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Biomedical subjects

E Wilkins

Publications and source records attributed to E Wilkins.

At least 55 records · Page 3Linked to original sources
PubMed1993

The use of omental transposition in the treatment of recurrent sarcoma of the back.

We report 2 patients with paraspinous sarcoma treated with omental transposition tunneled through a defect in the lumbar fascia that resurfaced in the soft tissues of the lower back. Traditional reconstruction with skin flaps was unsatisfactory because of prior irradiation to the area. In 1 patient the omentum obliterated a cavity connecting the dura to the skin to prevent cerebrospinal fluid leak. In the other patient a large soft tissue defect overlying the lower back and dura was covered with omentum and skin grafted. Although both patients lived < 2 years, the durable wound coverage remained intact over the surgical site.

Adult↗
PubMed1993

An integrated procedure for the direct detection of characteristic lipids in tuberculosis patients.

An integrated method is described for the sensitive detection of tuberculostearic, mycocerosic and mycolic acids in infected materials from tuberculosis patients. Tuberculostearic acid is analysed by two-dimensional gas chromatography of pentafluorobenzyl esters, the key component being switched from a short non-polar column to a high resolution polar column with final electron capture detection. Mycocerosic acids are identified by simple one-dimensional electron capture gas chromatography of pentafluorobenzyl esters, with the use of negative-ion chemical ionisation gas chromatography in indecisive cases. Conversion of mycolic acids to anthrylmethyl esters produces compounds which are suitable for sensitive detection by fluorescence high-performance liquid chromatography. Application of all three of these methods to sputum samples from tuberculosis patients gave profiles characteristic of Mycobacterium tuberculosis.

Chromatography, Gas↗
PubMed1992

Clostridium difficile toxin-induced reactive arthritis in a patient with chronic Reiter's syndrome.

The first case of Clostridium difficile toxin-induced reactive arthritis in a patient with chronic Reiter's syndrome is described and compared with previous cases of reactive arthritis associated with this organism. This case demonstrates how distinct clinical manifestations may develop at different times in Reiter's syndrome, according to the infecting organism. Diagnostic terminology is discussed in this context. Clostridium difficile should now be considered a firmly established cause of reactive arthritis.

Adult↗
PubMed1992

Disease association of antibodies to human and mycobacterial hsp70 and hsp60 stress proteins.

Structural homology between microbial and human stress proteins has been postulated to be a basis for autoimmunization in chronic inflammatory diseases. Therefore, we estimated by ELISA titration the antibody levels to mycobacterial (M) and human (H) recombinant hsp70 and M-hsp65 heat-shock proteins in sera of patients with Crohn's disease (n = 29), ulcerative colitis (n = 20) and nontuberculous mycobacterial disease of the lungs (n = 20). Antibodies to H-hsp60, separated by two-dimensional gel electrophoresis, were tested in six sera of each group of patients. In Crohn's disease, antibody titres to the M-hsp65 antigen without detectable H-hsp60 binding were significantly elevated in 52% of the patients. In contrast titres to both M-hsp70 and H-hsp70 were demonstrable and correlated, but increased over control values only in four (14%) patients. The antibody pattern in ulcerative colitis was found to be quite different: anti-H-hsp60 binding was demonstrable in most patients, although anti-M-hsp65 titres were not elevated. Furthermore, 25% of patients had significantly elevated titres to M-hsp70, but not to H-hsp70. In non-tuberculous mycobacterial pulmonary disease, about 50% of patients had elevated titres to both hsp65 and hsp71 mycobacterial antigens but not to the corresponding human proteins; patients with Mycobacterium xenopi infection had the highest titres in this group. These results demonstrate the existence of distinct disease-associated patterns in the human antibody response to stress protein antigens. However, these data are not sufficient to imply sensitization with mycobacteria in patients with inflammatory bowel diseases, since certain epitopes of heat-shock proteins are shared by several bacterial genera.

Autoantibodies↗
PubMed1992

Laparoscopic versus abdominal hysterectomy.

The perioperative and postoperative courses of hysterectomy with or without bilateral salpingo-oophorectomy were compared for 10 women who underwent total abdominal hysterectomy and 10 who underwent laparoscopically assisted vaginal hysterectomy. Although laparoscopic hysterectomy took longer (160 versus 102 minutes), the women undergoing it had a shorter duration of hospitalization (2.4 versus 4.4 days), more rapid recuperation (3 versus 5 weeks) and fewer complications. These preliminary results suggest that in the hands of experienced operative laparoscopists, laparoscopically assisted vaginal hysterectomy is preferable to abdominal hysterectomy for selected candidates.

Adult↗
PubMed1992

Xanthine oxidase: its role in the no-reflow phenomenon.

This study was designed to probe the hypothesis that oxygen-derived free radicals are involved in initiation of the no-reflow phenomenon. We developed a reproducible model of no reflow in the rat hind limb. Laser Doppler studies confirmed that the hind limbs perfused well after 2 or 4 hours of ischemia, but perfusion ceased in the first 10 minutes after 6 hours of ischemia. Venous blood samples and biopsy specimens of skin and muscle were taken after 2 and 4 hours of ischemia to study tissue injury. Blood samples were evaluated for xanthine oxidase (XO), xanthine dehydrogenase, and creatine phosphokinase (CPK) activities. Conjugated dienes and iodine 125-labeled albumin extravasation were quantified in tissue samples. Groups of animals were treated with inhibitors of XO (allopurinol), antioxidant enzymes (superoxide dismutase plus catalase), and free radical scavengers (dimethyl sulfoxide and dimethyl thiourea) to assess the roles of free radicals in ischemia-reperfusion injury in the hind limbs. After 4 hours of ischemia followed by reperfusion, plasma XO activity rose threefold over preischemia levels (p less than 0.05). Xanthine dehydrogenase activity did not change; conjugated diene levels in muscle rose twofold; CPK levels rose sixfold, and 125I albumin extravasation rose twofold (p less than 0.05). Pretreatment with the XO inhibitor allopurinol reduced XO activity to negligible levels and significantly attenuated conjugated diene levels, CPK levels, and albumin extravasation. Albumin extravasation was also significantly attenuated by pretreating animals with superoxide dismutase together with catalase, dimethyl thiourea, and dimethyl sulfoxide. In all animals pretreated with allopurinol or superoxide dismutase and catalase, reperfusion persisted after 6 hours of ischemia. These data suggest that, in ischemia followed by reperfusion, tissue injury is related to oxygen products derived from XO activity.

Allopurinol↗
PubMed1991

A rapid, simple enzyme immunoassay for detection of antibody to individual epitopes in the serodiagnosis of tuberculosis.

The antibody response to individual epitopes has previously been analysed by competition assay using 125I- or enzyme labelled monoclonal antibodies. A modification of the test is described in which competition of human sera with unlabelled mouse monoclonal antibodies at the limiting dilution is revealed by peroxidase labelled antimouse IgG conjugate. Analysis of 54 sera from patients with pulmonary (36) and extra-pulmonary (18) tuberculosis and 31 controls indicated that the modified test compares favourably with the test based upon directly labelled antibodies. Diagnostic sensitivity for five monoclonal antibodies evaluated was 11.1% (TB78), 35.2% (TB23 and TB68), 37.0% (TB71) and 61.1% (TB72) at 97.5% specificity. For TB72, sensitivity was highest for pulmonary disease (69.7%). The modified assay is also easier to standardise for screening new monoclonal antibodies using a single enzyme-labelled conjugate.

Adult↗
PubMed1991

Rechargeable glucose electrodes for long-term implantation.

A unique enzyme electrode was designed using glucose oxidase immobilized on fine graphite powder. The graphite-enzyme is in a fluid state which enables recharging of the system when the enzyme activity decreases, therefore allowing the system to have a long lifetime in a diabetic patient. The sensor was tested using glucose concentration in the range of 20-300 mg d-1. The electrode construction includes a hydrophobic membrane and a platinum electrode for detection of hydrogen peroxide. The signal output is large with minimal noise when tested in buffer. The sensor has been performing at ambient temperature for 4 months when stored overnight at 4 degrees C.

Biosensing Techniques↗
PubMed1991

Acute lung injury following reperfusion after ischemia in the hind limbs of rats.

In this study, we proposed that oxygen free radicals participate in the acute pulmonary injury that follows limb ischemia/reperfusion. Using an established model of hind limb ischemia, reproducible lung injury occurred after reperfusion. Lung microvascular permeability was measured with 125I-BSA and increased two-fold after 30 minutes of reperfusion. Pulmonary injury was blocked with DMSO, DMTU, allopurinol, indomethacin, and SOD plus catalase. The degree of pulmonary neutrophil sequestration as assessed by tissue myeloperoxidase activity was significantly diminished in animals pretreated with antioxidants. Pretreatment with indomethacin did not attenuate the neutrophil sequestration within the pulmonary parenchyma. These data suggest that increased lung microvascular permeability and neutrophil accumulation occur following hind limb ischemia/reperfusion. Therapeutic interventions with oxygen radical inhibitors blocked this process, while the prostaglandin inhibitor, indomethacin, only reduced lung permeability.

Allopurinol↗
PubMed1990

Biomaterials for implanted closed loop insulin delivery system: a review.

The potential of five different groups of materials--carbons, glass and ceramics, polymers, hydrogels and collagen--as biomaterials in artificial implant applications is examined. In addition to the physical and/or structural properties of these materials, the blood and tissue responses to implants made of these biomaterials for various applications are presented. Emphasis is placed on materials related to the intended application; as catheter tips and biosensors for glucose to be used in conjunction with an implantable insulin delivery system as a complete artificial pancreas.

Animals↗
PubMed1988

Lymphocytic adenohypophysitis.

Lymphocytic adenohypophysitis (LAH) is an uncommon disorder in the spectrum of pituitary disease. Twenty-three cases proven by biopsy or at autopsy have been reported since 1962. We report 2 further cases and review the etiology, immunology and pathology of the disease. The diagnosis should be considered in a female patient who presents during the post-partum period with the clinical picture of a non-functional or prolactin cell pituitary adenoma and evidence of hypopituitarism.

Adult↗
PubMed1983

Implantable glucose sensor.

Two new approaches for construction and testing of a miniature in vivo implantable glucose sensor are described. The first approach is to immobilize glucose oxidase onto a platinum wire, coated with special glass (Corning), and to cover the immobilized enzyme with a thin layer of polymer to prevent large molecules from poisoning the electrode. The second, and more successful, approach is to use the principle of coated wire electrodes by incorporating a quaternary ammonium salt with an insoluble glucose salt and poly(vinyl chloride). Potentiometric measurements were used to test the two electrodes, as well as records of voltage and current responses. Responses of the electrodes to varying glucose concentrations are described. Current work is concerned with the responses of these electrodes to plasma and blood, and in examining interference effects from blood chemicals and electrolytes. Alternative methods for preparation of the coated wire electrodes are under investigation, as is their mechanism of action.

Blood Glucose↗
PubMed1983

Osteoarthritis and articular chondrocalcinosis in the elderly.

One hundred consecutive admissions to an acute geriatric unit were examined for clinical and radiographic evidence of osteoarthritis (OA) and articular chondrocalcinosis (ACC). Thirty-four patients had ACC. This was age related, the prevalence rising from 15% in patients aged 65-74 years to 44% in patients over 84 years. The commonly involved joints were the knee (25%), public symphysis (15%), and wrist (9%). No other aetiological factors predisposing to ACC were found. Of the 25 patients with ACC in the knee 7 had no symptoms or signs and no radiographic evidence of OA at that site. However, the combination of ACC and radiographic OA was characterised by an increase in clinical joint disease. Features of inflammation (joint swelling and joint line tenderness) involving the knee, wrist, and elbow were particularly common in ACC. It is concluded that ACC is common in the elderly and is associated with an increased incidence of joint disease.

Aged↗
PubMed1979

Fenoterol in asthma.

Fenoterol is a beta 2-sympathomimetic bronchodilator. In a double-blind cross-over trial in 17 asthmatic patients with reversible airway obstruction inhalation of both fenoterol (0.4 mg) and terbutaline (0.5 mg) produced a statistically significant greater increase in peak expiratory flow rate than did placebo. The magnitude and duration of response to fenoterol exceeded that to terbutaline in the doses used. The patients' subjective assessment also suggested the relief of their symptoms with the active drugs. Side effects were minimal.

Adult↗