Biomedical subjects
Publications and source records attributed to M Elliott.
Two neonates with aneurysms of the ductus arteriosus were seen. One suffered a fatal spontaneous rupture of the aneurysm, and the second (in which it was an incidental finding) the aneurysm was monitored by echocardiography, and seemed to resolve spontaneously.
Many investigators have shown that a small proportion (13-36%) of subjects with nontrophoblastic gynecological cancers have elevated serum levels of human chorionic gonadotropin (hCG). The low proportion with detectable levels and the accompanying low titers have limited the use of hCG as a tumor marker. hCG is a glycoprotein composed of two noncovalently linked subunits (alpha and beta), which are the products of separate genes. With the intent of expanding the use of hCG as a tumor marker we investigated levels of hCG free beta-subunit and asialo free beta-subunit and its core glycopeptide (composed of beta-subunit residues 6-40 disulfide-linked to 55-92), collectively called urinary gonadotropin fragments (UGF), in healthy and cancer patients. An immunoradiometric assay was developed, using the core glycopeptide-directed antibody B204, that similarly measures the hCG free beta-subunit and the asialo free beta-subunit and its core glycopeptide. Parallel urine and serum samples were collected from 87 women with active gynecological cancer and hCG and UGF were measured. Just 18% of the women tested had detectable serum levels of hCG (greater than 0.2 ng/ml); none had elevated serum levels in the UGF assay (greater than 0.2 ng/ml). Of the same group, 32% had detectable urine hCG levels (mean titer, 0.50 ng/ml) and 74% exhibited elevated urinary levels in the UGF assay (mean titer, 2.0 ng/ml). In a control group (urines from 50 nonpregnant healthy women), 47 negative and three borderline positive results (0.30, 0.35, and 0.48 ng/ml) were observed in the UGF assay. These results suggested a sensitivity of 74% and specificity of 92% for the UGF test for gynecological cancers. By disease, 70% of those with cervical, 73% of those with ovarian, and 77% of those with endometrial cancers had detectable UGF levels (greater than 0.2 ng/ml). By stage, 50, 62, 75, 86, and 100% of those with stage 1, 2, 3, 4, or recurrent disease, respectively, had positive results. UGF is a promising new marker of gynecological malignancies.
A survey to find out the standard of sterilisation of dental equipment was conducted via a questionnaire sent out to all Division I dental surgeons in Singapore. Questions asked determined the main methods of sterilisation/disinfection of hand instruments, air rotor and air motor handpieces, burs, salivary ejectors, ultrasonic scaling tips, and the use of disposable needles, local anesthetic, carpules, and gloves. Results indicated that while most respondents sterilised or disinfected various instruments, there was an apparent misconception that sterilisation and disinfection were the same thing. The majority used boiling with water or cold chemical disinfection. Most respondents were willing to treat patients with known histories of hepatitis B but would refer patients with histories of Acquired Immune Deficiency Syndrome (AIDS).
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A small molecular weight factor, derived from bovine bone ('matrigenin'), stimulated glycosaminoglycan and proteoglycan synthesis of cultured human fibroblastic cells but not of mononuclear cells from human blood. However, proteoglycan synthesis and secretion by the mononuclear cells was stimulated by the addition of concanavalin A. The proteoglycan from the concanavalin-A-stimulated mononuclear cells was of smaller molecular weight than the proteoglycan from the 'matrigenin'-stimulated fibroblastic cells. The major increase in proteoglycan synthesis and secretion occurred much later during the culture period for concanavalin-A-stimulated mononuclear cells than for 'matrigenin'-stimulated fibroblastic cells.
This study is one of the very few which examines observers' evaluations of photographs of faces taken before and after relatively minor facial reconstructive surgery. Observers of over thirteen years of age judged the 'after' operation faces to be significantly more attractive, intelligent and happy than the 'before' faces. The judgements of observers aged under twelve years were not affected, thus suggesting that adult negative stereotyping of abnormal faces is due to social-learning. The results of this study lend weight to the argument that those who wish to have their facial abnormalities reduced may be accurately reporting that society is unkind to them. The evidence does not support the view that people wishing to have facial abnormality reduction must, by definition, be neurotic phantasizers.
The authors emphasize the recent advances in breast reconstruction provided by use of the skin expander device. A Silastic percutaneous skin expander developed by the authors and the Dow Corning Corporation has been used by them in breast reconstruction for the past 7 years with satisfactory results. Important design differences in the device suggested by the authors include the use of a reinforced backing which consists of Dacron Silastic sheeting extending beyond the inflatable tear-drop-shaped envelope for approximately 3/8 of an inch, thus adding strength and rigidity to the envelope and the rim, and making it possible for the rim of the expander implant to be sutured in an appropriate orientation.
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Continuous monitoring of blood glucose concentration was compared with frequent intermittent sampling in 12 non-diabetic adult patients undergoing open-heart surgery with cardiopulmonary by-pass using priming fluids free of glucose. Continuous monitoring revealed several changes which were not detected on intermittent sampling. Blood glucose concentration decreased by 2 mmol litre-1 +/- 0.5 (SEM) (P less than 0.01) immediately on the institution of CPB, and increased during the succeeding minutes. Rewarming from hypothermic by-pass was associated with a 3 (+/- 0.5)-mmol litre-1 increase in blood glucose concentration (P less than 0.01). Commencement of infusions of sympathomimetic agents resulted in a similar increase.
A register of children born between 1970 and 1979 in the South East Thames Regional Health Authority, and diagnosed as having pre-, peri-, and postnatal cerebral palsy, was set up between 1978 and 1981. We report the 527 children born between 1970 and 1974 for whom ascertainment is virtually complete. The estimated prevalence was 2.2 per 1000, with 7.4% multiple births, and 58% boys. Birthweight distribution is as expected, with 35% weighing less than 2500 g at birth. Parental permission for release of detailed medical information was sought, and the clinicians responsible gave us data on the type of cerebral palsy; details of impairments, disabilities, and anticipated future prospects; and an opinion on the probable timing of the cause. There was a high incidence of orthopaedic defects which must represent a considerable use of resources, although the prevalence of hearing and vision defects suggested that some of these may be undetected.
Prostacyclin (PGI2) was administered by inhalation (50 micrograms/min) and intravenous infusion (15 ng/kg/min) in 5 healthy male volunteers. Irrespective of the route of administration this substance was shown to have no effects on respiratory indices studied, whereas a significant inhibition of ADP-induced platelet aggregation and a fall in vascular resistance could be demonstrated. Mainly because of the latter action it is suggested that PGI2, or a stable synthetic analogue, might become a potent drug in various pathological conditions, in which hypertension of various causes is a problem.
Guinea pig spermatozoa isolated from the epididymis were capacitated by incubation in phosphate buffered saline at 37 degrees C for 5h. and the acrosome reaction induced by addition of calcium chloride (10mM). There was no significant difference between the phospholipid compositions of freshly prepared, capacitated or acrosome reacted spermatozoa. However, the % of the aminophospholipids available to trinitrobenzene sulphonate in the external medium was increased significantly in capacitated and acrosome reacted spermatozoa compared with freshly isolated spermatozoa. These observations are consistent with the morphological observations of others and suggest that on capacitation there is a change in the arrangement of phospholipids in the plasma membrane of spermatozoa to increase the concentration of fusogenic phospholipids in the outer leaflet.
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An osmotically driven minipump continuously delivering 19 microU of pork insulin daily (6 microliter/day) was implanted subcutaneously into the upper thigh of a rhesus monkey fetus in utero at 122 days of gestation. A female infant weighing 408 g was delivered spontaneously and prematurely at 141 days of gestation. Within 6-12 hours of birth, she was in shock with signs of hypoglycemia. A radiograph of the chest showed normal lung aeration. Her blood glucose was undetectable (less than 1 mg/dl) and plasma insulin was 130 microU/ml at 12 hours. The minipump was removed, and the monkey was treated with 50% dextrose orally (2.5 g/kg body weight). The infant recovered and had a normal rate of growth thereafter. There was no neurological impairment consistent with hypoxia or hypoglycemia. Subsequent plasma glucose and insulin levels determined at various intervals were within normal limits.
It was the aim of the present three series of investigations to determine conditions to improve the firmness of the clot produced by the fibrinogen-thrombin adhesive system. For methodological reasons the compressive strength and adhesive power of the clot, as well as the probability of a relation between deformation energy and tensile strength were examined. Furthermore, the influence of fibrinolysis on the effects of the adhesive system was investigated. The following factors proved to be relevant for the firmness of the clot: 1. Concentration of fibrinogen, 2. concentration of thrombin, 3. relation between volume of fibrinogen and of thrombin solution, 4. time of diffusion of constituents of mixture, 5. addition of blood-clotting factor XIII and solution of calcium ions. The following optimum concentrations of components of the adhesive system per ml of the mixture were established in the course of the investigations: Fibrinogen solution (approx. 10% clottable material) 0.86 ml Thrombin 100 E. Factor XIII 90 E. = 30 mg Ca++ 250 mMol A volume ratio of 6 parts of fibrinogen as cryoprecipitate to 1 part of a solution containing thrombin, factor XIII and calcium ions proved optimal for the preparation of the mixture.