Since 1986 in vitro fertilisation and allied techniques have formed a part of the fertility service at St. James's Hospital. By June 1988 using routine methodology, IVF or GIFT has been attempted at least once in 94 women with a further 17 having one repeat procedure and 4 two repeat procedures performed. Although embryos were cultured from 54% of oocytes in which fertilisation was attempted, no pregnancies were achieved during that period with IVF. Ten pregnancies had occurred during a GIFT cycle (9 at first attempt, 16%) 60% of these are on-going. Also continuing were pregnancies where ovulation induction was abandoned on day 8 (1) and where conception occurred spontaneously whilst on the waiting list for the procedure (8) and in untreated cycles following the procedure (4) (16%). Seventy percent of patients who failed the first time expressed a wish to try again.

Female↗

PubMed1989

Cutaneous fibropapillomas of green turtles (Chelonia mydas).

Six juvenile green turtles (Chelonia mydas) from the Indian River Lagoon System, Florida, U.S.A., with multiple cutaneous fibropapillomas, were kept in isolation and examined over a 6-month period. Histologically, the fibropapillomas consisted of a slightly to moderately hyperplastic epidermis overlying a thickened hypercellular dermis. In the earliest lesions, ballooning degeneration was present predominantly in the stratum basale where rete ridges extended into the dermis; aggregates of mixed inflammatory cells were present around dermal vessels. As the lesions matured, they developed an arborizing, papillary pattern. More mature lesions had a less verrucous, often ulcerated surface, with the dermis composed primarily of large collagenous fascicles and relatively few fibroblasts. While numerous trematode eggs were present within dermal capillaries of a histologically similar biopsy specimen from an Hawaiian green turtle, no trematode eggs were observed in any of 28 biopsies examined from the six Florida green turtles in this study. Low stringency Southern blot hybridization and a reverse Southern blot failed to demonstrate papillomavirus DNA in any of the samples extracted. Ultrastructural evaluation of the earliest lesions demonstrated membrane-bound intracytoplasmic vacuoles within epidermal cells in the stratum basale. Similar vacuoles were also observed in the epidermal intercellular spaces and within the dermis. Occasionally, particles with electron-dense centres and measuring 155 to 190 nm were observed in these vacuoles.

Animals↗

PubMed1989

Diagnosis of autoerythrocyte sensitization syndrome in the emergency department.

Autoerythrocyte sensitization syndrome is characterized by sudden and spontaneous painful bruising and swelling occurring in young female patients with psychiatric disorders. This syndrome may present with such severe swelling of involved areas that aspiration or excision may be needed to relieve pressure. The presentation of this condition in the emergency department must be differentiated from more common coagulopathies. Differentiation from the self-mutilation disorder, which often presents to the ED, can be difficult. Although the pathogenesis is uncertain, purpuric lesions are reproduced by injections of washed red cell erythrocyte stroma, suggesting an autoimmune etiology. We describe a patient with recurrent bruising diagnosed in the ED who responded with classic inflammation to autologous injection of red blood cells.

Adult↗

PubMed1989

Dermoids ('hairy polyps') of the oro-nasopharynx.

Dermoids, or hairy polyps, are rare lesions affecting the head and neck region. To date approximately 120 cases have been recorded. They arise during early embryogenesis and are invariably benign. Unlike the more differentiated types of teratoma, hairy polyps are derived from only two germinal layers, ectoderm and mesoderm. Most originate in the oro-nasopharyngeal region, either as pedunculated or sessile masses. They usually present at, or soon after, birth with signs of upper aerodigestive tract obstruction. Treatment consists of surgical removal. In young children with airway compromise, the expertise of an experienced paediatric anaesthetist is essential. Three new cases of hairy polyp are described to add to the present literature. Two originated in the nasopharynx and one in the oropharynx. Interestingly, one patient, a neonate, also suffered from severe osteopetrosis. All lesions were removed by simple surgical excision under general anaesthesia. There were no operative or post-operative complications.

Aged↗

PubMed1989

Treatment of combined subglottic and critically low tracheal stenoses secondary to burn inhalation injury.

We report a case of combined severe subglottic and lower tracheobronchial stenoses after an inhalation burn injury. The patient was successfully treated by the insertion of a bifurcated silicone rubber stent. The proximal limb of the silicone tube was used to stent the subglottic stenosis after it had been resected, a treatment option not previously reported. It is speculated that the diffuse airway damage resulted from a combination of thermal injury, mechanical trauma and infection. The relatively late symptomatic presentation of the lower tracheal stricture is stressed and the treatment options discussed.

Burns, Inhalation↗

PubMed1989

Objective assessment of vocal hyperfunction: an experimental framework and initial results.

This report describes the experimental design and initial results of an ongoing clinical investigation of voice disorders. Its major focus is the development and use of quantitative measures to provide objective descriptions of conditions referred to as "vocal hyperfunction." The experimental design for this project is based on a descriptive theoretical framework, which holds that there are different types and stages of hyperfunctionally related voice disorders. Data consist of indirect measures derived from noninvasive aerodynamic and acoustic recordings including (a) parameters derived from inverse filtered approximations of the glottal air flow waveform; (b) estimates of transglottal pressure, average glottal air flow, glottal resistance and vocal efficiency; and (c) measures of vocal intensity and fundamental frequency. Initial results (based on comparisons among 15 voice patients and 45 normal speakers) support major assumptions that underlie the theoretical framework, and indicate that the measurement approach being utilized is capable of differentiating hyperfunctional from normal voices and hyperfunctional conditions from one another. Organic manifestations of vocal hyperfunction (nodules, polyps, contact ulcers) are accompanied by abnormally high values for the glottal waveform parameters of AC flow and maximum flow declination rate, suggesting increased potential for vocal fold trauma due to high vocal fold closure velocities and collision forces. In contrast, nonorganic manifestations of hyperfunction (functional disorders) tend to be associated with abnormally high levels of unmodulated DC flow, without high values for AC flow and maximum flow declination rate, suggesting reduced potential for vocal fold trauma. Measures also suggest different underlying mechanisms for nodules and polyps as compared to contact ulcers. Results are discussed relative to predictions based on the theoretical framework for vocal hyperfunction.

Adult↗

PubMed1989

Comparison of manual and power toothbrushing, with and without adjunctive oral irrigation, for controlling plaque and gingivitis.

We compared the effects of four oral hygiene methods (manual tooth-brushing, power toothbrushing, manual toothbrushing plus irrigation, and power toothbrushing plus irrigation) on plaque and periodontal disease. These methods were tested both when used alone and when used in conjunction with professional mechanical oral hygiene. 108 subjects were clinically assessed for plaque, stain, gingival inflammation, bleeding to probing, probing depth and attachment loss, and randomly assigned to one of the 4 oral hygiene groups. Subjects were carefully instructed in the use of their assigned method and asked to discontinue all other forms of oral hygiene. After 3-months, subjects returned for re-examination and full-month professional mechanical oral hygiene care. 3 months later, subjects returned for a final oral examination. All subjects kept a diary of use of their assigned method and were called every 2 weeks to monitor discomfort, provide reinforcement and answer questions. Results showed that all the oral hygiene methods were equally effective in reducing plaque and stain accumulation, gingival bleeding, bleeding to probing ratio and the % of pockets 4 mm or deeper. None of the oral hygiene methods was associated with injury to soft or hard tissues.

Adolescent↗

PubMed1989

The development of conservation concepts in children with visual impairment.

The investigation was the last in a series examining similarity of sequence and structure in the development of children with different handicapping conditions. It focused on the development of conservation concepts by children who were visually impaired but not blind. Similarity in order of acquisition of conservation concepts for visually impaired and sighted children was found and was supported by scalogram analyses yielding very high coefficients of reproducibility. Similarity in structure or level of understanding of conservation was also evident for these groups of children at comparable chronological ages and was supported by multiple regression analyses. There was no evidence of delay in the visually impaired children's development of conservation concepts.

Adolescent↗

PubMed1989

Reversible ATP-dependent inactivation of glycerolphosphate acyltransferase from rat adipose tissue.

Microsomal glycerolphosphate acyltransferase from rat adipose tissue is shown to be inactivated with time upon incubation with ATP. The inactivation can be observed in postmitochondrial supernatant as well as in washed microsomes. However, the effect is more pronounced upon addition of the cytosolic fraction. This activity is specific for ATP, is dependent on the nucleotide concentration, and is prevented when ATP is substituted by beta,gamma-methylene-ATP. Some protection is provided by amiloride but not by EGTA or cAMP-protein kinase inhibitor. Also, the level of enzyme inactivation is not modified by addition of cAMP-dependent protein kinase and its substrates. Inactivated glycerol-phosphate acyltransferase from ATP-treated microsomes can be reactivated by incubation with partially purified protein phosphatase from rat liver. These results suggest the existence in adipose tissue of a protein kinase (cAMP independent) that may be involved in the regulation of glycerolphosphate acyltransferase.

Acyltransferases↗

PubMed1989

Correcting rotational displacement of femoral neck fractures.

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Adult↗

PubMed1989

The role of the clinical chemist in the modern medical laboratory: Part one. Interview by Bart Campbell.

Explore the source record for details and available documents.

Chemistry, Clinical↗

PubMed1989

Changes of plasma renin activity and atrial natriuretic factor during intravenous nicardipine treatment of severe hypertension.

Intravenous nicardipine was given to 32 severe hypertensive patients in an increasing dose, titration fashion. Samples for plasma renin activity and plasma atrial natriuretic factor concentration were obtained at the following times: before treatment, at the time of titration response and at the end of a maintenance period. The mean time required to achieve the titration response was 29 min. Plasma renin activity was increased by 32% (p less than 0.05) at the titration response and 181% (p less than 0.005) at the end of an 8-12 h maintenance nicardipine infusion. Atrial natriuretic factor concentration was unchanged from baseline at titration response and was decreased by 25% (p less than 0.005) at the end of maintenance. Mean plasma nicardipine dose was 6.95 mg/h at the titration response and 8.76 mg/h at the end of maintenance. These results suggest that alterations in plasma renin activity and atrial natriuretic factor concentrations may be associated with blood pressure reduction rather than with a direct drug action on release mechanisms.

Atrial Natriuretic Factor↗