Search PubMed⌕ Search

Biomedical subjects

K Wild

Publications and source records attributed to K Wild.

48 records · Page 3Linked to original sources
PubMed1995

Should we estimate liver span in the right mid-clavicular line or the midline?

OBJECTIVE: Comparison was made between the accuracy of repeated measurements of liver projection below the costal margin in the right mid-clavicular line (RMCL) and in the midline (ML). METHODOLOGY: Clinical measurement of liver span was studied in 34 children under 5 years of age by five members of junior ward staff. Three patients were followed longitudinally by the same observers. RESULTS: The coefficient of reliability between different observers for measurement in the RMCL was 13 mm but for that in the ML was 7 mm. Estimates of liver size in the RMCL were particularly inaccurate when examining larger livers. CONCLUSION: More reliable sequential estimates of liver size are likely to be obtained using measurements both in the midline and in a well-defined and agreed point below the right costal margin.

Age Factors↗
PubMed1995

[Schwannoma of the gastric wall].

Clinical and ultrasound examination showed a tumor adjacent to the posterior gastric wall in two patients with noncharacteristic upper abdominal pain. The structure of the at least fist-size masses was partly solid, partly cystic and on palpation appeared soft and spongy with a smooth surface. Colour ultrasound showed a high vascularity. All these factors were confirmed by computerized tomography. History as well as clinical and ultrasound examination suggested the diagnosis of schwannoma and this was confirmed by histopathology following laparotomy.

Aged↗
PubMed1992

Inguinal herniotomy in young infants.

Ninety-two consecutive infants aged up to 12 months underwent primary inguinal herniotomy over a 5-year period. All were treated in a district hospital paediatric surgical unit according to recommendations of the British Association of Paediatric Surgeons. After a mean follow-up of 45.8 months, one patient had a failed repair and four (4 per cent) a hernia recurrence. One infant developed a wound infection. Infantile hernia can be managed safely and efficiently in a district hospital.

Female↗
PubMed1992

Cell-mediated immunity and its glucocorticoid-sensitivity after clinical recovery from severe major depressive disorder.

This follow-up study investigated lymphocyte blastogenesis induced by concanavalin A, phytohemagglutinin A, and pokeweed mitogen and their sensitivity to in vitro dexamethasone administration in 12 patients clinically recovered from severe major depression. Although cortisol-levels at 4.00 p.m. decreased significantly after clinical remission, mitogen-driven lymphocyte proliferative responses were unchanged when assessed intra-individually. No impairment of in vitro glucocorticoid-sensitivity of lectin-induced lymphocyte blastogenesis could be observed in clinically recovered patients. The inhibitory potency of in vitro dexamethasone was found to be inversely correlated with in vivo adrenal cortical hormone levels. There were no correlations with age, weight, sex, antidepressant medication, severity or duration of depression. No differences from age- and sex-matched healthy individuals were found. These results indicate that reduced glucocorticoid receptor sensitivity occurs only during the acute depressive illness.

Adrenocorticotropic Hormone↗
PubMed1991

In vivo and in vitro effects of glucocorticoids on lymphocyte proliferation in depression.

Twelve severely depressed patients and 13 healthy controls were studied under baseline, metyrapone and metyrapone plus dexamethasone pretreated conditions. Lymphocyte proliferation data were obtained by concanavalin A, phytohaemagglutinin and pokeweed mitogen (PWM) stimulation. There was a decrease in PWM-induced B-cell proliferation and an increase in inhibition of spontaneous leucocyte proliferation by dexamethasone added in vitro following metyrapone administration in vivo, in healthy controls, which was not present in the depressed patients. These data support the concept of a decreased functional plasticity of the glucocorticoid receptor in depression also at the cellular level.

Adolescent↗
PubMed1991

Normal lymphocyte responsiveness to lectins but impaired sensitivity to in vitro glucocorticoids in major depression.

The mitogen-induced lymphocyte proliferative response and its sensitivity to in vitro (10(-10)-10(-6) M) dexamethasone (DEX) administration were investigated in 12 severely depressed patients and 13 healthy controls. Patients with major depressive disorder exhibited no impairment of lectin-induced blastogenesis, but a significantly weaker suppressive effect of in vitro DEX on 1.0 microgram/ml phytohemagglutinin A-induced proliferation. The inhibitory potency of in vitro DEX was inversely correlated with in vivo adrenal cortical hormone levels at 4.00 p.m. These effects were not observed with pokeweed mitogen- and concanavalin A-stimulated cells. There were no correlations with age, weight, sex or severity of depression. These results do not support the hypothesis of a primarily impaired cell-mediated immunity, but might be indicative of reduced glucocorticoid receptor sensitivity in major depressive disorder.

Adrenocorticotropic Hormone↗
PubMed1991

Stump the experts.

Explore the source record for details and available documents.

Diagnosis, Differential↗
PubMed1990

[Myelolipoma of the adrenals--a chance sonographic finding].

A markedly echogenic and sharply marginated suprarenal mass was found incidentally during an abdominal sonography in the case of three patients. One female patient died due to a mesenterial infarct, in the other cases the tumors were removed surgically. In two cases the histological diagnosis indicated a myelolipoma of the adrenal gland, in one case an angiolipoma attached directly to the adrenal. Myelolipoma is a benign and hormone-inactive tumorous lesion, which most commonly occurs in the adrenal gland. Knowledge of the clinical and sonomorphologic characteristics along with computed tomography helps to distinguish other tumors of the retroperitoneum. Thus, unnecessary surgical intervention can be avoided.

Adrenal Gland Neoplasms↗
PubMed1976

Hypophyseal function in the operative and postoperative phases after removal of pituitary tumours.

In 47 patients with various pituitary tumours plasma cortisol, LH, FSH, prolactin, and GH were measured by radioimmunoassays to investigate anterior pituitary function. In 14 subjects LH--RH and TRH stimulation tests were performed to assess pituitary reserve before, during, and after surgical therapy. The mean cortisol levels were raised during and after the operative procedures until the 14th postoperative days. In patients with functionless tumours the other hormone concentrations remained nearly unchanged and in the normal ranges. After the removal of the tumour a rapid decrease in hormone levels, as might be expected, was rare, with the exception of the GH and prolactin levels in patients with hypersecretion. The postoperative stimulation tests showed a maintained secretory pituitary reserve due to active tissue left behind after operative removal of the tumour.

Adenoma↗
PubMedDate not supplied

Longitudinal study of self-imposed driving restrictions and deficit awareness in patients with Alzheimer disease.

Thirty-five patients with Alzheimer disease (AD), including 19 who were still driving, were evaluated for level of awareness and driving status. There was no significant correlation between driving status and Mini-Mental State Examination (MMSE) scores. Only the attention subscore of the awareness questionnaire yielded a statistically significant difference between drivers and nondrivers. Follow-up of the patients who were still driving was conducted 12-18 months later. All but 4 patients had stopped driving. Caregivers responded to a questionnaire assessing the patient's driving behaviors since the onset of AD. There was no correlation between MMSE and driving status. In 7 of 10 cases, caregivers or patients made the decision that the patient should stop driving. However, caregivers reported long periods between the caregiver's perception that the patient should stop driving and actual cessation (0.5-48 months). Results suggest that AD patients do restrict several areas of their driving voluntarily and that a failure to do so may be associated with an awareness deficit. In particular, a deficit of awareness for attention was significantly associated with an absence of restricted driving behaviors such as avoiding unfamiliar routes. Awareness of a deficit that is related to driving performance may be critical to restricted driving behavior, and this change in behavior may enable the patient to prolong his or her status as a driver.

Adult↗
PubMedDate not supplied

In vivo and in vitro effects of glucocorticoids on lymphocyte proliferation in man: relationship to glucocorticoid receptors.

Interrelations between the hypothalamic-pituitary-adrenal system (HPA) and the immune system represent a well-documented biological phenomenon. While in vitro administration of glucocorticoids may inhibit concanavalin A (Con A)- and phytohemagglutinin (PHA)-induced T-cell proliferation, pokeweed mitogen (PWM)-driven B-cell mitogenesis is relatively resistant to glucocorticoids. To further explore the link between the HPA and the immune system in relation to glucocorticoid receptor function, dose-response curves were obtained for Con A- and PHA-induced T-cell mitogenesis, PWM-generated B-cell mitogenesis and spontaneous lymphocyte proliferation in 13 healthy controls. Glucocorticoid effects were assessed in vivo by depletion of endogenous glucocorticoids after oral administration of 1.5 g metyrapone (MET) and subsequent glucocorticoid replacement, and in vitro by incubation of the cells with different doses of dexamethasone (DEX). There was a significant decrease in PWM-induced B-cell mitogenesis and a more pronounced effect of DEX administered in vitro on spontaneous lymphocyte proliferation after MET treatment when compared with the DEX plus MET pretreated condition in vivo. These data suggest that the inhibition of spontaneous lymphocyte proliferation by glucocorticoids in vitro is related to glucocorticoid receptor function. The decrease in PWM-generated B-cell proliferation following cortisol depletion by MET may be seen in connection with impaired glucocorticoid-mediated induction of interleukin-1 receptor synthesis.

Adrenocorticotropic Hormone↗