Search PubMed⌕ Search

Biomedical subjects

D E Saunders

Publications and source records attributed to D E Saunders.

At least 55 records · Page 3Linked to original sources
PubMed1986

Growth of the cleft lip following a triangular flap repair.

This study involves 50 children who had a triangular flap repair for unilateral cleft lip. They have been followed for 5 to 14 years by serial measurements, photographs, and clinical evaluation. During the first 5 years, the lips were designed to allow for future growth. The expected growth did not occur. During the second 5 years, the lip length was designed equal to the normal side with the belief that unequal growth does not occur. In this group, the results supported the premise that deviation from the correct lip length would now be equally divided between too long and too short. None of the entire group has a lip which started too short becoming equal or starting equal to become too long. It is the conclusion of the authors that a repaired unilateral cleft lip retains the configuration and length determined at the time of the initial repair.

Adolescent↗
PubMed1985

Acute myocardial infarction: period prevalence, case fatality, and comparison of black and white cases in urban and rural areas of South Carolina.

Community surveillance revealed 1085 prevalent cases of acute myocardial infarction (AMI) during 1978 in urban metropolitan Columbia and rural Pee Dee areas of South Carolina. Six hundred fifty-eight hospitalized cases met our criteria and were classified as definite or probable. Death certificates identified 427 who died before admission to the hospital and who were classified as unvalidated. However, there is need to verify death certificate diagnosis in out-of-hospital deaths which account for approximately two thirds of total cases in blacks and about one third of white cases. Other findings were: White males had higher AMI rates in the rural Pee Dee area than in urban Columbia, while black males and black females had higher rates in Columbia than in the Pee Dee area and white females had similar rates in both areas. Rates for out-of-hospital AMI mortality were higher in blacks than in whites. Out-of-hospital AMI mortality rates in Columbia and the Pee Dee area were four times higher than in Minneapolis-St. Paul in 1978. For definite and all criteria AMI, white males had the highest rates, double the black male rate except for all criteria AMI in Columbia, where white male and black male rates were similar. Urban cases of both races experienced more anterior infarctions than rural cases.

Adult↗
PubMed1984

Myocardial infarction in sickle cell anemia.

A review of the electrocardiograms (ECG) of 108 patients with sickle cell anemia found only 3 with patterns consistent with myocardial infarction. Two of the 3 patients with ECG infarct patterns had postmortem examination confirmation of the infarction. These two patients had no significant coronary atherosclerosis nor did the other six autopsied patients in the present series. Literature reports of postmortem examinations on patients with sickle cell anemia confirm the scarcity of coronary atherosclerosis and myocardial infarction in these patients. Forty of the 108 ECGs showed signs of left ventricular hypertrophy and 20 others had nondiagnostic ST and T wave abnormalities. Nine showed first degree AV block and four right bundle branch block.

Adult↗
PubMed1984

A second career in academic medicine.

Career changes in all vocations are relatively common in the forties age group due to a variety of factors which include a crisis period caused by polarities of Generativity versus Stagnation as conceptualized by Erik H. Erikson. Generativity is served not only by procreativity but also by guiding the next generation through teaching. The result can be the strength of Care. Stagnation can result in unhappiness, irrational and destructive behavior, or withdrawal. Concepts of young, old and mortality also come into focus. A successful career change from private practice to academic medicine depends upon a combination of power, opportunity, and character. To be successful, the change should be made for positive reasons and be based upon youthful concepts in the cold reality of the financial and intellectual challenges of a new and competitive career. If properly done, both the personal rewards and the contribution to future medical care can be quite positive.

Adult↗
PubMed1984

Effect of growth on the estrogen receptor levels in MCF-7 cells.

MCF-7 cells have been shown to contain estrogen receptor in several cell fractions following homogenization: nuclei, microsomes, and cytosol. The amount of 17 beta-estradiol-binding capacity found in each cellular compartment depended on the inclusion of detergent in homogenization buffers and on the use of 0.25 M sucrose in the nuclear washes. 17 beta-Estradiol receptor (E2R) associated with nuclei (whole nuclei exchange assay, 0.6 M KCl soluble, and that found on membranes sheared from crude nuclear pellets by centrifugation in 0.25 M sucrose buffer) displayed a dissociation constant (Kd) of 0.77 +/- 0.01 (S.D.) nM (n = 7). KdS of the cytoplasmic (microsomes and soluble) receptors were determined to be 0.33 +/- 0.10 nM (n = 9). Exchangeable ligand on partially purified nuclei assumed its highest level in MCF-7 cells during logarithmic growth in serum-containing media (0.8 pmol/micrograms DNA) but declined after the culture reached confluence (0.2 pmol/micrograms DNA). Seventy-five % of the nuclear E2R declined linearly after feeding MCF-7 cells in logarithmic growth phase an estrogen- and serum-free medium (t1/2 3.5 days). Another class of salt-extractable nuclear receptor (0.2 pmol/micrograms DNA) persisted in postconfluent cultures whether fed estrogen (serum-containing media) or not (serum-free media). This residual binding capacity remained in nuclei of MCF-7 cells for an extended period of time. MCF-7 cells demonstrated functionality of E2R throughout their growth phases as evidenced by the replenishment of cytosolic E2R and the induction of progesterone receptor when given 17 beta-estradiol.

Breast Neoplasms↗
PubMed1983

Induction of porcine uterine estrogen sulfotransferase activity by progesterone.

Studies have been carried out which were designed to examine the hormonal requirement for the appearance of estrogen sulfotransferase activity in porcine uteri. Mature, ovariectomized (OVX) gilts were housed for 3 weeks before being treated with various regimens of estradiol-17 beta (E2) and progesterone (P). Uteri were then removed, minced, incubated for 2 h with [3H] E2 (10(-8) M) and Na2 35SO4 (10(-4) M) and the labeled metabolic products were extracted and analyzed. Endometrial samples were also taken for the determination of E2 and P cytoplasmic and nuclear receptors (R). It was found that 4 daily injections of 250 micrograms of E2 was sufficient to bring plasma E2 concentrations to that representative of a normal estrous cycle (approx. 30 pg/ml) and to induce cytoplasmic PR to high levels (7000--19000 fmol/mg DNA). Estrogen sulfotransferase activity, which was negligible in OVX and E2-treated pigs, increased to near normal secretory levels (4 pmol product/h per 0.4 g tissue) only in pigs primed with E2 and subsequently treated with E2 and P (25--250 mg/day, 3 days). This treatment also brought about the translocation of PR to the nuclear compartment. The steroid alcohol sulfotransferase activity in these tissues decreased upon ovariectomy and remained unaffected by the hormone treatments. Endometria from treated and untreated pigs were cultured for a period up to 7 days. During this time E2 (10(-8) M) induced and/or maintained PR and P (10(-6) M) was shown to stimulate estrogen sulfurylation concomitant with the translocation of PR to the nucleus. These studies have demonstrated that, in OVX pigs and endometrial cultures, P stimulated uterine estrogen sulfotransferase activity to a level normally found in secretory uteri. In order for P to bring about elevated levels of estrogen sulfurylation it was necessary that the endometrium contain adequate concentrations of cytoplasmic PR (which required E2 priming of the system) and the P receptor complex must display nuclear translocation.

Animals↗
PubMed1980

Relation of tumor content of estrogen and progesterone receptors with response of patient to endocrine therapy.

The levels of estrogen (E2R) and progesterone (PgR) receptors in 165 breast tumor biopsies have been determined. Seventy-seven percent of the specimens contained significant levels of E2R; 38.2% were positive for both receptors. Only four tumors displayed the unusual E2R=/PgR+ pattern. Tumors from pre- and postmenopausal patients had similar receptor characteristics. Two-thirds of the six patients with E2R+PgR+ tumors responded to hormonal therapy, whereas only 28.7% of the E2R+/PgR- tumors regressed after similar treatment. These data from a limited number of patients indicate that the presence of E2R and PgR in breast tumor biopsies is of higher prognostic value for response of the patient than in the presence of E2R alone.

Breast Neoplasms↗
PubMed1980

The prognostic value of estrogen receptor determinations in patients with primary breast cancer: an update.

Patients with estrogen receptor (E2R)-positive breast cancers experience a longer disease-free interval and longer survival following primary surgery than do patients with E2R-negative tumors. The presence of E2R is correlated with patient age at diagnosis and tumor grade but not with the presence of metastatic foci in axillary lymph nodes. The difference in the rates of recurrence between E2R-positive and negative tumors is greater in pre- and perimenopausal patients than in postmenopausal patients.

Adult↗
PubMed1980

Clinical application of estrogen receptor in breast cancer.

Patients with ER positive primary tumors usually have initial metastases at the more favorable sites. Twelve out of 14 patients with ER positive had first site of metastases in either bone or soft tissue. In contrast, 13 of 17 patients with negative ER developed first metastases in viscera. ER positive patients respond better to endocrine therapy and survived twice as long as negative ER patients from the onset of recurrent cancer until death. ER content is not a sufficient criterion for the prediction of the response to endocrine manipulation but serves as useful supplementary information to clinical judgement in to selection of systemic therapy. Prior employment of radiation therapy or the administration of hormones or antihormones, as well as inadequate tumor cells in the specimen and poor procurement of the tumor, can produce spuriously low ER. A protocol to study simultaneous endocrine and chemotherapy in comparison to the sequential approach of endocrine treatment followed by chemotherapy in ER positive patients is desirable.

Adenocarcinoma↗
PubMed1980

Microbial penetration of surgical gown materials.

In-use studies of microbial penetration of four surgical gowns were carried out. A laboratory test was developed which will dependably predict in-use performance. The test method, using trypticase soy broth containing 10(8)organisms per milliliter and placement of materials on blood agar, yielded results closely approximating findings in use. This method is recommended. It was shown that 140 thread count cloth fails to act as a microbial barrier and is, therefore, unacceptable as a surgical barrier material. Spunbonded olefin, Tyvek 1444A, was shown to be an effective barrier in use but had defects which reduced its barrier capabilities. Spunlaced wood pulp-polyester fabric, Fabric 450, and treated 270 plus pima cotton, Liquashield, were found to be effective barriers in both laboratory and in-use testing. Treated 270 plus pima cotton loses its ability to act as a barrier after 100 recyclings and must then be removed from use in the operating room. Cost factors were examined and found to be greatly in favor of the reusable fabric.

Disposable Equipment↗
PubMed1979

Skin abnormalities of the back in diastematomyelia.

The presence of congenital skin abnormalities on the back may be associated with a serious underlying spinal anomaly, diastematomyelia. The significance of the progressive development of neurological deficits, due to the presence of a bony or cartilaginous spur in the spinal cord, is stressed. An awareness of this condition should lead to an early diagnosis with a neurological evaluation and, if necessary, prophylactic surgery before irreversible nerve damage develops.

Adolescent↗
PubMed1978

Endocarditis related to transvenous pacemakers. Syndromes and surgical implications.

Two cases of microbial endocarditis related to transvenous pacemakers illustrate syndromes whose pathogenesis we consider to be distinctive. Acute Pseudomonas aeruginosa endocarditis related to a pacemaker developed in a 75-year-old man, an event which to our knowledge has not been previously described. There was no evidence of generator site infection, and the sequence of events indicated metastatic implantation of bacteria on traumatized endothelium. A 76-year-old women with a 3 year history of local generator site infection and recurrent fever was found to have extensive vegatative Staphylococcus epidermidis endocarditis at cardiotomy. The sequence of events indicated gradual spread of infection locally, related to the contaminated foreign body. Awareness of these separate pathogenetic mechanisms should facilitate recognition and appropriate management. Removal of the entire pacing system and prolonged antibiotic therapy were considered to be essential to cure of infection in both instances.

Aged↗