Search PubMed⌕ Search

Biomedical subjects

C Butler

Publications and source records attributed to C Butler.

At least 73 records · Page 4Linked to original sources
PubMed1987

Histopathology of lung cancer in New Mexico, 1970-72 and 1980-81.

In conjunction with a population-based case-control study of lung cancer in New Mexico, the histopathology of cases diagnosed during 1980 and 1981 and during 1970-72 was reviewed. Adequate histologic or cytologic material was obtained for 725 cases, with 308 during 1970-72 and 417 during 1980-81. The light microscopic histologic type was classified on the basis of review by 2 pathologists. No significant differences were found in the histologic-type distributions in Hispanics and non-Hispanic whites. In males, the distributions of histologic types were similar in the two time periods, but in non-Hispanic white women the proportion of adenocarcinoma declined during 1980-81 as the proportion of small cell carcinoma increased. The panel classification was compared with that recorded by the New Mexico Tumor Registry. Overall agreement was 52.1% for 1970-72 and increased to 65.2% for 1980-81. The discrepancies between the two classifications were largest for the categories of large cell undifferentiated carcinoma and "other malignancy."

Adenocarcinoma↗
PubMed1987

Histologic chorioamnionitis in pregnancies of various gestational ages: implications in preterm rupture of membranes.

A retrospective review of placental material derived primarily from preterm deliveries was conducted and inflammatory changes graded on a scale of 0-3. Reviewers were blind as to the clinical outcomes. Other reviewers, unaware of the pathologic results, surveyed the clinical data, and results were combined for analysis. The findings suggest that placental and membrane inflammation probably precedes preterm spontaneous rupture of membranes in 8-30% of cases without labor. The duration of ruptured membranes and labor enhance the frequency of inflammation. Inflammation is not associated with significant puerperal infection unless cesarean delivery occurs. Perinatal morbidity and mortality were not significantly enhanced nor associated with conservative management of spontaneous preterm rupture of membranes in this population beyond the influence of fetal weight and gestational age.

Birth Weight↗
PubMed1986

Immunofluorescence studies of florid rheumatic Aschoff lesions.

We studied cardiac tissues of a patient who died of severe rheumatic myocarditis. Multiple Aschoff lesions were present throughout both ventricles and auricles. Immunofluorescence studies showed large monocytoid cells staining with OKM1 and anti-Leu M-3 as well as anti-Ia. Scattered T cells in areas of focal myocarditis stained with OKT3. Parallel staining for cardiac myosin-heavy chain antigens showed patchy dissolution of cardiac muscle fibers and traces of cardiac myosin within large monocytoid Aschoff cells.

Adult↗
PubMed1986

Drainage of pediatric lung abscess by cough, catheter, or complete resection.

We treated eight children, aged 7 weeks to 17 years, for lung abscess. Each abscess followed an episode of aspiration or a bacterial pneumonia. Associated conditions were leukemia, congenital immune deficiency, endocarditis, cerebral palsy, and prematurity. Seven of the 8 children had polymicrobial infections, usually containing both aerobic and anaerobic bacteria. The success of medical treatment by antibiotics and chest physiotherapy was age related; 3 of the 8 children, aged 10 to 17 years, recovered on this regimen, whereas five children, aged 7 weeks to 7 years, required catheter drainage or resection for cure. Drainage by catheter pneumonostomy was performed for solitary peripheral bacterial abscesses. A large intercostal catheter was inserted into the cavity, either operatively or percutaneously. Wedge resection was performed for multiple, central, or fungal abscesses. Pneumonostomy was curative in 3 of 4 children. One chronic abscess recurred after pneumonostomy and required resection. Wedge resection was curative in the two children who came to thoracotomy; lobectomy was not necessary. Although all eight children recovered from their lung abscesses, three of them died within a year of sepsis. Lung abscess today occurs in immunocompromised children who are vulnerable to fatal infections. Chest physiotherapy is unlikely to achieve good drainage in children under 7 years of age. Medical failures can be identified within the first week of treatment. Early and aggressive surgical treatment is indicated in such children, and may be lifesaving.

Adolescent↗
PubMed1986

Effects of powered mobility on self-initiated behaviors of very young children with locomotor disability.

This study reports the effects of powered mobility on the self-initiated behavior of six children with various disabilities who, between 23 and 38 months of age, learnt to use motorized wheelchairs in less than three weeks. Using a multiple baseline design, two-hour observation periods were video-recorded at 10-day intervals before and after they achieved independent mobility. Frequency of self-initiated interaction with objects, spatial exploration and communication with care-giver were analyzed. Three children increased all three types of behavior; one increased in two types but decreased in interaction with objects; and two increased in spatial exploration only.

Child, Preschool↗
PubMed1986

Placebo responses: an experimental study of psychophysiological processes in asthmatic volunteers.

This study evaluated the effects of placebo medication on pulmonary responses in asthmatics, and investigated the roles of expectancy and anxiety. Twelve adult asthmatics were recruited for a laboratory experiment described as a study of the effectiveness of a new bronchodilator. Distilled nebulized water was inhaled in each session. The solution was described as water in session 1 (control), while in sessions 2 and 3 subjects were told that the nebulizer contained a chemical likely to cause chest tightness and wheezing (bronchoconstrictive suggestion). Prior to the inhalation sequence in sessions 2 and 3, subjects inhaled from an aerosol that they were told contained either a powerful new drug (placebo) or a non-active substance (neutral). Pulmonary function was measured with the forced oscillation technique and spirometry, while autonomic parameters, anxiety and expectancies were also monitored. Pulmonary function deteriorated following the inhalations accompanied by bronchoconstrictive suggestion, and this effect was abolished by pre-treatment with placebo. Neither subject expectations nor changes in anxiety were associated with the experimental manipulations. The implications of these results for theories of placebo action are considered.

Adult↗
PubMed1986

Clinical features of a population-based series of patients with lung cancer presenting with a solitary nodule.

We assessed survival in a population-based series of patients with lung cancer presenting with a solitary nodule. Using a population-based cancer registry, we identified 674 incident lung cancer cases in Bernalillo County, New Mexico, from 1977 to 1981. Both clinical information and chest roentgenograms were reviewed to identify 83 solitary nodule cases and 479 nonsolitary nodule cases. Chest roentgenograms were unavailable for 112. There were 83 patients with solitary nodules (55 men and 28 women), and adenocarcinoma was the predominant cell type. Overall, 5-yr survival was significantly greater for the patients with solitary nodules (24%) than for those with nonsolitary nodules (8%) (p less than 0.001). Of the 41 patients with solitary nodules who had surgery and Stage I disease, 49% lived 5 yr. In contrast, none of the 39 who did not have surgery lived longer than 2 yr. Our results imply that the varying survival described in previous series of patients with solitary nodules reflects different patient selection criteria.

Adult↗
PubMed1985

Preferred provider organization liability for physician malpractice.

The preferred provider organization (PPO) is a recent innovation in the health care industry, designed to reduce costs through selective contracting and utilization controls. This Note examines malpractice liability theories potentially applicable to PPOs. The Note compares PPOs to other health care institutions, including hospitals and HMOs, and concludes that PPOs are at minimal risk of incurring liability for physician negligence.

Insurance, Health↗
PubMed1984

Computer-assisted instruction and diagnosis of radiographic findings.

Recent advances in computer technology, including high bit-density storage, digital imaging, and the ability to interface microprocessors with videodisk, create enormous opportunities in the field of medical education. This program, utilizing a personal computer, videodisk, BASIC language, a linked textfile system, and a triangulation approach to the interpretation of radiographs developed by Dr. W. L. Thompson, can enable the user to engage in a user-friendly, dynamic teaching program in radiology, applicable to various levels of expertise. Advantages include a relatively more compact and inexpensive system with rapid access and ease of revision which requires little instruction to the user.

Computer-Assisted Instruction↗
PubMed1984

Pulmonary leukostasis in fatal human pneumococcal bacteremia without pneumonia.

An asplenic man developed fulminant pneumococcal bacteremia without pneumonia. He died of irreversible shock within 24 h. Autopsy revealed extensive pulmonary vascular leukostasis. This condition has been described in laboratory animals after intravascular challenge with endotoxin, gram-negative bacilli, and gram-positive organisms including pneumococci. This case illustrates that death in pneumococcal disease can occur in the absence of pneumonia and may be attributable to cardiovascular collapse. We present a proposed mechanism based on activation of complement and release of vasoactive mediators.

Adult↗
PubMed1984

Motorized wheelchair driving by disabled children.

Thirteen children with physical disabilities, normal intelligence and stable family situations were studied to learn whether children under age 4 years could learn competent control of a motorized wheelchair. Their mean age was 31.3 months (range 20 to 37 months). There were six girls and seven boys. Each child required adaptive seating to manipulate the control stick in a conventional motorized wheelchair. Without specific training instructions, parents introduced the wheelchairs under pleasant circumstances at home. Daily logs and engine-hour-meters indicate that 12 children learned seven pre-established driving skills within a mean cumulative period of 34.4 hours (range 6.6 to 168 hours) distributed over an average 16.3 days (range 3 to 50 days). Actual cumulative wheelchair movement averaged 8.1 hours (range 1.7 to 26.1 hours). All learned a cluster of four to five skills over a one to five day period. Start-stop and circling were the two initial skills in all but one case. In four children, the first skill appeared after a latent period of 5, 6, 12 and 43 days. Children as young as 24 months can learn to drive motorized wheelchairs. Because of the theoretical importance of approximating normal gross motor milestones, powered mobility should be considered an early rehabilitative intervention for physically disabled children.

Child, Preschool↗
PubMed1984

Pneumococcal-induced pulmonary leukostasis and hemodynamic changes: role of complement and granulocytes.

In the present study we investigated the cardiopulmonary dysfunction caused by systemic pneumococcal (PNC) disease. We studied the hemodynamic and hematologic effects of intravascular challenge with nonviable PNC in normal, granulocyte-depleted, and genetically C3-deficient dogs. In normal dogs PNC administration caused a decrease in cardiac output (CO) of 58% (p less than 0.001), an increase in pulmonary vascular resistance (PVR) of 151% (p less than 0.02), and an increase in systemic vascular resistance (SVR) of 72% (p less than 0.02). The PNC challenge also caused significant decreases in both circulating granulocytes (-73%; p less than 0.02) and platelets (-58%; p less than 0.02). Histologic examination revealed granulocyte plugging within small pulmonary vessels. PNC challenge in granulocyte-depleted and C3-deficient dogs resulted in hemodynamic and hematologic changes that were not significantly different from those seen in normal PNC-challenged animals. Infusion of PNC-activated plasma resulted in hematologic changes that were not significantly different from those seen in PNC-challenged animals. Infusion of plasma treated with ethylenediamenetetraacetic acid (EDTA) prior to PNC incubation induced the same hematologic alterations but the hemodynamic response was less pronounced. To control for PNC constituents not removed by centrifugation and filtration, saline was incubated with PNC. After the PNC was removed, infusion of the saline induced no significant hemodynamic changes, although profound granulocytopenia occurred. We conclude that an intact complement system, but not normal numbers of circulating granulocytes, is essential to PNC-induced hemodynamic changes. PNC generates a plasma factor in vitro that does not require an intact complement system or cellular machinery to induce granulocytopenia without hemodynamic effect.

Animals↗