Biomedical subjects
Publications and source records attributed to D J Manning.
An 11 year old boy presented with severe acute hereditary coproporphyria. Despite supportive measures his condition deteriorated after admission. Haem arginate, started two days after presentation, produced appreciable inhibition of porphyrin precursor overproduction and clinical improvement.
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Oesophageal pressure and ventilation were recorded during sleep in healthy full-term neonates with sleep state defined by one of two methods; in 35 infants by combined behavioural and electroencephalographic criteria, and in a further 13 infants by behavioural criteria alone. Spontaneous oesophageal contractions occurred in all infants during active sleep but rarely during quiet sleep. The transition from active to quiet sleep was accompanied by a gradual reduction in the frequency of these contractions. Oesophageal contractions associated with sighs and contractions shortly following interruption of breathing suggestive of swallowing were also significantly more common in active sleep. In 13 infants who showed periodic breathing the same differences in prevalence of spontaneous oesophageal contractions in each sleep state were observed.
Status epilepticus can complicate any type of seizure activity. A group of 13 children with non-convulsive status has been studied. Five presented with chronic fluctuating neurological features, while eight had intermittent episodes of their atypical status, although each of these lasted for several days. The clinical features, treatment, and outcome for these groups of children are described. Most of the children in both groups are mentally retarded after regressing at the time of their status epilepticus. The recognition and aggressive treatment of atypical status is important in reducing the risk of subsequent mental handicap.
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Mouth and dummy swabs for Candida spp. were obtained from 100 children under 18 months old admitted with acute medical conditions. Forty four per cent of dummies were colonised by Candida spp. Children who sucked dummies had clinical thrush and positive mouth swabs for candida more frequently than those who did not.
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A heterotopic bladder attached to an Ommaya reservoir was transplanted to the back of a syngeneic rat. Following transplantation, the mucosa underwent ischemic necrosis. However, it was rapidly reepithelialized in 2 weeks as a result of spreading of the epithelium originating from the ureterotrigonal region. By light microscopy the regenerated epithelium was indistinguishable from the normal transitional epithelium, and the cannula connecting the reservoir to the bladder remained patent throughout the observation period of 22 weeks. One bladder, when examined at 22 weeks, contained a transitional cell papilloma with squamous metaplasia. Although further study is needed, this model is potentially useful in studies related to bladder carcinogenesis.
The influence of sleep state on hypoxia-induced periodic breathing was evaluated in full-term babies studied during the first week of life. Following exposure to 15% O2, periodic breathing occurred in 7 of 42 babies during quiet sleep, and 5 of 20 during active sleep (p less than 0.05). The median levels of transcutaneous pO2 at which periodic breathing occurred during hypoxia, and was abolished on reoxygenation were similar in each sleep state. The median duration of periodic apnoea was significantly greater in quiet than active sleep. In 7 babies the occurrence of periodic breathing during hypoxia was accompanied by a change in sleep state. This was probably coincidental in 3 cases, but in the other 4 babies hypoxia may have induced both the change in state and breathing pattern.