[Transplantation of an hemipelvis. The nurse's viewpoint].
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Adult↗
Biomedical subjects
E Morgan
Publications and source records attributed to E Morgan.
Heme inhibits transferrin endocytosis in immature erythroid cells.
The inhibitory effect of heme on iron uptake from transferrin by rat and rabbit reticulocytes and erythroid cells from the fetal rat liver was studied in vitro. Addition of hemin was shown to cause a decrease in the rate of transferrin endocytosis, the degree of inhibition being proportional to the reduction in iron uptake. The heme synthesis inhibitors, isoniazid and succinylacetone, stimulated the rate of transferrin endocytosis by 15-30% and caused a proportional increase in the rate of iron uptake, possibly by reducing the intracellular free heme concentration. It is concluded from these results that heme affects iron uptake by influencing the rate of transferrin endocytosis and recycling.
Animals↗
Cell markers in lymphoma syndrome leukemia in children: a pilot study.
Children with acute lymphocytic leukemia (ALL) who have a "lymphoma syndrome" (LySLk) defined by the presence of at least three of the following criteria: a) Hg greater than 10 g/dl, b( lymph nodes greater than 3 cm, c) spleen below umbilicus, d) liver below umbilicus, and e) mediastinal mass, appear to represent a subgroup of ALL. These children have a poor prognosis for survival when treated with standard chemotherapy for ALL. We performed a retrospective review of 21 patients at Children's Memorial Hospital with LySLk diagnosed from Jan 24, 1977 to July 8, 1981 and of the surface markers on their leukemic cells at diagnosis. Surface markers identified included E-rosettes (E), surface immunoglobulin (Slg), and common ALL antigen (cALLA). Four patients were cALLA positive and E-rosette negative; nine patients were E-negative, cALLA negative; six patients were E positive, cALLA negative. In two patients E-rosettes could not be accurately determined because of a low percentage of lymphoblasts in the samples studied. Follow-up data on cALLA-positive and cALLA-negative patients revealed 4/4 cALLA-positive patients with no evidence of disease (NED) at 22 + to 45 + months from diagnosis and 2/16 cALLA-negative patients NED at 19 + and 57 + months. Thus it appears that the majority of children with LySLk have lymphoblasts which are cALLA negative. Patients who meet clinical criteria for LySLk but whose surface markers are E negative, cALLA positive may have a better prognosis and may represent a separate subgroup of patients with ALL and, therefore, should be given therapy appropriate for their prognostic classification by more standard criteria, such as white blood count, age, and sex.
Antigens, Neoplasm↗
Coping with pediatric leukemia: a two-year follow-up.
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Acute Disease↗
Rhythms of locomotion and oxygen consumption in the estuarine amphipod Corophium volutator (Crustacea: Amphipoda).
The estuarine amphipod Corophium volutator exhibits an endogenous circatidal rhythm of swimming activity, with maxima occurring just after the expected time of high water, under constant laboratory conditions. Oxygen uptake by Corophium is also subject to modulation across the tidal cycle. The period of highest oxygen uptake occurs during the ebb tide, in phase with the period of maximum swimming activity. A second increase in oxygen uptake during the early flood tide is thought to reflect either in-burrow activity or a previously described rhythm of emergence. This being so, this aspect of the animal's respiratory metabolism may be regulated by an autonomous oscillator independent of that governing the animal's swimming behaviour.
Activity Cycles↗
Treatment of patients with metastatic osteogenic sarcoma: a report from the Children's Cancer Study Group.
Fifty-three patients with metastatic osteogenic sarcoma were treated with vincristine, high-dose methotrexate with citrovorum factor rescue, and cisplatin. Metastases were surgically removed in most patients, either prior to chemotherapy or following initial response to therapy. Among 29 previously treated patients, responses to initial chemotherapy included two complete remissions, six partial remissions, and eight patients with stable disease. Twenty-three patients were disease-free, six for greater than 12 months. Toxicity was moderate, but usually reversible. There were two toxic deaths and one unexplained death 48 hours following a dose of cisplatin.
Adolescent↗
Psychosocial aspects of pediatric leukemia: from diagnosis through the first six months of treatment.
Newly diagnosed children with leukemia and their families were subjects of a longitudinal study to describe coping behaviors, to determine adequacy of coping, and to discover predictors of healthy coping with leukemia. Families were followed for six months during which time they were interviewed, completed tests and scales, and were rated by physicians, nurses, and psychosocial staff. Families showed a wide variety of reactions and coping behaviors. The data supported the hypothesis that most families cope well despite the stresses of the first six months post-diagnosis. Based on physicians' ratings, psychosocial intervention appeared to be effective for mothers during the early outpatient phase of treatment. Age of child, previous coping, coping of other family members, a good support system, and lack of additional stresses were significantly correlated with healthy coping. The need for longitudinal assessment of coping was stressed.
Adaptation, Psychological↗
Coagulopathy of disseminated neuroblastoma.
We performed coagulation studies in 16 patients with advanced neuroblastoma. Four of these patients had major hemorrhagic or thromboembolic complications. Abnormal coagulation screening tests were seen in all patients with active metastatic disease. We also measured plasma fibrinopeptide A, a sensitive measure of intravascular thrombin generation. Increased concentrations of fibrinopeptide A were found in each patient studied with active metastatic disease. Coagulopathy is a frequent finding in metastatic neuroblastoma and may cause severe morbidity. Laboratory studies suggesting either hyper- or hypocoagulability are frequent findings.
Blood Coagulation Factors↗
Thromboxane synthesis by sources other than platelets in association with complement-induced pulmonary leukostasis and pulmonary hypertension in sheep.
Infusion into sheep of plasma containing zymosan-activated complement produces leukopenia, pulmonary leukostasis, and pulmonary artery hypertension. We previously demonstrated a close relationship between the pulmonary vascular response and elevations of plasma thromboxane. We have investigated the source of thromboxane synthesis in this model. Plasma containing zymosan-activated complement added to whole blood did not stimulate thromboxane synthesis. This observation suggested that leukocytes do not synthesize thromboxane directly in response to complement added to whole blood did not stimulate thromboxane synthesis. This observation suggested that leukocytes do not synthesize thromboxane directly in response to complement. Sheep rendered severely thrombocytopenic by the administration of antiplatelet serum responded to complement infusion in the usual way. Pretreatment with aspirin (10 mg/kg) protected sheep against the pulmonary vascular response and completely blocked thromboxane synthesis. Transfusion of functional platelets did not restore these responses. Twenty-four hours after aspirin treatment, in vivo thromboxane synthesis was significantly greater than platelet thromboxane synthesis in vitro. Thromboxane is synthesized by a tissue which recovers cyclooxygenase enzyme activity at a rate that is more rapid than platelet turnover. Sheep lung synthesizes thromboxane actively in vitro. It is postulated that leukocytes exposed to activated complement components damage pulmonary vascular endothelial cells and stimulate synthesis of thromboxane A2 which causes pulmonary vasoconstriction.
6-Ketoprostaglandin F1 alpha↗
Improved bronchial healing in canine left lung reimplantation using omental pedicle wrap.
Bronchial complications are a major problem following lung transplantation. Ischemia of the donor bronchus is an important underlying cause of these complications. We have previously demonstrated the ability of an omental pedicle flap to revascularize the donor bronchus as early as 4 days following canine left lung reimplantation. In the present study, omental pedicle wraps markedly improved the healing of the bronchial anastomoses 23 days following canine left lung reimplantation. In dogs in which omentum was used (n = 6), the bronchial mucosal appearance was more normal and the degree of bronchostenosis was significantly less when compared with dogs without omental flaps (n = 10). These experiments suggest that the use of omental pedicle flaps may significantly reduce bronchial complications following lung transplantation.
Animals↗
A comparison between cyclosporin A and methylprednisolone plus azathioprine on bronchial healing following canine lung autotransplantation.
The effects of two low-dose immunosuppressive therapies upon the healing of the bronchial anastomosis and skin wounds following lung autotransplantation were evaluated. Autotransplantation was performed in three groups of dogs: Group 1 (nine dogs) received no immunosuppression, Group 2 (seven dogs) received postoperative immunosuppression with methylprednisolone (2 mg/kg) and azathioprine (1.5 mg/kg), and Group 3 (four dogs) received postoperative immunosuppression with cyclosporin A (20 mg/kg/day). Skin incisions 7 cm in length were made in the dorsal region of each dog. Dogs were put to death 23 days postoperatively, and the breaking strength of the bronchial anastomoses and skin wounds was evaluated with the Instron Universal Testing Machine, with a cross-head speed of 0.5 cm/min. Bronchial breaking strengths were similar in Groups 1 and 3 and significantly higher than in Group 2 (p less than 0.001). Skin breaking strengths were similar in Groups 1 and 3 and significantly higher than in Group 2 (p less than 0.001). Scanning electron microscopic (SEM) studies of both skin and bronchial wounds showed normal formation of collagen bundles in Groups 1 and 3 but a disorganized pattern in Group 2. Our results suggest that low-dose immunosuppression with methylprednisolone and azathioprine significantly affects wound healing and breaking strength of both bronchial anastomoses and healed skin incisions following canine lung autotransplantation. Immunosuppression with cyclosporin A had no adverse effect on either bronchial or skin healing.
Animals↗
Intracardiac Wilms' tumor: diagnosis and management.
Complete excision of Wilms' tumor may require resection of adjacent organs and removal of intracaval tumor propagation. Extension of tumor to the right atrium can be determined preoperatively guiding a direct and safe approach to intracardiac tumor at the time of nephrectomy. Preoperative ultrasonography of two children with Wilms' tumor demonstrated caval and right atrial tumor. Laparotomy for nephrectomy and abdominal caval exposure was combined with cardiopulmonary bypass and atriotomy. In both patients, tumor contiguous with the renal pelvis extended from the iliac bifurcation into the right atrium with a large atrial mass. In one patient nephrectomy was performed first, and she was then placed on cardiopulmonary bypass. Caval tumor was easily removed through the atriotomy and open renal vein. In the second patient, bypass was instituted first because of cardiac instability. The large right atrial mass extended through an atrial septal defect into the left atrium. The cardiac tumor and a large amount of caval tumor were removed. Bypass was discontinued after repair of the ASD. Tumor remained in the IVC below the renal veins necessitating a separate venotomy. Combined abdominal and cardiac exploration allows safe and complete excision of all gross tumor. Ultrasonography is a sensitive and noninvasive method of diagnosing retrohepatic and atrial tumor extension and can be obtained easily even on very sick patients.
Child, Preschool↗
Family coping with childhood leukemia: one year after diagnosis.
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Child↗
Successful revascularization of totally ischemic bronchial autografts with omental pedicle flaps in dogs.
In 10 dogs, the left lung was removed and a closed stump of bronchus, comprising the distal main and lobar bronchi, was reanastomosed to the main bronchus. This totally ischemic cul-de-sac of bronchus was wrapped by an omental flap in five of the 10 dogs. All dogs without an omental wrap died of graft necrosis within 5 days. Injection studies into the bronchial arteries failed to demonstrate any revascularization of the bronchial grafts. In contrast, those dogs with omental wraps, when put to death at 23 days, displayed healthy viable bronchial grafts with full revascularization from the omental vessels. In another three dogs the revascularization via the omentum was demonstrated as early as 4 days and well established at 8 days. The ability of the omentum to rapidly revascularize the bronchus may be of value in potentially ischemic bronchial anastomoses such as in lung transplantation.
Animals↗
Anaphylactic degranulation of guinea pig basophilic leukocytes. II. Evidence for regranulation of mature basophils during recovery from degranulation in vitro.
Mature circulating granulocytes have been considered functionally end stage cells unable to reconstitute their specific cytoplasmic granules. We have reevaluated this assumption by studying guinea pig peripheral blood basophils maintained in vitro for periods up to 72 hours after anaphylactic degranulation. Guinea pig basophils degranulated in vitro by exposure to either specific antigen (sheep serum) or lectin (Concanavalin A) synthesized new cytoplasmic granules. This process was characterized by the appearance of abundant rough endoplasmic reticulum, activation of the Golgi zone, interiorization of plasma membrane, and successive formation of empty vacuoles, multivesicular bodies, immature granules, and, finally, typical mature basophil granules. Although basophil neogranulogenesis in vitro was similar in most respects to that occurring in the bone marrow, it differed significantly in that regranulating basophils retained the nuclear characteristics of mature granulocytes. New basophil granule formation was more prominent and developed earlier when sheep serum was employed as the degranulation stimulus. Cultures degranulated with Concanavalin A, and, less commonly, sheep serum, also contained small numbers of basoblasts, large bizarre basophils with immature nuclear and cytoplasmic features, cytoplasmic lipid droplets, and mature, immature, and fused granules. These cells may arise by a process analogous to lymphocytes blast transformation.
Anaphylaxis↗
Decreased incidence of nonspecific interstitial pneumonitis in children with acute lymphocytic leukemia treated prophylactically with trimethoprim-sulfamethoxazole.
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Antineoplastic Agents↗
Anaphylactic degranulation of guinea pig basophilic leukocytes. I. Fusion of granule membranes and cytoplasmic vesicles formation and resolution of degranulation sacs.
Anaphylactic degranulation of guinea pig basophilic leukocytes, induced in vitro either with Concanavalin A or sheep serum (antigen), was resolved by transmission electron microscopy into two phases: (1) fusion of cytoplasmic granule membranes to form degranulation sacs communicating with the extracellular space by narrow pores and (2) resolution of degranulation sacs with concomitant granule matrix extrusion. Fusion of granule membranes occurred in the absence of obvious alterations of cytoplasmic filaments or microtubules but was preceded by a rapid increase in the number of 50- to 70-nm. cytoplasmic vesicles, a process evident 1 minute after exposure to lectin. By 5 minutes and at later intervals up to 20 minutes, as individual granule membranes fused to form degranulation sacs, vesicle frequency plunged to values one-half or less of control levels. Cytoplasmic vesicles were apparently incorporated into degranulation sacs and may have had a role in joining together the membranes of adjacent granules. Histamine release, detected at 5 minutes and maximal at 20 minutes, occurred at times when communications between degranulations sacs and the extracellular space were so narrow as to retain most recognizable granule matrix material. Resolution of degranulation sacs proceeded over a period of a day in culture and, in Concanavalin A-induced anaphylaxis, was sometimes incomplete even after 36 hours. During this phase, the frequency of cytoplasmic vesicles returned to normal or supernormal values, and the thin cytoplasmic processes forming the walls of degranulation sacs developed prominent, longitudinally disposed cytoplasmic filaments and ultimately retracted into the main cell body, depositing the membrane-free cytoplasmic granule matrix material outside the perimeter of the cell. Guinea pig basophil anaphylactic degranulation thus differs morphologically and kinetically from mast cell and basophil degranulation in other species in which granule membrane fusion and granule matrix extrusion occur nearly stimultaneously and are complete within minutes. The guinea pig basophil provides a useful model for dissociating these two intrinsic components of the degranulation process.
Anaphylaxis↗