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Biomedical subjects

J L Emery

Publications and source records attributed to J L Emery.

At least 109 records · Page 6Linked to original sources
PubMed1977

Multistage scoring system for identifying infants at risk of unexpected death.

Obstetric and perinatal records have been assembled on 250 infant deaths and an equal number of live controls including 55 deaths associated with congenital anomalies. The information was used to construct a scoring system to identify high-risk infants at birth. Parents of 115 of the cases and their controls were also interviewed and all hospital, general practitioner, and health service records abstracted. Cases and controls were compared item by item in respect of all information available up to the age of one month and a scoring system constructed for use at one month. The 'at birth' and combined scoring systems are presented. The chance of death by age attained is presented for various risk groups. In a small prospective test, the multistage scoring system was nearly 50% more effective than the birth score alone.

ABO Blood-Group System↗
PubMed1976

Possibly avoidable deaths in hospital in the age-group one week to two years.

In a complete analysis of all infant deaths in hospital between the ages of 1 week and 2 years, over a two and a half year period in Sheffield 21 children (26%) were found to have died from treatable diseases. 15 (71%) of these children were admitted moribund but had shown no difference in preadmission clinical features from a group of children admitted with similar diseases but surviving. The essential difference between the infants who died and those who survived was in the adequacy of medical care before admission.

Attitude of Health Personnel↗
PubMed1976

Some quantitative morphological aspects of post-natal human cerebellar growth.

Using a Quantimet 720 image analysing computer, the cellularity of the external and internal granular layer and the molecular layer has been measured in standard blocks of the lateral and central lobes of the cerebellum of apparently normal children. The DNA content of the nerve cells has also been measured and related to post-natal age. Standard cell concentrations per unit area have been established from birth to 14 years. The different lobules of the central lobe show different patterns of cellular development but all lobules reach their fully mature cellularity by 2 years. The maximum cellularity of the internal granular layer is maintained for several years, after which there is an apparent progressive reduction in the concentration of cells per unit area. Alterations in the DNA staining properties of the cell nuclei of the internal granular layer during normal development are presented.

Adolescent↗
PubMed1976

Heterotopic dorsal-root ganglion cells around the spinal cord in children with spina bifida aperta.

Sixty-three of 95 cords from children with spina bifida aperta had associated heterotopic ganglion cells, usually located in dorsal nerve roots posterior or lateral to the cord. Heterotopic cells were more common in cords with complete or partial diplomyelia, and the largest number was found in the upper sacral region. It is proposed that the heterotopic position of the cells is due to abnormal and delayed migration of neural crest cells during primary neurogenesis. The findings lend support to the concept that in children with myelomeningocele the cord lesion is not due to secondary rupture.

Child↗
PubMed1976

Gliosis and aqueductule formation in the aqueduct of Sylvius.

A study was made of the cerebral aqueducts of 30 children with hydrocephalus but without myelomeningocele. A sequence of events is demonstrated which suggests a mechanism of aqueductule formation and burial of ependymal cells. The cellularity of areas of gliosis may normally decrease and resemble normal neural tissue, but occasionally activity is perpetuated by continuing irritants. The only evidence of gliosis long after the event may be the presence of buried ependymal cells or aqueductules, The presence of a small aqueductal 'ghost' and ciliated columnar epithelial lining suggests an intra-uterine timing of the insult.

Cerebral Aqueduct↗
PubMed1976

Fatty change in the brain in perinatal and unexpected death.

The presence of fat-laden cells in the cerebrospinal fluid is usually associated with a fatty change found particularly in the area of the tapetum in the postnatal infant. In a series of 307 child deaths the presence of fatty change in this area of the brain was age-related, decreased with age, and was rarely present over the age of 4 years. It was particularly common in stillborns and in children dying with respiratory distress, but was rare in children dying from acute surgical conditions or from acute infections. It was found in one-half of a series of 41 infants found unexpectedly dead and in whom no adequate cause of death was found. The most likely cause of this fatty change is thought to be chronic hypoxia.

Brain↗
PubMed1976

Quantitative morphological studies of developing human cerebellar cortex in various disease states.

A quantitative morphological assessment was carried out of the cellularity and staining properties of the cells of the layers of the human cerebellar cortex, both in the normal child and in 41 children suffering from a series of disorders including mental retardation. A computerized image analyser and highly standardized procedures were used. All of the cases of mental retardation and some cases with congenital cardiac anomalies showed abnormal cell concentrations and staining properties. 3 cases of 'cot death' also showed abnormal results. These findings are presented as a new measurable aspect of brain disease, and as a indication for further study.

Cerebellar Cortex↗
PubMed1976

Development of germinal centres in the spleen in infants related to birth and unexpected death.

The development of germinal centres in the spleen has been estimated in a series of 266 children dying in hospital and 205 children presenting as unexpected death in infancy. The prevalence of germinal centres in the spleen increases rapidly after birth. The percentage of Malpighian bodies showing germinal centres in the spleen is greater in all categories of our classification of death in children dying unexpectedly at home when these are compared with hospital deaths. It is concluded that the children presenting as unexpected death in infancy show no evidence of any deficiency in cellular immunological response and may well have been subjected to increased or precocious antigenic stimulation.

Age Factors↗
PubMed1976

Cartilage in children's lungs: a quantitative assessment using the right middle lobe.

The amount and development of cartilage in the lungs of 150 children dying between 24 week's gestation and 12 years has been studied using standard sections of the right middle lobe. Both the cartilage-bearing bronchi and the cartilage fragments increase in number until approximately two months after birth, after which time a constant level is maintained. There is a progressive increase in the total area of cartilage in the child's lung during infancy and childhood, and this appears to be more directly related to the crown-rump length of the child than to its age. Percentiles of the quantity of cartilage found in the standard lung sections are presented.

Age Factors↗
PubMed1976

Squamous metaplasia of the tracheal epithelium in children.

Thirty-seven (1-6%) tracheas from 2170 children showed squamous metaplasia. (Cases with tracheo-oesophageal fistula and congenital heart disease were excluded). The metaplasia extended into the bronchi in 15 cases. Features of pulmonary retention were present in seven cases. Respiratory infection, probably viral, seemed to be the most significant causative factor in 20 children, including those with cystic fibrosis. Tracheal instrumentation was a possible factor in 11 cases but oxygen therapy alone did not seem important. The metaplasia was almost certainly congenital in one child and probably in two others but no stillborn infants showed metaplasia. In many children the metaplasia seemed to be due to a combination of factors.

Child↗
PubMed1976

Inclusions in the human thyroid.

A survey of the thyroids of 350 infants and children suggests that the presence of thymus and parathyroid tissue within the thyroid is so common as to be classified as normal. One in a hundred thyroids contains masses of cartilage, and one in a hundred shows small foci of ciliated epithelium. Compact masses of dark-staining cells that bear a resemblance to primitive follicular plate cells are also so common as to raise the possibility of their being a normal component with, possibly, an endocrine function. It has been suggested that they produce calcitonin, but this could not be confirmed. Peculiar granular cells replacing follicle cells were also noticed.

Adipose Tissue, Brown↗
PubMed1975

Ulceration and necrosis of vocal cords in hospital and unexpected child deaths.

Lesions are described in the vocal cords of an unselected group of 91 infants dying as "cot deaths", 11 stillbirths and 107 infants and children dying from conventional diseases. The lesions have been classified into six types. After allowances for the effects of intubation, the same incidence and type of change was present in all but the stillbirths. This argues against them being a specific pathogenic mechanism confined to the cot death situation. The aetiology and pathogenesis are unexplained but indicate the existence of an unsuspected laryngeal disorder that merits further study in mechanism leading to child death.

Autopsy↗
PubMed1975

Confluent lymphoreticular aggregates in the bronchi of children--'mural bronchitis'.

A study of a random series of 503 lungs from children of all ages and comprising a cross-section of almost all deaths in children in Sheffield shows that 'mural bronchitis' is not seen at birth but increases progressively with post-natal age. These lesions bear no relationship to unexpected death in infancy. They are probably a normal component of children's lungs, and an indication of bronchus associated lymphoid tissue. There is a positive correlation between the presence of prominent lesions and long-standing history of respiratory symptoms.

Adolescent↗
PubMed1975

A quantitative study of the cell population of the cerebellum in children with myelomeningocele.

A quantitative assessment has been carried out on the cell populations and DNA content of the cells in the internal granular layer of the central lobes of the cerebellum from 100 children with myelomeningocele and from 120 normal controls. The method used was a computerised analysis of a television image of the neurones in standardised sections. The cell and DNA complement of the declive and central lobe are only slightly reduced in the cases of myelomeningocele, but there is frequently cellular and DNA loss throughout the pyramid and uvula to the nodule. These findings suggest that the central lobes of the cerebellum are probably genetically normal but have irregular degeneration and arrest of growth, probably as an effect of pressure at the foramen magnum.

Age Factors↗
PubMed1975

The tectum and the aqueduct of Sylvius in hydrocephalus unassociated with myelomeningocele.

The brains of 30 children with hydrocephalus (but not myelomeningocele) were examined. It was found that secondary pressures on the tectum and aqueduct resulting from the hydrocephalus were responsible for further obstruction at this level in 15 of the 30 children and that they contributed to axial distortion in another 11 children. Occlusion of the aqueduct occurred as a result either of these external pressures or of internal gliosis. These events form a self-sustaining cycle which, if broken early, may lead to a more satisfactory control of the hydrocephalus.

Cerebral Aqueduct↗
PubMed1975

Unexpected postneonatal deaths (cot deaths) due to recognizable disease.

At least a quarter of the babies dying as unexpected home 'cot deaths' do so from recognizable diseases. A study of the background of such children, compared with age and admission controls, suggests that the disease symptomatology in this group of children differs in no way from children who are successfully treated. The factors leading to the death of these children appear to lie in the general lack of ability of some parents to recognize the importance of symptoms, their negative attitude and inability to avail themselves of health services, and the amount of drive and persistence required to obtain general medical practice services in some areas. There is also the failure of some practitioners to recognize severely ill children.

Acute Disease↗