Biomedical subjects
Publications and source records attributed to G Greene.
A photon deficient "cold spot" was noted in all three phases of a three phase bone study in a patient with gas gangrene of the foot. The scintigraphic findings correlated with the area of soft tissue gas noted in radiographs.
The clinical effects of 10-deaza-aminopterin, an inhibitor of dihydrofolate reductase with a better therapeutic index against several murine tumors than that of methotrexate, were examined during the course of a phase I study in patients with advanced malignant neoplasms. Three escalating dose schedules were explored: single iv injections once daily, single iv injections twice weekly, and continuous infusion. The maximum tolerated doses were: single injections at a dose of 7 mg/m2/day for 5 days; single injections at a dose of 15 mg/m2 twice weekly for four to six doses; and continuous infusion at a dose of 3 mg/m2/day for 5-6 days in patients with solid tumors and until bone marrow hypoplasia in patients with leukemia. Mucositis was dose-limiting in all schedules. Occasionally, mild leukopenia, thrombocytopenia, and skin rash were noted. A minor antitumor response was seen in a patient with gallbladder carcinoma. Marked leukemic cell kill was observed in several patients with acute leukemia or blastic phase of chronic myelogenous leukemia. Disease-oriented phase II trials are planned at this Center for several tumor varieties.
We report on 44 patients (18 with additional affected family members), with congenital distal limb contractures identified from a large study of over 350 patients with congenital joint contractures. Fourteen propositi (seven familial cases, seven isolated cases) had a newly recognized form of arthrogryposis, which we have designated distal arthrogryposis type 1, with the predominant manifestations of autosomal dominant inheritance; tightly clenched fists at birth, with medially overlapping fingers, ulnar deviation, and camptodactyly in adults; and positional foot deformities. Contractures at other major joints are variable. There are no associated visceral anomalies; intelligence is normal. There can be marked intrafamilial and interfamilial variability. Twenty-two propositi with similar distal contractures had additional findings and were classified into five subcategories of distal arthrogryposis (type IIA-E). Among type II patients cleft palate, cleft lip, small tongue, trismus, ptosis, epicanthal folds, keratoconus, short stature, scoliosis, a unique hand position, and dull normal intelligence were seen. These characteristics were seen in various combinations and patterns and allowed sorting into groups that were the basis for the categorization. The remaining eight propositi were recognized to have previously described conditions with distal contractures and autosomal dominant inheritance, ie, the Freeman-Sheldon syndrome, trismus-pseudo-camptodactyly syndrome, congenital contractural arachnodactyly, and familial camptodactyly. Pathogenetically we postulate similar underlying defects of abnormal tendon attachments, attenuation, and absence; careful nosologic comparisons are important for prognostic counseling and habilitative management.
Nonviable gram-negative bacilli were seen in smears of cerebrospinal fluid from eight infants in whom bacterial meningitis was ruled out. Tubes from commercial kits were the source of the factitious organisms.
We report here the effects of antibodies to estrogen receptor (ER) on the binding of tritiated 5 alpha-androstane-3 beta-17 beta-diol and antiestrogens to receptor in calf uterine cytosol. The antibodies, prepared from a rabbit immunized with purified estradiol-receptor complex from calf uterine nuclei, were found to decrease the affinity, but not the number of binding sites, of ER for 5 alpha-androstanediol and tamoxifen [alpha-(4 beta-N-dimethylaminoethoxy)phenyl-alpha'-ethyl-trans-stilbene]. This appeared to be due to the decrease in the association rate of the ligands, while the dissociation rate was not modified. The ER antibodies did not affect the binding of ER to estradiol or to the monohydroxylated metabolite of tamoxifen, nor did they affect the interaction of androgens with the androgen receptor. The formation of a ternary complex among [3H]hydroxytamoxifen [3H-labeled alph-(4 beta-N-dimethylaminoethoxy)phenyl-4-hydroxy-alpha'-ethyl-trans-stilbene], the ER, and the antibodies was demonstrated by sucrose gradient ultracentrifugation. For [3H]tamoxifen and [3H]5 alpha-androstanediol, ternary complexes were also formed with ER bound to monoclonal antibodies linked to Sepharose. These results confirm that ER directly binds androstanediol, tamoxifen, and hydroxytamoxifen. The lower affinity of ligands for ER in the presence of antibodies was only observed for the low affinity ligands and did not appear to be correlated to their antiestrogenic activities.
4'-Carboxyphthalato(1,2-diaminocyclohexane)platinum(II) is a new, second generation platinum analog which had demonstrated in vitro activity in L1210 cell lines resistant to cisplatin and had less nephrotoxicity than did cisplatin in preclinical animal testing. A Phase I trial with this agent has been performed in 45 patients with advanced refractory cancers. Nine dosage levels, ranging from 40 to 800 mg/sq m, were studied. Major toxicities seen were myelosuppression, nephrotoxicity (which was generally mild), nausea and vomiting (which was quantitatively less than that seen with cis-platin), allergic reactions, and a peripheral neuropathy. The dose-limiting toxicity was thrombocytopenia. Pharmacokinetics performed at three dosage levels indicates that 4'-carboxyphthalato-(1,2-diaminocyclohexane)platinum(II) has a long t1/2 of 20 to 30 hr (total platinum) and is only partially excreted in the urine and that a high proportion of the drug is nonfilterable within 30 to 60 min of administration. Therapeutic responses were seen in nasopharyngeal carcinoma, adenocarcinoma of the cervix, and lung and gastric cancer. As a starting dose for Phase II studies, which are planned for patients with ovarian, testicular, lung, gastric, and esophageal cancers, 640 mg/sq m given every 3 to 4 weeks is recommended.
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The relationship between length and head circumference can be expressed by the simplified formula: head circumference (centimeters) = 0.5 length +9.5 +/- 2.5; head circumference (inches) = 0.5 length + 3.75 +/- 1. This formula is accurate for 95% of measurements in the first 400 days of life. The correlation coefficient of length to head circumference is .94 (P = .0001).
A prospective follow-up study, from birth to age 5, of height, weight, and weight/height indices in 582 white children was carried out in a suburban private pediatric practice. The purpose of the study was to examine trends in height and weight over time, to evaluate any differences in measures of ponderosity between breast-fed and bottle-fed infants, and to locate the heaviest children at age 5. There were significant correlations between height, weight, the ratio of height to weight, the ponderal index (height/weight 1/3), and the Quetelet index (weight/height2) achieved during the first year of life, and that attained at age 5 years. However, approximately 70% of the variance in weight and ponderosity indices at age 5 could not be accounted for by measurement of weight and ponderosity during the first year of life. Breast-fed and bottle-fed infants did not differ in weight and weight/height indices. There was a modest, but consistent, "tracking" pattern among children in the upper decile for weight and ponderosity at age 5 years in that 30% of them were also in the top decile for weight and ponderosity at age 6 months, and 30% to 40% were in the top decile at age 1 year. More than half of the variance in weight or indices of body proportion at age 5 is not accounted for by these variables in the first year of life, indicating limitations to the generalizability of the concept, that obese infants become obese children.
A continuing interest in clarity of reporting generated a change in our reporting format from the traditional report to the problem-oriented structure. This article discusses the differences and the advantages and disadvantages of each.
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A speech pathologist developed a program with language goals which included spontaneous communication, focus, attention span, auditory memory, receptive and expressive vocabulary, and concepts such as body image, spatial relationships, and same and different polarities. The services of a professional mime were used to translate these goals into mimetic activities and to perform the activities in group sessions with the children. In addition, the mime taught the speech clinicians some simple mimetic activities. The subjects were five children with mental retardation, language delay, lack of spontaneity, short attention span and very poor visual and auditory memory. The results suggested increase in spontaneity and attention span in all the children and a facility to remember the illusions depicted for them by the mime. The experience with the mime training for clinicians was also positive.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.