Simplified manual systems for clinical management: tracking systems.
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Biomedical subjects
Publications and source records attributed to R Owens.
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The latency period, success rate, and minimal cell inoculum size required for transplantation of continuously passaged human tumor lines into congenitally athymic (nude) mice, antilymphocyte serum (ALS)-treated congenitally athymic (nude) mice, and congenitally athymic-asplenic (lasat) mice were compared. The 11 tumor lines studied included examples of breast adenocarcinoma, transitional cell carcinoma, osteosarcoma, fibrosarcoma, Hodgkin's disease, malignant melanoma, and rhabdomyosarcoma. Of these 11 tumor lines, 3 were successfully transplanted into nude mice, compared to 5 of 10 tumor lines in ALS-treated nude mice and 9 of 11 lines in lasat mice. Moreover, the latency period was shorter and the minimal cell inoculum size was lower for lasat mice than for either nude or ALS-treated nude mice. Despite this enhancement of heterotransplantation into lasat mice and despite the growth of large local masses, no evidence of distant metastases was found.
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An allergic contact dermatitis from fluorouracil developed in two patients 8 and 18 days respectively after institution of topical fluorouracil therapy. The character of the usual irritant dermatitis changed to that of an allergic dermatitis. Epicutaneous patch tests and intradermal tests with fluorourcil were reactive. Histologic specimens of positive test sites revealed the changes expected in allergic contact dermatitis. Twelve control subjects failed to react to intradermal fluorouracil tests.
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Potassium has been shown to suppress plasma renin activity (PRA). This study was designed to study the role of increased aldosterone production in the mediation of such a response. Five patients with adrenal insufficiency were placed on a diet of 60 meq potassium and 100-150 meq of sodium while receiving a constant amount of cortisone acetate and Florinef. Upright PRA was determined each day for 2-3 days in the control period and then for 3-4 days after potassium intake had been increased to 200-300 meq/day. Potassium loading induced a natriuresis. Hence, patients were either sodium replaced (six studies in four patients) or allowed to become sodium depleted (three patients). Potassium loading without replacement was associated with a decrease in weight, negative sodium balance, hyperkalemia, and a positive potassium balance. PRA rose during the experimental period. Potassium loading with sodium replacement was associated with little change in weight or sodium balance. Hyperkalemia and positive potassium balance were present to the same degree as found in the studies without sodium replacement. When all PRA values are considered (both morning and evening values) there was no significant change with potassium loading (+ 1.31 ng/ml per h; range + 6.9 to -2.0). We conclude that hyperkalemia or a positive potassium balance did not suppress PRA in Addisonian man in these studies when sodium balance was maintained, nor did it prevent a rise in PRA when sodium balance was negative.
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The reproducibility and correlation between the NAPTT, TGt50 in (vitro) tests and the Wessler (rabbit) stasis thrombus (in vivo) model have been studied using 10 different factor IX concentrates. The TGt50 test was more reproducible than the NAPTT and the overall reproducibility of the rabbit model was poor. The low reproducibility of the rabbit model appeared to be largely confined to those factor IX concentrates which showed a poor correlation between the NAPTT and TGt50 results. The TGt50 test emerged as the in vitro test which correlated most closely with the in vivo (rabbit) test. It is concluded that the NAPTT and TGt50 test are measuring different thrombogenic moieties in factor IX concentrates and that further studies are required to elucidate this phenomenon.
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BACKGROUND: We evaluated a new psychological test (Paindex) for identifying and quantifying psychological factors associated with poor surgical outcome, and predicting the degree of pain relief and return to work. METHOD: This test was administered to 120 randomly selected patients before carpal tunnel and laminectomy surgeries. RESULTS: This test correctly predicted the probability of pain relief and return to work in 46 of the 50 laminectomy patients (92%), and 63 of the 70 carpal tunnel patients (90%). The overall test sensitivity was 86% and the specificity 94%. CONCLUSION: These findings indicate that this can be a useful adjunctive test for identifying psychological problems that could have a bearing on the decision to operate and then problems that could occur after surgery, particularly in cases where the extent and degree of pain and disability are judged to be considerably in excess of the objective medical findings.