Spoon feeding the breast implant.
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Biomedical subjects
Publications and source records attributed to P Chapman.
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We report familial adenomatous polyposis coli (FAPC) with epidermoid cysts, osteomata, and areas of congenital hypertrophy of the retinal pigment epithelium (CHRPEs) in a male patient and his maternal aunt, both of whom suffered a mild to moderate degree of mental handicap. Both had an interstitial deletion of the long arm of chromosome 5 (del(5)(q22q23.2)). Two other normal family members had the underlying direct insertion of chromosome 5(dir ins(5)(q31.3q22q23.2)). Molecular genetic and fluorescent hybridisation studies have shown that loci D5S37 and D5S98 are outside the deletion whereas loci detected by probes EF5.44 and YN5.48 are lost. As expected, the molecular analyses indicate loss of one allele at the MCC and APC loci. The APC gene is located within band 5q22. Familial direct insertions should be considered as a cause of recurrent microdeletion syndromes.
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In a retrospective review (1970-1983), survival following block dissection of the groin was compared in two groups with clinical stage II melanoma. Twenty patients under one surgeon had ilioinguinal (high) block dissection, and 22 patients under another surgeon had inguinal (low) block dissection. The high block 5-year survival was 40 percent, and the low block 5-year survival was 35 percent. There was no statistical difference between groups on life-table or log-rank test analysis. It is concluded that the extent of groin dissection has no effect on survival of stage II melanoma.
Linkage analysis was carried out on 20 unselected UK families segregating for adenomatous polyposis coli (APC) using four closely linked DNA probes. Significant lod scores were obtained between APC and three markers: pi 227 (D5S37) theta = 0.16; C11p11 (D5S71) theta = 0.10; and YN5.48 (D5S81) theta = 0.00. The fourth, ECB27 (D5S98), gave low lod scores. The APC gene showed linkage with at least one of the probes used in all families, which is in agreement with previous publications. Combined lod scores are now sufficiently high to allow the use of these probes in presymptomatic diagnosis. Despite the fact that 61% of persons at risk were informative for at least one DNA marker, only 15% were informative with flanking probes. One prenatal diagnosis was performed where the initial request had been for sterilisation.
A polyposis register has been established in the Northern Region of England. A total of 48 families with 71 living affected subjects has been identified during the first three years of operation, a prevalence of 2.29 x 10(-5). Indirect ophthalmoscopy identifies the majority of gene carriers by showing multiple areas of congenital hypertrophy of the retinal pigment epithelium (CHRPE). The absence of this sign in families limits its value where a relative with CHRPE has not been identified. Combining eye examination with data on age of onset and linked DNA markers is highly effective in carrier exclusion; 38% of 528 first, second, and third degree relatives had their carrier risk reduced to less than 1 in 1000. Even with such assurance many subjects will request continued bowel screening at a reduced frequency. Little interest has been shown in prenatal diagnosis. The principal value of a genetic register with domiciliary nurse visiting is the reduction in early mortality among unrecognised gene carriers.
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The results in 76 tissue expansions of sites other than the breast and scalp in 56 patients are presented. The overall failure rate was 12%, being particularly high in the arm (31%) and low in the leg (0%). Details of the technique used and their relevance to success are discussed.
A simple clinical guide is provided for calculation of the size of tissue expander necessary for any given defect. The use of an expanded transposition flap is demonstrated and its advantages expounded.
Articular cartilage specimens from the distal articular surface of 32 radiocarpal bones from 24 2- to 5-year-old horses were analyzed. The total collagen content was determined on the basis of the 4-hydroxyproline content, using a colorimetric method. A method for estimating the proportions of types-I and -II collagen by measuring spectrophotometric densities of specific cyanogen bromide peptide bands from mixtures of types-I and -II collagen on sodium dodecyl sulfate-polyacrylamide gels was used. The cyanogen bromide peptides representative of each collagen types-I and -II were identified. The peptide ratios were then computed for each of several standards of type-I and -II mixtures. A standard curve was derived from the correlation between these ratios and the corresponding proportions of type-II collagen in standard mixtures. Galactosamine and glucosamine content (hexosamines) were measured by ion chromatography. The galactosamine-to-glucosamine ratio, chondroitin sulfate and keratan sulfate values, and total glycosaminoglycan content were derived from the measured hexosamine content. The total collagen content averaged 556 mg/g (55.6 mg/100 mg) of tissue (dry weight, [dw]). Type-II collagen was the major collagen type in normal articular cartilage specimens. The ratio of the area under the alpha 1 (II)CB10 peak to the area under the alpha 1 (I)CB 7,8 + alpha 1 (II)CB11 peak was a second-order polynomial function of the proportion of type-II collagen in the specimens. The mean galactosamine and glucosamine content were 20.6 mg/g and 7.9 mg/g (dw), respectively. The mean galactosamine-to-glucosamine ratio was 3.74 +/- 0.62.(ABSTRACT TRUNCATED AT 250 WORDS)
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Between 1980 and 1983 a total of 89 patients with infiltrating transitional cell carcinoma of the bladder were entered in a multi centre randomised controlled clinical trial with either misonidazole or placebo added to the first 40.00 Gy of radiotherapy. Depending on their referring clinican, patients then completed treatment with either further radiotherapy to a radical dose, or surgery four weeks later. All patients have been followed up for a minimum of three years, and no significant difference has been found in local control, survival, or pathological downstaging of the tumour. The neurotoxicity was considerable, with 43% of patients receiving misonidazole developing a peripheral neuropathy, starting five weeks on average after beginning treatment, and with a mean duration of 27 months. Eighty per cent of patients affected still had peripheral neuropathy at three years or their prior death. There is a suggestion that alcohol may predispose to the neuropathy. This study failed to show any benefit of misonidazole in tumour control and produced unacceptably high levels of toxicity.
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Upper lid loading by a gold weight has been used satisfactorily to treat 19 cases of lagophthalmos in facial palsy. The technique is simple to perform, produces an acceptable cosmetic and functional result and has a relatively low complication rate.
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Webs other than epicanthal folds can be corrected by the Mustardé "dancing man" procedure. A series of 20 patients is presented in whom this method has been used to correct either minor degrees of congenital syndactyly or burn scar contractures in fingers.
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