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Biomedical subjects

J M Edwards

Publications and source records attributed to J M Edwards.

At least 145 records · Page 8Linked to original sources

Mixed vascular deformities of the lower limbs, with particular reference to lymphography and surgical treatment.

A series of patients with congenital blood and lymph anomalies of the lower limb investigated and treated at St Thomas's Hospital, London, are reviewed. They fell into three classes: (1) those in which the venous element predominated (Klippel and other syndromes), (2) those with arteriovenous shunts and (3) those with angiomas of blood or lymph vessels scattered through the limb (diffuse mixed angiomas). Most of the patients were investigated by angiography (of blood or lymph systems) as well as by plethysmography, dermal temperature measurements and other techniques in the thermal laboratory. Phlebography showed most abnormalities in the Klippel group and was useful in delineating them before operation. The importance of confirming the existence of an adequate deep venous circulation prior to ablation of abnormal superficial vessels is emphasized. Arteriography showed most abnormalities in the group with suspected arteriovenous shunts. The most commonly performed operations in this group were for control of overgrowth of the limb or for ulceration. Lymphography showed many of the Klippel group to suffer from insufficiency of the main pathways, either aplasia or hypoplasia. In addition many had vesicles, fistulas and lymph cysts. Patients in the arteriovenous shunt group had large hyperplastic lymph pathways, which were possibly either congenital or a hypertrophic response. One hundred and thirty-eight operations were performed in 46 patients for a variety of lesions and disabilities. These are reviewed. The scope and benefit of surgery in these children are greater than has been accepted in the past. Three patients required amputation of a limb. There were 5 deaths in the series, 4 of these being in the scattered angioma group and in patients in whom the deformities extended beyond the limb into the trunk.

Adolescent↗

Correlation between serological and immunofluorescence results in the investigation of brucellosis in veterinary surgeons.

Four serological tests and three immunofluorescence tests for IgG, IgM, and IgA were compared for value in the investigation of brucellosis in veterinary surgeons. No one serological test stood out over the others, and the immunofluorescence tests did not appear to have advantages over the serological tests. If a laboratory is limited in time and resources then the saline agglutination or the complement fixation test would be reasonably satisfactory. The 2-mercaptoethanol test and the antihuman globulin (Coombs' test) have no advantages over the other two and could be dropped. Immunofluorescence tests are not recommended for routine testing of brucellosis sera. The results and these recommendations apply to the 'vet' sera tested; it is reasonable to suppose that what applies to 'vet' sera will also apply to sera of those who work with or are in repeated contact with cattle and who will have had previous experience of brucella antigen, that is, dairy farmers, herdsmen, or slaughter house employees.

Agglutination Tests↗

EB virus antibody and infectious mononucleosis in a boarding school for boys.

A study of EB virus antibody was undertaken in a boarding school for boys between 11 and 18 years of age; 35% of boys had EBV antibody when first sampled and a small number acquired antibody each year. Some of these boys had had no recorded illness during the period before the first positive sample and some developed classic infectious mononucleosis which was accompainied by a positive heterophil antibody test and detection of EB virus specific IgM. In a school of 800 boys there were 13 cases of infectious mononucleosis in four years.

Adolescent↗

Screening tests for hepatitis B antigen and antibody in two colleges of education and studies on the relationship between nonspecific positive antibody tests and EB virus infection.

Sera from 627 students entering Colleges of Education between 1969 and 1972 were tested for hepatitis B surface antigen and antibody. One was found positive for antigen, none for antibody. Six for 15 positive Hepanosticon results and two positive Hepatest results occurred in sera which also gave positive heterophil antibody tests indicative of current or recent EB virus infection. One of these six sera was still positive in the Hepanosticon test after one absorption, and one of two Hepatests gave no positive reaction with the control cells. Eleven of 14 sera from cases of infectious mononucleosis gave positive Hepanosticon results and two were still positive after one absorption. Seven were positive in the Hepatest and only three of these were positive with the control cells. The control tests in the Hepanosticon and Hepatest do not clearly identify all false positives due to Paul Bunnell antibody. It is suggested that when a positive result in a passive haemagglutination test can be removed by absorption or if positive after absorption cannot be confirmed by other tests for hepatitis Bs antigen, the patient from whom the serum specimen was taken should be investigated for indications of current EB virus infection.

Adolescent↗

Measurement of heterophil antibody and antibodies to EB viral capsid antigen IgG and IgM in suspected cases of infectious mononucleosis.

The EBV IgG titres in acute and convalescent specimens from 97 cases of infectious mononucleosis were compared with titres from acute and convalescent sera from 96 students with illnesses resembling infectious mononucleosis but without heterophil antibody, EB IgM or EB IgG seroconversion; and also with titres from 91 healthy students known to have had EB IgG antibody for at least six months. These titres were related to the titre of the Research Standard A.66/235 for infectious mononucleosis serum prepared by the National Institute for Biological Standards and Control. Serial sera were tested for heterophil antibody and EBVCA specific IgG and IgM from 61 university students with infectious mononucleosis. The period of persistence of heterophil antibody and EBV IgM after illness was outlined from the results of the tests. Single sera from 406 patients in hospital or general practice sent to the diagnostic laboratory for heterophil antibody tests were also tested for EBV antibodies without prior knowledge of the heterophil antibody result. The close agreement between heterophil antibody and EBV IgM results is shown. False positive EB IgM results were correlated with the presence of rheumatoid factor.

Antibodies, Heterophile↗

Brucellosis and veterinary surgeons.

Forty-six veterinary surgeons were given a full clinical examination, serological examinations with estimates of immunoglobulins, and supplementary haematological and radiological investigations. Thirty-five complained of one or more symptoms, and eight had abnormal physical signs which might have been caused by infection with Brucella abortus, but neither sereological tests results nor immunoglobulin estimates bore any special relation to the clinical features. The soundest way of assessing ill health which had possibly been caused by brucellosis seemed to be thorough clinical examination and disregard of serologican findings. Interpreting results by the usual serological tests in the absence of a clinical examination is probably of doubtful value and may even be misleading.

Adult↗

Studies on the diagnostic value of an immunofluorescence test for EB virus-specific IgM.

A modification of the test for EB virus/IgM introduced by Schmitz and Scherer (1972) is described. It is simple and gives reproducible results.EB virus/IgM was demonstrated in all but one case of infectious mononucleosis and in students with minor illness shown to have acquired EB virus/IgG recently. Unlike the EB virus/IgG, the IgM disappears within a few months. Although the Paul-Bunnell-Davidsohn test is still the test of choice for the diagnosis of infectious mononucleosis, the EB virus/IgM test could be useful to establish a diagnosis of current or recent EB virus infection where the Paul-Bunnell-Davidsohn test was negative or equivocal.

Fluorescent Antibody Technique↗