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Biomedical subjects

D G Kelly

Publications and source records attributed to D G Kelly.

At least 55 records · Page 3Linked to original sources
PubMed1985

Isolated renal mucormycosis.

Isolated renal mucormycosis is very rare and we describe such a case masquerading as a hypernephroma in a poorly-controlled diabetic.

Aged↗
PubMed1984

Urinary tract undiversion.

Nine children underwent urinary diversion for lower urinary tract obstruction and were followed for periods of 2.5 to 15 years (median 10 years). Eight had cutaneous ureterostomies and the ninth had an ileal conduit. Undiversion was performed because of the return of normal function, the possibility of renal transplantation and ileal conduit stomal obstruction. The patients have been followed for periods ranging from 6 months to 9 years (median 2.5 years) after undiversion. To date, eight have moderate to good renal function. The remaining child has progressive renal failure. Eight are continent and one has mild stress incontinence.

Adolescent↗
PubMed1984

Gunshot injuries of the urinary tract.

Five cases of gunshot injuries to the kidney, ureter, bladder, urethra and male external genitalia are reported. One case required nephrectomy. The others regained normal genitourinary function after surgical repair and/or adequate drainage and splintage.

Adult↗
PubMed1984

Radical prostatectomy in the management of localised carcinoma of the prostate.

During the years 1971 to 1983 24 patients underwent radical prostatectomy for localised carcinoma of the prostate. There was one post-operative death from a pulmonary embolism, but all other patients were available for follow-up. All tumours were confirmed on palpation to be clinically localised to the prostate. Patients with clinical stages T0, T1, and T2 were referred for radical surgery. Patients with incidental carcinoma (T0), with less than 10% of the total tissue involved with carcinoma, were not subjected to surgery, and were followed up by observation only. Two patients developed recurrence of tumour at 18 to 12 months, and 2 years. One patient died 1 year later from the disease; he had a pathological T3 tumour with microscopic extension into the seminal vesicles. All other patients are alive and tumour-free at follow-up and 20 of the 23 patients are fully continent.

Aged↗
PubMed1983

Dysfunction of the continent ileostomy: clinical features and bacteriology.

The pathogenesis and treatment of dysfunction of the continent ileostomy was investigated in 12 patients, five of whom had asymptomatic malabsorption and seven of whom had acute complaints. The number of anaerobic bacteria in jejunal aspirates was increased in patients with pouch malfunction (range 10(3) to 10(8)/g aspirate), but the microbiology of ileal effluent and the morphology of the ileal mucosa could not be correlated with dysfunction. Bile acid breath tests and lactose tolerance tests were not, however, reliable indicators of jejunal bacterial overgrowth. The symptoms, the malabsorption, and the number of jejunal and ileal anaerobic bacteria decreased in patients during treatment with metronidazole, implicating overgrowth of anaerobic bacterial flora in the pathogenesis of the syndrome.

Adolescent↗
PubMed1982

Association of cold weather with testicular torsion.

A retrospective study of 46 patients who presented with proved testicular torsion over five years at two Dublin hospitals showed that in 40 cases torsion had occurred when the temperature was under 2 degrees C; the incidence of torsion was higher during the cold months of the year. Both of these findings were statistically significant. These and other results suggest that the ambient temperature may have some role in the incidence and aetiology of testicular torsion.

Adolescent↗
PubMed1982

Giant hypertrophic gastropathy (Ménétrier's disease): pharmacologic effects on protein leakage and mucosal ultrastructure.

Seven patients with giant hypertrophic gastropathy participated in a gastric intubation perfusion study to investigate the route and mechanism of protein leakage associated with this disease. All patients had gastric tight junctions wider than those in healthy controls. Acute administration of propantheline bromide reduced gastric albumin leakage (-50.7%, p less than 0.05) and concurrently decreased width of tight junctions (p less than 0.05) in all patients. Another antisecretory agent, cimetidine, had no consistent effect on protein leakage or on the width of tight junctions. Pentagastrin and bethanechol chloride increased protein loss but had no effect on the width of tight junctions. These results are consistent with the hypothesis that proteins may take a paracellular route via the tight junctions as they traverse the gastric mucosa and that this may have a cholinergic mechanism.

Adult↗
PubMed1981

Ricinoleic acid causes secretion in autotransplanted (extrinsically denervated) canine jejunum.

To examine the role of extrinsic nerves and hormones in intestinal secretion of fluid, we studied the effect of ricinoleic acid on absorption by isolated, autotransplanted jejunal loops in four dogs. Compared to perfusion with control solution, the addition of ricinoleic acid caused reversible secretion of water and electrolytes and inhibition of glucose absorption, as previously described in the innervated intestine. In contrast, oral castor oil caused diarrhea but had no effect on absorption from the denervated loop. Thus, the secretory action of ricinoleic acid is maintained without the influence of extrinsic nerves; in addition, further support is added to the proposal that hormones do not mediate secretion in this model. These findings support a local mechanism for the secretion induced by ricinoleic acid.

Animals↗
PubMed1981

Chronic bile exposure increases resistance of canine gastric mucosa to bile.

Because four successive weekly exposures of the gastric mucosa of intact dogs to bile did not alter the appearance or the barrier function of the mucosa during subsequent challenges with bile, the effects of chronic continuous exposure to bile were tested. This was accomplished by diversion of the flow of bile from the duodenum into the stomach by cholecystogastrostomy and diversion of the common bile duct. After four weeks, on endoscopic examination the mucosa was dark red but covered in some areas by a creamy coloured, strongly adherent pseudomembrane. Histologically the mucosa was normal. Ion fluxes, when an acid test solution was used, were close to normal. Differences between control dogs and those with chronic bile diversion became very evident, however, when the mucosa was exposed to increasing concentrations of bile. The control dogs displayed increases in net fluxes of H+, Na+, Cl- and K+ as the concentration of the bile was increased but the dogs with chronic bile diversion did not. Also the changes in PD and fluxes in K+ were less in the dogs with bile diversion. In the intact control dogs bile placed in the stomach always produced bleeding and hemorrhagic erosion; in the dogs with chronic bile diversion added bile in the stomach never caused bleeding and the mucosa appeared normal on endoscopic and histological examination. We conclude that the resistance of the gastric mucosa to the barrier breaking action of bile was increased in the dogs with chronic gastric bile diversion.

Animals↗
PubMed1979

Physiological and morphological characteristics of progressive disruption of the canine gastric mucosal barrier.

The investigation had two major goals: to define the progression of physiological changes associated with disruption of the gastric mucosal barrier to sodium and hydrogen and to identify the morphological correlates of the physiological alterations. Fluxes of ions and water were determined before and after treatment of oxyntic mucosa with graded concentrations of butyric acid using dogs with gastric pouches. Three phases of barrier disruption were characterized: I, acceleration of normal Na+/H+ exchange; II, neutralization of H+; III, exudation of interstitial fluid. Parallel studies assessed morphological damage associated with these phases. In Phase I, cellular bulging into the lumen and dilation of intercellular spaces were evident. Some cellular erosion and extreme intercellular dilation were prominent in Phase II. Phase III was represented by necrotic changes and desquamation. It is concluded that disruption of transport mechanisms occurs sequentially and is closely correlated with morphological signs of progressive damage.

Animals↗