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Biomedical subjects

R M King

Publications and source records attributed to R M King.

At least 55 records · Page 3Linked to original sources
PubMed1983

Cardiac contusion: a new diagnostic approach utilizing two-dimensional echocardiography.

In the past, myocardial contusions after blunt thoracic trauma have been frequently overlooked or missed unless hemodynamic instability or dramatic electrocardiographic findings were observed. We now know that this entity is more common than once believed. However, our understanding of cardiac contusions remains unclear and obscure because of the inability to diagnose the condition accurately. Chest roentgenograms, electrocardiograms, and radionuclide imaging have had less than optimal success. We believe that the serial determination of creatine phosphokinase-myocardial band isoenzymes and subsequent two-dimensional echocardiographic sector scanning are the most sensitive indicators of structural and functional cardiac injury presently available.

Adolescent↗
PubMed1982

Colovesical and rectovesical fistulas.

Colovesical or rectovesical fistulas develop because of a congenital abnormality, a traumatic incident, or an underlying disease, such as inflammation or cancer. Inflammation, either diverticulitis or Crohn's disease, was the cause of fistula in 73 (67%) of 109 patients with colovesical or rectovesical fistulas seen at the Mayo Clinic, Rochester, Minn, between 1965 and 1980. Sixty-six of the 73 patients had colovesical fistulas, and 64% of them underwent resection and anastomosis in one stage. Cancer of the cervix, prostate, bladder, colon, or rectum was responsible for 27 fistulas, equally divided between colovesical and rectovesical types. Only seven (26%) could be treated by one-stage anterior resection. Fifteen patients required fecal diversion with or without resection of bowel. At follow-up, 80 patients were alive; only two (one with prostatic cancer and one with cervical cancer) had recurrence of fistula.

Adolescent↗
PubMed1982

Regulated high efficiency expression of human interferon-alpha in Saccharomyces cerevisiae.

The 5' control region of the yeast phosphoglycerate kinase gene (PGK) was fused to the coding sequence of a human interferon-alpha. This PGK-interferon fusion was then introduced into yeast on a high copy number 2mu-based plasmid vector. Strains containing this plasmid produced a PGK-interferon-alpha fusion protein as 1-2% of cell protein and the expression of interferon activity was regulated by the availability of a fermentable carbon source. The system is capable of making as much as 15 mg of human interferon-alpha per litre of batch culture.

Amino Acid Sequence↗
PubMed1982

Primary mediastinal tumors in children.

Mediastinal masses in children constitute a heterogeneous group of malignant and benign neoplasms. The majority of malignant tumors in our series of 188 children with a mediastinal mass were Hodgkin's and non-Hodgkin's lymphoma (87 patients) arising in the anterior and middle mediastinum. Ganglioneuroma (17) arising in the posterior mediastinum made up the bulk of benign tumors (52). Infants less than 2 yr old presented with symptoms of tracheal compression, whereas older children had fewer symptoms but a far greater likelihood of having a malignancy. In the assessment of patients with mediastinal tumors, the posteroanterior and lateral chest roentgenograms were most often diagnostic, and computed tomography of the chest provided the most information concerning preoperative resectability. The excellent survival of patients with stage I and II Hodgkin's disease reflects the radiosensitivity of the tumor; in our series of 33 patients, survival was not increased by radical resection. Unlike lymphomatous tumors, neurogenic masses should be completely excised. When initial exploration reveals unresectability, biopsy followed by radiation therapy and second-look excision of the tumor can be accomplished. In patients with primary mediastinal sarcomas, total resection should be carried out if possible. In our series, adjuvant radiation therapy or chemotherapy was effective in only 1 of 15 children with sarcoma. Surgical treatment of all mediastinal masses except lymphoma should be complete excision. In cases of suspected lymphoma, cervical or supraclavicular node biopsy can yield adequate tissue for diagnosis.

Adolescent↗
PubMed1982

The management of gastric polyps.

Gastric polyps are rare. Most patients either are asymptomatic or present with symptoms of vague epigastric pain and bloating. An upper gastrointestinal tract study can demonstrate gastric polyps in 85 to 90 per cent of the patients. Features that increase the suspicion of carcinoma include the presence of adenomatous polyps greater than 2 centimeters in diameter, especially if they are multiple. In most patients, gastrotomy and removal of the polypoid mass with a cuff of normal mucosa are sufficient treatment. In patients who have invasive adenocarcinoma found upon biopsy of the polyp, gastric resection should be done. In most patients with carcinoma in situ, wedge resection is adequate treatment. Endoscopy for the diagnosis and treatment of polyps is appropriate in selected patients with pedunculated polyps that are less than 2 centimeters in diameter. The morbidity after operation or endoscopy is similar. Patients who are at high risk of having carcinoma develop should be observed yearly by endoscopic examination and biopsy.

Female↗
PubMed1976

Suppression of ouabain-induced ventricular rhythms with aprindine HCl. A comparison with other antiarrhythmic agents.

Three groups of dogs were given ouabain (mean 60 mug/kg) until an accelerated ventricular escape (AVE) and repetitive ventricular response (RVR) followed cessation of pacing. In a group of six control dogs, the AVE and RVR were found to occur at stable escape intervals for periods of at least three hours. A second group of dogs received various antiarrhythmic agents in an attempt to suppress the AVE and RVR. Quinidine, diphenylhydration, lidocaine, procainamide, and propranolol, were successful in only 0 to 33% of trials. Potassium canrenoate, 12 mg/kg was unsuccessful in three dogs. Verapamil, by bolus, suppressed RVR in 41% and AVE in 21% of trials. KCl, infused until AVE and RVR were suppressed, was successful when the mean serum potassium rose from 3.8 mEq/L to 7.2 mEq/L. Aprindine, 2.86 mg/kg, suppressed AVE and RVR in 14 of 14 dogs. In the third group of dogs, verapamil was infused continuously and suppressed RVR and AVE at a mean cumulative dose of 2.93 mg/kg. Calcium chloride reversed aprindine and verapamil-induced suppression of RVR and AVE. This study demonstrates that RVR and AVE resist suppression by available antiarrhythmic agents in clinically-used doses. Only aprindine was 100% successful at doses used in man. The ionic pathogenesis of RVR and AVE is unknown, but some data suggest the slow current may play an important role.

Animals↗
PubMed1975

Termination of ventricular fibrillation in dogs by depolarizing a critical amount of myocardium.

The role of a critical myocardial mass required to maintain ventricular fibrillation initiated by rapid ventricular pacing was studied by two methods in dogs placed on total cardiopulmonary bypass. In the first method, depolarization of a limited myocardial mass was accomplished by injecting potassium chloride into one or two coronary arteries. Injection of potassium chloride simultaneously into the left circumflex and left anterior descending coronary arteries abolished ventricular fibrillation more often than did injection into any other single or combination of two coronary arteries (P less than 0.0001). Ventricular fibrillation could not be reinitiated as long as the left ventricle remained inexcitable. Immersing the heart in a solution of potassium chloride or injecting the solution into the right and left ventricular cavities failed to terminate ventricular fibrillation. The second method evaluated the amount of current necessary to terminate ventricular electrodes, between two left ventricular electrodes and between one right ventricular and one left ventricular electrode. Electrical shocks of equal magnitude terminated ventricular fibrillation most often when those shocks were delivered between an electrode located at the right ventricular apex and an electrode located at the posterior base of the left ventricle, and least often when the shock was delivered between two right ventricular electrodes. Successful defribillation results when a critical amount of myocardium becomes depolarized by either potassium chloride or electrical discharge; depolarization of every cell in both ventricle is not necessary to terminate ventricular fibrillation in the entire heart.

Animals↗