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Biomedical subjects

A D Stewart

Publications and source records attributed to A D Stewart.

At least 19 recordsLinked to original sources

Stenosis of pulmonary veins in Down syndrome.

Two patients with Down syndrome, intracardiac communications and elevated pulmonary arteriolar resistance presented early in life. Both patients had significant stenosis of pulmonary veins. The progressive nature of the stenosis is illustrated in one patient. Pulmonary venous stenosis in Down syndrome has been recorded only twice before in the literature, and may play a part in the early onset of pulmonary vascular occlusive disease in some patients.

Cardiac Catheterization

Epitopes within the HLA-B5,B35 cross-reacting group.

The HLA-B5,B35 cross-reacting group is a large and serologically complex antigen family which includes the World Health Organization-recognized specificities HLA-B5,B51,Bw52,B35,Bw53,B18,Bw70,Bw71, and Bw72. In addition, several variants of antigens in this cross-reacting group have been described in the past but have not yet gained official recognition. A genetic basis for the complexity and the protein and molecular bases of this highly cross-reactive and polymorphic cross-reacting group have yet to be established. The potential contributions of shared amino acid sequences, the occurrence of multiple epitopes on a single HLA-B molecule, and the presence of new HLA-C antigens have been difficult to resolve. To address this issue, we have carefully examined the serologic reactions of more than 900 allo- and monoclonal antibodies (Tenth International Workshop, Third Asia-Oceanic Workshop, and local reagents) versus lymphocytes from 92 individuals of diverse ethnic origin (North American Caucasians, North American blacks, Amerindians, Middle Eastern Caucasians), 84 of whom were informative for the HLA-B5,B35 cross-reacting group and related antigens. Our results demonstrate that the HLA-B5,B35 gene products share different combinations of distinct epitopes. We have constructed a model for the evolution of this cross-reacting group by assigning polarity to distinct diversification steps utilizing principles of maximum parsimony.

Antibodies, Monoclonal

Clinical results of hydrogel lens implantation.

Polymethylmethacrylate has proven to be a useful intraocular lens (IOL) implant material and remains the most widely used material for the fabrication of IOLs. Complications, however, from IOL implantation still occur. A hydrogel lens has been designed for posterior chamber placement. A clinical study from August 1983 to June 1985 was undertaken to determine the safety and efficacy of this new lens manufactured from 38% poly HEMA. The noninflammatory postoperative complications were limited to lens decentration and opacification of the lens capsule. Three cases of posterior capsule opacification required YAG laser capsulotomy. Laser capsulotomy is feasible and the lens appeared to be more resistant to damage from the YAG laser than polymethylmethacrylate lenses. In general, the material appeared to be well tolerated and there have been no cases of persistent iritis or clinically detectable cystoid macular edema. If the visual acuity outcome by age decade for all patients irrespective of follow-up time is considered, 92% of patients achieved 20/40 or better corrected visual acuity.

Aged

Relations between erythrocyte lithium efflux, blood pressure and family histories of hypertension and cardiovascular disease: studies in a factory workforce and hypertension clinic.

Sodium-dependent lithium efflux was measured in erythrocytes from 399 factory workers and 125 patients attending a hypertension clinic. Thirty-two factory workers had unsuspected essential hypertension (diastolic blood pressure phase V greater than 90 mmHg). These subjects had the same average erythrocyte lithium efflux as those with normal blood pressure, whereas lithium efflux was increased on average in the clinic hypertensives. Lithium efflux was greater in those subjects from both groups who had a family history of high blood pressure. Our clinic hypertensives did not have raised lithium efflux when they were matched for family history; the increased lithium efflux in the group as a whole (and in analysis of published reports) was explained by an excess of subjects with a family history of hypertension. Furthermore, when a family history of hypertension was present, lithium efflux was increased on average only in those whose relatives also had a cardiovascular event associated with their high blood pressure. These results, in conjunction with detailed analysis of the distributions of lithium efflux within the groups, suggest that, though not linked to blood pressure itself, an increase in lithium efflux is an inherited marker for those at risk from the cardiovascular complications associated with high blood pressure.

Adolescent

A rapid HPLC method for monitoring plasma levels of caffeine and theophylline using solid phase extraction columns.

A simple HPLC method for the determination of caffeine and theophylline in plasma is described. Separation of theobromine, paraxanthine, theophylline, beta-hydroxyethyltheophylline and caffeine is obtained using a mobile phase of 1% acetic acid/methanol (83:17, v/v) and a Waters Associates NOVA-PAK C18 column protected by a Guard-PAK precolumn module containing a Guard-PAK CN cartridge. Rapid sample preparation is achieved by solid-phase extraction columns (Bond-Elut C18, 1 mL capacity) which provide excellent recovery values for both drugs. The cost per sample using this approach can be minimised by column regeneration and re-use. Results obtained for theophylline are in good agreement with values determined by other techniques.

Caffeine

Amniotic fluid lecithin: sphingomyelin ratio and fetal lung development.

The normal range and trends of the ratio between lecithin and sphingomyelin in the amniotic fluid, estimated on thin-layer chromatograms, have been established for the last trimester. The accuracy of the ratio as an index of fetal lung development and of the risk of neonatal respiratory distress has been confirmed. The usual increase in the ratio towards term was not found in some pregnancies complicated by diabetes or severe rhesus incompatibility. Determination of the ratio may prove a valuable guide in the management of pregnancies with these complications.

Amniotic Fluid