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Biomedical subjects

K G Reid

Publications and source records attributed to K G Reid.

At least 19 recordsLinked to original sources
PubMed1989

Comparison of ventricular septal surgery and mitral valve replacement for hypertrophic obstructive cardiomyopathy.

We have reviewed the results of two different forms of surgical management of hypertrophic obstructive cardiomyopathy refractory to medical therapy. Twenty-one patients were treated with 22 procedures between 1963 and 1987. Eleven underwent a ventricular septal procedure by myotomy with or without myectomy, and 11 underwent mitral valve replacement (MVR), 1 of whom had previously undergone a ventricular septal procedure. The groups were comparable with respect to severity and duration of symptoms, age range, electrocardiographic features, and hemodynamic changes. Mitral valve replacement produced a greater and more consistent reduction in the left ventricular outflow tract pressure gradient than a ventricular septal procedure (MVR, 68.3 mm Hg preoperatively and 2.5 mm Hg postoperatively; ventricular septal procedure, 60.1 mm Hg preoperatively and 13.4 mm Hg postoperatively). This was associated with better postoperative ventricular configuration in diastole and more apparent loss of midcavity narrowing in systole. Ejection fraction did not fall after a ventricular septal procedure but decreased significantly from a mean of 79% to a mean of 61% after MVR. Similarly, left ventricular end-diastolic pressure remained unchanged after a ventricular septal procedure but fell from a mean of 26.6 mm Hg to 17 mm Hg after MVR. Although both groups experienced a generally satisfactory symptomatic result, this appeared more reliable with MVR. We suggest that MVR offers a more predictable improvement than a ventricular septal procedure and may be the procedure of choice for units with limited experience with ventricular septal procedures.

Adolescent↗
PubMed1988

Potential contribution of mild pepsin treatment at pH4 to the viral safety of human immunoglobulin products.

Different manufacturers use several different processes for the production of intravenous immunoglobulin. Several manufacturers include a production step where the immunoglobulin is treated with low levels of pepsin at pH 4. A series of experiments were undertaken to assess whether or not pH 4/pepsin treatment could inactivate a range of test viruses. Acid-labile viruses such as vaccinia, herpes simplex, mumps and Semliki Forest virus were found to be susceptible to pH 4/pepsin treatment whereas poliovirus type 2, an acid-stable virus, was completely resistant to this treatment. In immunoglobulin preparations, viral contaminants are likely to be present as antibody/virus complexes and such complexing was found to help protect the test viruses from inactivation by pH 4/pepsin treatment. Despite this protection, at least 99% of the test inoculum of two susceptible viruses (vaccinia and herpes simplex) was found to be inactivated after treatment and the subsequent dissociation of virus/antibody complexes. It is concluded that pH 4/pepsin treatment may contribute to the safety of intravenous IgG by inactivating potential viral contaminants.

Antibodies, Viral↗
PubMed1988

Surgical management of left ventricular aneurysm and diffuse coronary artery disease: immediate and long term results in patients receiving three or more grafts.

Because little information is available concerning the outcome of surgery for left ventricular aneurysm when multiple concurrent coronary grafts are required, we have reviewed 35 consecutive patients undergoing aneurysm surgery and multiple (greater than or equal to 3) grafts between December 1973 and April 1984. There were 6 operative deaths (17%). All occurred amongst those (16) undergoing LV plication procedures with no deaths amongst those (19) undergoing aneurysm resection (p less than 0.01). Operative mortality was not influenced by preoperative functional status, left ventricular end diastolic pressure, completeness of revascularisation, endarterectomy (13 patients) or whether cold crystalloid cardioplegia or intermittent aortic cross clamp with ventricular fibrillation was used. Overall 5-year actuarial survival was 70% with survival beyond surgery being 84% to 5 years and independent of the type of aneurysm procedure. Of the survivors, 16 were improved by 1-3 functional classes, 3 were unchanged and one was worse. Surgery in this group of patients offers the prospect of good symptomatic improvement and survival figures which at least equal the results of less complex ventricular aneurysm surgery and exceed those reported for medical management.

Adult↗
PubMed1987

The viral safety of intravenous immunoglobulin.

Human immunoglobulin for intravenous (IV) use has an established safety record with regard to transmission of hepatitis B virus. The bulk of available evidence also suggests that the human immunodeficiency virus (HIV) is not transmitted by IV immunoglobulin. There has been one report, however, of isolation of HIV from two patients with hypogammaglobulinaemia who had been treated with several immunoglobulin products. Certain IV immunoglobulin products have transmitted non-A, non-B (NANB) hepatitis but careful clinical assessment of recipients of other products suggests that non-infective preparations can be made. Interpretation of available data most likely to be correct is that contamination with NANB is reduced but not eliminated by cold-ethanol fractionation and that the use of further virucidal procedures in the finishing of immunoglobulin products will confer a higher degree of safety.

Animals↗
PubMed1986

Truncus arteriosus: successful surgical correction without the use of a valved conduit.

A new operation for the restoration of continuity between the right ventricle and pulmonary circulation in truncus arteriosus in infancy without the use of a tube graft is described. This was achieved by anastomosing the inferior margin of the detached confluent branch pulmonary arteries to the apex of a vertical infundibular ventriculotomy to form the posterior wall of the reconstructed right ventricular outflow tract. A patch of pericardium was used to form the anterior wall and complete the primary cardiac repair.

Female↗
PubMed1985

Correlation of cell-envelope phenotypes of Neisseria gonorrhoeae with site of infection and serogroup.

The envelope phenotypes and coagglutination (CoA) W serogroups of 301 unselected clinical isolates of Neisseria gonorrhoeae were studied. Of the 287 isolates from infections acquired in the Edinburgh area, 252 (88%) were of the wild-type phenotype, 17 (6%) were of Env phenotype with increased permeability of the cell envelope, and 18 (6%) were of Mtr phenotype with reduced permeability of the cell envelope. Mtr strains were isolated significantly more often from homosexual men than from heterosexual men and women (p less than 0.001). Of the isolates from homosexual men there were considerably fewer Mtr phenotypes among rectal isolates than among urethral and throat isolates. All isolates from homosexual men, 57% from heterosexual men and 52% from women were of CoA serogroup WII (including WII/WIII). Although the Mtr phenotype was strongly associated with serogroup-WII isolates from homosexual men, there was no such correlation between the Mtr phenotype and serogroup-WII isolates from heterosexual patients. It is suggested that hydrophobic compounds in the rectal environment are not the major factor in selecting serogroup-WII strains of Mtr phenotype associated with homosexually acquired infection. The hypothesis that the Mtr phenotype and serogroup WII are selected independently as a result of a more general selective pressure such as antibiotic usage, common to all infected sites, is discussed.

Agglutination Tests↗
PubMed1984

Successful cardiopulmonary bypass in diabetics with anaphylactoid reactions to protamine.

Two insulin dependent diabetics with previous anaphylactic like (anaphylactoid) reactions to protamine underwent successful cardiopulmonary bypass for coronary artery surgery. Platelet concentrates instead of protamine were used to neutralise their systemic heparinisation. In both cases the anaphylactoid reactions first became apparent after administration of protamine sulphate at the end of cardiac catheterisation. These cases show that adverse reactions to protamine need not be a contraindication to cardiopulmonary bypass and cardiac surgery and emphasise that this condition should be considered in all patients with a history of previous protamine exposure or one which may be associated with anaphylactoid reactions to protamine.

Adult↗
PubMed1984

Immunological identification of Neisseria gonorrhoeae with monoclonal and polyclonal antibody coagglutination reagents.

The reliability of immunological identification of Neisseria gonorrhoeae using polyclonal and monoclonal antibody coagglutination reagents has been evaluated. When clinical isolates of neisseriae were tested in an "in use" trial the sensitivity and specificity of each reagent were similar and the overall agreement with carbohydrate utilisation was 97.9% (141/144) for the polyclonal antibody reagent and 97.2% (140/144) for the monoclonal reagent. When results of testing 13 stock cultures of N lactamica and five stock cultures of beta-lactamase producing Branhamella catarrhalis were combined with the results for clinical isolates of non-gonococcal neisseriae the agreement with carbohydrate utilisation was 86.5% (64/74) for the polyclonal reagent and 97.3% (72/74) for the monoclonal reagent: this difference is statistically significant at the 5% level. Calculation of positive and negative predictive values showed differences in the reliability of the coagglutination reagents when testing Gram negative diplococci isolated from various anatomical sites. The value and limitations of the polyclonal and monoclonal reagents were similar with respect to anogenital isolates: N gonorrhoeae was confirmed by a positive result but not excluded by a negative result. The monoclonal reagent was superior for testing throat isolates; although a negative result with either reagent confirmed Gram negative diplococci as non-gonococcal neisseriae, a positive result with the monoclonal reagent was more reliable (predictive value 93%) than a positive result with the polyclonal reagent (predictive value 86%).

Agglutination Tests↗
PubMed1984

Serogrouping Neisseria gonorrhoeae: correlation of coagglutination serogroup WII with homosexually acquired infection.

With coagglutination reagents prepared against W antigens, 205 clinical isolates of Neisseria gonorrhoeae were classified into three serogroups WI, WII, and WIII. Of 195 strains isolated from patients who acquired their infection in the Edinburgh area, 85 (44%) belonged to serogroup WI and 110 (56%) to serogroup WII. Serogroup WII accounted for 90% of all isolates from homosexual men and for 34% and 47% of isolates from heterosexual men and women respectively (p less than 0.001). In homosexual men serogroup WII predominated regardless of the anatomical site from which the strain was isolated, and accounted for 94% of rectal, 90% of urethral, and 81% of pharyngeal isolates.

Agglutination Tests↗
PubMed1975

Alpha-methyl-L-glutamic acid uptake by high affinity dicarboxylic amino acid transport system in Streptococcus faecalis.

The transport of alpha-methyl-L-glutamic acid was studied in Streptococcus faecalis. Energey-dependent uptake against substantial concentration gradients was observed. Kinetic experiments indicated that, in contrast to L-glutamic acid, only a single catalytic component (high affinity) and a diffusion controlled process participated in alpha-methyl-L-glutamic acid uptake. At concentrations up to 10 mM, alpha-methyl-glutamate transport was almost completely abolished in a mutant strain lacking a high affinity dicarboxylic amino acid transport system. In competition experiments, alpha-methylglutamic acid antagonized glutamate uptake via the high affinity system, and only slightly via the low affinity system. Column chromatography of cell extracts showed that very little (approx. 5%) of the accumulated amino acid was converted to metabolites during short term incubations. These studies indicate that, at concentrations up to 3-5 mM, alpha-methyl-L-glutamic acid can be used as a specific, relatively metabolically inert substrate of the high affinity dicarboxylic amino acid transport system in S. faecalis.

Amino Acids, Dicarboxylic↗