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Biomedical subjects

J M Roseman

Publications and source records attributed to J M Roseman.

At least 73 records · Page 4Linked to original sources
PubMed1986

Host factors in juvenile periodontitis.

This study was undertaken to determine whether defects in leukocyte function or in genes at the MHC play a role in the etiology of either localized (LJP) or generalized (GJP) juvenile periodontitis. Thirteen LJP and five GJP patients (ranging in age from 13 to 22 years) and their matched controls were compared with respect to selected leukocyte functions and HLA phenotypic frequencies. The results of these studies indicated that there were significant decreases in the phagocytic and chemotactic abilities of polymorphonuclear leukocytes (PMN) in both LJP and GJP. All JP patients displayed intrinsic cell defects in chemotaxis compared with controls; in addition, some patients displayed multiple defects, including those which were serum-associated. Also, there appeared to be a significant association between JP and HLA-DR2 and HLA-A33 phenotypes. Fifty percent of the JP patients were HLA-DR2-positive, whereas only six percent of the matched controls were positive. Thirty-six percent of JP patients were HLA-A33-positive, whereas none of the controls was positive. The association seen with DR2 may be due to sampling, since there were no significant differences between the JP cases and a larger unmatched control sample which was not evaluated for periodontal disease. We conclude from these data that increased susceptibility of some patients to a very aggressive and destructive form of periodontal disease (JP) is based on defects in PMN responsiveness. Further investigations are necessary to determine whether these defects are under genetic control.

Adolescent↗
PubMed1985

The safe use of cisplatin in hyperthermic isolated limb perfusion systems.

A patient presenting with aggressive squamous cell carcinoma successfully received cisplatin chemotherapy via hyperthermic, isolated limb perfusion (renal impairment ruled out systemic use). Human tumor stem cell assay identified cisplatin as the drug of choice and supports the potential benefit of this procedure in single therapeutic situations. The case illustrates the safety of cisplatin and the ability to give large doses of the nephrotoxic drug with no damage to renal function. The potential efficacy over systemic cisplatin has yet to be established except when systemic use is limited from renal dysfunction.

Aged↗
PubMed1984

Branchial cleft cyst to jugular vein fistula. An unusual complication.

Although fistulization between branchial cleft cysts and major vascular structures is extremely rare, it is a potentially serious complication, particularly with recurrent episodes of inflammation. Needle aspiration of a fluctuant lesion prior to formal incision and drainage is crucial. It confirms the nature of the lesion, thus avoiding potential complications. The importance of early exploration and excision of this type of fistula makes possible the early definitive treatment of branchial cleft cysts.

Branchioma↗
PubMed1984

Pharmacokinetics and urinary excretion of clavulanic acid after oral administration of amoxicillin and potassium clavulanate.

Clavulanic acid is a beta-lactamase inhibitor which prevents microbial lactamase inactivation of beta-lactam antibiotics. The pharmacokinetics and urinary excretion of clavulanic acid were studied in eight healthy adult volunteers after oral administration of 500 mg amoxicillin and 125 mg potassium clavulanate. Serum and urine clavulanic acid concentrations were assayed using high-performance liquid chromatography. Pharmacokinetic parameters were: t 1/2 beta = 1.019 +/- 0.090 hour, t 1/2 alpha = 0.276 +/- 0.031 hour, lag time = 0.321 +/- 0.018 hour, tmax = 1.042 +/- 0.80 hour, Cmax = 2.098 +/- 0.441 micrograms/ml, and AUC = 4.897 +/- 0.979 micrograms X hr/ml. Cumulative urinary excretion of clavulanic acid (as percentage of dose administered) was: 14.05 +/- 2.87 within 2 hours, 25.77 +/- 3.98 within 4 hours, and 27.85 +/- 4.27 within 6 hours after administration.

Administration, Oral↗
PubMed1984

The complement component C4 in black Americans with type 1 (insulin-dependent) diabetes mellitus.

The complement component C4 variants C4A 4, C4B 4 and C4B Q0 were found to be significantly increased in 64 black patients with Type 1 (insulin-dependent) diabetes compared with 169 black control subjects, yielding relative risks of 3.3, 2.9 and 3.4, respectively. The increased frequencies of C4B 4 and C4B Q0 in black Type 1 diabetic patients are similar to those found in Caucasoid Type 1 diabetic patients. The data suggest that Type 1 diabetes in black Americans may be partially due to admixture of genes from whites.

Adult↗
PubMed1983

Aggressive surgery for management of recurrent intraabdominal carcinoma.

With the evolution of effective multimodality control of various tumors, the role of surgery for recurrent malignancies is emerging as significant factor in not only maintaining that control, but in permitting the possibility of late cure of certain, even advanced intraabdominal malignancies. Several patients with Stage IV colon or ovarian carcinoma were evaluated and found to benefit from such an aggressive surgical approach with the result of long term control as well as apparent clinical cure in the several instances. These possibilities are becoming increasingly significant as progress is made in the various treatment modalities for neoplastic diseases.

Colonic Neoplasms↗
PubMed1983

Deep, percutaneous antecubital venipuncture: an alternative to surgical cutdown.

In a 6 month period, I encountered 18 instances in which deep percutaneous venipuncture seemed appropriate. In every instance, venipuncture was successfully accomplished, avoiding a cutdown procedure, as well as obviating the need for central venous catheter placement. The ease of cannulation and the minimization of trauma to the patient make this technique a useful alternative to surgical venous cannulation.

Arm↗
PubMed1983

Population genetic analyses of insulin dependent diabetes mellitus using HLA allele frequencies.

In order to try to detect heterogeneity within insulin dependent diabetes mellitus (IDDM) and to distinguish a mode of inheritance of IDDM, population genetic analyses were performed using HLA allele frequencies. HLA-A and -B typing performed on 231 IDDM individuals and 268 controls from the southeastern U.S. showed significant increases with IDDM in A2, B8, B15 and B18, and significant decreases in Aw23, B7, B14 and B17. The combination of HLA-B8/B15 showed a greatly increased risk (RR = 25.5). Between the 120 IDDM individuals and 123 controls HLA-DR typed, HLA-DR3 and -DR4 were significantly increased among the IDDM group and DR2 and DR7 were decreased. The risk for DR3/4 was 29.2. It appeared that the B15 association was secondary to the DR4, but the B8/DR3 association showed no difference. Using the method of Curie-Cohen, no significant increases in risk were found for the B8/B15 or DR3/DR4 heterozygotes when compared to the respective homozygotes. Using the method of Thomson and Bodmer, the dominant mode of inheritance was excluded for DR4 only. There was a significant increase in B15 and DR4 in those with onset before age 20. No significant differences were found among the DR phenotypes with respect to season.

Age Factors↗
PubMed1983

Phenotypes of the fourth complement component (C4) in black Americans from the southeastern United States.

C4 is composed of two tightly linked genes (C4A and C4B) lying within the major histocompatibility complex of chromosome 6 that can be demonstrated by agarose gel electrophoresis. Seven alleles and five alleles at the C4A and C4B loci, respectively, were detected in 169 black individuals from the southeastern United States. Furthermore, the phenotypic frequencies of C4A6, C4A5, C4A4, C4B4, C4B3 and C4BQ0 were significantly different between black and white Americans.

Alleles↗
PubMed1983

Genetic analysis of multiply-affected families of insulin-dependent diabetes mellitus (IDDM) probands.

The present study combines segregation and linkage information on 30 families ascertained through a proband and a first degree relative affected with insulin-dependent diabetes mellitus (IDDM). An autosomal dominant model with incomplete penetrance was much more likely to fit the family data than a recessive model, whether or not linkage to HLA was assumed. The lod scores for linkage to HLA were 2.46 at theta M = theta F = 0.00 for dominant and 1.45 at theta M = theta F = 0.22 for a recessive model. The results are discussed in light of heterogeneity in likelihood and lod scores when the families are grouped by familial types, which indicate that the increase in likelihood of a dominant hypothesis can be attributed to the parent-child families and not the sib-sib families.

Adult↗
PubMed1982

The significance of the internal mammary lymph nodes in medially located breast cancer.

The efficacy of adjuvant radiotherapy for medial breast cancers in Stage I or II disease was studied with a retrospective clinical analysis. All cases of breast cancer free of axillary node metastases at the time of standard or modified radical mastectomy were included. These were grouped by location and size of the primary tumor. There were 76 medial lesions, including those in the 6:00 or 12:00 axis. Seventeen of these had received postoperative radiation. Lateral tumors included 59. The size was based on the largest linear dimension and grouped less than or equal to 2 cm or greater than 2 cm. At the time of initial recurrence, all areas of metastases were determined. The data suggests that: (1) medial breast cancers have a greater rate of recurrence than lateral ones; (2) adjuvant radiation for medial lesions decreases that recurrence rate to the range of lateral tumors; (3) large lesions may have a greater chance for local recurrence as well as medial lesions of all sizes; and (4) the potential problems with local recurrence may be diminished with adequate radiotherapy as an adjunctive measure. When recurrence does occur, prior radiotherapy seems to delay the appearance of that recurrence.

Breast↗
PubMed1982

Metastatic cancers to the neck from undetermined primary sites: long-term follow-up.

When a patient presents with a mass in the neck, diagnosis by fine needle aspiration cytology is recommended. This allows an accurate diagnosis of malignancy with minimal morbidity. Tissue planes, important in any future definite neck surgery, are not altered, as they would be from an excisional biopsy. Once the diagnosis of metastatic cancer is confirmed, thorough search for the primary tumor must be made. The history, physical examination, and radiographic and laboratory studies must be complete. Finding no origin of tumor, local treatment of the metastases must be done, with the objective being complete eradication of disease. Regular follow-up, with a continual search for the primary malignancy is then recommended. The specifics of this approach and the results of our series are outlined.

Biopsy, Needle↗
PubMed1982

Villous adenomatosis and carcinoma in a 66-year-old man with familial polyposis.

A patient evaluated and treated for carcinoma of the colon and multiple polyps and the patient's family represent a new pattern of clinical and pathologic manifestations of familial polyposis. The lack of antecedent family history of polyposis, the presence of diffuse villous degeneration, and the occurrence of cancer at age 66 years are departure from the usual character of this syndrome. Subsequent generations continued the expression of familial polyposis with prominent villous changes. New insight into a possible relationship among the various types of polyps as well as between them and cancer is suggested by this family.

Adenoma↗
PubMed1982

Associations of properdin factor B with melanoma.

We investigated 98 melanoma patients and 135 normal controls for differences in phenotype and genotype frequencies at the properdin factor B locus. A significant negative association with the Bf-F allele and melanoma was found, resulting in an estimated relative risk of 0.5. The estimated relative risk for developing melanoma among people with the Bf-FF genotype is 0.07. The Bf-S phenotype was significantly increased among the melanoma sample, with an estimated risk of 6.5. The data suggest association of the Bf locus with a melanoma protection and/or susceptibility gene(s).

Complement Factor B↗
PubMed1982

HLA-A, -B, and -DR associations in type I diabetes mellitus with onset after age forty.

It remains to be convincingly demonstrated whether insulin-requiring, ketosis-prone, lean-at-onset, type I diabetics who develop their disease after age 40 have the same disease as the children with similar characteristics. To address this question, we examined the population HLA genetic associations of this group. One hundred forty white, insulin-using diabetics with onset of disease past age 40 yr and 268 normal white controls have thus far been analyzed for HLA type. In the group of patients who were lean-at-onset and/or ketosis-prone (N = 54), there was a significantly increased frequency of DR4 (RR = 4.63; P less than 0.01) and significantly decreased frequency of DR2 (RR = 0.18; P less than 0.05) after correction. DR4 was also significantly increased after correction (RR = 5.72; P less than 0.25) in the subgroup who were both lean and ketosis-prone (N = 23). No significant differences in HLA-DR frequencies were found between the obese and not-ketosis-prone group (N = 69) and controls. No significant associations of HLA-A or-B antigens with either group were observed after correction for the number of antigens tested. To our knowledge, this is the first such study in the United States, and the first demonstrating that late onset diabetics who are lean-at-onset and/or ketosis-prone exhibit HLA-DR antigen associations which are similar to early onset cases.

Adult↗