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Biomedical subjects

G H Conner

Publications and source records attributed to G H Conner.

At least 19 recordsLinked to original sources

Human papillomavirus type 16 in bowenoid papulosis, intraoral papillomas, and squamous cell carcinoma of the tongue.

A 33-year-old immunosuppressed man developed bowenoid papulosis on his genitalia, velvety papules and plaques in his mouth, and invasive squamous cell carcinoma of his tongue. All three lesions were positive for human papillomavirus type 16 (HPV-16). The case provides further circumstantial evidence for a role of HPV-16 in epithelial neoplasia. The possible roles of a second HPV infection and of immunosuppression are also discussed.

Adult

A comparison of retention and complication rates of large-bore (Paparella II) and small-bore middle ear ventilating tubes.

Large-bore myringotomy tubes are usually reserved for the treatment of refractory middle ear effusion. Theoretically, they have an extended intubation time and a higher complication rate. There is, however, scant support of this in the literature. The duration of intubation, efficacy, and complication rates of the large-bore Paparella type II tube were compared with Paparella type I, Shepard, and Armstrong tubes. The study included 242 patients with 600 intubations. In addition, a subpopulation of patients receiving their initial intubation during this study was reviewed. Findings were similar for both groups. Paparella type II tubes had a prolonged period of intubation and a decreased reintubation rate when compared with the smaller bore tubes. Larger bore tubes had an increased complication rate when compared with the smaller bore tubes. Complications included occasional or frequent otorrhea and an increased rate of permanent perforation of the tympanic membrane. There was no instance of cholesteatoma formation secondary to intubation. Guidelines are presented for the use of the Paparella type II tube.

Adolescent

Tumor sterilization following high-dose pre-operative irradiation for advanced cancer of the larynx or pyriform sinus.

Twenty-two patients with advanced laryngeal cancer and 5 with advanced pyriform sinus cancer were given 51 Gy (5,100 rad) followed by surgical resection. In 10 (45%) of patients with laryngeal cancer, no tumor was found at the primary site pathologically; 15 (68%) had negative neck specimens. All of those with pyriform sinus cancer had positive specimens. Eighteen patients with laryngeal cancer are free of disease. In contrast, only 1 with pyriform sinus cancer is free of disease; 1 has had a local recurrence and 3 have had metastases. The data suggest that 51 Gy (5,100 rad) are insufficient to sterilize pyriform sinus cancer; higher doses together with adjuvant chemotherapy are needed.

Adult

Orotracheal intubation in the newborn.

One hundred consecutive cases of orotracheal intubation in the premature and term newborn at the Hersehy Medical Center were studied retrospectively. The reason for intubation was for respiratory failure most commonly associated with hyaline membrane disease. The duration of intubation ranged from six hours to 63 days. Seventy-nine percent required intubation for more than 24 hours and 28 percent required intubation for more than one week. No tracheotomies were performed. There were 56 survivors, 50 of which were seen in follow-up examination at three, six or 18-month intervals. There were no cases of clinically evident upper airway damage or obstruction in this group. Post mortem examinations were carried out on 35 infants with tracheal necrosis found in one case. The authors feel that orotracheal intubation is superior to nasotracheal intubation and tracheotomy in this age group. This method of management should be carried out where there is adequate trained personnel and professional staff and equipment capable of proper orotracheal tube placement and management.

Follow-Up Studies

Immune responses of the bovine fetus.

The bovine fetus is capable of mounting an antibody response when a bacterial antigen (killed Escherichia coli) or viral antigen (live reovirus) is deposited into the amniotic fluid. Time required for the fetus to respond to bacterial antigen given orally (amniotic fluid) is approximately 10 to 14 days and 8 to 10 days for viral antigen. Calves vaccinated prenatally with E. coli from 9 to 102 days before birth and deprived of colostrum survived oral challenge doses of viable E. coli which killed calves not vaccinated prenatally. One mechanism of protection was the local production of antibody in the gastrointestinal mucosa where immunofluorescent techniques showed immunoglobulins IgG, IgM, and anti-E. coli antibody in the duodenum, jejunum, and ileum as well as in the jejunal lymph node. Prenatal vaccination has been used in the field for prevention of colibacillosis. However, the occurrence of some stillbirths and premature births indicates the need for further research before there can be widespread field application of the technique.

Amniotic Fluid

Local immune responses in the bovine fetus vaccinated in utero with Escherichia coli antigen.

Using specific immunofluorescent examinations, the local immune responses were studied in 14 calves prenatally vaccinated (10 to 50 days before birth) with Escherichia coli (O26:K60:NM) antigen or sterile saline solution. All calves were colostrum-deprived, were given oral doses of homologous organisms (killed or live), and were necropsied either at birth or within 12 days after birth. Immunofluorescent plasma cells were not seen in duodenum, jejunum, jejunal lymph nodes, ileum, ileal lymph node, or spleen of control calves prenatally vaccinated with sterile saline solution. All of these tissues, except ileal lymph node, from calves vaccinated in utero with E coli showed fluorescence. Jejunum, jejunal lymph node, and ileum had the greatest number of immunofluorescent plasma cells. There were more immunoglobulin G2-than immunoglobulin M-producing cells. The cells producing specific antibodies against E coli (1 calf studied) comprised approximately 33% of the total number of immunofluorescent cells.

Animals

Prenatal immunization by the oral route: stimulation of Brucella antibody in fetal lambs.

No simple means exists for immunizing infants and large animals in utero. The feasibility of stimulating immune response by the oral route was investigated by using the fetal lamb as experimental model and Brucella as prototype antigen. Antigenic stimulation was assessed by serum agglutinin levels. Primary and secondary responses were elicited in fetal lambs by Brucella antigen introduced into the amniotic fluid 10 to 50 days prenatally. One lamb born 75 days after primary exposure in utero mounted a secondary response to antigen at 2 days of age. The evidence of immunization by the oral route suggests that local intestinal immunity also might be acquired in fetal life by this route.

Administration, Oral