Biomedical subjects
Publications and source records attributed to J Hammond.
For some burn victims who are recognized early to be nonsurvivors, the decision to "make comfortable" is a treatment option. The guidelines for a "do not resuscitate" order must be based on an individual center's experience, but general principles can be formulated.
Twelve different potyviruses and cytoplasmic inclusion proteins were purified from a range of plant species utilizing a single purification protocol. Highly purified preparations have been obtained with yields that reflect the relative concentrations in the starting material; virus yields of up to 15 mg per 100 g of tissue were obtained. In some cases aggregation resulted in losses of significant amounts of virus to the inclusion fraction; this varied among preparations of the same virus. Preparations obtained from cesium gradients were typically unaggregated and essentially free of host materials. Purified virus was suitable for the production of antisera with high specific titers and low titers against healthy plant antigens. Both purified virus and RNA prepared from the virus retained infectivity. Purified RNA was free of detectable host plant nucleic acids, as complementary DNA preparations synthesized using virion RNA as template were highly virus-specific.
We have reported the unusual finding of a grossly bile-stained peritoneal lavage 24 hours after blunt abdominal trauma, associated with neither enteric, hepatic, nor biliary tract injury at laparotomy. Intraoperative transcholecystic cholangiography is recommended in such a situation to rule out biliary tract injury.
Six families with at least one infant each with confirmed ornithine transcarbamylase deficiency were investigated by DNA analysis. All the affected sons had died, and no DNA had been stored. Using the restriction endonucleases MspI and Bam HI three restriction fragment length polymorphisms were detected which led to eight distinct haplotypes. Using these results and those of protein loading tests that diagnosed heterozygote (carrier) status in some family members, some carriers were detected, and prenatal diagnosis was offered to two families. In two further families no polymorphisms were found and no prenatal diagnosis was possible. In the remaining two families prenatal diagnosis was impossible because of the lack of DNA from an affected or unaffected son, or in one case from the father, of an obligate carrier. These studies emphasise the importance of preserving tissue for DNA extraction from infants dying of inborn errors of metabolism, and also show the way in which information from conventional biochemical studies can complement diagnostic tests using DNA.
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A case of sialuria is described in a girl who presented in the neonatal period with hepatosplenomegaly, and who has moderate developmental delay at the age of 2 years. There was massive urinary excretion of free sialic acid (N-acetylneuraminic acid). The clinical, biochemical and ultramicroscopical features were distinct from those described in Salla disease and in infantile sialic acid storage disorder.
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A family is presented in which 7 members over 3 generations were affected by cardioskeletal myopathy. A vacuolar myopathy with excessive free and intralysosomal glycogen storage in skeletal and cardiac striated muscle was identified in biopsy studies. Post-mortem studies in several patients revealed changes of a congestive cardiomyopathy with myocardial fibrosis. Acid maltase, phosphorylase, debrancher and lysosomal enzyme screens, and glycolytic enzyme levels in skeletal muscle, were normal in 1 case. This is the third report of non-acid maltase deficient lysosomal glycogen storage disease and adds to previous reports with the presentation of detailed family studies, examined of ante- and post-mortem cardiac histology and reports of detailed glycolytic and lysosomal enzyme analysis. This syndrome is unusual among glycogenoses in having a dominant inheritance pattern.
Significant cardiac complications among immediate survivors of high-voltage electrical injuries are less common than previously suspected. Transient arrhythmias predominate. The MB isoenzyme of serum creatine phosphokinase may be factitiously elevated within the first 48 hours after injury. In the absence of clinical symptoms or electrocardiographic signs of ischemia, early isolated elevation of this cardiac isoenzyme should not preclude an aggressive surgical approach.
Direct gene analysis was used in the prenatal exclusion of ornithine transcarbamylase (OTC) deficiency; karyotyping the family's previously affected child had already identified the defect as a small deletion. A cloned OTC gene and two other X chromosome-specific probes were mixed, and hybridised to fetal DNA obtained from cultured amniocytes; the fetus was shown to be a normal male.
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Because of the widespread use of ammonia in industry and agriculture there is a growing opportunity for ammonia burns to occur. Two fatal cases are presented. The injury is thermal as well as chemical, to skin, eyes, airway and lungs. Prompt (5-10 seconds) irrigation of the eyes is required, and immediate treatment of airway and pulmonary injuries. Fluid resuscitation and skin wound care are similar to that of other burns. Presence or absence of abnormal chest findings on admission is the best prognostic factor.
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To evaluate the risk to nurses of childbearing age of acquiring cytomegalovirus (CMV) infection during the care of patients at high risk of the infection, 374 female hospital employees (288 nursing personnel) were interviewed and screened for antibody to CMV. Fifty-six percent of the population surveyed had antibody to CMV as measured by an immunofluorescent assay. Among nursing personnel, analysis of antibody prevalence by job title, work area, and duration of work showed no association between seropositivity and either current or past exposure to "high-risk" patients, such as infants and immunosuppressed individuals. Age, race (non-white), and the number of pregnancies reported by participants were significantly associated with the presence of antibody. Among 73 employees of a children's hospital, the prevalence of CMV antibody was 41%. This survey suggests that hospital nursing is not a major risk factor for acquiring CMV infection. However, this finding needs further evaluation in a prospective study of seroconversion rates among seronegative nurses.
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