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Biomedical subjects

M Glynn

Publications and source records attributed to M Glynn.

9 recordsLinked to original sources

Elevated liver enzymes and thrombocytopenia in the third trimester of pregnancy: an unusual case report and a review of the literature.

A woman presented in the third trimester of pregnancy with epigastric pain, elevated liver enzymes, and thrombocytopenia. The frozen-section liver biopsy findings were compatible with acute fatty liver of pregnancy. The light and electron microscopic findings were those of preeclampsia. All clinical and laboratory abnormalities resolved before delivery.

Acute Disease

Proliferation patterns and aneuploidy in adenomatous polyps of the colon.

The frequency of aneuploidy and the proliferative activity of 57 colorectal adenomatous polyps was investigated by static cytophotometry and compared with 43 adenocarcinomas and 60 samples of normal mucosa. Twenty per cent of the adenomas contained aneuploid cells compared with 63 per cent of the adenocarcinomas. Except in the case of villous adenomas, there was a general increase in the proliferative activity of the diploid adenomas with increasing degrees of dysplasia. All of the adenomas showed an increase in proliferation compared with normal mucosa. There was a positive correlation between the size of the diploid adenomas and proliferative activity (P less than 0.001).

Adenocarcinoma

Blood viscosity in ocular hypertension.

Blood viscosity and its determinants were measured in 27 patients with primary open-angle glaucoma, 15 patients with ocular hypertension and 18 healthy control subjects matched for sex, blood pressure and smoking habits. The mean blood viscosity value was significantly higher in the glaucoma group than in the two other groups at all three shear rates studied; there was no difference in viscosity between the hypertension group and the control group. The mean hematocrit value was significantly lower in the hypertension group than in the two other groups. The results suggest that blood viscosity may contribute to nerve damage in patients with primary open-angle glaucoma. The low hematocrit observed in the patients with ocular hypertension may, by contributing to low viscosity, in some measure protect this group from optic nerve damage.

Blood Viscosity

Alteration in colonic epithelial cell DNA associated with intestinal neoplasia: selection of high risk patients.

The proliferative activity of the colonic crypts of patients who are at high risk of developing colonic tumours has been assessed. Cells from the upper parts of the colonic crypts were collected at colonoscopy, and were stained for DNA by the Feulgen technique. Using a microdensitometer the DNA content of the cells was measured and a proliferative index calculated. Patients with single neoplasms had a proliferative index similar to controls although individual patients with hyperplastic mucosa could be identified. Patients with multiple neoplasms had an elevated proliferative index. These results may form the basis of a screening programme for colonic tumours.

Adenoma

Blood viscosity in primary open-angle glaucoma.

To determine whether hemorrheologic factors play a part in optic nerve cupping and visual field loss in glaucoma, blood viscosity was measured at three shear rates in 27 patients with primary open-angle glaucoma and 18 healthy control subjects matched for sex, mean arterial blood pressure and smoking habits. The study was conducted between 1984 and 1986. The mean viscosity was significantly higher in the glaucoma group than in the control group at all three shear rates. The possible relevance of raised blood viscosity as a causal factor in optic nerve cupping in patients with glaucoma is discussed.

Aged

Thrombosis of a prosthetic valve managed by thrombolysis: a case report.

Thrombosis of a prosthetic valve is one of the most serious cardiovascular events. Emergency replacement of the prosthetic valve has been the standard method of management but carries a high operative risk. This paper describes the successful use of streptokinase, given intravenously, to manage a patient with this complication in the acute phase. Eventually, operation was necessary because the presence of residual organized clot was suspected, but the procedure was performed electively 10 days later.

Adult

Pulmonary angiography. Application in a new spectrum of patients.

Guidelines that are frequently used to select patients with suspected pulmonary embolus for pulmonary angiography evolved from studies conducted 10 to 15 years ago. To determine if clinical practice in a referral medical center should continue to be based on these guidelines, clinical and angiographic data on 106 patients recently studied were compared with similar data obtained from the same institution in the previous era. The need to perform angiography if a lung scan demonstrated low or high probability for embolus was also examined, along with clinical, laboratory, and hemodynamic findings previously reported to be of diagnostic utility. There has been a marked change in the spectrum of patients studied. Cancer patients and patients who have undergone abdominal and pelvic surgery comprise the preponderance of patients undergoing angiography. Lung scans had a clinically important error rate in that more than one third of these selected patients with either a high- or low-probability scan had discordant results on angiography. Clinical criteria for selecting patients for pulmonary angiography should reflect the contemporary spectrum of patients with pulmonary embolus, as well as the limitations of clinical judgment and of the lung scan.

Angiography

Immune-mediated thrombocytopenia of malaria.

Thrombocytopenia frequently complicates malarial infections but the mechanism has not been elucidated. We studied 28 patients with malarial infections and noted that 16 of 17 thrombocytopenic patients had elevated levels of platelet-associated IgG (PAIgG). In all thrombocytopenic patients studied, the level of PAIgG returned to normal as the platelet count rose to normal levels. To study the mechanism of the elevated platelet-bound IgG, IgG and F(ab')2 from patients with recurrent Plasmodium falciparum infections was purified and radiolabeled. Labeled and unlabeled P. falciparum antigen was also prepared. IgG did not nonspecifically bind to malaria-damaged platelets. Binding studies with 3H-malarial antigen demonstrated platelets have saturable binding sites for malarial antigen. Increasing concentrations of malarial antigen displaced the 125I-IgG antimalarial antibody from the platelets. The binding of 125I-IgG and 125I-F(ab')2 was similar and this excluded significant immune complex binding. The thrombocytopenia that complicates at least some malarial infections is caused by immune mechanisms; specific IgG binds to platelet-bound malaria antigen through the Fab portion of the immunoglobulin molecule.

Binding Sites, Antibody