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Biomedical subjects

C B Wilson

Publications and source records attributed to C B Wilson.

At least 451 records · Page 25Linked to original sources
PubMed1981

Intrathecal chemotherapy for leptomeningeal dissemination of medulloblastoma.

Cerebrospinal fluid dissemination of medulloblastoma occurs despite adequate systemic chemotherapy, and unless it is present at the time of initial diagnosis, occurs late in the course of the disease. Intrathecal chemotherapy with an implanted Ommaya reservoir can produce short-term benefit. We report here our protocol for and the results of intrathecal chemotherapy for leptomeningeal dissemination of medulloblastoma.

Adolescent↗
PubMed1981

Abrogation of macrophage-dependent injury in experimental glomerulonephritis in the rabbit. Use of an antimacrophage serum.

Macrophages were shown by the use of glomerular cell culture and morphologic techniques to be present in large numbers within the glomeruli of rabbits with acute serum sickness (AcSS) and in a passive model of the autologous phase of antiglomerular basement membrane (GBM) antibody-induced glomerulonephritis (PAGBMN). To determine the part played by these cells in the glomerular injury, animals were treated with a sheep anti-rabbit macrophage serum (AMS) or normal sheep serum (NSS). NSS administration had no effect on the development of either model of glomerulonephritis. The use of AMS reduced the number of circulating monocytes and prevented the accumulation of macrophages within glomeruli in both models (AcSS/NSS, mean 126/glomerulus, range 40-251; AcSS/AMS, mean 8, range 1-44; PAGBMN/NSS, mean 52, range 27-69; PAGBMN/AMS, mean 5, range 2-7). The AMS-treated rabbits had only minor histologic lesion and profound reduction in proteinuria (AcSS/NSS, mean 516 mg/24 h, range 200-991; AcSS/AMS, mean 41, range 3-161; PAGBMN/NSS, mean 335, range 55-975; PAGBMN/AMS, mean 10, range 2-24). Similar studies in the heterologous phase of glomerular injury induced by the same anti-GBM antibody revealed no effect of the AMS on this polymorphonuclear leukocyte-related phase of injury, demonstrating the selectivity of the antisera. Complement depletion, with cobra venom factor, did not affect the development of glomerulonephritis nor the accumulation of macrophages in either model. Inhibition of macrophage accumulation can largely prevent these forms of experimental glomerulonephritis, thereby implicating macrophages as mediators of glomerular injury and consequent proteinuria.

Animals↗
PubMed1981

Silent pituitary apoplexy: subclinical infarction of an adrenocorticotropin-producing pituitary adenoma.

A young woman developed intermittent headaches and progressive hyperpigmentation after bilateral adrenalectomy for Cushing's disease. Results of sellar polytomography were abnormal. Her plasma ACTH levels increased to 4750-7340 pg/ml and did not rise with insulin-induced hypoglycemia. Although she experienced no clinical features associated with spontaneous infarction of a pituitary tumor, plasma ACTH levels fell to 474-575 pg/ml, and hemorrhagic necrosis was found in a 5-mm chromophobe adenoma at transsphenoidal surgery. Postoperatively, ACTH levels returned to normal (51-88 pg/ml), with the rest of her anterior pituitary function remaining intact 4 yr later. Spontaneous infarction of pituitary microadenomas may be subclinical, resulting in improvement of pituitary hormone hypersecretion without impairment of other anterior pituitary hormone secretion.

Adenoma, Chromophobe↗
PubMed1981

Symptomatic parasellar granular cell tumors.

Six cases of symptomatic parasellar granular cell tumor (pituicytoma, myoblastoma, choristoma) are reported. The clinical presentations included visual loss, dementia, and adenohypophyseal insufficiency. Lack of calcification and a suprasellar blush on angiography often help to differentiate these lesions from craniopharyngioma, pituitary adenoma, and optic glioma. These are the first cases studied by computed tomographic scan, which shows a high density, sharply demarcated lesion in the suprasellar region with dense, frequently homogeneous contrast enhancement. At operation these are characteristically tough, nonsuckable, vascular tumors. All previously reported patients with long survival (seven cases) have been contacted recently. The data do not support a role for postoperative radiation therapy. The surgical goal should be limited to decompression of the suprasellar if total excision seems too hazardous.

Adult↗
PubMed1981

Development of pseudotumor cerebri after the removal of an adrenocorticotropic hormone-secreting pituitary adenoma: case report.

A patient with Cushing's disease developed intracranial hypertension 1 month after the removal of an adrenocorticotropic hormone-secreting pituitary adenoma. A computed tomographic scan demonstrated normal ventricles and no intracranial mass, establishing the diagnosis of pseudotumor cerebri. The elevated intracranial pressure was apparently consequent to an abrupt reduction in circulating corticosteroids. The development of pseudotumor cerebri after the correction of endogenous hypercortisolism has not been reported previously. This potential complication of the surgical treatment of Cushing's disease can be managed with prompt recognition and appropriate treatment of the syndrome.

Adenoma↗
PubMed1981

Multiple forms of growth hormone: detection in medium from cultured pituitary adenoma explants.

Three pituitary adenomas obtained from patients wtih acromegaly were maintained in organ explant culture for a period of 12 days in a defined culture medium. Lyophilized culture medium from each was then examined by electrophoresis to determine which forms of growth hormone were secreted by the explants. All three explants secreted principally the major form of growth hormone. One adenoma however secreted unusually large amounts of two slowly migrating forms which were in low concentration in the GH-containing granules of normal pituitaries. On the other hand the adenoma produced a much lower amount of a 20,000-dalton variant than was seen in normal pituitary glands. The other two adenomas did not secrete the relatively large amounts of the slowly migrating forms although the quantity of the 20,000-dalton form was less than the amount seen in the normal pituitary. There was no evidence of proteolytic alteration of the growth hormone during the culturing process. In companion experiments with rat pituitary glands the growth hormone did not undergo proteolytic degradation in the gland left in situ for 96 h at 5 degrees C.

Adenoma↗
PubMed1981

Chemotherapy of pediatric brain-stem tumors.

Forty-five children harboring brain-stem tumors were treated at the University of California, San Francisco, between 1969 and 1979. Pathological diagnoses were made in 19 patients. All patients received radiation therapy (RT). Thirteen patients received chemotherapy before, during, or immediately after RT. Twenty-four patients were treated with chemotherapy at the time of tumor progression, after initial treatment with RT alone. No statistically significant difference in time to tumor progression or survival was found for treatment with chemotherapy as an adjuvant to RT compared to treatment with RT alone followed by chemotherapy administered at the time of tumor progression. There were, however, more long-term survivors in the group that was first treated with chemotherapy at the time of tumor progression. There was no statistically significant correlation between survival and tumor pathology or location, although there were more long-term survivors among patients harboring low-grade gliomas and among patients with tumors confined to the midbrain. The authors documented the response of some brain-stem tumors to chemotherapy; however, cooperative controlled studies will be required to determine the optimum treatment for this disease.

Adolescent↗
PubMed1981

Isolated hypertrophic interstitial neuropathy of the trigeminal nerve associated with trigeminal neuralgia. Case report of an entity not previously described.

Hypertrophic interstitial neuropathy (HIN) of the trigeminal nerve was observed in a patient with trigeminal neuralgia who had no other neurological abnormalities. Pathological documentation confirmed focal HIN. No similar histologically documented case of isolated trigeminal nerve involvement by HIN has been reported previously.

Adult↗
PubMed1981

Selective venous sampling for ACTH in Cushing's syndrome: differentiation between Cushing disease and the ectopic ACTH syndrome.

We performed selective venous catheterization and sampling for ACTH in six patients with ACTH-secreting pituitary adenomas (Cushing's disease) and four patients with occult ectopic ACTH-secreting neoplasms. In five patients with Cushing's disease in whom the inferior petrosal sinus could be catheterized, ACTH levels were unequivocally higher than simultaneous peripheral values: The ratio was greater than 2.0, with a range of 2.2 to 16.7. In contrast, the inferior petrosal sinus-to-peripheral ACTH ratio in three patients with ectopic ACTH secretion was less than 1.5. In the fourth patient, an arteriovenous gradient of 6.8 was shown 2 years before a bronchial carcinoid tumor was clinically apparent. Central-to-peripheral ACTH ratios at the level of the jugular bulb and jugular vein were not diagnostic. We conclude that selective venous ACTH sampling from the inferior petrosal sinus is a reliable and useful aid in the differential diagnosis of Cushing's syndrome when standard clinical and biochemical studies are inconclusive.

ACTH Syndrome, Ectopic↗
PubMed1981

Nephritogenic immune reactions involving immune complex formation in the circulation and in situ within the kidney.

The circulating immune complex (IC) mechanism of renal and vascular injury is now well established based on observations in experimental serum sickness in animals and detection of circulating and localized IC of known antigen and antibody content in glomerulonephritis (GN) in man. Studies continue on the factors responsible for formation and vascular deposition of circulating IC. Utilization of assays to detect circulating IC has revealed that some patients with chronic presumed IC GN have no unusual amount of circulating IC. The possibility that nephritic individuals may handle relatively normal amounts of circulating IC in a nephritogenic fashion points out the need to study host and genetic factors in the development of IC GN. Observations in experimental animals have demonstrated the nephritogenic potential of the direct reaction of antibody with antigens, either structural in nature or "planted" within the glomerulus in a discontinuous pattern. This suggests that some GN previously thought to be from deposition of circulating IC IC by the pattern of irregular Ig accumulation on immunofluorescence study might be the product of a direct reaction of antibody with glomerular capillary wall antigens. Models of such reactions involving nonclassic glomerular basement membrane (GBM) glomerular capillary wall antigens are being identified in animals and sought in man. Finally, the reaction of antibodies with foreign materials that are first trapped or "planted" within the glomerulus can be nephritogenic in animal models and conceivably in man. The local nephritogenic immune reaction within the glomerulus should not distract from the circulating IC mechanism but rather expand our ideas of how the immune system can damage the kidney.

Animals↗
PubMed1981

Bacteremia in a small non-urban community hospital.

Forty-six episodes of bacteremia were observed during a three-year period at a small, non-urban community hospital. The incidence of bacteremia was 4.3 episodes per 1,000 admissions; this rate is similar to the incidence of bacteremia in large, urban community hospitals but lower than the incidence of bacteremia in municipal or academic hospitals. Eleven percent of bacteremias were hospital acquired, an incidence of 0.5 hospital acquired bacteremias per 1,000 admissions. The low incidence of hospital acquired bacteremia was a reflection of the low incidence of nosocomial, aerobic, gram-negative bacteremia (0.1 per 1,000 admissions). Thirteen percent of bacteremic patients died. The mortality in patients with community acquired bacteremia (10%) was lower than that reported from larger, urban hospitals; the mortality in patients with hospital acquired bacteremia (40%) was similar to that reported from larger, urban hospitals. The lower rates of bacteremia and associated mortality that were observed appear to be due to the lesser severity of underlying diseases in these patients.

Adult↗
PubMed1981

Anti-basement membrane antibodies in immunologic renal disease.

Anti-basement membrane antibodies are now being associated with an increasing spectrum of disease, including Goodpasture's syndrome, rapidly progressive and occasionally milder forms of glomerulonephritis (GN), tubulointerstitial nephritis, pulmonary damage, and potentially other forms of tissue injury. We have developed a radioimmunoassay to detect circulating antiglomerular basement membrane (GBM) antibodies. The antigens for this assay are derived from the noncollagenous portion of the GBM remaining after collagenase digestion. After immunoabsorptive purification, the major antigens precipitated by human anti-GBM antibodies can be characterized by polyacrylamide gel electrophoresis (PAGE) into an unresolved high molecular weight fraction and two antigenic peaks of 54,000 and 27,000 daltons. The noncollagenous nature of the antigenic material has been confirmed by amino acid analysis. The radiolabelled antigen has proven useful in detecting circulating anti-GBM antibodies in over 500 patients. The assay is of use in monitoring the activity of disease and judging the patient's response to therapy. It is also useful in determining the timing of renal transplantation, if required. Differences in antigenic content of glomerular and tubular basement membranes (TBM) have been noted between individuals. These antigenic differences, under certain circumstances, can lead to the induction of anti-basement membrane antibody responses after transplantation.

Adult↗
PubMed1981

Potentials and limitations of a clonogenic cell assay for human brain tumors.

Single cells from biopsies of ten malignant gliomas were treated with 1,3-bis (2-chloroethyl)-1-nitrosourea (BCNU) in vitro, and tumor cell survival was compared to patient response to nitrosourea therapy. The limitations of the methods and their interpretations and future prospects for clonogenic cell analyses are discussed.

Adult↗