St Thomas' Hospital

About: St Thomas' Hospital is a healthcare organization based out in London, United Kingdom. It is known for research contribution in the topics: Population & Pregnancy. The organization has 12105 authors who have published 15596 publications receiving 624309 citations. The organization is also known as: St Thomas's Hospital & St. Thomas's.

Lymphangioma of skin. A review of 65 cases.

Abstract: SUMMARY Sixty-five cases of lymphangiomata involving skin or mucous membrane have been reviewed and found on clinical and histological grounds to fall into 3 groups. “Classical” lesions of lymphangioma circumscriptum were often extensive, had a predilection for certain areas and were usually present at birth or appeared in early life. Small “localized” lesions had no particular sites of predilection and could appear for the first time at any age. A small number of lesions with a characteristic sponge-like histological appearance were found in areas where skin or mucous membrane was interwoven with striated muscle. A review of the results of surgery in these patients showed recurrence to be unusual after excision of “localized” lesions but to be common when an attempt was made to excise lesions of the “classical” type.

Length-dependent tension in the failing heart and the efficacy of cardiac resynchronization therapy.

Abstract: Aims Cardiac resynchronization therapy (CRT) has emerged as one of the few effective and safe treatments for heart failure. However, identifying patients that will benefit from CRT remains controversial. The dependence of CRT efficacy on organ and cellular scale mechanisms was investigated in a patient-specific computer model to identify novel patient selection criteria. Methods and results A biophysically based patient-specific coupled electromechanics heart model has been developed which links the cellular and sub-cellular mechanisms which regulate cardiac function to the whole organ function observed clinically before and after CRT. A sensitivity analysis of the model identified lack of length dependence of tension regulation within the sarcomere as a significant contributor to the efficacy of CRT. Further simulation analysis demonstrated that in the whole heart, length-dependent tension development is key not only for the beat-to-beat regulation of stroke volume (Frank–Starling mechanism), but also the homogenization of tension development and strain. Conclusions In individuals with effective Frank–Starling mechanism, the length dependence of tension facilitates the homogenization of stress and strain. This can result in synchronous contraction despite asynchronous electrical activation. In these individuals, synchronizing electrical activation through CRT may have minimal benefit.

Preimplantation Genetic Diagnosis of Inherited Cancer: Familial Adenomatous Polyposis Coli

Abstract: Purpose:Our purpose was to achieve preimplantation genetic diagnosis (PGD) of the dominant cancer predisposition syndrome, familial adenomatous polyposis coli (FAPC), as an alternative to prenatal diagnosis. Methods:The affected patient was superovulated and oocytes were retrieved and fertilized by intracytoplasmic sperm injection (ICSI). Two cells were biopsiedfrom each embryo and the whole genome was amplified by primer extension preamplification (PEP). Nested PCR was then used to amplify two APC fragments: one including the APC mutation site and the other an informative intragenic polymorphism. Both were detected by simultaneous singlestrand conformation polymorphism and heteroduplex analysis. Results:Four normally fertilized embryos were biopsied on day 3 post ICSI, and two cells were successfully removed from each embryo. Following PEP the APC mutation was successfully amplified in 7 of 8 cells, and the polymorphism in 6 of 8 cells. The APC mutation was detected in three embryos. This result was confirmed by identification of the mutation associated polymorphism in two cases. A single embryo was diagnosed as homozygous normal for the mutation and the polymorphism in both cells sampled. This unaffected embryo was transferred to the mother, but no pregnancy resulted. Conclusions:We report here the first diagnosis of a cancer predisposition syndrome in human preimplantation embryos. Our results indicate that difficulties associated with single-cell PCR, allele-specific amplification failure in particular, need not prevent preimplantation diagnosis of diseases with a dominant mode of inheritance, provided appropriate strategies are applied.