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Biomedical subjects

J L Edwards

Publications and source records attributed to J L Edwards.

At least 19 recordsLinked to original sources
PubMed1994

An experimental model for intraamniotic infection and preterm labor in rhesus monkeys.

OBJECTIVE: Our purpose was to describe the temporal and quantitative relationship between intraamniotic infection and preterm labor in a nonhuman primate model. STUDY DESIGN: On day 130 of gestation (term 167 days) four chronically instrumented rhesus monkeys (Macaca mulatta) were infected with an intraamniotic inoculation of 10(6) colony-forming units of group B streptococci. Four additional noninfected monkeys were followed up to spontaneous parturition as controls. Amniotic fluid was serially sampled in all monkeys both before and after inoculation for bacterial growth, tumor necrosis factor-alpha, interleukin-1 beta, interleukin-6, prostaglandin E2, and prostaglandin F2 alpha, and uterine activity was continuously recorded. RESULTS: Increases in uterine contractility occurred 28 hours (range 14 to 40 hours) after inoculation and were preceded by increases in amniotic fluid cytokines and prostaglandins. Intraamniotic concentrations of tumor necrosis factor-alpha, interleukin-6, and interleukin-1 beta all rose dramatically 9, 15, and 18 hours after infection and 10 to 20 hours before increases in uterine contractility. In spontaneous parturition only interleukin-6 concentrations rose moderately (from 0.1 to 1.2 ng/ml). Increases in prostaglandin E2 and prostaglandin F2 alpha paralleled those of the cytokines. Peak prostaglandin concentrations in intraamniotic infection exceeded by severalfold concentrations seen in spontaneous parturition (16,046 pg/ml vs 2765 pg/ml for prostaglandin E2, p < 0.05; and 5547 pg/ml vs 708 pg/ml for prostaglandin F2 alpha, p < 0.05). In spite of intraamniotic none of the monkeys were febrile or had peripheral leukocytosis at the onset of labor. CONCLUSION: In the rhesus monkey, after intraamniotic infection, there is a predictable and sequential increase in amniotic fluid tumor necrosis factor-alpha, interleukin-1 beta, and interleukin-6, followed by increases in prostaglandin E2 and prostaglandin F2 alpha. These increases all occur before an increase in uterine contractility and before clinical signs of infection. Our data provide evidence for a cause-and-effect relationship between intraamniotic infection and preterm labor and support the utility of measuring interleukin-6 or other cytokines in the diagnosis of intraamniotic infection.

Amnion↗
PubMed1991

Clinical presentation and final diagnosis of patients referred to a temporomandibular joint clinic.

The clinical presentation and final diagnosis of 182 consecutive patients referred to the Temporomandibular Joint Clinic at the University of Otago School of Dentistry over a 12-month period were reviewed. The definitive diagnosis utilised a classification based upon accepted pathological concepts. Thirty-six percent of patients had internal derangement of the TMJ, 33 percent had joint overload, 12 percent had an acute muscle disorder, 12 percent had degenerative joint disease, and 7 percent had other conditions including ENT disorders and pulpitis. Only six percent of patients underwent treatment involving occlusal modification or TMJ surgery. The remainder received a variety of conservative treatments confirming the widely held view that the majority of patients with a TMJ disorder can be managed with a variety of reversible therapeutic methods.

Adolescent↗
PubMed1991

Fractures of the facial bones in the Otago region 1979-1985.

The aetiology, type, distribution, and treatment of fractures of the facial bones is described in the 484 patients with such injuries treated at Dunedin Hospital during the period 1979-1985. The mean annual rate was 51.7 per 100,000. The rate of facial bone fractures has remained relatively constant over a 32-year period in the Otago area. Interpersonal violence is now the most common cause of these injuries. Fractures of the zygomatic complex and fractures of the mandible remain the most common facial fractures. There is an increasing trend towards the use of direct internal fixation for fractures that require treatment.

Adolescent↗
PubMed1990

Parotid gland biopsy for investigation of xerostomia.

A technique is described for biopsy of the parotid salivary gland under local anaesthesia, which has been undertaken for a series of 59 patients who presented with suspected inflammatory exocrinopathy. The procedure is reliable and is associated with negligible postoperative discomfort. The advantages of the technique suggest that parotid gland biopsy is an acceptable alternative to conventional lower lip biopsy of minor salivary glands in the investigation of xerostomia.

Adolescent↗
PubMed1988

Glutaric acidemia type II. Comparison of pathologic features in two infants.

Glutaric acidemia type II (GA II) is a metabolic disorder caused by deficiency of electron transport flavoprotein or its oxyreductase. It is characterized by acidosis, hypoglycemia, hyperammonemia, organic aciduria, and "sweat-sock" odor. Neonatal GA II differs from most inborn metabolic errors in that there are prominent congenital malformations. We recently observed two infants at autopsy with GA II whose malformations included: subcortical renal glomerular cysts, renal medullary dysplasia, cerebral pachygyria, pulmonary hypoplasia, and facial dysmorphism. In addition, there was lipid accumulation in liver, heart, and renal tubular epithelium, tissues that use fatty acids as a primary source of energy. Review of previous reports of 12 patients showed that these lesions are typical of neonatal GA II. The pattern of lesions, in particular the striking localization of renal dysplasia to the medulla, suggests that the malformations may be the consequence of an accumulation of toxic metabolites that is not corrected by placental transfer.

Brain↗
PubMed1983

Studies of the mechanism of glucocorticoid-induced pyknosis in isolated rat thymocytes.

The lethal action of glucocorticoids on rat thymocytes in vitro is associated with the progressive accumulation of cells that display a discrete reduction in size. Techniques for the separation and quantitation of these structurally transformed cells have now been used to investigate the relationship between cell size changes and the effects of dexamethasone treatment on chromatin condensation and DNA fragmentation. The steroid-induced reduction in thymocyte size was invariably and exclusively associated with morphologically evident chromatin condensation and with fragmentation of DNA into units that were acid-precipitable but failed to sediment on low-speed centrifugation. The generation of cells of reduced size in response to dexamethasone was inhibited by actinomycin D, cordycepin and cycloheximide; the kinetics of inhibition indicate that glucocorticoid-induced cell death depends on the synthesis, processing and translation of mRNA coding for a protein or proteins whose subsequent lethal effect is expressed in a stochastic manner.

Animals↗
PubMed1980

Salicylate intoxication in family practice.

Abuse of readily available, widely advertised drugs like the salicylates often challenges the family physician. But self-medication by the patient may be only part of the problem. This case dramatizes the hazards of "knee jerk" therapeutics and the critical importance of the three C's of primary care.

Bicarbonates↗
PubMed1979

Relation between transmucosal potential difference, ionic flux, and the intraluminal supply of H+ in the ferret stomach.

To investigate the relation between gastric transmucosal potential difference, ionic flux, and the intraluminal concentration of H+, test solutions containing various concentrations of HCl were instilled into ferret stomachs both before and after exposure to various doses of acetic acid. The changes in ionic composition of the test solution were determined and the transmucosal potential difference was recorded throughout each experiment. The results showed that after exposure to the organic acid (1) ionic flux was proportional to the concentration of acetic acid used and was a direct function of the concentration of H+ within the lumen, and (2) the decrease in transmucosal potential difference was proportional to the concentration of acetic acid used but did not appear to be related to the subsequent magnitude of ionic flux. It is suggested that the decrease in gastric transmucosal potential difference that follows exposure of the gastric mucosa to an organic acid is a measure of the increase in mucosal permeability, whereas the subsequent ionic movements are governed by the concentration of H+ within the gastric lumen.

Acetates↗
PubMed1979

Hypertensive crisis possibly due to drug interaction.

This report describes a case of possible drug interaction in a patient taking chlorpromazine and guanethidine who experienced a hypertensive crisis following initiation of doxepin therapy. (We have been unable to find a report of a similar interaction at the doses described.) It is advised that physicians exercise caution when contemplating concomitant use of doxepin and guanethidine, even in usually recommended doses.

Blood Pressure↗
PubMed1979

Double-blind comparison of cimetidine and placebo in the maintenance of healing of chronic duodenal ulceration.

Patients suffering from chronic duodenal ulceration were allocated at random to treatment with either cimetidine (400 mg twice daily) or matching placebo for six months. Before entry to the trial all patients were shown to have healed ulcers on endoscopy. Most of the patients had participated in a one-month trial of cimetidine during which their ulcers healed. The trial showed that four of 29 patients relapsed on maintenance treatment with cimetidine, which therefore did not confer complete immunity from relapse. However, cimetidine treatment was very much better than placebo treatment, on which 18 of 31 patients relapsed. Of the 22 patients who relapsed clinically, 20 were submitted to endoscopy and 19 of these were shown to have ulcerated again. Endoscopy at the end of the trial showed that ulcers had also redeveloped in five of 28 asymptomatic patients. Length of previous dyspeptic history had no bearing on the results of the trial but there was evidence that relapse on placebo was less likely if the ulcer had originally healed on a high dose of cimetidine. Clinical relapse was associated with worsening duodenitis. Symptoms, clinical observation, and laboratory tests showed no important abnormalities in the patients.

Chronic Disease↗
PubMed1978

The selective use of combined supraduodenal and transduodenal exploration of the common bile duct.

The results of combined supraduodenal and transduodenal exploration of the common bile duct in 42 selected cases are presented. The indications for this operation were: the presence of multiple calculi in the common bile duct; stones impacted in the ampullary region; residual stones in the common bile duct following previous surgery on the biliary tract; stricture at the papilla and pancreatitis associated with cholelithiasis. After the procedure no patient had residual stones in the common bile duct. Serious complications were infrequent; there were no postoperative deaths and post-operative pancreatitis occurred in only one patient.

Adult↗
PubMed1978

Asymptomatic IgA nephropathy associated with pulmonary hemosiderosis.

A glomerular lesion identical to that of IgA nephropathy was demonstrated unexpectedly in a 17 year old boy who presented with clinical manifestations of pulmonary hemosiderosis and with no evidence of renal disease. This subclinical glomerular lesion would have remained undetected in this patient unless kidney tissue was obtained and examined by immunofluorescence or electron microscopy. It is unknown if the glomerular lesion in this case is causally related to pulmonary hemosiderosis.

Adolescent↗