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Biomedical subjects

A E Wilkinson

Publications and source records attributed to A E Wilkinson.

At least 19 recordsLinked to original sources
PubMed1999

Correlation of survival time with size of axonal swellings in diffuse axonal injury.

Widespread damage to axons in the white matter of the brain is a well-recognised consequence of non-missile head injury. This diffuse axonal injury is characterised by a gradual swelling of the axon associated with an accumulation of cellular organelles and proteins. We have investigated the relationship between the size of the swellings of the damaged axon with survival time in post-mortem brain tissue. Sixty-six cases of head injury with known length of post-traumatic survival were selected for study, and immunohistochemistry for beta-amyloid precursor protein (betaAPP) was carried out. The minimum diameter of the betaAPP-immunolabelled damaged axons was measured in micrometers using the IBAS image analysis system. There was a strong, positive and significant relationship between the mean size of axonal swelling and survival time which plateaued at around 85 h post injury. With longer survival times the situation becomes more complex. betaAPP immunolabelling of damaged axons can contribute evidence about trauma and post-injury survival time in the forensic setting but should always be assessed with other evidence.

Adolescent↗
PubMed1989

SED88: a Pascal program for the analysis of sedimentation equilibrium data.

Analytical ultracentrifugation is commonly used for the determination of molecular weights (sedimentation equilibrium) and sedimentation coefficients (sedimentation rate) of biological macromolecules in solution. A Turbo Pascal program for the analysis of sedimentation equilibrium centrifugation data produced by absorbance optical systems is described. The user may enter data from a scan of absorbance versus distance from the centre of rotation, via a graphics tablet (or ASCII file). This is subsequently manipulated to yield an apparent weight average molecular weight for the given sample. Plots of ln (absorbance) versus (radius2) may also be produced. The method described uses readily available computational equipment requiring only a graphics tablet in addition to an IBM PC compatible computer. This technique and the software developed have been used to investigate the molecular weight range of two International Humic Substances Society (IHSS) reference samples from the Suwannee River.

Absorption↗
PubMed1989

Emergency room arteriography: a useful technique in the assessment of peripheral vascular injuries.

Emergency room arteriography is a useful aid in the assessment of limbs for possible vascular injury. It can be performed quickly by junior staff in the emergency room, using simple equipment, thereby avoiding the delays commonly associated with formal radiology suite arteriography. It can also be performed in units which lack formal arteriographic facilities, and resuscitation procedures need not be interrupted while this procedure is being performed. The resulting pictures are adequate for immediate diagnosis of vascular lesions and are of great value to the trauma surgeon. This pilot study of 50 cases confirms that emergency room arteriography is a safe and effective means of diagnosis in the resuscitation area and that the films are as useful as formal angiography for immediate diagnosis of vascular lesions of a traumatic nature.

Angiography↗
PubMed1989

Review of diagnostic methods in abdominal trauma.

The diagnostic methods used in examining 1,214 patients who underwent laparotomy for abdominal injury are evaluated. Diagnosis was based on clinical examination and the results of tests. Peritoneal lavage was useful for the early detection of bleeding, especially in unconscious patients, paraplegics and intoxicated patients. Radiological examination of the abdomen was unreliable in patients with blunt injury. Routine radiography of the pelvis was rewarding. Intravenous pyelography is now used only in patients with frank haematuria. Transurethral cystography was reliable when 350-400 ml contrast fluid was used. A radiograph of the chest should seldom be omitted in patients with blunt injury.

Abdominal Injuries↗
PubMed1989

Traumatic rupture of the diaphragm. An analysis of 121 cases.

Rupture of the diaphragm from blunt injury occurred in 4.4% of patients submitted to surgery for abdominal injury. Rupture should be suspected when there are physical signs of a crush injury to the lower chest or upper abdomen. Typical radiological signs are often obscured by a haemothorax. Passage of a nasogastric tube before radiography for blunt injury or the placing of metal markers on wounds in the 'nipples to umbilicus' area assist in diagnosis. Peritoneal lavage may be negative. Prognosis depends on associated injuries. Only 2 deaths in this series were directly related to the diaphragmatic injury.

Adolescent↗
PubMed1989

The problems of haemorrhage due to trauma from large vessels in the abdomen.

The major problems of blood loss from large vessels in the peritoneal cavity because of trauma in 48 patients are discussed. There were 21 patients with inferior vena-caval injuries, and 8 with injuries of the aorta. Bleeding from other large vessels was also encountered. The problems relate to rapid transport to hospital, early recognition of bleeding, energetic resuscitation--including rapid replacement of blood, tamponade of bleeding areas until the sites of bleeding vessels can be identified, or tamponade or temporary clamping of the aorta or inferior vena cava proximally and distally.

Abdomen↗
PubMed1989

Injuries of the stomach. An analysis of 95 cases.

In this series the stomach was involved in 8% of patients undergoing surgical exploration for abdominal injuries (most commonly by penetrating trauma). The stomach has strong walls and these are not torn by blunt trauma unless it is severe. Such trauma commonly involves adjacent vascular organs such as the liver, spleen and pancreas, resulting in dangerous haemorrhage. Careful search of both walls of the stomach and the diaphragm, especially after penetrating blunt trauma, is mandatory if complications are to be avoided. The mortality in this series was mostly caused by associated injuries.

Abdominal Injuries↗
PubMed1989

Injuries of the large bowel.

An analysis of 120 patients with colonic injuries showed that minor injuries, especially if caused by penetrating trauma, can be treated satisfactorily by suturing without resorting to colostomy.

Adolescent↗
PubMed1989

Injuries of the duodenum.

The incidence of duodenal injury in patients operated on for abdominal injury by the Accident Service of Johannesburg Hospital was 2.71%. A study was made of 33 patients. From the results of treatment it is concluded that minor injuries of the duodenum are adequately treated by suturing and nasogastric suction, but more severe injuries require resection and additional decompression with a jejunostomy or gastrostomy.

Adolescent↗
PubMed1989

Injuries of the jejunum and ileum. A series of 188 patients.

Bullet and stab wounds accounted for approximately 70% of penetrating jejunum and ileum injuries. Blunt injuries were the result of motor vehicle accidents. Injuries were most common in men in the 21-30-year age group. Treatment was by suture or resection. Complications related to the bowel injury occurred in 10 patients, and were the cause of death in 6 (3%).

Adolescent↗
PubMed1989

Injuries of the pancreas.

Pancreatic injuries were most common in patients in the 21-30-year-old age group. In two-thirds of patients the pancreatic duct was torn by blunt injury. Pancreatitis progressing to pseudocyst formation occurred in 5 patients after blunt trauma. Penetrating injury always involved adjacent viscera (stomach, liver, spleen). Drainage was used for contusions and minor wounds. Large wounds were sutured or distal pancreatectomy was carried out. Six patients died; haemorrhage was the cause of death in 3.

Adolescent↗
PubMed1989

Injuries of the liver. A series of 338 patients treated by an accident service.

An analysis of 338 patients with injuries of the liver, among 1,214 patients all operated on for abdominal injuries, is presented. Motor vehicle accidents were the major cause of trauma. Liver injury was accompanied by other abdominal injuries in 196 patients (58%) and chest injuries in 147 patients (43%). Haemostasis alone or suturing alone were employed in the majority of patients. Haemorrhage was both the principal complication and the main cause of death.

Adolescent↗
PubMed1989

Injuries of the kidneys. An analysis of 117 cases.

Renal trauma in 117 patients who underwent laparotomy is reviewed. Sixty-six per cent of the injuries occurred in motor vehicle accidents and were usually associated with other damage, most commonly to the liver and spleen. Dipstick urine tests were too sensitive for diagnostic purposes. Intravenous pyelography was performed in all patients with macroscopic haematuria and, in the absence of hypotension, when there was no concentration of dye, this was followed by renal angiography. Thrombosis of the renal artery occurred in 4 patients. The overall mortality rate was 13%.

Female↗
PubMed1989

Rupture of the spleen. An analysis of 421 cases.

A detailed analysis of a prospective series of 421 patients with rupture of the spleen, who all underwent laparotomy, is presented. Delayed rupture occurred in 8% of cases. In 37% of patients with blunt injury there were additional intraperitoneal injuries that required laparotomy, and also in 79% with penetrating injury. Fifty per cent of patients with blunt trauma had chest injuries; 18% of ruptured spleens were sutured. Only 3 patients died from haemorrhage due to splenic injury--less than 1%.

Adolescent↗
PubMed1988

Purification and properties of an extracellular glucoamylase from a diastatic strain of Saccharomyces cerevisiae.

The extracellular glucoamylase from certain strains of Saccharomyces cerevisiae can be purified from culture medium by a simple chromatographic procedure. The native enzyme is heavily glycosylated and has an Mr of about 250,000, but gel filtration indicates the existence of oligomers of larger size. Dissociation yields a form of Mr about 70,000. The glucoamylase is rich in serine and threonine and in aspartic acid plus asparagine, and has a pI of 4.62 and a pH optimum of 4.5-6.5. The thermostability and resistance to denaturants of the yeast enzyme is compared with those of two other fungal glucoamylases. Kinetic data for the yeast enzyme and a variety of substrates is presented; the enzyme is particularly ineffective in cleaving alpha-(1----6)-glycosidic bonds.

Amino Acids↗