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Wiggins J, Geddes DM. Respiratory aspects of Shwachman's syndrome in adults. Eur Respir J 1989. [DOI: 10.1183/09031936.93.02030285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Shwachman's Syndrome is a rare disorder which causes considerable morbidity in childhood and can be confused with cystic fibrosis. Six patients (4 males; mean age 27 yrs) are described in order to illustrate the clinical picture of the syndrome in adults. Recognized features persisting in later life include pancreatic insufficiency and bone marrow dysfunction (all patients), short stature (5/6), advanced dental caries (4/6), and impaired glucose tolerance (2/6). Chest radiograph was normal in all patients whilst lung function tests showed mild restriction in three and obstruction in two. All patients were cyclically neutropenic (nadir count 2.1 x 10(9).l-1). Four of the six patients were thrombocytopenic and three had persistent immunoglobulin deficiencies. Neutrophil chemotaxis was abnormal in four patients and the nitro blue tetrazolium test was abnormal in a fifth. Two patients suffered from recurrent respiratory infections, one of whom died from bone marrow aplasia. Although Shwachman's Syndrome may be less troublesome in adults than in children, many of the abnormalities persist into adult life and may continue to cause diagnostic difficulty.
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Wiggins J, Sheffield E, Jeffery PK, Geddes DM, Corrin B. Bronchial casts associated with hilar lymphatic and pulmonary lymphoid abnormalities. Thorax 1989; 44:226-7. [PMID: 2705154 PMCID: PMC461760 DOI: 10.1136/thx.44.3.226] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
A patient who has expectorated bronchial casts for 23 years is reported. The casts contained mucus, fibrin, and lymphocytes, and the resected middle lobe showed dilated lymphatics with thickened walls at the hilum and lymphoid aggregates in the terminal bronchioles.
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Abstract
A case of pulmonary endometriosis is reported, to illustrate the classic catamenial symptoms of the disease. The patient also developed symptoms and signs suggesting a perforated abdominal viscus; laparotomy was normal and the features may have resulted from a previously unreported effect of diaphragmatic endometrial foci.
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54
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Wiggins J, Lyster W. Will falling death rates from acute and chronic bronchitis continue? Lancet 1988; 2:286. [PMID: 2899282 DOI: 10.1016/s0140-6736(88)92585-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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55
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Abstract
A case of primary B cell lymphoma of the trachea is reported. It is suggested that it is an example of a tumour of mucosa associated lymphoid tissue, or "maltoma."
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Manchester DK, Pretorius DH, Avery C, Manco-Johnson ML, Wiggins J, Meier PR, Clewell WH. Accuracy of ultrasound diagnoses in pregnancies complicated by suspected fetal anomalies. Prenat Diagn 1988; 8:109-17. [PMID: 3283717 DOI: 10.1002/pd.1970080205] [Citation(s) in RCA: 52] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Referral of pregnancies complicated by suspected fetal anomalies to level III perinatal centres for further evaluation and management is increasing as use of real-time ultrasound spreads, but the sensitivity and specificity of the prenatal diagnoses made in this population are unknown. We undertook a prospective study that followed pregnancies referred to a designated programme dealing with suspected fetal abnormalities. Follow-up of 257 pregnancies revealed that 282 separate anomalies were accurately diagnosed in 212 cases. Normal anatomy was correctly predicted in 42 cases, 16 per cent of the referred population. False-positive and false-negative rates were 1.5 per cent (4/257) and 2 per cent (1/46), respectively. However, 37 per cent of those infants born with anomalies had additional problems not prenatally detected by ultrasound. These results indicate that prenatal ultrasound diagnoses are remarkably accurate overall but that they may be insensitive to associated anomalies in individual cases.
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Abman SH, Schaffer MS, Wiggins J, Washington R, Manco-Johnson M, Wolfe RR. Pulmonary vascular extraction of circulating norepinephrine in infants with bronchopulmonary dysplasia. Pediatr Pulmonol 1987; 3:386-91. [PMID: 3696807 DOI: 10.1002/ppul.1950030603] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Although the pulmonary circulation in infants with advanced bronchopulmonary dysplasia (BPD) is characterized by abnormal structure and vasoreactivity, metabolic lung functions have not been studied in these infants. To test the hypothesis that patients with severe BPD may have abnormal metabolic lung function, we assessed the pulmonary vascular extraction of circulating norepinephrine in six children with BPD during cardiac catheterization. Plasma norepinephrine levels were measured from simultaneously drawn mixed venous (main pulmonary artery) and left atrium or femoral artery samples. In comparison with four infants with mild heart disease without pulmonary hypertension, we found that infants with BPD extract proportionately less norepinephrine than non-BPD infants [-7 +/- 50% (BPD) versus +27 +/- 6% (non-BPD); P less than 0.001, t test]. Three infants with BPD had higher arterial than mixed venous concentrations of plasma norepinephrine, suggesting net production across the lung. Plasma catecholamine levels and percent extraction correlated poorly with cardiac index and systemic and pulmonary vascular resistance indices. However, this study group was characterized by a high incidence of pulmonary (6/6) and systemic (4/6) hypertension, left ventricular hypertrophy (4/6), and subsequent death (3/6). We conclude that infants with severe BPD and pulmonary hypertension have decreased pulmonary vascular clearance or net production of circulating norepinephrine, but links between altered pulmonary catecholamine metabolism and pulmonary hypertension, or other cardiovascular abnormalities associated with BPD, remain speculative.
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58
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Smith SR, Wiggins J, Stableforth DE, Skinner C, Kendall MJ. Effect of nifedipine on serum theophylline concentrations and asthma control. Thorax 1987; 42:794-6. [PMID: 3321539 PMCID: PMC460954 DOI: 10.1136/thx.42.10.794] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
The effect of adding slow release nifedipine to oral theophylline has been studied in eight patients with stable but symptomatic asthma, a double blind placebo controlled crossover protocol being used. No change in asthma control occurred during the nifedipine treatment period as assessed by serial peak flow measurements and symptom scores. Serum theophylline concentrations were significantly lower after nifedipine than after placebo (6.8 v 9.7 micrograms/ml) and in three patients were well below the therapeutic range (less than 4 micrograms/ml).
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59
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Davey D, Erhardt PW, Lumma WC, Wiggins J, Sullivan M, Pang D, Cantor E. Cardiotonic agents. 1. Novel 8-aryl-substituted imidazo[1,2-a]- and -[1,5-a]pyridines and imidazo[1,5-a]pyridinones as potential positive inotropic agents. J Med Chem 1987; 30:1337-42. [PMID: 3039131 DOI: 10.1021/jm00391a012] [Citation(s) in RCA: 89] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Several 8-arylimidazo[1,2-a]pyridines, 8-arylimidazo[1,5-a]pyridines, and 8-arylimidazo[1,5-a]pyridinones were prepared and tested in vitro for potential cardiac inotropic and electrophysiological activity. Selected analogues were further tested in vivo in canine hemodynamic and cardiac electrophysiology models. Compounds having an imidazole substituent consistently showed activity. A pharmacophoric relationship between heterocycle-phenyl-imidazole and positive inotropic activity was noted. The significance of this relationship is discussed.
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Packe GE, Wiggins J, Singh BM, Nattrass M, Wright AD, Cayton RM. Blood fuel metabolites in asthma during and after progressive submaximal exercise. Clin Sci (Lond) 1987; 73:81-6. [PMID: 3111774 DOI: 10.1042/cs0730081] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Ten male stable asthmatic subjects and 10 matched control subjects performed a progressive exercise test on a treadmill to 85% of their predicted maximum heart rate. Blood lactate, pyruvate, hydrogen ion, glucose, alanine, glycerol and total ketone body concentrations were measured at frequent intervals during and up to 60 min after exercise. Carbon dioxide production, oxygen consumption, ventilation, respiratory exchange ratio and oxygen saturation were also measured during and up to 10 min after exercise. There were no significant differences between the asthmatic and control subjects in levels of carbon dioxide production, oxygen consumption and ventilation. The respiratory exchange ratio was greater in the asthmatic subjects during recovery from exercise (P less than 0.05). No changes in oxygen saturation were observed during exercise in either group. In both asthmatic and control subjects, lactate, pyruvate, hydrogen ion, alanine and glycerol concentrations showed an increase from baseline levels, reaching maximum levels up to 10 min after exercise and returning to baseline within 1 h after exercise. Total ketone body concentrations decreased during exercise. There were no significant differences between the asthmatic and control subjects in the concentration of any metabolite over the study period. These data indicate that fuel metabolism during and after short-term progressive exercise is similar in stable asthmatic and normal subjects.
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61
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Wiggins J. Bedside theophylline assay in severe acute asthma. Lancet 1986; 2:1394. [PMID: 2878249 DOI: 10.1016/s0140-6736(86)92032-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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62
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Wiggins J, Arbab OA, Stableforth DE, Ayres JG. Intravenous aminophylline in patients already taking oral theophylline: effect on calculated dose of knowledge of serum theophylline concentration on admission. Thorax 1986; 41:759-65. [PMID: 3538477 PMCID: PMC460473 DOI: 10.1136/thx.41.10.759] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Measurement of serum theophylline concentration is usually recommended before intravenous aminophylline is given to patients taking oral theophylline. Fifty patients with worsening airflow obstruction, all of whom were taking oral theophyllines and who had no contraindication to the use of parenteral aminophylline, were randomly allocated into two groups before treatment was given. The dose of aminophylline was calculated without (group A) and with (group B) knowledge of admission serum theophylline concentration. In group A a regimen incorporating corrections to account for factors affecting theophylline clearance was used in an attempt to represent a "knowledgeable" approach; in group B a formula incorporating the known serum theophylline concentration at the time of admission was used. All loading doses were given over 30 minutes as "mini infusions." The two groups were well matched for age, blood gas tensions, and severity of airflow obstruction. The results for four patients (one from group A and three from group B) were excluded from analysis after completion of the study. In each group the mean admission serum theophylline concentration measured (group A: 8.4 (SD 6.0)mg/l; group B: 7.2 (5.7)mg/l) and the aminophylline doses used (group A: loading bolus 172 (45.5)mg, infusion 815 (198)mg; group B: loading bolus 233(189)mg, infusion 788(214)mg) were similar. Mean serum theophylline concentrations during 24 hours' aminophylline treatment, number of patients with a serum theophylline concentration greater than 20 mg/l, symptoms of toxicity, and outcome were also similar in the two groups. Although satisfactory use of parenteral aminophylline was achieved for most patients without knowledge of serum theophylline concentration at the time of admission to hospital (with the aid of a "knowledgeable" clinical approach and constant infusion pumps), prompt measurement of serum theophylline concentration at the time of admission identified patients with either suboptimal or potentially hazardous theophylline concentrations.
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Lourie RW, Baghaei H, Bertozzi W, Blomqvist KI, Finn JM, Hyde-Wright CE, Kalantar-Nayestanaki N, Nelson J, Kowalski S, Sargent CP, Sapp WW, Ulmer P, Wiggins J, Cottman BH, Teng PK, Winhold EJ, Yamazaki M, Calarco JR, Hersman FW, Kelly JJ, Schulze ME. Reaction 12C(e,e'p) in the dip region. PHYSICAL REVIEW LETTERS 1986; 56:2364-2367. [PMID: 10032967 DOI: 10.1103/physrevlett.56.2364] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
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65
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Wiggins J, Arbab O, Ayres JG, Skinner C. Elevated serum theophylline concentration following cessation of erythromycin treatment. EUROPEAN JOURNAL OF RESPIRATORY DISEASES 1986; 68:298-300. [PMID: 3732425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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66
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67
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Collingham KE, Littlejohns PD, Anfilogoff N, Wiggins J. Pneumococcal meningitis in a husband and wife. J Infect 1985; 10:256-8. [PMID: 4031518 DOI: 10.1016/s0163-4453(85)92663-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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68
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Wiggins J, Brooks R, Beckerman M, Gazes SB, Grodzins L, Smith AP, Steadman SG, Xiao Y, Videbaek F. One-neutron transfer in Ni-Ni interactions below the barrier. PHYSICAL REVIEW. C, NUCLEAR PHYSICS 1985; 31:1315-1322. [PMID: 9952653 DOI: 10.1103/physrevc.31.1315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
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69
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Gove RI, Wiggins J, Stableforth DE. A study of the use of ultrasonically nebulized lignocaine for local anaesthesia during fibreoptic bronchoscopy. BRITISH JOURNAL OF DISEASES OF THE CHEST 1985; 79:49-59. [PMID: 3986113 DOI: 10.1016/0007-0971(85)90007-5] [Citation(s) in RCA: 26] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The use of nebulized lignocaine, with and without intravenous diazepam premedication, was compared with lignocaine given by bolus in 52 patients undergoing fibreoptic bronchoscopy (FOB). Changes in airflow, cardiac rhythm, and transcutaneous PO2 were recorded, and patient acceptability, blood lignocaine levels, and the duration of the procedure were also monitored. Nebulized lignocaine alone provide adequate anaesthesia and the procedures were performed more quickly (P less than 0.05) than when bolus lignocaine was used. Nebulized lignocaine without diazepam was acceptable to the patients and was not associated with the significant (P less than 0.03) falls in transcutaneous PO2 which followed diazepam administration. Nebulized lignocaine, with and without, diazepam premedication is a safe, effective and acceptable method of inducing topical anaesthesia for FOB.
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Takayama K, Qureshi N, Raetz CR, Ribi E, Peterson J, Cantrell JL, Pearson FC, Wiggins J, Johnson AG. Influence of fine structure of lipid A on Limulus amebocyte lysate clotting and toxic activities. Infect Immun 1984; 45:350-5. [PMID: 6378795 PMCID: PMC263228 DOI: 10.1128/iai.45.2.350-355.1984] [Citation(s) in RCA: 86] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
We examined the relationship between the fine structure of lipid A and the toxicity of endotoxin or lipopolysaccharides as measured by the Limulus amebocyte lysate (LAL), rabbit pyrogenicity, chicken embryo lethal dose, and dermal Shwartzman reaction tests. Lipid A and lipid A-like compounds obtained from deep-rough mutants of Salmonella spp. and Escherichia coli had a wide range of structural variations. These compounds included native lipopolysaccharides, diphosphoryl and monophosphoryl lipid A's, and lipid X (a monosaccharide). The LAL test was positive for all lipids tested with lysates from Travenol Laboratories and from Associates of Cape Cod (2.9 X 10(3) to 2.6 X 10(7) endotoxin units per mg), except for O-deacylated and dephosphorylated lipid X, which were negative. The Mallinckrodt lysate gave negative tests for lipid X. In the rabbit pyrogenicity and chicken embryo lethal dose tests, only native lipopolysaccharide and diphosphoryl lipid A's were judged toxic. The Shwartzman reaction was positive for a specific purified diphosphoryl lipid A (thin-layer chromatography-3 fraction) but negative for the purified monophosphoryl lipid A (also a thin-layer chromatography-3 fraction). These results show that the LAL test is not a valid measure of all parameters of toxicity of a lipid A or lipid A-like compound and can yield false-positive results. However, these findings are not in conflict with the widespread use of the LAL assay for pyrogens in the pharmaceutical industry since a good correlation exists between LAL results and pyrogenicity when undegraded endotoxin is evaluated in parallel assays.
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71
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Wiggins J, Stockley RA. Variability in the secretory IgA system in sputum sol phase in stable chronic obstructive bronchitis. EUROPEAN JOURNAL OF RESPIRATORY DISEASES 1984; 65:433-40. [PMID: 6381082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Within and between patient variability in the sputum sol phase secretory IgA system was studied in 31 patients with clinically stable chronic obstructive bronchitis. Within patient coefficients of variation (CV) were similar for secretory component (SC), free secretory component (FSC), total immunoglobulin A (IgA) and the immunological amount of IgA present in its dimeric (11S) form (average CV 32%). The immunological proportion of IgA present in the dimeric form was about 70% of the total and relatively constant (average CV 7%). Between patients, variability was greater but also similar for SC, FSC, total IgA and the amount of dimeric IgA (average CV 50%). The proportion of IgA present in dimeric form was again less variable (CV 21.1%). 'Standardisation' of samples, using protein ratios to either albumin or the 'local' components of the secretory IgA system, did not produce variability. Furthermore, the effect of such standardisation was to increase the between patient variability for total IgA and FSC (2p less than 0.01). However, despite this variability, 4 patients studied previously remained clearly distinct, suggesting defects of the secretory IgA system. The methods described provide a means of identifying such patients.
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Burns JC, Glode MP, Clarke SH, Wiggins J, Hathaway WE. Coagulopathy and platelet activation in Kawasaki syndrome: identification of patients at high risk for development of coronary artery aneurysms. J Pediatr 1984; 105:206-11. [PMID: 6235335 DOI: 10.1016/s0022-3476(84)80114-6] [Citation(s) in RCA: 100] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Prospective evaluation of platelet activation and hypercoagulability was performed in 31 patients with Kawasaki syndrome. Most patients had elevated acute-phase reactants when studied during the first 3 weeks of their illness; 17 of 25 (68%) patients had factor VIII activity greater than 150%, 18 of 24 (75%) had fibrinogen greater than 400 mg/dl, and 17 of 31 (55%) had a platelet count greater than 450,000/mm3. Antithrombin III was depressed initially in 17 of 25 (68%) patients. Depleted fibrinolytic activity, as measured by a euglobulin lysis time greater than 300 minutes, was documented in nine of 20 (45%) patients. Plasma beta-thromboglobulin (BTG) measured at 0 to 3 weeks was elevated (greater than 43 ng/ml) in seven of 24 (29%) patients. All patients with coronary artery aneurysms had elevated BTG values. The mean BTG in the group with aneurysms was 72.3 ng/ml when measured during the first 3 weeks after onset of fever, and 87.7 ng/ml at 4 to 7 weeks. The group without aneurysms had mean BTG values of 29.4 and 28.3 ng/ml at 0 to 3 and 4 to 7 weeks, respectively. The difference between the two groups was significant (P less than 0.002) for both the initial and later values. An elevated BTG during the first 3 weeks after onset of fever was highly associated with aneurysm formation in our patients (P less than 0.007). No aneurysms occurred in patients with a normal BTG value.
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Wiggins J, Hill SL, Stockley RA. The secretory IgA system of lung secretions in chronic obstructive bronchitis: comparison of sputum with secretions obtained during fibreoptic bronchoscopy. Thorax 1984; 39:517-23. [PMID: 6463931 PMCID: PMC459852 DOI: 10.1136/thx.39.7.517] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
The constituents of the secretory immunoglobulin A system (dimeric IgA, total secretory component and free secretory component) were measured in sputum sol phase, tracheal aspirates, and bronchoalveolar lavage fluids from 15 patients undergoing fibreoptic bronchoscopy. All of the proteins showed a progressive decrease in concentration from sputum to the bronchoalveolar lavage fluids (2p less than 0.001). Standardisation of samples by means of protein concentration ratios showed that all secretions were generally similar in respect of their secretory IgA profiles, although major differences remained in some individual patients. The between patient variability of the results was generally reduced by the use of protein concentration ratios, allowing closer comparison between subjects. When the secretion albumin concentration was used as a standard, however, it increased the variability of the sputum sol phase IgA components (2p less than 0.01), whereas it decreased the variability of the IgA components in the bronchoalveolar lavage fluid (2p less than 0.05). The role of albumin as a standard protein for assessing the secretory IgA system in lung secretions remains uncertain.
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Ayres J, Fish DR, Wheeler DC, Wiggins J, Cochrane GM, Skinner C. Subcutaneous terbutaline and control of brittle asthma or appreciable morning dipping. BMJ : BRITISH MEDICAL JOURNAL 1984; 288:1715-6. [PMID: 6428511 PMCID: PMC1441578 DOI: 10.1136/bmj.288.6432.1715] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
In a pilot study two patients with brittle asthma and two with morning dipping received terbutaline or a placebo administered subcutaneously either by continuous infusion or in injections every six hours. In two patients brittle asthma was completely suppressed by terbutaline 1 mg/day given by either method. In the two others early morning dipping responded only to continuous subcutaneous infusions of terbutaline 12 mg/day. Terbutaline administered subcutaneously may be an effective treatment in asthmatic patients who show important diurnal variations in air flow.
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75
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Reed BR, Lee LA, Harmon C, Wolfe R, Wiggins J, Peebles C, Weston WL. Autoantibodies to SS-A/Ro in infants with congenital heart block. J Pediatr 1983; 103:889-91. [PMID: 6644424 DOI: 10.1016/s0022-3476(83)80707-0] [Citation(s) in RCA: 96] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Antibodies to SS-A/Ro have been proposed to be a serologic marker for the neonatal lupus syndrome, which is characterized by congenital heart block or cutaneous lupus or both. The antibodies occur in the mother and are transiently found in the child's serum. We examined an unselected series of 12 children with idiopathic CHB, isolated in 10 children and with cutaneous lupus lesions in two. Six of these children and their mothers were studied during the child's neonatal period, and six were studied retrospectively. All six neonates had SS-A/Ro autoantibodies. Nine of 12 mothers had SS-A/Ro autoantibodies. Of the seropositive mothers, one had systemic lupus erythematosus, two had sicca syndrome, one had photosensitivity, one had arthralgias, and four were asymptomatic. We propose that congenital heart block may be related to transplacental passage of maternal SS-A/Ro antibodies and that neonatal lupus may be the most common cause.
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76
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Wiggins J, Stockley RA. Variability in sputum sol phase proteins in chronic obstructive bronchitis. The value of using albumin for standardization. THE AMERICAN REVIEW OF RESPIRATORY DISEASE 1983; 128:60-4. [PMID: 6603183 DOI: 10.1164/arrd.1983.128.1.60] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
The variability of sputum sol phase proteins was studied in 27 patients with stable chronic obstructive bronchitis. Within individual patients (n 1/2 11), variability over 5 consecutive days was similar for each of 4 proteins studied: average coefficient of variation (CV) for albumin was 39.8% for alpha 1-antitrypsin (alpha 1AT), 32.1%, for alpha 1-antichymotrypsin (alpha 1ACh), 26.6%, and for immunoglobulin A (IgA), 35.1%. The calculation of sputum-to-serum ratios did not affect this variability. Between patients (all patients studied on a single day) the variability of sputum sol phase proteins was greater (CV: albumin 1/2 84.5%, alpha 1AT 1/2 90.1%, alpha 1ACh 1/2 58.3%, and IgA 1/2 71.6%) and was also unaffected by the use of sputum-to-serum concentration ratios. "Standardization" for albumin reduced the average within-patient variability for sputum alpha 1AT (CV from 32.1 to 19.7%) but it had no effect on alpha 1ACh and IgA. However, although between-patient CV for sputum alpha 1AT was also reduced (from 90.1 to 53.4%, 2 p less than 0.01) it significantly increased for alpha 1ACh (from 58.3 to 86.0%, 2 p less than 0.05) and IgA (71.6 to 170.1%, 2 p less than 0.001), suggesting that such standardization may be inappropriate for these proteins.
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77
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Wiggins J, Hill SL, Stockley RA. Lung secretion sol-phase proteins: comparison of sputum with secretions obtained by direct sampling. Thorax 1983; 38:102-7. [PMID: 6602395 PMCID: PMC459497 DOI: 10.1136/thx.38.2.102] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
The protein content of tracheal secretions and of bronchial lavage and bronchoalveolar lavage fluid was compared with that of sputum in 33 patients who underwent fibreoptic bronchoscopy. The secretion-to-serum concentration ratios for albumin, alpha 1-antitrypsin, alpha 1-antichymotrypsin, and immunoglobulin A (IgA) fell progressively as samples were obtained from further down the bronchial tree, probably reflecting greater sample dilution. The secretion-to-serum protein ratios when standardised for the corresponding albumin ratio were similar in all secretions studied. In particular, the IgA ratios were about eight times those of albumin and alpha 1-antichymotrypsin ratios were about twice those of albumin, suggesting similar degrees of "local production" of these proteins in all secretions studied. Some patients showed considerable differences in IgA ratios between sputum and bronchial lavage fluid. The significance of these differences is not clear.
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Abstract
Mucocutaneous lymph node syndrome (MLNS), or Kawasaki's disease, affects thousands of infants and children each year and is associated with a high incidence of coronary artery aneurysm, which may lead to subsequent myocardial infarction. Successful use of the right subclavian-axillary artery to bypass a thrombosed aneurysm of the left anterior descending coronary artery is documented angiographically and forms the basis of this report. A management plan for MLNS patients is proposed.
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Campbell DN, Carson SD, Wolfe RR, Wiggins J, Mahoney LT, Clarke DR. Congenital heart surgery: a five year study. THE SURGICAL TECHNOLOGIST 1983; 15:14-9. [PMID: 10317309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
The practice of surgery for congenital heart disease has undergone a major evolution in the past few years. Technical advances, the introduction of operative procedures, and a change in philosophy relating to the proper timing of surgical intervention are the major factors responsible for this change. To document our experience, a comprehensive review of all surgery performed for congenital heart disease at the University of Colorado Health Sciences Center during the last five years was conducted.
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80
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Wiggins J, Elliott JA, Stevenson RD, Stockley RA. Effect of corticosteroids on sputum sol-phase protease inhibitors in chronic obstructive pulmonary disease. Thorax 1982; 37:652-6. [PMID: 6984237 PMCID: PMC459399 DOI: 10.1136/thx.37.9.652] [Citation(s) in RCA: 25] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Corticosteroids caused a reduction in the ratio of sol-phase sputum concentration to serum concentration of albumin in 12 patients with chronic obstructive bronchitis, suggesting a reduction in protein transudation. Alpha-1-antitrypsin values followed the same pattern as those of albumin in both the control and treatment periods, confirming the similar behaviour of the two proteins. The alpha 1-antichymotrypsin ratios were on average three times higher than those of albumin in the control period, confirming the presence of local mechanisms in the lung for preferentially concentrating this protein. The sputum-to-serum ratio of alpha 1-antichymotrypsin, however, rose during steroid treatment with the result that there was a selective increase in this protease inhibitor, which may be of potential benefit to such patients.
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81
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Lehr JT, Gaide MS, Ezrin AM, Wiggins J, Bassett AL. The effect of X-537A (lasalocid) on potassium contracture in rat ventricular muscle. ARCHIVES INTERNATIONALES DE PHARMACODYNAMIE ET DE THERAPIE 1982; 259:106-11. [PMID: 7181574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
The effects of the carboxylic ionophore X-537A on contracture induced by high external K+ were determined in stimulated and unstimulated rat papillary muscles. X-537A (5 X 10(-6) M - 10(-5) M) increased peak K+-contracture force in stimulated but not unstimulated muscle. X-537A may alter myocardial force development by influencing transport of Ca2+ across the sarcolemma or Ca2+ release from sarcoplasmic reticulum.
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82
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Strick P, Morrell J, Wiggins J, Yates S. Implications of strengthening unit administration. THE HOSPITAL AND HEALTH SERVICES REVIEW 1981; 77:314-6. [PMID: 10253791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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83
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Abstract
Two cases of feprazone-induced hepatic injury are reported. Both patients developed jaundice within one month of commencing therapy. Histological investigation showed a granulomatous reaction in one case and hepatitic changes in the other. The changes were similar to those seen as a complication of phenylbutazone therapy. When the administration of feprazone was discontinued both the clinical and biochemical changes were resolved.
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84
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Abstract
Accidental ingestion of eucalyptus oil by a 3-year-old boy caused profound central nervous system depression within 30 minutes, but he recovered rapidly after gastric lavage. The extreme toxicity of eucalyptus oil is emphasised.
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85
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Way GL, Pierce JR, Wolfe RR, McGrath R, Wiggins J, Merenstein GB. ST depression suggesting subendocardial ischemia in neonates with respiratory distress syndrome and patent ductus arteriosus. J Pediatr 1979; 95:609-11. [PMID: 480044 DOI: 10.1016/s0022-3476(79)80780-5] [Citation(s) in RCA: 30] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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86
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Wiggins J, Harclerode J. Effect of imidazole on bone 45Ca release in white-throated sparrow, Zonotrichia albicollis. COMPARATIVE BIOCHEMISTRY AND PHYSIOLOGY 1970; 34:297-300. [PMID: 5426566 DOI: 10.1016/0010-406x(70)90169-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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87
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Wiggins J. Information--in all it's forms--it's use in parent education. BULLETIN OF THE AMERICAN COLLEGE OF NURSE-MIDWIFERY 1968; 13:9-12. [PMID: 5184266 DOI: 10.1111/j.1542-2011.1968.tb00048.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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