Urbanization, occupation and disease in the United States, 1870-1920: the case of New York City.
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Biomedical subjects
Publications and source records attributed to G Rosen.
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A case of a sclerosing variant of osteosarcoma of a toe phalanx is reported in a 28-year-old man. This represents the first reported case of osteosarcoma of any kind at this site. This is based on a review of 4,214 cases of conventional osteosarcoma. The reason for the extraordinary rarity in toe or hand phalanges is unknown although osteosarcoma is the second most common primary tumor of bone. Since the neoplasm had minimal signs of cytologic anaplasia, it was originally mistaken for and treated as an osteoid osteoma. The lesion recurred and extended into soft tissues. Reevaluation revealed the tumor to be an osteosarcoma, sclerosing variant with "normalization" of nuclei. The lesions that this tumor should be distinguished from are osteoid osteoma and osteoblastoma.
Although high-dose intravenous (IV) methotrexate (MTX) with leucovorin rescue (HDMTX) is effective for certain recurrent primary brain tumors, concern for inducing leukoencephalopathy has restrained its use as adjuvant therapy following therapeutic brain irradiation (RT). We have conducted a phase I to II clinical trial using four biweekly courses of HDMTX (8 g/m2) in a neoadjuvant setting in ten patients with newly diagnosed high-risk pediatric primary brain tumors. Four patients experienced an objective response after two to four courses of HDMTX alone (medulloblastoma, one; pineoblastoma, one; malignant cerebral astrocytoma, two). All ten patients subsequently received a course of therapeutic RT, and in seven cases, adjuvant chemotherapy with other agents. One patient acquired an acute transient encephalopathy before RT that completely resolved, and another developed a seizure disorder following RT associated with white matter abnormalities on a magnetic resonance imaging (MRI) scan. Five patients have survived a minimum of 33+ months, and four remain in continuous remission. The acute and delayed neurotoxicity of neoadjuvant HDMTX is acceptable, and we favor further use of this neoadjuvant approach in the context of a phase III trial.
We reviewed the clinical features and results of treatment in 24 patients with osteogenic sarcoma of the spine treated over a 35-year period. There were 14 male and 10 female patients 13 to 71 years old. The tumor arose de novo in 13 patients and was secondary to other conditions in 11. All patients presented with pain, and 16 (67%) had neurological deficits. Patients were divided into two treatment groups. Thirteen patients treated from 1949 to 1977 usually underwent limited tumor resection and external radiation therapy. The second group, 11 patients treated from 1978 to 1984, underwent more aggressive surgical resection and received combination chemotherapy as well as local radiation to the tumor bed. In the second group, there were 5 long term survivors, and only 1 patient developed metastatic disease while on therapy. Failure to obtain local control was the major cause of treatment failure. Complete surgical resection of the tumor by spondylectomy and combination chemotherapy offer the best prospect for cure of osteogenic sarcoma of the spine.
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Vaginal wet smear, endocervical swab test, gynecologic examination, and history were investigated in 148 healthy female adolescents. Cultures for Chlamydia trachomatis were obtained from all patients. The overall prevalence was 19/148 (13%). No significant correlation was found between chlamydia infection and any of the parameters investigated in the wet smear. Results of swab test or history showed no discrimination between young women with cultures positive for C. trachomatis and those with cultures negative for C. trachomatis. Chlamydia was found in 32% of patients when the gynecologic examination showed signs of infection and in 10% when no signs of infection were seen (p less than 0.025). Thirteen of the 19 (70%) adolescents with chlamydia infections had no signs of infection. We conclude that neither swab test, vaginal wet smear, nor the history of the patient can give conclusive evidence of a chlamydial infection. Detection of C. trachomatis in this population can be done only by culture or other specific methods.
Auditory Brainstem Evoked Potentials (ABEP) were recorded from 53 adult subjects suffering from sudden deafness at the time of examination. The onset of sudden deafness was up to three years prior to the study. ABEP were recorded in response to 75 dBHL clicks presented at rates of 10/sec and 40/sec. ABEP peak latencies as well as interpeak latency differences, and also the effect of increasing stimulus rate, were determined for each patient and compared with the clinical symptoms. The psychoacoustic and ABEP detection thresholds were also compared. A highly significant correlation was observed between ABEP detection threshold and the psychoacoustically determined hearing threshold, and the differences between them were found to be insignificant. The results of this study indicate a central component in sudden deafness. This impairment manifests itself in abnormal effects of increasing stimulus rate on ABEP, and may be related to reduced central synaptic efficacy.
An enzyme-linked immunosorbent assay for rapid detection of malarial antibodies and antigens was developed. Plasmodium falciparum antigen preparation, obtained from sonicated cultures of the parasite at a parasitemia of 10%-15%, was applied to cellulose filter discs in volumes of 0.1 microliter in 96-well microtiter plates. Antibodies were detected by successive incubations with: bovine serum albumin for blocking, tested serum at different dilutions, peroxidase-conjugated antihuman IgG, and the precipitable substrate 4-chloro-1-naphtol. Positive reactions appeared as blue dots on a white background which are easily read by eye. Pools of sera from patients with recent disease or from individuals with a history of malaria, contained antibodies detectable up to a dilution of 1:64,000. Negative results were obtained when normal RBC were used for dotting the filters. Normal sera showed no reaction at any antigen concentration. P. falciparum antigens were detected by their ability to inhibit the binding of antibody to the filters. RBC infected with P. falciparum in vitro can be detected at a level of 0.001% parasitemia. This report presents the feasibility of an assay for detecting malarial antibodies and antigens in blood samples which is easily applicable to field conditions.
A lipid extract obtained from reticulocyte membranes of Plasmodium berghei-infected rats showed antigenic activity against sera from convalescent or immune rats. Following chromatography on silicic acid column, 85% of the activity was recovered from the column with chloroform:methanol (1:3, vol/vol). The active fraction was further resolved by thin layer chromatography (TLC) into four lipid components, two sugar-containing components and two phosphorous-containing components, but neither the individual components nor various combinations of the components showed antigenic activity after elution from the TLC plate. The immunological activity was not affected by phospholipase A2 treatment.
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A radioimmunoassay for the quantitative determination of antileishmanial antibody in sera from patients suffering from cutaneous leishmaniasis was developed. The assay, using as antigen either the soluble fraction from freeze-thawed sonicated Leishmania major (LRC-L137) promastigotes or a carbohydrate-lipid containing fraction obtained by extraction with hexane-isopropanol, was shown to be sensitive and reproducible. The sera of 95 patients were examined. These were from patients with cutaneous leishmaniasis (26 from the Jordan Valley and 13 from Sinai), kala-azar (9), malaria (24), schistosomiasis (10), toxoplasmosis (5), and leprosy (8); controls were 37 normal human sera. No significant antigen dependent differences were observed using sera from cutaneous leishmaniasis patients, although differences in the immunological response were observed between the two populations of these patients. Antileishmanial activity was not detected in sera from patients with malaria, schistosomiasis, or toxoplasmosis. Although sera from leprosy patients crossreacted with the carbohydrate-lipid containing fraction, it was nevertheless more strain specific than freeze thawed sonicated L. major.