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Biomedical subjects

W Kelly

Publications and source records attributed to W Kelly.

At least 37 records · Page 2Linked to original sources
PubMed1995

Improved competitive enzyme immunoassay for the diagnosis of bovine brucellosis.

A modification of the competitive enzyme-linked immunosorbent assay (C-ELISA) for differentiating the antibody response of cattle vaccinated with Brucella abortus strain 19 and B. abortus infected cattle is described. This assay utilizes lipopolysaccharide as the antigen, immobilized on a polystyrene matrix, and a monoclonal antibody (M84) with specificity for an epitope of the O-polysaccharide. A goat anti-mouse IgG antibody-enzyme conjugate is used for detection. The specificity of the modified assay was 99.7% when 1446 sera from brucellosis free herds were tested and it correctly identified 636 sera from B. abortus infected cattle as positive, using a cut-off of 30% inhibition, for a sensitivity estimate of 100%. No reactions were noted among 261 sera from vaccinated cattle. However, in testing 1147 sera that gave positive reactions in the buffered plate antigen test, the indirect ELISA, the complement fixation test or a combination of these tests from the serum bank, 31 gave positive reactions. Twenty-seven of the 31 sera originated from recently vaccinated cattle. The overall specificity for sera from vaccinated cattle was 97.3%. Because of the sensitivity and specificity of this procedure and its ease of performance, it would be a reasonable alternative as a single assay for serological diagnosis of brucellosis.

Animals↗
PubMed1994

[An outbreak of methicillin-resistant Staph aureus in a nursing home].

The introduction of methicillin-resistant Staphylococcus aureus (MRSA) in an Amsterdam nursing home (312 beds) by a patient discharged from a local hospital, the spread of this strain to other residents and staff of the nursing home and the actions taken to prevent this spread are described. During the period when this MRSA strain was circulating residents and staff members were checked periodically for presence of MRSA. In spite of all preventive measures as implemented in Dutch hospitals (including isolation of infected residents) additional residents (in a total of 8) and staff members acquired the MRSA strain. Relaxation of the precautions (no more isolation) and continued instruction of the members of the staff was attended by a decrease of further contamination. Four of 8 residents died while being colonised or infected. The course of this epidemic illustrates that limited precautions and proper training of staff in hygiene can restrict spread of MRSA in nursing homes.

Aged↗
PubMed1994

The use of divalent cation chelating agents (EDTA/EGTA) to reduce non-specific serum protein interaction in enzyme immunoassay.

An indirect enzyme immunoassay (ELISA) for detection of bovine antibody to Brucella abortus was modified by the addition of divalent chelating agents to the serum diluent. This addition resulted in an increase in specificity from 96.0% in the regular assay to 99.4% in the modified procedure. Of the 15,715 sera initially tested by the indirect ELISA, 691 that had given positive reactions were selected for retesting in the indirect ELISA with EDTA/EGTA added. The buffered plate antigen test (BPAT) correctly identified 98.6% of the samples as negative. The addition of chelating agents did not alter the sensitivity of the indirect ELISA, which correctly classified 609 sera from animals from which B. abortus had been isolated as positive. The sensitivity of the BPAT was 97.8%.

Agglutination Tests↗
PubMed1992

Fulminant primary Pseudomonas aeruginosa pneumonia and septicaemia in previously well adults.

We report two cases of primary, community acquired, Pseudomonas aeruginosa pneumonia, occurring in previously well adults without any recognisable environmental risk factors. Both patients died within 36 h of the onset of symptoms, despite broad spectrum antibiotics and aggressive supportive care. In neither case was the diagnosis considered in life and neither patient received adequate anti-pseudomonas therapy. Heightened awareness of this rare, fulminant, variant of primary Pseudomonas pneumonia is required if specific anti-pseudomonas therapy is to have any impact on outcome.

Adult↗
PubMed1991

Comparison of the PREMIER cryptococcal antigen enzyme immunoassay and the latex agglutination assay for detection of cryptococcal antigens.

A new enzyme immunoassay (EIA), PREMIER Cryptococcal Antigen, was compared with latex agglutination (LA) for the detection and quantitation of circulating capsular polysaccharide antigen from Cryptococcus neoformans. The clinical evaluation of PREMIER EIA as a screening assay, including 475 specimens with 120 LA and EIA positives, resulted in 99% sensitivity and 97% specificity. The clinical specimens included sera and cerebrospinal fluids as well as 10 rheumatoid factor-positive and 20 anti-nuclear antibody-positive serum samples. This monoclonal antibody-based assay detects serotypes A to D at 0.63, 0.63, 7.8, and 62 ng/ml, respectively. With three different known positive specimens, the assay was found to yield coefficients of variation of 2 to 12% for intra- and interassay comparisons of precision and reproducibility. The primary use for semiquantitative values derived with the LA or EIA is to follow the course of disease and monitor drug therapies. The present data suggest that the PREMIER EIA will be a valuable method for this purpose. We conclude that the PREMIER Cryptococcal Antigen EIA provides a rapid, convenient, and reliable antigen detection method for screening and semiquantitative determination of antigen levels.

Antibodies, Monoclonal↗
PubMed1989

Testicular enlargement and elevated serum inhibin concentrations occur in patients with pituitary macroadenomas secreting follicle stimulating hormone.

We studied four male patients with pituitary macroadenomas. Before treatment all had high serum FSH concentrations, but LH and testosterone were normal or subnormal; all patients were found to have large testes. All had had normal sexual function, and three patients had fathered children. After pituitary surgery there were decreases in serum gonadotrophins and testosterone, which were accompanied by decreases in testicular volumes. hCG stimulation tests in two patients showed normal responses of testosterone and oestradiol, confirming normal Leydig cell function. Inhibin levels were increased in two patients studied when FSH levels were high, suggesting a defect in gonadal-pituitary feedback control. Later, as FSH concentrations decreased to normal, so did inhibin levels. Histology showed that increased testicular size was due to increased lengths of seminiferous tubules. The association of pituitary macroadenomas, large testes and increased serum inhibin has not been reported previously. Assessment of testicular size in patients with raised serum FSH is important, since enlarged testes suggest the likely pathogenesis is that of a pituitary gonadotrophinoma, rather than primary gonadal failure. Increased inhibin levels may then confirm this, and be a biochemical marker for these tumours.

Adenoma↗
PubMed1989

Histochemical characterization and functional significance of the hyperintense signal on MR images of the posterior pituitary.

MR imaging of the pituitary fossa characteristically shows a well-circumscribed area of high signal intensity in the posterior lobe on T1-weighted images. We used a combination of high-field MR, electron microscopy, and histologic techniques in experimental animals to determine whether the hyperintensity of the posterior lobe might be functionally related to hormone neurosecretory processes, and to attempt to establish its chemical nature. Histologic sections of a dog's pituitary gland processed with lipid-specific markers showed intense staining in the posterior lobe but not in the anterior lobe, thus documenting the location of fat in the posterior pituitary. Administration of vasoactive drugs known to influence vasopressin secretion to anesthetized cats produced changes in the volume of high-intensity signal in the posterior pituitary. Subsequent electron microscopy showed a significant increase in posterior lobe glial cell lipid droplets and neurosecretory granules in dehydration-stimulated cats. The data suggest that the pituitary hyperintensity represents intracellular lipid signal in the glial cell pituicytes of the posterior lobe or neurosecretory granules containing vasopressin. The volume of the signal may, in turn, reflect the functional state of hormonal release from the neurohypophysis.

Animals↗
PubMed1989

Diurnal weight gain among patients with mental retardation.

We compared the diurnal weight gain of 46 patients with mental retardation to that of 21 patients with organic mental syndromes. They were weighed at 7 a.m. and 4 p.m. weekly for 3 weeks. We normalized the diurnal weight gain as a percentage by subtracting the 7 a.m. weight from the 4 p.m. weight, multiplying the difference by 100, and dividing the result by the 7 a.m. weight. Normalized diurnal weight gain was abnormal among one fourth of patients with mental retardation and two thirds of those with organic mental syndromes. Differences in age, sex, baseline weight, antipsychotic drugs, lithium, carbamazepine, blood pressure, and pulse did not explain our results. We believe that our findings provide additional evidence to separate patients with mental retardation from those with psychosis.

Adult↗
PubMed1989

Vasopressin secretion in the DIDMOAD (Wolfram) syndrome.

The diabetes insipidus which accompanies the DIDMOAD (Wolfram) syndrome is thought to be hypothalamic in origin, though no formal study of vasopressin secretion in the syndrome has been published, and some data in the literature suggest a renal tubular defect. We have studied vasopressin secretion in seven patients with the Wolfram/DIDMOAD syndrome during three dynamic stimuli: an osmotic stimulus (hypertonic saline infusion), hypoglycaemia (insulin tolerance test) and a baroregulatory stimulus (trimetaphan infusion). Hypertonic saline infusion demonstrated three patients to have complete and four to have partial hypothalamic diabetes insipidus; administration of (per nasal) desmopressin excluded nephrogenic diabetes insipidus in all seven patients. Insulin hypoglycaemia failed to stimulate vasopressin release, but trimetaphan-induced hypotension produced significant though subnormal rises in plasma vasopressin in three patients with partial diabetes insipidus, though it produced a negligible rise and no rise in plasma vasopressin in two patients with complete diabetes insipidus. The data suggest a much greater frequency of hypothalamic diabetes insipidus in the Wolfram/DIDMOAD syndrome than is reported, but did not identify nephrogenic diabetes insipidus. The absence of vasopressin responses to non-osmotic stimuli in patients with complete diabetes insipidus suggests global lack of vasopressin secreting neurones, rather than an isolated osmoreceptor defect or selective vasopressin secreting neuronal loss, as the lesion producing diabetes insipidus in the DIDMOAD syndrome.

Adult↗
PubMed1988

Long-term treatment of Nelson's syndrome with sodium valproate.

Eleven patients with Nelson's syndrome were given sodium valproate (Epilim, Sanofi). Plasma ACTH and cortisol levels were measured under carefully controlled conditions which were designed to eliminate spontaneous fluctuations in ACTH. At 6 weeks all 11 patients were reassessed while taking sodium valproate 600 mg/day; there was then a small but significant (P less than 0.05) reduction in plasma ACTH concentration. Six patients continued to take sodium valproate, and were reassessed at 1 year when five were taking 1200 mg/day and one patient was taking 600 mg/day. At 1 year for these six patients there had been an increase in mean plasma ACTH which was then not significantly different from basal values. The five patients who discontinued sodium valproate were also reassessed at 1 year, when there were no significant differences compared to basal or 6-week values. During therapy with sodium valproate, there were no significant changes in the half-life of plasma cortisol, plasma sodium and potassium concentrations, or serum liver enzymes. Weight gain on sodium valproate was the main reason for patients asking to discontinue therapy. Sodium valproate is not an effective long-term therapy for reducing plasma ACTH for patients with Nelson's syndrome.

Adolescent↗
PubMed1987

Application of a bovine cervical mucus penetration test.

One hundred seventy-eight ejaculates obtained from infertility patients were evaluated by routine semen analysis and by a bovine cervical mucus penetration test (BCMPT). A significant correlation (p less than 0.01) was observed between mucus penetration and both sperm count (r = 0.349) and sperm motility (r = 0.394). One hundred fifty-two of 178 patients (85%) had normal sperm counts (greater than 20 x 10(6)/ml). Of these patients, 68% had good (greater than 30 mm), 26% had questionable (21-30 mm), and 7% had abnormal (less than 20 mm) penetration values. One hundred sixty-one of 178 patients (90%) had normal sperm motilities (greater than 40%). Of these patients, 71% had good, 25% had questionable, and 4% had abnormal penetration values. Conversely, 46% and 18% of patients with abnormal sperm count and motility, respectively, had normal penetration values (greater than 30 mm). A significant relationship (p less than 0.05) was observed between the BCMPT and pregnancy problems not apparent by semen analysis data, and may prove to be a useful adjunct to the use of routine semen analysis in evaluating male fertility.

Animals↗
PubMed1987

Bilateral carotid body tumors managed with preoperative embolization: a case report and review.

A patient with large bilateral carotid body tumors had preoperative, superselective embolization of major arterial afferent vessels. After marked reduction in tumor vascularity, total surgical extirpation was then possible without significant morbidity or carotid sacrifice. The use of preoperative embolization in the treatment of large bilateral lesions is emphasized and discussed.

Adult↗
PubMed1986

Cholinergic neurons and fibres in the rat visual cortex.

Choline acetyltransferase (ChAT), the acetylcholine synthesizing enzyme, was localized immunocytochemically in neurons and fibres in the rat visual cortex using a monoclonal antibody. ChAT-labelled cells were non-pyramidal neurons, primarily of the bipolar form, distributed in layers II through VI but concentrated in layers II & III. Their perikarya contained a large nucleus and a small amount of perinuclear cytoplasm. The somata and dendrites of all labelled cells received Gray's type I and type II synapses. ChAT-stained axons formed a dense and diffuse network throughout the visual cortex and particularly in layer V. Electron microscopy revealed that the great majority formed type II synaptic contacts with dendrites of various sizes, unlabelled non-pyramidal somata and, on a few occasions, with ChAT-labelled cells. However, a very small number of terminals appeared to form type I synaptic contacts. This study describes the morphological organization of the cholinergic system in the visual cortex, the function of which has been under extensive investigation.

Animals↗
PubMed1986

Pulmonary veno-occlusive disease. A report of four cases.

Four cases of pulmonary veno-occlusive disease are described. Two patients, who were brothers, had respiratory tract infections. The third patient had chronic active hepatitis and coeliac disease suggesting an abnormality of the immune system; the fourth patient had no obvious cause but presented initially with systemic hypertension. Three of the cases had been diagnosed initially as primary pulmonary hypertension either on open lung biopsy or clinically. In all cases the pulmonary arteries were abnormal with medial hypertrophy, intimal fibrosis and, in some cases, thrombosis in elastic pulmonary arteries. These findings suggest that pulmonary veno-occlusive disease is not confined to veins and should be considered as a widespread pulmonary vascular disease. The range of aetiological factors indicate that it should not be considered as a single disease entity.

Adolescent↗
PubMed1986

Hemodynamic and plasma renin responses to treatment of a renal arteriovenous malformation.

We report a case of a right renal arteriovenous malformation with high output cardiac failure and hypertension which was cured by nephrectomy. Hemodynamic findings pre- and post-operatively are presented. Plasma renin activity (PRA), both from peripheral venous and renal vein samples, was assessed. The fall in PRA associated with nephrectomy lends support to the suggestion that the renin-angiotensin system plays a role in the hypertension in these patients.

Adult↗