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Biomedical subjects

E Wilson

Publications and source records attributed to E Wilson.

At least 163 records · Page 9Linked to original sources

Anthracycline-induced cardiomyopathy in children: a report of six cases.

Although anthracycline antibiotics are among the most useful chemotherapy agents, the risk of producing cardiomyopathy and the absence of a reliable noninvasive technique to predict subclinical cardiomyopathy remain a major problem. We retrospectively reviewed our experience with anthracyclines over a 5-year period. Cardiomyopathy developed in 6 of 112 patients (5.3%) treated with anthracyclines and was fatal in 5 of the 6 patients. Our incidence and mortality rates are higher than those previously reported.

Adolescent↗

Anaphylactic reaction associated with sulindac.

Reported is the case of an anaphylactic reaction following sulindac ingestion. A 64-year-old man developed marked shortness of breath following the ingestion of a 200-mg sulindac tablet. On admission he had a palpable blood pressure of 50 mm Hg and diffuse inspiratory and expiratory wheezes on auscultation. He demonstrated marked cardiovascular instability for 24 hours following the adverse reaction. He was treated successfully with a continuous intravenous infusion of epinephrine, a corticosteroid, and an antihistamine. Recovery was complete. This case demonstrates that caution is needed in prescribing sulindac and other nonsteroidal anti-inflammatory drugs.

Anaphylaxis↗

Collaborative study of pregnancy rates following danazol therapy of stage I endometriosis.

Pregnancy rates following danazol therapy of endometriosis vary widely. In order to reduce variations in patient selection and establish danazol effectiveness, six collaborative centers evaluated 75 infertile patients with normal infertility screening studies and mild (stage I) endometriosis documented by laparoscopy. Following diagnosis and 3 months coital exposure, all patients were treated with danazol for 6 months, and patient surveillance after danazol therapy lasted at least 12 months, with a range of 12 to 34 months. Of the 75 patients treated, 21 (28%) conceived, and the term pregnancy rate was 20% (15 of 75). The low pregnancy rate observed in these patients suggests that the role of danazol therapy for patients with mild endometriosis and infertility should be reconsidered.

Adult↗

Early death in acute leukemia in children.

Therapy for acute leukemia in children has improved dramatically in recent years so that early death is rare. A subset of patients with extreme elevation of the WBC at diagnosis have been noted to have a higher rate of early death. We reviewed our experience with acute leukemia in children retrospectively over a 10 year period to assess the incidence and outcome of this problem. Nine early deaths occurred in a total of 185 cases (4.9%). One hundred and sixty patients presented with WBC less than 100,000/mm3 at diagnosis and four (2.5%) early deaths occurred. Twenty-five patients presented with WBC greater than 100,000/mm3 at diagnosis and five (20%) early deaths occurred (p less than 0.001). While early death in acute leukemia in children is uncommon (4.9%), patients with extremely elevated WBC at diagnosis have a significantly higher risk of early death.

Acute Disease↗

Mode of action of dl-norgestrel and ethinylestradiol combination in postcoital contraception. II. Effect of postovulatory administration on ovarian function and endometrium.

A combination of 1.0 mg dl-norgestrel and 0.1 mg ethinylestradiol (EE) was administered orally at 36 hours after the detection of the luteinizing hormone peak and again at 48 hours in 12 healthy volunteers with normal menstrual cycles. The effects on ovarian function were studied by comparing the daily serum levels of progesterone (P), 17 alpha-hydroxyprogesterone, and estradiol (E2) in control (placebo) and treatment cycles. Five subjects showed no significant change in the levels of these steroids but had a shortened luteal phase. The treatment significantly decreased both P and E2 levels in three subjects, while two subjects showed diminished E2 levels only. The remaining two subjects had lower P levels and fluctuating E2 patterns. Endometrial biopsies from both study cycles indicated asynchronous development of the epithelial and stromal components in the treatment cycle. These findings (abnormal luteal phase steroid levels and duration and outphased endometrial development) indicate that corpus luteum function was variously affected by the action of norgestrel-EE treatment.

Adult↗

Mode of action of dl-norgestrel and ethinylestradiol combination in postcoital contraception. III. Effect of preovulatory administration following the luteinizing hormone surge on ovarian steroidogenesis.

A combination of 1.0 mg dl-norgestrel and 0.1 mg ethinylestradiol was administered orally at 18 hours after the detection of luteinizing hormone rise and again at 30 hours in five healthy volunteers with normal menstrual cycles. The effects on ovarian function were studied by comparing the daily serum levels of progesterone (P), 17 alpha-hydroxyprogesterone, and estradiol (E2) measured in a control (placebo) cycle with those in two consecutive treatment cycles. Treatment did not alter the steroid levels in one subject. P was suppressed in one or both treatment cycles of four subjects. E2 was suppressed in both treatment cycles of one subject and produced widely fluctuating patterns in another. The hormonal patterns in the two consecutive treatment cycles of the same individual were similar in all but one instance, where only the P level in the second treatment cycle was diminished. These results showed that this treatment can elicit steroidogenic responses of varying degrees and duration. The contraceptive action may lie in the altered P and/or E2 level at certain points in the menstrual cycle.

17-alpha-Hydroxyprogesterone↗

CPR skills retention of lay basic rescuers.

In 1979-1980, 950 telephone company personnel were trained and tested at the basic rescuer level on recording manikins. In October 1981, a random group of 40 were retested without warning on the recording manikin. Skills retention was measured by comparing the tapes from training and retesting. Sixteen (40%) of those retested were able to perform effective ventilations and compressions of the manikin with 60% to 70% average retention compared to their training scores. The remaining 24 (60%) had ineffective ventilations or compressions or both. The two groups did not differ in the performance level achieved during training, or in the time interval between training and retesting. Eleven individuals retested at 13 to 14 months did not perform better than those retested later, suggesting the maximum skills deterioration had occurred within the first year. However, the effective performance group on the average were younger, and the majority had first aid training in addition to their CPR training. Only one had CPR retraining. This study supports the following recommendations: 1) lay basic rescuers should be retrained within the first year; 2) further studies of the factors influencing retention are advisable; 3) the younger age groups should be the first priority for citizen CPR training; and 4) because first aid training appears to improve CPR retention, training in both should be encouraged.

Adult↗

Intermittent positive pressure ventilation and high frequency ventilation in dogs with experimental bronchopleural fistulae.

This study evaluated respiratory and cardiovascular responses of canines in whom bilateral bronchopleural fistulae were created surgically, and in whom ventilation was varied between intermittent positive pressure ventilation (IPPV) and high frequency ventilation (HFV). An Emerson prototype ventilator was used for HFV at rates of 300-1400/min at driving pressures of 2.5, 5.0, and 10 psi. Gas exchange was judged by arterial and mixed venous blood gases. Cardiac performance was measured by cardiac index, heart rate, stroke index, stroke work index, systemic and pulmonary vascular pressures and resistances. Ventilation during IPPV with the fistula open resulted in a statistically significant increase in PaCO2 and a decrease in PaO2 when compared to both HFV modes. Variations in cardiac function in these open-chested animals were insignificant for all variables tested except pulmonary artery pressures which rose significantly in the IPPV group.

Animals↗

Effects of 4-nitroestrone 3-methyl ether on dimethylbenz(a)anthracene-induced mammary tumors.

4-Nitroestrone 3-methyl ether has been shown to be an effective growth inhibitor of certain dimethylbenz(a)anthracene-induced rat mammary tumors in intact or ovariectomized rats. When administered at optimum levels (24 mg/kg daily), this A-ring-substituted estrone displayed no toxicity, slight estrogenicity, and an antitumor activity which was comparable to that of tamoxifen and nafoxidine and was surpassed only by ovariectomy or pharmacological doses of 17 beta-estradiol 3-benzoate. In addition, the appearance of mammary tumors was prevented when this estrogen derivative was administered to rats just prior to or after dimethylbenz(a)anthracene intubation. Unique to the action of the methyl ether of 4-nitroestrone on mammary tumors was the destruction of adenocarcinomas while permitting the appearance of fibroadenomas. Systemically, 4-nitroestrone 3-methyl ether brought about focal atrophy within the pituitary and ovaries while causing moderate hypertrophy of the uterus. Plasma prolactin was unaffected.

9,10-Dimethyl-1,2-benzanthracene↗

Assay of urinary N-acetyl-beta-glucosaminidase in a centrifugal analyzer.

We describe a kinetic, fluorometric assay for urinary N-acetyl-beta-glucosaminidase (EC 3.2.1.30) by measurement of the release of 4-methylumbelliferone (7-hydroxy-4-methylcoumarin). The method is simple, involving only a single reagent, and is applicable to the assay of other enzymes that hydrolyze similar fluorescent-labeled substrates. The enzyme distribution in human tissues and fluids is described. The enzyme is present in high concentrations in human kidney, liver, and lung. Its concentration in urine is shown to be a sensitive indicator of early renal damage, which precedes changes in serum creatinine and urinary protein. Assay of the enzyme is quite useful in monitoring renal damage due to myoglobinuria.

Acetylglucosaminidase↗

Immunoglobulin M antibody titers in the diagnosis of Legionnaires disease.

The purpose of this study was to determine whether measurement of immunoglobulin M (IgM) antibodies against Legionella pneumophila serogroup 1 can aid in the diagnosis of Legionnaires disease. On the basis of measurements of antibody levels in 1,942 control sera, we used an IgM titer of 1:256, observed in 2.3% of the controls, as presumptive evidence of Legionnaires disease. Measurement of IgM titers permitted us to presumptively or definitively diagnose Legionnaires disease in 13 of 34 patients earlier than we would have if only IgG titers had been measured. Of the 13 patients, 5 were diagnosed serologically only by IgM antibody determination. IgM titers were presumptively diagnostic in week 1 of clinical symptoms in 4 of the 13 patients. We conclude that conjugates used for antilegionella indirect fluorescent-antibody tests should be capable of detecting IgM antibodies so that the value of serological results in diagnosing and managing Legionnaires disease will be maximized.

Fluorescent Antibody Technique↗

Urine cytology in patients with calculi.

The cytological changes in voided urines were analysed in 154 patients with calculi. No abnormality was seen in 52.6%; 40.9% contained smooth-bordered clusters of transitional cells with essentially normal, centrally placed nuclei. These, when found in routine urines, were reliable in predicting calculi in 62.5% of cases. Of the calculus urines, 6.5% showed features suspicious of differentiated transitional carcinoma. Although their morphological features overlapped with those observed in urines from 40 cases of proved differentiated transitional carcinoma, they contained significantly fewer single and clusters of transitional cells with abnormal nuclear morphology. Histological examination of urothelium adjacent to calculi in eight patients showed no evidence of malignancy although one case showed hyperplasia and severe epithelial atypia.

Carcinoma, Transitional Cell↗

Cerebral abscess caused by Cladosporium bantianum. Case report.

A case is presented of a cerebral abscess in a 59-yr-old woman caused by the dematiaceous fungus Cladosporium bantianum (Sacc.) Borelli (= Cladosporium trichoides Emmons). The morphological and physiological properties of the isolate and its pathogenicity for experimental animals were investigated and compared with some other Cladosporium species. The neurotropism exhibited by C. bantianum in human infections was found also in the test animals. Despite surgical excision and therapy with the antifungal drugs amphotericin B and flucytosine, the case had a fatal outcome, the patient dying from a pulmonary embolism 6 mth after the onset of symptoms. The clinical entity of central nervous system infections by dematiaceous fungi is discussed in relation to the present case.

Amphotericin B↗