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Biomedical subjects

D D King

Publications and source records attributed to D D King.

At least 19 recordsLinked to original sources
PubMed1998

Effects of thermal endometrial ablation. Clinicopathologic correlations.

Electrothermal ablation of endometrium was performed on 207 women for abnormal and sometimes painful uterine bleeding. Recurrence of symptoms or inadequacy of treatment led to hysterectomy in 33 women at intervals of 2 weeks to 60 months. Patterns of uterine tissue destruction, healing and repair, and endometrial regeneration were correlated with the postablation interval. The endometrial thickness was completely destroyed. Necrosis dominated the first month, and a chronic repair-regeneration phase followed. Foreign body giant cells reacted with necrotic eschar, remnants of which were present to 47 months. Intact endometrium regenerated focally in 10 uteri and diffusely in 5. Indications for hysterectomy were attributed directly to ablation failure in 18 of 33 cases. Familiarity with the morphologic effects of ablation will aid in relating ablation failures to direct mechanisms, complications of the procedure, or unrelated events.

Adult↗
PubMed1996

Incidence and histologic characteristics of blebs in patients with abdominal aortic aneurysms.

PURPOSE: Aortic blebs-focal outpouchings within aortic aneurysms-may contribute to their eventual rupture. In this study we determine the incidence of aortic blebs and describe their microscopic features. METHODS: Computed tomographic scans of the abdominal aorta were obtained in 188 patients with aortic diameters measuring > or = 3 cm and were independently evaluated by a radiologist. The number and location of blebs were recorded, and each was measured with calipers. Sixteen blebs, with an adjacent uninvolved aneurysmal segment of aorta, and tissue from two patients with ruptured aneurysms were examined by light microscopy and immunohistochemical analysis. Specimens from six blebs and five aneurysms were examined for alpha 1 (I) procollagen messenger RNA by in situ hybridization. RESULTS: Twenty blebs, ranging in size from 5 to 30 mm (mean, 12 +/- 7 mm), were detected in 11% (20 of 188) of computed tomographic scans. Blebs were observed in 10% (11 of 111) of patients with aortic diameters between 3.0 and 4.9 cm, 10% (6 of 61) of patients with aneurysms between 5.0 and 6.9 cm, and 19% (3 of 16) of patients with aortic diameters > or = 7 cm. Histologically, the major difference between the aneurysmal aortic wall and blebs was found in the media. In aneurysmal aortas, the media consisted of multiple layers of fragmented elastic lamellae, whereas the number of elastic tissue elements along the circumference of the blebs progressively decreased; only a few isolated fragments of elastic tissue were present at the apices. Histologic evidence of rupture was evident in two specimens. A chronic inflammatory cell infiltrate composed of T and B lymphocytes, plasma cells, and macrophages, common to both the aneurysmal and the blebs, was most prominent in the adventitia of aneurysmal tissue, but involved both the media and adventitia of the blebs. In situ hybridization demonstrated the presence of alpha 1 (I) procollagen messenger RNA in four of the five aneurysm segments that were evaluated, compared with only one of six blebs. CONCLUSIONS: Blebs were discovered in aneurysms of all sizes; their frequency appeared to be unrelated to aneurysm size. The presence of inflammatory cell infiltrates and absence of alpha 1 (I) procollagen messenger RNA in five of six blebs suggest that a local imbalance of matrix degradation and repair plays a role in the cause of these lesions. Attenuation of the aortic wall accompanying the formation of blebs may predispose these sites to rupture.

Aorta, Abdominal↗
PubMed1991

Use of the Natural Death Act in pediatric patients.

OBJECTIVE: To review the use of Natural Death Act declarations (living will procedures) in pediatric patients. The implementation of such declarations for children is now possible in six states, including Texas, by specific statutory provisions. DESIGN: Retrospective study. SETTING: Pediatric ICU in a university hospital. PATIENTS: Records of patients who had a Texas Natural Death Act declaration, either discussed and signed or discussed only, were studied. Patients who had another vehicle of limiting care (e.g., a do-not-resuscitate order) were excluded from the study. MEASUREMENTS AND MAIN RESULTS: Reviewed characteristics included age, primary diagnosis, and concurrent complications. Also examined were who raised the issue of limiting care (parent or physician), the initial reaction of the other party, what support was withdrawn, what support was added, the final outcome (including the time from implementing limited care to death), and the description of witnesses. Discussions were held with parents of 17 patients, and 13 Natural Death Act declarations were actually implemented. In all but three instances, the patient died within 4 hrs from the time support was withdrawn. The main supports that were withdrawn were ventilators and catecholamines. In half of the cases, morphine sulfate was added for anticipated pain relief and sedation. All decisions were reached by close consultation between the family and the physicians, with the physicians raising the issue in 11 of the 17 cases and the family raising the issue in six cases. In 15 of the 17 patients, consultation with the Bioethics Committee was not necessary. The majority of difficulties involved resolving issues that beset patients with HIV infections, and finding appropriate witnesses as prescribed by the statute. CONCLUSIONS: We conclude that the Natural Death Act works well in situations involving dying children and their parents.

Adolescent↗
PubMed1988

Infection of a human leukemia K-562 cell line with Semliki Forest virus.

Infection of the human leukemia hematopoietic stem cell line, K-562, with Semliki Forest virus (SFV) can be characterized by three stages: (1) an early virus-proliferating stage lasting 1 to 4 days post-infection (pi) in which infectious virus is produced in high titers (10(3)pfu/cell) but in which there is minimal cytopathic effect. All cells appear viable by trypan blue dye exclusion, although they do not proliferate, and DNA and cell protein synthesis decrease to less than 3% of uninfected controls within 24 hours; (2) an intermediate stage extending from day 5 to about day 24-30 pi in which the amount of infectious virus declines to low levels. During this stage, viral protein synthesis decreases to undetectable levels, although viral gylcoproteins are readily demonstrated by immunofluorescence and by immunoblot; however, capsid protein appears to degrade within 21 days pi. Cell numbers remain constant but the viability of the non-proliferating cells determined by trypan blue exclusion could not be determined with confidence; (3) a final long-term stage in which viral glycoproteins, E1 and E2, are detectable by immunoblots and immunofluorescence for many months but the cells are metabolically inactive and do not synthesize viral proteins. These non-viable cells do not lyse for as long as 2 years.

Antigens, Viral↗
PubMed1977

Treatment of captive giant Canada geese affected by avian cholera.

In the spring of 1975, an epornitic of avian cholera in Nebraska affected wild waterfowl, common crows (Corvus brachyrhynchos), and a captive flock of guant Canada geese (Branta canadensis maxima). Measures taken to control the disease in the captive geese included flushing the water of their pen with fresh well water, parenteral (50mg oxytetracycline intramuscularly) and feed (tetracycline 500 g/ton) antibiotic treatment, and removing dead waterfowl and crows from the pen, and keeping wild waterfowl and crows out of the pen. Other measures taken to prevent a recurrence of the outbreak included monitoring the area with susceptible sentinel birds and culturing nasal swabs for Pasteurella multocida. Young Canada geese and wood ducks (Aix sponsa) raised in the area also were cultured before release to assure that carriers would not be released into the wild. Presently, ponds in the pen have been dried up so that the area is less attractive to wild waterfowl. Swine feeders and waterers that have been modified to discourage their use by crows are being used to feed and water the geese.

Animals↗
PubMedDate not supplied

Administrators and computerized maintenance management systems: a case study.

The dramatic success that the plant operations division experienced in the procurement, implementation, and application of the MMS is a direct result of the hospital administration's early involvement in the process. With the support of the administration, effective managers can rely on the MMS as a source for continued improvement and strategic planning, rather than just for documentation and justification of current levels of activity. With proper administrative support, progressive goals will continue to be formulated and achieved.

Biomedical Engineering↗