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Biomedical subjects

D Kelly

Publications and source records attributed to D Kelly.

At least 163 records · Page 9Linked to original sources

Evaluation of infant feeding in acute gastroenteritis.

Sixty-eight bottle-fed babies under 9 months of age with mild acute gastroenteritis were observed to evaluate current feeding regimens following acute gastroenteritis in infancy. All babies were fed for 24 h with a glucose-electrolyte mixture (GEM) and then randomly assigned to either a gradual reintroduction to their normal milk, i.e., slow regrade; immediate return to full-strength formula; or a rapid regrade to a hypoallergenic whey hydrolysate formula. All groups were well matched for age, sex, ethnic origin, nutritional state, and degree of hydration. There was no significance difference in stool frequency or reducing substances, vomiting, and duration of hospital stay between the three groups. Many infants (6/24) refused to take the whey hydrolysate formula, presumably because of unpalatability. Weight gain was more rapid when full-strength milk was given. Clinical relapse developed in 12 (17%) of patients. An enteric pathogen was detected in eight of this group and cow's milk protein intolerance in three (one from each feeding group). No infant had clinically significant lactose intolerance, in marked contrast to previous experience at Queen Elizabeth Hospital. In this group of previously healthy, well-nourished babies with mild acute gastroenteritis, there was no advantage in regrading slowly to milk or a hypoallergenic formula. An immediate return to normal formula 24 h after GEM feeding was well tolerated and simpler for parents.

Acute Disease↗

Inhibitory effects of transforming growth factor-beta on laminin production and growth exhibited by endoderm-like cells derived from embryonal carcinoma cells.

Previous studies have shown that two mouse embryonal carcinoma (EC) cell lines do not express cell surface receptors for transforming growth factor type-beta (TGF-beta) until they are induced to differentiate. To understand the effects of TGF-beta in this model system, we have examined the effects of TGF-beta on parietal endoderm-like cells derived from EC cells. We have determined that TGF-beta exerts three effects on these cells. TGF-beta inhibits proliferation of the parietal endoderm-like cells, and this occurs even in the presence of growth factors that stimulate their proliferation. TGF-beta also alters the morphology of the parietal endoderm-like cells by increasing their spreading. Moreover, the morphological effect of TGF-beta is observed in the presence of dibutyryl cyclic AMP (dbcAMP), which reduces the spreading of these cells. Lastly, TGF-beta, but not other growth factors, decreases the production of laminin by the parietal endoderm-like cells. This was unexpected since TGF-beta has been shown to increase the production of extracellular matrices in other systems. Thus, our findings indicate that parietal endoderm-like cells provide a useful system for broadening the study of TGF-beta. Furthermore, our findings provide additional support for the possibility that TGF-beta plays important roles during the early stages of mammalian development.

Animals↗

Antenatal screening for hepatitis B is medically and economically effective in the prevention of vertical transmission: three years experience in a London hospital.

We describe our experience over a three-year period in the detection of antenatal patients with hepatitis B virus (HBV) carriage, and the successful prevention of vertical transmission in the infants of HBsAg-positive women. Nine of the 26 infants born to HBsAg-positive mothers were considered to be at high risk of infection. Eight of these nine remained HBsAg-negative after passive or passive/active immunization. The majority of infants tested had anti-HBs antibody titres above 10 i.u./l from the first month. In comparison with the cost of caring for patients with chronic hepatitis B infection and decompensated cirrhosis, non-selective testing of pregnant women for HBsAg is found to be cost effective.

Carrier State↗

Human perioral directional sensitivity.

The capacity of 41 neurologically healthy young adults to distinguish opposing directions of brush motion across the skin innervated by the mental nerve was determined. The velocity and orientation and the length and width of skin traversed by the moving tactile stimuli were carefully controlled. Directional sensitivity, d', was found to vary curvilinearly with velocity over the range 0.5 to 32 cm/s. Because the data from most subjects were well described by a generalized gamma function, it was possible to characterize this velocity dependency quantitatively. Specifically, indices derived from these functions were found to describe the subject's peak (i.e., maximal) sensitivity, the velocity which resulted in peak sensitivity (i.e., the optimal velocity), and the degree to which stimulus velocity influenced the ability to recognize direction of motion (i.e., the velocity-tuning of d'). Peak sensitivity, optimal velocity, and the degree of global velocity-tuning were found to differ between males and females. Confidence limits (the lower and upper 2.5% points) for the normative data were determined to enable detection and characterization of deficits in orofacial tactile motion sensitivity in individuals with damaged mandibular nerves.

Adult↗

Primary amyloidosis of lower urinary tract.

Primary amyloidosis of the lower urinary tract is a rare condition with an excellent prognosis in most cases. Three patients with this condition are described. In the cases of localized amyloidosis of the urethra and urinary bladder, the clinical presentation mimicked cancer of the respective sites. This was also true in the case of primary systemic amyloidosis involving the bladder. If significant associated systemic or local disease can be excluded, management is symptomatic and expectant.

Aged↗

Additive and synergistic interaction of atrial natriuretic peptide and volume expansion.

To investigate whether atrial natriuretic peptides (ANP) are entirely responsible for the natriuresis of volume expansion (VE), we studied the natriuresis from acutely snared and nonsnared kidneys of rats undergoing sustained saline VE and subsequent infusion of maximal doses of ANP (atriopeptin II), or vice versa. Fractional excretion of Na (FENa) was increased from control (0.15 +/- 0.03%) to 4.6 +/- 0.6% by VE and to 10.9 +/- 1.5% by subsequent ANP infusion. With ANP alone FENa increased from control (0.24 +/- 0.04%) to 2.6 +/- 0.3%, and to 10.8 +/- 0.9% with VE, showing additive effects by both. Natriuresis with VE was significantly greater than with ANP alone (P less than 0.01) and both exhibited synergism, producing significantly greater natriuresis in the presence of the other than alone (P less than 0.05 for both). A reduction in perfusion pressure inhibited the effects of ANP and reduced that of VE. Natriuresis was produced by ANP independently of changes in glomerular filtration rate. It is concluded that 1) VE and ANP produce natriuresis by different renal mechanisms and that therefore, ANP can only account for part of the natriuresis of sustained VE; 2) the two have a synergistic interaction on natriuresis, probably through an intrarenal mechanism.

Animals↗

Non-seminomatous germ cell testis cancer in Ireland (1980-1985). Management, results and prognostic variables with relevance to national management protocols.

All non-seminomatous germ cell testis cancer in Ireland (1980-1985) was analysed (n = 131) and 3-year survival was: stage I = 95% (n = 58), stage II = 54% (n = 36), stages III and IV = 24% (n = 34). Countrywide results were not as favourable as those achieved in specialist units and this supports the development of a national strategy to maximise disease control. No management protocols existed during this study and the variety of approaches helped to identify the most suitable types of treatment in this broad context.

Clinical Protocols↗

The effects of in vivo antibiotics on neutrophil (PMN) activity in rabbits with peritonitis.

Antibiotics play an important role in helping the host fight infection; however, the direct cellular effect of antibiotics on polymorphonuclear cells remains undefined. Adherence, chemotaxis, phagocytosis, and superoxide anion production are important steps in the cascade of events initiated by the polymorphonucleocyte in bacterial killing. Previous studies have shown inhibition as well as stimulation of neutrophil antibacterial therapy by antibiotics. Peritoneal and blood polymorphonuclear neutrophils (PMN) respond differently to peritonitis and to external agents. The purpose of this study was to investigate the effects of in vivo clindamycin and netilmicin on infected rabbit peritoneal and blood polymorphonuclear adhesiveness, phagocytosis, chemotaxis, and superoxide anion production. Peritoneal and blood PMNs were obtained from rabbits which had undergone appendiceal devascularization 18 hr earlier: antibiotics were administered intramuscularly 1 hr prior to appendectomy and every 8 hr postoperatively for 5 days; these PMNs were compared to infected rabbits which did not receive antibiotics. Clindamycin and netilmicin in vivo cause significant inhibition of phagocytosis, peritoneal adhesiveness, and, when used in combination, blood adhesiveness and peritoneal superoxide anion production. No effects were seen on chemotaxis. Based on this data we conclude that antibiotics, while vitally important in fighting infections, may in and of themselves be agents of immunosuppression at the cellular level.

Animals↗

The effect of dexamethasone in vivo on blood and peritoneal neutrophils (PMN) in rabbits with peritonitis.

Neutrophils play an essential role in the host's defense against infection. Our previous studies have shown that blood and peritoneal neutrophils (PMN) have different basal activities and responses to infection. We also demonstrated that peritonitis produces divergent changes in the cellular function of PMN both in the blood and in the peritoneal fluid. Steroids are well documented to cause immunosuppression both clinically and, more variably, at the cellular level. Understanding the mechanism of steroid-induced immunosuppression in surgical infection may impart insight on the management of this condition. Using a model of surgical peritonitis, we studied the effects of immunosuppression on rabbit blood and peritoneal PMN. Blood and peritoneal PMNs were harvested after the development of fibrinopurulent peritonitis. Rabbits were divided into two groups: immunosuppressed and control. Immunosuppression was accomplished by intramuscular injection of dexamethasone (2 mg/kg) for 10 days preoperatively and 10 days postoperatively. Purified PMNs were studied for phagocytosis, adhesiveness, superoxide anion production and chemotaxis from both groups. Survival was computed from the number of days the rabbit survived after the operation up to a total of 10 at which time they were sacrificed. Immunosuppression with dexamethasone resulted in inhibition of peritoneal phagocytosis and peritoneal adhesiveness; there were no changes in blood adhesiveness nor blood phagocytosis. Also, there was no significant change in superoxide anion production nor in chemotaxis. Survival of the rabbits was significantly reduced when treated with dexamethasone.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

Near-haploidy in a case of plasmocytoma.

Chromosome studies of a solitary plasmocytoma in the femoral bone revealed a near-haploid chromosome number of 31-32 with a loss of one homolog of each chromosome pair except #1, #7, #9, #15, #19-21, and the sex chromosomes (XY). The cytogenetic findings have been compared with 16 cases of near-haploid neoplasms from the literature studied using banding techniques. A common feature present in 13 of the 16 cases reported was found to be disomy 21; the only chromosomes consistently present in one copy in all neoplasms were #2, #3, #4, and #5.

Chromosome Aberrations↗

Comparison of blood and peritoneal neutrophil activity in rabbits with and without peritonitis.

The neutrophil (polymorphonuclear cell, or PMN) function is an essential component of the host defense against infection. However, infection itself may alter PMN activity. To investigate both the effects of infection on PMN activity and PMN activity on survival, we evaluated control and infected blood and peritoneal PMN phagocytosis, chemotaxis, and superoxide anion production in rabbits with and without peritonitis. Control blood and peritoneal PMNs were obtained from noninfected rabbits which were subjected to intraperitoneal infusion of sterile hypertonic saline. Infected blood and peritoneal PMNs were obtained from rabbits which had undergone appendiceal devascularization and ligation 18 hr earlier. Phagocytosis was similar in all groups except for a threefold increase in normal peritoneal PMNs. Chemotaxis was inhibited by infection in the blood and peritoneal PMNs. Normal peritoneal PMNs also had decreased chemotaxis. Superoxide anion production was comparable in the infected and control blood; however, both control and infected peritoneal PMNs had elevated superoxide anion production. Of the infected rabbits, four died in 5 days or less. Of the six that lived, two developed intraabdominal abscesses. Blood and peritoneal PMN activity was similar in all rabbits despite their outcome. We conclude that (1) blood and peritoneal PMNs have different basal activities and responses to infection; (2) the milieu of the peritoneal cavity appears to alter the PMNs present; and (3) PMN activity did not predict morbidity or mortality.

Animals↗