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Biomedical subjects

M C Kew

Publications and source records attributed to M C Kew.

At least 181 records · Page 10Linked to original sources
PubMed1978

The effect of dopamine on renal cortical blood flow in baboons with experimentally induced obstructive jaundice.

The effect of dopamine hydrochloride on renal blood flow in bile duct ligated baboons was assessed using the 133Xe washout technique. Intrarenal infusions of dopamine in different concentrations did not significantly increase renal cortical blood flow. On the contrary, over the lower dose range, the normal dopamine-induced renal vasodilatation was abolished in the jaundiced state. An in vitro experiment that measured the perfusion pressure of an isolated rabbit kidney perfused with normal and jaundiced baboon plasma confirmed the in vivo results. These observations suggest that dopamine would not be of value in treating the renal failure that may develop in patients with obstructive jaundice.

Animals↗
PubMed1978

Ultrastructural changes in the liver in heatstroke.

The ultrastructural changes in the human liver 24 to 96 hours after an attack of heatstroke are described. The alterations are most obvious along the vascular pole of the hepatocytes. These consist of degenerative changes or desquamation of sinusoidal lining cells, ballooning or flattening of microvilli, breaks in hepatocyte outer membranes, and electron-lucent vacuoles along the sinusoidal border. Also noteworthy is the appearance, in a number of cases, of basement membranes or ill-defined electron-dense material which may be of basement membrane character. Sinusoidal elements, such as erythrocytes, are found in hepatocytes, and hepatocellular debris appears in sinusoids. The membranes of hepatocytes and sinusoidal lining cells thus seem to be the prime targets of the hepatic injury in heatstroke. Other changes in the hepatocytes include vesiculation of endoplasmic reticulum, detachment of ribosomes, and alterations of mitochondria. Morphologic evidence of intravascular coagulation of intravascular hemolysis is often encountered. A comparison between the findings described here and those in experimental hyperthermia suggests that many of the hepatic changes seen in heatstroke are due to an excessively high tissue temperature per se but that some of the alterations are probably a consequence of complicating factors such as hypoxia, intravascular hemolysis, or disseminated intravascular coagulation.

Heat Exhaustion↗
PubMed1977

Mechanism of feminization in primary liver cancer.

Primary liver cancer occasionally presents with feminization. The mechanism is unknown. We studied a young man with primary liver cancer associated with feminization that disappeared after removal of the tumor. Before operation, the serum estrone level was markedly (1113 pg per milliliter) and estradiol and estriol levels were slightly elevated. Human placental lactogen was also increased (0.52 microng per milliliter). Luteinizing hormone, follicle-stimulating hormone and prolactin levels were normal, and testosterone reduced. Beta subunits of human chorionic gonadotropin were not detected in the serum. In vitro assay of tumor tissue showed estrogenic activity and high levels of these subunits. With a reversed isotope dilution technic with crystallization to constant specific activity, we showed the tumor tissue to convert dehydroepiandrosterone sulfate and dehydroepiandrosterone to estrone and estradiol. Production of beta subunits of chorionic gonadotropin and raised serum levels of placental lactogen provided further evidence that the tumor was functioning as trophoblastic tissue.

Adult↗
PubMed1977

Some characteristics of Mozambican Shangaans with primary hepatocellular cancer.

Certain characteristics of 328 Mozambican male Shangaans with primary hepatocellular cancer (PHC) have been compared with those of 163 Shangaan men with hepatomegaly from causes other than PHC and with those of 122 Black Southern African men with the same tumour but who belonged to tribes other than the Shangaan. Shangaans with PHC were significantly younger than non-Shangaans with the tumour (mean age 33,4 cf. 40,0 years; Pless than 0,001). They also had a significantly higher positivity rate of alpha-fetoprotein by immunodiffusion (71,4%) than the non-Shangaans (16%), although in other respects the tumours appeared to be similar. Cirrhosis of the non-tumorous part of the liver was present at necropsy in 62% of the Shangaans and in 66% of the non-Shangaans. The hepatitis B (surface) antigen (HBsAg) was detected in the serum of 60% of the Shangaans with PHC compared with only 9% of the controls. The antigen was present in 53,4% of the non-Shangaans with PHC (the difference between this fifure and that in the Shangaans was not significant). HBsAg was detected in the serum of 64% of the Shangaans with PHC and cirrhosis, but also in 74% of those with the tumour without associated cirrhosis. The possible role of the hepatitis B verus in the aetiology of PHC is considered in the light both of these findings and of the possibility that the frequency with which the tumour is associated with cirrhosis may be decreasing in Shangaans. Some of the dietary habits of the Shangaans with PHC were compared with those of the controls. Virtually all the patients with PHC, but also almost all the controls, ate groundnuts in large quantities from an early age, as well as cashew nuts in smaller amounts. Cycad pips, mopani leaves and pods, mopani worms and locusts were not eaten by significantly more of the Shangaans with PHC than the controls. The limitations of this type of dietary analysis are discussed.

Adolescent↗
PubMed1977

Hemostatic factors in primary hepatocellular cancer.

Detailed coagulation studies were performed in a group of 19 patients with primary hepatocellular cancer (PHC) and the results were compared statistically with the findings in 19 control subjects. Various funcitonal and immunochemical methods were employed in determining the possible presence of functional or structural coagulant protein abnormalities. The patient group was characterized by prolonged prothrombin times, partial thromboplastin times, and Reptilase times, increased levels of fibrinogen, factor VIII, and factor VIII-related antigen, moderately devreased levels of factor V, factor IX, factor X, antithrombin III, and plasminogen, and reduced levels of factor II and factor VII. Functional, immunochemical, and biochemical analysis failed to detect the presence of acquired protein abnormalities. These findings indicate that hemostatic changes in primary hepatocellular cancer are nonspecific in character. Severe alterations in the plasma levels of one or more of these hemostatic factors may occur.

Adolescent↗
PubMed1977

Hepatitis-B virus infection in anaesthetists.

To determine whether anaesthetists are at risk from developing hepatitis-B virus (HBV) infection from their patients, 95 anaesthetists working with black South Africans (who have a high prevalence of hepatitis-B antigenaemia) were questioned about attacks of viral hepatitis and their blood was tested for hepatitis-B (surface) antigen (HBsAg) and antibody (Anti-HBs). Anti-HBs was detected in the serum of 17.9% of the anaesthetists, but none was a chronic carrier of HBsAg. Two anaesthetists had suffered from acute viral hepatitis during their careers, one of whom is now positive for Anti-HBs. Forty-five of the anaesthetists (47.4%) were known to have anaesthetized patients with HBs antigenaemia, and of these seven were Anti-HBs-positive. Anaesthetists working with a population having a high carrier rate of HBV appear to be more at risk from HBV infection than the general population.

Adult↗
PubMed1977

Hepatitis-B surface antigen and antibody in Black and White patients with venereal diseases.

The prevalence of both the hepatitis-B surface antigen (HBsAg) and its specific antibody (anti-HBs) was significantly greater in the sera of White patients suffering from sexually transmitted diseases than that in White blood donors. However, Black patients with venereal diseases did not show an increased prevalence of either HBsAg or anti-HBs. These findings support the view that heterosexual transmission of the hepatitis-B virus is less likely to occur in populations in whom this infection is largely acquired before the age of sexual maturity.

Antibodies, Viral↗
PubMed1976

The chest radiograph in primary liver cancer: an analysis of 449 cases.

The value of plain chest radiography in the diagnosis of primary hepatocellular cancer (PHC) was assessed in 449 patients. An elevated right hemidiaphragm and pulmonary metastases were present in 11% and strongly suggest a diagnosis of PHC. In all, the right hemidiaphragm was raised in 30% of patients. Pulmonary metastases were present on admission in 19% of patients and appeared later in a further 6%. Secondary deposits were found in the lungs at necropsy in 52% of patients, compared with only 24% in whom there was radiological evidence of metastases during life. In 36% of patients chest radiographs were normal on admission.

Adult↗
PubMed1976

Occurrence of primary hepatocellular cancer and peliosis hepatis after treatment with androgenic steroids.

Three patients are reported in whom treatment of Fanconi's anaemia with androgenic steroids was complicated by the development of either primary hepatocellular cancer (PHC) or peliosis hepatis. The first, a White woman aged 34 years, was found to have PHC after receiving first methyltestosterone and then oxymetholone for a total period of 7 years. She died 4 months after the diagnosis was made. The other 2 patients were White children who presented with peliosis hepatis after receiving methyltestosterone and oxymetholone for 8 years and oxymetholone for 5 years, respectively. Both died from their primary diseases shortly after oxymetholone treatment was discontinued. Possible pathogenic mechanisms involved in the development of these serious complications are discussed and the therapeutic dilemma raised by their occurrence is emphasised.

Adolescent↗
PubMed1976

Pulsus paradoxus in the bedside assessment of patients with bronchial asthma.

Pulsus paradoxus (PP) was measured in 35 patients with bronchial asthma. The presence and degree of PP correlated well with the clinical conditions of the patient and with peak expiratory flow rate (PEF). PP and PEF are useful bedside measurements in the assessment and management of patients with bronchial asthma. Although the degree of PP is usually directly related to the severity of the attack of asthma, it was absent in the one patient who remained severly ill with unreleived bronchospam when he became exhausted. Our experience with this patient, and with previous patients who are not included in the present analysis, emphasises the fact that PP must not be considered in isolation but in conjunction with the patient's clinical state and with other indices of the severity of the astmatic attack.

Acute Disease↗
PubMed1976

Hepatitis-B surface antigen and antibody in Bantu patients with primary hepatocellular cancer.

Hepatitis-B surface antigen (HBsAg) was found in the serum of 58 of 158 (36-4%) southern African Bantu patients with primary hepatocellular cancer by counter immunoelectrophoresis and in 94 (59-5%) by radioimmunoassay (RIA). The prevalence of this antigen in the general Bantu population using these methods was 7% and 9% respectively. Antibody against HBsAg was detected in 11-6% of the patients by passive haemagglutination (PH) and 13-4% by RIA, and in 33-4% (by PH) of a control population. Antibody sub-types were predominantly "adw" (69-2%) with a lesser frequency of "ayw" (23%), while 7-8% were indeterminate. The corresponding figures in the controls were 80-4, 8-4 and 11-2%. HBsAg was more common in younger patients. No relationship could be demonstrated between hepatitis-B antigenaemia and the presence of alpha-foetoprotein in high concentration, although there were far fewer patients in the alpha-foetoprotein-negative group.

Adolescent↗
PubMed1976

Pituitary-gonadal function in men with alcoholic cirrhosis of the liver.

Fourteen adult males with alcoholic cirrhosis were studied. Gonadotrophin responses to luteinizing hormone-releasing hormone (LRH) and testosterone (T) responses to human chorionic gonadotrophin (HCG) were determined and basal 17 beta oestradiol (E2) levels were measured in each case. The mean basal luteinizing hormone (LH) and follicle stimulating hormone (FSH) levels, and the mean LH and FSH responses to LRH were not significantly different from a group of age-matched male controls. However, the five men with testicular atrophy all had an elevated basal FSH level and an exaggerated FSH response to LRH. The mean serum T of the cirrhotic men was significantly lower than that of the controls (P less than 0.05), while the mean E2 level was not significantly different. However, the mean E2 level in the eight patients with gynaecomastia was significantly higher than in those without gynaecomastic (P less than 0.05). All patients had a T response to HCG, including those 5 with low basal T levels. A significant negative correlation was found between the maximum rise in T after HCG (delta T) and the maximum LH response to LRH (delta LH), suggesting a mediating effect of T reserve on the LH response to LRH. These findings tend to exclude a suppressive effect of alcohol on the pituitary gland as a cause for the hypogonadism found in men with alcoholic cirrhosis. Furthermore, the evidence of some testicular T reserve despite low basal T levels, and the presence of normal basal LH levels, suggests that the low T production is not primarily due to leydig cell dysfunction.

Adult↗
PubMed1976

Prevalence of hepatitis B surface antigen and antibody in white and black patients with diabetes mellitus.

The prevalence of hepatitis B surface antigen (HBSAg) and antibody (anti-HBS) was determined in 531 white and 519 black diabetic outpatients and in appropriate white and black control populations. There was no difference between the prevalence of either HBSAg or anti-HBS in either the white or black diabetics and that in the white and black controls. These findings make it unlikely that the vast majority of patients with diabetes mellitus have either an increased susceptibility to infection by the hepatitis B virus or an impaired ability to clear the virus once they are infected.

Adolescent↗
PubMed1976

Serum immunoglobulin levels in White and Black patients with virus-A and-B hepatitis.

Serum immunoglobulin G, M and A levels were measured in 106 White patients with acute virus-A (hepatitis-B surface antigen-negative) hepatitis and 27 White patients with acute virus-B (hepatitis-B surface antigen-positive) hepatitis and compared with the values previously obtained in Black patients with these diseases. The mean serum IgM level in the White patients with virus-A hepatitis was significantly higher than that in virus-B hepatitis (p less than 0,001). This difference was much more obvious than that in Black patients, mainly due to a much lower mean serum IgM response in Black patients with virus-A hepatitis. The reason for the blunted IgM response in Black patients with virus-A hepatitis is not known, but it may be related to a difference in the reaction against altered host tissues rather than any difference in antibody production against the virus per se. The mean serum IgG and IgA levels were not significantly different in the White patients with virus-A and virus-B hepatitis and they were lower than the corresponding figures in Blacks.

Adolescent↗
PubMed1975

Outbreake of Marburg virus disease in Johannesburg.

The first recognised outbreak of Marburg virus disease in Africa, and the first since the original epidemic in West Germany and Yugoslavia in 1967, occurred in South Africa in February 1975. The primary case was in a young Australian man , who was admitted to the Johannesburg Hospital after having toured Rhodesia. Two secondary cases occurred, one being in the first patient's travelling companion, and the other in a nurse. Features of the illness included high fever, myalgia, vomiting and diarrhoea, hepatitis, a characteristic maculopapular rash, leucopenia, thrombocytopenia, and a bleeding tendency. The first patient died on the seventh day from haemorrhage resulting from a combination of disseminated intravascular coagulation and hepatic failure. The other two patients were given vigorous supportive treatment and prophylactic heparin and recovered after an acute phase lasting about seven days. During this period on developed pancreatitis, the serum amylase remaining raised until the 32nd day after the onset of the illness. The other developed unilateral uveitis after having been asymptomatic for two months. This persisted for several weeks and Marburg virus was cultured from the anterior chamber of the eye.

Adult↗