thirty-nine per cent of patients had malignant prostates and 14% had bladder tumours (overall malignancy rate 53%). The dangers of mismanagement of high pressure chronic retention include uraemic death and hypovolaemic circulatory collapse from neglected post-obstructive diuresis. The clinician should be prepared to find a high incidence of urological malignant disease in patients presenting with this syndrome.

Aged↗
PubMed1986

Does ovarian sex cord tumour with annular tubules produce progesterone?

Probable progesterone production was identified by an immunoperoxidase assay in a case of an ovarian sex cord tumour with annular tubules. The tumour was associated with a serous cystadenofibroma in the opposite ovary and with adenoma malignum (adenocarcinoma) of the cervix.

Adenocarcinoma↗
PubMedDate not supplied

The biochemical and histological effects of artificial ligament wear particles: in vitro and in vivo studies.

Growing evidence suggests that biochemical mechanisms play a role in the pathogenesis of arthritis. Cartilaginous wear particles have been shown to induce destructive enzymes and cytokines. To assess the biocompatibility of artificial ACL replacements, the effects of wear particles from the following ligaments were analyzed biochemically and histologically: GORETEX, Stryker Dacron Ligament Prosthesis, Versigraft carbon, Kennedy LAD, Xenograft, Leeds-Keio, and human patellar tendon allograft. Ligaments were frozen and ground to produce wear particles similar to those seen clinically and were added to lapine synovial cell cultures. The resulting conditioned medium was analyzed for collagenase, gelatinase, and chondrocyte activating factor (CAF) production. All of the ligaments induced significantly elevated enzyme and CAF production by the synoviocytes, with Xenograft and carbon inducing significantly higher enzyme levels than those of the other five ligaments. Five milligrams of wear particles were injected into the knees of 4 kg to 5 kg rabbits that were analyzed histologically after 14 weeks. Wear particles accumulated in the periarticular synovial folds and induced modest to severe macrophage infiltration in the synovium. A hypothetical model explaining the role of artificial ligament wear particles in the pathogenesis of arthritis is presented.

Animals↗