Biomedical subjects

R H Wilkinson

Publications and source records attributed to R H Wilkinson.

At least 73 records · Page 4Linked to original sources

PubMed1977

Plasma urate and serum deoxycytidylate deaminase measurements for the early diagnosis of pre-eclampsia.

The value of measuring plasma urate and serum deoxycytidylate deaminase (dCMP deaminase) for the early diagnosis of pre-eclampsia has been investigated in 45 patients. A combination of increased blood pressure and increased plasma urate identified 19 patients with a high incidence of fetal and maternal morbidity ascribable to pre-eclampsia. Seventeen of the 19 patients also had an increased serum dCMP deaminase. Serial antenatal observations for a mean period of 104 days (36-179 days) on 33 of the patients demonstrated that plasma urate and serum dCMP deaminase increased together as early changes in the development of pre-eclampsia. In six patients, blood pressure, plasma urate and serum dCMP deaminase all increased but in only one was the rise in blood pressure the first change. Elevations of plasma urate and serum dCMP deaminase are therefore both early features of pre-eclampsia. Serial measurements can give warning of the disorder before the appearance of other clinical features. The change in dCMP deaminase is probably another reflection of early renal involvement in the pre-eclamptic process.

Blood Pressure↗

PubMed1977

Aseptic necrosis: a complication of dislocation of the metacarpophalangeal joint.

Explore the source record for details and available documents.

Child↗

PubMed1977

Reactive sclerosis of a pedicle and spondylolysis in the lumbar spine.

Eleven patients were seen with reactive sclerosis and hypertrophy of one pedicle and lamina of a lumbar vertebra and a contralateral spondylolysis in the same vertebral segment. Differentiating the reactive sclerosis in this condition from that associated with osteoid-osteoma is necessary since excision of a sclerotic pedicle associated with contralateral spondylolysis will create painful instability. In asymptomatic patients observation is sufficient, while in those with symptoms not relieved by external immobilization, spine fusion, usually of three levels, is indicated.

Adolescent↗

PubMed1976

Plasma-urate measurements in predicting fetal death in hypertensive pregnancy.

The relation of perinatal mortality to plasma-urate concentrations and blood-pressure was studied in 332 pregnant patients with hypertension. Perinatal mortality was markedly increased when maternal plasma-urate concentrations were raised, generally in association with severe pre-eclampsia of early onset. Plasma-urate was a better indicator than blood-pressure of prognosis for the fetus. Maternal hypertension, even severe, without hyperuricaemia, was associated with an excellent prognosis for the fetus. Conversely, when maternal hypertension was mild and hyperuricaemia was severe, the prognosis for the fetus was poor. These findings suggest that, in terms of fetal health, changes in renal handling of urate may be a more important feature of pre-eclampsia than the hypertension.

Blood Pressure↗

PubMed1976

Osteomyelitis: early scintigraphic detection in children.

The value of scintigraphy in the early detection of osteomyelitis is demonstrated in children who had signs and symptoms suggestive of bone infection. Nine patients between 2 and 13 years of age were evaluated with technetium Tc 99m diphosphonate bone scintigrams and roentgenograms. Blood cultures were performed in all patients, and bone biopsy or drainage was obtained in six patients. The diagnosis of osteomyelitis was made in seven patients; one patient had a subperiosteal abscess surrounded by osteomyelitis, and one patient had cellulitis. The seven children with osteomyelitis had focal increase of radiopharmaceutical uptake in the bone. The child with the subperiosteal abscess had an area of decreased uptake in the center of the abscess surrounded by a zone of increased uptake of the radioactive bone-seeker. The patient with cellulitis had soft tissue changes by X-ray and a normal bone scintigram. In the seven patients with osteomyelitis, the bone scintigram was performed during the early phase of the disease and no bony changes were present on the roentgenogram. In one patient with subacute osteomyelitis, soft tissue changes were seen radiologically. Only three of the seven children with osteomyelitis developed radiological bony changes. Since bone scintigraphy can detect early local bone derangement, it is recommended in the initial evaluation of children in whom osteomyelitis is suspected.

Abscess↗

PubMed1975

Technetium 99m sulfur colloid spleen/liver ratio and other liver tests in the diagnosis of cirrhosis.

The results of seven laboratory tests of liver function, including spleen/liver activity ratios obtained by densitometric analysis of scans, are analyzed in 50 patients with proven Laennec's cirrhosis. In this series, the liver scan not only disclosed the liver gross anatomy and structural abnormality and established the best possible site for biopsy examination, but also, the increased splenic activity served as a useful diagnostic indication of Laennec's cirrhosis. Of 50 proven cases of Laennec's cirrhosis, 41 (82%) had abnormal spleen/liver ratios. An abnormal spleen/liver ratio in combination with abnormal results from any one or two other tests was relatively effective in the detection of cirrhosis. The accuracy is improved if the other laboratory tests are chosen from among tests for serum albumin, serum bilirubin, and SGOT. (Liver abnormalities other than cirrhosis can also present an abnormal spleen/liver ratio.) This simple determination extends the value of the liver scan commonly requested in search of metastases, primary lesions, or inflammatory processes, or in preparation for needle biopsy examination.

Alkaline Phosphatase↗

PubMed1975

Congenital asymmetry (hemihypertrophy) and abdominal disease: radiological features in 9 cases.

Coexistent abdominal disease was found in 9 cases of congenital asymmetry. These patients appear to be at risk of malignant neoplasms of the adrenal gland, kidney, and liver. Five of the 6 neoplasms in this group of patients were malignant. Approximately 25% of the reported cases of hemihypertrophy have been associated with hamartomas or congenital defects, especially genitourinary anomalies. Benign disorders encountered in this group included medullary sponge kidney, renal ectopia, renal cyst, nephromegaly, adrenomegaly, and hypospadius.

Abdomen↗

PubMed1975

Pulmonary embolic disease: the roles of angiography and lung scanning in diagnosis.

The definitive diagnosis of pulmonary embolism remains difficult despite recent advances in nuclear medicine and angiography. In 10% of a selected series of 145 patients a negative chest x-ray and a positive lung scan was associated with no arteriographic evidence of pulmonary emboli. A normal perfusion lung scan excludes significant pulmonary embolism. When pulmonary arteriography is necessary, a biplane selective pulmonary angiogram should be performed and subselective injections may be required. Pulmonary arteriography is less of a threat to a patient suspected of having pulmonary embolic disease than inappropriate treatment.

Angiography↗

PubMed1974