Biomedical subjects

A King

Publications and source records attributed to A King.

At least 343 records · Page 19Linked to original sources

PubMed1990

Malignant mixed müllerian tumor of the oviduct.

Malignant mixed müllerian tumor is an uncommon gynecologic neoplasm, especially in the oviduct, where fewer than 30 have been described. We report two additional cases which clinically mimicked carcinoma of the oviduct. Both patients were postmenopausal and had the chief complaint of abdominal pain associated with increased abdominal girth. Presurgical vaginal cytologies were negative and both diagnoses were made only with histologic examination of tissues removed at surgery. As most of the cases from the literature involved low-parity women, the high parity of these women is unusual. Unfortunately both presented with stage III disease and died of recurrent disease 18 and 12 months following surgery.

Fallopian Tube Neoplasms↗

PubMed1990

Regional distribution of cholecystokinin messenger RNA in rat brain during development: quantitation and correlation with cholecystokinin immunoreactivity.

The regional distribution of CCK-octapeptide (CCK) and CCKmRNA were studied in parallel in rat brain during development in order to characterize changes in gene expression in different structures at different periods of development and to determine whether differential regulation of translation and peptide turnover occurs, by correlating peptide and mRNA levels. CCK was characterized by Northern blot analysis. Methods were developed for quantitation of CCKmRNA by in situ hybridization (ISH) and compared with results obtained by slot blot analysis. Analysis of CCKmRNA by ISH showed that CCKmRNA was abundant in cerebral cortex, hippocampus, dentate gyrus, thalamus, inferior colliculus and periaqueductal grey in keeping with the high concentrations of CCK-like immunoreactivity in cell bodies located in these regions. Quantitation of CCKmRNA by computerized densitometric image analysis by reference to [35S]brain paste standards gave a similar pattern to that obtained by slot blot analysis of regional RNA extracts. Distinctive patterns of CCK development were seen. In cerebral cortex and hippocampus, a marked increase in peptide and mRNA levels was found from day 1 which showed a steady increase up to adult levels. However, in the thalamus, the highest levels of mRNA and peptide were reached at a much earlier stage, generally by 14d. In contrast, inferior and superior colliculus showed a delayed onset of peptide expression.

Animals↗

PubMed1990

Hyperproduction of TEM-1 beta-lactamase in clinical isolates of Escherichia coli serotype O15.

During an outbreak of infection with ampicillin-resistant, TEM-1 beta-lactamase-producing Escherichia coli serotype O15, some strains were noted to differ from the majority in that they showed reduced susceptibility to amoxycillin/clavulanic acid (Augmentin), ureidopenicillins and first generation cephalosporins and produced increased amounts of beta-lactamase. The plasmid from one such isolate was compared with that from an isolate that produced normal amounts of beta-lactamase. Restriction analysis with EcoRI revealed extra fragments in the plasmid from the beta-lactamase hyperproducer and use of DNA-DNA hybridisation with a biotinylated TEM-1 probe showed genetic rearrangement in the beta-lactamase hyperproducer so that the TEM gene appeared to be present in larger amounts and was located on a smaller fragment than for the plasmid from the strain that produced normal amounts of beta-lactamase.

DNA, Bacterial↗

PubMed1990

The rabies viruses of bats.

In the 1930s rabies was shown to affect blood-, insect- and fruit-eating bats. We have prepared anti-nucleocapsid monoclonal antibodies (MAbs) using Mokola and bat (Lagos, Duvenhage and Denmark) rabies viruses as immunogens. With these MAbs we have examined rabies viruses from vampire, insectivorous and frugivorous bats from the Americas, Africa, Europe and the Soviet Union and have compared them with isolates from terrestrial species including man. As well as confirming the findings of others with viruses of African and American bat origin, the results revealed the presence of a second biotype in European bats and demonstrated the presence of serotype 1 as well as serotype 4 viruses in bats of the Soviet Union.

Africa↗

PubMed1990

(Pyrimidinyloxy)acetic acids and pyrimidineacetic acids as a novel class of aldose reductase inhibitors.

Pyrimidineacetic acids and (pyrimidinyloxy)acetic acids were synthesized by alkylation, with methyl bromoacetate or tert-butyl bromoacetate as alkylating agents. Alkylation reaction at the nitrogen or oxygen atom for different substrates was found to be solvent dependent. N-Alkylation was favored in ethereal solvent, e.g., tetrahydrofuran and dimethoxyethane, whereas O-alkylation was predominant in dimethylformamide. These compounds were tested in vitro to determine their ability to inhibit bovine lens aldose reductase. Selected compounds were assayed in vivo, in a 4-day galactose-fed rat model. The decrease in galactitol from the control was determined in lens, nerve, and diaphragm. Several of the 6-oxopyrimidine-1-acetic acids and (pyrimidinyl-4-oxy)acetic acids were found to be potent inhibitors of bovine lens aldose reductase. A study was also undertaken to determine in vitro the transport behavior of selected compounds in the isolated rat sciatic nerve. A discussion of the structure-activity relationship of this class of compounds with reference to their intrinsic biochemical activity is reported. It is concluded, in general, that ability of a compound to penetrate the tissue membrane plays an important role in the genesis of in vivo lens aldose reductase (LAR) inhibitory activity.

Acetates↗

PubMed1990

Importance of organisms producing broad-spectrum SHV-group beta-lactamases into the United Kingdom.

We report the isolation of three strains of Klebsiella pneumoniae sensu lato, brought into the United Kingdom by patients from Greece and Egypt, that showed plasmid-determined resistance to ceftazidime. All three produced beta-lactamases shown by DNA hybridisation studies to belong to the SHV group. One produced an enzyme that appeared to be related to, but distinguishable from, SHV-1; another SHV-2 and the third SHV-5.

Blotting, Southern↗

PubMed1990

Intraperitoneal ciprofloxacin for the treatment of peritonitis in patients receiving continuous ambulatory peritoneal dialysis (CAPD).

Ciprofloxacin was evaluated as single-agent therapy for the empirical treatment of patients presenting with CAPD peritonitis in an open, uncontrolled trial. Seventy-five episodes of peritonitis in 44 patients receiving continuous ambulatory peritoneal dialysis were entered in the study. The antibiotic was administered intraperitoneally, at a dose of 50 mg/l in each bag of dialysate, for seven days. Treatment with ciprofloxacin was appropriate (organisms isolated sensitive to ciprofloxacin) and successful (clinical and bacteriological cure of peritonitis) in 62 (83%) of the 75 episodes. The mean ciprofloxacin concentrations in serum and effluent were 1.1 mg/l (range 0-2.9 mg/l) and 10.0 mg/l (range 0.2-33.4 mg/l), respectively, with no evidence of accumulation. Side effects were seen in two patients only, and were mild and transitory.

Adult↗

PubMed1990

The antibiotic sensitivity of bacteria isolated from the blood of patients in St Thomas' Hospital, 1969-1988.

We have monitored the antibiotic sensitivity of bloodstream isolates of common bacteria over a period of 20 years. Among the Gram-positive bacteria, the proportion of isolates of Staphylococcus aureus resistant to methicillin, erythromycin, fusidate, or gentamicin has increased marginally, while that of coagulase-negative staphylococci (mostly Staph. epidermidis) has increased markedly. Enterococci are becoming serially more resistant to high concentrations of aminoglycosides. The Enterobacteriaceae have become considerably less sensitive to ampicillin (and amoxycillin) and trimethoprim but more sensitive to the aminoglycosides, whilst their susceptibility to cefotaxime, ceftazidime, cefepime, cefpirome, imipenem, meropenem and temocillin has remained constant. We have some evidence that in-vitro resistance is clinically relevant since the mortality rate rises if inappropriate antibiotics are used empirically. Although many drug regimens could be used, we are able to recommend initial therapy with a combination of gentamicin and cefuroxime for most of our patients, the exceptions being those known to be infected with resistant organisms before the onset of septicaemia.

Coagulase↗

PubMed1990

Analysis of the two-team approach to anterior spinal fusion.

An anterior approach to the spine via a thoracoabdominal incision offers the surgeon many advantages. The major vascular structures are visualized, stabilization of a long segment of the spine is strong, and recovery is speedy. Nevertheless, this is a major operation and one with potential morbidity and mortality. At Children's Hospital of New Orleans, the Pediatric Surgery and Pediatric Orthopedic Surgery Services work together to reduce these risks and in so doing maintain an acceptable morbidity. With this two-team approach; we operated on the spines of 39 patients between 1978 and 1988. The most common indications for operation included idiopathic scoliosis, neuromuscular disease, and congenital abnormalities. A thoracoabdominal approach was used in 32 patients, a thoracic approach in four patients, and an abdominal approach in three patients. Twenty-nine patients experienced 65 complications; 45 of these complications were respiratory in nature. There were no postoperative deaths. Factors unrelated to the incidence of postoperative complications included age, volume of crystalloid infused during operation, volume of blood replacement, and length of anesthesia.

Adolescent↗

PubMed1990

Abnormal fucosylation of ileal mucus in cystic fibrosis: I. A histochemical study using peroxidase labelled lectins.

Peroxidase conjugated lectins were used to analyse the glycoproteins of small intestinal mucins in normal infants and those with cystic fibrosis to ascertain whether there are any detectable histochemical differences in saccharide composition. A significant decrease in Lotus tetragonolobus (LTG) binding fucose was shown in normal small intestinal mucin starting around 36 weeks' gestation with total absence of staining at term and beyond. In contrast, the age matched patients with cystic fibrosis showed persistent and intense LTG binding of fucose. These results provide the first clear histochemical evidence that cystic fibrosis mucin is abnormal and confirm the findings of previous biochemical studies.

Cystic Fibrosis↗

PubMed1990

Abnormal fucosylation of-ileal mucus in cystic fibrosis: II. A histochemical study using monoclonal antibodies to fucosyl oligosaccharides.

Abnormal fucosylation of cystic fibrosis mucin was previously shown using peroxidase conjugated lectins on ileal tissue sections. These abnormally fucosylated glycoproteins were investigated further using monoclonal antibodies to fucosyl oligosaccharides based on type 1 and type 2 blood group precursor chains. The results of this study, using monoclonal antibodies to blood group glycoproteins in cystic fibrosis, were negative, yet abnormal fucosylation had been found using lectin histochemistry. Using monoclonal antibodies, lectins, and appropriate enzymes, such as glycosyl hydrolases, it should be possible to delineate further the abnormality found in glycoproteins in cystic fibrosis on appropriately fixed ileal sections, obtained from infants at term presenting with meconium ileus.

Antibodies, Monoclonal↗

PubMed1990

Outcome of congestive heart failure, dilated cardiomyopathy, hypertrophic hyperkinetic disease, and ischemic heart disease in dialysis patients.

Congestive heart failure in dialysis patients is associated with dilated cardiomyopathy, hypertrophic hyperkinetic disease and ischemic heart disease. To determine the natural history of these four diseases, 150 dialysis patients were prospectively followed for 3-5 years. The 2-year cumulative survival rate was 33% in those with recurrent or persistent congestive heart failure vs. 80% in dialysis patients without. Survival was significantly worse in patients with an echocardiographic diagnosis of dilated cardiomyopathy compared to patients with normal echo-cardiogram (2-year survival rate 67 vs. 90%). In hypertrophic hyperkinetic disease the 2-year survival rate was 30% after entry into the study, and 43% after first admission with congestive heart failure. Symptomatic ischemic heart disease did not have an adverse impact on mortality when compared to those without ischemic heart disease. We conclude that congestive heart failure in dialysis patients has a bad prognosis. Its associated disorders include dilated cardiomyopathy and hypertrophic hyperkinetic disease, the latter being associated with a high mortality. As the prognosis for patients with overt ischemic heart disease was not different from patients without, it is likely that the underlying cardiomyopathy directly influenced survival.

Cardiomegaly↗

PubMed1990

The clinical course of left ventricular hypertrophy in dialysis patients.

To determine the clinical and echocardiographic outcome of left ventricular hypertrophy a prospective study was undertaken of 104 nondiabetic dialysis patients without dilated cardiomyopathy, who were followed for 3-5 years. 33% of patients had normal echocardiogram, 41% mild and 27% severe hypertrophy (left ventricular wall thickness greater than or equal to 1.4 cm in diastole). In the first 2 groups 16% progressed to severe hypertrophy, 23% were admitted with congestive heart failure after starting dialysis therapy, and 2-year cumulative survivals were 97 and 85%. In the group with severe hypertrophy 88% already had severe hypertrophy on starting dialysis therapy, it was persistent in 87%, 50% were admitted at least once with congestive heart failure, and the 2-year cumulative survival was 53%. 71% of those who died in the severe group died from cardiac or cerebrovascular causes compared to none of those with normal echocardiogram, which accounted for the significantly worse (p = 0.001) survival. We conclude that severe left ventricular hypertrophy occurs frequently in dialysis patients, is often present at the start of end-stage renal disease therapy, is persistent, may predispose to congestive heart failure, and is associated with a high mortality.

Cardiomegaly↗

PubMed1990

Are women using postmenopausal estrogens? A community survey.

Self-reported estrogen and progestin use in a California community was determined in 1986-87 from a telephone survey of postmenopausal women (n = 954) ages 50-65 years. Current use of hormones was reported by 32 percent; 26 percent took estrogens alone while 6 percent used estrogen + progestin. Comparisons pointed to significant social network and medical care utilization differences. Women who used estrogen therapy were younger, thinner, lived in smaller household units, and were less likely to be widowed.

Aged↗

PubMed1990

Beneficial effects of long-term treatment with SK&F 105685 in murine lupus nephritis.

MRL/Mp-lpr/lpr (MRL/lpr) mice were studied from 6 to 19 weeks of age. Proteinuria began to increase at 15 weeks, and continued to increase until the animals were sacrificed at 19 weeks. This proteinuria was associated with lymphadenopathy and splenomegaly, as well as changes in lymph node cell phenotype and histologic changes in the glomeruli. Oral administration of SK&F 105685 starting at 12 weeks of age prevented the increased urinary protein loss, inhibited the histologic changes in the glomeruli, reduced the increase in spleen and lymph node weight and modified the phenotypic profile of the lymphoid cells. SK&F 105685 appears to act by increasing the number/activity of nonspecific suppressor cells in MRL/lpr mice. On the basis of this evidence, we conclude that SK&F 105685 can attenuate the progression of renal damage in MRL/lpr mice by exerting a unique effect on cells which may be involved in the autoimmune process.

Animals↗

PubMed1989

Centrally acting alpha-2 agonists, peripherally acting adrenergic-blocking drugs, and direct vasodilators in the treatment of mild and moderate essential hypertension.

The experience with three groups of antihypertensive agents in a large hypertension clinic serving a black patient population is reported. A retrospective review of clinic records was undertaken to determine the efficacy and adverse effects of the centrally acting adrenergic agonists methyldopa and clonidine, the alpha-1 antagonist prazosin, and the direct vasodilator hydralazine in patients with mild and moderate hypertension. Treatment with methyldopa, clonidine, or prazosin, usually in combination with a diuretic produced a 30 to 38 mmHg decrease in systolic blood pressure, and a 24 to 28 mmHg reduction in diastolic blood pressure. Similar declines in blood pressure levels occurred when hydralazine was used with an alpha-2 adrenergic agonist or beta-adrenoceptor blocking agent. Evidence of clinical efficacy, defined as a decrease in systolic blood pressure to below 140 mmHg and in diastolic blood pressure to below 90 mmHg, was observed in 80% or more of the patients. An 88% efficacy rate was seen with methyldopa. Effective doses of the drugs varied considerably; most patients, however, responded at a dose close to the average dose for each agent. The most serious adverse effect observed was elevation of hepatic enzyme levels in patients receiving methyldopa, which necessitated withdrawal of the drug. Two patients treated with 0.4 mg clonidine twice a day experienced "rebound" hypertension when the drug was abruptly discontinued. Overall, good clinical efficacy and patient acceptance were found with these three groups of antihypertensive agents.

Adult↗

PubMed1989

Early human decidual cells exhibit NK activity against the K562 cell line but not against first trimester trophoblast.

The susceptibility of cultured first trimester human trophoblast cells to lysis by NK cells has been studied. Trophoblast cells are resistant to lysis by NK cells from both peripheral blood and decidua. However, decidual cells extracted by enzymatic disaggregation do exhibit cytotoxicity against the NK-sensitive cell line K562. The relevance of these findings to successful implantation of the blastocyst is discussed.

Cell Separation↗

PubMed1989

Age as a prognostic factor in carcinoma of the cervix.

The influence of age on prognosis for carcinoma of the cervix was evaluated for a population of 218 patients treated at Loma Linda University between 1972 and 1982. Treatment methods were consistent over this time interval and were tailored according to age and extent of disease. Minimum follow-up is 5 years. The age groups were less than 35, 35-55, 55-75, and greater than or equal to 75. There was a significantly higher percentage of stages IIB and III in the older (greater than 55) age groups. The age groups were subdivided by stage for analysis of local-regional and distant failures. No significant age differences in local-regional or distant failures were found. Actuarial analysis of disease-free survival demonstrated no significant difference by age group. Age could not be verified as a prognostic factor in this study population.

Adult↗