Biomedical subjects
E A Wilson
Publications and source records attributed to E A Wilson.
Extensive gangrene of the bowel after haemorrhagic shock: a case report.
A 20-year-old man presented with an acute abdominal condition within 15 hours after having sustained severe extra-abdominal injuries with associated hypovolaemic shock. At laparotomy virtually the whole bowel was found to be ischaemic and perforation had occurred at the site of maximum ischaemia. No trauma to the bowel, mesenteric vessels or any other abdominal organ was noted, and it was concluded that the ischaemia had resulted from a prolonged splanchic vasospasm in an attempt to compensate for hypovolaemic shock. The condition is well recognized in animals, but has rarely been recorded in humans. Early resuscitation of the shocked patient is mandatory in order to prevent not only renal shutdown but also mesenteric ischaemia. It is possible that some patients who suffer from 'irreversible shock' may develop endotoxaemia owing to the absorption of toxins from partially ischaemic bowel which does not proceed to frank gangrene.
Diazepam and local anaesthetic spray versus general anaesthesia for gastroduodenoscopy.
A randiomized, controlled trial was performed on 50 patients to compare the advantages and disadvantages of the intravenous injection of diazepam (Valium) plus local anaesthetic spray with those of general anaesthesia (methohexital (Brietal) plus succinylcholine (Scoline)) for gastroduodenoscopy. Careful records were kept of blood pressure, pulse rate nd ECG recordings before, during and after the procedure. In addition, the time taken to perform the procedure, the ease with which it was performed, and an interview with the patients before they left the hospital were recorded. Both procedures have advantages and disadvantges. While there is still a role for general anaesthesia when the endoscopist uses the large types of gastroduodenoscope, the advent of the more sophisticated paediatric endoscopes currently available makes it likely that in future general anaesthesia will rarely be necessary.
Luteinizing hormone-releasing hormone suppression of human placental progesterone production.
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Estradiol and progesterone binding in uterine leiomyomata and in normal uterine tissues.
To explain the sensitivity of uterine leiomyomata to endogenous and exogenous estrogens, specific cytosol receptor proteins for estradiol-17 beta and progesterone were found in tissue from uterine leiomyomata and compared with the concentrations of receptors in normal myometrium and endometrium from the same patient. The concentration of cytoplasmic estrogen receptors in leiomyomata (40.5 +/- 7.6 cytoplasmic estrogen receptors in leiomyomata (40.5 +/- 7.6 fmole/mg cytosol proteins, mean +/- SEM) was significantly greater than that found in myometrium (16.5 +/- 1.5) and significantly less than that found in endometrium (131 +/- 15.1). The concentration in leiomyomata of cytoplasmic progesterone receptors (104.4 +/- 41.2 fmole/mg cytosol protein, mean +/- SEM) was also greater than that found in myometrium (80.8 +/- 29.9) and less than that of endometrium (194.7 +/- 5.5); however, individual variation precluded statistical significance. The presence of cytoplasmic receptor proteins in myomatous tissues explains the sensitivity of the leiomyoma to endogenous or exogenous steroids and may provide information useful in the clinical management of this neoplastic disorder.
A simple upper abdominal retractor.
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Corticosteroid-binding globulin and estrogens in maternal and cord blood.
Corticosteroid-binding globulin (CBG) is produced by the liver in small concentrations and binds steroids with high affinity. Its concentration in the blood is sensitive to endogenous or exogenous estrogens in a dose-response manner and serves as a biological assay for estrogens. CBG concentrations were measured in sera collected from maternal and umbilical vein blood during labor and delivery and at elective cesarean section and correlated with endogenous estradiol and estriol concentrations. CBG and estradiol concentrations of maternal blood were significantly exceeded those of maternal serum. A highly significant increase in cord blood estriol concentration was found following vaginal delivery compared to elective cesarean section, indicating an increase in adrenal activity due to the stress of labor. CBG levels correlated directly with maternal estradiol but not estriol cencentrations. Cord blood CBG concentration varied little despite a wide range of estrogen concentrations. The physiologic significance of CBG concentrations in maternal and fetal blood is discussed.
Reactive hypoglycaemia mimicking a phaeochromocytoma.
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Endocrine studies of normal and polycystic ovarian tissues in vitro.
The purpose of this study was to compare the steroidogenic potential of the granulosa, theca, and medullary tissues from polycystic and normal ovaries. These ovarian endocrine compartments were isolated from appropriate ovaries and were cultured in vitro for three days in the absence (control) and presence of follicle-stimulating hormone (FSH)/luteinizing hormone (LH) (1 lU/ml), N6,O2-dibutyryladenosine-3':5''-cyclic monophosphoric acid (Bu2cAMP) (10(-2)M), and adrenocorticotropic hormone (ACTH) (1.3 U/ml). After the incubation, steroids in the media were measured by radioimmunoassay. Granulosa cells (10(5) cells per dish) from 4 to 7 mm follicles of normal and polycystic ovaries secreted progesterone spontaneously during the culture period and the production of progesterone was markedly stimulated (between tenfold and thirtyfold) by gonadotropins and Bu2cAMP but not by ACTH. Little, if any, androgen (androstenedione, dehydroepiandrosterone, and testosterone) or estrogen (estrone and estradiol) accumulated in the media of any granulosa cell culture. The control cultures of theca tissue from normal and polycystic ovaries secreted large amounts of androstenedione and progesterone and the production of these steroids by normal and polycystic ovary theca was stimulated in most cases by LH/FSH and Bu2cAMP but not by ACTH. Both normal and polycystic ovary theca secreted some testosterone and dehydroepiandrosterone but little, if any, estrone or estradiol accumulated in any theca culture. The medullary tissue of normal and polycystic ovaries produced only trace amounts of steroids in vitro except for the results from one polycystic ovary with hyperthecosis in which case significant quantities of C19 and C18 steroids were secreted. These experiments have demonstrated that isolated granulosa and theca cells from midantral follicles of normal and polycystic ovaries have a similar capacity to secrete C21 and C19 steroids in the absence and presence of trophic agents. Therefore, it seems probable that chronic anovulation in patients with polycystic ovaries is not caused by an obvious deficiency in the de novo steroidogenic potential of the multiple midantral follicles of the polycystic ovaries or by the absence of gonadotropin receptors on the polycystic ovary follicular cells.
Management of upper gastro-intestinal tract bleeding.
Approximately half the patients who die from peptic ulceration do so because of the complication of bleeding. Mortality can be reduced by earlier diagnosis and treatment. All patients with upper gastro-intestinal tract bleeding should be transferred as soon as possible to centres where the necessary diagnostic and operative facilities are available. Cimetidine plays a role in the management of certain types of gastro-intestinal tract bleeding and endoscopy has been a major breakthrough in terms of accurate and early diagnosis.
The effect of trophic agents on fetal ovarian steroidogenesis in organ culture.
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Sequence of emotional responses induced by infertility.
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Functional hypoglycaemia presenting with a phaeochromocytoma symptom complex.
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Improved radioimmunoassay of urinary estriol.
We report a rapid double-antibody radioimmunoassay for urinary estriol. Advantages over other current methods include: (a) 30-min hydrolysis; (b) total incubation time, 55 min; (c) assay unaffected by urinary glucose; (d) no degradation of estriol evident during hydrolysis; (e) superior (85%) analytical recovery of estriol conjugates; (f) linear standard curve by logit-log extrapolation; (g) good correlation (r = 0.83) with total estrogen determination by a generally accepted colorimetric method; (h) only 20 muL of urine required; and (i) the detection range is 1.9 to 100.5 mg/24-h urine.
Uterine anomalies associated with renal agenesis: role of gray scale ultrasonography.
Anomalies of the female genital tract were successfully characterized by gray scale ultrasonography in three cases; all three were found in association with unilateral renal agenesis. Findings at intravenous urography prompted ultrasound studies. The high incidence of genital tract anomalies associated with unilateral renal agenesis, particularly in females, indicates ultrasonography be used to examine the pelvis (as well as the renal bed). Further diagnostic procedures can then be assessed on a more informed basis.
The diabetic diet: nuisance or necessity?
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Intravenous pyelography in the diagnosis and management of postpartum ovarian vein thrombophlebitis: a case report.
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A preliminary report on gonadotropin responsivity in the Rokitansky-Küster-Hauser syndrome (congenitally absent uterus).
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