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Biomedical subjects

J Wilkins

Publications and source records attributed to J Wilkins.

At least 19 recordsLinked to original sources
PubMed1992

The interactions of gamma delta T cells with extracellular matrix: receptor expression and utilization patterns.

Purified populations and clones of human gamma delta T cells were examined for their ability to interact with extracellular matrix (ECM) components. The stimulation of these cells with phorbol ester induced cellular adhesion for ECM. The adhesion structures for fibronectin and collagen were shown to be members of the CD29 integrin family. The expression patterns of beta 1, beta 2 and beta 3 integrins by these cells were examined. The receptor expression and utilization patterns suggest that alpha beta, gamma delta T cells and B cells have similar repertoires of adhesion structure.

Antigens, CD↗
PubMed1992

Oculocutaneous manifestations of the erythema multiforme/Stevens-Johnson syndrome/toxic epidermal necrolysis spectrum.

Although they were once believed to be distinct diseases, many observers currently consider erythema multiforme, Stevens-Johnson syndrome, and toxic epidermal necrolysis to represent a mild-to-severe continuum of the same process. Each shares certain clinical, histologic, and etiologic characteristics; among the latter two are frequent ocular involvement. Because long-term ophthalmic sequelae may be catastrophic, early recognition and therapy of this acute oculocutaneous disease spectrum are critically important.

Conjunctivitis↗
PubMed1991

Antibodies to different members of the beta 1 (CD29) integrins induce homotypic and heterotypic cellular aggregation.

Members of the beta 1 (CD29) integrin family are involved in cellular adhesion to extracellular matrix. However, there have been several reports of CD29 integrin participation in intercellular adhesion. For example, the treatment of the human T cell line Jurkat with antibodies to alpha 4 (CD49d) causes homotypic aggregation. The present report describes the induction of aggregation of Jurkat cells by antibodies to alpha 5 (CD49e) and to a lesser extent by antibodies to the common beta 1/CD29 chain of these integrins. The metabolic requirements for these aggregations are compared with that of the CD49d-induced process. The possible involvement of fibronectin in the cytoadhesion appears to be unlikely as (1) the aggregates form in the absence of plasma fibronectin; (2) antibodies to fibronectin do not inhibit the cell adhesion; and (3) exogenous fibronectin does not influence the process. One of the cognate partners involved in the CD49e-induced aggregation appears to be present on non-antibody-treated Jurkat cells as the cells are coincorporated into aggregates of anti-CD49e-stimulated cells. The adhesion does not appear to involve members of the CD2, CD3, CD4, or CD18 receptor groups. These results indicate that interaction with alpha 4, alpha 5 chain or the beta 1 chain of the CD29 integrins leads to the induction of intercellular adhesion. The possible biological significance of this process is discussed.

Animals↗
PubMed1991

A silicone pellet for continuous cocaine: comparison with continuous amphetamine.

An inexpensive silicone pellet is described for the continuous administration of cocaine for up to 5 days. Rats implanted with this pellet show minimal skin irritation and go through distinct behavioral stages, with an initial period of hyperactivity followed by motor stereotypies. Then, at 3-4 days after implantation, a variety of hallucinogen-like ("late-stage") behaviors appear, including limb flicks, sudden startle responses, and repetitive mid-air grasping movements. Compared to continuous d-amphetamine, continuous cocaine induces decreased motor stereotypies but heightened "late-stage" behaviors.

Animals↗
PubMed1991

HIV/AIDS workshop for primary health care staff.

The purpose of this study was to develop and pilot a workshop to train general practitioners and other primary care workers to become competent in the primary, secondary and tertiary prevention of acquired immunodeficiency syndrome (AIDS). The development of the workshop took place at four venues in the South West Thames Region and involved 41 general practitioners and 33 primary care nurses. Questionnaire evaluation before and immediately after each workshop showed a significant improvement in participants' attitudes towards the prevention and management of human immunodeficiency virus (HIV) infection in general practice. We conclude that a suitably designed workshop can be effective in improving the attitudes of primary health care workers towards AIDS prevention and care.

Acquired Immunodeficiency Syndrome↗
PubMed1991

Choice and duration of antibiotics in open fractures.

Open fracture wounds are contaminated wounds, and wide spectrum antibiotic therapy effective against both gram-positive and gram-negative organisms is recommended. Combination therapy has been shown to be effective in significantly reducing the infection rate in open fractures. For type I and II open fracture wounds, 3 days of antimicrobial therapy is recommended; for type III open fracture wounds, 5 days of treatment is recommended. When secondary procedures are performed, such as bone grafting, open reduction and internal fixation, soft tissue transfers, and other procedures involving the fracture site, an additional 72 hours of therapy is recommended. When antibiotic therapy is given after the initial period, antimicrobials administered should be selected on the basis of the culture and sensitivities of the original infecting organisms.

Administration, Topical↗
PubMed1991

Analysis of 61 cases of vertebral osteomyelitis.

Sixty-one cases of bacterial vertebral osteomyelitis from July 1969 to July 1979 were analyzed. The ages of the 49 men and 12 women ranged from 21 to 66 years. The portal of entry was hematogenous in 58 cases, gunshot wounds in two cases, and and adjacent retroperitoneal abscess in one case. Biopsy was performed in 60 patients. There were 15 complications related to the disease. Gram-negative rods were the predominant bacteria isolated. Blood culture was positive in 13 of the 26 (50%) patients tested. Eleven of the 13 (85%) organisms isolated from the blood cultures correlated with organisms recovered from biopsy specimens. Eleven of the patients had more than one disk level involved. Of the 61 patients, 29 went on to spontaneous fusion, 17 were lost to follow-up study, 11 failed to fuse, three had surgical fusion, and one patient died. Recommendations for diagnosis included the collection of blood cultures and radionuclide bone scans. Management recommendations included systemic antibiotics for at least three weeks and immobilization with either bed rest or spinal orthoses. Surgery was indicated if an abscess was present, neurologic complications occurred, instability became a factor, or the medical treatment failed.

Adult↗
PubMed1990

Cloning of a gene that encodes a new member of the human cytotoxic cell protease family.

A family of unusual serine proteases that are believed to be involved in the effector mechanism of cell-mediated cytotoxicity have previously been described in the mouse. However, in the human only one gene encoding a member has been isolated. By use of a mixture of murine cDNAs as probes, a second human gene has now been isolated. The primary structures of the gene and the predicted protein are very similar to those of the mouse. In addition, in keeping with the postulated involvement in cytolysis, transcripts were detected only in cytotoxic cells. The organization of the coding and noncoding regions of the gene, the clustering of family members, and the chromosomal location, close to the alpha chain of the T cell antigen receptor, are all conserved between human and mouse.

Amino Acid Sequence↗
PubMed1990

Gunshot injuries to the hip and abdomen: the association of joint and intra-abdominal visceral injuries.

A retrospective review of all gunshot injuries to the hip at our medical center over a 24-year period was performed. Adequate information and radiographs were available for 49 patients. Of these, five patients (10.2%) had associated abdominal visceral injuries. These five patients were examined at an average of 5.9 years after their injury, and compared by utilizing the Harris Hip Score rating. Radiographs were also obtained. Four of these five patients (80%) had initially developed infections in their hip joints, with all four having poor functional outcomes, with an average Harris Hip Score of 48.5 from their hip injury. Careful initial evaluation and aggressive surgical and antibiotic treatment are recommended to prevent these poor results.

Abdominal Injuries↗
PubMed1990

A comparison of the efficacy and safety of ceftizoxime with doxycycline versus conventional CDC therapies in the treatment of upper genital tract infection with or without a mass.

It is well known that sexually transmitted infections of the upper genital tract are widespread. A variety of regimens are used to treat these conditions, many of which have not been subjected to randomized, prospective clinical trials (including the 1985 Centers for Disease Control [CDC] Guidelines for the treatment of upper genital tract infections [UGTI]). This investigation was undertaken to compare the 1985 CDC treatment guidelines with different doses of ceftizoxime, a third-generation cephalosporin with an intermediate half-life, plus doxycycline in patients with UGTI. The patients were divided into subgroups, depending on the presence or absence of a pelvic mass. Sixty-seven women participated in the study. They were older than 14 years of age and required hospitalization for the treatment of UGTI. These women had lower abdominal pain and tenderness, cervical motion or adnexal tenderness, and one of the following: temperature greater than 100.4 degrees F orally, leukocytosis greater than 10,500/mm3, or presence of a suspected inflammatory pelvic mass on pelvic examination or by ultrasound. Informed consent was obtained from all patients in a manner approved by the Institutional Review Board. Pelvic examinations and ultrasound evaluations of the pelvic soft tissues were performed on all patients at the time of admission. Those who were found not to have a pelvic mass or who had a pelvic mass less than 4 cm in transverse diameter were randomly allocated to receive either ceftizoxime 2 gm intravenously every 12 hours with doxycycline 100 mg intravenously twice daily (Rx 1, n = 13) or cefoxitin 2 gm intravenously every six hours with doxycycline 100 mg intravenously twice daily (Rx 2, n = 14). Those patients found to have a pelvic mass (greater than 4 cm in transverse diameter) were randomly allocated to receive either ceftizoxime 2 gm intravenously every eight hours with doxycycline 100 mg intravenously twice daily (Rx 3, n = 19) or clindamycin 900 mg intravenously every eight hours with a 2-mg/kg loading dose of gentamicin followed by 1.5 mg/kg intravenously every eight hours, with adjustments as necessary (Rx 4, n = 21). All UGTI patients without a mass treated with either Rx 1 or Rx 2 responded adequately. However, UGTI patients with a mass treated with Rx 4 were more likely than those treated with Rx 3 to require a change in antibiotics or need extirpative surgery in order to obtain a satisfactory clinical response (Fisher's exact test = 0.046, two-sided).(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗
PubMed1990

Cefmetazole and cefonicid. Comparative efficacy and safety in preventing postoperative infections after vaginal and abdominal hysterectomy.

A single 1-g dose of cefmetazole was compared with a single 1-g dose of cefonicid for prophylaxis in vaginal and abdominal hysterectomy to determine their efficacy and safety. The antibiotics were administered intramuscularly 15-90 minutes before the incision was made. Cefmetazole and cefonicid had similar activity against most of the aerobic organisms recovered, but cefmetazole was significantly more active against anaerobic gram-negative microorganisms. The patterns of regrowth of vaginal flora were similar in the two treatment groups. Patient demographic characteristics and surgical procedures were similar in both groups. The difference in primary prophylactic failure (e.g., cuff cellulitis) with the two study drugs (1 of 53 [1.9%] with cefmetazole and 2 of 28 [7.1%] with cefonicid) did not reach statistical significance, and the results were similar for the two routes of hysterectomy. Cefmetazole, at a dose of 1 g intramuscularly preoperatively, is a safe and effective agent for prophylaxis during hysterectomy.

Adult↗
PubMed1990

Peripheral teflon catheters. Potential source for bacterial contamination of orthopedic implants?

To detect low numbers of bacterial cells on Teflon catheters removed from peripheral veins, 74 catheter tips were incubated in thioglycollate media for up to ten days. Fifteen (20.3%) of the catheters were found to be culture-positive. Propionibacterium acnes was isolated from seven, Staphylococcus epidermidis from six, and Staphylococcus haemolyticus and Staphylococcus hominis from one each, all common skin organisms associated with infection of implants. An increase in documentation of bacterial contamination resulted from incubating greater than 72 hours; this allowed the slower-replicating Propionibacterium acnes to grow to detectable numbers. Because of these findings and those of others, attention is focused on the peripheral vein conduit as a potential source for hematogenous seeding of implants with bacterial cells. Changing peripheral catheters within 24 hours is recommended to reduce the constant risk of occult bacteremia.

Bacteria↗
PubMed1989

Comparative efficacy and safety of cefmetazole or cefoxitin in the prevention of postoperative infection following vaginal and abdominal hysterectomy.

We evaluated three 1-g doses of cefmetazole in comparison with the standard three 2-g doses of cefoxitin for prophylaxis in vaginal or abdominal hysterectomy to determine efficacy and safety. The antibiotics were administered intravenously 30-90 min before the incision and were followed with additional intravenous doses 8 and 16 h or 6 and 12 h later, respectively. The patients received povidone-iodine vaginal preparations before surgery; vaginal packs, when used, contained no antibiotic agents. Vaginal cultures were obtained before the vaginal preparation, at the time of discharge from hospital and when there was a suggestion of operative site infection. The activity of both antibiotics against these organisms was tested. Patient demographic characteristics and surgical procedures were similar in each treatment group. The difference between the primary failure rates with the two antibiotics (2 of 35 (5.7%) with cefmetazole and 2 of 16 (12.5%) with cefoxitin) did not reach statistical significance, and results were similar for the two routes of hysterectomy. Cefmetazole was more active than cefoxitin against the majority of the aerobic and anaerobic organisms recovered, although approximately 20-30% of the isolates showed resistance, or intermediate sensitivity, generally to both antibiotics.

Adult↗
PubMed1989

The use of adaptive algorithms for obtaining optimal electrical shimming in magnetic resonance imaging (MRI).

A method of determining the dc coil current values to electrically shim the static magnetic fields used in magnetic resonance imaging (MRI) using modified steepest descent adaptive algorithm is described. Using a 32 cm diameter by a 40 cm long water phantom as the test volume, the algorithm achieved field homogeneities of 0.2 parts per million (ppm) peak-to-peak within a 20 cm diameter spherical imaging volume, and 1.3 ppm peak-to-peak within the entire phantom. The algorithm achieved an inhomogeneity variance of 0.18 ppm2. The shim system was successfully modeled as a sum of adaptive linear combiners. The model contains 13 parameters that can be varied, 12 shim coil currents, and the receiver mixer frequency. The model was then used to predict key adaptive algorithm parameters. Experimental verification of these parameters lends support to the accuracy of the model.

Algorithms↗
PubMed1989

Wound site as a predictor of complications following deep nail punctures to the foot.

The site of injury, condition of the nail, and type of foot covering were compared in 36 inpatients and 34 outpatients with nail puncture wounds to the foot. Of the 36 inpatients, 34 (94%) had pyarthrosis, osteomyelitis, or both. The plantar surface of the foot was divided into 3 zones. Of the 36 inpatients, 35 (97%) had deep puncture wounds in zone 1. In contrast, only 6 of 34 (18%) outpatients had injury to this area. Tennis shoes were shown to predispose to infection with Pseudomonas aeruginosa. Based on our findings, an early hospital admission should be considered for all patients with deep puncture wounds located in zone 1 and for patients who give a history of bone penetration in zone 2 or 3 at the time of injury. All patients who meet the above criteria and who are not admitted to hospital should be observed closely.

Adolescent↗
PubMed1989

Factors influencing infection rate in open fracture wounds.

Seventy-seven infections in 1104 open fracture wounds were evaluated to identify those factors that predisposed to infection. Factors could be placed into three categories: (1) increased risk, (2) no effect, and (3) inconclusive. The single most important factor in reducing the infection rate was the early administration of antibiotics that provide antibacterial activity against both gram-positive and gram-negative microorganisms. In this study, surgical debridement was performed on all open fracture wounds.

Adolescent↗