Admission times for patients with myocardial infarct.
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Humans↗
Biomedical subjects
M J Wilkinson
Publications and source records attributed to M J Wilkinson.
Treatment of pseudotumor cerebri by primary and secondary optic nerve sheath decompression.
We performed optic nerve sheath decompression in 53 patients (101 eyes) with pseudotumor cerebri and visual loss. Sixty-nine eyes (85 patients) with acute papilledema uniformly had improved visual function after optic nerve sheath decompression. Of 32 eyes with chronic papilledema (18 patients), only ten had improved visual function after optic nerve sheath decompression. This difference was significant (P = .0001). Thirteen eyes required secondary or tertiary optic nerve sheath decompression after an initial successful result. Eleven of 13 eyes had improved visual function after repeat optic nerve sheath decompression. We believe that patients with acute papilledema and visual loss should be offered optic nerve sheath decompression, and if symptoms recur, repeat optic nerve sheath decompression is a safe and effective treatment option.
Acute Disease↗
Optic nerve sheath decompression for the treatment of progressive nonarteritic ischemic optic neuropathy.
We performed optic nerve sheath decompression on four patients (five eyes) with visual loss secondary to nonarteritic anterior ischemic optic neuropathy. Four of the five eyes had marked improvement in visual function after the operation. Optic nerve sheath decompression is an effective treatment for patients with nonarteritic ischemic optic neuropathy and progressive visual loss.
Aged↗
Treatment of traumatic optic neuropathy with corticosteroids--correction.
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Adrenal Cortex Hormones↗
MMAF for advanced gastric cancer.
65 patients with metastatic gastric carcinoma were treated with a combination of methotrexate 1.5 g/m2 with 5-fluorouracil 1.5 g/m2 on day 1 and doxorubicin 30 mg/m2 with mitomycin 4 mg/m2 on day 14. Cycles of chemotherapy were repeated every 4 weeks. The overall response rate was 29% with 6% complete responses and 23% partial responses. Prognostic factors that individually affected response were Karnofsky performance (P less than 0.002), and site of the primary tumour (P less than 0.007). Multivariate analysis showed that only increasing Karnofsky performance (P = 0.01) and disease status (P less than 0.02) (patients with recurrent tumours responding better than patients with postoperative residual disease and those with inoperable disease) were important in predicting response to therapy. The overall median survival was 7 months. All 4 patients with a complete response are alive in remission at 13, 28, 48 and 52 months from the date of starting chemotherapy. Univariate analysis identified increasing Karnofsky performance (P less than 0.0001), response to chemotherapy (P less than 0.02) and higher serum albumin (P less than 0.03) as prognostic indicators for survival. Multivariate analysis, of pretreatment factors and day 14 full blood count showed that only Karnofsky performance (P less than 0.0001) and day 14 platelet count (P less than 0.03) were shown to predict survival, higher platelet values being associated with decreased survival.
Adenocarcinoma↗
Bactericidal effects of amoxycillin/clavulanic acid against a Legionella pneumophila pneumonia in the weanling rat.
Amoxycillin/clavulanic acid and clavulanic acid have been previously reported to demonstrate bactericidal activity in tissue culture studies against intracellular Legionella pneumophila. A rat model of legionellosis was therefore developed for the purpose of assessing the efficacy of these agents against L. pneumophila in vivo. Therapy by the subcutaneous route was started 12 h after infection when the majority of the bacteria observed in lavage fluid were residing in alveolar macrophages. Treatment with amoxycillin was ineffective in reducing the bacterial counts of L. pneumophila in lung homogenates whereas amoxycillin/clavulanic acid displayed bactericidal effects of the same order as the control antibiotic, erythromycin. Further in-vivo studies are planned to assess the clinical relevance of these findings.
Age Factors↗
Use of ultrasound in the measurement of subcutaneous fat and prediction of total body fat in dogs.
An ultrasonographic unit (A-scan mode) has been evaluated as a noninvasive method for estimating body fat in 25 dogs. Six anatomical sites were defined and subcutaneous fat thickness was measured by means of ultrasound and histology. Total body fat was subsequently calculated in 12 dogs. There was a high correlation between histology and ultrasound for the measurement of subcutaneous fat (r = 0.81; P less than 0.001). Total body fat was successfully predicted using measurements taken with ultrasound at the lumbar area (r = 0.87; P less than 0.001). Measurements of subcutaneous fat thickness from other anatomical sites did not estimate body fat with the same accuracy. These results suggest that ultrasound can reliably measure subcutaneous fat in dogs and that these measurements, when taken from the mid lumbar area, can be used to predict total body fat.
Adipose Tissue↗
Bactericidal effects of ticarcillin-clavulanic acid against Legionella pneumophila pneumonia in immunocompromised weanling rats.
A model of acute Legionella pneumophila pneumonia in neutropenic weanling rats was developed as a means of assessing the efficacies in vivo of the beta-lactams ticarcillin, ticarcillin-clavulanic acid, and clavulanic acid, agents active against the organism in vitro. Weanling rats were dosed with cyclophosphamide 3 days before and immediately prior to infection by intrabronchial intubation with L. pneumophila. The bacteria persisted in the lungs of untreated animals at high counts (5.0 to 7.0 log10 CFU/g of lung tissue) for up to 168 h after infection, and the histological characteristics of the infection were similar to those of the disease in humans. Transmission electron micrography revealed the presence of L. pneumophila multiplying within alveolar macrophages. Therapy with ticarcillin was ineffective in reducing the bacterial numbers in the lung tissue, whereas ticarcillin-clavulanic acid and clavulanic acid were active, producing bactericidal effects similar to those of erythromycin. The ticarcillin-clavulanic acid combination was significantly more efficacious (P less than 0.01) than corresponding doses of clavulanic acid alone. Synergistic activity between ticarcillin and clavulanic acid against L. pneumophila has been demonstrated in vivo, and the combination showed activity similar to that of erythromycin.
Animals↗
Comparison of the diagnostic yields of disposable and reusable cytology brushes in fibreoptic bronchoscopy.
Disposable rake and reusable bristle type cytology brushes have been compared in 50 patients undergoing fibreoptic bronchoscopy for suspected malignancy. Forty seven patients were eventually found to have carcinoma of the bronchus. A diagnosis of malignancy was made from the specimens taken with one or other brush in 34 patients, from the reusable brush in 28, and from the disposable brush in 31. The specimens taken with the two types of brush were of similar quality. The reusable brush is about five times less expensive per procedure but carries a risk of cross contamination and cross infection, and time is needed to clean the brush after each bronchoscopy. The diagnostic yield appears to be at least as good with the disposable brush.
Adult↗
Treatment of traumatic optic neuropathy with corticosteroids.
We treated 21 patients (22 eyes) with traumatic optic neuropathy by using intravenous megadose methylprednisolone (13 patients) or high-dose dexamethasone (eight patients). Of 13 patients treated with megadose methylprednisolone, 12 had improved visual function, as did seven of nine eyes treated with intravenous dexamethasone. This difference was not significant (P = .3). Initial total blindness, mechanism of injury, or time from injury to treatment did not correlate with visual improvement.
Adolescent↗
The influence of residual methylcellulose solution on Tono-Pen readings.
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False Positive Reactions↗
The malignancy grading method is not a reliable assessment of malignancy in mesothelioma.
The ploidy of a series of pleural lesions--reactive proliferations, malignant mesotheliomas and metastatic tumours--was measured on a Leitz Miamed DNA image analyser using Feulgen-stained slides. The technique successfully recognized all the metastatic tumours as malignant; this corresponds to previous work. However, it was not successful in classifying mesothelial lesions as benign or malignant, resulting in a very high false-negative rate and a moderately high false-positive rate. Mesothelial lesions appear to have a wide range of ploidy values irrespective of their biological behaviour. Thus, for primary mesothelial tumours, the ploidy value cannot be used as a reliable diagnostic index.
False Negative Reactions↗
Necator americanus in the mouse: histopathological changes associated with the passage of larvae through the lungs of mice exposed to primary and secondary infection.
The mouse/Necator americanus model was studied to assess the histopathological changes that occur in the lungs following primary and secondary exposure to infective larvae. Groups of BALB/c mice were infected percutaneously and killed on various days post infection. Parasite numbers were counted, the bronchoalveolar leukocyte response was quantified and histological sections of lung material were examined for evidence of host protective inflammatory reactions. An increase in the inflammatory infiltration was observed between days 5 and 9 in both primary and secondary infections but was considerably more intense in re-infected animals. This involved a marked change in the character of the infiltrate, particularly in the number of eosinophils that were recovered in lavage fluid. More worms were trapped in the lungs of challenged mice, as assessed through their inability to escape from lung material incubated in vitro. Overall, the results were found to be compatible with the development of acquired resistance to N. americanus and the expression of host protective immunity during the development of challenge-infection larvae in the lungs.
Animals↗
A nonradioactive assay for type IV collagen degradation.
A sensitive assay for type IV collagen degradation using an avidin-biotin sandwich technique is described. Biotinylated type IV collagen is allowed to bind to an avidin-coated microtiter plate. The solution to be assayed is incubated with the biotinylated collagen bound to the avidin plate. Collagen degraded by the solution is released into the supernatant and transferred to a second plate coated with avidin. By addition of biotinylated horseradish peroxidase to this second plate, the amount of collagen degraded is determined. Our assay requires only 0.5 microgram of type IV collagen per microtiter plate and detects nanogram quantities of bacterial collagenase activity.
Animals↗
Postmortem demonstration of intrapulmonary arteriovenous shunting.
The measurement of the pressure required to drive a 2% solution of gelatin across the pulmonary vascular bed of a group of 49 infants dying suddenly at less than 44 weeks' postnatal age, has shown the presence of low pressure arteriovenous shunting in 30 cases (61%). Injection of polymethylmethacrylate beads in three cases has demonstrated that the vessels that form the shunts are up to 60 microns in diameter. The presence of vessels allowing shunting at pressures as low as 0.1 kPa (1 cm H2O) could severely compromise the gas exchange function of the lung.
Arteriovenous Malformations↗
Neonatal cilia: ultrastructure.
The number of inner and outer dynein arms and gross cilial abnormalities of well newborn children and adults were similar. Inability to see all nine outer dynein arms in healthy adults may be due to technique and not recent infection or congenital cilial malformation.
Adult↗
Vascular changes in irradiated lungs: a morphometric study.
The lungs from eight patients who had received thoracic irradiation for the treatment of malignant disease have been studied and a morphometric analysis of the vascular changes present has been made. We found a marked difference between the changes we observed in the pulmonary vessels and those described in systemic vessels after exposure to irradiation. In the former the changes are more pronounced in the venous circulation, and in the latter they are described as being almost confined to the arteries. This difference is a reflection of the difference in oxygen saturation of the blood in the two types of vessels. We suggest that this difference can be explained by the possible role of super-oxide free radicals in the generation of these effects.
Humans↗
Pleural complications of acute pancreatitis--an autopsy study.
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Acute Disease↗