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Biomedical subjects

G Mortimer

Publications and source records attributed to G Mortimer.

At least 37 records · Page 2Linked to original sources
PubMed1989

A clinical role for right ventricular endomyocardial biopsy.

There is considerable uncertainty about the value of endomyocardial biopsy (EMB) in the diagnosis and management of patients with suspected primary myocardial dysfunction. To determine the clinical utility of this procedure in patients referred to our centre, we reviewed the clinical records and biopsy findings of the first 21 consecutive patients in whom we performed right ventricular EMB. Patients were divided into four groups according to the clinical indications for EMB: unexplained congestive cardiac failure and a dilated heart (Group 1: 11 patients); unexplained congestive cardiac failure and a non dilated heart (Group 2: three patients); unexplained cardiomegaly in the absence of cardiac failure (Group 3: one patient); suspected hypertrophic cardiomyopathy (HCM) (Group 4: six patients). Histological examination of EMB tissue obtained from all patients in Group 1 as well as the single patient in Group 3 showed non specific features judged to be compatible with a diagnosis of dilated cardiomyopathy. Accordingly, in all patients in Groups 1 and 3, a potentially treatable cause of primary myocardial dysfunction was excluded. Biopsy examination demonstrated the presence of a specific disease process in two of three patients in Group 2 (one patient had amyloidosis, the other endomyocardial fibrosis). In five of the six patients in Group 4, the biopsy findings were either diagnostic or suggestive of HCM. Our results suggest that EMB is a clinically useful tool in patients presenting with features suggestive of a primary myocardial disorder.

Biopsy↗
PubMed1988

Perinatal mortality in multiple pregnancy patients.

A study of perinatal mortality in multiple pregnancy over a period of 12 years, 1972 to 1984, showed prematurity and low birthweight as the major causes of fetal loss. The highest risk was found at 28 to 30 weeks gestation (306/1,000). There was a significantly greater risk to babies delivered by the breech (136/1,000), and likewise in the second twin when compared with the first, ratio 1:14. A significant drop in the perinatal mortality rate, from 98/1,000 to 39/1,000, was observed between 1972-1978 and 1979-1984. Ultrasound has facilitated the earlier diagnosis of twins and provides more accurate serial fetal assessment. Bedrest, more vigilant antenatal care, intrapartum surveillance and improved neonatal care, are required to maintain and further reduce the perinatal mortality rate. When regional analgesia was employed in labour, the number of babies lost was 41/1,000, vs 93/1,000 in patients not receiving regional analgesia. External cephalic version and vertex delivery of the second twin is preferable to internal version and breech extraction. It should also be contemplated, as an alternative to elective cesarean section for a transverse lie or breech presentation of the second fetus.

Birth Order↗
PubMed1987

Zygosity and placental structure in monochorionic twins.

To test the assumption that monochorionic twins are monozygotic, cord bloods from 12 sets of monochorionic twins were tested for a total of 16 red cell antigens. Discrepancies were noted among the minor blood groups in 3 of the 12 sets. The result of this pilot study strengthens the contention of others who have previously questioned the general acceptance that monochorionicity and monozygosity are synonymous.

Blood Group Antigens↗
PubMed1986

Pathologic findings in fetal GM1 gangliosidosis.

A 24-week fetus with GM1 gangliosidosis (type 1) was studied using biochemical and histopathologic methods. Foam cells in viscera and placenta demonstrated widespread accumulation of a lipidlike material. By microscopy, central nervous system storage appeared confined to the retina and dorsal root ganglia, but the brain ganglioside content was measurably elevated compared with that of age-matched controls. These data, along with those of others, imply that, if the observed pathologic findings are irreversible, any attempts at intrauterine therapy must commence prior to the middle of the second trimester.

Abortion, Induced↗
PubMed1985

A role for amniotic epithelium in control of human parturition.

A peroxidase anti-peroxidase staining technique was used to determine the presence of pregnancy-associated prostaglandin synthetase inhibitor (PAPSI) in human amniotic epithelium from 20 pregnant women at 36-40 weeks' gestation. PAPSI was present in amniotic epithelial cells in 12 of 15 women before the onset of labour. No PAPSI was found in amniotic epithelium from 5 women in clinically established labour. These findings indicate that the amnion is a source of this endogenous prostaglandin synthetase inhibitor and suggest a local role for amniotic epithelium in initiating labour at term.

Amniotic Fluid↗
PubMed1985

A pilot study of the frequency and significance of placental villitis.

The prevalence of inflammatory villous lesions was determined in a prospective study of 120 consecutive placentas. Cord blood IgM level was measured as an indicator of fetal intrauterine infection, and the birthweights of the infants were noted. Ten cases of villitis were found. Two infants had elevated cord blood IgM and one of them also had amniotic infection. As only one case of villitis had corroborative evidence of transplacental intrauterine infection, 90% of the lesions require an alternative explanation. The severity of the lesions correlated with the presence of low birthweight. The quality of the inflammatory infiltrate was also considered. Only one case included plasma cells; the remainder showed lymphohistiocytic infiltration. The case with plasmacytic infiltration was the one with elevated cord blood IgM. It is concluded that placental villitis is usually not an infective condition and its aetiology remains unknown.

Birth Weight↗
PubMed1985

Conduction system defects in three perinatal patients with arrhythmia.

The cardiac conduction systems of three patients who died in the perinatal period were studied histologically. Rhythm disturbances were observed in these patients immediately before death. The sinus node was notably hypoplastic without increase in fibrous content in all cases. The atrioventricular node was smaller than expected in all, and the entire atrioventricular conduction axis was small in two cases. This study supports the need for a detailed examination of the cardiac conduction system so as to provide a better understanding of the clinicoanatomical relation in the context of fatal perinatal arrhythmias.

Arrhythmias, Cardiac↗
PubMed1984

Patterns of Refsum's disease. Phytanic acid oxidase deficiency.

Four children each exhibiting a profound deficiency of phytanic acid oxidase activity in cultured skin fibroblasts but with very different phenotypes, are described. A consistently raised plasma phytanic acid value, generally considered to be pathognomonic for Refsum's disease (phytanic acid oxidase deficiency), was observed in three of these children but not in the fourth, who also showed no evidence of accumulation of phytanic acid in liver or fat biopsies. Our data suggest that the clinical diagnosis of Refsum's disease in children is more difficult because the full spectrum of clinical features usually observed in adults with the disorder is not always present. Moreover, a failure to detect a raised plasma phytanic acid value may not necessarily indicate normal fibroblast phytanic acid oxidase activity.

Adult↗
PubMed1982

Recurring digital fibroma.

Seven cases of recurring digital fibroma were seen over a 35-year period. All demonstrated the classical clinical, macroscopic, and microscopic features of this distinct tumour, including the pathognomonic round, eosinophilic cytoplasmic inclusion bodies. Ultrastructurally, all seven cases were confirmed to be myofibroblastic in nature, and the morphology and intracellular topography of the inclusion bodies suggested their derivation from contractile protein. These findings establish recurring digital fibroma as a neoplastic lesion of the myofibroblast.

Child↗
PubMed1981

Serum acid phosphatase activities in patients with lung cancer: a biochemical and immunohistochemical analysis of 25 cases.

A series of 25 cases of lung cancer are presented in which total (TAcP) and nonprostatic serum acid phosphatase (NPAcP) activities were measured. Of these cases, 36% had raised TAcP and NPAcP activities in their serum. However, the serum activities of TAcP and NPAcP did not correlate with either the presence of lung cancer nor with the morphological tumour type. This fact indicates that, despite isolated reports of raised serum acid phosphatase activities in cases of lung cancer, acid phosphatase is of no value as a marker for lung cancer. We sought alternative explanations for the raised TAcP and NPAcP activities observed in our series in the hope that this enzyme might prove useful as a marker for early metastatic disease in lung cancer patients. This possibility is not substantiated, and the findings are analyzed and discussed. It is tentatively suggested that raised NPAcP activities in patients with lung cancer may relate to haemostasis.

Acid Phosphatase↗
PubMedDate not supplied

Papillary carcinoma in a thyroglossal duct remnant--a review of thyroglossal surgery in a regional centre in the west of Ireland.

A review of thyroglossal duct remnants presenting to a regional centre in the West of Ireland was undertaken. Over a 15 yr period, 25 patients were operated on for duct remnants. The mean age was 19.6 yr and ranged from 3 to 68 yr. There were 16 (64 per cent) males and 9 (36 per cent) females. Seventeen (68 per cent) patients were less than 20 years at the time of surgery. Four patients presented with a sinus and the remainder with a cystic lesion. Two patients experienced recurrent disease. One patient, a 41 yr old female, had a papillary carcinoma of a thyroglossal cyst. There were no clinical features distinguishing this patient from those with benign cystic remnants of the thyroglossal duct. The possibility of carcinoma in older patients, in particular females, presenting with thyroglossal cysts emphasises the importance of performing a formal Sistrunk's operation. It reduces the risk of recurrence of the cyst and may reduce the risk of recurrence of the tumour as the duct may provide a route for the spread of tumour.

Adolescent↗