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Biomedical subjects

M O'Brien

Publications and source records attributed to M O'Brien.

At least 73 records · Page 4Linked to original sources

Blast crisis of chronic granulocytic leukemia with mast cell and basophilic precursors.

The authors report a patient with Ph1-positive chronic granulocytic leukemia (CGL) who developed "blast crisis" after six years of chronic phase. The presence of mast cell precursors and basophil blasts was demonstrated by ultrastructural morphology and cytochemistry. Membrane phenotype studies with monoclonal antibodies helped in the further characterization of these cells. The possible implication of these findings in the origin of mast cells and the relationship of these cells with basophils are discussed.

Adult

Characterization of blast cells in chronic granulocytic leukaemia in transformation, acute myelofibrosis and undifferentiated leukaemia. I. Ultrastructural morphology and cytochemistry.

A systematic analysis of the blast cell population was carried out on samples from 50 patients suffering from blast transformation of chronic granulocytic leukaemia (CGL) (31) and of myelofibrosis (4), acute myelofibrosis (AM) (11) and undifferentiated acute leukaemia (4). Transmission electron microscopy (TEM), used in 41 samples, included: morphology and techniques for myeloperoxidase (MPO), platelet-peroxidase (PPO) and acid phosphatase (AP). The majority of cases were also studied by light microscopy cytochemistry and with a battery of cell markers which are reported in the accompanying paper (San Miguel et al, 1985). The characterization of the type(s) of proliferating blasts was made from the integration of ultrastructural and immunological data. TEM morphology allowed the precise recognition of specific granules in basophil and mast-cell precursors and of ferritin particles in blasts of erythroid lineage; these rare cell types were not adequately characterized by other methods. The PPO reaction made possible the identification of pure megakaryoblastic proliferations in 38% of cases, including eight of the 11 with AM; megakaryoblasts were also present in nine of 12 cases with mixed blast cell types. The MPO and AP reactions were useful for the characterization of myeloblasts and monoblasts, respectively. Lymphoblasts could be distinguished from other cell types by TEM morphology and negative MPO and PPO reactions. TEM techniques were valuable for diagnosing correctly the type of blast cell in this study in which only four cases (8%) remained unclassifiable.

Acute Disease

Osteolytic lesion as the presenting feature of chronic granulocytic leukaemia.

We describe a woman in whom the first manifestation of chronic granulocytic leukaemia (CGL) was an osteolytic lesion. Six months later the peripheral blood showed the picture of CGL in blast crisis. Chromosome studies confirmed the diagnosis and immunological and ultrastructural studies demonstrated the presence of two blast populations: basophil blasts and megakaryoblasts.

Aged

Modified taurocholate-tellurite-gelatin agar for improved differentiation of Vibrio species.

A total of 78 strains, representing 21 Vibrio species, were examined by using taurocholate-tellurite-gelatin agar (TTGA) medium and modified TTGA medium containing 4-methylumbelliferyl-beta-D-galactoside (150 micrograms/ml). Modified TTGA medium allowed for simple and direct detection of beta-D-galactosidase (beta-gal) activity. This feature, in conjunction with other differential characteristics of TTGA medium, gave improved differentiation of the vibrios tested. The modified TTGA medium allowed for easy differentiation of Vibrio cholerae (beta-gal+) from Vibrio parahaemolyticus (beta-gal-). The 4-methylumbelliferyl-beta-D-galactoside substrate is inexpensive and very stable. Incorporation into the agar did not affect the performance of TTGA as a differential medium. The assay for beta-gal activity with this substrate was specific and sensitive.

Agar

Psychological, nutritional and physical status of olympic road cyclists.

Six members of the Irish Olympic Road Cycling Squad underwent a comprehensive medical, nutritional, psychological and biochemical assessment in January 1983. They were given specific medical and dietary recommendations and were reassessed in January 1984 after a period spanning the competitive racing season. The cyclists' diets at both sessions were comparable and generally conformed with recommended daily intakes. Supplementary ingestion was unnecessary to attain recommended daily intakes of vitamins. Serum levels of HDL-cholesterol increased and triglyceride decreased during the period of the study. The squad had characteristics indicating traits of self-sufficiency, toughness and practical mindedness. At the second assessment there was evidence of heightened ambition and competitiveness and an improvement in mood states with reduced ratings for confusion and tension.

Adult

Breech delivery: evaluation of the method of delivery on perinatal results and maternal morbidity.

A retrospective study of 460 single-gestation infants in breech position was conducted at the University of Colorado Medical Center to assess the impact of a policy for the selection of cases for vaginal delivery. Among infants weighing more than 2,500 grams, there was an increase in the cesarean section rate from 13% to 54%, with an associated increase in maternal morbidity from 7% to 15%. This occurred with no significant reduction in adverse perinatal outcome. However, a case-by-case review suggests that more frequent and timely cesarean sections would have further reduced perinatal morbidity and deaths among term infants. Among the infants weighing 2,500 grams or less there was an increase in cesarean births from 5% to 55% following the introduction of the strict criteria for vaginal delivery. Among the infants weighing 1,501 to 2,500 grams there was no significant difference in survival between the cesarean and vaginally delivered patients. Although infants weighing 501 to 1,500 grams delivered by cesarean section survived more frequently than did those delivered vaginally, the differences in perinatal deaths may have been due to a higher birth weight in the cesarean-delivered infants or an over-all improvement in neonatal intensive care for infants of very low birth weight.

Apgar Score

Direct tissue isoelectric focusing in agarose.

We are isoelectric focusing small amounts of tissues placed directly on electroendosmosis-free agarose gels instead of using the saline extracts of tissue homogenates. More numerous proteins are extracted during isoelectric focusing of the solid tissues than present in the same tissues.

Adenocarcinoma

'Prolymphocytoid' transformation of chronic lymphocytic leukaemia.

We report clinical, morphological and surface marker studies on seven patients with the common type of chronic lymphocytic leukaemia (CLL) whose disease underwent an insidious though progressive change in character with increasing refractoriness to treatment. This transformation was accompanied by the appearance of a population of immature-appearing cells in the peripheral blood which resembled prolymphocytes, both at light and electron microscopy. The characteristic morphological feature was the presence of two distinct populations of cells, the typical CLL lymphocytes and the 'prolymphocytoid' cells. These cells retained the surface characteristics of CLL, i.e. the information of mouse RBC rosettes and sparse surface-bound immunoglobulin. This transformation can be distinguished by morphological and surface marker criteria from acute leukaemia occurring in CCL, Richter's syndrome and prolymphocytic leukaemia. The recognition of this group of CLL patients may add a new prognostic index to CLL and may help plan subsequent trials for the treatment of the disease.

Aged

A pilot study on left ventricular dimensions and wall stress before and after submaximal exercise.

Left ventricle dimensions and wall stress were measured echocardiographically before and immediately after exercise in 14 athletes and 7 control subjects. Our findings suggest that afterload is an important determinant of cardiac performance and wall hypertrophy in athletes. In spite of major changes in heart rate and blood pressure, left ventricular wall stress remains unchanged following submaximal exercise, in trained and untrained hearts. It would appear that the changes in heart size during exercise are to a large extent limited in untrained ventricles, as smaller left ventricular dimensions are required, to "normalise" wall stress. This results in a lower stroke volume for a given stroke dimensional change. Consequently cardiac output is a function of heart rate rather than stroke volume in untrained subjects. The effect of increased muscle mass in athletes, is to permit larger left ventricular dimensions for a given afterload, thus stroke volume can be augmented. The increase h/R ratio suggests that afterload is more important than preload in the development of left ventricular hypertrophy in rowers and swimmers.

Adolescent

Management of ventricular shunt infections.

The authors report the incidence (2.7%) of shunt infection in a series of 778 consecutive shunt procedures. The management of these infections and an additional group of infected patients operated elsewhere is discussed. A protocol is given for the treatment of external infections, gram-positive internal infections and gram-negative internal infections.

Anti-Bacterial Agents

Ultrastructural, cytochemical and surface marker analysis of cells during blast crisis of chronic granulocytic leukaemia.

The blast cells of 19 patients with Ph1-positive chronic granulocytic leukaemia (CGL) in blast crisis (BC) were studied by means of several techniques: morphology, cytochemistry, ultrastructure, surface markers and the enzyme terminal transferase. Cells of BC were, in most case, extremely undifferentiated by morphology and cytochemistry. Our data showed that in 80% of cases the cells in BC were myeloid and in 20% they were "lymphoblastic". The M1, M2 and M3 forms (FAB classification) were rare in CGL BC compared with acute myeloid leukaemia (AML). A megakaryoblastic type was seen in 15% of BC cases; the existence of this form could only be demonstrated by electron microscopy. The limphoblastic BC cells were, as in acute lymphoblastic leukaemia (ALL), positive with Greaves' anti-ALL serum and had elevated levels of terminal transferase. A case of a 17-year old boy presenting as ALL, reverting to chronic-phase CGL after complete remission and developing terminally a myeloid BC is described in detail. This case helps to illustrate a new form of natural history of CGL unveiled by the present study.

Adolescent