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Biomedical subjects

B Gardner

Publications and source records attributed to B Gardner.

At least 55 records · Page 3Linked to original sources
PubMed1994

Analysis of multiple primary cancers in a single institution.

Records of 120 patients with two and 16 with three primary cancers were evaluated. There were 49 males and 71 females among the double primaries with ages ranging from 27-102 years (average 68 years at the time of fist cancer). Of 35 breast cancer patients 16 new primaries developed in the opposite breast and other sites including four colon, three lung, and three endometrium. Of 20 colon cancer patients second primaries occurred in 11 sites most commonly colon (four) and lung (three). The frequency of second primaries may be skewed by the fact that patients with lethal cancers did not live long enough to develop them. This is borne out by the fact that 74 of the 120 patients were alive at the time of the study, implying a highly favorable group of patients. The interval between primaries was longer in females than males (P < 0.05) and this difference disappeared when breast and endometrial cancer were eliminated. When age was evaluated as a factor younger patients appeared to have a longer interval between primaries (P = 0.24) and this became significant for breast patients under age 55 years (91 months vs. 36 months) (P < 0.05). The stage of the second breast primary bore no relationship to the interval between primaries.

Adult↗
PubMed1993

Are positive axillary nodes in breast cancer markers for incurable disease?

OBJECTIVE: This study was designed to determine if resection of positive regional nodes in patients with breast cancer provided a group of cured patients. SUMMARY BACKGROUND DATA: Previous studies of long-term follow-up of patients with breast cancer have demonstrated that 30% of patients with positive nodes may be alive at 10 or 20 years. Randomized, prospective studies have not shown a difference in survival between modified radical and total mastectomy. METHODS: The authors analyzed the statistical basis of randomized, prospective studies of breast cancer. Patients from University and Kings County Hospital with breast cancer were observed (n = 1024) and the 10-year survival curves were analyzed. Data from the Surveillance, Epidemiology, and End Results (SEER) program were evaluated to determine the prognosis of patients with positive-node breast cancer who survived 10 and 15 years. RESULTS: The authors found that no current randomized study of primary treatment of breast cancer has the power to determine the advantage of one treatment over another if the primary cancer is treated. Additionally, evaluation of the patients in this study demonstrated that those with regional disease usually had a recurrence by 7 years; however, at 10 years, 30% are still alive and have the same prognosis as patients with negative-node breast cancer. CONCLUSIONS: Regional breast cancer is a curable disease in some resected patients.

Adult↗
PubMed1993

Monoclonal antibodies against Kell glycoprotein: serology, immunochemistry and quantification of antigen sites.

Monoclonal antibodies BRIC 18, BRIC 68, BRIC 107 and BRIC 203 recognize high-frequency epitopes absent from erythrocytes expressing the Ko phenotype. BRIC 107 has anti-k (K2)-like specificity. BRIC 203 has a unique specificity denoted anti-Kpbc. All four monoclonal antibodies identify an M(r) 95,600 erythrocyte membrane protein by immunoprecipitation from radio-iodinated erythrocytes. In quantitative binding studies using IgG it is estimated that there are from 2000 (BRIC 18) to 4000 (BRIC 68) copies of the Kell glycoprotein per erythrocyte. Using Fab fragments the estimates are in the range 4000 (BRIC 18) to 18,000 (BRIC 68) copies. In competitive binding assays the four epitopes defined by the BRIC monoclonal antibodies fall into two non-overlapping groups. The first group comprises BRIC 18, BRIC 68, BRIC 203 and an antibody (6-22) with anti-K14 specificity. The second group contains BRIC 107 and two further anti-k-like monoclonal antibodies (BS45 and OSK5). The results suggest that the polymorphisms encoded at the K/k and Kpa/Kpb/Kpc loci may be located in two spatially distinct regions of the Kell glycoprotein(s).

Animals↗
PubMed1993

Management of patients diagnosed as acute intestinal obstruction secondary to adhesions.

In an attempt to define an optimal strategy for managing small bowel obstruction secondary to adhesions, we reviewed 116 such cases encompassing a 5-year period at Hackensack Medical Center. Ninety-five patients underwent a trial of nonoperative treatment with a 35 per cent failure rate necessitating operation. This result was not influenced by the type of enteral tube used for decompression or predictable on the basis of initial clinical or laboratory findings. Significant complications occurred in those patients delayed more than 48 hours. The classic signs were poor indicators of strangulation. Patients with small bowel obstruction secondary to adhesions should be operated upon early (within 24 hours) but may be treated nonoperatively for 24 to 48 hours, provided that no signs of strangulation are present or develop. Failure to show improvement during this 48-hour period requires immediate operative intervention. The group as a whole would have benefited if early operation were done routinely.

Acute Disease↗
PubMed1992

Evidence that the antigens of the Yt blood group system are located on human erythrocyte acetylcholinesterase.

The Yt blood group system comprises two antigens, Yta and Ytb. Human anti-Yta and human anti-Ytb immune precipitate a component of the same apparent molecular weight as acetylcholinesterase from radioiodinated erythrocytes of appropriate Yt phenotype. Immune precipitates obtained with anti-Yta and anti-Ytb contained acetylcholinesterase activity. In contrast, immune precipitates obtained with human anti-Gya and murine monoclonal anti-CD55, which identify other glycosylphosphatidylinositol-linked erythrocyte surface proteins, did not have acetylcholinesterase activity. Quantitative binding assays using murine monoclonal antiacetylcholinesterase antibodies (AE-1 and AE-2) gave 3,000 to 5,000 binding sites/cell for IgG and 7,000 to 10,000 sites/cell for Fab fragments. Endo F digestion of immune precipitates obtained with AE-1 and anti-Yta indicated that approximately 10% of the enzyme comprises N-glycans. These results indicate that the Yt antigens define an inherited polymorphism on erythrocyte acetylcholinesterase and that the recent assignment of the Yt blood group locus to the long arm of chromosome 7 (Zelinski et al, Genomics 11:165, 1991) provisionally identifies the position of the acetylcholinesterase gene.

Acetylcholinesterase↗
PubMed1992

En bloc caudate lobe and partial vena cava resection using a Gott shunt for retrohepatic caval bypass.

A technique of retrohepatic inferior vena cava bypass is described, useful for resection of the hepatic caudate lobe. A 77 year old female developed a solitary metastatic tumor mass in the caudate lobe compressing the Inferior Vena Cava (IVC), with cavography showing the IVC to be compressed, but patent. Without evidence of other metastatic disease radical resection of this tumor was performed. Successful resection was accomplished using a Gott shunt and porta hepatus compression for hepatic vascular isolation. No pump was used to avoid heparinization. Postoperative imaging confirmed IVC patency. The serum carcinoembryonic antigen (CEA) level fell to normal and remained so for 18 postoperative months. This introduces a new use of an atriocaval shunt for hepatic isolation during resection.

Aged↗
PubMed1992

Complications of intrathecal baclofen delivery.

The medical records of 46 consecutive patients who have had intrathecal Baclofen drug delivery systems implanted in the National Spinal Injuries Centre, the Paddocks Hospital Spinal Unit, Princes Risborough, Lodge Moor Hospital Spinal Unit, Sheffield, the Northern Regional Spinal Injuries Unit, Hexham and The Radcliffe Infirmary, Oxford, were reviewed. Patients were contacted to describe their views on the treatment. The complications of the treatment are described. Some, such as overdose and meningitis are particularly hazardous. Others, in particular pump tubing revisions, are more of an inconvenience and time consuming for the patient and physician. If the serious risks of this valuable treatment are to be minimized and the therapy applied most effectively than a well co-ordinated team is essential, involving in particular the physician responsible for the initial assessment and follow-up of the patient and an experienced surgeon. It is recommended that only a small number of centres in the UK undertake these implants.

Adolescent↗
PubMed1992

New monoclonal antibodies in CD59: use for the analysis of peripheral blood cells from paroxysmal nocturnal haemoglobinuria (PNH) patients and for the quantitation of CD59 on normal and decay accelerating factor (DAF)-deficient erythrocytes.

CD59 is a widely expressed cell surface glycosylphosphatidylinositol (GPI)-linked glycoprotein which acts as an inhibitor of the assembly of the membrane attack complex of autologous complement. Four new monoclonal antibodies to CD59 (2/24, 1B2, BRIC 229, BRIC 257) are described. Competitive binding experiments using these antibodies, two known CD59 antibodies (MEM-43, YTH 53.1) and a previously described antibody LICR-LON-Fib75.1 demonstrated that all seven antibodies see related epitopes on human erythrocyte CD59. In common with other GPI-linked proteins, CD59 (as defined by antibody 2/24) was sensitive to treatment with phosphatidylinositol-specific phospholipase C (PI-PLC) on lymphocytes and monocytes but not on erythrocytes. Flow cytometric analysis using antibody 2/24 identified two populations (CD59 positive and CD59 deficient) of lymphocytes, monocytes and erythrocytes in peripheral blood from a patient with paroxysmal nocturnal haemoglobinuria (PNH). The abundance of CD59 on normal erythrocytes was determined as 21,000 copies/cell when radioiodinated BRIC 229 was used. Other CD59 antibodies gave values of 10,000 (IF5) and 15,000 (2/24) against the same target cells. Radioiodinated Fab fragments of BRIC 229 gave a value of 39,000 copies/cell. Erythrocytes from two individuals with a rare inherited deficiency of decay accelerating factor (DAF), known as the Inab phenotype, expressed normal levels of CD59.

Antibodies, Monoclonal↗
PubMed1991

Ability of unstimulated and phorbol-ester-stimulated human blood-monocyte-derived macrophages to metabolize drugs and its implications.

Solutions containing 5,5-diphenyl[4-14C]hydantoin (15 micrograms/ml) or pheno[2-14C]barbital (20 micrograms/ml) were incubated for 0.5-6 h with monolayers of unstimulated and phorbol-ester-stimulated human blood-monocyte-derived macrophages and suspensions of K562 cells. The incubated solutions were centrifuged and the cell-free supernatants subjected to chromatography on Q-Sepharose Fast Flow anion exchange resin. The interaction with unstimulated macrophages but not with K562 cells resulted in a time-dependent conversion of the original radioactive drug molecules to molecules with a larger negative charge in the case of diphenylhydantoin and a smaller negative charge in the case of phenobarbital. These conversions were prevented by 20 mM tetrahydrofurane and partially inhibited by 300 U/ml superoxide dismutase (SOD) and, therefore, appeared to depend on cytochrome-P-450-mediated reactions and to some extent also on superoxide anion radicals. Macrophages which were stimulated by 20 nM phorbol myristate acetate metabolized both drugs at much faster rates than unstimulated macrophages. Since this increased metabolism was abolished in the presence of SOD, it appeared to be entirely dependent on superoxide anion radicals. These data provide biochemical evidence that unstimulated human monocyte-derived macrophages have a substantial capacity to metabolize certain xenobiotics and that stimulated macrophages have an even greater capacity to do so. This property of macrophages may have considerable biological significance and be important in the pathogenesis both of drug-induced tissue damage and of malignant disease.

Chromatography, Ion Exchange↗
PubMed1991

The abundance and organization of polypeptides associated with antigens of the Rh blood group system.

Twelve murine monoclonal antibodies, which react with human red cells of common Rh phenotype but give weak or negative reactions with Rh null erythrocytes, were used in quantitative binding assays and competitive binding assays to investigate the abundance and organization of polypeptides involved in the expression of antigens of the Rh blood group system. Antibodies of the R6A-type (R6A, BRIC-69, BRIC-207) and the 2D10-type (MB-2D10, LA18.18, LA23.40) recognize related structures and 100,000-200,000 molecules of each antibody bind maximally to erythrocytes of common Rh phenotype. Antibodies of the BRIC-125 type (BRICs 32, 122, 125, 126, 168, 211) recognize structures that are unrelated to those recognized by R6A-type and 2D10-type antibodies and between 10,000 and 50,000 antibody molecules bind maximally to erythrocytes of the common Rh phenotype. The binding of antibodies of the R6A-type and the 2D10-type, but not of antibodies of the BRIC-125-type could be partially inhibited by human anti-D antibodies (polyclonal and monoclonal) and a murine anti-e-like antibody. These results are consistent with evidence (Moore & Green 1987; Avent et al., 1988b) that the Rh blood group antigens are associated with a complex that comprises two groups of related polypeptides of M(r) 30,000 and M(r) 35,000-100,000, respectively, and suggest that there are 1-2 x 10(5) copies of this complex per erythrocyte. The polypeptide recognized by antibodies of the BRIC-125 type is likely to be associated with this complex.

Animals↗
PubMed1991

The Nation's governors look toward reform.

Washington state's governor, who is chairman of the National Governors' Association, reviews the serious problems governors and their states face in making sure their residents have access to adequate health care.

Health Policy↗
PubMed1991

New monoclonal antibodies in CD44 and CD58: their use to quantify CD44 and CD58 on normal human erythrocytes and to compare the distribution of CD44 and CD58 in human tissues.

The cell-surface glycoproteins CD44 and CD58 are involved in cell adhesion reactions. In this paper 12 monoclonal antibodies in CD44 and two in CD58 are described. Competitive binding assays using CD44 antibodies identified three distinct epitope groups. Antibodies in Group 1 and, with one exception (BRIC 214), antibodies in group 2, but not antibodies in Group 3, recognized epitopes that are sensitive to reduction and to trypsin or chymotrypsin treatment of intact erythrocytes, and so these epitopes probably reside on the N-terminal disulphide-bonded domain of CD44. Antibodies in CD44 did not inhibit the binding of CD58 antibodies to erythrocytes or vice versa. Quantitative binding studies using radioiodinated IgG measured 1888-5592 copies of CD44 and 1772-3290 copies of CD58 on normal erythrocytes. Similar measurements with radioiodinated Fab fragments gave values of 6508-10,450 (CD44) and 3457-7622 (CD58). Immunocytochemical studies indicated that CD44 is much more widely expressed in non-haemopoietic tissues than CD58. Comparison with previously described CD44 antibodies suggests that antibodies in our Group 1 encompass Hermes 2 and that those in Group 2 encompass Hermes 1. All the CD44 antibodies gave weakened reactions with Lu(a-b-) erythrocytes of the In(Lu) type by one or more methods. BRIC 214 and antibodies in epitope Group 3 were used to demonstrate that CD44 on these variant cells gives membrane-bound trypsin and chymotrypsin cleavage fragments of similar molecular weight to those obtained with normal erythrocytes.

Antibodies, Monoclonal↗