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Biomedical subjects

R D King

Publications and source records attributed to R D King.

At least 73 records · Page 4Linked to original sources
PubMed1981

A new approach to gonorrhea control. The asymptomatic man and incidence reduction.

Reduction of gonorrhea incidence in the United States continues to resist public health intervention. Control strategies currently in use are associated with containment of the disease; about 1 million cases have been reported annually since 1975. Control efforts emphasize treatment of symptomatic men and the detection of asymptomatic women. Asymptomatic gonorrhea in men is well known clinically, but its epidemiologic significance has not been detailed. More than 60% of the infected partners of certain selected women are asymptomatic. By focusing control resources on these women and removing their asymptomatic partners from the disease reservoir, a substantial reduction in gonorrhea incidence can be expected.

Colorado↗
PubMed1981

Immediate postoperative digitalization in the prophylaxis of supraventricular arrhythmias following coronary artery bypass.

Regimens of acute preoperative digitalization have been evaluated previously in the prophylaxis of supraventricular tachycardias (SVT) following coronary artery bypass operations, with equivocal results. This study assesses the effectiveness of immediate postoperative digitalization on the incidence of arrhythmias in 407 consecutive patients recovering from myocardial revascularization. In 137 patients treated by our regimen, which begins digitalization within 4 hours postoperatively, the incidence of supraventricular tachyarrhythmias was 2%, while the corresponding figure for 270 untreated patients was 15%. Digitalization reduced the incidence of supraventricular arrhythmias significantly (p less than 0.01), whereas death, ventricular ectopy, and infarction rates were similar in the two groups. The few patients who did have supraventricular arrhythmias while receiving prophylactic digoxin were no more easily treated than patients in the undigitalized group. The timing of administration of digoxin for SVT prophylaxis may be more important than previously recognized. Immediately postoperative digitalization, theoretically preferable to preoperative regimens, is a safe, effective way to reduce the incidence of supraventricular arrhythmias following myocardial revascularization.

Arrhythmias, Cardiac↗
PubMed1980

Intravenous leiomyomatosis of the uterus with extension into the heart.

A 42 year old woman presented with impaired filling of the right atrium and right ventricle two years after removal of uterine leiomyomas. At the time of hysterectomy, intravenous leiomyomatosis was noted, with extension of the tumor into the inferior vena cava. The tumor subsequently extended into the right atrium and coronary sinus, and protruded through the tricuspid orifice. It was successfully removed from the heart, and proved to be histologically benign.

Adult↗
PubMed1980

Adherence of Candida albicans and other Candida species to mucosal epithelial cells.

To study the possible involvement of candidal adherence in mucosal colonization, we examined the in vitro adherence capabilities of seven Candida species. Adherence was evaluated by direct microscopic examination and by a quantitative radiometric adherence test. The results indicate that C. albicans adheres to vaginal and buccal epithelial cells to a significantly greater degree (P less than 0.01) than the other species tested. C. tropicalis and C. stellatoidea demonstrated moderate adherence capabilities, while C. parapsilosis adhered only to a slight degree. Other species failed to interact with isolated mucosal cells. These findings suggest that there is a relationship between the adherence capabilities of the Candida species and their abilities to colonize mucosal surfaces, since those species which adhere are those which most frequently colonize mucosal surfaces. C. albicans was found to be adherent under a variety of environmental conditions. Stationary-phase blastospores of C. albicans were found to be more adherent than logarithmic-phase yeasts, and larger blastospore cell-to-epithelial cell ratios resulted in greater adherence values. The actual number of adherent yeasts varied considerably when epithelial cells were obtained from different donors.

Adhesiveness↗
PubMed1980

Organizational effects on mentally retarded adults: a longitudinal analysis.

Normalization has gained wide acceptance as a goal that residential institutations for the mentally retarded should strive to achieve, but many organizations have been shown to have difficulty achieving the goal. Theories developed from the organizational contingency perspective suggest that organizations with bureaucratic structures will have particular difficulty accomplishing the nonroutine tasks associated with normalization. Our major purpose was to test the usefulness of such theories for the evaluation of mental retardation facilities by ascertaining whether a less bureaucratic organization for the mentally retarded would achieve greater success than a more bureaucratic organization. The closing of a large public hospital and the subsequent transfer of most of its residents to two new facilities (one of which was more bureaucratic than the other) allowed us to examine bureaucracy's effect on treatment. As predicated, the analysis showed that the less bureaucratic organization produced a greater average positive change in behavior than did the more bureaucratic organization. A number of clinical and demographic characteristics of the residents which could have influenced the observed changes in behavioral level were identified and controlled. They were not found to explain the differences between facilties. Other factors, which could not be controlled in this study, provide suggestions for future research.

Analysis of Variance↗
PubMed1980

Focused interviewing in gonorrhea control.

To develop an operational approach to the identification of high risk gonorrhea transmitters, three groups of women infected with Neisseria gonorrhoeae (recent repeaters, routine discoveries, and women with pelvic inflammatory disease) were offered intensive casefinding services during an 18-month period. Approximately three contacts per case were investigated, and 27.4% of the contacts were infected. Of infected contracts, 61% were asymptomatic. Asymptomatic, remote contacts to these women appear to be important in the continuing transmission of gonorrhea. The interviewing approach used reflected that employed in syphilis (thorough, detailed, and long) rather than the more casual interviews usually employed for gonorrhea patients. During this period, gonorrhea morbidity declined 22%. Further exploration of a targeted approach to gonorrhea epidemiology is indicated.

Adolescent↗
PubMed1980

Treatment of tinea nigra palmaris with miconazole.

A patient with tinea nigra palmaris was successfully treated with 2% miconazole nitrate cream. In vitro studies demonstrated sensitivity of the causative agent, Exophiala werneckii, to this antifungal agent.

Adolescent↗
PubMed1978

Occlusion, carbon dioxide, and fungal skin infections.

Occlusion of the skin renders it susceptible to acute fungal skin infections (dermatophytosis and candidiasis). Occlusion also raised carbon-dioxide (CO2) tensions at the skin's surface. Comparable CO2 tnesions have a pronounced effect on the morphology and metabolism of dermatophytes in vitro. It is postulated that dermatophyte conida and hyphae produce infective units under conditions of raised CO2 tensions, and that occlusion of the skin produces the concentrations of CO2 required for the conversion. Fungal skin infections might be prevented or controlled by interference with the action of CO2 or by prevention of its accumulation under wet, occlusive clothing.

Acute Disease↗
PubMed1978

The effect of occlusion on carbon dioxide emission from human skin.

The effect of occlusion on the carbon dioxide (CO2) emission rate (CDER) of human skin was determined. Occlusive plastic tape elevated the CDER 4.5 times (90nl/cm2/hr) over the normal CDER (20nl/cm2/hr). This increase was noted within a 3-hour period. Non-occlusive paper tape had no effect on CDER. Quantitation of the amount of CO2 under plastic tape revealed that CO2 was present at a concentration of 8-10%. Removal of the plastic tape after 24 hours allowed the CDER to return to approximately normal values within 2 hours. The mechanism by which occlusive plastic tape mediates this dramatic effect on CDER as well as the significance of elevated CO2 concentrations under occlusion are discussed.

Adult↗
PubMed1977

Aortocoronary vein graft flow in response to peripheral venous administration of sodium nitroprusside or diazepam.

Vein graft flow (VGF) in response to peripheral venous administration of sodium nitroprusside (SNP) or diazepam was studied in 13 anesthetized patients following cardiopulmonary bypass for aortocoronary vein bypass graft operations. SNP (0.5 microgram/kg/min) significantly reduced mean arterial pressure (p less than 0.05). VGF paralleled the decreased blood pressure, but the reduction was not significant (p greater than 0.05). Diazepam (0.1 mg/kg) did not significantly alter blood pressure or VGF. We conclude that peripheral venous administration of SNP or diazepam is not a pharmacologically reliable method by which to increase VGF in the period immediately following a graft operation.

Blood Pressure↗
PubMed1977

Development of arthrospores of Trichophyton mentagrophytes.

Arthrosporogenesis of the dermatophyte Trichophyton mentagrophytes was examined by light and by scanning and transmission electron microscopy. Sabouraud dextrose agar plates were inoculated with microconidia and incubated in an atmosphere of 8% CO2. Typical germination and hyphal branching continued to day 4, when hyphae began to be increasingly coated with granular-fibrillar material. Multiple replication of nuclei and formation of segregating septa followed. By day 6 the thick surface mesh sometimes was restricted to protruding rings, probably over septa. Between days 6 and 7, after thickening of outer and septal walls, units began to round and separate. Triangular gaps, which developed at the junction of septa and outer wall layers, enlarged so that spores were held together at their poles and along a tangential ring. With elongation of the spore to its barrel shape, the halves of the septum separated and the ring pulled apart, leaving a jagged, circular flange originating from the outer layer of cell wall extended toward the poles, covering the apparently exposed inner wall layer. Newly formed arthrospores, which measured 2.0 to 3.3 by 2.9 to 3.8 micronm and possessed walls of about 0.33-micronm thickness, has smooth sides but somewhat rough poles.

Spores, Fungal↗
PubMed1976

A quantitative dermatophyte infection model in the guinea pig--a parallel to the quantitated human infection model.

A method is described for inducing quantitative dermatophyte infections in guinea pigs. This model is unique in that the epidermis in the infection site is not traumatized nor is it epilated. One hundred spore-inocula of Trichophyton mentagrophytes var. granulosum ATCC number 18748 induced infections in 85% of tested guinea pigs. The course of these infections in guinea pigs that had not had a previous infection (inexperienced) and those that had (experienced) paralleled that seen in experimental infections of human volunteers.

Animals↗
PubMed1976

Identification of carbon dioxide as a dermatophyte inhibitory factor produced by Candida albicans.

A factor produced by Candida albicans, which inhibits dermatophyte growth and induces arthrospore formation is characterized and identified. Candida dermatophyte inhibitory factor (CDIF) is volatile and fungistatic. Analysis of volatile materials produced by C. albicans was subsequently identified as carbon dioxide. The involvement of carbon dioxide in the inhibition of dermatophytes was demonstrated by: (1) utilization of commercial carbon dioxide to produce dermatophyte inhibition as well as arthrospore formation, and (2) prevention of dermatophyte inhibition by C. albicans through incoporation of soda lime into the incubation atmosphere. The ability of carbon dioxide to inhibit dermatophyte growth was shared with other gases (methane and helium), but arthrospore formation was observed only with carbon dioxide. The possible significance of carbon dioxide's induction of arthrospores, a form occasionally observed in active dermatophyte lesions, is discussed.

Antifungal Agents↗
PubMed1975

Transferrin, iron, and dermatophytes. I. Serum dematophyte inhibitory component definitively identified as unsaturated transferrin.

The factor present in normal human serum which inhibits growth of dematophytic fungi is characterized and identified. Serum inhibitory factor (SIF) is nondialyzable, heat stable at 56 degrees C. for 4 hours, and fungistatic. SIF was found to be an inhibitor of the dermatophyte genera Trichophyton, Microsporium, and Epidermophyton as well as the dimorphic yeast Candida albicans. SIF activity directly correlated with a serum's unbound iron-binding capacity (UIBC) in that lower UIBC'S were less inhibitory. Addition of iron to serum neutralized the inhibitory activity and this neutrilization was shown to be specific for iron since zinc, magnesium, managnese, and copper failed to alter serum inhibitory activity. Furthermore, addition of purified iron-free transferrin to a neutralized serum restored the SIF activity in parallel with the UIBC. Removal of transferrin from serum by affinity chromatography was confirmed by polyacrylamide gel electrophoresis and iron-binding assays. Transferrin-free serum produced by this procedure was shown to lack inhibitory activity. These data indicate that SIF is unsaturated transferrin and strongly suggests that it inhibits dermatophytes by binding iron which many organisms need for growth.

Arthrodermataceae↗