Biomedical subjects
Publications and source records attributed to P Pease.
A persistent Gartner's duct cyst associated with ipsilateral renal agenesis or dysplasia is rare. A vaginal cyst at the introitus as the presenting complaint is very rare, and has not been previously described in a neonate. Sepsis despite the presence of renal agenesis, or non- or poorly functioning renal tissue, is an indication for ureterectomy or nephroureterectomy on the affected side.
It is known that neonates with congenital abnormalities of the intestine tend to be growth-retarded. We wished to explore the hypothesis that normal fetal gut function is needed for normal growth in late gestation. If this is true, then different populations of babies with different congenital gut abnormalities would be expected to have similar impairments of growth and be small at birth. This growth retardation would be more marked in term than in preterm babies and would be independent of other congenital anomalies. To test these hypotheses, we examined 43 babies born with gastroschisis (GS) in Auckland, New Zealand; 69 babies born with GS in Birmingham, England; and 60 babies born with intestinal atresia (IA) in Auckland. For Auckland babies with GS, the mean weight standard deviation score (WSDS) (i.e., birth weight relative to the mean birth weight for gestation) for term babies was lower than that for preterm babies (-0.932+/-0.180 vs -0.064+/-0.237, P=0.014). This was also true for Birmingham babies with GS (-0.991+/-0.193 vs -0.36 +/-0.153, P=0.028). For babies with IA, the mean WSDS for term babies was lower than that for preterm babies (-0.627+/-0.266 vs 0. 057+/-0.211, P=0.034). There was no significant difference between the mean WSDS of babies with and without major congenital abnormalities (-0.402+/-0.201 vs -0.271, P=0.70). Our results demonstrate that term babies born with GS are significantly growth-retarded compared with premature babies born with GS. Term babies born with a proximal IA are also growth-retarded. This strongly suggests that in late gestation, the normal growth is dependent on a normally functioning gastrointestinal tract that allows exposure of the proximal intestinal mucosa to ingested amniotic fluid.
Intussusception is the commonest surgical complication of Henoch-Sch onlein purpura (HSP), occurring in 1.3%-13.6% of affected children. Colo-colic intussusception is a rare occurrence in HSP, with only three other reported cases. Intussusception in HSP almost always originates in the ileum (90%) or jejunum (7%), and more than one-half of cases (58.4%) are confined to the small bowel. This is in contrast to idiopathic intussusception, where the majority (80%-90%) are ileo-colic and can be diagnosed and reduced by contrast enema.
T-cell activation involves interactions between a number of different receptors on the T-cell with their respective ligands on the antigen presenting cell. One approach to studying the contributions of the individual receptors is the use of purified ligands, alone or in combination, to stimulate the cells. However, effective T-cell recognition requires that the ligands be displayed on a surface having dimensions similar to those of a cell. Methods are described for the rapid and efficient immobilization of purified membrane proteins, including class I MHC proteins, B7.1 and ICAM-1, on 5 microm diameter latex microspheres in a manner that preserves biological activity. Non-membrane proteins, such as anti-receptor antibodies, can be immobilized in a similar manner and can be coimmobilized along with membrane proteins. These artificial cell surface constructs can be handled in the same way as cells, including characterization by flow cytometry using antibodies specific for the immobilized proteins and stimulation of T-cell responses. The density of ligand on the surface of the microspheres can be easily varied and controlled and multiple proteins can be immobilized on the same surface. Thus, the described methods provide a great deal of flexibility in assessing the contributions of the various receptors to T-cell signaling and activation, and should be applicable to the study of other cell-cell interactions.
OBJECTIVE: The objective was to establish the likelihood that antenatal upper urinary tract dilatation identified after 28 weeks of gestation will progress to significant postnatal uropathy. STUDY DESIGN: In 5 years, 3856 fetuses had ultrasonography after 28 weeks of gestation when the mothers were first seen in advanced pregnancy for delivery appointments or for other obstetric indications. Fetuses with urinary tract anomalies had ultrasonographic surveillance after 6 days and 6 weeks of life with further evaluation as necessary. RESULTS: Renal tract anomalies were identified in 313 fetuses, and 55 infants had significant renal tract abnormalities. There were 7 deaths; 2 infants were anephric and 5 with hydronephrosis had lethal congenital abnormalities. Dilatation of the upper urinary tract was identified in 7.7% of the fetuses (298/3856) but was transient in 216 of them (72%). Follow-up of children with transient renal pelvis dilatation found only one with a history of urinary tract infection. Obstruction occurred in 23 infants (6.0/1000) and 16 required surgical correction. Vesicoureteric reflux was identified in 14 infants (3.6/1000) and resolved by age 2 years in 64%. Unilateral multicystic renal dysplasia occurred in 8 and posterior urethral valves occurred in 3 infants. CONCLUSION: Antenatal ultrasonography after 28 weeks' gestation identified significant renal tract abnormalities with a frequency of 14.3 per 1000 births, permitting early treatment of the asymptomatic newborn and reducing later renal damage.
A prospective study was carried out during 1986 to find out the incidence of fetal renal tract anomalies in 3228 pregnant mothers delivered in one hospital. Ultrasound examination of the fetus was performed as part of the routine antenatal assessment at 16-20 weeks' gestation, and later examinations were done if there were obstetric indications. Fetuses with any degree of dilatation of the renal pelvis or other renal tract anomalies were followed up with serial ultrasound examinations in utero and then postnatally at 6 days and 6 weeks of age, or earlier if indicated. No renal tract anomalies were detected before 28 weeks' gestation, but of 761 fetuses examined later, 62 had dilatation of the renal pelvis not associated with overdistended bladders, and one fetus was anephric. After birth 10 of these infants (16%) were found to have pronounced renal tract abnormalities. Three who had associated serious congenital abnormalities died, five infants had obstruction of the pelviureteric junction, and two infants had vesicoureteric reflux. Antenatal ultrasonographic examination after 28 weeks identifed pronounced renal tract abnormalities in asymptomatic infants with a frequency of 9.2/1000 births (seven of 761) thus permitting early treatment and reducing the incidence of late complications.
The first large cluster of patients with Crohn's disease, identified in the parish of Blockley, Gloucestershire is reported. Twelve patients with Crohn's disease have been identified of whom only two (a father and daughter) are known to be related. The age and sex distribution and macroscopic site of disease at diagnosis is similar to that expected in an unselected series. The identification of such a cluster suggests that environmental factors may be important in pathogenesis.
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Ectoparasite-free, SPF Italian Wistar rats were consistently found to carry a latent infection with Haemobartonella muris, activable by splenectomy. In an inbred line this diminished and eventually ceased in six generations. Experimental infection from wild rats demonstrated that this was not apparently due to immunity.
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