Biomedical subjects
Publications and source records attributed to E Strauss.
Normal adult men and women were given a dichotic listening test to determine ear advantage. On the basis of a lateral preference questionnaire, subjects were classified as to handedness, footedness, eyedness, earedness and overall congruency across lateral preferences. Ear preference was the most successful variable in predicting ear advantage on the dichotic listening test.
The haemolytic process in hepatosplenic schistosomiasis is often regarded as a result of splenomegaly that can be increased by spontaneous or surgical shunts. The importance of splenomegaly and/or shunt on the etiology of haemolysis was studied in a group of 74 patients with hepatosplenic schistosomiasis and portal hypertension. They were divided into 4 groups: Group I (22 cases) - pre-operative; Group II (15 cases) - classic splenorenal shunt; Group III (22 cases) - selective portal decompression and Group IV (15 cases) - azygoportal disconnection with splenectomy. The first group is characterized by the presence of splenomegaly and the absence of shunt; the second by the presence of shunt and absence of splenomegaly; the third, by the presence of both splenomegaly and shunt and the last by absence of both, shunt and splenomegaly. In all cases, the levels of sensitive markers of haemolysis, such as haptoglobin and hemopexin as well as non-conjugated and total bilirubins were determined. Biochemical and coagulation parameters, used to evaluate the hepatic function, were also studied. The data was initially analysed according to a factorial experiment of 2 and standard least squares techniques were used to evaluate the effects of splenomegaly, shunt and their interaction. The results showed that the shunts always provoked haemolysis, even in the absence of splenomegaly, but the presence of both, splenomegaly and shunt, always increased the process of haemolysis.
From 1977 to 1983, 94 patients with esophageal varices and gastrointestinal bleeding secondary to mansonic schistosomiasis were entered into a prospective randomized trial comparing the three operations mainly used in Brazil: esophagogastric devascularization associated with splenectomy (EGDS, 32 patients), classical splenorenal shunt (SRS, 32 patients), and distal splenorenal shunt (DSRS, 30 patients). The randomization was interrupted because of a significant incidence of portosystemic encephalopathy (PSE) in the SRS group (26%), as compared to the DSRS (7%) and EGDS (0%) groups. The rate of rebleeding was the same in the three groups, but the rate of failure, as defined by the presence of technical problems, postoperative complications, or death, was significantly higher in the SRS group. This 2-year follow-up shows that SRS should be abandoned in hepatosplenic schistosomiasis and that a comparison between DSRS and EGDS with a longer follow-up is urgently needed.
The analysis of 27 human beta cDNA clones has revealed striking insights as to the germ line, combinatorial, and somatic mechanisms that operate to diversify V beta gene segments. It appears that the repertoire of human V beta genes is limited to 60 or so functional gene segments. Deletional mapping together with the analysis of large DNA fragments by field inversion gel electrophoresis and the isolation of cosmid clones should permit us to map the entire human V beta gene family. The polymorphisms that are present in these V beta gene segments will facilitate a search for interesting disease associations. A detailed comparison of the mouse and human V beta loci should permit us to come to understand in more detail the evolutionary mechanisms that have created these fascinating gene families.
Twenty-nine patients with advanced colorectal carcinoma were entered in this study to evaluate the efficacy and toxicity of a sequential chemotherapeutic schedule with methotrexate (MTX), 200 mg/m2 intravenously (IV) (push injection) and 5-fluorouracil (5-FU), 1,200 mg/m2 in continuous IV infusion, using a 20-hour time interval. All patients received calcium leucovorin (LV), 25 mg, intramuscularly (IM) every six hours for eight doses beginning 24 hours after methotrexate administration. Courses were administered every 15 days. Of the 24 patients evaluable for response, 11 (46%) had major objective regressions (one complete remission [CR] and ten partial remissions [PR]). The survival rate of patients who responded to treatment was 60% at 16 months, whereas patients with no change and those in whom the disease progressed had a median survival of 9 months and 3 months, respectively. The median duration of response has not yet been reached in patients who presented objective tumor regression, and was 7.5 months in those with no change. Significant differences were found between objective regression and no change (P less than .0005) and between no change and tumor progression (P less than .05). All patients were evaluable for toxicity. There were three toxic-related deaths (10%) because of severe myelosuppresion, sepsis, and hemorrhage. These promising results, despite important toxicity, reveal the synergism between the two chemotherapeutic agents and also indicate that the response rate achieved could be a consequence of the 20-hour interval and high dose of 5-FU. Further studies are necessary to determine the optimal time interval and the adequate 5-FU dose.
Combined infarction scintigraphy with 201Tl-chloride and 99mTc-pyrophosphate (PPi) by simultaneous seven-pinhole tomography was investigated with a phantom as well as in patients. No artificial defects occurred when the collimator was centered correctly in axial position, but a very high standard of image uniformity and linearity of the gamma camera was required. Artefacts by overlying activity from the skeleton or cardiac blood pool were not observed. All 11 controls showed normal results. Despite a poor depth resolution due to limitations of the system even small areas of partially damaged myocardium could be recognized and correlated three-dimensionally. Of 24 patients with proven myocardial infarction, in 16 both a positive (99mTc-PPi) and a negative (201Tl) image was obtained in congruence with the necrosis. 8 patients (33%) showed discordant results providing however additional information on the nature and extent of the necrosis. 4 out of 6 non-transmural infarctions seen by tomography had been suspected clinically.
We report the case of a patient bearing a sigmoid colon carcinoma, stage IV, who after 11 months of antiblastic therapy, having completed a dose of 81,000 mg of 5-FU and CCNU, suffered a myocardial infarct. We attribute this complication to 5-FU. Due to the fact that the coronary angiogram did not confirm the arteriosclerotic nature of the lesion, we suggest that it could have been caused by an endoarteritis, resulting from an immuno-allergic or toxic cumulative process.
Serum creatine kinase (CK) values in reference populations generally vary by greater than one order of magnitude. This large range of variation overlaps the range of values found in female carriers of Duchenne muscular dystrophy and limits the clinical usefulness of serum CK testing. In order to examine whether the source of this variation is intrinsic variability of individual CK values, or whether the variation is due to day-to-day variation in each individual's CK activities, we tested 15 female medical students at weekly and 22 female medical students on at least 3 occasions. Each venesection followed a 3-day exercise free interval, according to a standard protocol, designed to minimise the effects of exercise. Each individual tended to have consistent CK activities. The range of variation in the same individuals on different occasions was small (the mean coefficient of variation, CV was 19%). There was a much greater range of serum CK activities between individuals (CV 47%). Even when sporting activities were excluded slightly higher values were found after minor exercise was recorded in the three days prior to venesection. The conclusion that individuals have consistent serum CK activities was supported by the results from a larger population tested under standardised resting conditions on three different occasions which yielded similar frequency distributions on each occasion.
Epileptic patients whose speech dominance had been ascertained using the carotid Amytal test were given a verbal-visual half-field task. Patients with left-hemisphere speech dominance, like normal controls, tended to show a RVF effect whereas patients with atypical speech patterns showed a bias in favor of the LVF.
Morphological asymmetry of the posterior sylvian region was measured in carotid arteriograms of patients with medically refractory seizures. Anatomical asymmetry correlated with ear superiority on dichotic listening tests.
Facial size asymmetries for the upper and lower face were measured from photographs of 40 neonates (3 days old), 40 preschoolers (2-4 years), and 40 young adults (18-24 years), approximately equally divided by sex. The right hemiface was significantly larger than the left in the three age groups, and there were no differences in the distributions of asymmetry as a function of age.
Twenty patients bearing advanced colorectal carcinoma, confirmed by histology, were evaluated after undergoing a sequential chemotherapeutic schedule which consisted of methotrexate, 200 mg/m2 in intravenous infusion during 4 h followed 1 h later by 5-fluorouracil, 600 mg/m2 in intravenous bolus. Twenty hours after ending the MTX administration, leucovorine, 14 mg/m2, was given intramuscularly every 6 h, in 8 doses. Courses were repeated every 15 days. Of 20 patients, 3 bearing colon carcinoma, without previous radiotherapy or chemotherapy, had a partial response. No change was registered in 6 cases. There was no significant difference in the survival of responders, those with stable illness and those with progression. Results were no better than those obtained with 5-fluorouracil used as a single drug and are in agreement with studies that established a 1-h interval between the administration of both drugs.
sulfadiazine appeared to be as effective as sulfapyridine or sulfathiazole in every condition in which it was used. Toxic effects from sulfadiazine were relatively mild and infrequent. Nausea and vomiting occurred in 9.2 per cent of the cases. Nitrogen retention of moderate degree was noted in 5 cases. Leukopenia occurred early and was transient in some cases. In 3 cases the leukocyte counts dropped between the eleventh and the sixteenth day and returned to normal on cessation of therapy. Morbilliform eruptions were observed in 9 cases
A cDNA clone YT35 , synthesized from poly(A)+ RNA of the human T cell tumor Molt 3, exhibits homology to the variable (V), joining (J), and constant (C) regions of immunoglobulin genes. We have isolated and sequenced the germ-line V and J gene segment counterparts to YT35 from a human cosmid library, and these failed to encode 14 nucleotides of the cDNA clone between the V and J regions. We postulate that these 14 nucleotides are encoded by a third gene segment analogous to the diversity (D) gene segments of immunoglobulin heavy chain genes. This T cell antigen receptor V gene appears to be assembled from three gene segments, V, D, and J, and accordingly most closely resembles immunoglobulin heavy chain V genes.
Levy and Reid's claim (1976, 1978) that writing hand/posture is predictive of cerebral dominance was examined in patients who had undergone bilateral sodium Amytal speech testing. Contrary to their prediction, inverted writers showed the same pattern of speech representation as did straight writers.
The authors present an unusual case of a femoral condylar fracture incurred in childhood, 10 years before the patient came to them for treatment.
Advanced gastric carcinoma is one of the digestive tract sites which best responds to chemotherapy. Single drug therapy offers an objective regression between 0.30% (Table I). Combined chemotherapy is considered to be more effective, results varying from 6.55% (Table II). Since March 1979 till May 1983, we initiated a cooperative protocol between the hospitals J. M. Penna and L. Lucero of Bahía Blanca and the Regional Hospital of Neuguén, for the treatment of advanced gastric carcinoma, associating 5-fluorouracil (5FU) and adriamycin (ADM). Characteristics of the 20 evaluated patients are shown in Table III. Objective regressions represented 40% (8/20 patients), with a median duration of 8, 5 months (Table IV). The mean survival rate of responders was 11.5 months and of non-responders 3,5 months (P +/- 0.005). Table V illustrates the clinical status and response induced by this therapy. Tolerance was acceptable (Table VI). Severe or very severe toxicity reported in other trials after the administration of 5-FU - ADM combined with methyl CCNU or mitomycin C, did not occur. In our study there was no indication to interrupt therapy due to hematologic or non-hematologic side effects. Results indicate that the combination 5-FU - ADM might be promising for this neoplasm and should be further investigates in a larger number of patients in order to establish its real usefulness.
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