Search PubMed⌕ Search

Biomedical subjects

C King

Publications and source records attributed to C King.

At least 109 records · Page 6Linked to original sources
PubMed1994

Detection of Candida casts in experimental renal candidiasis: implications for the diagnosis and pathogenesis of upper urinary tract infection.

The distinction between upper versus lower urinary tract infection in patients with candiduria is a commonly encountered and therapeutically important diagnostic dilemma. Candida casts have been reported in the urine of several individual case reports of human renal candidiasis. The specificity of Candida casts would identify unequivocally a patient with upper urinary tract disease. Little is known, however, about the sensitivity and the formation of Candida casts. We therefore studied the diagnostic yield, methods for detection and pathogenesis of Candida cast formation in serially collected urine specimens from immunologically intact and granulocytopenic rabbit models of haematogenous disseminated candidiasis. Refractile blastoconidia and pseudohyphae of Candida encased in the granular matrix were seen on wet mounts while Candida stained a brilliant red in the fuschia pink tubular matrix on periodic acid Schiff (PAS) stained cytopathology filters. Among 24 rabbits with disseminated candidiasis, 11 (46%) had Candida casts detectable by wet mount and PAS-stained urine filters in comparison to none of 10 non-infected immunologically normal controls (P = 0.014). Fifteen (70%) of 21 episodes of Candida casts were detected within the first 3 days of infection, indicating possible utility in the early diagnosis of renal candidiasis. No Candida casts were detected in the urine of granulocytopenic rabbits, possibly due to the rapid destruction of tubules and abrogation of cast formation. This absence of detectable Candida in eight infected granulocytopenic rabbits differed significantly from that of 24 non-granulocytopenic infected rabbits, in which Candida casts were detected in 11 (46%) (P = 0.029). Candida cast formation occurred predominantly in the cortex. Histopathological examination demonstrated invasion of Candida into the glomerular tufts and peritubular capillaries, followed by development of Candida casts in the proximal and distal tubules, respectively. Detection of renal Candida casts may be a useful diagnostic marker in distinguishing upper versus lower urinary tract candidiasis.

Animals↗
PubMed1994

Discrimination of speech-like contrasts in the auditory thalamus and cortex.

The neurophysiologic discrimination of acoustic contrasts was investigated as reflected by the mismatch negativity (MMN) response. Evoked responses were recorded from guinea pig thalamus (medial geniculate nucleus) and epidural surface in response to synthesized speech contrasts /ga/-/da/ and /ba/-/wa/. From the caudomedial portion of the medial geniculate nucleus, /ba/-/wa/ elicited a strong mismatch response, whereas /ga/-/da/ did not. Neither stimulus contrast elicited an MMN from the ventral, or primary, portion of medial geniculate. Both stimulus contrasts elicited an MMN from the midline surface. Neither contrast elicited an MMN from the surface over the temporal lobe. Results indicate a hierarchy of processing of the spectrotemporal changes which characterize formant transitions. Also, results indicate that the nonprimary portions of the auditory pathway contribute substantially to the MMN.

Animals↗
PubMed1994

Nonprimary auditory thalamic representation of acoustic change.

1. The mismatch response, or mismatch negativity (MMN), is a neurophysiologic response to stimulus change. In humans and other animals, the MMN may underlie the ability to discriminate acoustic differences, a fundamental aspect of auditory perception. 2. This study investigated the role of the thalamus in the generation of a tone-evoked MMN in guinea pigs. Electrodes were placed in the caudomedial (nonprimary) and ventral (primary) subdivisions of the auditory thalamus (medial geniculate nucleus). Surface epidural electrodes were placed at the midline and over the temporal lobe. The MMN was elicited by a deviant stimulus (2,450-Hz tone burst) embedded in a sequence of standard stimuli (2,300-Hz tone bursts). 3. A tone-evoked MMN was present in nonprimary thalamus but was absent in the primary thalamus. Surface-recorded MMNs were measured at the midline but not over the temporal lobe. The correspondence between nonprimary thalamic responses and midline surface potentials, and between primary thalamic responses and temporal surface potentials, is consistent with data reported for the auditory middle latency responses in guinea pigs. 4. The results demonstrate that the nonprimary auditory thalamus contributes to the generation of a tone-evoked MMN in the guinea pig. Furthermore, the data indicate that the guinea pig is a feasible model for investigating central auditory processes underlying acoustic discrimination.

Acoustic Stimulation↗
PubMed1994

The reliability and factor structure of the index of spouse abuse with African-American women.

This study investigated the reliability and validity of the Index of Spouse Abuse (ISA) when used with a sample of 504 African-American women. The initial factor validity analysis for the ISA (Hudson & McIntosh, 1981) resulted in two subscales: a physical abuse scale (ISA-P) and a nonphysical abuse scale (ISA-NP). Factor analysis with this sample of African-American women revealed three factors instead of two. Coefficient alpha estimates of reliability were over .90 for the original ISA subscales and with the African-American sample. The discussion compares and contrasts the factor structure observed with the sample of African-American with the factor structure reported in the original validation studies. The study demonstrates the need to critically evaluate the extent to which instruments developed to measure spouse or partner abuse are valid and reliable when used with diverse groups that may not have been represented in the samples used for initial instrument development and validation work.

Adolescent↗
PubMed1994

The use of gamete intra-fallopian transfer with donor spermatozoa after failed donor insemination.

The objective of this study was to assess the efficacy of gamete intra-Fallopian transfer (GIFT) in couples who had failed to conceive by donor insemination. The study was designed as a retrospective analysis of couples who entered the GIFT programme after 12 failed cycles of donor insemination. It took place in a comprehensive reproductive clinic with large donor insemination and in-vitro fertilization/GIFT programmes. A total of 197 patients received a total of 350 treatments from 1985 until 1992. Couples entered the GIFT programme with the routine stimulation and monitoring. The only difference was that frozen spermatozoa were used for the insemination. The main outcome measure was pregnancy, defined as a positive beta-human chorionic gonadotrophin (> 30 IU/l) at 16 days after replacement of gametes. The overall pregnancy rate achieved was 31% per cycle. Life table analysis showed a cumulative pregnancy rate of 75.4 +/- 5.7% after four cycles and 96.0 +/- 2.7% after eight cycles. It was concluded that the use of GIFT with donor spermatozoa is a highly effective treatment and should be offered to all couples who fail to conceive with donor insemination.

Cryopreservation↗
PubMed1993

Pathogenic significance of interleukin-6 in angioimmunoblastic lymphadenopathy-type T-cell lymphoma.

Patients with angioimmunoblastic lymphadenopathy (AILD)-type T-cell lymphoma may develop hypergammaglobulinemia. Among four cases of AILD-type T-cell lymphoma that we have studied, we detected a correlation between the number of plasma cells in tissue and the extent of interleukin-6 (IL-6) expression in lymphoma cells. We did not detect IL-6 in three patients who had no hypergammaglobulinemia and whose tissues showed only minimal plasma cell infiltration. In the fourth patient we observed an abundant IL-6 production by lymphoma cells, which accounted for a B-cell plasmacytic tissue response and for hypergammaglobulinemia. The pathogenic significance of IL-6 was substantiated by a concomitant decrease in the serum IL-6 level, measurable tumor mass, and immunoglobulin levels, as well as by a decline in the proportion of plasmacytoid cells in peripheral blood promptly on administration of chemotherapy. Plasmacytoid B cells could be maintained in culture in the presence of IL-6, but viability was lost on co-incubation with anti-IL-6. Interleukin-1 and tumor necrosis factor were not produced by T lymphoma cells and were incapable of sustaining plasmacytoid B-cell viability in vitro. Small amounts of IL-4 were noted in T lymphoma cells. Thus, in this case of AILD-type T-cell lymphoma, tumor cells with a T-cell phenotype produced IL-6 in large quantities, explaining the accompanying B-cell and plasmacytic histologic changes and humoral disease manifestations, including marked hypergammaglobulinemia. Although not all cases of AILD-type T-cell lymphoma have an accompanying plasma cell proliferation and hypergammaglobulinemia, and although the cytokine network in these patients may be more complex than has been recognized, this case with IL-6 expression serves to illustrate the utility of cytokine assays in the analysis of the histopathologic and clinical heterogeneities of peripheral T-cell lymphomas.

Aged↗
PubMed1993

Proposed fellowship training program in pediatric emergency medicine for emergency medicine graduates.

Interest in pediatric emergency medicine has grown steadily during the past decade among pediatricians and emergency physicians. With the rapid proliferation of pediatric emergency medicine programs for pediatricians has come extensive and valuable experience with this type of fellowship education. As a result, the structure and scope of these programs have become increasingly well established. Because the number of pediatric emergency medicine fellowship programs for emergency physicians has yet to reach "critical mass," no similar de facto standards exist for these programs. The recent establishment of guidelines for pediatric emergency medicine subspecialty certification by the American Board of Emergency Medicine and the American Board of Pediatrics brings new importance to fostering such standards for the training for emergency physicians. To this end, we present a proposed pediatric emergency medicine fellowship program developed during a retreat that included physicians from an emergency medicine program and two pediatric hospitals. We also review some of the significant events that have occurred in the evolution of pediatric emergency care.

Algorithms↗
PubMed1993

Reproducibility of resting cerebral blood flow measurements with H2(15)O positron emission tomography in humans.

Two consecutive measurements of resting CBF were carried out in normal volunteers (n = 25) using H2(15)O positron emission tomography. Absolute whole-brain blood flow (WBBF; ml 100 g-1 min-1, mean +/- SD) for the first (40.3 +/- 6.4) and second (39.3 +/- 6.5) measurements was not significantly different (mean % difference 2.3 +/- 8.7). Analysis of regions of interest showed no significant differences in absolute regional CBF (rCBF) and normalized (rCBF/WBBF) rCBF. Left-right differences were also not significant. These data demonstrate the reproducibility of resting CBF measurements in normal humans.

Adult↗
PubMed1993

Improving the reliability of the auditory middle latency response by monitoring EEG delta activity.

The auditory middle latency response (MLR), a useful tool in the assessment of low-frequency auditory sensitivity, can be consistently recorded in young children during wakefulness, stages 1 and 2, and REM sleep. Responses are often absent or questionable during stage 4. An on-line measure indicating favorable periods for recording MLR during sleep is important for interpretation of absent potentials. Here, for children 5 to 7 years old, the reliability and detectability of MLR was compared to sleep state and the dominance of delta activity (0-3 Hz) in the EEG frequency spectrum. Dominance of delta activity, a characteristic of stage 4, was expressed in a "delta ratio," a measure of relative EEG energy in the 0 to 3 Hz frequency spectrum. A fixed delta ratio (DR = 9) allowed the differentiation of periods favorable for MLR. MLR wave Pa amplitude and latency also varied with delta ratio. Results indicate that on-line monitoring of the delta ratio will allow reliable testing of MLR in clinical situations.

Acoustic Stimulation↗
PubMed1993

[Non-stimulated cycles and GIFT].

Authors, following a 19 natural cycle survey, used a simplified protocol for GIFT. 13 oocytes recoveries were followed by GIFT and two pregnancies occurred for a 15.4% success per attempt. We considered this technique as successful if having regard to the patients clinical situation, and the use of GIFT without ovarian stimulation should therefore be considered as a alternative to stimulate cycle.

Adult↗
PubMed1993

A non-invasive evaluation of flosequinan on haemodynamics and exercise capacity in chronic congestive heart failure.

The efficacy of flosequinan 100 mg once daily was evaluated in 15 patients with severe congestive heart failure (New York Heart Association [NYHA] class II-IV) who had not responded adequately to digoxin and diuretics. Efficacy assessments using non-invasive techniques included exercise capacity, haemodynamics and left ventricular function. Determinations were made after 3 and 21 days' treatment, and compared with baseline. Flosequinan significantly increased exercise capacity by 27% after 3 days (+79 seconds, p = 0.015) and by 43% after 21 days (+123 seconds, p = 0.0007) and was accompanied by an increase in heart rate (+7.2 beats/min, p = 0.03; +9.1 beats/min, p = 0.03, respectively). Cardiac index and cardiac output were also significantly increased but only after 21 days' treatment (+0.3 l/min/m2, +16% and +0.5 l/min, +14%, respectively; both p = 0.008). Flosequinan was well tolerated, with headache being the most frequently reported adverse event and only 1 patient being withdrawn. One patient died but this was not unexpected in a group of patients with severe heart failure. Using non-invasive techniques this study demonstrated that in patients with severe chronic congestive heart failure, flosequinan increased exercise capacity and cardiac output, the latter being achieved mainly by an increase in heart rate.

Aged↗
PubMed1992

An outbreak of melioidosis in imported primates in Britain.

An outbreak of melioidosis, a bacterial infection caused by Pseudomonas pseudomallei, was identified in a batch of feral cynomolgus monkeys (Macaca fascicularis) imported to Britain from the Philippines. Thirteen confirmed or possible cases occurred among a batch of 50 animals. Subsequent investigations revealed that the infection was uncommon among imported primates from a variety of sources, although three other cases were identified in monkeys imported from Indonesia. The majority of the affected monkeys had splenic abscesses, and hepatic abscesses and infections of the soft tissues and skin were also frequently observed. Most of the infected animals had no clinical signs despite extensive abscesses, and the presence of infection was only suspected when they were shown to have serum antibodies to P pseudomallei by an enzyme-linked immunosorbent assay. Although there was no evidence of cross infection of other animals or human handlers, this outbreak is a reminder of the dangers of working with wild-caught primates and the potential for the establishment of environmental foci of melioidosis.

Abscess↗
PubMed1992

Interfacing with police in the pediatric emergency department.

In summary, ED staff and local police departments should make a concerted effort to work together. The ED director should develop management protocols in conjunction with local police chiefs to plan strategies in advance. It is helpful to provide "orientation sessions," so that each group of professionals knows what to expect of the other. It may also be helpful to arrange tours of the ED so that police know where to go when they are called to the ED. All of these efforts should foster better care of children in the ED and will reduce tensions between the dedicated groups who work with such children.

Adolescent↗