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Biomedical subjects

D H Buss

Publications and source records attributed to D H Buss.

At least 37 records · Page 2Linked to original sources

Multiple myeloma associated with multilobated plasma cell nuclei.

Ten cases of multiple myeloma are reported in which there were a large number of plasma cells with excessively convoluted or lobulated nuclei. These cases represent 3% of the 297 evaluable multiple myeloma patients treated at our institution over a 22-year period. All 10 had intermediate or advanced stage disease at the time of diagnosis, and all have died after a mean survival of 19.5 months. Ultrastructural features of 2 cases are described. When found in abundance, such cells can cause difficulty in establishing a morphologic diagnosis of multiple myeloma because of their resemblance to other cell types. Therefore, it may be necessary to perform immunoperoxidase staining and/or electron microscopy to confirm the plasmacytic identity of these cells. The findings add further support to the contention that the presence of excessive nuclear convolutions is not a completely reliable indication of T-cell, as opposed to B-cell, lineage.

Aged↗

Single high dose-large field irradiation in drug resistant non-Hodgkin's lymphoma.

Single high dose-large field irradiation (SHD-LFI), also described as half-body irradiation (HBI), has previously been reported as an effective modality for the palliation of symptoms in a number of solid tumors. This report concerns the ability of SHD-LFI to produce palliation of symptoms and/or objective response in patients with drug resistant non-Hodgkin's lymphoma (NHL). From 1981 to 1984, 34 patients with advanced drug resistant NHL were treated with SHD-LFI either to the whole abdomen (24 patients) or to the upper half body (10 patients). Overall, 19 of 23 patients achieved symptomatic improvement, while objective response was noted in 23 of 30 patients. We noted subjective and objective response in all histologies, and duration of response was not significantly different. Our results suggest a beneficial role for the early and judicious use of SHD-LFI in NHL.

Dose-Response Relationship, Radiation↗

Trace nutrients. 5. Minerals and vitamins in the British household food supply.

1. The amounts of magnesium, copper, zinc, phosphorus, manganese, potassium, vitamin B6, vitamin B12, folate, pantothenic acid, biotin, vitamin E and dietary fibre in the British household diet were calculated by applying appropriate values from recent analytical studies to the amounts of foods recorded in the National Food Survey during 1986. 2. National average intakes were (mg/person per d): Mg 247, Cu 1.25, Zn 9.0, P 1249, Mn 3.43, K 2694, vitamin B6 1.73, vitamin B12 6.33 micrograms, folate 230 micrograms, pantothenic acid 6.07, biotin 35 micrograms, vitamin E 8.4. Regional and income-group differences were estimated, and found to be small. Additional contributions from alcoholic drinks and confectionery were also determined. 3. Dietary fibre was estimated both as unavailable carbohydrate and as non-starch polysaccharide. The national average intakes were 21.8 and 12.9 g/d respectively. 4. Intakes were compared with Canadian (Department of National Health and Welfare, 1983) and American (National Research Council, 1980) recommended dietary allowances (RDAs). With the exception of biotin, the Canadian RDAs were met by the household diet but the much higher American RDAs were only met for vitamin B12 and pantothenic acid.

Food Analysis↗

Marrow fibrosis and multiple myeloma.

A retrospective review of pretreatment bone marrow material from 297 patients diagnosed and treated for multiple myeloma (MM) at a single institution during a 22-year period (1961-1982) was performed in order to assess the frequency and significance of associated simple marrow fibrosis (SMF). The presence of SMF was suspected in the hematoxylin and eosin-stained sections in 48 of the 297 cases and was confirmed by reticulin stains in 26 (8.8%) cases, with seven of these also showing collagen on trichrome stain. However, the literature on MM documents little recognition of this association. SMF is often responsible for inadequate marrow aspirates yielding spurious or inconclusive results. Thus, bone marrow trephine biopsies may be required to histologically confirm the diagnosis of MM when there is concurrent SMF.

Adult↗

Extrinsic-pathway enzyme-linked coagulation assay (EP-ELCA). A clot-based alternative to prothrombin time for measurement of extrinsic pathway factors in plasma.

This solid-phase colorimetric microtiter-plate clotting assay is much more sensitive than standard clotting tests. In enzyme-linked coagulation assay (ELCA), enzyme-labeled fibrinogen and solid-phase fibrinogen are the substrate for thrombin generated in the clotting cascade. We used this assay to measure the factors of the extrinsic pathway by an extrinsic pathway-specific assay (EP-ELCA) and to determine the individual factors of the extrinsic pathway (VII, X, V, II) in plasmas of coumadin-treated and heparin-treated patients, with prothrombin time (PT) values used as a reference. In the ELCA method, samples and controls are incubated on the same plate, eliminating the requirement for pre-standardization of the substrate "plasma" before the factor assay is done. Concentrations of factors are determined by serially diluting sample and control plasmas to yield equivalent activity at given dilutions, a more direct approach for measuring specific factors than determining log concentrations vs log clotting time. Changes in the concentrations of clotting factors are seen before changes are apparent by PT. For coumadin-treated patients, all vitamin K-dependent factors were significantly (P less than or equal to 0.001) less than in normal controls, whereas factor V concentrations were normal, as expected. For patients treated with heparin, concentrations of factors X and VII were less than in normal controls (P less than 0.01) and results for EP-ELCA, II, and V assays were normal. This methodology can readily be automated.

Adult↗

Plasma cell dyscrasias.

In this article we have discussed the usefulness and limitations of the bone marrow examination in the differential diagnosis of the plasma cell dyscrasias. Because of the overlapping clinical and morphologic features encountered with these disorders and problems due to random marrow sampling, the difficulties in making a correct bone marrow interpretation may be quite formidable. The applicability of immunohistochemistry has been discussed and the need for clinical correlation emphasized.

Bone Marrow↗

Low dose Ara-C for patients with myelodysplastic syndromes.

Forty patients with high risk myelodysplastic syndromes--refractory anemia with excess blasts, refractory anemia with excess blasts in transformation, or chronic myelomonocytic leukemia--were treated with subcutaneous low dose cytosine arabinoside, 10 mg/m2 twice daily for up to 42 days. In 38 evaluable patients there were nine (24%) complete and four (11%) partial responses. Response was associated with symptomatic improvement and resolution of the need for red cell and platelet transfusions. The median duration of complete response was 9.8 months (range, 2.4-17.9); these patients had a median survival of 15.7 months (range, 6.0-22.7). Toxicities were predominantly those associated with pancytopenia, i.e., infection and hemorrhage.

Adult↗

Comparison of the usefulness of bone marrow sections and smears in diagnosis of multiple myeloma.

Pretreatment bone marrow specimens from 273 patients with multiple myeloma (MM) and 148 patients with nonmyelomatous plasmacytosis were studied retrospectively to evaluate the usefulness of bone marrow sections and smears in establishing the diagnosis of MM. The combined findings in the sections and smears confirmed the clinical impression of MM in 83% of myeloma patients: in 59%, both sections and smears were diagnostic; in 17% the smears were diagnostic, the sections nondiagnostic; in 7% the sections, but not the smears, were diagnostic. In the remaining 17% of myeloma patients, both the sections and the smears failed to confirm the clinical impression of MM. Of the 148 patients with nonmyelomatous plasmacytosis, a pathologic over-diagnosis of MM was made in 2 patients. Reasons for these discrepancies, and problems relating to the validity of the current diagnostic criteria for MM are discussed. It is concluded that both bone marrow sections and smears should be examined when attempting the diagnose MM since either, by themselves, may not be diagnostic. Recommendations are made that immunoperoxidase staining methods be used in difficult cases, and that the marrow findings be correlated with clinical, laboratory, and radiologic findings prior to establishing the diagnosis of MM.

Amyloidosis↗

McCance and Widdowson's 'The composition of foods': supplementary information and review of new compositional data.

Publications are reviewed which give detailed nutritional analyses of a wide range of representative samples of UK foods that have been undertaken since the publication of the fourth edition of McCance and Widdowson's 'The composition of foods'. These include trace elements, vitamin A, immigrant foods, cereals, milk and milk products and potatoes. Typographical corrections to the fourth edition are also given as well as the weight loss on cooking the recipe dishes.

Animals↗

Initial bone marrow findings in multiple myeloma. Significance of plasma cell nodules.

A retrospective review of bone marrow specimens from 235 patients with multiple myeloma and 148 patients with reactive plasmacytosis was performed in an attempt to evaluate the usefulness of bone marrow sections in distinguishing between these conditions. Although the presence of large homogeneous nodules and/or infiltrates of plasma cells in bone marrow sections remains the best criterion for the diagnosis of myeloma, a few specimens (2%) from patients with reactive plasmacytosis also showed this feature. In addition, 26% of the patients with myeloma had bone marrow sections that were considered nondiagnostic in that they lacked recognizable homogeneous nodules and/or infiltrates of plasma cells. Finally, distinguishing multiple myeloma from bone marrow involvement by lymphoplasmacytic lymphomas can be very difficult, if not impossible, based on findings in the sections alone.

Bone Marrow↗

Low iron intakes among young women in Britain.

A large survey by the Ministry of Agriculture, Fisheries and Food of people aged 15 to 25 showed that the women, and especially the participants "on a diet" or "watching their weight," generally had iron intakes well below the recommended daily allowance. Reduced iron intake appeared to result from diets of reduced iron concentration as well as from energy restriction. Further research is needed to establish whether this population is compromised or whether the current recommended daily allowances are unnecessarily high.

Adolescent↗

The incidence of thrombotic and hemorrhagic disorders in association with extreme thrombocytosis: an analysis of 129 cases.

We have presented a retrospective study of 129 patients with platelet counts of 1,000 X 10(9)/L or more--72 with myeloproliferative disorders (MPD), and 57 with reactive thrombocytosis (RT)--in an effort to determine the incidence of thrombohemorrhagic complications. Thrombotic disorders occurred with approximately equal frequency in the two groups, being found in three patients (4%) with MPD and three (5%) with RT when the platelet count was over 1,000 X 10(9)/L and in 11% of the patients in each group when the platelet count was less than 1,000 X 10(9)/L. In contrast, bleeding manifestations were more common in MPD, where 36% of patients were affected on one or more occasions versus only 4% of those with RT. However, bleeding was generally not severe, with only six patients requiring transfusions, and three of these patients had been receiving aspirin or corticosteroids when they developed severe gastrointestinal bleeding.

Aged↗

Phosphorus in the British household food supply.

The intake of phosphorus in Britain was calculated for 1975 by applying the values for phosphorus in foods from the 4th edition of McCance and Widdowson's 'The composition of foods' to the average household food purchases recorded in the National Food Survey (NFS). A similar exercise was carried out for 1982, but using many updated values for the phosphorus content of foods. In 1975 the average household intake of phosphorus was 1310 mg per person per day while by 1982 it had declined to 1223 mg per person per day. The calcium: phosphorus ratio was 1 : 1.3 in both years. These intakes are above the US recommendation for adults but well below the maximum tolerable daily intakes for phosphorus.

Diet↗