Recombinant human erythropoietin (rHuEpo) and fertility in women on dialysis.
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Adult↗
Biomedical subjects
M K Patel
Publications and source records attributed to M K Patel.
Monoclonal antibody detects embryonic epitope specific for nerve-derived transferrin.
Monoclonal antibodies were generated against transferrin purified from chick embryo extract by fusing spleen cells from BALB/c mice immunized against embryonic transferrin, with myeloma cells. Antibodies produced by the selected hybridoma clones were all type IgG. Twelve clones were selected for secretion of antibodies to the embryo extract-derived transferrin, and three clones were studied extensively. Immunoblotting was used to demonstrate antibody binding to several avian transferrin proteins derived from adult chicken serum, adult chicken peripheral nerves, and ovotransferrin. Screening and detailed epitope analysis were accomplished by solid-phase immunoassay. The results indicated that two clones, 2G9.1 and 2B11.1, recognized the embryonic and egg antigens in preference to the adult proteins. However, a third clone, 6H2.1, recognized the nerve-derived transferrin preferentially to both the embryonic and adult serum antigens. None of the clones recognized the serum-derived transferrin in preference to the other antigens. These results indicate that embryonic epitope(s) are conserved in the nerve- but not the serum-derived transferrin. They also show that the neural antigen has site(s) distinct from the embryonic proteins. No changes in displacement curves were observed after these proteins were digested with neuraminidase, indicating that the epitope differences discovered are not intimately related to sialic acid residues on the various transferrins.
Animals↗
Body temperature and heart rate rhythms in acutely head-injured patients.
This descriptive pilot study investigated the circadian (24-hour) rhythms of heart rate and temperature in acutely head-injured patients and the relationships between these variables. The convenience sample consisted of 10 patients who were admitted to the hospital with the diagnosis of acute head injury. Patel's Method of Partition was used to estimate rhythmicity. Only one patient demonstrated circadian rhythms for body temperature and heart rate with the peaks occurring at appropriate times. While three other patients had significant rhythms for these variables, the rhythms had cycles of less than 24 hours and peaks occurring at inappropriate times. Although significant correlations were found between body temperature and heart rate rhythms, they were low.
Adult↗
Oxidants and vascular smooth muscle.
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Animals↗
Influence of retinoids on growth and metastasis of hamster melanoma in athymic mice.
The effects of 2-hydroxyethyl retinamide, N-(4-hydroxy-phenyl) all-trans-retinamide, and 13-cis-retinoic acid on the growth and metastasis of a malignant hamster melanoma cell line HM1-F5 was determined in a double blind study using 4- to 5-week-old male NIH Swiss and BALB/c derived athymic nu/nu mice. Mice were fed retinoids (0.75 and 1.0 or 1.5 mmol/kg diet) or a placebo diet ad libitum beginning on the day of s.c. inoculation of 5 x 10(5) HM1-5 cells. Tumor incidence, latency, and growth rate were similar in both strains of mice. All placebo-treated mice had lung metastasis on the day of autopsy, although the total number of metastases was lower in NIH Swiss derived athymic mice. While mean tumor incidence and latency were not significantly altered by any retinoid treatment, tumor growth rate (volume) and final tumor weight were inhibited (P less than 0.05) by 0.75 mmol/kg 13-cis retinoic acid and 1.5 mmol/kg N-(4-hydroxyphenyl) all-trans-retinamide. In contrast, at 1.0 or 1.5 mmol/kg diet, 2-hydroxyethyl retinamide had no significant effect on tumor growth rate. 13-cis retinoic acid, 0.75 mmol/kg, 2-hydroxyethyl, 1.0 mmol/kg, and N-(4-hydroxyphenyl), 1.0 mmol/kg significantly reduced the mean number of metastatic lesions in NIH Swiss derived mice, but N-(4-hydroxyphenyl) all-trans-retinamide also reduced metastatic incidence while 2-hydroxyethyl retinamide and 13-cis retinoic acid had no effect. A concentration of 1.5 mmol/kg diet of 2-hydroxyethyl and N-(4-hydroxyphenyl) all-trans-retinamide significantly reduced the overall number of gross lung metastases in BALB/c and Swiss mice, and mean number of metastases in Swiss mice. Analysis of correlation indicated that the inhibitory effect of high-dose N-(4-hydroxyphenyl) and 2-hydroxyethyl retinamide on metastasis was not associated with (independent of) any inhibitory effect on primary tumor invasiveness or growth rate. Our observations suggest that agents such as retinoids have an antimetastatic potential.
Animals↗
An adult onset metachromatic leukodystrophy with dominant inheritance and normal arylsulphatase A levels.
A family with a variant of adult onset metachromatic leukodystrophy is presented. Clinical details from three affected members are given. The neurophysiological and neuroradiological data on the two brothers who have been recently studied are included. One of these died and the post-mortem findings are discussed along with those from a cousin who died some years ago. Arylsulphatase A levels were normal in both brothers yet the histological findings in the one who died are of a metachromatic leukodystrophy and thin-layer chromatography confirms an excess of sulphatides in the white matter of his brain. Disabling hypotension was a striking feature in both brothers but adrenal function was shown to be intact and autonomic neuropathy seemed the likely cause. Study of the family suggests a dominant mode of inheritance.
Cerebroside-Sulfatase↗
Soft tissue sarcomas of the adult thoracic wall.
Forty-nine adult patients with soft tissue sarcomas of the thoracic wall have been treated by the Division of Surgical Oncology at the University of Illinois. Fibrosarcoma was the most common histologic type (20%). Patients with dermatofibrosarcoma protuberans had the longest mean overall survival time (150.8 months). The mean overall survival time for all patients was 98.2 months, and the disease-free 2-, 5-, and 10-year survival rates were 68%, 51%, and 34%, respectively. Wide excision was the treatment of choice; selected patients also received adjuvant radiotherapy, chemotherapy, or both. In all 10-year survivors, the sarcomas were low grade and well differentiated, or were less than or equal to 5.0 cm in diameter. Aggressive treatment afforded these patients good long-term results.
Adult↗
Cutaneous thick melanoma. Prognosis and treatment.
Among proponents of elective lymph node dissection (ELND) for clinical stage I melanoma, controversy exists as to whether there is an upper limit of tumor thickness beyond which ELND should not be considered. We reviewed 169 patients with clinical stage I and II melanoma that was greater than or equal to 3.0 mm thick and who were treated at the University of Illinois Hospital, Chicago. Of 139 patients with clinical stage I disease, 117 underwent ELND. Five- and ten-year survival rates were 55.7% and 48.9%, respectively. Multifactorial analysis demonstrated that anatomical location, level, pathologic stage, and ulceration were the best predictors of survival. Thickness did not emerge as a significant variable. Our findings do not support basing treatment decisions, eg, ELND in this group of patients, solely on the thickness of the primary tumor. We continue to recommend ELND in patients with either intermediate or thick melanomas.
Adult↗
Estrogen receptor in malignant melanoma.
The significance of an estrogen binding protein (ER) in malignant melanoma remains controversial. We have prospectively assayed for ER on 141 patients with malignant melanoma and correlated the presence of the ER with known prognostic variables. The overall incidence of ER was 43%. The incidence of ER in males was 38.7% and 50% in females (not significant). There is an increased incidence of ER+ melanoma in women with extremity lesions (P = .08). The disease-free interval (DFI), survival, and recurrent interval were 42.0 +/- 4.0, 52.3 +/- 4.3, 13.7 +/- 1.7 months in ER- patients; 63.7 +/- 11.6, 76.1 +/- 11.4, 26.5 +/- 7.3 months in ER+ patients (1 to 10 fmol/mg cytosol protein), and 69.8 +/- 17.9, 102.7 +/- 27.9, 29.4 +/- 9.9 months in ER+ patients (greater than 10 fmol/mg cytosol); respectively. When ER+ groups were combined, the DFI in women with ER+ lesions was significantly longer than those with ER- tumors (P less than .05). Cox multivariate analysis demonstrated that ER status is a significant variable of survival along with thickness level and nodal status. These observations suggest that ER may be a marker for a more biologically indolent melanoma.
Female↗
Case study of psychophysiological diary: infradian rhythms.
A 4-year case study was made of a 42-year-old white woman as seen through the psychophysiological diary. There was an awakening diary and a bedtime diary composed of 125 variables. The data are divided into two series: series I containing a manic episode, and series II as a control. Spectral analysis shows infradian rhythms in hypoglycemia and fear (11 days) and time to fall asleep (5 days). Depressed feelings showed a circatrigintan (28-day) rhythm, which was not correlated with menses. Mania had an annual rhythm (spring) but no circatrigintan or less rhythm. The following correlations have a P value less than or equal to 0.01: mania was directly correlated with number of sleeping pills, time to really wake up, need for rest, moodiness, and helplessness, and indirectly with expectations, pressure at work, sense of time, and emotional state. Interestingly, awakening pulse is directly correlated with awakening temperature, number of sleeping pills, bedtime pulse, tiredness at bedtime, hypoglycemia, and fear. Bedtime pulse is directly correlated with awakening pulse and awakening temperature. Both pulse and temperature at bedtime are directly correlated with negative variables such as tiredness, moodiness, helplessness, and depression, and inversely correlated with positive variables such as happiness, loving, performance at work, and thinking efficiency. This study demonstrates a significant correlation between physiological variables.
Adult↗
Spinal cord injury during windsurfing.
Two patients are described who developed severe pain in the thoracic region after windsurfing in rough weather. On examination there were signs of a thoracic cord lesion. Investigations revealed no evidence of cord compression and, since the symptoms and signs resolved spontaneously, an ischaemic aetiology is postulated.
Adult↗
Lumbar puncture and subarachnoid haemorrhage.
Medical notes of 123 patients with subarachnoid haemorrhage were examined. No patient deteriorated at the time of lumbar puncture. All but 2 patients with associated intracerebral haematomas had markedly impaired consciousness or focal signs. Two of 30 patients with meningitis were initially diagnosed as subarachnoid haemorrhage, and one died without lumbar puncture. If consciousness is not markedly impaired and focal signs are absent, lumbar puncture is safe in patients with subarachnoid haemorrhage.
Adult↗
Soft tissue sarcomas of the adult head and neck.
From 1969 to 1983, 53 adult patients with head and neck soft tissue sarcomas were evaluated and treated by the Division of Surgical Oncology at the University of Illinois. The most common anatomic location was the neck (36%), and these patients had the highest 5-year disease-free survival rate (67%). Fibrosarcoma was the most common histologic type (26%); patients with aggressive fibromatosis had the longest mean survival time (93 months). The mean overall survival time was 58.7 months, and the disease-free 2-year, 5-year, and 10-year survival rates were 68%, 54%, and 28%, respectively. Wide excision was the treatment of choice, with adjuvant radiotherapy or chemotherapy, or both, used in selected patients. In all of the long-term survivors, the tumors were either well-differentiated or less than or equal to 5.0 cm in diameter. It is apparent that aggressive therapy of such tumors can provide good long-term results.
Adolescent↗
Pharmacokinetics of melphalan in clinical isolation perfusion of the extremities.
The pharmacokinetics of melphalan in clinical hyperthermic isolation perfusion was studied in 16 patients with malignant melanoma. Analysis by computer-generated lines of best fit showed that the loss of melphalan from perfusate conforms best to a biexponential equation. The initial loss with a half-life (t1/2) of approximately 5 to 10 min is interpreted as rapid uptake of melphalan by the tissue of the perfused extremity. The terminal portion of the curve with a half-life of approximately 35 to 50 min is interpreted as due predominantly to the hydrolysis of melphalan, with a lesser component of loss due to absorption of melphalan to the filters and tubing of the perfusion apparatus. Determination of the area under the curve suggests that there is no appreciable uptake of melphalan by the tissue of the perfused extremity after 30 min.
Chemotherapy, Cancer, Regional Perfusion↗
Are spinal injuries more common in rugby union than in rugby league football?
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Adolescent↗
Limb salvage in extremity soft-tissue sarcoma: combined modality therapy.
Thirty-two consecutive patients with high-grade soft-tissue sarcoma of an extremity were treated preoperatively with concomitant intra-arterial infusion of Adriamycin (doxorubicin) (10 mg/m2 daily for 10 days) and radiotherapy (2500 rad [25 Gy] in 10 fractions in 2 weeks). En bloc resection was then performed. Postoperatively, depending on the surgical specimen findings, radiotherapy was given to a dose ranging from 5000 rad (50 Gy) in 5 weeks to 6000 rad (60 Gy) in 6 weeks equivalent continuous schedules. No residual tumor was found in 28% of the surgical specimens and only minimal tumor in 41%. A functionally intact limb was preserved in 30 patients (94%). Local recurrence developed in one patient (3%). The actuarial overall survival at three years was 70% and disease-free survival 57%.
Adult↗
Iron stores in adults with sickle cell anemia.
Iron status was investigated in 60 adults with sickle cell anemia as determined by stainable iron in bone marrow aspirates, serum ferritin, serum iron, and the total iron-binding capacity. Seventeen patients (28%) were found to have absent bone marrow iron. There was an excellent inverse correlation between serum ferritin and the serum transferrin (p less than 0.001), and a significant positive correlation between serum ferritin and transferrin saturation (p less than 0.005), bone marrow iron (p less than (p less than 0.001), and history of prior blood transfusion (p = 0.005). Results of complete radiologic examination of the gastrointestinal tract and proctoscopy were negative in the 17 patients in the iron-deficient group. The high incidence of iron deficiency may be related to excessive urinary losses of iron. Our data indicate that serum ferritin values of less than 30 ng/ml are diagnostic of iron deficiency in patients with sickle cell anemia, with a high degree of specificity (98.7%). However the sensitivity of the test at a serum ferritin level of 30 ng/ml is only 32%. The diagnostic evaluation and the management of sickle cell anemia in iron-deficient patients needs to be better defined.
Adolescent↗