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Biomedical subjects

P Kay

Publications and source records attributed to P Kay.

At least 37 records · Page 2Linked to original sources
PubMed1985

Emergency coronary artery bypass surgery after intracoronary thrombolysis for evolving myocardial infarction.

Sixteen patients underwent emergency coronary artery bypass surgery immediately after intracoronary streptokinase infusion for acute evolving myocardial infarction. Of these, 11 patients had 70% residual stenosis in the recanalised vessel, and in five thrombolysis was unsuccessful. There were no hospital deaths. All the patients sustained myocardial necrosis, the peak activity of creatine phosphokinase correlating with the time to reperfusion. Chest tube drainage (mean 960 ml) was significantly higher than for control patients but did not correlate with the total dosage of streptokinase. No patients had further myocardial infarction or developed recurrent angina. Selected patients may benefit from coronary bypass surgery after intracoronary streptokinase infusion. If necessary this may be performed immediately with low mortality and morbidity.

Adult↗
PubMed1985

CR1 deficiency in SLE: acquired or genetic?

Erythrocytes from 30 patients suffering from systemic lupus erythematosus (SLE) were tested for CR1 activity by an immune adherence haemagglutination technique. Defective CR1 activity (CR1D) was found in 11 (37%) of the patients on initial testing. On repeat testings, however, CR1 activity often varied from time to time and was shown to be inversely related to serum anti-DNA binding and apparent complement activation in vivo. Two of the 19 patients with normal CR1 activity acquired CR1D during the study. One patient with previously defective CR1 attained normal activity in the course of the study. The increased occurrence of CR1D in patients with SLE is largely or wholly acquired rather than genetically determined.

Adolescent↗
PubMed1985

Antiacetylcholine receptor and antinuclear antibodies in myasthenia gravis. Correlation with HLA, sex and Gm.

Sera from 27 subjects with myasthenia gravis (MG) were examined by immunoassay for antibodies to double-stranded DNA (ds-DNA), RNA-nucleoprotein complexes (ENA) and acetylcholine receptor (ACHR). The prevalence of the genetic markers of sex, HLA and Gm were analyzed in relation to various parameters of these autoantibodies. The highest levels of ds-DNA antibodies were associated with HLA B8 as compared to other HLA antigens (p less than 0.05), females as compared with males (p less than 0.05), and females with HLA B8 (p less than 0.05) when both sex and HLA were analyzed concurrently. An association between low titers and HLA B7 (p less than 0.05), with a significant difference between the B8 females and B7 males (p less than 0.05) was also noted. By contrast, no Gm association was noted for antinuclear antibody parameters, but was observed in females between high ACHR antibody titers and the homozygous phenotype (3; 5, 13) (p less than 0.05). This study of MG implicated HLA and sex factors in the production of a broad spectrum of antinuclear antibodies, while the contrasting Gm association noted with ACHR antibody titers was indicative of distinctive immunogenetic influences over autoantibody production in MG.

Adult↗
PubMed1984

Abuse of a fire-extinguishing agent and sudden death in adolescents.

Two cases of abuse of bromochlorodifluoromethane (BCF - a fire-extinguishing agent) by inhalation are reported. In the first case, a 15-year-old youth presented in ventricular fibrillation; the second youth was dead on arrival at hospital. Port-mortem toxicological investigations confirmed BCF inhalation in the latter patient. Management of the surviving patient included cardioversion, controlled mandatory hyperventilation, intravenous infusions of mannitol, and barbiturate protection against cerebral ischaemia. He had completely recovered after eight days. Community agencies report that BCF inhalation occurs frequently on the Gold Coast, Queensland. This behaviour can be associated with sudden death from ventricular arrhythmias after cardiac sensitization to endogenous adrenaline. The "lone sniffer" is at greatest risk, and identification of such individuals may prevent a fatal outcome.

Adolescent↗
PubMed1983

The microheterogeneities of thyroxine-binding globulin and alpha 1 protease inhibitor (alpha 1-antitrypsin) are interrelated.

Addition of 125I-thyroxine to serum allows autoradiography for thyroxine-binding globulin microheterogeneity to be carried out after isoelectric focusing has been performed to display (by protein stain) the heterogeneous bands of the alpha 1-antitrypsin (PI) system. Comparison of the protein stain for PI with the autoradiograph for thyroxine-binding globulin indicates that these two systems are interrelated with the major bands of the PI system corresponding to the bands on the autoradiograph. This correspondence holds for PI variants other than the common M type and in particular it holds for the deficient Z type in which the autoradiograph for thyroxine-binding globulin is strikingly different from normal. We conclude that the major cause of microheterogeneity of TBG is due to an association with the PI system under the conditions of isoelectric focusing as normally performed. Precipitation experiments with antisera to PI and TBG suggest that the complex between these biologically important globulins may occur under conditions other than isoelectric focusing, but further work will be needed to examine this possibility.

Chemical Phenomena↗
PubMed1979

Hepatitis Bs antibody in alcoholic cirrhosis.

Sera from patients with chronic liver disease were tested for antibody against hepatitis B surface antigen by radioimmunoassay. The antibody was found in 25% of patients with alcoholic cirrhosis and in 52% when alcoholic cirrhosis was associated with portal hypertension, these results being significantly higher than in a matched control population. Other forms of chronic liver disease did not differ from the control population. Hepatitis B virus infection might be a factor in determining which alcoholic patients go on to develop chronic liver disease and cirrhosis.

Antibodies, Viral↗
PubMed1979

Antibodies to the acetylcholine receptor in myasthenic dogs.

Antibodies to the AChR and anti-striational antibodies have been detected in dogs suffering from myasthenia gravis. The detection of these antibodies adds to the known similarities between the human and canine disease. This animal model will facilitate investigation of agents involved in the induction of spontaneous myasthenia gravis.

Acetylcholine↗
PubMed1977

The assessment of late effects on a population exposed to activity released into the environment.

The long term effects resulting from an accidental release of radioactive material are considered. The magnitude of the release is defined in terms of the percentage of total excess cancer mortalities relative to the number that would have been expected in the same population had the accident not occurred. The increased risk is expressed as the change in life expectancy as a function of age at the time of exposure. Loss of life-years per person is calculated for an increase of 0.1, 1, 10 and 100% in cancer deaths and are quoted for ages 1, 10, 20, 30, 40 and 50 years at time of exposure. The variation of the effect with age may be summarised using the ratio of the reduced life expectancy to the reduced life expectancy for a person aged zero at the time of the accident. For the initial external dose, this ratio exhibits a linear decrease up to about age 45 years at the rate of about 2% per year so, for example, the increased risk for a person aged 40 at exposure is 20% of the increased risk of a child just born. Similar estimates are made for a dose which is prolonged over 50 years, to represent doses from internally incorporated radionuclides.

Accidents↗
PubMed1976

The observation and analysis of cancer deaths among classified radiation workers.

The extent to which occupational radiation exposure contributes to cancer mortality is an influence on future world energy policy. It is also a factor in deciding the level of expenditure to reduce radiation levels experienced by workers. Here we discuss some of the difficulties in analysing the situation and present the results of some calculations which estimate the expected age-specific radiation mortalities from all inducible cancers and also from leukaemia separately. Using a high value for the average occupational exposure and a conservative estimate of the associated risk, we find that a survey of mortality among radiation workers must run over many years before sufficient data would be accumulated to resolve the effects of radiation-induced neoplasms from those arising from other causes. We show the advisability of determining the cause of death both of persons who remain employed in the industry and all for only a short time. Our estimates are based on maintenance of an occupationally exposed dose of one rad per person per year during the period of the survey which may extend over several decades. However, scaling of the estimates to any other exposure rates is easily performed. We also give estimates of the lowest risk coefficients detectable in a given observation time. Since for a work force of 3000 these lowest detectable values are an order of magnitude larger than those expected, it is clear that only a national or international survey can produce data adequate for even modest objectives.

Dose-Response Relationship, Radiation↗