Search PubMed⌕ Search

Biomedical subjects

R G Wilson

Publications and source records attributed to R G Wilson.

At least 73 records · Page 4Linked to original sources

Renal transplantation: the non-starters.

Renal transplants do not always function immediately and this non-function may be related to poor long-term graft survival. The causes of this primary non-function (PNF) are poorly understood. The incidence of PNF in 106 consecutive renal transplants was found to be 57 per cent. Using stepwise logistic regression analysis of 20 prospectively collected variables for each transplant two have been found to be positively associated with PNF of the transplant: (1) the use of cyclosporin as an immunosuppressant and (2) a second warm ischaemia (anastomosis) time of more than 30 min. It is proposed that the use of cyclosporin be restricted in the early post-transplant period until initial function of the transplant is established. The surgical procedure of kidney transplantation should be planned to minimize the anastomosis time prior to recirculation of the graft.

Cyclosporins↗

The predictive value of blood flow velocity in femoro-distal bypass.

The predictive value of peroperative blood flow measurements has been evaluated in a prospective study of femoro-distal bypass grafts. Seventy grafts placed in patients with critical ischaemia were assessed with a minimum follow-up of 2 years. Thirty-one grafts were performed using autogenous saphenous vein (ASV), 27 using a polytetrafluoroethylene prosthesis (PTFE) and in 12 human umbilical vein (HUV) was used. Six grafts failed early (within 1 month of operation) and 19 failed late, giving an overall patency rate of 60% at 5 years. ASV grafts had a significantly better patency rate than either prosthetic material. Analysis of flow rates measured before and after regional vasodilatation revealed no significant differences between types of graft or between grafts that subsequently failed and those remaining patent. Flow velocity prior to vasodilatation was significantly higher in patent grafts (mean 13.6) compared to those failing early (mean 6.3), but not compared to those failing late (mean 9.4). Flow velocities were also significantly higher in ASV grafts than prosthetic grafts. Flow velocity measured after vasodilatation was significantly higher in grafts remaining patent (mean 28.4) than those which failed late (mean 19.2). It is concluded that flow velocity is of value in the prediction of graft outcome. Graft velocity after vasodilatation of less than 20 cm/s. Predicted failure in 19 of 25 grafts that occluded. We are currently evaluating the selective use of anticoagulants in femoropopliteal grafts with a maximal flow velocity below 20 cm/s.

Blood Flow Velocity↗

Prophylactic subcutaneous heparin does not increase operative blood loss in transurethral resection of the prostate.

A prospective randomised study of subcutaneous heparin compared with no heparin was performed in 60 patients undergoing transurethral resection of the prostate. Operative blood loss in the irrigation fluid was measured using a haemoglobinometer. Blood loss correlated with the amount of prostate resected and the duration of the procedure. Subcutaneous heparin had no significant effect on the measured blood loss in transurethral resection of the prostate and can be used as a safe means of prophylaxis against thrombo-embolic complications.

Administration, Cutaneous↗

Activity of ICI 195,739--a novel, orally active bistriazole--in rodent models of fungal and protozoal infections.

ICI 195,739 shows superior potency to other azoles in eliminating vaginal candidosis or dermatophyte infections in animal models of infection by both oral dosing and topical application; effective doses are in the range of 0.5-5.0 mg/kg/day or 0.01-0.30% in a topical formulation. ICI 195,739 is likewise effective in models of systemic fungal infection; 1, 10, 25 mg/kg/day will protect animals given a lethal inoculum of C. albicans, C. neoformans, or A. fumigatus, respectively, as long as dosing is continued, showing activity in this respect superior to that of other azoles tested. ICI 195,739 will suppress infections in mice with T. cruzi and prevent mortality with five daily doses of 1 mg/kg; cure rather than suppression of patent infections has been achieved with 35 daily doses of 10 mg/kg.

Animals↗

An alternative method of draining the pelvis after excision of the rectum and anterior resections.

An alternative method of draining the extraperitoneal pelvis using a constant suction and irrigation drain in the retrorectal space was used in 16 patients undergoing excisional or restorative rectal operation for either inflammatory intestine disease or carcinoma. A transient fecal fluid leak from the drain site developed in one patient. The other patients showed no clinical evidence of anastomotic leakage or infective operative complication. We believe that continuous low pressure suction drainage and irrigation of the retrorectal space is important in the healing of excision and restorative operations of the rectum.

Drainage↗

Analyses of protein extracts of human breast cancers: changes in glycoprotein content linked to the malignant phenotype.

The protein and glycoprotein composition of Triton X-100 extracts of breast biopsies from 17 women with benign breast disease and from 11 women with invasive breast carcinoma were investigated using electrophoresis in SDS-containing gradient polyacrylamide gels, followed by Coomassie Blue (CB) staining and the binding of radio-iodinated wheat germ agglutinin (WGA). Patterns were analysed after the CB-step for differences in protein composition, and after the WGA-step for differences in glycoprotein composition. Tissue extracts from patients with benign breast disease have less CB stained bands than similar extracts from the cancer patients. A particular consistent change was the appearance of an extra band at 58 Kdaltons in the cancer extracts. In contrast to the CB results, WGA detected less major bands, in the 40-60 Kd region, in the cancer extracts than at similar locations in benign extracts. Analysis of blood sera using the above techniques suggested that certain serum proteins could account for some of the WGA changes, but not the changes after CB staining. However, residual contamination of the specimens by blood proteins seemed unlikely because of the washing procedure used, unless these components were very strongly associated with the tissue. Differential synthesis of serum proteins by benign and malignant breast tissue may also explain some of our findings. Examination of the histopathology adjacent to the extracted tissue suggested that the degree of reduction in WGA-binding may be related to the extent of local invasiveness. Other animal and human studies suggest that reduced glycosylation of tumour-associated proteins may be linked to increased malignancy. The current findings may reflect a general pattern of change in tumour glycoprotein composition linked to malignant expression.

Adult↗

Glucose metabolism in a pony mare with a tumour of the pituitary gland pars intermedia.

A case of pituitary dependent hyperadrenocorticism in a horse is reported. Clinical signs included hirsutism, polydipsia and general debility. The horse was persistently hyperglycaemic and glucose values were unchanged following subcutaneous administration of insulin. Resting cortisol values were normal, but dexamethasone suppression of cortisol concentration was shorter than normal. Plasma glucose, cortisol, insulin and glucagon concentrations were measured as part of an intravenous glucose tolerance test. The patient responses were different from those in a control pony.

Adrenocortical Hyperfunction↗

A comparative study of cefotetan and metronidazole against metronidazole alone to prevent infection after appendectomy.

The role of metronidazole in reducing the incidence of infectious complications after appendectomy has been established, but the value of an additional antibiotic to act against aerobic pathogens remains controversial. Patients who received 2 grams of cefotetan intravenously at the time of appendectomy and those who did not were compared for the incidence of infection. All patients received 1 gram of metronidazole per rectum preoperatively and every 12 hours for five days postoperatively. Infection occurred in three patients who received cefotetan and 16 of those who did not (p less than 0.01). We conclude that a single dose of cefotetan, an antibiotic which is effective against aerobic and anaerobic organisms, produces a significant reduction in the incidence of infection when added to metronidazole in the management of patients after appendectomy.

Adolescent↗