Biomedical subjects
Publications and source records attributed to H Monaghan.
Reflex sympathetic dystrophy is characterized by severe pain and autonomic dysfunction in a limb, usually after an injury. We describe a patient with childhood reflex sympathetic dystrophy with unilateral Beau's lines on the nails of the affected hand. Unilateral Beau's lines have not been described previously in this condition to our knowledge, and we discuss their possible pathogenesis.
Synovial fluid and peripheral blood mononuclear cells from juvenile chronic arthritis (JCA) patients have previously been shown to exhibit substantial proliferative responses to both human and mycobacterial heat shock protein (hsp) 65. We investigated the nature of the antibody response to mycobacterial and E. coli hsp 65 and human and E. coli hsp 70 in 56 JCA patients using an ELISA. Elevated levels of antibodies to both human and E. coli hsp 70 were demonstrated. With hsp 65, raised levels of antibodies to the mycobacterial but not the E. coli protein were detected. Overall, 48% of patient serum samples contained antibodies of at least one isotype to mycobacterial hsp 65. These antibodies were predominantly of IgG and IgM isotype, a finding in contrast to adult rheumatoid arthritis, where IgA and IgG isotypes are most often detected.
Inflammatory mediators have been implicated in the stimulation of decidual prostaglandin (PG) production during infection-driven preterm labour. The aim of the present study is to investigate a potential interaction between interleukin-1 beta (IL-1) and bradykinin (BK) in the regulation of decidual PGF2 alpha production and PG precursor release. Pretreatment of primary decidua cell cultures with IL-1 significantly enhanced PGF2 alpha production in response to BK. This effect was accompanied by an increase in unesterified arachidonic acid and an enhanced turnover of arachidonoyl phosphatidate. Bradykinin also stimulated arachidonic acid release in decidual fibroblasts, an effect which was potentiated in the presence of epidermal growth factor (EGF), but which was not accompanied by an increase in PGF2 alpha production. Decidual fibroblasts pretreated with IL-1 manifest a 10-fold increase in PGF2 alpha production in response to BK and EGF. These observations provide the first description of synergism between cytokine, kinin and growth factor in the uterine decidua which may partly mediate the in vivo increase in prostaglandin production associated with decidual activation and infection-driven labour.
The endocrine and intracellular mechanisms regulating prostaglandin precursor release in the uterine decidua during labor are unknown. This in vitro study investigates a potential role for a kallikrein-kinin system in the activation of phospholipid hydrolysis and arachidonic acid release in human decidua cells. Primary cultures of human decidua cells were prelabeled with [3H]inositol or [14C]arachidonic acid to monitor phosphoinositide hydrolysis and prostaglandin precursor release, respectively. Bradykinin (100 nmol/L) stimulated a rapid release of arachidonic acid (within 2 min) associated with an increase in inositol trisphosphate which was detectable after 20 s. Protein kinase C activation by phorbol ester enhanced arachidonic acid release in response to both bradykinin and the Ca++ ionophore A23187 but inhibited bradykinin-stimulated phosphoinositide hydrolysis. Epidermal growth factor also enhanced arachidonate release in response to both bradykinin and A23187. Kallikrein stimulated both phosphoinositide hydrolysis and arachidonic acid release in decidua cells. Kallikrein action was inhibited by the kallikrein protease inhibitor aprotinin and D-Arg[Hyp3Thi5,8,D-Phe7] bradykinin, a B2 receptor antagonist. Bradykinin also stimulated prostaglandin F2 alpha production in both primary decidua cell cultures and fibroblasts in the presence of interleukin-1 beta. These findings are consistent with a mediatory role for bradykinin in the action of kallikrein on decidua cells and suggest that inositol phospholipid hydrolysis is instrumental for arachidonic acid release in response to bradykinin in these cells. This study supports a novel role for a kallikrein-kinin system in the human uterine decidua.
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A case of the neuroleptic malignant syndrome, an idiosyncratic response to neuroleptic drugs, is described. Symptoms persisted for eight weeks. The stopping of neuroleptics and general supportive measures are the mainstay of treatment. Failure to recognise this syndrome can lead to morbidity and death.
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The finding of elevated HbA1 levels in two galactosemic infants of 24.1% and 23.8% (normal 6.3-8.2%) led to an assessment of the effects of dietary management in galactose-1-phosphate uridyl transferase deficiency and galactokinase deficiency. Exclusion of dietary galactose and lactose in the two propositi resulted in a reduction of HbA1 levels to normal in one and towards normal in the other. HbA1 was measured in twelve treated subjects with transferase deficiency, seven carriers, and one child te uridyl transferase deficiency and galactokinase deficiency. Exclusion of dietary galactose and lactose in the two propositi resulted in a reduction of HbA1 levels to normal in one and towards normal in the other. HbA1 was measured in twelve treated subjects with transferase deficiency, seven carriers, and one child te uridyl transferase deficiency and galactokinase deficiency. Exclusion of dietary galactose and lactose in the two propositi resulted in a reduction of HbA1 levels to normal in one and towards normal in the other. HbA1 was measured in twelve treated subjects with transferase deficiency, seven carriers, and one child with galactokinase deficiency. Five transferase deficient children had elevated HbA1 levels, and four of these agreed to a six week strict dietary exclusion of galactose and lactose. This trial resulted in a fall in HbA1 levels in all subjects (mean 12.6% to mean 9.2%). These results suggest HbA1 levels may be of value in assessing and ensuring dietary compliance in galactosemia.
Of 435 infants with diarrhoea aged under one year, 6% were found to have Giardia lamblia; the incidence ranged from 3% housed infants to 12% in itinerant infants. All infants had duodenal fluid and faeces examined. Infants under 12 weeks may experience severe diarrhoea in association with infection by this parasite, but seem more likely to respond to metronidazole than older infants.
PURPOSE: To describe an unusual patient who presented with hemi-retinal vein occlusion and lymphomatoid papulosis (LyP). METHODS: Clinicopathological case study. RESULTS: A 42 year old female patient presented with blurring of vision in her left eye and a nodular eruption of the skin involving arms, face and torso. She also complained of a non-itchy, blotchy rash on the arms, face and torso lasting for period of three months. Ocular examination showed a left superior hemi-retinal vein occlusion. The nodules resolved spontaneously over a period of two-three weeks leaving a faint scar. Hematological and systemic evaluation for auto-immune disorders, hypercoagulability, systemic malignancy and lymphoma were negative. A biopsy of the skin nodule was performed which showed infiltration of lymphoid blast cells which were CD30 positive. Based on the clinicopathological features a diagnosis of lymphomatoid papulosis (LyP) was made. CONCLUSIONS: Clinical and pathological features of this patient may suggest the retinal vein occlusion may be secondary to LyP.
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As nurses working with older patients, the authors noticed a marked increase in the use of subcutaneous fluid administration as an alternative to the more traditional intravenous route, as a means of managing hydration in certain patients.