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Biomedical subjects

A King

Publications and source records attributed to A King.

At least 397 records · Page 22Linked to original sources
PubMed1986

Spinal cord tumor presenting as a herniated lumbar disc.

The lesion encountered in this case was that of an intradural-extramedullary tumor. Histologic section showed an organized hematoma, which is a very rare tumor. In a recent review of the literature, only 85 cases have been reported, most in relation to a bleeding intraspinal neoplasm. Our case is especially unusual because there was no clotting abnormality or repeated lumbar punctures or arteriovenous malformation. This case also points out the necessity of a complete physical examination. A CT scan was initially negative because the scan started just below the tumor, hence it was never visualized. Metrizamide myelogram followed by the enhanced CT scan provides a more complete diagnostic study. In this patient's case, the CT scan would have led to inappropriate therapy, whether lumbar laminectomy or chemonucleolysis.

Adult↗
PubMed1985

Riboflavin as a tracer of medication compliance.

Three experiments were conducted to evaluate the accuracy of urine ultraviolet fluorescent tests for riboflavin, which has been used as a tracer for medication compliance in several clinical drug trials. Observer accuracy in discriminating riboflavin-positive or negative urine samples was found to vary with the method of observation, dose of riboflavin, observer experience, and time postingestion. The results showed that, while the 5-mg dose used in previous clinical trials was too small to permit reliable assessment of compliance, larger doses of riboflavin could produce nearly 100% accuracy for minimally trained observers who used a matching-to-sample observation procedure. The findings are discussed in terms of the potential clinical and research applications of this type of simple but reliable compliance assessment procedure.

Adult↗
PubMed1985

Is continuous sulfasalazine necessary in the management of patients with ulcerative colitis? Results of a preliminary study.

The efficacy of continuous and "on-demand" sulfasalazine in the maintenance of remission of ulcerative colitis was tested in a randomized trial. Patients were reviewed at four monthly intervals for one year. Twenty-eight patients completed the trial. Ten took continuous sulfasalazine and three relapsed, while 18 took "on-demand" sulfasalazine and seven relapsed (N.S.). Rectal biopsies from each patient group were compared at each attendance, and no significant difference in histologic score was found. It is concluded that "on-demand" sulfasalazine may be as effective as continuous sulfasalazine in the maintenance of remission of ulcerative colitis.

Adult↗
PubMed1985

Excitatory amino acid-induced responses of frog motoneurones bathed in low Na+ media: an intracellular study.

Motoneurones of the frog spinal cord slice preparation were impaled with microelectrodes and superfused at 7 degrees C with the excitatory amino acids glutamate, quisqualate or N-methyl-D-aspartate. The role of Na+ in the action of these amino acids was studied by comparing amplitude matched depolarizations obtained in control Ringer solution with the responses recorded from the same cells after replacing (86-100%) Na+ by choline or glucosamine. Effective replacement of extracellular Na+ proved to be a rather slow process requiring 30-60 min. In glucosamine solution depolarizations evoked by glutamate, N-methyl-D-aspartate or quisqualate were abolished or strongly reduced with recovery following return to control Ringer. In choline solution, glutamate and N-methyl-D-aspartate effects were blocked whereas the quisqualate response was surprisingly unaffected. Mn2+ (2 mM) added to choline solution strongly diminished the action of quisqualate. These results suggest that Na+ was important in mediating amino acid responses and that quisqualate activated an additional conductance mechanism (perhaps to Ca2+) unmasked only in choline-containing solution.

Amino Acids↗
PubMed1985

The in-vitro activities of enoxacin and ofloxacin compared with that of ciprofloxacin.

The in-vitro activities of enoxacin and ofloxacin were compared with that of the other new 4-quinolone, ciprofloxacin. All three compounds were highly active against Enterobacteriaceae, Haemophilus influenzae and Neisseria gonorrhoeae (MICs mostly less than 1 mg/l). The other Gram-negative aerobes tested were in general less susceptible, though for Acinetobacter and Pseudomonas species (including aeruginosa) MICs seldom exceeded 8 mg/l. Ofloxacin and ciprofloxacin were more active against Gardnerella vaginalis (MICs 0.5-2 mg/l) than was enoxacin (MICs 8-32 mg/l). Staphylococci were susceptible to ofloxacin (MICs 0.12-1 mg/l) and enoxacin (MICs 0.5-2 mg/l) as well as to ciprofloxacin. Streptococci also were mostly sensitive to the compounds though the MICs of enoxacin (4-64 mg/l) were noticeably higher than those of ofloxacin (1-4 mg/l). Anaerobes were in general susceptible though, as with streptococci, ofloxacin, with activity similar to that of ciprofloxacin, was more active than enoxacin. Variants of Enterobacteriaceae with reduced susceptibility were readily selected in the laboratory with either enoxacin or ofloxacin as the selective agent. The MICs of all the 4-quinolones were usually increased four- to 16-fold for these strains; they could therefore be regarded as remaining susceptible to the newer compounds.

Bacteria↗
PubMed1985

Sch 34343: in-vitro antibacterial activity and susceptibility to beta-lactamases.

The in-vitro activity of the penem Sch 34343 was assessed in comparison with third-generation cephalosporins, aztreonam and imipenem. Sch 34343 was active, with MICs generally 2 mg/1 or less, against a broad spectrum of organisms amongst which were staphylococci (including methicillin-resistant strains), streptococci (though enterococci were less susceptible with Sch 34343 MICs mostly 4-8 mg/1), anaerobes (including the Bacteroides fragilis group), Haemophilus influenzae and Neisseria gonorrhoeae. It was also active against the Enterobacteriaceae though Enterobacter cloacae and Serratia spp. were somewhat less susceptible than other members of this group. Sch 34343 lacked useful activity against most species of Pseudomonas (including Ps. aeruginosa) but was active against Ps. acidovorans and some isolates of Ps. cepacia. Sch 34343 showed a high degree of resistance to plasmid-determined and most chromosomally-determined beta-lactamases; however, it was hydrolysed rapidly by enzymes from some isolates of Aeromonas hydrophila and more slowly by enzymes from Ps. maltophilia and Bact. melaninogenicus subspecies intermedius. We did not observe any reduction in sensitivity to Sch 34343 for most beta-lactamase-producing organisms, including strains of Enterobacter spp. and Citrobacter freundii that were resistant to most other beta-lactams.

Aeromonas↗
PubMed1984

Stromal invasion in endometrial adenocarcinoma.

The ability to predict myometrial invasion by endometrial adenocarcinoma is useful for preoperative treatment purposes. The presence of stromal invasion is one possible method of predicting myometrial invasion, but criteria for the presence of stromal invasion have been lacking. Recently, criteria for its detection were proposed. We evaluated the validity of the proposed criteria in two conditions: (1) atypical hyperplasia (119 cases) and (2) endometrial adenocarcinoma Stage I, grade 1 (83 cases). Adenocarcinoma without stromal invasion according to the criteria of Kurman and Norris was present in 43 cases and adenocarcinoma with stromal invasion was present in 40 cases. This series demonstrated the ability of prehysterectomy endometrial sampling to predict the probability of myometrial penetration. In addition, none of our patients without stromal invasion in the resected uterus had myometrial penetration and no metastases have occurred. In those showing stromal invasion in the excised uterus, the myometrium was invaded in 34 of 51 cases (67%). Since myometrial penetration was not present when there was no stromal invasion in the resected uterus, stromal invasion deserves further evaluation and should be considered in future classification of endometrial adenocarcinoma.

Adenocarcinoma↗
PubMed1984

Microinvasive squamous carcinoma of the vulva: present status and reassessment.

A retrospective analysis of 24 patients with early invasive squamous carcinoma was performed. No nodal metastases were noted in these patients. Based on a review of the literature, no absolute definition of microinvasive carcinoma could be formulated, but a treatment outline has been formulated based on depth of invasion for Stage I lesions.

Adult↗
PubMed1984

The in-vitro activity of ciprofloxacin compared with that of norfloxacin and nalidixic acid.

The in-vitro activity of ciprofloxacin , a new 4-quinolone, was compared with that of norfloxacin and nalidixic acid against recent clinical isolates of medically important bacteria. Overall, ciprofloxacin and norfloxacin had similar spectra of activity, but ciprofloxacin had somewhat greater intrinsic activity against most organisms. Minimum inhibitory concentrations (MIC) were in the range 0.004-4 mg/l for Enterobacteriaceae, 0.016-2 mg/l for Pseudomonas spp., 0.004-1 mg/l for Acinetobacter, 0.004-0.016 mg/l for Haemophilus influenzae, 0.001-0.004 for gonococci, 0.004-0.03 mg/l for Cmpylobacter , 0.12-2 mg/l for staphylococci, 0.25-4 mg/l for streptococci, 1-32 mg/l for the Bacteroides fragilis group and mostly in the range 0.25-8 mg/l for other obligate anaerobes. Resistant variants could be selected readily in vitro by culture on any of the three compounds investigated. However, while the MICs of nalidixic acid were high for these variants those of ciprofloxacin and norfloxacin were much lower.

Anti-Bacterial Agents↗
PubMed1984

Effective oral treatment of severe Paget's disease of bone with APD (3-amino-1-hydroxypropylidene-1,1-bisphosphonate); a comparison with combined calcitonin + EHDP (1-hydroxyethylidene-1,1-bisphosphonate).

Ten patients with severe Paget's disease of bone and serum alkaline phosphatase (sAP) greater than 900 IU/l were treated for six months with the oral diphosphonate APD, (3-amino-1-hydroxypropylidene-1, 1-bisphosphonate). By the end of the treatment period there was a reduction in the log mean urine hydroxyproline (uHP) and the log mean sAP of 92% and 87% respectively. In four patients both sAP and uHP fell to within the normal range and remained normal for at least six months after therapy was stopped. Bone scintigraphy showed a fall in 99mTc-MDP uptake in sites of active Paget's disease in all patients and histomorphometry showed no increase in osteoid. Repair of radiological osteolytic lesions was observed in 6/6 patients and progression of tibial osteolytic wedges was arrested in 5/5 patients and reversed in four. This improvement persisted six months after completion of therapy but further wedge progression occurred in one patient whose urine HP remained elevated. There were no serious effects though five patients complained of nausea. The clinical and biochemical responses to APD were equivalent to those observed in the same patients during a previous six month course of combined therapy with human calcitonin (CT) + EHDP except that there was additional biochemical and radiological evidence of bone healing. This study confirms PAD as an effective treatment of severe Paget's disease of bone.

Aged↗
PubMed1984

Neutropenic enterocolitis due to Clostridium septicum infection.

Three cases of neutropenic enterocolitis are described. This unusual condition occurs almost exclusively in neutropenic patients and has a fulminating course which is almost invariably fatal without surgical intervention. The lesion is centered on the caecum and hitherto its pathogenesis has been unclear, partly because most studies have been performed on material obtained at necropsy. In these three patients, all of whom were treated surgically, Clostridium septicum was identified by specific immunofluorescence in the bowel wall of the resected specimens. Two patients also had C septicum septicaemia. Various forms of mucosal damage can be identified which predispose towards invasion of the bowel wall by this organism. These cases provide further confirmation of a primary role for C septicum in the pathogenesis of neutropenic enterocolitis.

Adolescent↗