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Biomedical subjects

K Anding

Publications and source records attributed to K Anding.

13 recordsLinked to original sources
PubMed1998

Primary pigmented nodular adrenocortical dysplasia.

A 29-year-old female patient presented clinical features of Cushing's syndrome. Biochemical tests suggested the presence of an autonomously functioning adrenocortical neoplasm. However, the adrenal glands were normal on MRI. Diagnostic adrenalectomy revealed a slightly enlarged organ studded externally and on multiple cut surfaces by small yellow and brown nodules. Microscopically, the nodules were composed of enlarged cortical cells with eosinophilic cytoplasm and nuclear pleomorphism, without mitotic figures. The morphology was consistent with primary pigmented nodular adrenocortical dysplasia (PPNAD). Additional right adrenalectomy was performed for curative treatment of Cushing's syndrome. The pathogenesis of PPNAD is not yet established, though, a defect on chromosome 16 was recently suggested. Since our patient had a malignant melanoma earlier in her history, the PPNAD may be a manifestation of the Carney complex.

Adrenal Cortex↗
PubMed1996

[Primary pigmented nodular adrenocortical dysplasia. A rare cause of Cushing's syndrome].

HISTORY AND CLINICAL FINDINGS: A 29-year-old woman was found to have arterial hypertension (175/115 mm Hg). The 24-hour profile showed no diurnal cortisol variations with normal concentrations and 24-hour urinary cortisol was normal. 14 months later there was definite hypercortisolism with discrete Cushing signs and no amenorrhoea. She also had signs of depression. INVESTIGATIONS: Routine laboratory tests were unremarkable. ACTH and dehydroepiandrosterone levels were reduced and there was marked hypercortisolism (600 micrograms/24h). Bone densitometry showed osteoporosis. The low- and high-dose dexamethasone inhibition tests showed no suppression of 24-hour urinary cortisol, raising the suspicion of adrenal cortical adenoma or carcinoma. Magnetic resonance imaging (MRI) of both adrenals was normal, and scintigraphy showed physiological storage. MRI of the skull was normal. TREATMENT AND COURSE: As ACTH-independent hypercortisolism had been proven, unilateral adrenalectomy was performed. The specimen showed primary pigmented nodular adrenocortical dysplasia (PPNAD). While cortisol levels and blood pressure were at first normal, hypercortisolism had recurred 5 months postoperatively. The other adrenal was removed and showed a similar histology. A malignant melanoma of the shoulder was also found, perhaps part of a Carney syndrome. CONCLUSION: PPNAD should be included in the differential diagnosis of an ACTH-independent Cushing's syndrome with normal adrenal on imaging, perhaps as part of a Carney syndrome.

Adrenal Cortex↗
PubMed1996

Pharmacokinetics and bactericidal activity of a single daily dose of netilmicin in the treatment of CAPD-associated peritonitis.

Single daily dosage of netilmicin is generally accepted in systemic infections, due to biphasic bactericidal activity and prolonged postantibiotic effect of aminoglycosides. Since little is known about the efficacy of single daily intraperitoneal application of netilmicin in the treatment of CAPD-associated peritonitis, we conducted this prospective study. Seven patients with CAPD-associated peritonitis were treated with a single daily dose of netilmicin (loading dose 1.5 mg/kg, followed by 40 mg/21 bag/day). Serum and intraperitoneal levels as well as bactericidal activity of netilmicin against Acinetobacter baumanii, E. coli and Pseudomonas aeruginosa were measured for 48 hours. Serum and peritoneal levels widely varied among the patients due to different interindividual plasma clearance of netilmicin. The intraperitoneal antibacterial action of netilmicin was decreased, more over, substantial differences in the bactericidal activity were found among the patients. However, with high initial netilmicin levels sufficient bactericidal activity was found for Acinetobacter and E. coli, but not for Pseudomonas aeruginosa. Hence, a single daily dosage of netilmicin can be a suitable treatment of CAPD-associated peritonitis, only if the dose is adapted according to the first serum and peritoneal levels. In infections with Pseudomonas aeruginosa higher peritoneal levels of netilmicin and the combination with other antibiotics will be needed for a sufficient peritoneal bactericidal activity.

Acinetobacter↗
PubMed1995

Combined effect of human neutrophils, ceftazidime and granulocyte colony-stimulating factor on killing of Escherichia coli.

The combination effect of subinhibitory and inhibitory concentrations of ceftazidime, granulocyte colony-stimulating factor (G-CSF) and polymorphonuclear leukocytes (PMNL) against Escherichia coli was investigated. PMNL obtained from healthy volunteers were incubated with different concentrations of G-CSF and ceftazidime for 180 min. The addition of 0.25 x MIC of ceftazidime or 1 x MIC significantly enhanced the bactericidal activity of PMNL. G-CSF at a concentration of 6,000 units/ml led to only a slight improvement in the bactericidal activity of PMNL. The combination of 6,000 units/ml G-CSF and ceftazidime in inhibitory as well as subinhibitory concentrations, however, showed a significant synergistic effect (p < 0.01) on the antibacterial activity of PMNL during the entire incubation period. Combinations of G-CSF and antibiotics could therefore be beneficial for infected patients, especially those with impaired cellular host defence.

Adult↗
PubMed1993

Enhancement of in vitro bactericidal activity of neutrophils from trauma patients in the presence of granulocyte colony-stimulating factor.

In order to determine whether granulocyte colony-stimulating factor (G-CSF) can enhance the bactericidal activity of polymorphonuclear leukocytes (PMNL) in trauma patients, PMNL obtained from severely injured patients one or two days after trauma were incubated with G-CSF and Staphylococcus aureus for different periods of time. G-CSF at a concentration of 6000 units/ml significantly improved the antibacterial activity of PMNL in trauma patients (n = 10) and healthy volunteers (n = 12) during the incubation period of 180 min. No difference in the bactericidal function of PMNL could be found between severely injured patients and healthy donors.

Adult↗
PubMed1993

[The bactericidal effect of oxybuprocaine. A possible cause of false negative results in bronchoalveolar lavage].

New approaches in the diagnosis of pneumonia, especially in intensive care units, are quantitative cultures of bronchoalveolar (BAL) fluid or the protected specimen brush. The sensitivity of these methods, however, has often been found to be as low as 50-60%. One possible explanation for the low sensitivity of these diagnostic tools is the antimicrobial activity of local anaesthetics used in bronchoscopy. Therefore, we investigated the bactericidal properties of oxybuprocaine, a topical anaesthetic used for bronchoscopy in our clinic, in order to test the reliability of specimens obtained from BAL. METHODS. The bactericidal activity of oxybuprocaine in concentrations of 1%, 0.1%, 0.05% and 0.01% was tested by constructing time-kill curves for Streptococcus pneumoniae, Hemophilus influenzae, Pseudomonas aeruginosa and Escherichia coli. Five stains of each bacterial species were tested. The inoculum size was 10(4) ml, and bacteria were counted after 10, 20, 30, 60 and 120 min. RESULTS. The resulting time-kill curves are demonstrated in Figs. 1-4. The most sensitive bacteria were S. pneumoniae and H. influenzae, in which significant bactericidal activity could be shown even with a 0.01% solution of oxybuprocaine. E. coli and P. aeruginosa were also inhibited, but only at the highest concentration of 1%. CONCLUSIONS. The use of local anaesthetics before material is taken for culture, e.g. from BAL, may give rise to false-negative results and should therefore be avoided or reduced. For each local anaesthetic used in bronchoscopy, the concentrations that can be used without the risk of false-negative results should be determined.

Anesthetics, Local↗
PubMedDate not supplied

Shunt nephritis associated with Propionibacterium acnes.

Membranoproliferative glomerulonephritis was observed in a 22-year-old male patient in whom a ventriculoatrial shunt and a ventricular catheter were implanted after he was diagnosed in September 1989 with a cerebral cyst. Propionibacterium acnes infection of a central nervous system shunt was diagnosed. The ventriculoatrial shunt was removed (the catheter had become embedded in tissue and was left in place) and the patient was treated with cefotaxime (3 x 2 g) for 14 days. Renal function improved, but recovery was not complete.

Adult↗