A new malpractice shield for doctors who go bare.
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Biomedical subjects
Publications and source records attributed to B Sheridan.
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A group of patients with retroperitoneal liposarcoma is presented and general guidelines of management reviewed. It is suggested that aggressive, radical total surgical excision followed by adjuvant postoperative irradiation be used as the treatment of choice. Although the management of recurrent disease may be discouraging in terms of ultimate cure, reasonable palliation and prolonged survival may result from aggressive therapy.
A uniform method of recording data on head and neck cancer patients is presented. This has been shown to work well in the clinical field. The records are always completely up to date and immediately available at any time for data analysis.
Plasma corticotrophin (ACTH) was lowered in 4 out of 5 patients with pituitary dependent Cushing's syndrome (one of whom was studied only after bilateral adrenalectomy) after a single oral dose of 2.5 mg bromocriptine, but plasma cortisols were unaltered in the 3 patients in whom it was measured. Three patients were observed during treatment with bromocriptine for 16 to 87 weeks. One improved symptomatically while maintained on a combination of metyrapone and bromocriptine, but plasma ACTH levels remained high even when the dose of bromocriptine was increased to 20 mg daily. Bromocriptine therapy was discontinued after 16 weeks in the second patient due to the development of mental depression. Her clinical features had not improved during this time. The third patient, who also underwent a course of pituitary irradiation, became, and remains, symptom free, with satisfactory plasma ACTH and cortisol levels for the 87 weeks he has received bromocriptine. The role of bromocriptine in the management of Cushing's disease seems limited despite the fact that plasma ACTH may fall after a test dose of the drug.
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The predictive values of plasma progesterone levels in 70 patients threatening to abort was investigated. It was found that no patient aborted whosed plasma progesterone level remanined above 35 nmol/l between 7 and 16 weeks of pregnancy, whereas if the plasma progesterone level was less than this, subsequent abortion always occurred. The predictive value of cornification index in vaginal smears was also examined: many smears were unsatisfactory for assessment and in patients with threatened abortion there was a 14 per cent incidence of falsely optimistic and 29 per cent of falsely pessimistic predictions.
Procedures for cholera enterotoxin purification previously developed in this labarotory were not applicable to large-scale purification, and these methods resulted in low yields of pure toxin. An efficient scheme has been developed whereby pure cholera enterotoxin can be obtained from 6 to 8 liters of culture supernatant fluid. This method consists of concentration by membrane ultrafiltration followed by gel filtration and cation-exchange chromatography. Pure cholera enterotoxin of high biological potency was obtained after a final step of preparative acrylamide gel electrophoresis. The degree of purity of the toxin-antigen as well as its biological activity were determined at various setps of purification. This alternate technique for purification is offered because of the widespread interest in cholera enterotoxin as a specific stimulator of adenyl cyclase.
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Oral glucose tolerance tests were carried out on 51 men with atherosclerotic peripheral vascular disease, none of whom were known diabetics or had suffered recent myocardial infarction. The plasma insulin and blood sugar responses were compared with 47 age and sex-matched controls. There was no significant difference in obesity between the two groups. The patient group showed an increased plasma insulin response with a delay in return to fasting levels, and the blood sugar response was similar. These results suggest that hyperinsulinaemia and hyperglycaemia are often associated with atherosclerosis, and may have a role in its aetiology.
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