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Biomedical subjects

J L Emery

Publications and source records attributed to J L Emery.

At least 19 recordsLinked to original sources
PubMed1979

Apparent disapperance of hypernatraemic dehydration from infant deaths in Sheffield.

The death certificates and necropsy reports of the 1115 Sheffield infants who died under 2 years of age in 1969-78 were examined. This study showed the apparent disappearance of deaths with hypernatraemia and in particular deaths presenting as cot deaths. The fall in incidence may be as much the result of an intensive local campaign on child care and infant feeding as of the change in the composition of dried milk for baby feeding.

Breast Feeding↗
PubMed1979

Identification of some infants at immediate risk of dying unexpectedly and justifying intensive study.

Children who die unexpectedly in infancy often have symptoms of illness before death. Survey data are used to evaluate risks associated with symptoms. There is a 1 in 50 chance of unexpected infant death occurring in the next 9 days when two or more symptoms occur in infants defined to be at high risk by a discriminant score. The score is based on data collected on all infants at birth and by health visitors at 1 month. This system would identify 50% of cot deaths and provides a basis for prospective physiological studies.

Child Reactive Disorders↗
PubMed1979

The trachea in children with tracheo-oesophageal fistula.

Forty tracheas from children with tracheo-oesophageal fistulae were histologically analysed for structural deformity. Thirty (75%) had a deficiency of cartilage; 24 (60%) showed an increase in the length of the transverse muscle, and 26 (65%) had a longer than average internal perimeter. Only six tracheas were entirely normal. The position of the fistula bore little relationship to the abnormalities found. Since in only nine patients were abnormalities restricted to the site of the fistula, we believe that careful examination of the whole length of the trachea is needed at the time of surgery to determine the extent of the anomaly and to anticipate tracheal problems. This is also relevant to autopsy studies and to elucidate the cause of death.

Cartilage↗
PubMed1979

The seminiferous tubules of the testis before, around and after birth.

A study has been carried out on the width of the seminiferous tubules, and the proportion of pre-germinal cells, in 174 stillborn children between 24 and 40 weeks of gestation, and in 146 children dying between the ages of birth and six years. There was a general diminution in the diameter of the seminiferous tubule throughout the last trimester and immediately before birth, followed by a slow and steady increase in the diameter of the tubule throughout childhood. The germinal cells within the seminiferous tubules appear to be under some slightly increased stimulatory influence during the last few weeks prior to delivery, and under considerable stimulation in the first 4 or 5 weeks after birth. Following this these cells appear to diminish in size and become hidden among the Sertoli cells, to be re-stimulated around the time of puberty.

Aging↗
PubMed1979

Changes in the spleen related to birth.

The spleens of 124 anatomically normal weight-for-age fetuses and 115 term babies dying between birth and four weeks have been assessed histologically. The mean weight of the spleen shows a steady increase from 27 weeks of gestation up to 42 weeks. There is a weight loss of about 4 gm at the time of birth. The weight of the spleen increases steadily in neonates and, by the fourth week, it reaches the same weight as the full term stillbirth. The amount of lymphatic tissue in the spleen increases steadily in the stillbirths of different gestations and continues, without interruption, at the time of birth and in neonates. The weight loss of the spleen at birth can only be accounted for on the basis of a reduction in the blood lake of the pulp.

Gestational Age↗
PubMed1979

Myelination of the corpus callosum. II. The effect of relief of hydrocephalus upon the processes of myelination.

A clinico-pathological study has been carried out on 32 brains of children with hydrocephalus in whom the hydrocephalus had been completely controlled by shunting. The cell and myelination activity of the corpus callosum in these children is within the normal range for children of the same age, which contrasts markedly with the findings in children in whom the hydrocephalus is in a progressive state.

Cerebrospinal Fluid Shunts↗
PubMed1979

The infundibulum of the hypophysis in hydrocephalus.

This study describes the normal gross anatomy of the infundibulum and compares it with those in untreated and treated hydrocephalus. The infundibular length is 2-8 mm long (mean 5 mm) and shows little or no increase in length after birth. In treated hydrocephalic brains it has a mean length of 4 mm and in the untreated cases a mean length of 2.4 mm. The normal anterior angle is 65 degrees-120 degrees (mean 90 degrees). The treated cases range between 40 degrees to 130 degrees (mean 81 degrees) whereas the range of the untreated cases is even wider at 0 degrees to 160 degrees (mean 88 degrees). There is no correlation in the hydrocephalic groups between the angle and the length, angle and cortical thickness or length and cortical thickness. The changes observed appear to depend on the stage and severity of the hydrocephalus the caudal and cranial displacement of the brain stem. In only two of the fifty hydrocephalic brains examined did the infundibulum have a "normal" length, thickness and angle. Histological and cytochemical examination of the hypothalamus, infundibulum and hypophysis is needed to correlate the clinical findings of frequent endocrine abnormalities with histological ones.

Adolescent↗
PubMed1979

The superior surface lesion of the cerebellum in children with myelomeningocele.

The lobular pattern of the superior surface of the cerebellum has been described in 100 children with myelomeningocele. There is a wide range of abnormality. The inferior displaced cerebellar segment shortens with age, but the superior surface deformity probably remains unchanged and is, therefore, useful in indicating the original extent of the caudal part of the defect in the older child. The most severe change showed the cerebellar h emispheres to be separated by a deep midline identation (split cerebellum); this was associated with hypoplasia of the superior vermis which supports an inception during the organogenetic period of development. Other cerebellums showed less severe deformities and their inception was comparatively later in development. Thus the degree of deformity of the cerebellum is probably related to its time of onset. Furthermore, the findings suggest that we are dealing with a secondary disturbance. It is evident that the cerebellar defect is not limited to its caudal aspect; this should increase the specificity of the hindbrain malformation is children with myelomeningocele.

Cerebellum↗
PubMed1979

The mortality and birth rates of spina bifida during a period of treatment, selection and antenatal screening in Sheffield, 1963-1978.

The birth rates for all neural tube defects and the mortality rates from spina bifida and encephalocele have been obtained for Sheffield children by examining the congenital anomalies register and death certificates during the period from 1963-1978. The introduction of atenatal alpha foetoprotein screening of all pregnant women in 1977 is associated in time with a sharp fall in the birth rate of neural tube defects. The mortality rate for spina bifida with encephalocele rose gradually from 1967 to 1976, apparently unaffected by the introduction of clinical selection prior to surgery in 1971. The antenatal screening of previously affected families (since 1973) did not affect the mortality rate, but screening the total pregnant population since 1977 has been associated with a sharp reduction in the mortality rate. The mortality rate curve for spina bifida with encephalocele is markedly different from the birth rate curve which makes the common practice of inferring birth rates from mortality rates invalid. There was a gradual increase from 1967 to 1978 in the proportion of children born with spina bifida in any given year who died before their second birthday. This increase appears to have been uninfluenced by the introduction of selection or antenatal screening. The changes in mortality rate and survival may be as much due to unknown factors as to changes in medical management.

Amniotic Fluid↗
PubMed1978

Terminal symptoms in children dying suddenly and unexpectedly at home. Preliminary report of the DHSS multicentre study of postneonatal mortality.

Terminal symptoms in 145 children who died suddenly and unexpectedly at home were investigated and compared with symptoms in 154 control children. Eighty-five (59%) of the children who died had had terminal symptoms, which in 69 cases (48%) appeared to have been major. Non-specific symptoms were especially common among the children who died. Symptoms were often present for several days before death. Only 12 of the 69 children who died with major symptoms had been seen by a doctor within 24 hours before death. We conclude that many deaths in young children might be prevented if doctors and parents were more aware of the importance of non-specific symptoms as markers of life-threatening illness.

Age Factors↗
PubMed1978

Germinal centers in the spleens of neonates and stillbirths.

Sections of spleens from 235 stillbirths and 227 babies who died between the ages of 1 and 35 days were examined. None of the stillbirths showed any germinal centres, neither did the spleens of any of the babies who died between the ages of 1 and 14 days. From the age of 15 days onwards, the germinal centres started to appear in varying numbers. The appearance of germinal centres in the spleen is further delayed in infants born before 37 wk gestation. Germinal centres in the spleen in neonates do not appear to be related to the presence of inflammatory changes elsewhere in the infant.

Age Factors↗
PubMed1978

Endocardial fibrosis in apparently normal infant hearts.

A classification of the histological appearance of the endocardium in infants, and observers' reproducibility tests have been carried out. In a retrospective survey of 262 overtly normal hearts, what is considered to be abnormal thickening of the endocardium was found in 3.4%, and probably significant thickening in 20%. The changes occurred in unexpected home deaths as well as in hospital deaths and the lesions may be a contributing factor in some cot deaths, but a prospective study is required to confirm this.

Endocardial Fibroelastosis↗
PubMed1978

Structure of periadrenal brown fat in childhood in both expected and cot deaths.

A quantitative study was carried out of the fat cells of the hilar pannicle of the adrenal in 150 infants comprising 60 hospital deaths, 2 accidental deaths, and 88 cot deaths. The cells were rated in categories of fat vacuolation. For a period of up to 8 weeks after birth there is an apparent depletion in the number and size of overt fat vacuoles in the cell and from this time on there is a progressive change to monolocular fat cells. The postnatal discharge of fat from the cell in the pannicle seems to be reduced in some children presenting as unexpectec death in infancy.

Adipose Tissue, Brown↗