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Biomedical subjects

C R Taylor

Publications and source records attributed to C R Taylor.

At least 307 records · Page 17Linked to original sources
PubMed1981

Hemodynamic effects of oral pirbuterol in chronic severe congestive heart failure.

The achievement of satisfactory ambulatory therapy of severe chronic congestive heart failure may be helped by the development of safe and orally effective cardiotonic agents. Therefore, we evaluated by cardiac catheterization and limb plethysmography the temporal cardiocirculatory responses of the new ingestible beta agonist pirbuterol in 10 coronary heart disease patients with severe congestive heart failure refractory to digitalis and diuretics. After a single oral dose of 0.4 mg/kg, ventricular dysfunction was considerably improved during 6 hours of hemodynamic monitoring. Cardiac index increased from a control of 1.7 l/min/m2 to 2.6 l/min/m2 (p < 0.001) at 1 hour and to 2.4 l/min/m2 (p < 0.005) at 3 hours and was 2.2 l/min/m2 (p < 0.001) at 6 hours; left ventricular filling pressure decreased from a control of 24 mm Hg to 19 mm Hg (p < 0.005) at 1 hour and to 18 mm Hg (p < 0.005) at 3 hours and was 22 mm Hg (p < 0.05) at 6 hours. Concomitantly, the peak increment in heart rate (6 beats/min) was minimal and without ectopy and mean arterial blood pressure decreased only 10 mm Hg. total systemic vascular resistance declined by 887 dyn-sec-cm-5, forearm venodilation occurred and the rate-pressure product was unaltered. Thus, oral pirbuterol provides beneficial hemodynamic effects in patients with severe left ventricular dysfunction and appears potentially useful for long-term management of low-output congestive heart failure.

Adult↗
PubMed1981

Acute effects of oral pirbuterol on myocardial oxygen metabolism and systemic hemodynamics in chronic congestive heart failure.

Pirbuterol hydrochloride, an orally effective beta-adrenergic agonist, improves hemodynamic abnormalities in patients with congestive heart failure, but its effects on myocardial oxygen consumption (MVO2) and coronary blood flow have not been characterized. We studied the effects of 20-30 mg of oral pirbuterol on myocardial metabolic and hemodynamic parameters in 12 patients (six with coronary artery disease) with chronic CHF refractory to standard medical therapy. Pirbuterol induced an increase in cardiac index (1.7 +/- 0.1 to 2.3 +/- 0.2 l/min/m2, p less than 0.05) and a fall in systemic vascular resistance (1884 +/- 118 to 1391 +/- 69 dyn-sec-cm-5, p less than 0.01) 2 hours after administration. Pulmonary capillary wedge pressure fell from arterial and right atrial pressures did not change. Heart rate remained constant. Arterial-coronary sinus oxygen content difference narrowed (from 12.9 +/- 0.4 to 11.1 +/- 0.3 vol%, p less than 0.05), while no significant change occurred in MVO2. Myocardial oxygen extraction ratio and myocardial lactate extraction ratio did not change, and no patient developed angina or electrocardiographic evidence of myocardial ischemia. Patients with coronary artery disease had hemodynamic and myocardial metabolic responses similar to those without coronary artery disease. Pirbuterol effects substantial acute hemodynamic improvement in patients with chronic congestive heart failure without increasing requirements for coronary blood flow or myocardial oxygen delivery and without provoking myocardial ischemia.

Adult↗
PubMed1981

Electrical activity and relative length changes of dog limb muscles as a function of speed and gait.

Electrical activity and length changes of 11 muscles of the fore- and hind- limbs of dogs walking, running, and galloping on a treadmill, were measured as a function of forward speed and gait. Our purpose was to find out whether the activity patterns of the major limb muscles were consistent with the two mechanisms proposed for storage and recovery of energy within a stride: a 'pendulum-like' mechanism during a walk, and a 'spring-like' mechanism during a run. In the stance phase of the walking dog, we found that the supraspinatus, long head of the triceps brachii, biceps brachii, vastus lateralis, and gastrocnemius underwent only minor length changes during a relatively long portion of their activity, Thus, a major part of their activity during the walk seems consistent with a role in stabilization of the joints as the dog 'pole-vaulted' over its limbs (and thereby conserved energy). In the stance phase of trotting and/or galloping dogs, we found that the supraspinatus, lateral head of the triceps, vastus lateralis, and gastrocnemius were active while being stretched prior to shortening (as would be required for elastic storage of energy), and that this type of activity increased with increasing speed. We also found muscular activity in the select limb flexors that was consistent with storage of kinetic energy at the end of the swing phase and recovery during the propulsive stroke. This activity pattern was apparent in the latissimus dorsi during a walk and trot, and in the biceps femoris during a trot and gallop. We conclude that, during locomotion, a significant fraction of the electrical activity of a number of limbs muscles occurs while they undergo little or no length change or are being stretched prior to shortening and that these types of activities occur in a manner that would enable the operation of pendulum-like and spring-like mechanisms for conserving energy within a stride. Therefore these forms of muscular activity, in addition to the more familiar activity associated with muscle shortening, should be considered to be important during locomotion.

Animals↗
PubMed1981

Malignant B-cell lymphoma following and associated with infectious mononucleosis. A comparison of two cases.

The present report describes two young males with clinically diagnosed infectious mononucleosis (IM) who subsequently were diagnosed as having malignant B-cell lymphoma (i.e., immunoblastic sarcoma of B-cells). Despite these apparent similarities, there were fundamental differences between the two cases. The first patient, who lymphoma was diagnosed 9 months after IM, was one of a well-described kindred with the X-linked lymphoproliferative syndrome (XLP) in which affected young males lack the ability to mount an effective immune response to primary infection with the Epstein-Barr virus (EBV) (i.e., infectious mononucleosis), and subsequently develop fatal lymphoproliferative disorders of the B-cell type. This was in contrast to a second patient, also a young male, who did not have the X-linked lymphoproliferative syndrome, who did develop specific antibodies to the Epstein-Barr virus and whose malignant lymphoma was closely associated in time (i.e., 5 weeks) with the clinical diagnosis of infectious mononucleosis. The comparative immunologic and virologic features are discussed as well as the importance of careful clinicopathologic correlation in young adults and children developing malignant lymphoma both following and in association with infectious mononucleosis.

Adolescent↗
PubMed1981

Immunoblastic sarcoma of T-cell versus B-cell origin: I. Clinical features.

Within the Lukes-Collins classification system of malignant lymphoma, a tumor of large transformed lymphocytes, termed immunoblastic sarcoma (IBS), is described. This morphological type would have been included within the "histiocytic" category of Rappaport. Immunoblastic sarcoma may be of B-lymphocytic or T-lymphocytic origin. Since differences or similarities of these two variants have not yet been described, we reviewed the case histories of 35 such patients, all of whom had immunologic marker studies performed. Nineteen patients had T-cell IBS (T-IBS), whereas 16 had B-cell IBS (B-IBS). Median age for both groups was approximately 50 yr. A history of prior immune disorder was found in 31% of B-IBS and 16% of T-IBS cases. Prior lymphoproliferative malignancy was noted in 21% of T-IBS and 13% of B-IBS patients. All T-IBS patients first presented because of lymphadenopathy, whereas 56% of B-IBS cases initially presented because of extranodal disease. Systemic "B" symptoms were common in both. Similarly, most patients had widespread disease (stage III or IV) at diagnosis. Clinically suspected hepatic (p = 0.05) and retroperitoneal node (p = 0.01) involvement were more often found in T-IBS. Forty-one percent of T-IBS patients demonstrated polyclonal hypergammaglobulinemia, a finding seen in no B-IBS patient (p = 0.02). Although not statistically significant because of small numbers of patients, data on therapy and survival suggest that IBS of B-cell type may be successfully treated with aggressive, multiagent chemotherapy, while alternative approaches appear warranted in T-cell disease.

Adult↗
PubMed1981

Detection of terminal transferase in paraffin sections with the immunoperoxidase technique.

Terminal deoxynucleotidyl transferase (TdT) is an early T-cell differentiation marker in a number of species, including man. We have demonstrated TdT in the nuclei of cortical thymocytes in paraffin-embedded sections of calf, rat, and human thymus by indirect immunoperoxidase techniques. In addition, these techniques have been used to verify and extend enzyme assay results by detecting TdT in blast cells from 10 patients with convoluted T-cell lymphoma/leukemia, 1 patient with acute granulocytic leukemia, 1 patient with chronic granulocytic leukemia in blast crisis, and 1 patient with non-T non-B acute lymphocytic leukemia.

Animals↗
PubMed1981

Design of the mammalian respiratory system. I. Problem and strategy.

This paper introduces a series of reports on the structure and function of the respiratory system of mammals. We propose and justify the hypothesis that structural design is a limiting factor for O2 flow at each level of the respiratory system. The background, the reasons, and the plan for the studies are described. The main approach is to compare the size of respiratory structures with maximal O2 consumption in a series of mammals spanning several orders of magnitude in body size. The papers that follow present the methods and results for maximal O2 consumption, pulmonary diffusing capacity, mitochondrial volume, and capillary density in muscles.

Animals↗
PubMed1980

Extratesticular gonadal stomal tumor in the pelvis. A case report with immunoperoxidase findings.

A 40-year-old man with two normally descended testicles and no signs of hormonal anomalies developed a fist-sized extraperitoneal tumor to the left of the urinary bladder. Histologic diagnosis was that of a probably malignant gonadal stromal tumor because of considerable mitotic activity and widespread vascular invasion. Retroperitoneal lymphadenectomy showed no metastatic disease, and the patient is well two years after surgery. By use of an immunoperoxidase method we could demonstrate estradiol and testosterone in the tumor cells. The findings in this case are unique in regard to the extratesticular location of the tumor and support the current view that gonadal stromal tumors arise from a primitive cell with a multidirectional potential for differentiation.

Adult↗
PubMed1980

Primary mediastinal lymphoma in adults.

The incidence of primary mediastinal lymphoma in adults was investigated in 184 patients with non-Hodgkin's lymphoma. This entity was defined as disease within the mediastinum in patients who presented with symptoms due to an enlarging mediastinal mass. Of 184 patients, 17 presented with primary mediastinal lymphoma. All had a diffuse histologic pattern. The most common pathologic type was poorly differentiated lymphocytic lymphoma, diffuse (PDL-D), (11 cases). In nine of these 11 cases the patients had tumors of convoluted lymphocytes. The presentation was rapid in onset, with heart failure, pericarditis, dyspnea and superior vena caval syndrome predominating. Eleven of the 17 were clinical stage I or II, but eight of these had widespread disease on pathologic staging or rapid dissemination soon after diagnosis. In conclusion (1) primary mediastinal lymphoma is always diffuse in histology. (2) The most frequent pathologic type is PDL-D, with convoluted morphology. (3) Compression of vital intra-thoracic structures is common. (4) Although seemingly localized at presentation, this entity usually implies disseminated disease.

Adult↗
PubMed1980

Direct tissue visualization of normal cross-reacting antigen in neoplastic granulocytes.

Normal cross-reacting antigen, a glycoprotein that shares some antigenic determinants with carcinoembryonic antigen, was consistently demonstrated by tissue immunoperoxidase staining in the cytoplasm of both non-neoplastic and neoplastic neutrophilic granulocytes. It was absent in lymphoid cells, but occasional cells of the macrophage/histiocyte series showed variable staining. Malignant cells from patients who had non-Hodgkin or Hodgkin lymphomas were negative for normal cross-reacting antigen. These findings were in contrast to the findings of specific normal cross-reacting antigen positivity in neoplastic granulocytes from three patients who had acute granulocytic leukemia, three who had chronic granulocytic leukemia, and one who had a granulocytic sarcoma. Similar normal cross-reacting antigen positivity was also seen in granulocytes from two patients who had granulocyte dysplasia. It is suggested that direct tissue visualization of normal cross-reacting antigen using immunoperoxidase technics may be of value in the classification and diagnosis of hematologic malignancies, and may provide an additional marker for cells of the granulocytic series.

Antigens, Neoplasm↗
PubMed1980

Orbital and adnexal lymphomas. A multiparameter approach.

The application of immunologic, cytochemical, and electron-microscopic technics to the study of lymphoid lesions of the orbit and adnexa was found to enhance the accuracy of diagnoses of malignant lymphoma in five challenging referral cases. Although careful specimen collection, ideal fixation, and processing constitute the cornerstone of the morphologic diagnosis of nodal and extranodal lymphomas, the immunologic characterization of these lymphoproliferative disorders is emphasized as an especially useful diagnostic parameter. The occurrence of false-negative diagnoses of pseudolymphoma of the orbital region may be partially explained by a failure to recognize the relatively frequent plasma-cytoid lymphocytic lymphoma, a distinctive entity that may mimic a reactive inflammatory process. All of the cases of malignant lymphoma reported represented stage I or stage II disease, suggesting that primary lymphoma of the orbital region may be a disease with a favorable prognosis.

Adult↗
PubMed1980

Serum immunoglobulin levels in patients with non-Hodgkin's lymphoma.

Immunoglobulin quantitation was performed on pretherapy sera from 120 patients who had non-Hodgkin's lymphoma in an attempt to correlate abnormalities with histologic cell type and pattern. Patients with diffuse lymphomas had significantly (P less than 0.05) higher levels of IgG and IgA than patients with follicular lymphomas. Furthermore, polyclonal hyperimmunoglobulinemia was overall more common than hypoimmunoglobulinemia, and abnormally high immunoglobulin levels were most frequently found in patients who had diffuse histologic patterns. The highest values were associated with either lymphomas composed of T (thymus-derived) cells or large B (bursa-derived) cells. The incidence of quantitative immunoglobulin abnormalities in patients with T-cell lymphomas was comparable with that in patients with B-cell lymphomas. These abnormalities in the former group of patients were exclusively above the normal range, whereas they were equally above and below the normal range in the latter group. The frequent polyclonal hyperimmunoglobulinemia in patients with T-cell lymphomas may be related to the pathophysiology of these lesions.

Adult↗
PubMed1980

Clinical and immunologic spectrum of plasmacytoid lymphocytic lymphoma without serum monoclonal IgM.

As first suggested by Lukes & Collins (1975), and recently confirmed in the literature, the pathological lesion associated with Waldenström's macroglobulinaemia can be found in patients with serum IgG or IgA monoclonal proteins. To expand upon the clinical and immunologic spectrum of this lesion, we reviewed the records of 12 patients with identical tumour morphology, though lacking an IgM paraprotein. The median age of the patients was 62 years. In five patients the tumour secreted monoclonal IgG, while one secreted monoclonal IgA. One patient had normal serum protein electrophoresis, although monoclonal light chains were demonstrated on urinary protein electrophoresis. The remaining patients had no detectable monoclonal protein. Marker studies demonstrated the B cell origin of tumour, these findings were consistent with the monoclonal protein secreted. Clinically, these cases varied, from peripheral blood involvement resembling chronic lymphocytic leukaemia, to typical lymphomatous processes, to presentations resembling multiple myeloma, reflecting the similarity of all of these conditions as varying expressions of neoplasia of the B cell system.

Adult↗
PubMed1980

An antitumor antibody in normal human serum: reaction of anti-T with breast carcinoma cells.

Carcinoma of the breast is now the most common malignant disease of females in Europe and North America. The most critical single factor in determining the success or failure of treatment is the extent of the disease at diagnosis. A sensitive immunoperoxidase technique was utilized to (1) detect the presence in normal human serum of antibody directed against breast carcinoma cells (anti-T antibody), and (2) determine whether this antibody could be used to discriminate between benign and malignant breast epithelium in sections of formalin-fixed, paraffin-embedded tissue. A total of 11 benign and 11 malignant breast lesions were examined for evidence of binding of human immunoglobulin, before and after application of purified anti-T antibody or normal human AB serum (containing anti-T antibody). Malignant cells showed significant binding of human immunoglobulin (anti-T); benign or normal cells did not. Clear immunohistological separation of benign and malignant breast lesions appears to be potentially feasible by this method.

ABO Blood-Group System↗