Search PubMed⌕ Search

Biomedical subjects

M Kelly

Publications and source records attributed to M Kelly.

At least 307 records · Page 17Linked to original sources
PubMed1988

Selective application of cervical spine radiography in alert victims of blunt trauma: a prospective study.

Four hundred sixty-seven adult victims of blunt trauma undergoing cervical spine radiography (CSR) were prospectively studied to identify any clinical parameters which would aid in the selective application of CSR. Eight persons (1.7%), six of whom were alert and two who presented comatose, sustained cervical spine injuries. In this study, persons injured in falls demonstrated a statistically significant greater risk of cervical spine injury compared to those injured in motor vehicle accidents (p = 0.001). In alert trauma victims, a statistical correlation with cervical spine injury was noted for individuals who had complaints of neck discomfort (p = 0.028) and for patients who manifested tenderness to neck palpation (p = 0.000039). No cervical spine injury was noted in any alert, not intoxicated, neurologically intact patient who had no complaints of neck discomfort upon questioning or palpation. We conclude that alert trauma victims with no complaints of neck discomfort upon questioning and with no tenderness on neck palpation need not undergo CSR.

Adolescent↗
PubMed1988

Dopamine receptor modulation of corticosterone secretion in neonatal and adult rats.

The effects of the dopamine agonist, pergolide, upon plasma corticosterone levels have been studied in 30 day old neonatal and adult rats. Dose-related elevations in corticosterone were observed at both ages and these elevations were blocked by the dopamine (D2) receptor antagonist spiperone. These studies demonstrate that dopaminergic neurochemical control of the hypothalamus-pituitary-adrenal axis exists in four week old rats in contrast to our previous studies which have shown opioid control to be absent at this age. It appears that neurochemical control of corticosterone is dissimilar in the neonate.

Aging↗
PubMed1988

Failure of oral thiomalate to act as an alternative to intramuscular gold in rheumatoid arthritis.

Ten patients with active rheumatoid arthritis (RA) were entered into a pilot study to evaluate the effectiveness of thiomalic acid as a disease modifying agent and to assess its toxicity. Oral thiomalic acid (100 mg) was given daily for up to six months. Changes in disease activity were recorded monthly and all side effects noted. No patient recorded any improvement in subjective well being, pain score, or duration of early morning stiffness. No significant change occurred in articular index or haemoglobin (Hb); the erythrocyte sedimentation rate (ESR) showed a tendency to increase. Only three patients completed six months' treatment; six withdrew because of toxic reactions (three with rashes and three with severe gastrointestinal upset) and one because of lack of effect. Thiomalic acid alone appears to have no significant antirheumatic activity and is associated with an unacceptably high incidence of adverse reactions.

Absorption↗
PubMed1988

Patellar fracture type and prognosis in condylar total knee arthroplasty.

Fractures of the patella occurred following implantation of 36 condylar total knee arthroplasties in 35 patients. The end results were evaluated in relation to fracture type after an average 4.5-year follow-up period. The follow-up observations included a physical examination, quantitative knee score, and roentgenographic evaluations of extremity alignment and implant position. Twenty-two of the 36 knees had a good or excellent knee score and 14 had a fair or worse score at the time of the latest follow-up evaluation. The satisfactory knees had an average arc of motion of 100 degrees, while the unsatisfactory knees had an average arc of motion of 80 degrees. Fourteen fractures through the mid-body or superior pole of the patella not involving the implant, cement, or quadriceps mechanism (Type I) and two nondisplaced fractures through the inferior pole of the patella (Type IIIB) were managed nonoperatively, with all knees rating either a good or excellent score. Fractures of the patella disrupting the quadriceps mechanism or implant/bone/cement composite (Type II) were managed operatively in the six knees. Fractures of the inferior pole of the patella with disruption of the patellar ligament (Type IIIA) were managed operatively in seven of eight knees (one patient refused surgery). Lateral fracture-dislocations were managed operatively in all six knees. Six of the knees operated upon had a good or better score, and nine knees were rated as poor or failed. Those fractures alignment and implant position were seen had the more severe patellar fractures and poorest outcomes.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1987

Catecholamines predict outcome in traumatic brain injury.

Activation of the sympathetic nervous system attends traumatic brain injury, but the association of the severity of neurological impairment and recovery with the extent of sympathetic nervous system stimulation is poorly defined. In this study, plasma norepinephrine (NE), epinephrine (E), and dopamine (DA) levels were measured serially in 33 patients with traumatic brain injury and compared with the Glasgow Coma Score (GCS), which was obtained concurrently. A catecholamine gradient that reflected the extent of brain injury was demonstrated within 48 hours of the injury. In patients with a GCS of 3 to 4, NE and E levels increased four- to fivefold and the DA level increased threefold above normal (NE, 1686 +/- 416 pg/ml; E, 430 +/- 172 pg/ml; DA, 236 +/- 110 pg/ml), while patients with mild brain injury (GCS, greater than 11) had slightly elevated or normal levels. Patients with marked (GCS, 5 to 7) and moderate (GCS, 8 to 10) traumatic brain injuries had intermediate levels. The prognostic value of determining admission levels of NE was shown in patients with an admission GCS of 3 to 4 1 week after injury. Patients with severe and unchanging neurological impairment 1 week after injury had markedly elevated initial NE levels (2,176 +/- 531 pg/ml), whereas initial NE levels (544 +/- 89 pg/ml) were only mildly elevated in patients who improved to a GCS of greater than 11. These data indicate that markedly elevated NE levels predict outcome in patients with comparable neurological deficits. Thus levels of circulating catecholamines are excellent endogenous and readily quantifiable markers that appear to reflect the extent of brain injury and that may predict the likelihood of recovery.

Adolescent↗
PubMed1987

Evidence for isoaspartyl (deamidated) forms of mouse epidermal growth factor.

A variant form of mouse submaxillary gland epidermal growth factor (EGF) was identified by isocratic reversed-phase HPLC of EGF obtained by Bio-Gel P-10 column chromatography ("culture grade"). The variant form was essentially absent in preparations of EGF further purified by chromatography on DEAE-cellulose ("receptor-grade" EGF). The spectral properties and amino acid composition of the variant form (EGF-I) could not be distinguished from those of the intact polypeptide isolated by HPLC (alpha-EGF). Receptor-binding and mitogenic properties of EGF-I were also equivalent to those of alpha-EGF. These data suggested that EGF-I was structurally very similar to EGF. However, the very low yield (less than 4%) obtained by Edman degradation indicated that the N-terminal (Asn1) of the polypeptide was modified. Isoelectric focusing of EGF-I revealed two major immunoreactive bands: one with a pI equivalent to that of alpha-EGF (pI 4.6) and another at pI 4.1. Alkaline treatment of alpha-EGF (0.1 M NH4OH) yielded peak material by HPLC that coeluted with EGF-I; the alkaline-generated EGF-I yielded bands that also focused at pH 4.6 and 4.1. Ammonium hydroxide treatment of [des-Asn1]-EGF (beta-EGF) did not produce conversion to EGF-I. On the basis of these data, we propose that EGF-I was formed by selective deamidation of the N-terminal Asn of intact EGF. This notion is also supported by liquid secondary ion mass spectrometry, which showed that EGF-I was approximately 1.5 mass units greater than alpha-EGF. The heterogeneity observed by isoelectric focusing supports previous studies which have shown that, following deamidation of N-terminal asparagine, a beta-aspartyl shift can occur, which in the present study might yield succinimido-aspartyl1-EGF and beta-aspartyl1-EGF. Low yields observed during Edman degradation indicate that negligible amounts occur as the alpha-aspartyl1-EGF isomer.

Amino Acid Sequence↗
PubMed1987

Bladder irrigation with chlorhexidine for the prevention of urinary infection after transurethral operations: a prospective controlled study.

The value of postoperative bladder irrigation with the antiseptic agent chlorhexidine was assessed in a randomized prospective controlled study of men after transurethral operations. In patients with sterile preoperative urine the incidence of postoperative bacteriuria was 12.8 per cent, compared to 36.7 per cent in control patients. The difference is significant (chi-square 5.54, p less than 0.02). On the other hand, chlorhexidine irrigation did not eliminate pre-existing infection. Small amounts of chlorhexidine were demonstrated in the blood of some patients. There was no evidence of damage to the bladder and no toxic side effects.

Administration, Intravesical↗
PubMed1987

Facilitated intravenous access through local application of nitroglycerin ointment.

Thirty-four patients with diminutive peripheral veins requiring peripheral IV access (PIVA) in the emergency department setting were randomly assigned to one of two treatment groups. One group of patients (Group A) received application of a bland ointment to the dorsum of the hand prior to attempts at cannulation, while the other group (Group B) received application of 2% nitroglycerin ointment to the dorsum of the hand prior to cannulation attempts. Cannulation was achieved in all 34 patients in the study, but required significantly fewer attempts in Group B patients (P = .04). No side effects of the drug were observed in any patient or any staff member applying the ointments. We conclude that application of 2% nitroglycerin ointment to the dorsum of the hand is a safe, effective method of inducing local venodilation that will ensure PIVA with significantly fewer attempts at cannulation.

Adolescent↗
PubMed1987

Myalgia cruris epidemica (benign acute childhood myositis) associated with a Mycoplasma pneumonia infection.

We report the case of a 6-year-old boy who presented with difficulty ambulating and an elevated creatinine phosphokinase level following an upper respiratory tract infection. Crural myositis was diagnosed; convalescent serum was negative for viruses, but demonstrated significant titers to Mycoplasma pneumoniae. Benign acute crural myositis has not heretofore been associated with Mycoplasmal infection.

Acute Disease↗
PubMed1987

A cytological comparison between regeneration, hyperplasia and early neoplasia in the rat liver.

Regeneration, hyperplasia and neoplasia are three different responses to injury in the rat liver. These phenomena were induced in rat liver and the parameters of ploidy, nuclearity and DNA synthesis were examined. Analysis of hepatocytes from animals undergoing liver regeneration following two-thirds partial hepatectomy revealed that there is an increase in the cycling of diploid hepatocytes and a large increase in the frequency of binucleated tetraploid cells undergoing DNA synthesis and amitotic cytokinesis to mononucleated tetraploid cells. This results in an overall increase in the ratio of tetraploid:diploid cells but no change in the proportion of binucleated cells. The liver appears, temporarily, to undergo an increased rate of maturation. In both hyperplasia inducted by oral administration of 25 mg/kg methylclofenapate or diethylhexylphthalate (1 g/kg for 4 weeks) and neoplasia induced by the hepatocarcinogens 3'-methyl-4-dimethylaminoazobenzene (3'M), 6-p-dimethylaminophenylazobenzthiazole (6BT), 5-phenylazoindazole (5I), diethylnitrosamine (DEN) and thioacetamide (TA) the binucleated cell is sensitive to the action of the chemicals, although its response is different. Both types of carcinogen induce a reduction in the frequency of binucleated cells but the mononucleated diploid cells produced by cytokinesis without a preceding S phase as a result of the action of genotoxic carcinogens appear to be incapable of polyploidization and give rise to a liver with a permanently depressed tetraploid:diploid hepatocyte ratio. The nongenotoxic carcinogens methylclofenapate and DEHP cause an initial hyperplastic response due to the rapid conversion of binucleated cells to mononucleated tetraploids by amitotic cytokinesis following S phase. Over a longer period of exposure there is an increase in the tetraploid:diploid ratio due to the continued conversion of newly formed binucleates to tetraploid mononucleates.

Animals↗
PubMed1987

The prevalence of baby bottle tooth decay among two native American populations.

Baby bottle tooth decay (BBTD) is a disease characterized by severe dental caries in the primary dentition that may have significant short-term and long-term implications for the health of children. Its prevalence and various etiologic factors have not been addressed fully in the dental literature. In 1985, 514 Native American Head Start children in Alaska and Oklahoma were screened to establish the prevalence of BBTD in those populations. The prevalence of BBTD ranged between 17 and 85 percent, with a mean of 53 percent. BBTD is clearly a significant health problem for this population group. Concerted intervention efforts to lower the prevalence of this preventable condition should be instituted and their effectiveness evaluated for potential utility among other affected groups.

Alaska↗
PubMed1986

alpha-Difluoromethylornithine induces differentiation of a human embryonal carcinoma cell line in vitro.

Human embryonal carcinoma cells could serve as a useful model system for analysis of early human development. A limited number of human embryonal carcinoma cell lines have been generated from in vivo tumors. We report here that alpha-difluoromethylornithine, a specific enzyme-activated inhibitor of ornithine decarboxylase activity, can induce differentiation in human embryonal carcinoma cells. The differentiated phenotype could be distinguished from undifferentiated cells by altered cellular morphology, biochemical and cell surface antigenic properties. These results suggest that alterations in the intracellular levels of polyamines may play a role in human embryonal carcinoma cell differentiation, and possibly human embryogenesis.

Actins↗