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Biomedical subjects

G F Smith

Publications and source records attributed to G F Smith.

At least 73 records · Page 4Linked to original sources

Fibrinogen-fibrin conversion. The mechanism of fibrin-polymer formation in solution.

The fibrin polymers formed in solution during the earliest phase of the fibrinogen-fibrin conversion are shown to be stable soluble molecules at pH7.4 and 0.15m- or 0.3m-NaCl. The various sequential soluble fibrin polymers produced from the fibrinogen-thrombin reaction can be observed by gel chromatography and can be isolated for characterization. The mechanism of fibrin polymerization proposed from the present studies suggests that the initial event is the thrombin activation at only one of the Aalpha-chains in fibrinogen. The resulting highly reactive intermediate is the true fibrin monomer and it rapidly, and irreversibly, self-associates to form the stable fibrin dimer (s(20.w)=12S). Fibrin dimer possesses the N-terminal pattern alanine/glycine/tyrosine (1:1:2) per 340000 molecular weight, and possesses the chain structure [(alpha)Aalpha)(Bbeta)(2)(gamma)(2)](2). The fibrin dimer is a soluble inert molecule, but additional thrombin activation of its remaining intact Aalpha-chains leads to new associations into larger inert soluble fibrin polymers. In this manner progressively larger fibrin oligomers are constructed with thrombin continually in control of the process because of the necessity to repeatedly re-activate the various fibrin polymers in solution. The inert character of the soluble fibrin polymers can be explained by the reciprocal alignment of the associating molecules, which mutually consumes their active surfaces and leaves an intact Aalpha-chain at either end of each fibrin oligomer. The soluble fibrin polymers will proceed to further association only if thrombin activates these remaining Aalpha-chains, otherwise the fibrin molecules are stable indefinitely. The intermolecular associations within the soluble fibrin polymers are essentially irreversible under these nearly physiological conditions. However, the bonding is not covalent. This mechanism accounts for the clinical observations of stable fibrinogen-derived polymers in the plasma from patients undergoing thrombotic processes. Since it is shown that the intermediate fibrin polymers, themselves, are stable soluble molecules, it is no longer necessary, nor warranted, to invoke hypothetical ;fibrinogen-fibrin complexes' to explain observations of fibrin solubility.

Amino Acids↗

Anaesthesia for transurethral prostatectomy. A comparison of spinal intradural analgesia with two methods of general anaesthesia.

One hundred and fifty patients who presented for transurethral prostatectomy were randomly allocated to one of three groups for the purpose of anaesthesia. Group A received spinal intradural analgesia, Group B general anaesthesia with spontaneous ventilation and Group C general anaesthesia with controlled ventilation. The comparability of the three groups was established. There were no significant differences in the corrected blood loss, postoperative morbidity or mortality in the three groups. Dysrhythmias were significantly higher in Group B. The results support the conclusion that the methods of choice for anaesthesia for transurethral prostatectomy are spinal analgesia or general anaesthesia using muscle relaxants and controlled ventilation. The final decision is a matter of personal preference.

Anesthesia, General↗

Non-rotational teaching of obstetrics in a family practice residency.

The E. W. Sparrow Family Practice Residency Program has developed a unique system of training family practice residents in obstetrics. A continuous obstetrical training experience is provided on a non-rotational basis over the three-year residency training period. This experience has been arranged through the creation of the family practice obstetrical population, the use of family practice faculty as primary teachers, and the use of residents and faculty in obstetrics-glynecology as consultants. Extensive documentation and evaluation is used to allow residents to progress through varied levels of privileges in preparation for private practice.

Curriculum↗

Visual and computer-assisted assessment of the EEG in epilepsy of late onset.

A study was made of 275 patients presenting with suspected epilepsy after the age of 20 years. In 122 it was concluded that the attacks were non-epileptic. In 60 others cerebral pathology was found. If the EEG was visibly abnormal the risk of cerebral pathology was 8 times greater than when the record was normal. The EEGs were also assessed by an automatic pattern recognition technique, which classified them as abnormal by reference to a control population of 300 volunteers. 90% of EEGs from patients with pathology were classified as abnormal and, conversely, 86% of patients with abnormal records (as assessed by the automatic analysis) had pathology.

Adult↗

Computer-assisted interpretation of clinical EEGs.

A multivariate pattern recognition technique has been developed, to distinguish the EEGs of patients with cerebral pathology from those of normal controls and to localize any abnormalities detected. Two methods of feature extraction have been used, power spectral density and slope descriptor analysis, together with various types of feature compression. These techniques have been evaluated on EEGs from 63 patients with proven pathology. Spectral analysis proved more reliable than slope descriptor analysis and predicted the site of cerebral pathology more accurately than did visual assessment of the EEGs. This apparent improvement over the diagnostic reliability of visual analysis in considered to justify further development and evaluation of this technique.

Adult↗

Trisomy 4p and deletion 4p- in a family having translocation, t(4p-; 12p+).

Chromosome studies on a newborn infant with the clinical features of 4p-syndrome revealed a 46,XY,4p-karyotype with deletion of bands distal to 4p14. Investigation of the family revealed normal chromosomes in the mother and a balanced translocation rcp(4;12) (p14;p13) in the father, the paternal grandfather and an uncle. A severely retarded and malformed aunt is a partial trismoy for the short arms of chromosome 4, with the unbalanced karyotype 45,XX,12p+. It appears that monosomy of bands 4p15 and 4p16 leads to the full clinical features of 4p-syndrome, while trisomy of this region causes disabilities consistent with the rather more variable 4p trisomy syndrome. From currently reported cases, a summary is presented of the results of pregnancies of both male and female translocation carriers.

Abnormalities, Multiple↗

Sacral agenesis and associated anomalies.

Sacral agenesis can no longer be considered an uncommon disorder. The condition occurs often enough that the clinician should be alert to any signs that may suggest its presence in a newborn. This disease is frequently associated with other anomalies, especially those of musculoskeletal, GU and GI systems. Diagnosis--early diagnosis--is the key to prevention of permanent damage to the kidneys and urinary tract in patients with the disease.

Child↗

Phenylketonuria.

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Female↗