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Biomedical subjects

E Neville

Publications and source records attributed to E Neville.

At least 37 records · Page 2Linked to original sources
PubMed1988

Progressive apical pleural fibrosis: a 'constrictive' ventilatory defect.

We report two patients with bilateral apical pleural fibrosis which may be a form of benign asbestos-related pleurisy, one of these being steroid responsive. The pulmonary function defect of reduced lung volumes with raised gas transfer coefficient is characteristic and is best described as 'constrictive'.

Adult↗
PubMed1988

Sarcoidosis: the clinical problem.

This paper reviews the clinical manifestations of acute and chronic sarcoidosis. The indications for measuring serum angiotensin converting enzyme and for performing pulmonary function tests, bronchiolo-alveolar lavage and gallium scans are discussed and the modern indications for performing a Kveim Siltzbach test are also considered. The main treatment available for patients with sarcoidosis is systemic steroids and the indications in the various systems for using these drugs are discussed.

Acute Disease↗
PubMed1988

Extracts of brewer's yeast contain GABA which enhances activation of glycogen synthetase by insulin in isolated rat hepatocytes.

Extracts of brewer's yeast have been fractionated, and the effects of fractions on the incorporation of 14C-labelled precursors into glycogen by hepatocytes have been studied. Purification of fractions which enhanced response to insulin resulted in the isolation of gamma-aminobutyric acid (GABA) which stimulated glycogen synthetase activity in the presence but not in the absence of suboptimal insulin concentrations.

Animals↗
PubMed1987

Mercury pulmonary emboli following intravenous self-injection.

The attempted intravenous injection of metallic mercury resulted in multiple mercury pulmonary emboli. Few of the abnormalities of respiratory or renal function reported previously were demonstrated. In particular the isotope ventilation/perfusion scan was unhelpful in confirming the diagnosis. Extravasation of mercury at the injection site produced a severe local inflammatory reaction and in the presence of toxic blood mercury levels surgical excision was undertaken. The blood mercury levels fell significantly but remain elevated within the toxic range to date. This may be due to the continued absorption of embolized mercury. The long-term effects of chronically elevated blood mercury levels is unknown.

Adult↗
PubMed1987

A phaeochromocytoma presenting with Cushing's syndrome associated with increased concentrations of circulating corticotrophin-releasing factor.

The case is described of a 61-year-old male who presented with hypertension and Cushing's syndrome which resolved on excision of a unilateral adrenal mass. Histology of the tumour revealed a benign phaeochromocytoma which immunostained for corticotrophin-releasing factor (CRF-41) but not for ACTH. Preoperative plasma concentrations of immunoreactive CRF-41 were increased, and gradients for both CRF-41 and ACTH were demonstrated across the tumour. Post-operatively, CRF-41 was undetectable in plasma. The tumour contained high concentrations of immunoreactive CRF-41 which co-eluted with synthetic human CRF-41 on reversed-phase high-performance liquid chromatography. Tumour CRF-41 stimulated the release of ACTH in a dose-dependent manner from isolated rat anterior pituitary cells. We conclude that this tumour secreted CRF-41 and ACTH and had the capacity to produce ACTH-dependent Cushing's syndrome directly by secreting ACTH and indirectly by secreting CRF-41 to stimulate ACTH secretion from the anterior pituitary.

Adrenal Gland Neoplasms↗
PubMed1986

Detection of occult cardiac invasion by two dimensional echocardiography in patients with bronchial carcinoma.

Cardiac invasion by bronchial carcinoma may prevent successful resection but may be undetected before operation. In a retrospective analysis of 100 consecutive thoracotomies nine patients had unsuspected cardiac invasion by tumour. A prospective study of preoperative two dimensional echocardiography was therefore undertaken in patients with bronchial carcinoma who had no clinical evidence of cardiac tumour. Comparison with anatomical findings was possible in 65 patients in whom an echocardiogram of suitable quality had been obtained. There was one false negative among 55 negative echocardiograms and three false positives among 10 positive echocardiograms; non-malignant pericardial disease accounted for the echocardiographic finding in one of the latter. The predictive value of a negative test was 98%, and the predictive value of a positive test was highest (80%) if the echocardiogram suggested atrial invasion.

Carcinoma, Bronchogenic↗
PubMed1984

A standardised method of estimating KCO on exercise.

This study was designed to standardise a progressive exercise test for the assessment of change in carbon monoxide transfer coefficient (KCO) with exercise and to examine the variation between subjects and the reproducibility within subjects. Normal subjects exercised on a bicycle ergometer while ventilation, heart rate, and expired gas concentrations were recorded continuously. Preliminary studies showed that reduction of the breath hold time to six seconds made measurements of KCO during heavy exercise more comfortable without affecting the result. When KCO was measured immediately after exercise it was lower than when measured during exercise. KCO was measured in 50 normal subjects at rest and at three different work loads maintained for three minutes with a pause of five minutes between each. The relationships between KCO and both oxygen consumption and work load were linear in all subjects but the relationship between KCO and heart rate was distorted by high resting heart rates in some subjects. The mean slope of the relationship between KCO and oxygen consumption (VO2) was steeper in women than in men (mean slopes 0.627 and 0.348 mmol min-1 kPa-1 l-1 per 1 min-1 respectively), and the same was true for the relationship between KCO and work rate. The heart rate rose more steeply in relation to VO2 in women, so that the relationship of KCO to heart rate was similar in men and women (mean slope 0.01 mmol min-1 kPa-1 l-1 per beat min-1). Repeat studies on five occasions in five individuals gave coefficients of variation for the slopes of the relationships between KCO and VO2, work rate, and heart rate of 5-10%.

Adolescent↗
PubMed1983

Subacute massive pulmonary embolism treated with plasminogen and streptokinase.

Major pulmonary embolism occurring insidiously over several weeks (subacute massive pulmonary embolism) has a high mortality and may not respond well to standard anticoagulant or thrombolytic treatment. A priming dose of plasminogen was used to enhance thrombolysis produced by a streptokinase infusion in five consecutive patients with subacute massive pulmonary embolism. In each patient a dramatic clinical improvement occurred with a substantial increase in pulmonary blood flow. All five patients survived to leave hospital. Malignant disease was the underlying cause of embolism in three patients, two of whom died of their malignant disease in the six months after treatment of their pulmonary embolism. The third patient with malignant disease had a choriocarcinoma; at least some of the pulmonary obstruction may have been tumour tissue but this obstruction was dramatically cleared by the treatment. The use of a combination of plasminogen with streptokinase should be considered in severely ill patients with subacute massive pulmonary embolism, particularly if other treatment, including streptokinase alone, has failed.

Adult↗
PubMed1983

Respiratory tract disease and obstructive azoospermia.

Male infertility may be linked to respiratory tract disease in conditions such as cystic fibrosis and Kartagener's syndrome. Young's syndrome constitutes another such link, in which bronchiectasis is found in association with obstructive azoospermia and normal testicular function. We have studied 34 infertile men with mechanical azoospermia and appropriate control subjects to assess the number of patients with respiratory tract disease and the type and frequency of such disorders. Nineteen patients (59%) had grossly abnormal sinus radiographs compared with six controls (18%) (p less than 0.01) and 19 (56%--NS) gave a history of sinusitis; of these, six (18%) had had sinus operations (p less than 0.01). Eleven patients (32%) had histories of repeated otitis media, of whom two had had mastoid operations. Twelve (35%) had chronic bronchitis, of whom three were non-smokers. Ten other patients had bronchiectasis (p less than 0.001) and three of these had had a lobectomy. The chest radiograph was abnormal in 18 patients (p less than 0.001), including all 10 with bronchiectasis. Two patients had severe airflow obstruction and 13 others had a mildly obstructive pattern. This controlled study confirms that a significant excess of sinorespiratory disease can be identified in young men with obstructive azoospermia. We have found no features in the history or in the results of examination or investigations to explain why some of these patients have respiratory tract disease while others do not.

Adult↗
PubMed1983

Dose-response study of inhaled salbutamol powder in chronic airflow obstruction.

Dose-response relationships for salbutamol were studied in eight patients suffering from chronic airflow obstruction with no asthmatic features. Each inhaled, double blind, in randomised order 0, 200, 400, 800, and 1600 micrograms salbutamol on five successive mornings. Before and at intervals up to six hours after the inhalation FEV1, vital capacity, maximum inspiratory and expiratory flow-volume curves, and 12-minute walking distances were measured. Analysis of variance of the results indicated significant dose-response relationships and showed the larger doses to have a longer duration of action. Simple spirometric tests were as useful in providing objective evidence of benefit as maximum inspiratory flows or the 12-minute walking distance.

Aged↗
PubMed1983

Prognostic factors predicting the outcome of sarcoidosis: an analysis of 818 patients.

A computerised, retrospective study of 818 patients with sarcoidosis was analysed to study the prognosis of each individual manifestation of the disease. The good prognosis of erythema nodosum, acute arthritis and bilateral hilar lymphadenopathy was confirmed, though 16 per cent of patients presenting with erythema nodosum pursued a chronic course. Cor pulmonale and nephrocalcinosis reflected the poorest prognosis while lupus pernio and sarcoidosis of the mucosa of the upper respiratory tract rarely resolved. Bone sarcoidosis also implied chronicity but in four of 31 patients there was no clinical evidence of disease activity two years after the initial diagnosis, although naturally the bone radiograph was still abnormal. Hepatomegaly carried a worse prognosis than splenomegaly, or indeed, than the finding of pulmonary mottling without hilar glands--a stage three chest radiograph.

Adult↗
PubMed1982

Lung function in young adults with cystic fibrosis.

Pulmonary function tests have been carried out on eight adults with cystic fibrosis. There were statistically significant correlations between the severity of the patient's clinical state as assessed by the Shwachman score and TLco, TLC and VC. In addition the RV/TLC ratio increased with increasing clinical severity. There were no significant correlations between clinical severity and other measurements of lung function such as FEV1, PEFR, RV or PCO2. Serial studies indicated that the TLCO falls with increasing clinical severity of the disease. It is suggested that the objective measurements of pulmonary function should be included in any future 'scoring' system used to assess the severity of cystic fibrosis and that measurements of the single-breath TLCO might be one of the more discriminant tests.

Adolescent↗
PubMed1981

Orogenital ulcers, SLE and hydralazine.

The case is reported of a man developing drug-induced systemic lupus erythematosus while taking hydralazine. The illness was characterized by arthritis and a purpuric rash particularly in the light-sensitive areas as well as orogenital and cutaneous ulceration. Anti-nuclear antibody and DNA binding were positive. All clinical manifestations disappeared on withdrawal of hydralazine.

Humans↗