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Biomedical subjects

H Lyall

Publications and source records attributed to H Lyall.

34 records · Page 2Linked to original sources
PubMed1996

Total middle ray amputation.

Eight patients underwent middle ray amputation with excision of the whole of the middle metacarpal and careful soft tissue repair. Excision of the base of the middle metacarpal allowed easier approximation of the index and ring rays without the tendency of these fingers to either scissor on finger flexion or to remain slightly apart. Complete removal of the middle metacarpal appears to allow the bases of the index and ring metacarpals to migrate together. The removal of the metacarpal base caused no functional problems and the technique created a good three-finger hand from both a functional and cosmetic point of view.

Adult↗
PubMed1995

Hypothalamic GLUT 4 expression: a glucose- and insulin-sensing mechanism?

The insulin-regulatable glucose transporter, GLUT 4, is expressed primarily in peripheral tissues (skeletal muscle and adipose tissue). In response to insulin this transporter moves rapidly from an intracellular storage site to the plasma membrane, thus accounting for the substantial increase in glucose uptake by these tissues following insulin stimulation. The recent finding that GLUT 4 is also expressed in the hypothalamus suggests that this brain region, which is outside the blood-brain barrier and therefore sensitive to circulating insulin, may experience stimulation of glucose uptake in response to insulin. We propose that this may allow regions of the hypothalamus to respond directly to elevated blood glucose, constituting a form of metabolic regulation by allowing circulating glucose (and therefore insulin) in concert with other mechanisms to maintain blood glucose homeostasis. We consider the possible physiological role of such a mechanism and speculate that disturbances of this mechanism may occur in endocrine disease associated with insulin resistance.

Animals↗
PubMed1995

Donated ovarian tissue in embryo research and assisted conception--the view of women of reproductive age.

In response to widespread interest by the media, the Human Fertilisation and Embryology Authority (HFEA) recently produced a document entitled 'Donated Ovarian Tissue in Embryology Research and Assisted Conception'. Interested organizations and the public were asked for their views on the use of eggs or ovarian tissue obtained from live donors, cadavers or fetuses for both research and the treatment of infertility. For 6 weeks from mid-March 1994, we made the HFEA document available to women attending a Family Planning/Well Woman Clinic (n = 1142), an Infertility Clinic (n = 241) and 200 women about to have a termination of pregnancy, in an attempt to develop an understanding of the attitudes of the general public. We asked them to answer anonymously the questions posed by the HFEA. Over 89% of women thought that ways should be sought to increase the supply of eggs for research and treatment. There were no significant differences in attitudes between the three groups, except that women seeking an abortion were significantly less likely to support the use of cadavers as a source of eggs for either research (48 versus 67%) or treatment (48 versus 59%) (P < 0.05 in both cases). Although all three groups of women found live donors the most acceptable source (90% for research, 88% for treatment), the majority supported the use of fetal eggs/tissue for both research (60%) and treatment (54%) of infertility. This study represents the first systematic attempt to determine the opinion of women who may not otherwise make their views known to the HFEA.

Aborted Fetus↗
PubMed1994

Early detection of metabolic abnormalities in preterm infants impaired by disorders of blood glucose concentrations.

We recently reported (Acta Paediatr Scand 1992;8: 580-4) three preterm infants with severe respiratory distress syndrome and abnormal glucose profiles for the first 5 days of life who subsequently died in infancy; only at autopsy were they shown to have abnormal glucose-6-phosphatase activity. We have therefore studied retrospectively in a matched cohort of 109 infants the blood glucose profiles correlated with the severity of respiratory distress syndrome (expressed as the fraction of inspired oxygen, FiO2): group A, mild, FiO2 < 0.25; group B, moderate, FiO2 0.26-0.50; group C, severe, FiO2 > 0.51. All groups had a similar frequency of low blood glucose values (15% < or = 2.2 mmol/L; 29% < or = 2.6 mmol/L), but high blood glucose values and greater variability in glucose values were more common in groups B and C despite lower caloric intakes (A, 4.3%; B, 9.3%; C, 9.6% > or = 7 mmol/L). We conclude that the early blood glucose patterns in those three previously described preterm infants with abnormal hepatic glucose-6-phosphatase activity at autopsy cannot be viewed as abnormal when considered against a matched cohort of infants. Preterm infants at risk of genetic or developmental delays in blood glucose homeostasis should be reassessed after recovery from their acute illnesses.

Blood Glucose↗
PubMed1992

Impairment of the activity of the hepatic microsomal glucose-6-phosphatase system in three preterm infants.

Three preterm infants born at 26-30 weeks' gestation who died between 103 and 266 days after birth were found to have elevated hepatic glycogen levels. Kinetic analysis of the hepatic microsomal glucose-6-phosphatase system demonstrated that one infant had abnormally low levels of activity of the glucose-6-phosphatase enzyme (partial type 1a glycogen storage disease) and two had deficiencies of T2, a microsomal phosphate/pyrophosphate transport protein (type 1c glycogen storage disease). In all three cases glycogen storage disease was not suspected prior to death even though both hypo- and hyperglycaemic episodes were recorded in the first 15 days after birth indicating that they had somewhat disordered blood glucose regulation. In the infant with low glucose-6-phosphatase enzyme activity, abnormal development of the glucose-6-phosphatase enzyme cannot be ruled out. This is the first description of abnormalities in the glucose-6-phosphatase system in preterm infants.

Biopsy↗
PubMed1992

Glucose metabolism and hypoglycaemia in SIDS.

Once a child is born its survival depends on the maturation of the blood glucose homeostatic control mechanisms. When this fails or where there is an inborn error of metabolism the infant is susceptible to potentially fatal hypoglycaemic episodes. A variety of environmental stresses, either singly or in combination, such as inappropriate or low caloric intake, acute infections of childhood, endotoxaemia, fever, xenobiotic exposure, oxidative stress or anaphylaxis, can greatly exacerbate the deficiency of the normal homeostatic compensatory mechanism and result in the onset of hypoglycaemia. Various inborn errors have been found in infants who died of SIDS. Our approach to this problem has been to use the six microsomal glucose-6-phosphatase proteins as a model system to study defects in carbohydrate metabolism in cases of SIDS. Initial studies determined the ontogeny of the glucose-6-phosphatase proteins and showed that intact microsomes isolated from unfrozen liver samples can be used to study glucose-6-phosphatase in cases of SIDS that were presumably due to the low concentrations of liver lipid peroxidation. More recently we have used a combination of techniques to demonstrate the abnormalities of glucose-6-phosphatase in cases of SIDS. Classic gross pathology and histology have now clearly defined the various subgroups of sudden and unexpected deaths of infancy. This now enables us to develop new molecular approaches to predict and prevent hypoglycaemia in infants who are at risk of SIDS.

Blood Glucose↗
PubMed1991

Anterior fontanelle size in Scottish infants.

Very limited information is available on the normal size of the anterior fontanelle but this measurement may be of value in the early diagnosis for example of bone diseases, and of hypothyroidism. The purpose of this study was to provide a reference range applicable to the first two years of life, using a larger sample population than previous studies. Measurements were made of the anterior-posterior and transverse dimensions in 334 full term infants between birth and the age of 24 months. Despite the wide variation, both in size and age of closure, it proved possible to define a reference range and also, for the first time, to present a centile chart.

Bone Diseases↗
PubMedDate not supplied

Inaccuracy of cytologic diagnosis in high grade squamous intraepithelial lesions (CIN 3).

Through a retrospective review of records, this study attempted to determine whether a correlation between cytology and histology would change with time in one laboratory. The study encompassed a geographic area of Scotland with a female population of 175,500 served by one colposcopy clinic, at Ninewells Hospital and Medical School, Dundee. The subjects were referred to the Nine-wells colposcopy clinic between January 1, 1985, and December 31, 1990. The results showed many women with high grade squamous intraepithelial lesions (SILs) (CIN 3) and cytology revealing abnormalities milder than severe dyskaryosis, for an average of 71.9% over the six years of the study. The referral of women for colposcopic assessment if they have persistent smears showing mild dyskaryosis suggestive of low grade SILs seems to be worthwhile.

Biopsy, Needle↗