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Biomedical subjects

P Adams

Publications and source records attributed to P Adams.

At least 127 records · Page 7Linked to original sources
PubMed1984

Aseptic peritonitis secondary to myocardial infarction.

Three percent to 30% of the episodes of peritonitis occurring in patients undergoing chronic peritoneal dialysis are culture-negative or aseptic. The etiology of these episodes remains poorly defined, though endotoxin-contaminated dialysates and fastidious anaerobic organisms occasionally have been implicated. We treated a patient who had fever, epigastric pain, and peritoneal fluid neutrophilic leukocytosis while undergoing chronic peritoneal dialysis. Despite multiple negative pretherapy aerobic, anaerobic, fungal, and mycobacterial cultures, bacterial peritonitis was the presumptive diagnosis. At postmortem examination, there were no findings to suggest infectious peritonitis; however, myocardial infarction with pericarditis was noted. We conclude that myocardial infarction should be included in the differential diagnosis of aseptic peritonitis in the patient undergoing peritoneal dialysis.

Diagnosis, Differential↗
PubMed1983

Why do secondary cadaver renal transplants succeed? Results of the South-Eastern Organ Procurement Foundation prospective study, 1977-1982.

We report the selective and therapeutic factors affecting multiple kidney transplant success from a prospective multicenter study of the South-Eastern Organ Procurement Foundation. From June 1977 to March 1982, 3,215 cadaver kidney transplants were performed at 39 institutions. There were 2,535 first, 564 second, 103 third and 13 fourth grafts. The actuarial graft survival rates at 1 and 2 years were 52 plus or minus 1 and 45 plus or minus 1 per cent, respectively, for first grafts, 44 plus or minus 2 and 40 plus or minus 3 per cent for second grafts, and 42 plus or minus 5 and 31 plus or minus 6 per cent for third grafts. Graft survival rates were significantly lower for second and third than for first transplants (p less than 0.003). There was no difference in patient survival rates. The data were analyzed to determine which selective and therapeutic variables governed success of primary and secondary grafts. Pre-transplant blood transfusions were associated with a significant increase in graft survival rates in primary (p less than 0.00005) and secondary transplants (p less than 0.01), and did not affect patient survival rates. The administration of antilymphocyte serum also improved graft survival rates significantly in primary (p less than 0.00005) and secondary grafts (p less than 0.00002), without alteration of patient survival rates. HLA compatibility improved primary graft survival rates (p less than or equal to 0.022) but this did not reach statistical significance in secondary graft survival rates. Second transplant graft survival rates were best when the primary graft functioned for more than 12 months (Breslow p less than or equal to 0.02) but were not related to the reason for loss of the first graft. Pre-transplant bilateral nephrectomy improved graft survival rates significantly but this phenomenon was linked to other treatment factors. No beneficial effect on graft survival rate could be shown after pre-transplant splenectomy in patients with primary or secondary grafts and this procedure was associated with reduced patient survival rates in both groups.

Adolescent↗
PubMed1983

Congenital left coronary artery - right ventricular fistula.

The case of a neonate with heart failure and myocardial ischaemia due to a large coronary artery fistula is reported. ECG monitoring and Thallium - 201 imaging indicated pre-operative myocardial ischaemia. The diagnosis was confirmed by cardiac catheterization. Successful surgical ligation of the fistula was performed at the age of 10 days and to our knowledge is the first successful ligation in the neonatal period. Follow up Thallium - 201 imaging was normal. Repeat cardiac catheterization demonstrated complete closure of the fistula and normal left ventricular function.

Cardiac Catheterization↗
PubMed1982

Local protein synthesizing activity in axonal fields regenerating in vitro.

The goldfish retinal explant system of Landreth and Agranoff was used to study endogenous protein synthesizing activity of retinal ganglion cell axons regenerating in culture. Light and electron microscopic examination of axonal fields showed that axons were free of nonneural cell investment. Decentralized axons were incubated with a mixture of tritiated amino acids, and direct quantitative microanalysis of protein and tritium radioactivity was carried out on individual axonal fields. Our findings showed that radioactive amino acids were incorporated into axonal protein in a manner that inhibited significantly by cycloheximide, but not by chloramphenicol. Decentralized axons appeared to maintain their viability for at least 3-4 h. Axonal fields maintaining their central connections to the explant incorporated 3H-amino acids at an apparent rate that was similar to decentralized axonal fields. Labeled material transported into axonal fields from ganglion cell bodies appeared in significant amounts after a delay of 2-3 h. Fluorographic patterns of axonal proteins after labeling with either 3H-amino acids or [35S]methionine and separated by microelectrophoresis indicated that primarily tubulin and, to a lesser extent, actin were labeled. Our findings indicate that goldfish retinal ganglion cell axons regenerating in vitro exhibit measureable endogenous protein-synthesizing activity.

Amino Acids↗
PubMed1978

Histocompatibility antigens as markers of abnormal iron metabolism in idiopathic hemochromatosis.

To determine the frequency of HLA histocompatibility antigens in persons with idiopathic hemochromatosis and their usefulness as genetic markers of the disease, HLA typing for the A, B and C loci was carried out. HLA-A3 was found in 61% of 18 unrelated individuals with idiopathic hemochromatosis compared with 25% of 253 randomly chosen control subjects (P less than 0.001), and HLA-B7 was found in 50% and 22% respectively (P less than 0.025). Eighty-six members of seven families with idiopathic hemochromatosis were screened for abnormalities in iron metabolism with tests for serum iron concentration, transferrin saturation, serum ferritin concentration and iron content of the hepatocytes. Of the 14 persons selected for liver biopsy because of abnormalities detected by these tests, 8 had increased amounts of stainable iron in the hepatocytes. Body iron overload was subsequently demonstrated in six of the seven, who had undergone repeated phlebotomy. In sibships having one member with hemochromatosis, only 1 of 22 members had two haplotypes in common with the proband, whereas in sibships having more than 1 member with the disease 4 of 5 affected members had two haplotypes in common. HLA typing in families with hemochromatosis may provide a means of identifying persons at risk of acquiring the disease.

Epitopes↗
PubMed1978

Thermodynamics of protein cross-links.

The thermal transitions of native lysozyme and a well-characterized cross-linked derivative of lysozyme [Imoto, T., and Rupley, J. A. (1973), J. Mol. Biol. 80, 657] have been studied in 1.94 M guanidine hydrochloride at pH 2. The observed increase in the melting temperature from 32.4 degrees C for native lysozyme to 61.8 degrees C for the cross-linked derivative corresponds to a calculated 5.2 kcal/mol increase in the free energy of denaturation. This free-energy change is attributed to the decreased entropy of the unfolded polypeptide chain following introduction of a cross-link and is shown to compare well with theoretical predictions. The possibility that an introduction of a cross-link could also affect the enthalpy of an unfolded protein was investigated. The heats of reduction of bovine serum albumin and lysozyme by dithioerythritol in 6 M guanidine hydrochloride were determined and compared to that for the model peptide, oxidized glutathione. The near identity of the observed heats was taken as evidence that the introduction of cross-links into a random-coil protein does not, in general, introduce strain.

Chemical Phenomena↗
PubMed1977

Displacement of the heart by a giant mediastinal cyst.

A giant mediastinal cyst caused marked cardiac displacement, factitious cardiomegaly and clinical and hemodynamic findings suggestive of constrictive pericarditis. The correct diagnosis was established with echocardiography and confirmed with angiography and surgery.

Cardiomegaly↗
PubMed1977

Biochemical aspects of development and ageing of human lumbar intervertebral discs.

Nucleus pulposus and annulus fibrosus from individual normal discs of different ages have been separately examined, and the topographical distribution of constituents across the annulus fibrosus has been determined. Collagen content, including the molecular species, and proteoglycans have been estimated. Type I collagen was found in the outermost regions of the annulus and type II in the innermost, whereas the nucleus contained type II collagen. In older spines the collagen content of the annuli increased both outwards in the disc, and downwards along the spinal levels. Proteoglycan content was higher in the nucleus, and the proportion of keratan to chondroitin sulphate increased with age, as did the hyaluronate content. It is concluded that differences in mechanical function may be reflected by differences in chemical composition of the discs, and that mechanical failure could result from local variations in chemical composition.

Adolescent↗