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Biomedical subjects

R King

Publications and source records attributed to R King.

At least 235 records · Page 13Linked to original sources

HLA in maturity-onset type of hyperglycemia in the young.

HLA haplotypes in a kindred with a maturity-onset type of hyperglycemia in the young (MOHY) were studied. All diabetics had mild hyperglycemia of early onset, and the inheritance pattern suggested an autosomal dominant trait. Eight of 11 subjects with hyperglycemia shared haplotype A3, Bw15. When only this haplotype was considered, there appeared to be a significant association with hyperglycemia chi2 = 6.36). However, since both haplotypes in the proband could be associated with hyperglycemia (both proband's parents had hyperglycemia), the data for both haplotypes were combined, and analysis for an association between both haplotypes and hyperglycemia was not significant (chi2 = 2.53). Linkage between a diabetes gene causing MOHY and the HLA, evaluated by lod score analysis, was suggested, but the values were not significant.

Adolescent↗

Chloride-transport stimulatory factor in urine of chronically sodium-chloride loaded man.

Urinary extracts (in methylene dichloride) of subjects on high sodium-chloride (NaCl) intake produce net Cl- efflux (active transport) in isolated short-circuited frog skin. Activity is not found in the urine of NaCl-deprived normal subjects or NaCl-loaded subjects with adrenal insufficiency. These findings suggest that presence of an adrenocortical steriod which participates in adaptation to high salt intake. We describe here a lipid-soluble factor extracted from urine of chronically salt-loaded subjects which stimulates active Cl- transport in isolated frog skin. Our findings indicate that the factor is of adrenal origin and that it induces active ion transport in the direction opposite to that stimulated by the adrenal hormone, aldosterone. Aldosterone produces NaCl conservation in states of salt deprivation. We expect this new factor to produce NaCl excretion in states of excess salt ingestion.

Adrenal Cortex Hormones↗

Radiosensitization of normal tissue by chloroquine.

Severe radiation reaction with chest wall necrosis occurred following 5,000 rads of 60Co irradiation. The patient was arthritic and on chloroquine therapy. This delayed reaction was due to chloroquine radiosensitization. Rats treated with combined chloroquine and chest wall irradiation were compared to rats receiving irradiation alone. The acute radiation reaction was greater in the drug treated animals.

Animals↗

The histocompatibility system in juvenile, insulin-dependent diabetic multiplex kindreds.

We have histocompatibility (HLA) genotyped 24 families with two or more juvenile, insulin-dependent, ketosis-prone diabetic siblings. This criterion for family selection was used to obtain a homogeneous form of diabetes within a sibship, because diabetes appears to be a genetically heterogeneous disease. 58 diabetic and 53 nondiabetic sibs and 40 parents were studied. 55% of the diabetic pairs were concordant for both HLA haplotypes (expected 25%), 40% were concordant for one haplotype (expected 50%), and 5% were discordant for both haplotypes (expected 25%). These values are significantly different from the expected values (P < 0.001). On the other hand, the inheritance of haplotypes among the nondiabetic sibs in these families was not significantly different from the expected mendelian segregation. When comparing 20 pairs of HLA identical (sharing two haplotypes) with 15 pairs of haploidential (sharing one haplotype) diabetic sibs for the intrapair difference in age of onset of disease, we found that the HLA identical sibs were significantly more concordant for age of onset (3.9 yr difference) than the haploidential (7.3 yr difference) (P < 0.05). The same type of analysis for the difference in seasonal incidence in months revealed that the HLA indentical sibs were more concordant (1.8 mo difference) than the haploidentical sibs (3.2 mo difference) (P < 0.025). Furthermore, the HLA identical diabetic sibs were more likely to develop diabetes in the winter months (78%) than the haploidentical diabetic sibs (21%). No particular HLA haplotype or antigen seemed to be associated with any particular clinical feature. These data are compatible with the theory of genetic heterogeneity of juvenile, insulin-dependent diabetes. It is suggested that there are one or more diabetes response genes in the HLA region playing an important role in the pathogenesis of juvenile, insulin-dependent diabetes in the families studied here. It is, however, possible that other genes, not associated with the HLA complex, may play an etiologic role in some cases of juvenile, insulin-dependent diabetes, resulting in lack of association between HLA and some forms of diabetes.

Adolescent↗

Carcinoma of the gallbladder: staging, treatment, and prognosis.

Sixty-six cases of carcinoma of the gallbladder treated at The Memorial Hospital, Danville, Virginia, and the Medical College of Virginia, Richmond, were staged according to depth of invasion and spread and graded histologically; the findings were correlated with survival. Results from the two hospitals were essentially identical and the survival figures correlated well with 399 reported cases in the medical literature which could be staged according to the depth of invasion. A simple method combining staging and histologic grading of cancer of the gallbladder, which can easily be applied to all cancers of the gallbladder removed surgically and which should prove useful in the management of this disease, is described. Essentially all of the carcinomas of the gallbladder in the series were incidental findings at surgery for gall stones which may explain a relatively high proportion of superficial carcinomas which are cured by the removal of the gallbladder.

Gallbladder Neoplasms↗

Bilateral adrenalectomy for metastatic breast carcinoma.

Ninety-five patients who underwent bilateral adrenalectomy for metastatic breast carcinoma are reviewed. An objective remission of tumor was observed in 66% of the patients over the age of 45 years with metastasis limited to soft tissue, osseous, or pulmonary system. In those patients below the age of 45, only 19% had remission irrespective of the sites of metastasis. Thirty-three patients were admitted with no "free interval," with objective remission occuring in 42%. This observation indicates that the "free interval" is not as striking a determinant in selecting adrenalectomy candidates as had been stressed by others. The serial treatment of adrenalectomy followed by chemotherapy after adrenalectomy failure or relapse was shown to objectively benefit 74% of 72 patients evaluated. Sulfokinase activity in breast cancer tissue was studied in 17 patients. The results were not as definitive as reported by others.

Adrenal Gland Neoplasms↗

Pneumopericardium associated with tracheal rupture. Management of a case complicated by the shock lung syndrome.

A case history of a patient with unusual injuries following blunt thoracic trauma is presented. There was a pneumopericardium, bilateral tension pneumothoraces and rupture of the thoracic trachea, and the shock lung syndrome developed. Some points which arose in the management of the case are discussed, and it is pointed out that such injuries may be missed and must be considered in all patients with thoracic trauma especially those who do not improve with routine therapy.

Accidents, Traffic↗