Biomedical subjects
Publications and source records attributed to A E Steel.
A child with transient hyperphosphatasaemia of infancy is reported. The syndrome followed rotavirus infection. Reports of transient hyperphosphatasaemia of infancy are reviewed.
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The Boehringer Mannheim test (BM test) for cystic fibrosis has been applied to 15 734 neonates. A positive result occurred in 130, seven of whom were subsequently shown to have the disease. To our knowledge no cases have been missed. Tests have been performed centrally by experienced laboratory staff and the false-positive rate of 0.83% is considered acceptable. It is important to follow up weak as well as strongly positive reactions to the BM test strip.
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A prospective study is described comparing microscopy of random faecal specimens for the presence of neutral and split fat by a relatively simple, cheap, and rapid methods with standard chemical estimation of faecal fat. The method of microscopy was found to be reliable in excluding steatorrhoea in children over the age of 3 months.
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The clinical results and changes in sputum found in both a short-term inpatient trial and a subsequent long-term outpatient investigation (three-month double-blind controlled study) of 82 patients with chronic bronchitis treated with a new mucolytic agent, S-carboxymethylcysteine (Mucodyne), are reported. Fluidification of sputum with reduction in certain measurements of the viscosity of morning sputum aliquots, associated with improvement in the ability to cough up bronchial secretions, significant increase in sputum volume output, and improvement in ventilation (as estimated by the forced expiratory volume in one second), were observed in both trials as dose-related responses, with an increase in the ease of expectoration and a reduction in cough frequency and dyspnea. Therapy with S-carboxymethylcysteine was well tolerated, and there were no serious adverse effects, either immediate or delayed. We suggest that the effect of the drug in fluidifying sputum may be due to a mucoregulatory mechanism which reverses the sputum macromolecular disturbances seen in chronic bronchitis.
The composition of milks usually fed to 25 infants admitted to hospital with a dehydrating illness was studied. 15 hypernatraemic babies had been given feeds of greater sodium concentration and osmolality than those fed to the 10 infants whose plasma sodium was below 150 mEq/l. Hypernatraemic dehydration may be followed by death or permanent brain damage. Most infants in the survey were receiving milk with a sodium content greater than that advised by the manufacturers. Suggestions are made for reducing the sources of error commonly made in the reconstitution of dried milk formulae.
The results from a regional quality control scheme for clinical biochemistry are analysed. Comparison with results from an earlier period shows that the quality of several of the 15 routine analyses has improved. The methods by which the sera are produced and distributed, and the weekly results are analysed, are described. Each of the 25 laboratories receives an individual weekly computer printout within 24 hours of the deadline for the receipt of results. At the end of each six-month period a printout is produced ranking each laboratory for ;accuracy' and ;precision' for each test.
In a case of neuroblastoma the presence of an abnormal blood constituent was suspected from the raised erythrocyte sedimentation rate, sludging of the red cells, marked rouleaux formation, an atypical Leishman stain, increased plasma viscosity, and a distorted protein electrophoresis pattern. The abnormal constituent was shown to be a mucopolysaccharide which was either hyaluronic acid or chondroitin sulphate.
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