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Biomedical subjects

K L Cox

Publications and source records attributed to K L Cox.

107 records · Page 6Linked to original sources
PubMed1981

Gastroesophageal scintigraphy with and without compression.

This study compares the results of radionuclide gastroesophagography performed by the compression and computer-assisted noncompression techniques. The overall accuracy of the compression and noncompression methods was 71% and 84%, respectively. The use of computer processing significantly enhances the ability to detect minor degrees of reflux and may explain the better results obtained with the noncompression method. Other advantages of the noncompression technique include its technical ease and uniformity and the acquisition of more physiologic data for comparison with results of the acid reflux test.

Child, Preschool↗
PubMed1981

Pancreatic sonography in cystic fibrosis.

Sonographic examination of the abdomen was performed in 20 patients with cystic fibrosis aged 3--41 years. The predominant acoustic architecture of the pancreas was one of moderate to markedly increased echogenicity when compared to the liver at the same depth. Increased echogenicity of the pancreas was independent of the presence of malabsorption. The usual reduced echo pattern associated with pancreatic inflammation was seen in only one of five cystic fibrosis patients with clinical evidence of pancreatitis. Other pancreatic abnormalities included pancreatic calcifications in one child with pancreatitis and a pseudocyst in an adult with pancreatitis. Eight patients had hepatosplenomegaly and gallstones were seen in two; one had a markedly contracted gallbladder. Sonography offers an effective method of following patients with cystic fibrosis.

Adolescent↗
PubMed1980

The ultrasonic and biochemical diagnosis of pancreatitis in children.

Pancreatic ultrasonography and the determination of serum amylase and amylase creatinine clearance ration were performed on 17 normal children and on 35 children with abdominal pain. In all 17 normal subjects the echodensity of the pancreas was equal to or greater than that of the liver. Nineteen patients with abdominal pain had reduced echodensity of the pancreas when compared to that in normal children, and two of the 19 had pseudocysts. Serum amylase values and/or amylase creatinine clearance ratio correlated poorly with ultrasonic and clinical evidence of pancreatitis.

Adolescent↗
PubMed1980

Hereditary generalized juvenile polyposis associated with pulmonary arteriovenous malformation.

A 28-yr-old mother and her 10-year-old daughter with generalized juvenile gastrointestinal polypsis, arteriovenous (AV) malformations of the lung and severe digital clubbing are described. The AV malformations were documented by pulmonary angiography in both subjects, and generalized juvenile polyposis was confirmed histologically and radiographically. Since pulmonary AV malformations associated with juvenile polyposis has not been previously reported, a new hereditary syndrome is proposed.

Adult↗
PubMed1979

The effect of cimetidine on maldigestion in cystic fibrosis.

Ten patients (6 to 27 years of age) who had severe pancreatic exocrine insufficiency due to cystic fibrosis were studied to determine whether cimetidine would improve dietary fat and nitrogen absorption. When a constant diet was consumed and oral pancreatic enzymes were administered, the addition of cimetidine (150 or 200 mg taken orally one-half hour before meals) signficantly reduced fecal fat excretion from 25.3 +/- 2.9 to 17.3 +/- 2.1 gm/24 hours and fecal nitrogen excretion from 4.5 +/- 0.6 to 3.4 +/- 0.5 gm/24 hours (P less than 0.05). Lower doses of cimetidine resulted in less significant reductions of steatorrhea and azotorrhea. Cimetidine may be a useful adjunct to oral pancreatic enzyme therapy in patients with cystic fibrosis who continue to have steatorrhea and azotorrhea with enzyme therapy alone.

Adolescent↗
PubMed1976

Osteochondritis dissecans of the talus: discussion and case report.

A brief discussion of the salient clinicopathologic features of an entity known as osteochondritis dissecans and an illustrative case have been presented. High quality radiographic studies are of prime importance in formulating the diagnosis. Successful treatment of this relatively uncommon lesion can be provided once a thorough evaluation is made.

Adult↗
PubMed1976

Double osteotomies for structural correction of hallux abducto valgus.

The authors discuss their procedure for performing osteotomies for correction of hallux abducto valgus. Their technique involves the use of a paper template which aids in establishing normal values according to the functional position in which they desire to place the joint. They outline their procedure for performing the closing abductory wedges of the base of the first metatarsal and the closing medial wedges of the head of the first metatarsal. After the correction has been completed, they apply a below-the-knee cast.

Hallux Valgus↗
PubMedDate not supplied

Ultrasound and radionuclide biliary scanning in acute pediatric abdominal pain.

Seven pediatric patients (ages 2-14) who presented with acute abdominal symptomatology and an abnormal cholecystosonogram are reviewed. Etiologies of the abnormal sonograms included: hepatitis (3 of 7), acalculous cholecystitis (1 of 7), calculous cholecystitis (1 of 7), cholangitis with associated cholecystitis (1 of 7), and chronic active hepatitis with low serum albumin (1 of 7). The combined use of the sonogram and the radionuclide biliary scan is helpful in predicting and distinguishing between cases of cholecystitis and uncomplicated hepatitis.

Abdomen↗
PubMedDate not supplied

The use of recombinant DNA techniques to study tylosin biosynthesis and resistance in Streptomyces fradiae.

A substantial amount of information on the biosynthesis of tylosin has been obtained over the past ten years. Physiological studies and experiments with tylosin-blocked (tyl) mutants have suggested the probable pathway by which tylactone is converted to tylosin. The development of recombinant DNA methodology for streptomycetes in general, and for Streptomyces fradiae in particular, has allowed us to apply gene cloning techniques in further studies of tylosin biosynthesis in S. fradiae. The macrocin O-methyltransferase (MOMT), which catalyzes the last step in tylosin biosynthesis, was purified, and the sequence of the 35 amino acids at its amino-terminus was determined. A synthetic 44 base oligonucleotide probe was constructed on the basis of the amino acid sequence. The probe was used to identify sequences containing the MOMT structural gene in bacteriophage and cosmid libraries of S. fradiae DNA. Complementation of tyl mutants with the cloned DNA sequences identified nine tyl biosynthetic genes (tylC, D, E, F, H, J, K, L, and M) in a 42 kb stretch of DNA. Genes complementing four mutant classes, tylA, B, G, and I were not found. A tylosin-resistance gene, tlrB, was located just left of the tyl gene cluster. Tylosin-sensitive mutants of S. fradiae, which were isolated from regenerated protoplasts and which have pleiotropic deficiencies in tylosin biosynthesis, contained deletions which included at least some of the identified tyl loci and one or both of two tylosin-resistance genes, tlrB and tlrC. Possible schemes for the functional organization of the tyl region of the S. fradiae genome are discussed.

DNA, Bacterial↗
PubMedDate not supplied

Hepatobiliary scintigraphy with technetium-99m disofenin in the evaluation of neonatal cholestasis.

To assess the reliability of technetium-99m disofenin scanning in evaluating neonatal cholestasis, 33 neonates (less than 3 months of age) with direct hyperbilirubinemia were evaluated prospectively by cholescintigraphy. Results of this test were compared to those of standard serum tests of liver function, ultrasonography, and liver biopsy. The diagnosis of biliary atresia was suggested by a serum gamma-glutamyl transpeptidase (gamma-GTP) greater than 300 units/L, absence of the gallbladder on ultrasonography, and a lack of detectable radioisotope in the gastrointestinal and/or extrahepatic biliary tract on cholescintigraphy. Each of these tests lacked sensitivity and/or specificity when compared to liver biopsy. Of the nine neonates with biliary atresia, three had gallbladders identified by ultrasonography and two had gamma-GTP less than 300 units/L. Of the 24 neonates without biliary atresia, eight had cholescintigraphy without detectable radioisotope excretion, four had ultrasonography that failed to visualize the gallbladder, and nine had gamma-GTP greater than 300 units/L. Cholescintigraphy excluded the diagnosis of biliary atresia when gut and/or extrahepatic biliary excretion of isotope was seen. However, cholescintigraphy required more time, 6-8 days, and was less specific than ultrasonography and liver biopsy. We recommend that cholescintigraphy should not be routinely used in evaluating neonatal cholestasis, especially if it delays surgical intervention.

Biliary Atresia↗
PubMedDate not supplied

Determinants of change in blood pressure during S.W.E.A.T.: the sedentary women exercise adherence trial.

1. In a long-term study of the optimal approach to initiating and maintaining a regular exercise programme in previously sedentary older women (40-65 years), we have assessed determinants of change in resting blood pressure (BP) after 6 and 12 months. 2. Women (n = 126) were randomly assigned to either a centre-based or home-based exercise programme for an initial 6 months. The centre-based group attended supervised sessions three times per week, while the home-based group exercised unsupervised at home three times per week. Both groups were home-based during a second 6 months. Within each arm, subjects were further randomized to either exercise at moderate intensity (40-55% heart rate reserve; HRres) or at vigorous intensity (65-80% HRres). A nonintervention comparison group of 30 women was followed throughout. 3. At 6 months there was a fall in BP with moderate, but not vigorous intensity exercise (-2.7 mmHg; P = 0.025), an effect no longer significant at 12 months. 4. Change in BP was unrelated to improvements in fitness (VO2max), increases in lean tissue mass, number of exercise sessions completed or a composite measure of the total number of exercise sessions completed multiplied by the mean exercise intensity expressed as a percentage of heart rate reserve (%HRres). 5. Continuing participation in any regular exercise was a consistent predictor of change in BP, with those subjects still exercising in the 2 weeks before BP measurement having 1.9 mmHg lower BP at 6 months (P = 0.038) and 3.8 mmHg lower BP at 12 months (P = 0.016). 6. We conclude that the small effects of exercise on resting BP in these older women are predominantly related to continuing participation in lower intensity exercise, rather than to improvements in fitness or body composition.

Adult↗
PubMedDate not supplied

Home total parenteral nutrition during pregnancy: a case report.

A 26-year-old female was given total parenteral nutrition without complications during the last 2 months of her pregnancy. A partial small bowel obstruction caused by Crohn's disease prevented oral alimentation, necessitating parenteral nutrition. A term, female infant weighing 2680 grams was delivered vaginally without complications. At birth and 11 months of age, the infant's physical and developmental assessments were normal. This case report demonstrates that total parenteral nutrition can be administered during the last trimester of pregnancy to improve maternal nutrition so as to promote fetal growth.

Adult↗
PubMedDate not supplied

Selenium responsive myositis during prolonged home total parenteral nutrition in cystic fibrosis.

The need for routine supplementation of total parenteral nutrition solutions with selenium (Se) has not been clearly defined. Although clinical selenium deficiency in patients on prolonged total parenteral nutrition has been reported, it is rarely observed in the United States. We report a 19-year-old woman with cystic fibrosis who developed muscle pain and weakness after 3 months on total parenteral nutrition which was not supplemented with Se. Coincident with her onset of symptoms, markedly elevated serum creatine kinase values were observed compared to baseline levels. Subsequent evaluations revealed undetectable (less than 0.02 microgram/ml) serum and urine Se levels in this patient. In addition, electromyographic evidence of myositis and nonspecific membrane irritability was documented. Therapy with oral Se rapidly reversed her symptoms and normalized with serum creatine kinase values over a 10-day period. Prolonged treatment with Se was required to achieve normal values of Se in the serum. Patients with severe pancreatic insufficiency, such as cystic fibrosis, may be at risk for clinical Se deficiency if on prolonged total parenteral nutrition without supplementation. Elevated creatine kinase levels should alert physicians to the possibility of Se deficiency in such patients.

Adult↗
PubMedDate not supplied

Sclerema neonatorum: a sign of transient hyperammonemia of the newborn.

We cared for four neonates with transient hyperammonemia of the newborn (THAN), all of whom exhibited sclerema during their course. Sclerema is a hardening of the subcutaneous tissues, which gives the tissue a firm, rubber-like quality. This association has not been previously reported, and it may provide a clue to early diagnosis and intervention in THAN.

Ammonia↗