Biomedical subjects
Publications and source records attributed to R Jackson.
Basal cell carcinoma is the most easily cured carcinoma, but because of the many forms it can take, and because it grows so slowly, it can be misdiagnosed or neglected. The author discusses its more common forms and etiologic considerations.
Phagedena is an old term for serious deep, necrotic and gangrenous skin ulcers. In the past these have been regarded as severe infections. A review of 31 cases revealed that except in cases of Streptococcus pyogenes or Clostridium welchii infection a bacterial of fungal infection was only one of several factors that led to the development of phagedenic ulcers. Initiating factors may be a bacterial infection, a debilitated state as a result of immunosuppressive therapy or of such conditions as alcoholism, severe diabetes, inflammatory bowel disease or severe arteriosclerosis, and various types of injury or trauma. Continuing factors include enzymatic mechanisms, the release of toxins from large areas of dead tissue and vascular disorders. In general, antibiotics are of limited value. systemic corticosteroid therapy may be useful in the subacute or chronic case. In acute, spreading, gangrenous phagedena with surrounding erythema, fever and systemic toxic effects, immediate excision of dead tissue may be lifesaving.
To determine if human milk provides for adequate growth and bone mineralization during the lst yr of life, 91 term infants were evaluated. Infants were divided into three groups human milk alone, human milk with supplemental vitamin D, and Similac. Lactating mothers who were receiving supplements of calcium and vitamin D were also studied to determine the effects of lactation on their bone mineral status. Blood was drawn from infants and mothers for measurements of serum calcium, phosphate, alkaline phosphatase, and 25-hydroxyvitamin D. Bone mineral content was measured by photon absorptiometry. Growth was similar between breast-fed and formula-fed infants. Regardless of type of feeding, male infants grew heavier and longer than corresponding female infants. Serum calcium and phosphate levels were similar among the three infant groups: only 25-hydroxyvitamin D levels at 4 months and serum alkaline phosphatase at 2 wk and 6 months of age were different among the three infant groups. Biochemical and vitamin D values were similar among the lactating mothers. There were no differences in infant bone mineral content among the three groups, but male infants had higher bone mineral content than female infants. There were no effects of the duration of lactation of maternal bone mineral content or vitamin D status.
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To address the dual problems of maldistribution of physicians and an increasing need for physicians who are lifelong learners, an experimental curricular track was developed at the University of New Mexico School of Medicine. Increased student responsibility for learning is encouraged by student-centered, small-group, problem-based tutorial learning, and early, primary care role modeling is offered during an early, lengthy, rural preceptorship. Preliminary outcomes reveal there is reinforcement of career interest in rural primary care with important linkages forged between the university and communities as a program by-product. Further, the experimental students, as compared to students in the conventional track, showed a greater appreciation of their learning environment, showed less stress, and failed to become cynical. The reorientation of undergraduate medical education toward the future health care needs of communities and the learning needs of physicians may require major modifications of curriculum design and role modeling experiences.
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The anatomy and location of the cervical spine make it vulnerable to injury and to the cumulative effects of chronic stress and strain. Tumors (local and metastatic), arthritis, and metabolic disorders also take their toll. Trauma from accidents may not be apparent immediately, and only some time later an unusual neck motion unexpectedly precipitates pain and muscle spasm.
A study was carried out to define nutritional problems of women attending family planning clinics (FPCs). Methods of nutritional assessment were chosen to examine relationships between diet and biochemical measures of folacin, riboflavin, and vitamin A status. Findings showed that in the sample of 219 FPC women, 30 percent were obese, 75 percent were low or deficient in plasma folacin, 58 percent were low or deficient in erythrocyte folacin, and 39 percent were low or deficient in riboflavin status (by erythrocyte glutathione reductase assay). Monotonous diets, low plasma folacin, and obesity were characteristic of less well-educated women. Women on contraceptive steroids had slightly lower red blood cell folacin. Riboflavin status was not related to intake of contraceptive steroids but was related to ethnicity.
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To determine if human milk provides sufficient nutrients for adequate bone mineralization in healthy term infants, 76 term Caucasian infants were evaluated at 2 and 16 weeks of age. The infants and their mothers were divided according to the infant's diet into three groups: human milk alone, human milk with supplemental vitamin D, and Similac. At 2 and 16 weeks of age, bone mineral content was measured by photon absorptiometry and blood was drawn for measurement of serum calcium, phosphate, alkaline phosphatase, and 25-OH vitamin D. At both 2 and 16 weeks of age, BMC was similar among all three feeding groups. At 16 weeks of age there was no difference in serum total Ca, ionized Ca, P, or alkaline phosphatase values. At 16 weeks of age the serum 25-OH D concentration was lower in the infants fed human milk alone (P less than 0.05), but was within the normal adult range. Maternal BMC and serum 25-OH D values are similar among the three groups. No seasonal effect on BMC was observed. Our data suggest that during the first 16 weeks of life, routine vitamin D supplementation for breast-fed term Caucasian infants may not be necessary.
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The high incidence of viral infections in patients with lymphocytic leukemia is well documented, but the role played by interferon in the pathogenesis of such infections is not known. In this study, we investigated the possibility that gamma (gamma) interferon production, induced by phytohemagglutinin (PHA) might be impaired in leukocytes from patients with acute lymphocytic leukemia (ALL). We also compared this response with alpha (alpha) interferon production, and with PHA-stimulated lymphocyte transformation. We have shown that the gamma interferon response of leukocytes from patients, both in relapse and in remission, was markedly lower than in leukocytes from normal donors. However, the alpha interferon response in leukocytes from the patients was normal. In contrast the defective gamma interferon response to PHA stimulation of cells from patients in remission, lymphocyte transformation by PHA was normal. Lymphocytes from patients in relapse has a delayed response. Our findings suggest (1) that the defective gamma interferon response which occurs in cells from patients with ALL, both in relapse and remission, contributes to increased susceptibility to viral infections, (2) that alpha interferon may not be the optimal type of interferon for treatment of certain viral infections, and (3) that different triggering mechanisms, or different receptors, exist for PHA-induced gamma interferon production and for lymphocyte transformation in cells of patients with ALL.
Markedly unusual appearances of cutaneous cancers are uncommon, but they deserve comment upon for reasons other than their appearances. Ten unusual cases are illustrated and briefly commented upon.
Approximately 50% of Wistar "BB" rats spontaneously develop overt diabetes mellitus characterized by loss of beta-cells and "insulitis." To define abnormalities of immunoregulation in these rats, we quantitated their major circulating lymphocyte subsets. Independent of the development of diabetes, we found the BB rats to have a markedly increased percentage of circulating B lymphocytes which is secondary to a severe T-cell lymphocytes which is secondary to a severe T-cell lymphocytopenia, with the major circulating T-cell subset reacting with monoclonal antibody W3/25 markedly decreased. This lymphocytopenia is present in every animal studied and contrasted with studies of the nondiabetic Wistar strain from which the "BB" rats were developed.
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