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Biomedical subjects

M Wilkins

Publications and source records attributed to M Wilkins.

17 recordsLinked to original sources
PubMed1991

Selective alpha 1-adrenoreceptor blockers in the treatment of hypertension: should we be using them more?

It has become apparent in recent years that in the treatment of essential hypertension, reduction of blood pressure alone is not sufficient to reduce significantly the morbidity and mortality from ischaemic heart disease. Since the emergence of a multifactorial approach to the prevention of cardiovascular disease, the potential interaction between antihypertensive therapy and metabolic factors, such as control of blood glucose and lipid levels, has become an important consideration. Abnormal function of the sympathetic nervous system may contribute to both the initiation, or maintenance, of hypertension and the associated metabolic disturbances. The new generation of selective alpha 1-adrenoreceptor blockers, besides lowering blood pressure, appear to have favourable effects on lipid and glucose metabolism. The use of these drugs and their place in the treatment of hypertension are discussed.

Adrenergic alpha-Antagonists↗
PubMed1991

Mast cells in the female genital tract.

Mast cells in the human uterus and adnexa have been studied using basic lead acetate fixation and a long toluidine-blue technique to maximise the numbers of cells stained. Counts were performed on measured areas of tissue and the numbers of mast cells related to clinical and pathologic variables. Considerable variation in numbers was found among individual cases at all the sites studied. In the endometrium and myometrium, a drop in the number of mast cells has been demonstrated with advancing age, particularly after menopause. In leiomyomas the highest counts were in the smaller and more cellular lesions. It is concluded that the numbers of mast cells are at least partly related to the degree of cellularity or atrophy of the surrounding tissues. No significant association was found with menorrhagia or with the presence of leiomyomas.

Adnexa Uteri↗
PubMed1989

Relationship between ANP, cyclic GMP and tissue kallikrein following saline infusion in healthy volunteers.

Infusion of saline in healthy volunteers produced a significant rise in plasma atrial natriuretic peptide, which was accompanied by the urinary excretion of cyclic GMP and sodium. Although the time-course of cyclic GMP excretion almost mirrored that of plasma ANP, that of sodium showed sustained phase, indicating involvement of additional humoral regulators. ANP did not stimulate the excretion of enzymic or immunoreactive tissue kallikrein.

Adult↗
PubMed1988

Intravenous diltiazem worsens regional function in compromised myocardium.

The effect of intravenous diltiazem on regional myocardial function was assessed in a canine model of critical constriction of the left anterior descending coronary artery (LAD). Maintenance anesthesia with fentanyl (1.5 micrograms.kg-1.min-1), 60% inspired nitrous oxide, and 0.7% inspired halothane resulted in regional dysfunction, measured as postsystolic shortening (20.6 +/- 10.7%), which was significantly worsened after 0.1 mg/kg (48.7 +/- 12.5%, P less than 0.05) and after 0.2 mg/kg (68.8 +/- 11.7%, P less than 0.05) intravenous diltiazem. Systolic shortening in the compromised LAD territory was substantially depressed after 0.1 mg/kg diltiazem (8.2 +/- 0.6% to 5.3 +/- 1.3%, P less than 0.05) and was essentially abolished after 0.2 mg/kg diltiazem (8.2 +/- 0.6% to 0.7 +/- 2.3%, P less than 0.05). At the higher dose of diltiazem, cardiac output was substantially decreased (1.37 +/- 0.23 L/min to 0.88 +/- 0.30 L/min, P less than 0.05) and LV dP/dtmax significantly depressed (1090 +/- 90 mm Hg/sec to 744 +/- 80 mm Hg/sec, P less than 0.05). These results demonstrate significant depression of regional systolic shortening and substantial worsening of regional dysfunction in myocardium with a compromised blood supply, in association with significant depression of left ventricular performance, with intravenous diltiazem administration during anesthesia.

Anesthesia, Inhalation↗
PubMed1986

Length of follow-up in teratomas--results of a modification of Einhorn's regime in testicular teratomas.

A modification of Einhorn's original chemotherapy schedule was used to treat 40 patients with metastatic testicular teratomas. Each cycle of chemotherapy consisted of cisplatin (100 mg/m2), bleomycin (30 mg X 3) and vinblastine (5 mg/m2 X 2). Four patients failed to achieve a complete response and died with advanced disease. There was one treatment death. Only two of 14 patients who had residual masses resected still had active tumour. The 2-year actuarial disease free survival for patients in first remission was 85%, but this fell to 77% at 5 years as 3 patients relapsed (34, 36, 37 months). The results are comparable with other series but are associated with less toxicity. The need for continued follow-up is demonstrated in view of relapses occurring after 2 years.

Aged↗
PubMed1984

Motion sickness susceptibility in student navigators.

Identification of individuals highly susceptible to motion sickness could be of significant benefit in managing flying personnel in training. Several studies in the past four decades with this end have been primarily aimed at pilot trainees. The following study is a prospective evaluation of airsickness in Air Force navigation students. Motion Sickness Questionnaires and Minnesota Multiphasic Personality Inventories were given to the students at the beginning of navigator training. Airsickness was assessed by means of questionnaires and evaluation by a flight surgeon. Motion sickness among navigation trainees was found to be quite common. However, prediction of susceptible individuals by methods used was not reliable. Further investigation of airsickness susceptibility in navigation students by means of physiologic techniques is suggested.

Adult↗
PubMed1983

Lack of evidence for polymorphism in metoprolol metabolism.

The claim for polymorphism in the metabolism of metoprolol is based on a logical fallacy. A frequency distribution of metoprolol AUC data is presented and, although highly skewed, no evidence of more than a single population is apparent. Plasma and urine metoprolol and metabolite data are also presented to support this.

Acebutolol↗
PubMed1981

A study of amyloid arthropathy in multiple myeloma.

Forty-three patients with classical multiple myeloma were studied to assess the prevalence and characteristics of amyloid arthropathy using clinical, radiological, and histological methods. Two patients were found to have amyloid arthropathy, and a third case is described in detail. Complement and cryoprecipitate analysis of the synovial fluid, and electronmicroscopy of the synovium, synovial debris and cartilage were undertaken in an attempt to shed further light onto the pathogenesis of what has hitherto been regarded as a rare complication of multiple myeloma. Complement components were not depressed and no evidence of specific light chain containing immune complexes was found in synovial fluid cryoprecipitates. Histochemical and electron microscopic localization of amyloid in perichondrocytic lacunae as well as in synovial fluid debris, synovium and the articular cartilage surface suggest the possibility that chondrocytes and synovial macrophages may share a role in processing immunoglobulin components as a prelude to the formation of amyloid fibrils. Amyloid arthropathy occurs in about 5 per cent of patients with multiple myeloma. The clinical picture can resemble rheumatoid arthritis with median nerve compression in the carpal tunnel and symmetrical arthritis of the wrists and small joints of the hands. Diagnosis can be established by examination of Congo red stained synovial fluid sediments under polarized light even in the absence of other clinical features of amyloidosis and when rectal biopsy is negative.

Aged↗
PubMed1980

A comparison between midline and mediolateral episiotomies.

A randomised prospective study of 407 primiparous patients compared the consequences of midline and mediolateral episiotomies. The patients' estimates of the pain from their episiotomies were similar. Anal sphincter injury was significantly more common after a midline procedure but no rectovaginal fistulae occurred. Scarring was less noticeable after the midline incision and intercourse began earlier.

Adult↗
PubMed1979

The effect of gold salts on the phagocytic activity of synovial macrophages in organ culture.

The effect of the gold salt, gold sodium thioglucose, has been studied on the phagocytic activity of tissue macrophages in synovium excised from patients with rheumatoid arthritis (RA) and maintained as explants in organ culture. Specimens of synovial membrane were taken for culture from synovial tissue excised from the knee joints of 22 patients with RA undergoing surgery and 14 menisectomy controls. Glass coverslips coated with yeast were placed on the synovium and the specimens maintained in organ culture. The phagocytic activity was assessed by counting the percentage of macrophages containing yeast on the coverslip removed after 24 hr in culture. The effect of gold salts was assessed by adding gold sodium thioglucose at concentrations of 3 and 30 microgram/ml to the medium, and using sodium thioglucose as an additional control. Results (means %) indicated significantly higher phagocytic activity in RA macrophages (68.6) compared with controls (40.1), p smaller than or equal to 0.001. Gold thioglucose significantly suppressed phagocytosis at 3 microgram/ml (48.0) p smaller than 0.01, and at 30 microgram/ml (47.7) p smaller than 0.02 in RA but had not effect on control synovium. Sodium thioglucose had no significant effect on phagocytosis at either concentration on RA synovium.

Arthritis, Rheumatoid↗
PubMed1977

Transferrin iron uptake by human synovium.

55Fe-labelled transferrin was injected into the synovial fluid before synovectomy in 6 patients with rheumatoid arthritis. The results show that transferrin iron is taken up by synovial macrophages.

Arthritis, Rheumatoid↗