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Biomedical subjects

J C Meek

Publications and source records attributed to J C Meek.

At least 19 recordsLinked to original sources
PubMed1995

Herniation of the lung following video-assisted minithoracotomy.

Intercostal pulmonary hernia is a rare finding in surgical practice. The hernia presents as an elastic expansion on the outer surface of the chest wall that is usually easily reducible. The protrusion increases in size during expiration and decreases, or disappears, during inspiration. Usually there are no other symptoms. We describe a man who developed a thoracic herniation of the lung 2 1/2 months after a video-assisted minithoracotomy. A concise review of the literature is included.

Aged↗
PubMed1992

Clinical and bacteriological experience with cefodizime in acute purulent exacerbations of chronic bronchitis.

1 or 2 g doses of cefodizime i.m. were studied in 287 patients admitted to hospital with acute purulent exacerbations of chronic bronchitis, mostly associated with Haemophilus influenzae, Streptococcus pneumoniae or Moraxella catarrhalis. Pharmacokinetic studies in serum and sputum on the first treatment day yielded mean peak serum concentrations of 50 to 100 mg/l, with corresponding sputum concentrations of 1.4 and 2.7 mg/l, after the two respective doses. No great differences were found between the clinical and microbiological results in the various dosage groups, and no corresponding improvement was noted with the highest dosages studied. In general, infection was eliminated in 90 to 95% of patients at the end of treatment, and in approximately 70 to 80% after a follow-up week. Some infections associated with beta-lactamase producing M. catarrhalis persisted or relapsed after treatment. Unwanted drug effects were recorded in five patients, leading to discontinuation in two. It is concluded that a single daily intramuscular dose of 1 g cefodizime for seven days produces satisfactory results in most patients.

Aged↗
PubMed1992

Practical approach to the treatment of hypothyroidism.

Hypothyroidism most commonly is the result of primary thyroid failure due to autoimmune thyroiditis, but also may follow treated Graves' disease or may occur as transient hypothyroidism. Laboratory evaluation of thyroid function has been refined by the development of ultrasensitive thyroid-stimulating hormone determinations, allowing accurate diagnosis of primary hypothyroidism and assessment of treatment response. Determining whether therapy is appropriate for patients with subclinical hypothyroidism or euthyroid sick syndrome requires clinical judgment in addition to laboratory evaluation. Thyroid hormone replacement for hypothyroidism is best accomplished with levothyroxine. Factors that may affect serum thyroxine levels include thyroid binding globulin levels, drug interactions and variations in thyroxine absorption and clearance.

Female↗
PubMed1991

Pain in scar as an early symptom of acquired thoracic lung hernia.

Hernia of the lung manifests itself as an elastic, usually replaceable, swelling in the chest wall, which changes in size during inspiration and expiration. It does not generally cause any symptoms. We describe the case history of a 49 yr old man with an acquired thoracic lung hernia, which had first presented three years previously as pain in an operation scar during coughing and lifting. Histopathology of the excised lung tissue showed abnormalities suggestive of previous episodes of strangulation.

Cicatrix↗
PubMed1990

Cefodizime and cefotaxime in acute exacerbations of chronic bronchitis: a randomized double-blind prospective study in 180 patients.

In a double-blind prospective study, 180 patients admitted to hospital with acute purulent exacerbations of chronic bronchitis were treated for seven days with twice daily 1 g intramuscular injections of either cefodizime or cefotaxime. Sputum cultures performed before, during and immediately after treatment showed complete eradication of the infection in 89/90 given cefodizime and 86/90 receiving cefotaxime. Some symptomatic Pseudomonas aeruginosa superinfections occurred with each agent. During the follow-up week, recurrences or reinfections after apparent clearance occurred in 15 patients given cefodizime and in 21 receiving cefotaxime. Pharmacokinetic studies in blood showed mean Cmax values of 50.8 mg/l for cefodizime and 36.5 mg/l for cefotaxime, corresponding values in the sputum being 1.61 and 0.62 mg/l. Mean AUC values in both blood and sputum were 2 1/2- to 3-fold higher for cefodizime. Some features suggested better performance by cefodizime than by cefotaxime, but the clinical results were not statistically significantly different.

Acute Disease↗
PubMed1990

The diagnostic value of neuron-specific enolase and carcino-embryonic antigen analyses in patients with carcinoma of the lung.

Neuron-specific enolase and carcino-embryonic antigen were quantified simultaneously in sera of 135 patients attending the Department of Respiratory Diseases for diagnostic bronchoscopy. Fifteen small cell lung carcinomas, 24 non-small cell lung carcinomas and 96 benign pulmonary diseases were investigated. Lung biopsies or bronchial washings were obtained from about 75% of the patients, including all patients with neoplastic diseases. Serum neuron-specific enolase was measured by a recently introduced enzyme-immuno assay (WaKo NS-Enolase EIA-II testkit). The results obtained with this kit were similar to those based on RIA assays. Receiver Operating Characteristic curves (ROC curves) were constructed for comparison of the discriminating ability of neuron-specific enolase and carcino-embryonic antigen in small cell lung carcinomas and non-small cell lung carcinomas. For small cell lung carcinomas the sensitivity and the specificity of neuron-specific enolase (cutoff value: 10 micrograms/l) were 87% and 88%, respectively, and for carcino-embryonic antigen values 60% and 77% were obtained. There was no correlation between neuron-specific enolase and carcino-embryonic antigen in small cell lung carcinoma patients. The diagnostic value of neuron-specific enolase and carcino-embryonic antigen in non-small cell lung carcinomas is illustrated by sensitivities of 13% and 58%, respectively. An extensive literature survey is included to allow comparison with other studies. The use of ROC curves is recommended for the determination of optimal cutoff values for the assays employed.

Carcinoembryonic Antigen↗
PubMed1990

Tests of thyroid function: update in the diagnosis and management of thyroid disease.

Current thyroid function tests give the clinician powerful tools for the accurate assessment of thyroid status in the majority of patients encountered. There are, however, a small number of clinical situations in which there appear to be inconsistencies in the interrelationship of the thyroid function tests and/or in which they are apparently inappropriate to the clinical status of the patient. In most instances, there is a rational explanation for these observed alterations. The application of this information should allow clinicians to further refine their diagnostic accuracy and thereby enable them to proceed with an appropriate therapeutic or management program.

Adult↗
PubMed1989

A prospective study of ofloxacin in acute exacerbations of chronic respiratory disease associated with Pseudomonas aeruginosa.

Forty patients (32 inpatients and 8 outpatients) with acute purulent exacerbations of obstructive respiratory disease associated with Pseudomonas aeruginosa were treated orally with 800 mg ofloxacin twice daily for seven days. Sputum was cultured before, during and after treatment. The drug was extremely well tolerated, only one patient discontinuing because of alleged nausea. The infection was completely eradicated, with excellent clinical results and negative sputum cultures, in 23 patients. In six others the Ps. aeruginosa infection was cleared although reinfection with different organisms followed. Five patients showed recurrence of the infection after apparent initial eradication, but Ps. aeruginosa persisted in three others. Three patients were not evaluable because of death, transfer elsewhere, or discontinuation. There was a slight tendency for the mean MICs to rise during treatment, owing to eradication of all highly sensitive strains. Resistance did not develop. These results suggest that purulent exacerbations of chronic respiratory disease caused by Ps. aeruginosa can safely be treated orally with 800 mg ofloxacin twice daily, but that further studies in outpatients should be performed.

Adolescent↗
PubMed1979

Circadian rhythms of plasma cortisol in migraine.

Diurnal rhythm of plasma cortisol, of psychological state, and of pain was measured for two days in 25 migraine patients and eight control subjects. Fourteen of the migraine patients and none of the controls displayed either consistently high plasma cortisol or an occasional aberrant peak. Abnormal psychological findings, particularly depression, were found in the Minnesota Multiphasic Personality Inventory only in migraine patients with abnormal plasma cortisol levels. Neither psychological abnormality nor pain seemed the single cause of elevation of plasma cortisol.

Adult↗
PubMed1977

Insulin, S-sulphonate A and S-sulphonate B-chain receptor binding to human cultured lymphocytes.

The ability of insulin and the S-sulphonate A and B-chain derivatives to bind to a receptor on cultured human lymphocytes was evaluated. A receptor site for the S-sulphonate A-chain was identified and was strongly influenced by the intact insulin molecule. S-sulphonate A-chain weakly interfered with insulin binding. S-sulphonate B-chain showed no evidence of significant binding and did not interfere with insulin or S-sulphonate A chain binding. 14CO2 production from 14C-1-glucose was stimulated by insulin in cultured lymphocytes and this effect was blunted by S-sulphonate A-chain. The sulphhydryl blocking agent used in the production of insulin A-chain appears to be of critical importance.

Animals↗
PubMed1977

Gonadal dysgenesis with Graves's disease.

Hashimoto's thyroiditis has previously been associated with gonadal dysgenesis. Recent evidence suggests that Graves's disease and Hashimoto's thyroiditis are disorders of cell-mediated immunity and may have a common genetic predisposition. However, patients with both Graves's disease and the Turner syndrome have been reported only rarely. Three such cases are presented and the relation among gonadal dysgenesis, Hashimoto's thyroiditis, and Graves's disease is discussed.

Adolescent↗
PubMed1977

The insulin receptor in myotonic dystrophy.

Insulin binding was studied using circulating monocytes obtained from seven patients with myotonic dystrophy and seven control subjects. During an oral glucose tolerance test the 2 h plasma glucose value was significantly higher in patients with myotonic dystrophy compared to controls, and 5 out of the 7 patients demonstrated hyperinsulinemia. This combination of abnormal glucose tolerance and hyperinsulinemia suggests insulin resistance. There was no difference in insulin binding to monocyte receptors between the two groups. These results suggest that no abnormality exists in the insulin receptor in myotonic dystrophy.

Adolescent↗
PubMed1975

Hypothyroidism.

We found biochemical evidence of hypothyroidism (low T3 and T4 and elevated TSH) in azotemic patients. Hemodialysis did not correct the hypothyroidism but renal transplantation did. The hypothyroidism is probably a consequence of impaired thyroidal elaboration of thyroid hormone, as well as decreased peripheral conversion of T4 to T3. The impaired thyroidal gland function may be secondary to the increased concentration of aryl acids found in chronic renal disease.

Blood Urea Nitrogen↗