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Biomedical subjects

J S Goodwin

Publications and source records attributed to J S Goodwin.

At least 109 records · Page 6Linked to original sources
PubMed1989

Survival after cancer surgery of elderly patients in New Mexico, 1969-1982.

To examine the effects of advancing age, sex, and ethnicity on estimated 30-day survival after surgery for cancer, we reviewed population-based data on 16,130 cancer cases collected by the New Mexico Tumor Registry from 1969-1982. For surgery at most sites, mortality increased with increasing age. The highest mortality was observed for sites requiring laparotomy or thoracotomy. Sex and ethnicity (Hispanic versus non-Hispanic white) had little effect on short-term survival. Comparison of short-term survival for two time periods, 1969-1975 and 1976-1982, showed a strong trend of improving survival for many sites.

Age Factors↗
PubMed1988

Changing treatment of breast cancer in New Mexico from 1969 through 1985.

A review of information from the New Mexico Tumor Registry on women diagnosed as having primary breast cancer from 1969 through 1985 revealed temporal changes in the surgical treatment of this disease. After 1980 the percentage of women receiving breast-conserving surgery for local-stage disease increased from 6% to 25%. Most surgeons performing operations for breast cancer had not performed a breast-conserving operation before 1981 but had used this procedure at least once in the period from 1981 through 1985. Women younger than 50 years or older than 80 years were most likely to undergo this procedure. In that period, radiotherapy after breast-conserving surgery could not be documented for 26% of the women 65 years old or younger or for 56% of the women aged 65 years or older. Thus, there has been a marked shift in New Mexico in the surgical approach to local-stage breast cancer in the 1980s. This shift involved most surgeons treating the disease and included women of all age groups. The apparent lack of adjuvant radiotherapy in some women receiving conservative surgeries may prove to be a deleterious consequence of this change in surgical management.

Age Factors↗
PubMed1988

Delay in seeking care for cancer symptoms: a population-based study of elderly New Mexicans.

To characterize the delay by the elderly in seeking care for cancer symptoms, we interviewed 800 New Mexicans, greater than or equal to 65 years of age, with newly diagnosed cancer. Overall, 29.4% of the subjects were asymptomatic when cancer was detected, and 48.0% presented within 2 months of symptom onset. However, 19.2% of the subjects delayed seeking care for at least 12 weeks and 7.4% delayed at least 1 year. Site of cancer was the strongest determinant of delay. Hispanics tended to report longer delay than non-Hispanics, and age was not associated with delay. Of the numerous other factors considered, only having a regular checkup was significantly associated with delay interval.

Aged↗
PubMed1988

Serum inhibitors of interleukin-2.

Interleukin-2 (IL-2) is an important modulator of cell-mediated immunity. Its activity is suppressed by various serum inhibitors generated under normal and pathological conditions. It is believed that an inhibitor which occurs in normal serum is a T-cell derived heat labile protein (or protein-glycolipid complex), and it acts in a homeostatic mechanism to restrict IL-2 action to the vicinity of the activated T cells. Changes in inhibitory activity have been found in various physiological and pathological states, e.g. during ontogeny, in systemic lupus erythematosus, in rheumatoid arthritis, and with some systemic infections. There are also suggestions that some tumor cells generate IL-2 inhibitors which diminish killer cell activity against the tumor. It is possible that a better understanding of IL-2 inhibitors would help elucidate some pathological mechanisms connected with disturbed cellular immune responses.

Animals↗
PubMed1988

Mechanism of lithium-induced augmentation of T-cell proliferation.

The mechanism whereby lithium augments mitogen-stimulated T-cell proliferation was investigated. Lithium in a concentration of 5mM caused a significant increase in interleukin 2 (IL-2) production after phytohemagglutinin (PHA) stimulation. Lithium also caused an increase in interleukin 1 production from peripheral blood monocytes. Lithium did not influence the expression of IL-2 receptors on T-cells. However, lithium did result in increased proliferative response to IL-2 in an IL-2 responsive cell line. Thus, lithium influences the T-cell proliferation response to mitogens in several ways, by stimulation of lymphokine and monokine production as well as by augmenting the response of IL-2 responsive cells to IL-2.

Cell Division↗
PubMed1988

Lack of correlation between indices of nutritional status and immunologic function in elderly humans.

We studied 230 independently living healthy elderly men and women to examine the hypothesis that subclinical nutritional deficiencies contributed to depressed immune function seen in the elderly. Immunologic function was assessed with delayed type hypersensitivity skin testing to four antigens, in vitro lymphocyte culture with phytohemagglutinin, lymphocyte count, and presence of serum autoantibodies and circulating immune complexes. Nutritional status was assessed by 3-day diet records and also biochemical analyses of blood for vitamins A, B12, C, D, E, riboflavin, folic acid, and the minerals iron, copper, and zinc. Using a variety of analyses we found no association between malnutrition and depressed immunologic function in this population. We conclude that subtle nutritional deficiency is not a noticeable contributor to the immunodeficiency of aging, and that previously reported beneficial effects of "megadose" nutritional supplements on the immune response of elderly individuals probably represent a pharmacologic effect rather than the correction of nutritional deficiencies.

Aged↗
PubMed1988

Cancer treatment protocols. Who gets chosen?

We compared the age distribution of all adults in New Mexico with cancer incident from 1959 through 1982 with that of all adult New Mexican patients enrolled in cancer treatment protocols sponsored by the Southwest Oncology Group (New Mexico). For all cancer sites, elderly patients were substantially underrepresented in the Southwest Oncology Group protocols. While 31% of all adult patients with cancer were over age 70 years, only 7% of patients with cancer enrolled in Southwest Oncology Group protocols were in that age group. The underrepresentation of elderly individuals in cancer treatment protocols will make it difficult to determine optimal therapies for older patients with cancer.

Age Factors↗
PubMed1988

Mechanism of action of glucocorticoid-induced immunoglobulin production: II. Requirement for fetal calf serum.

Corticosteroids have been reported to stimulate immunoglobulin (Ig) production by otherwise unstimulated peripheral blood mononuclear cells. In this paper we confirm that observation but report the necessity for an additional minor antigenic stimulus. Lymphocytes cultured with HB101, a complete medium not requiring serum supplement, did not increase Ig production after addition of hydrocortisone, but did if small concentrations (1-10%) of fetal calf serum were added. Various antigens such as candida, tetanus, and albumin of different sources could substitute for fetal calf sera in allowing corticosteroids to stimulate Ig production in resting lymphocytes. We conclude that corticosteroids do not stimulate Ig production by lymphocytes de novo; rather, corticosteroids greatly enhance the Ig production stimulated by the foreign antigens present in fetal calf sera.

Adjuvants, Immunologic↗
PubMed1987

The effect of marital status on stage, treatment, and survival of cancer patients.

The effects of marital status on the diagnosis, treatment, and survival of patients with cancer were examined in population-based data on 27,779 cancer cases. Unmarried persons with cancer had decreased overall survival (relative hazard, 1.23; 95% confidence limits, 1.19 to 1.28). We identified three complementary explanations for the poorer survival of the unmarried persons. First, unmarried persons were more likely to be diagnosed at a regional or distant stage (odds ratio, 1.19; 95% confidence limits, 1.12 to 1.25). After adjustment for stage, unmarried persons were more likely to be untreated for cancer (odds ratio, 1.43; 95% confidence limits, 1.31 to 1.55). Finally, after adjustment for stage and treatment, unmarried persons still had poorer survival. Previous studies have demonstrated that unmarried persons have decreased overall mortality. For cancer, our results suggest that the favorable consequence of being married on overall survival is secondary to the beneficial effects at several steps in the diagnosis, choice of treatment, and response to treatment.

Adult↗
PubMed1987

Thyroid failure in the elderly. Microsomal antibodies as discriminant for therapy.

Thyrotropin (thyroid-stimulating hormone [TSH]) levels were elevated above 4.0 mU/L (microU/mL) in serum samples from 13.2% of 258 healthy elderly subjects. To investigate the natural history of progressive thyroid failure, serial thyroid functions were measured for four years in 26 of these subjects with elevated TSH levels. In one third of these subjects, biochemical thyroid failure developed (thyroxine level less than 58 nmol/L [4.5 micrograms/dL]) within the course of the study. All subjects with initial TSH levels above 20 mU/L (microU/mL), and 80% of those with high-titer thyroid antimicrosomal antibodies (regardless of initial TSH level), became overtly hypothyroid. Compared with subjects with high-titer antibody, those with antibody titer less than 1:1600 had lower TSH and higher thyroxine levels, and thyroid failure developed in none during the study. These results suggest that among older patients with isolated elevations of the TSH level, only those with markedly elevated TSH levels or high-titer antimicrosomal antibodies should be prophylactically treated with levothyroxine sodium replacement.

Aged↗
PubMed1987

Peripheral blood mononuclear-cell interleukin-2 production, receptor generation and lymphokine-activated cytotoxicity in inflammatory bowel disease.

The interleukin-2 pathway is essential for the normal immune response to antigen stimulation; we have examined the possibility that this may underlie abnormal peripheral blood lymphocyte immunoregulatory function that has been observed in patients with inflammatory bowel disease. We studied 11 patients with Crohn's disease and 5 with ulcerative colitis, all with quiescent disease activity. Peripheral blood mononuclear cells were isolated from these patients and from healthy age- and sex-matched controls. Interleukin-2 production after mitogen and phorbol-myristate acetate stimulation was similar in both groups: 381 +/- 71 (mean +/- SE) U/ml by control cells and 451 +/- 70 by patient cells. Interleukin-2 receptor generation was also measured pre- and poststimulation by labeling with anti-Tac antibody. This was 10.45 +/- 1 and 69.95 +/- 3.85% for control cells and 11.41 +/- 1.38 and 60.9 +/- 4.25% for patients cells. Finally, we examined the response of these cells to interleukin-2 stimulation by generating cells with direct cytotoxicity to 51Cr-labeled Daudi-cell targets. Control cells caused 59.5 +/- 46% 51Cr release, whereas patient cells caused 50.8 +/- 5.18% release. None of the above results achieved statistical significance. We conclude that the peripheral blood interleukin-2 pathway is normal in inactive inflammatory bowel disease.

Cells, Cultured↗
PubMed1987

Diagnostic importance of an elevated erythrocyte sedimentation rate in the elderly.

The usefulness of the erythrocyte sedimentation rate (ESR) in elderly individuals has recently been questioned. ESR measurements were obtained on 100 elderly individuals using the Westergren method. In 4% of the patients screened the ESR was responsible for uncovering previously undiagnosed illnesses. Elevated ESR's, while more prevalent in the elderly than in younger individuals, have a similar pathological significance.

Aged↗
PubMed1987

Interleukin-1-production by monocytes from patients with systemic lupus erythematosus.

Production of interleukin-1 (IL-1) by glass-adherent monocytes from 18 patients with systemic lupus erythematosus (SLE) was measured. Patients were divided into three groups according to disease activity. A deficient production of IL-1 was found in monocytes of SLE patients both without stimulation and after stimulation with 5 micrograms of lipopolysaccharide. The decreased production correlated with the degree of disease. Addition of phorbol myristate acetate to monocytes caused only partial normalization of the decreased IL-1 production. The IL-1 deficiency in SLE is postulated to be a part of complex abnormalities of cell-mediated immunity in this disease.

Female↗
PubMed1987

Effect of misoprostol on immune function in elderly subjects.

The immunologic effects of misoprostol, an oral prostaglandin E1 (PGE1) analog, were tested in 25 individuals over age 65, compared to 25 individuals given placebo. Elderly subjects were chosen because previous in vitro studies had found an increased sensitivity to PGE of lymphocytes in older subjects. After two weeks of ingestion of misoprostol or placebo, there was a small but statistically significant decrease in IgM-rheumatoid factor in the misoprostol group when compared to control and a significant decrease in the in vitro sensitivity of lymphocytes from the misoprostol group to inhibition by PGE. There were no differences in total lymphocyte count, T cell or T cell subset count, delayed hypersensitivity skin test reactivity, serum immunoglobulins, or response to mitogens between the two groups. Therefore, the short term administration of an oral PGE analogue to normal elderly individuals is not associated with any detrimental effects on immunologic function after two weeks.

Aged↗
PubMed1987

Vitamin A intake and plasma retinol levels in healthy elderly men and women.

We examined intakes of vitamin A (diet plus supplement) and plasma retinol levels in a select group of elderly men (n = 90) and women (n = 110) on three separate occasions over a 4-y period. Median dietary levels remained at approximately 1400 retinol equivalents (RE) in men and 1250 RE in women. There were no time trends or gender differences noted in plasma retinol concentrations. Approximately 44% of the elderly men and women consumed an average of 2000 RE of a vitamin A supplement daily. Those taking supplement had a greater mean plasma retinol concentration than those not taking a supplement. This effect was greater in men than in women. A review of previous studies revealed that plasma retinol increases from a mean of approximately 35 micrograms/dL (1.22 mumol/L) at preschool age to a plateau of approximately 60 micrograms/dL (2.09 mumol/L) by age 40 y in men and 60 y in women.

Age Factors↗