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Biomedical subjects

J B Green

Publications and source records attributed to J B Green.

At least 91 records · Page 5Linked to original sources
PubMed1987

Presacral myelolipoma.

Extramedullary tumors of hematopoietic tissue can be divided into two categories: those associated with a bone marrow disorder, myelolipomas which have no apparent relation to a bone marrow disorder. The etiology of myelolipoma is unknown and the vast majority are adrenal in location. Extramedullary myelolipomas are usually presacral in location and none of the approximately ten reported cases has been diagnosed before surgery. Although radiographic and ultrasound features of myelolipomas are relatively characteristic, they are not specific and biopsy is required for diagnosis. Microscopic diagnosis requires demonstration of benign lipomatous tissue admixed with cellular hematopoietic tissue resembling normal bone marrow. This study reports a patient with presacral myelolipoma and an unusual finding of urinary retention and azotemia associated with compression of urinary bladder neck by the myelolipoma.

Female↗
PubMed1987

Doxorubicin-cisplatin-vinblastine combination chemotherapy of advanced endometrial carcinoma: a Southwest Oncology Group Study.

A combination of doxorubicin (30 mg/m2 iv), cisplatin (50 mg/m2 iv), and vinblastine (5 mg/m2 iv) repeated every 3-4 weeks was used to treat 55 patients with advanced stage III or IV or recurrent disease. Of the 42 fully evaluable patients, there were 3 complete responders (7%) and 10 partial responders (24%). Responses were of short duration (median of 8 months, range 3-15 months) and the median survival of all evaluable patients was only 10 months from the start of therapy. Leukopenia was the major toxicity and was at least moderate in two-thirds of patients. We conclude that the addition of cisplatin and vinblastine to doxorubicin does not improve the clinical utility of doxorubicin in patients with advanced endometrial cancer.

Adult↗
PubMed1987

Variation in retinol utilization rate with vitamin A status in the rat.

The relationship of vitamin A status to retinol (ROH) utilization rate (disposal rate, DR) and other kinetic parameters was studied in rats with low (LO), marginal (MAR) or high (HI) mean liver vitamin A levels (2.2, 43 and 985 micrograms, respectively) and low or normal plasma ROH concentrations (6.8, 46 and 42 micrograms/dL). Kinetic parameters were calculated by input-output analysis of plasma [3H]ROH turnover monitored for 35 (LO and MAR) or 115 d (HI) after injection of [3H]ROH in its plasma transport complex. There was a highly significant negative correlation between fraction of dose in plasma 5 d after injection of [3H]ROH and the natural log of liver total vitamin A. The total time an average ROH molecule spent in plasma (residence time), as well as the time spent during each pass (transit time), was significantly lower in HI (0.77 d and 1.9 h) than in LO (0.98 d and 2.7 h) and MAR (0.92 d and 2.8 h) rats; however, the total time in the system (mean sojourn time) increased markedly with vitamin A status (5, 18 and 77 d). The number of times an average ROH molecule recycled through plasma before irreversible loss (7-9 times) was similar in all groups. Most of the ROH molecules (approximately 90%) that left the plasma were recycled, not irreversibly metabolized, in all groups. Among groups, ROH DR increased significantly from 1.2 (LO) to 8.0 (MAR) to 11.8 micrograms/d (HI). For LO versus MAR and LO versus HI, differences in DR were positively related to differences in the plasma ROH pool size. These results suggest that low plasma ROH concentrations are associated not only with low liver vitamin A levels, but also with a decreased ROH DR. This decreased DR may or may not reflect a compromised functioning of ROH-dependent systems.

Animals↗
PubMed1987

Peritoneal lavage in pediatric patients sustaining blunt abdominal trauma: a reappraisal.

One hundred twenty-eight patients from 0 to 18 years of age underwent diagnostic peritoneal lavage following blunt abdominal trauma. Seventy-eight had negative lavages and 50 were positive. Forty-one patients underwent exploratory celiotomy after positive lavage results. A review of the operative findings and need for surgical intervention led to the conclusion that 12 of these operations were not necessary. Due to the oversensitivity of peritoneal lavage a strongly positive result mandates further diagnostic evaluation unless the patient's clinical status requires exploratory celiotomy.

Abdominal Injuries↗
PubMed1986

Digital zero-phase-shift filtering of short-latency somatosensory evoked potentials.

Short-latency somatosensory potentials evoked by median nerve stimulation were averaged after analogue bandpass of 30-3000 Hz and then filtered by a zero-phase-shift digital filter with bandpass of 200-1500 Hz. Both near- and far-field potentials recorded by scalp to scalp, ear and extracephalic references were enhanced, without temporal distortion or the introduction of spurious peaks. Components were identified at the same or similar peak latencies as reported by other investigators. Zero-phase-shift digital filtering may increase the usefulness of recording short-latency somatosensory potentials.

Adult↗
PubMed1986

A familial visceral myopathy with dilatation of the entire gastrointestinal tract.

We are reporting a new kindred in which familial visceral myopathy was identified in four siblings. There was no other symptomatic case identified in this 75-member, four-generation family, suggesting an autosomal recessive inheritance. All patients had recurrent symptoms of intestinal obstruction, and 3 died from malnutrition. Gastrointestinal lesions showed marked dilatation of the entire digestive tract from the esophagus to the rectum, which is different from other types of familial visceral myopathies. Microscopic examination of the gastrointestinal smooth muscle showed degeneration and increased fibrosis indistinguishable from other types of familial visceral myopathy.

Adult↗
PubMed1986

Postsplenectomy sepsis in pediatric patients following splenectomy for trauma: a proposal for a multi-institutional study.

Eighteen patients less than 15 years of age (range, 1.5 to 15 years) were followed prospectively after undergoing splenectomy for blunt trauma. Follow-up time ranged from 1 to 12 years with a mean of 5.8 years. During the follow-up period significant septic episodes developed in two of the 18 (11.0%) patients. During the same period 16 patients less than 15 years of age (range 2 to 15 years) who underwent splenorrhaphy were followed. In none of the patients in the splenorrhaphy group has sepsis developed to date (P = .11). Follow-up studies in both groups included a CBC, peripheral smear, platelets counts, history of infections, and radionuclide scans in the patients undergoing splenorrhaphy. The two patients with significant sepsis were an 18-month-old male with pneumococcal septicemia and a 13-year-old with meningococcal meningitis. Both patients survived these episodes. Although the numbers are small, this prospective study reemphasizes the increased risk of sepsis in the asplenic pediatric patient and the need for close surveillance, parental education, appropriate immunizations, and vigorous treatment of infections. The methods used in this prospective study of patients from one institution could be expanded to a multi-institutional study to obtain prospective data concerning the natural history of pediatric patients undergoing splenectomy because of trauma.

Adolescent↗
PubMed1986

Absorption of water-miscible forms of vitamin E in a patient with cholestasis and in thoracic duct-cannulated rats.

Oral administration of vitamin E (100 mg tocopherol X kg-1 X day-1) as tocopheryl polyethylene glycol 1000 succinate (TPGS) to a child with congenital hepatic cholestasis (unresponsive to oral administration of dl-alpha-tocopheryl acetate) promoted an increase of tocopherol in plasma and adipose tissue while tocopheryl acetate emulsified with medium chain triglycerides and polysorbate 80 (MCT-E) did not. alpha-Tocopherol absorption, quantitated in thoracic duct-cannulated rats receiving intraduodenal infusions of soybean oil and saline, was similar for TPGS, MCT-E, and dl-alpha-tocopheryl acetate; gamma-tocopherol absorption from soybean oil was not affected by the presence of the supplemental alpha-tocopherol. Following bile duct ligation in one rat, TPGS promoted the absorption of alpha-tocopherol while absorption of gamma-tocopherol from soybean oil was decreased 30 fold, demonstrating that TPGS, which forms a micellar solution, delivers alpha-tocopherol through the unstirred water layer to enterocytes, while free tocopherol (alpha or gamma) absorption requires the presence of bile salts.

Administration, Oral↗
PubMed1986

Late septic complications in adults following splenectomy for trauma: a prospective analysis in 144 patients.

One hundred forty-four patients were prospectively followed through our Asplenic Registry for the development of late septic complications following splenectomy for trauma. There were 114 males and 30 females with a mean age of 28.6 years. The total time of followup was 8,810 patient months with a mean followup of 61 months (range, 12-144 months). Indications for splenectomy were blunt trauma, 111 patients; penetrating trauma, six patients; and intra-operative injury, 27 patients. During the followup to date, 15 late major septic complications requiring hospitalization have occurred in 13 patients (9%). Fulminant pneumococcal sepsis resulted in the death of a 27-year-old male, 3 years after splenectomy. Septicemia occurred in four patients, pneumonia in five, abscess in two, infection of a prosthetic heart valve in one, meningitis in one, and fever of unknown origin in one. All but two of these infections were due to encapsulated organisms. Minor septic complications occurred in 44 patients (30%), and consisted of infections which required outpatient medical care. Major late septic complications occurred more frequently following incidental splenectomy than following splenectomy for blunt or penetrating trauma (18.5% and 5.9% respectively; p less than 0.05). The mortality from major septic complications in this series (7%) is lower than previously reported by other investigators (30-80%). Our data suggest that adults undergoing splenectomy for trauma are at an increased risk of developing late major septic complications. This risk is significant enough to warrant attempts at splenic salvage, especially when injury is incidental to an elective operative procedure.(ABSTRACT TRUNCATED AT 250 WORDS)

Abscess↗
PubMed1986

Chemotherapy of drug-resistant ovarian cancer: a Southwest Oncology Group Study.

We present a final analysis, including pathology review, of a cooperative group study of drug-resistant ovarian cancer. Of 200 patients registered, 112 were eligible and evaluable, with a response rate of 26% and median survival of 7 months. Because these results are poorer than those reported in the preliminary and interim analyses of this study, we scrutinized the 88 excluded patients, most of whom failed to meet our strict pathologic criteria for a diagnosis of ovarian cancer of epithelial type, and who, as a heterogeneous group, fared better than patients who did meet the eligibility criteria. We believe this analysis provides insight into the spectrum of diseases that are frequently called ovarian cancer, but might be more properly labeled abdominal carcinomatosis.

Adult↗
PubMed1985

A multicompartmental model of vitamin A kinetics in rats with marginal liver vitamin A stores.

A linear, first-order, constant-coefficient multicompartmental model is presented which describes the dynamics of [3H]retinol turnover in adult rats with normal plasma retinol concentrations but low liver stores (less than 100 micrograms of retinol equivalents). To fit plasma and tissue (liver, kidney, and rest of carcass) tracer and tracee data, eight physiological compartments were required in the model: two in plasma (proposed to correspond to the retinol transport complex, and retinyl esters in plasma lipoproteins) and two each in liver, kidneys, and other extrahepatic tissues. Extensive recycling of retinol among plasma, liver, and the rest of carcass was also required. The model predicted that 44% of whole body vitamin A (143 micrograms) was in extrahepatic tissues. The vitamin A utilization rate (system disposal rate) was 6.9 micrograms of retinol equivalents/day. The system residence time (mean sojourn time) for vitamin A was 21 days, and the fractional catabolic rate for the system was 5%/day. The mean transit time (turnover time) for vitamin A in its plasma retinol transport complex was 0.078 days (1.9 hr); the residence time was 0.98 day, versus 11 days in the liver, 9 days in carcass, and 0.54 days in kidneys. The model predicted that, of the plasma turnover, 48% recycled to the liver and 52% to extrahepatic tissues. The liver retinol secretion rate was 48 micrograms/day, more than half of which was from recycled plasma retinol. Since the plasma retinol turnover rate (87 micrograms/day) was 13 times the system disposal rate, the data suggest that this is a high response system in which changes in the dynamics of recycling of retinol allow for rapid adjustment in vitamin A distribution in response to changes in nutritional, metabolic, or physiological conditions; and in which plasma retinol levels are controlled homeokinetically by changes in hepatic and extrahepatic recycling of holo retinol-binding protein.

Animals↗
PubMed1984

Hereditary and acquired coagulation factor abnormalities. A primary care primer.

The primary care physician is usually the first to see patients with acquired or previously undiagnosed hereditary coagulation factor disorders. In addition, although such patients are best referred to a comprehensive center with specialized personnel and equipment, the referring physician is often involved in the overall care of such patients. Thus, some basic knowledge of these rare and complex syndromes is necessary to enable recognition of a suspicious history or clinical findings and to permit an understanding of the principles of therapy.

Blood Coagulation Disorders↗
PubMed1984

Multicompartmental analysis of the effects of dietary fat saturation and cholesterol on absorptive lipoprotein metabolism in the rat.

The potential contribution of the metabolism of absorptive lipoproteins to effects of dietary cholesterol and saturated (versus polyunsaturated) fat on plasma lipids and lipoproteins was studied in rats. Recipients were fed either a commercial stock diet, a low fat/cholesterol-free semipurified diet with a neutral P/S ratio, or one of two high fat/cholesterol-containing diets that had a high (4.6) or low (0.2) P/S ratio. Chylomicrons and intestinal very low-density lipoproteins labeled with 3H-oleic acid and/or 14C-cholesterol were isolated from donor rats receiving the high or low P/S ratio oil and were injected into recipients. Data on plasma disappearance and hepatic recovery of labels were analyzed by compartmental analysis. A multicompartmental model was required to fit these data and included steps interpreted to correspond to activation of newly secreted intestinal lipoproteins; delipidation on capillary endothelia by lipoprotein lipase, with transfer of cholesterol to other lipoproteins and tissue uptake of cholesterol and fatty acids; hepatic clearance of remnants; and secretion of lipoproteins by the liver. Metabolic state of the recipients (especially plasma triglyceride concentrations) had a greater influence on the rate of chylomicron turnover than did the source of donor chylomicrons, although saturated chylomicrons tended to be metabolized more slowly than polyunsaturated ones. For recipients fed the commercial stock diet and injected with saturated (versus polyunsaturated) chylomicrons, the mechanistic model predicted an increased retention of triglycerides during remnant formation, and thus an increased delivery of triglyceride to the liver. A consequent elevation in hepatic production of very low-density lipoprotein triglycerides may be related to the observed slower clearance of chylomicrons and increased plasma lipid levels in rats fed saturated fat and cholesterol.

Absorption↗
PubMed1984

Pilomotor seizures.

A 44-year-old man had frequent episodes of piloerection, or " gooseflesh ." Clinical and EEG evidence suggested that the attacks were pilomotor seizures, originating in the right temporal lobe. The cause was a glioblastoma. Paroxysmal piloerection is a rare manifestation of epilepsy.

Adult↗