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Biomedical subjects

R Wilkinson

Publications and source records attributed to R Wilkinson.

At least 397 records · Page 22Linked to original sources

Pityriasis rosea in a patient with epidermolysis bullosa dystrophica.

A patient with clinical and histologic features of epidermolysis bullosa dystrophica-recessive (EBD-R) developed superimposed clinical lesions of pityriasis rosea (PR). Electron microscopy showed distinct "blebbing" of basal cells at the basement membrane zone in clinically normal skin of a non-predilected area, as well as in scarred skin from a predilected area and a lesion of PR. An increased susceptibility of the basement membrane zone to proteolytic enzymes is suggested as a possible hypothesis to explain these observations.

Adult↗

Plasma renin activity during the development of paracetamol (acetaminophen) induced acute renal failure in man.

Plasma renin activity has been measured daily in 36 patients suffering from self poisoning with acetaminophen. In 3 developing porto-systemic encephalopathy terminal renal failure developed with high plasma renin activity. In 2 who developed acute renal failure without porto-systemic encephalopathy, plasma renin activity was noted to rise before serum creatinine and to return to initial levels after 3 or 4 days while renal failure persisted. Six other patients with similar hepatic damage showed comparable rises in renin without developing renal failure. Our findings are consistent with but do not establish a pathogenetic role for renin in acetaminophen-induced acute renal failure. It is suggested that other factors may act with renin to bring about renal failure.

Acetaminophen↗

Enhancement of the nuclear reactivity of alkylating agents by prednisolone.

We have compared the nuclear reactions of the alkylating agents chlorambucil, melphalan, and cyclophosphamide used alone, with those produced when the same drugs were used in combination with the corticosteroid prednisolone. Studies were performed in vivo in Wistar rats bearing ascites forms of either the Yoshida sarcoma or the Walker carcinosarcoma. Strains of both tumor lines, which were sensitive to alkylating agents, showed loss of condensed chromatin, increased phosphorylation of nuclear proteins, and increased DNA cross-linking after exposure to the alkylating agents alone; these changes were generally enhanced in the presence of prednisolone. When paired tumor lines which exhibited acquired resistance to alkylating agents were studied, no nuclear changes were detected when individual alkylating agents were given alone. However, in combination with prednisolone, each of the three alkylating agents produced loss of condensed chromatin, increased nuclear protein phosphorylation, and DNA cross-linking. These chromatin changes were associated with tumor cell death and may determine drug sensitivity in the tumors studied.

Alkylating Agents↗

Sodium and renin in the hypertension of early renal disease.

1. Plasma renin activity, response to saralasin and exchangeable sodium have been measured in 43 patients with early renal disease. 2. Blood pressure was directly proportional to plasma renin activity. However, mean plasma renin activity was lower in patients with renal disease than in normal controls. 3. Blood pressure fell in response to saralasin infusion in proportion to the pre-infusion plasma renin activity. 4. Exchangeable sodium in hypertensive patients with renal disease did not exceed that in normotensive patients in contrast to earlier reports. Discrepancies may arise from the difficulty in interpreting measured exchangeable sodium in relation to body build.

Adolescent↗

Further studies on the umbilical cord and its water content.

The results show that the varied appearance of the umbilical cord at birth can be related to its water content and that there are associated changes to be seen histologically in all layers of the cord, but especially in Wharton's jelly. Quantimet analysis confirms these findings and highlights a small group where dual pathology may exist. The relationship between oedematous cords, large drip volume, and respiratory distress in the newborn is considered, and a possible explanation for reduced placental transfusion and low red cell mass in these babies is proffered.

Body Water↗

Plasma renin activity following renal transplantation.

Plasma renin activity (PRA) was studied serially for up to 21 days following transplantation in thirteen patients receiving renal allografts. PRA was measured during fasting and recumvency and its relationship to renal function, diuretic administration, plasma sodium, allograft rejection and blood pressure was examined. PRA fell steadily as renal function improved and plasma sodium rose following transplantation and when rejection episodes were excluded an inverse relationship between PRA and renal function could be seen. It is not possible to say whether the changes in PRA and function are causally related or whether changes in plasma sodium alone account for the observed changes in PRA. Some rejection episodes were accompanied by an increase in PRA, but this was not sufficiently consistent to be of value in the diagnosis of rejection. PRA also increased in relation to frusemide-induced fluid loss. There was no relationship in these patients between PRA and blood pressure.

Creatinine↗

Adverse effect of splenectomy in renal transplantation.

Between January 1968 and June 1974 at Newcastle upon Tyne, 63 patients underwent splenectomy in association with transplantation; 45 of these had splenectomy with bilateral nephrectomy before (20) or at the time of (25) transplantation; 18 had post-transplant splenectomy for leucopenia. Mortality was significantly higher in splenectomized patients than in 136 non-splenectomized controls. Of the 63 splenectomized patients, 25 died within 1 year of transplantation, 12 of severe infection associated with leucopenia. Although splenectomy produced a temporary rise in white cell count, leucopenia during the first year of immunosuppressive therapy was not significantly less frequent in splenectomized patients than in controls. There was no significant difference in graft loss between the splenectomy and control groups. It is concluded that splenectomy is contra-indicated in patients who are to undergo renal transplantation and confers no benefit when carried out because of leucopenia developing after renal transplantation.

Azathioprine↗

Immune complexes in psoriasis with and without arthritis.

Two different assays were employed to detect soluble immune complexes in the serum of a large group of patients with psoriasis and psoriatic arthritis. Using a Raji cell assay no evidence of complexes was found. However, with the Clq deviation method, sera from 29% of the patients with psoriasis alone and 35% of those with associated arthritis, exhibited Clq reacting material.

Antigen-Antibody Complex↗

Factors affecting the outcome of cadaver renal transplantation in Newcastle upon Tyne.

In an analysis of a series of 186 consecutive first cadaver renal transplants in Newcastle upon Tyne, the most significant finding was the improved graft survival in patients who received pre-transplant blood-transfusion. This apparent benefit was not dependent on the number of units of blood received nor on the interval between transfusion and transplantation. A significant advantage was also shown when there was identity between donor and recipient at the HLA-B locus. This advantage outweighs any disadvantage resulting from the extra time required to transfer kidneys from one centre to another and indeed cold-ischaemia times up to 18 hours did not adversely affect graft survival. It is suggested that the present national distribution of cadaver kidneys in the U.K. is fully justified, but preference should be given to B-locus identity in determining selection.

Blood Transfusion↗

An investigation into the pathogenesis of hypertension in acromegaly.

1. In 29 patients with acromegaly, plasma renin activity and growth hormone were measured during fasting and recumbency on free diet. Exchangeable sodium was measured in all cases and expressed as a percentage of the expected value on the basis of lean body mass. 2. Twenty-two control subjects without evidence of cardiovascular, renal or endocrine disease were studied in the same way. 3. There was a significant increase in exchangeable sodium and suppression of plasma renin activity in the acromegalic patients in comparison with control subjects. 4. There was a significant positive correlation between exchangeable sodium and plasma growth hormone. 5. Hypertensive acromegalic patients (diastolic blood pressure larger than or equal to 100 mmHg) tend to have a lower (although not significantly so) exchangeable sodium than normotensive subjects. 6. We conclude that (a) suppression of plasma renin activity in acromegaly can be explained by sodium retention, (b) hypersecretion of growth hormone is probably responsible for the increased exchangeable sodium, and (c) sodium overload cannot be directly related to blood pressure but may contribute to the increased occurrence of hypertension in acromegaly.

Acromegaly↗