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Biomedical subjects

J Reid

Publications and source records attributed to J Reid.

At least 253 records · Page 14Linked to original sources

Immunological monitoring and immunotherapy in carcinoma of the lung.

One hundred and seven patients with carcinoma of the lung underwent immunologic testing, and 62 of these patients were randomized to an immunotherapy protocol comparing the effects of Pasteur strain BCG, either alone or combined with allogeneic tumor cells, to the effects of no immunotherapy. Patients with residual disease left at the time of surgery or with metastatic disease at the time of diagnosis showed no increase in survival as a result of this form of immunotherapy. An insufficient number of patients with less advanced disease, in whom we would expect the most beneficial effect, have been entered in this study. In general, we were unable to document substantial effects of immunotherapy on the immunologic parameters tested. Only in recall antigen skin testing was there a statistically significant increase in reactivity in the immunotherapy groups. Tests of general immune status appeared to have a predictive value in monitoring lung cancer patients. Anergic patients had a poorer prognosis than did patients who demonstrated skin test reactivity. Patients with normal percentages of lymphocytes (T cells) forming rosettes with sheep erythrocytes at 29 degrees C were generally normal in other tests of immune competence. In serial studies of rosette formation, all patients who developed recurrent disease had a pattern of depressed or falling rosette values, and these abnormalities occurred an average of 3.1 months prior to clinical detection of recurrence. Patients with large-cell anaplastic carcinoma were found to have a significantly higher incidence of depressed rosette levels than the other histologic types. Both large and small-cell anaplastic patients had significantly depressed lymphocyte proliferation by mitogens and allogeneic cells. Although lung cancer patients have been described as immunologically depressed, they are capable of recognizing tumor-associated antigens. When tested in leukocyte migration inhibition assays with tumor-associated antigens, the majority of the patients in our study were found to be reactive. The use of a 3 M KCl extract of pleural effusion cells from a patient with pulmonary adenocarcinoma has given good reactivity and specificity in lung cancer patients of all histologic types. In addition, these patients have been shown to respond in a mixed lymphocyte/tumor interaction to tumor-associated antigens (Dean, 1976b).

Adenocarcinoma↗

Granulocytic sarcoma: local presentation of a systemic disease.

The case of a pregnant woman with a breast mass that proved to be a granulocytic sarcoma is presented. Her systemic therapy was initiated at a time when her tumor burden was possibly relatively low and a good response to the aggressive combination chemotherapy including Daunomycin was obtained. She was successfully carried through pregnancy and delivered a normal child despite combination chemotherapy. Factors relating to her case have been reviewed in the literature.

Adult↗

Mineral and nitrogen metabolic studies on Skylab flights and comparison with effects of earth long-term recumbency.

A metabolic study of the effects of space flight on various chemical elements, particularly those with special relevance to the musculo-skeletal system, was carried out on the nine astronauts who participated in the three Skylab flights of 28, 59 and 84 days in 1973-1974. The study required of the cooperating crewmen constant dietary intake, continuous 24-hour urine collections and total fecal collections for 21-31 days before each flight, throughout each flight and for 17-18 days post-flight. Increases in urinary calcium and negative calcium balances during space flight were generally similar to those found in previous immobilization and bedrest studies. The persistence of these alterations in calcium metabolism throughout the flights suggested that calcium losses would continue in weightlessness for a very long time. Significant losses of nitrogen and phosphorus occurred, associated with observed reduction in muscle tissue. Both mineral and muscle losses occurred despite vigorous exercise regimens in flight. It was concluded that unless protective measures can be developed, capable musculo-skeletal function is likely to be impaired in space flights, ultimately to be conducted to Mars, of 11/2 to 3 years duration.

Bed Rest↗

Mineral and nitrogen balance study observations: the second manned Skylab mission.

A metabolic study of the effects of space flight on various chemical elements, particularly those with special revelance to the musculoskeletal system, was carried out on the three astronauts of the SL-3 mission for 21 d preflight, during the 60 d flight phase, and for 17 d postflight. The study required of the cooperating crewmen quite constant dietary intake, continuous 24-hour urine collections and total fecal collections. Urinary calcium was significantly increased during flight in all three crewmen with man-to-man variation in pattern and amount; the degree of calcium loss was, in general, similar to that in the prior study of the 28-d Skylab flight (SL-2). The similarity to bedrest immobilization in the pattern of urinary calcium increases and of total calcium shifts suggested that calcium losses would continue for a very long time. Significant losses of nitrogen and phosphorus occurred that were associated with observed reduction in muscle tissue. Both mineral and muscle losses occurred despite vigorous exercise regimens during flight. It was concluded that these studies give warning that capable musculoskeletal function may be significantly impaired during prolonged space flights lasting 1.5 to 3 years unless protective measures are developed.

Adult↗

Osteoporosis; evaluation of diagnosis and therapy.

Bone mineral content was determined in the radius of 29 osteoporotic patients by the photon absorption method. Mineral content was within the normal range in nine of 24 osteoporotic women. Ratios representing the bone mineral content in the proximal and distal areas of the radius did not distinguish osteoporotic subjects or patients with hyperparathyroidism from normal subjects. Ten osteoporotic women had mineral measurements during a two-year period while receiving placebo or an intake of 2,200 mg of phosphorus and 2,400 mg of calcium. No increase in radial mineral content was observed during this regimen or after adding vitamin D. We conclude that the mearurement of mineral in the radius does not always accurately reflect the overall skeletal mass in an individual patient and that prolonged therapy with high phosphorus and calcium intake did not increase the radius mineral content.

Adult↗

Simple bone cyst. Report of two cases.

Two cases of simple bone cyst are presented. The first is unusual because of its radiologic appearance simulating ameloblastoma and its prolonged healing time, requiring surgical intervention on several occasions. The second is presented because of the occurrence of bilateral cysts, of which there are only eight other reported cases. It is postulated that the first case might represent a single large simple bone cyst that had several chambers with tenuous connections or that it might be an example of multiple simple bone cysts in close proximity.

Adolescent↗

Chlorocresol sensitivity.

Contact allergic sensitivity may follow the use of chlorocresol incorporated as a preservative into both betamethasone cream and aqueous cream, which are commonly prescribed as a mixture in South Australia. In several cases, although the clinical courses indicated sensitivity to chlorocresol, patch test reactions to this chemical were negative. In these cases positive patch test reactions to chloroxylenol, a chemical closely related to chlorocresol, confirmed the diagnoses.

Adult↗

The influence of chemotherapy on the management of non-Hodgkin's lymphomata at the Princess Margaret Hospital. A comparison of the results from 1962-64 with 1967-69.

A retrospective study of 460 non-Hodgkin's lymphoma patients seen in 1962-64 (185) and 1967-69 (275) revealed a marked improvement in the survival of patients treated during the later interval. The increased survival was not due to differences in the age or sex distribution of patients, the proportions with systemic symptoms or extranodal presentations. The improvement was due partially to a disproportionate increase in the number of patients with well- and intermediately differentiated nodular lymphocytic lymphomata in 1967-69. When these patients were removed, the proportions of patients with "good" and "poor" pathology were comparable for the two intervals, and a markedly improved survival was still evident for the 1967-69 group. An improvement in the proportion of patients achieving a complete remission occurred only in patients who received some form of chemotherapy. Relapses occurred in 44.6% of patients with Stage I and II disease treated with radiotherapy alone. The results of this study indicate that we must re-evaluate carefully the indications for radiotherapy in the treatment of the non-Hodgkin's lymphomata. The addition of chemotherapy appears to be a promising method for increasing the proportion of patients who will achieve a long complete remission.

Adult↗

A retrospective analysis of the clinical results in relation to the Rappaport histological classification.

The Rappaport classification of the non-Hodgkin's lymphomata was applied to 460 cases at the Princess Margaret Hospital. Statistically significant differences in the numerical incidence between the nodular and diffuse patterns was found for the entire series and for the lymphocytic, "histiocytic" and mixed cell types individually. All of the undifferentiated types were diffuse. These differences were sustained for the degrees of differentiation within the lymphocytic group. The "histiocytic" group was not subclassified by differentiation. The cell types differed in the numerical distribution of the patterns. The lymphocytics were predominantly diffuse but their nodular forms constituted a higher proportion of the nodular pattern than did their diffuse types of the diffuse group. More of the well differentiated lymphocytics were nodular than were diffuse and they formed a higher proportion of the nodular group than they did of the diffuse. On the other hand, the poorly differentiated lymphocytics were predominantly diffuse and these were less well represented in the nodular group than in the diffuse tumours. The intermediate differentiated types were usually diffuse but slightly better represented in the nodular group. Most tumours of the "histiocytic" type were diffuse and these constituted a higher proportion of diffuse than the nodular tumours. The mixed cell lesions were predominantly nodular and comprised a much higher proportion of nodular lesions than diffuse. No real differences were identified amongst the histological types according to age or sex distributions. The crude survival to 4 years differed significantly for the histological types. For the entire series and for each cellular type, the nodular patterns were superior to the diffuse, although, in the lymphocytic well differentiated types, pattern made no real difference to survival.

Bone Neoplasms↗