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Biomedical subjects

J A Sullivan

Publications and source records attributed to J A Sullivan.

At least 109 records · Page 6Linked to original sources
PubMed1984

Stages I and II non-Hodgkin's lymphomas of Waldeyer's ring and the neck.

In a previous communication we reported our results for patients with localized extranodal presentations of non-Hodgkin's lymphomas of the head and neck who were admitted between 1961-1969. This review describes our larger experience from 1947-1982 in treating 137 Stages I and II Waldeyer's ring patients whose slides were available for reclassification according to the modified Rappaport System. All of these patients were treated definitively as follows: radiotherapy only, 113 patients; radiotherapy and combination chemotherapy, 17 patients; chemotherapy only, seven patients. The overall 5-year survival was 50%. Significant differences were determined for specific subgroups. For patients staged after lymphangiography, the 5-year survival was 67% as compared with 32% for non-lymphangiogram staged patients (p = 0.002). Stage (Ann Arbor) also influenced results. The 5-year survival figure for Stage I was 70% as compared with 42% for Stage II (p = 0.002). The combination of extent of disease in Waldeyer's ring and the status of the neck had a major impact on survival. When the disease was staged according to the TNMAJCC System, the 5-year survivals were: 75% for T1-T2-TX N0; 53% for T1-T2-TX N+; 54% for T3-T4 N0; and 36% for T3-T4 N+. Also, results for tonsil (52%) and base of tongue (66%) disease were better than for disease involving the nasopharynx (39%) or multiple sites (25%). Treatment also influenced survivals and disease-free survivals. The best results were obtained in patients who were treated with radiotherapy and combination chemotherapy. The 5-year survival and disease-free survival figures were 78% and 69%, respectively.

Antineoplastic Agents↗
PubMed1984

Role of specific antibody in interaction of leptospires with human monocytes and monocyte-derived macrophages.

It has previously been shown that human neutrophils ingest and kill nonpathogenic Leptospira biflexa in the absence of serum but that pathogenic Leptospira interrogans is not ingested by neutrophils even in the presence of normal serum. We extended this study by examining the interactions of human monocytes and monocyte-derived macrophages with pathogenic L. interrogans (serovar icterohaemorrhagiae) and evaluating the opsonizing effect of serotype-specific immune serum on the phagocytosis of pathogenic leptospires by monocytes and neutrophils. Leptospires were incubated with monocytes in pellets at 37 degrees C in 5% CO2. No ingestion or killing of pathogenic leptospires occurred when 10% normal serum was used. However, when the pathogenic leptospires were pretreated with serotype-specific immune serum, monocytes or neutrophils in pellets ingested 96% of the organisms and killed 94% of those ingested. Microscopic observations of the interaction confirmed that phagocytosis of the opsonized pathogenic leptospires by monocytes, monocyte-derived macrophages, and neutrophils had occurred. The opsonizing effect of specific antibody may play an important role in the mechanism of host defense against leptospirosis.

Antibodies, Bacterial↗
PubMed1984

The effects of nitrous oxide on myocardial metabolism and hemodynamics during fentanyl or enflurane anesthesia in patients with coronary disease.

Twenty patients about to have coronary artery bypass grafts were studied before and after 15 min of 50% nitrous oxide added to either fentanyl (75 micrograms/kg) or enflurane (0.5%) anesthesia. Arterial and central pressures and cardiac output were measured, plus coronary sinus blood flow and arterio-coronary sinus differences in oxygen, hemoglobin, and lactate contents. Fentanyl-N2O and enflurane-N2O both decreased systemic resistance, heart rate, cardiac output, and hence arterial pressure. Stroke work decreased significantly with little or no change in wedge pressure: ventricular function was impaired. Coronary flow and myocardial O2 consumption decreased with fentanyl-N2O. Oxygen extraction increased with enflurane-N2O, as did lactate contents of coronary sinus blood. Hemodynamic depression occurred from the combined effects of nitrous oxide and fentanyl or enflurane. The beta-blocked myocardia of nonstimulated coronary patients were becoming ischemic globally on 50% oxygen, after significant hypotension. From this and other evidence, we conclude that nitrous oxide may not be benign in patients with coronary arterial disease.

Adult↗
PubMed1984

Interrelationships of polymorphonuclear neutrophil membrane-bound calcium, membrane potential, and chemiluminescence: studies in single living cells.

Stimulated neutrophils show ionic fluxes that may function as "transducers" between stimuli and effector functions. Using fluorescent probes, patterns of membrane-associated calcium (chlortetracycline, CTC) and membrane potential (3-3'-dipentyloxacarbocyanine, di-O-C5 (3)) in single living human neutrophils were observed with a fluorescence microscope fitted with an image intensifier and photometer. Fluorescence changes were related to chemiluminescence. In unstimulated neutrophils, CTC and di-O-C5 (3) fluorescence was brightest in the perinuclear region. Di-O-C5 (3) fluorescence was also seen in mitochondria. Neutrophil stimulation with zymosan, phorbol myristate acetate (PMA) or calcium ionophore (A23187) resulted in loss of di-O-C5 (3) and CTC fluorescence and chemiluminescence proportional to the strength of the stimulus. Experiments demonstrated the independence of these processes. (1) Digitonin stimulation caused chemiluminescence and di-O-C5 (3) darkening without loss of CTC fluorescence. (2) Depolarization of neutrophils did not induce CTC darkening or chemiluminescence. (3) Calcium ionophore (A23187) stimulation of neutrophils in calcium-free medium resulted in normal di-O-C5 (3) and CTC darkening, but a blunted chemiluminescence peak. (4) Calcium ionophore (A23187) stimulated the loss of di-O-C5 (3) and CTC fluorescence from chronic granulomatous disease neutrophils, but did not trigger an oxidative burst. Although neutrophil depolarization, calcium release from membranes, and oxidative activity are linked, these processes can clearly be separated.

Animals↗
PubMed1984

Sublaminar wiring of Harrington distraction rods for unstable thoracolumbar spine fractures.

Sublaminar wiring of Harrington distraction rods enhances stability and resistance to pullout and is an effective means of managing unstable thoracolumbar spine fractures. The incidence of distraction rod-related failure and the duration of postoperative immobilization are reduced. Early return to full activity and successful rehabilitation are facilitated by efficient stabilization of the spinal column.

Adolescent↗
PubMed1983

Motility of human polymorphonuclear neutrophils: microscopic analysis of substrate adhesion and distribution of F-actin.

Directed movement of polymorphonuclear neutrophils (PMN) requires cell polarization and the orderly making and breaking of cell-substrate contacts. We compared the movement of human PMN suspended from the underside of glass coverslips to that of PMN seen in "profile" on fibers, using brightfield, differential interference contrast and reflection interference microscopy. Images were recorded on film and videotape and analyzed in real time and time lapse. The distribution of F-actin was observed with image-enhanced fluorescence microscopy after staining with NBD-phallacidin. PMN exhibited two patterns of motility. Fifteen to twenty-five percent of cells moved in a low profile gliding pattern and exhibited caudad displacement of dorsal surface folds. Most PMN made progress by cycles of partial release of the lamellipodium from the substrate and anterior advance followed by arching or rolling and lamellipodial reassociation with the substrate. Cells stimulated with bacteria, casein, or chemotactic formyl peptide rarely spread on the coverglass but waved into the medium attached only by the uropod. Eventually, many detached completely from the substrate. Cells confined to the substrate surface with overlying agarose were able to locomote when confronted with these substances. F-actin was irregularly distributed in nonpolarized suspended cells but concentrated in the lamellipodium in polarized cells. As cells arched along a substrate, F-actin accumulated in foci corresponding to the substrate-PMN interface, particularly at the uropod and retraction fibrils. Conversely, cells that were physically restricted to movement in the plane of the substrate surface by overlying agarose exhibited diffuse F-actin along the entire cell. Suspended PMN polarized with formyl peptide and incubated with Con A accumulated F-actin at the uropod. These observations suggest that both PMN locomotion and the movement of Con A binding sites involve the caudad redistribution of F-actin.

Actins↗
PubMed1983

Cast brace management of the femoral shaft fracture in children and young adults.

Seventy-two children and adolescents, 5-19 years of age, sustaining femoral fractures were treated with immediate cast bracing at Oklahoma Children's Memorial Hospital. Ambulation was started an average of 3 days after fracture when there were no associated injuries. The average length of hospitalization was 18.7 days; the average length of immobilization in plaster was 67.4 days. Results were generally comparable to those of more standard methods of treating a fractured femur in this age group. Proximal as well as middle and distal fractures were treated, but varus and anterior angulation was not well controlled in proximal fractures. No patient had a clinically significant deformity. Sixty-one percent of the entire group healed with less than 6 mm discrepancy. Middle-third fractures showed more tendency toward shortening. All six fractures that healed with more than 1.5 cm of shortening were middle third. No injured femur was longer than the uninjured femur at a 6-month follow-up. Immediate cast bracing can provide an opportunity for early ambulation and avoid the sequelae of immobilization. Weekly assessment for the first 4 weeks is mandatory to monitor length and angulation. The adolescent male with a midshaft fracture was most difficult to manage, and in this situation, closed intramedullary nailing is recommended.

Adolescent↗
PubMed1983

Interaction of Leishmania donovani promastigotes with human phagocytes.

Leishmania donovani is an important intracellular protozoal pathogen of humans, which resides solely within mononuclear phagocytes. Phase-contrast microscopy and cinemicroscopy were used to examine the interaction of L. donovani promastigotes with human phagocytes to characterize and quantitate the sequence of events that results in leishmanial infection.

Animals↗
PubMed1983

Human neutrophil membrane topography: examination of distribution, movement, and regeneration of recognition sites using lectins as probes.

We have studied the pattern of membrane binding site redistribution, movement, and reappearance in polarized and nonpolarized human neutrophils using fluorescein and rhodamine-labeled lectins as probes. In suspension, polymorphonuclear leukocytes (PMN) were spherical and displayed a random array of recognition sites for all of the probes. PMN polarized in suspension by 10(-6) M N-formyl-L-methionyl-L-phenylalanine (f-Met-Phe), and PMN attached to substrate accumulated the bound lectin recognition site complex at the uropod (for Con A; 92.0 +/- 0.2% of cells and 91.3 +/- 9.8% of cells, respectively). Glutaraldehyde fixation of neutrophils oriented in a chemotactic gradient prior to lectin addition revealed the innate unbound recognition site array. Unbound Con A recognition sites were clustered at the front of 74.7 +/- 0.8% of cells in a "headlight" pattern, but binding sites for other lectins were distributed randomly around the polarized cell. When bound Con A complexes are swept to the tail of the polarized living PMN, "new" unbound Con A binding sites appear at the front of the cell. Neither cycloheximide nor KCN nor colchicine interferred with new binding site appearance. Cytochalasin B and sodium iodacetate prevented PMN polarization and interfered with appearance of new receptors. This suggests that these fresh sites are uncovered, previously cryptic binding sites rather than newly synthesized structures. Lectin binding site topography and movement are related to the functional state of the PMN. Since both Con A and certain bacteria bind to mannose derivatives, we postulate that the "headlight pattern" and uncovering of fresh binding sites aid the PMN in engulfing organisms as the phagocyte moves forward.

Cell Membrane↗
PubMed1982

Treatment of patients with stages I and II nonmediastinal Hodgkin's disease.

In this study, 95 patients with laparotomy-staged I and II nonmediastinal Hodgkin's disease were treated with involved fields (41 patients), mantle (17), extended fields (26), or involved fields followed by 6 cycles of MOPP (11). Eighty-five patients had upper torso presentations. Seventy had Stage I disease and 25 had stage II. Pathologic findings were nodular sclerosing, 33; mixed cellularity, 41; lymphocyte predominance, 20; and unclassified, one. Five-year overall survivals were excellent regardless of stage, pathologic findings, or treatment: 98% for involved fields or mantle, and 100% for both extended fields and involved fields followed by 6 cycles of MOPP. Corresponding disease-free survivals were 77%, 82%, and 86%, respectively. For patients with upper torso presentations, disease-free figures for the mantle (94%) were better than those for involved fields alone (67%). In addition, regression analysis proved involved fields to be a prognostic factor for a lower disease-free survival. No difference between extended fields or mantle radiotherapy could be detected using this model. Relapses usually occurred in nonirradiated upper torso sites. Only three of the 36 patients treated with involved fields and one of 21 treated with extended fields relapsed in the abdomen alone. Most patients in relapse were salvaged. Rescue treatment was most often radiotherapy and adjuvant combination chemotherapy. Based on this study, the use of mantle radiotherapy is recommended in treating laparotomy-staged I and II patients with nonmediastinal presentations, and the use of extended fields or adjuvant chemotherapy as primary prevention is not recommended.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1982

The roles of staging laparotomy, chemotherapy, and radiotherapy in the management of localized diffuse large cell lymphoma: a study of 75 patients.

A retrospective study of 75 laparotomy-studied Stage I and II patients with diffuse large cell (histiocytic) lymphoma was conducted to determine the relative contributions of laparotomy, radiotherapy, and combination chemotherapy to their management. The treatment programs were radiotherapy alone, radiotherapy followed by adjuvant chemotherapy, and alternating chemotherapy-radiotherapy. Treatment selection was based on disease presentation, with limited therapy used for favorable patterns and intensive therapy used in prognostically unfavorable settings. Disease-free survival was best in those treated with initial chemotherapy, even though these patients comprised the least favorable prognostic group. A select subset of patients, those with extranodal head and neck disease, obtained good results with radiotherapy alone, but for other presentations this was not a successful approach. Differences in results for the three treatment programs are discussed in relation to future treatment decisions.

Abdominal Neoplasms↗
PubMed1982

Kinematic analysis and simulation of vertebral motion under static load-part I: kinematic analysis.

The paper presents the kinematic analysis of motion segments of ten, humanlumbar spines. In order to achieve this objective, a spine fixture and a linkage transducer were designed. The spine fixture is capable of holding the motion segment in a prescribed plane of loading. With the designed fixture it becomes possible to apply three types of shear loads, and three types of bending loads. In addition, if desired, a compressive preload may be applied to a motion segment. The linkage transducer consists of six rotary potentiometers connected by seven rigid links. The transducer is capable of measuring all possible components of vertebral motion. The motion data in the motion segments of ten lumbar spine were collected under the influence of combined shear and bending loads applied in an incremental manner. Maximum shear load was 35.6 N and maximum bending load was 6780 N. mm. The motion segments did not show any appreciable difference in their motion beyond these loads. The motion segments were not subjected to any compressive preload. The range of motion data were collected in twelve loading planes 15 deg. apart. The characteristic vertebral motion may be described in terms of range of motion, its components, and the parameters associated with the screw motion. The paper presents data in the chart form to describe the kinematic characteristics of the lumbar motion segment.

Humans↗
PubMed1982

Kinematic analysis and simulation of vertebral motion under static load-part II: simulation study.

Based on the earlier work by the author on the development of a theoretical motion simulation model of an open-loop, kinematic chain, the present paper examines the motion characteristics of a human spine motion-segment. Based on the experimental data collected from the human spine cadaver specimens of lumbar spine, a static simulation model of a lumbar segment is proposed. The equivalent motion characteristic of the intervertebral joint is described by a spherical pair which is located for an intervertebral joint by fitting in a least-square sense a cone to a set of motion data describing the axode characteristics of the joint. The intervertebral disk and the ligaments are represented by an equivalent stiffness matrix whose elements are assumed to be constant over the entire range of mobility. The proposed model showed a good agreement with the observed motion data of an intervertebral joint.

Humans↗
PubMed1982

Femoral neck anteversion in perspective.

Routine evaluation of anteversion by biplanar radiographic means is unreliable, poorly reproducible, and unnecessary. Isolated measurement of femoral neck anteversion is a concept which has outlived its usefulness. The relationship of the femoral head to the acetabulum is more important than the direct measurement of femoral anteversion. Computerized axial tomography can provide both forms of information. The radiation dose in computerized tomography is relatively large and its use in children should be correspondingly limited.

Child↗
PubMed1981

Reassessment of prognostic factors in stage IIIA and IIIB Hodgkin's disease treated with MOPP and radiotherapy.

Prognostic factors have been re-evaluated for 88 patients with Stage III Hodgkin's disease to see if they have remained significant on a long-term basis. Treatment had consisted of two cycles of MOPP followed by radiotherapy to the mantle, abdomen, and pelvis; all patients had achieved complete remission. Case material was grouped according to the presence of absence of mediastinal disease. Five-year survivals for Stage IIIA and IIIB patients were 85 and 80%; corresponding disease-free survivals were 76 and 73%. Significant prognostic factors include age, histopathology, and extent of abdominal disease, but the relative importance of these factors differs for the mediastinal and nonmediastinal patients. Modifications of current treatment policy for both mediastinal and nonmediastinal patients are discussed in relation to the prognostic factors.

Adult↗