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Biomedical subjects

R M Taylor

Publications and source records attributed to R M Taylor.

At least 145 records · Page 8Linked to original sources
PubMed1989

Renal allograft rejection: possible involvement of lymphokine-activated killer cells.

Human renal allograft tissue was recovered at transplant nephrectomy from three patients with irreversible loss of graft function. This tissue was disaggregated and separated into two fractions on the basis of particle size. Fraction 1 contained glomeruli and developed a mixed outgrowth containing adherent epithelial and mesangial cells after a limited period of culture. Fraction 2 contained fragments of renal tubules and produced monolayers of tubular epithelial cells during culture. A population of lymphoid cells was observed to grow from the primary disaggregate into medium supplemented with recombinant human interleukin-2 (IL-2). After culture for 5 days these lymphoid cells were predominantly CD3-positive and carried both class II major histocompatibility antigens (MHC) and the CD25 IL-2 receptor. Culture of peripheral blood-derived mononuclear cells with IL-2 caused the generation of lymphokine-activated killer (LAK) cells; these cells were able to lyse both glomerular and tubular cells grown from nephrectomy tissue without showing MHC antigen restriction. The lymphoid cells grown from renal allograft tissue showed a similar lytic potential for both renal cells prepared from the same nephrectomy specimen and from third party renal tissue. It is possible that any LAK cells formed within a renal allograft by the action of IL-2 may contribute to the tissue destruction observed during graft rejection.

Cells, Cultured↗
PubMed1988

Rapid detection of low levels of donor specific IgG by flow cytometry with single and dual colour fluorescence in renal transplantation.

Lymphocytotoxic immunoglobulin is routinely assayed before human renal transplantation. If IgG directed against donor T cells is detected in the serum of the potential recipient, transplantation is not performed as it is associated with a poor graft outcome. Poor sensitivity of the conventional assay has been postulated as being the cause of some graft failures. Two new flow cytometric assays are described which are more sensitive than the conventional test. The first assay requires manual separation of T and B lymphocytes and therefore takes a similar time to perform as the conventional assay. The second assay utilises a two-colour system and lymphocyte's separation is by fluorescence. This assay takes half the time to perform, thereby decreasing graft ischaemic time before transplantation.

Dose-Response Relationship, Immunologic↗
PubMed1988

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↗
PubMed1988

Cholecystokinin (CCK) provocation test: long-term follow-up after cholecystectomy.

Over a 6-year period 264 cholecystokinin (CCK) provocation tests have been performed in 174 patients with undiagnosed right upper quadrant pain. All were carried out by one person (T.W.J.L.) as part of a prospective placebo-controlled crossover study. Following infusion of CCK but not saline, 103 patients developed pain (CCK + ve). These patients were offered cholecystectomy and 90 accepted. Seventy patients developed no pain during either infusion (CCK - ve), and one patient experienced pain with both CCK and saline infusions. Of the 90 patients who underwent cholecystectomy, 81 (90 per cent) have been followed up for a mean of 35 months (range 12 months to 5 1/2 years), 67 per cent have had complete resolution of symptoms and a further 24 per cent have had a marked improvement in symptoms. Only 9 per cent of patients did not benefit from cholecystectomy. This compares well with patients undergoing cholecystectomy for uncomplicated calculous gallbladder disease, 88 per cent of whom, in our study, were improved by surgery. Patients with a positive CCK test have an excellent chance of symptomatic improvement following cholecystectomy.

Biliary Tract Diseases↗
PubMed1988

Red alert.

Explore the source record for details and available documents.

Animals↗
PubMed1988

Treatment of Crohn's disease in relapse with cyclosporin A.

It has been suggested that cyclosporin A might be of some benefit to patients with Crohn's disease. The clinical response and side-effects of cyclosporin A in Crohn's disease are described in a series of 13 adults. The majority of patients had ileal disease and all but one were started on an initial oral dose of 15 mg/kg per day. Duration of treatment ranged from 3 to 42 weeks. Of the 13 patients, 6 showed a response to therapy; the remainder showed no response or deteriorated. The commonest side-effect was hyperaesthesia, but one patient developed nephrotoxicity and one developed hepatotoxicity. Significant drug malabsorption occurred in one case. The side-effects were dose dependent and reversible. Cyclosporin A may have a part to play in the treatment of resistant Crohn's disease, and in our hands has been associated with a 46 per cent response rate; however, the precise role of cyclosporin A in the management of Crohn's disease awaits further study.

Adult↗
PubMed1988

Ceroid-lipofuscinosis in border collie dogs.

Five Border Collie dogs with ceroid-lipofuscinosis developed progressive neurological disease between 18 and 22 months of age. These dogs had behavioural abnormalities, gait and visual deficits and became progressively demented. All dogs examined had common ancestors. Light microscopic examination of tissues demonstrated extensive accumulation of granular, sudan black-staining autofluorescent material in the cytoplasm of neurones, retinal ganglion cells and some visceral cells. At ultrastructural examination inclusions of variable morphology were observed.

Animals↗
PubMed1988

Surgical management of long-term central venous access in uraemic patients.

Over a 5-year period, 1980-1985, 39 patients from a dialysis population of over 400 treated at this centre experienced major difficulties in achieving adequate access for dialysis by conventional techniques (i.e. arteriovenous fistula or CAPD). This study has evaluated the long-term results of a new approach to circulatory access, central venous catheterisation (CVC) for so called "high risk" patients. CVC consists of inserting a single-lumen CAPD-type silastic catheter into the right atrium via an external or internal jugular vein. Forty-seven catheters have been inserted into 39 uraemic patients. All patients had failed on, or were unsuitable for, conventional access to haemodialysis or CAPD. Ten patients (26%) had previous failed renal transplants. The median duration of catheter use was 7 months (range 1-60 months) and a total of 6500 high-performance dialyses have been performed using this technique. No patient has died of catheter-related problems. The catheters were easily managed by nurses and well tolerated by the patients. The incidence of complications among patients was low: displacement (1), catheter thrombosis (2), skin exit-site infections (5), septicaemia (2). Central venous catheterisation is a method of providing safe and reliable long-term vascular access which is immediately usable by high-risk patients who have either failed on or are unsuitable for conventional circulatory access.

Adolescent↗