Analysis of the primary sex ratio, sex chromosome aneuploidy and diploidy in human sperm using dual-colour fluorescence in situ hybridisation.

In situ hybridisation technology provides a new tool for chromosome analysis of human spermatozoa. We have used dual-colour fluorescence in situ with probes specific for the X and Y chromosomes and chromosomes 1 and 12 to (a) identify the primary male gametic sex chromosome ratio; (b) assess the number of numerical sex chromosome abnormalities, and (c) quantify the incidence of diploid sperm. We have examined over 60,000 sperm from three normal males and found the primary sex ratio to be indistinguishable from unity.

Origin of the microangiopathic changes in diabetes.

The mechanism of development of microangiopathy is incompletely understood, but relates to a number of ultrastructural, biochemical and haemostatic processes. These include capillary basement membrane thickening, non-enzymatic glycosylation, possibly increased free radical activity, increased flux through the polyol pathway and haemostatic abnormalities. The central feature appears to be hyperglycaemia, which is causally related to the above processes and culminates in tissue ischaemia.

Management of adults with cystic fibrosis.

Many patients with cystic fibrosis now survive into adulthood seeking continuation of their care from adult physicians rather than paediatricians. Attention to detail is the key to successful management of this complex multisystem disorder; care is best provided in the context of a multidisciplinary, team-oriented approach.

Syringobulbia: a surgical appraisal.

Syringobulbia is a term which has been clinically applied to brain stem symptoms or signs in patients with syringomyelia. Syringobulbia clefts are found on investigation or at necropsy caused by cutting outwards of the CSF under pressure from the fourth ventricle into the medulla. These should be differentiated from the ascending syringobulbia which may occur from upward impulsive fluid movements in a previously established syringomyelia.

Risk factors for peripheral vascular disease in hypertensive subjects with type 2 diabetes mellitus.

Possible factors predisposing to peripheral vascular disease (PVD) in hypertensive subjects with Type 2 diabetes mellitus were studied. Details of age, sex, duration of diabetes, blood pressure, and smoking habit were recorded in 180 subjects of either White, West Indian Black or Asian ethnic origin. Glycosylated haemoglobin, fasting serum total cholesterol, total high density lipoprotein (HDL), HDL2, low density lipoprotein (LDL-cholesterol), and triglycerides were measured in all subjects.

Serum creatinine assays in patients receiving the antibiotic Cefpirome (HR 810): a study of three different routine methods compared with a specific HPLC method.

Sequential timed samples were taken from patients after a single dose of a new cephalosporin--Cefpirome HR810. The patients had been recruited in a multi-centre trial over a 12-month period. Creatinine was estimated in all of these specimens by four different techniques, embodying four different analytical principles.

A comparative study of imipenem versus piperacillin plus gentamicin in the initial management of febrile neutropenic patients with haematological malignancies.

Three-hundred and twelve episodes of fever in 234 neutropenic patients with haematological malignancies were treated empirically with either imipenem or a combination of piperacillin and gentamicin. There were no significant differences in the percentages of patients responding to therapy at either 72 h (59% and 56% of assessable episodes in the imipenem and combination groups respectively) or at the end of treatment (55% and 53% of assessable episodes in the imipenem and combination groups respectively). Patients in the piperacillin plus gentamicin group experienced significantly more renal tubular damage whereas those who received imipenem suffered more nausea or vomiting.

Unusual spinal tuberculosis after adequate chemotherapy for lymph node tuberculosis in an immunocompetent man.

A 35 year old man developed paraplegia due to an epidural mass 15 months after completion of a full chemotherapy course for pulmonary and lymph node Mycobacterium bovis infection. His cellular immune function was normal after treatment. It is suggested that the lesion was a granulomatous healing response rather than bacteriological recurrence.

Chronic transmural bronchiolitis: a non-specific lesion of small airways.

Aims: To investigate nine patients with histological changes at open lung biopsy compatible with so-called "small airways disease"; to define these changes and distinguish them from other types of bronchiolitis; and to correlate them with clinical features, respiratory physiology, and other laboratory investigations.

Methods: The open biopsy sections and the clinical records were reviewed.

Results: There was chronic inflammation of the walls of centri-acinar respiratory bronchioles and peribronchiolar alveoli.

Effects of chemotherapy on ultrastructure of oesophageal adenocarcinoma.

Aims: To compare and contrast the ultrastructural appearance of resected oesophageal adenocarcinomas treated with preoperative chemotherapy with that of non-treated resected controls; and to determine the usefulness of this method in the assessment of the effectiveness of the chemotherapeutic regimen.

Methods: Ten resected oesophageal adenocarcinomas treated with preoperative chemotherapy--mitomycin-C, ifosfamide, and cisplatin (MIC)--were examined by transmission electron microscopy and their appearance compared with that of 13 concurrent untreated resected oesophageal adenocarcinomas.

Results: The treated adenocarcinomas showed cytotoxic damage although complete tumour eradication was not achieved.

Serum cortisol levels predict infarct size and patient mortality.

We have investigated prospectively the serum cortisol response to acute myocardial infarction in 70 consecutive patients admitted to a coronary care unit and we have shown that the levels are significantly raised early in the course of the illness and prior to elevation of the cardiac specific enzyme fraction, creatine kinase MB. The magnitude of the cortisol response is related to the size of the ensuing infarction (rs = 0.54) as calculated from the total creatine kinase MB release (P < 0.

Inguinal herniotomy in young infants.

Ninety-two consecutive infants aged up to 12 months underwent primary inguinal herniotomy over a 5-year period. All were treated in a district hospital paediatric surgical unit according to recommendations of the British Association of Paediatric Surgeons. After a mean follow-up of 45.

A high incidence of asthma and respiratory symptoms in 4-11 year old children.

A study assessing the prevalence of respiratory symptoms in two primary schools in Birmingham, U.K. was performed.

The middle ear as a baroreceptor.

Under pressure in the middle ear is thought to be important in the pathogenesis of chronic otitis media with effusion and its sequelae, but the cause of the under pressure and the mechanisms responsible for regulation of the normal middle ear pressure are a matter of debate. Numerous studies have examined the effect of large pressure changes on the ear; however, the ear's sensitivity to smaller pressure changes has received little attention. This study examines the sensitivity of the ear to atmospheric air pressure changes induced in the external ear canal.

Occupational asthma due to polyethylene shrink wrapping (paper wrapper's asthma).

Occupational asthma due to the pyrolysis products of polyvinyl chloride (PVC) produced by shrink wrapping processes has previously been reported. The first case of occupational asthma in a shrink wrap worker using a different plastic, polyethylene, is reported; the association was confirmed by specific bronchial provocation testing.

Relationship between Legionella pneumophila and Acanthamoeba polyphaga: physiological status and susceptibility to chemical inactivation.

Survival studies were conducted on Legionella pneumophila cells that had been grown intracellularly in Acanthamoeba polyphaga and then exposed to polyhexamethylene biguanide (PHMB), benzisothiazolone (BIT), and 5-chloro-N-methylisothiazolone (CMIT). Susceptibilities were also determined for L. pneumophila grown under iron-sufficient and iron-depleted conditions.

Meiotic and sperm chromosome analysis in a male carrier of an inverted insertion (3;10)(q13.2;p14p13).

A phenotypically normal male who fathered a son with the karyotype 46,XY,del(10)(p13) was found to be a balanced carrier of an inverted insertion (3;10) (q13.2;p14p13). Karyotyping five later pregnancies showed four to be unbalanced with respect to the insertion, one of which was also trisomic for chromosome 18.

The ultrastructure of oesophageal carcinomas: multidirectional differentiation. A transmission electron microscopic study of 43 cases.

Forty-three oesophageal carcinomas, comprising 15 squamous cell carcinomas, 22 adenocarcinomas, 5 small cell carcinomas, and 1 adenosquamous carcinoma, were examined by transmission electron microscopy. The ultrastructural features of each tumour type are detailed. Multi-directional differentiation (heterogeneity) was observed in 11 cases: 5 squamous cell carcinomas with focal glandular features; 4 adenocarcinomas with focal squamous features; and 2 small cell carcinomas, one with glandular and the other with squamous features.