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Biomedical subjects

R S Foster

Publications and source records attributed to R S Foster.

At least 199 records · Page 11Linked to original sources
PubMed1984

Relationship between breast self-examination and death from breast cancer by age groups.

To quantitate the relationship between breast self-examination and survival from breast cancer, we have studied 1,003 newly diagnosed patients with invasive breast cancer in Vermont general hospitals since July 1, 1975. Death certificates, autopsy reports, and hospital records were reviewed to determine the cause of death. Examination of product limit survival curves by three age groups demonstrated that death due to breast cancer was less likely in breast cancer patients who had performed breast self-examination than in nonperformers in each of the three age groups. The associated lead-time would have to exceed 36 months to negate the apparent beneficial effects of breast self-examination in decreasing the likelihood of death from breast cancer. We conclude that in this population of breast cancer patients, breast self-examination probably contributed to earlier detection and thereby improved survival.

Adult↗
PubMed1983

Improved survival after pneumococcus in splenectomized and nonsplenectomized mice with Corynebacterium parvum.

Splenectomy increases the susceptibility to infections with certain bacteria, particularly Streptococcus pneumoniae. Because the immunomodulator Corynebacterium parvum expands the phagocytic cell compartment and enhances reticuloendothelial function, we tested the effect of C parvum in mice challenged with aerosolized pneumococci. Mice splenectomized seven days before pneumococcal challenge and treated intraperitoneally with 700 micrograms of C parvum immediately after exposure were protected when compared with splenectomized or sham-operated saline-injected controls. Analysis of proportional hazards showed the risk of dying in order of greatest to least as follows: splenectomy/saline, sham/saline, splenectomy/C parvum and sham/C parvum. The benefits of an intact spleen and C parvum seemed to be additive in their protective effects after aerosol pneumococcal challenge. After intravenous challenge, bloodstream clearance was improved in sham-operated mice at three days after C parvum injection compared with saline-injected sham-operated controls and C parvum-injected splenectomized mice. A significant improvement in bacterial clearance did not occur until seven days after C parvum treatment in splenectomized mice. The results demonstrate the value of a nonspecific immunomodulator for enhancing the defense mechanisms of both normal and splenectomized animals.

Adjuvants, Immunologic↗
PubMed1983

Effects of protein-calorie malnutrition and refeeding on fluorouracil toxicity.

Mice were used to study the effects of protein-calorie malnutrition and its reversal on granulocyte-macrophage production and fluorouracil's toxic effect on bone marrow. An in vitro quantitative clonal culture technique for bone marrow granulocyte-macrophage progenitor cells (GM-CFC) was used. Animals on a protein-free but otherwise complete diet for ten days had a significant contraction in total marrow cellularity and GM-CFC numbers paralleling the animal's weight loss. The acute toxic effect of fluorouracil on bone marrow was not increased in protein-deprived animals. On refeeding, there was a biphasic response in the degree of toxic effect on marrow. Animals refed for one day had significantly increased fluorouracil-related marrow abnormalities. However, animals refed for four days, when marrows were repleted, were partially protected from the drug's cytotoxic effects. The increased sensitivity in mice refed for one day was related to more GM-CFC in active DNA synthesis.

Animals↗
PubMed1983

Content and context in health education: persuading women to perform breast self-examination.

Content in a breast self-examination (BSE) education program was tested according to three motivational approaches with 923 women in Vermont women's clubs. The program was a slide-tape presentation using one of the three approaches and a BSE demonstration followed by a group discussion led by a nurse. A post-test of 374 women 6 months later showed a significant increase in monthly BSE performance from 40 to 71% regardless of motivational approach and an increase in breast cancer knowledge that was somewhat varied by approach, but was significant across all three approaches. Women who did not adopt monthly BSE after the program had an increase in knowledge similar to those who had adopted it. After the program, older women had somewhat less knowledge but performed BSE as often as younger women. Women with a family history of breast cancer were somewhat less likely to perform monthly BSE than other women, and women admitting to inhibitions about BSE were significantly less likely to adopt the practice than other women, yet their monthly BSE also increased as a result of the program. The significant positive change in BSE and knowledge across all groups appeared to be more a result of the supportive women's club context than of variations in program content. Thus, to achieve desired changes in prevention-oriented health behavior, it is suggested that health educators emphasize structuring a favorable context for the presentation of recommended actions such as BSE.

Adult↗
PubMed1983

Lack of protection by pneumococcal vaccine after splenectomy in mice challenged with aerosolized pneumococci.

The efficacy of pneumococcal vaccine given after splenectomy lacks experimental validation. Adult CD-1 male mice that received type III pneumococcal capsular polysaccharide vaccine 1 microgram IP, 48 hours postsplenectomy and 7 days before challenge with aerosolized type III Streptococcus pneumoniae had a significantly higher mortality (96%) compared to immunized controls (64%) (p less than 0.002). The vaccine protected immunized sham-operated mice compared to unimmunized controls (p less than 0.015). Mice immunized 7 days before splenectomy were equally protected when compared to immunized sham-operated mice (p = NS). All deaths were secondary to culture-proven pneumococcal infection. These findings corroborate previous experimental and clinical studies demonstrating an impaired immunologic response and increased susceptibility to infection in asplenic individuals. Pneumococcal vaccines should be given before nonemergent splenectomy. Alternatives to splenectomy should be considered for patients with traumatized spleens where possible.

Aerosols↗
PubMed1983

Hematopoietic toxicity by cimetidine. Reexamination using the antimetabolite azathioprine.

By using an in vitro quantitative clonal culture technique for bone marrow granulocyte/macrophage progenitor cells (GM-CFC), we studied the effects of cimetidine alone and cimetidine plus azathioprine on bone marrow toxicity in C57BL/6 mice. Femoral bone marrow showed no effect of cimetidine in doses from 31.25 to 500 mg/kg on either marrow cellularity or the number of GM-CFC. Cimetidine pretreatment with single doses of 62.5 mg/kg or 250 mg/kg had no effect on the bone marrow suppression of azathioprine at 100 mg/kg. Chronic cimetidine pretreatment at 62.5 mg/kg daily for 7 days also had no effects on the single-dose azathioprine toxicity. Cimetidine given either before or after azathioprine had no effect on the rate or final level of recovery of GM-CFC in the marrow after depletion by azathioprine. Cimetidine in vitro at doses of 3.1 to 200 micrograms/ml caused no alteration in the proliferative response of the GM-CFC. Analysis of the serum colony-stimulating activity 1 to 24 hr following doses of cimetidine of either 12.5 mg/kg or 31 mg/kg caused no change in the serum colony-stimulating activity. We could find no evidence that at clinically relevant doses, cimetidine increased the hematopoietic toxicity of the azathioprine or altered the rate of bone marrow recovery after azathioprine depletion.

Animals↗
PubMed1981

Staging of breast cancer: a new rationale for internal mammary node biopsy.

Metastases to the axillary nodes, the internal mammary nodes, or both, define a group of patients at very high risk of having systemic micrometastases leading to recurrent disease and death if surgical therapy alone is used. In our review of 7,070 patients with breast cancer in whom both axillary nodes and internal mammary nodes were examined histologically, 5% to 10% had internal mammary node metastases in the absence of axillary node metastases. With the availability of effective systemic therapy that can improve the survival of patients with operable breast cancer who have lymph node metastases, information obtained from internal mammary node biopsies assumes practical significance. Our current policy is to perform internal mammary node biopsies on patients with operable breast cancer who have medial and central primary tumors of any size and lateral primary tumors 2 cm or greater in diameter if a frozen section of the most suspicious node in the axillary dissection shows no histologic evidence of metastasis.

Biopsy↗
PubMed1981

Legionnaires' disease in renal transplant patients.

Legionnaires disease, which is commonly manifested as pneumonia, was only recently recognized to be a bacterial infection. Diagnosis can be difficult because Gram's stain does not readily stain the bacterium in pulmonary secretions, the organism is not readily cultured, and legionellae is not affected by many commonly used antibiotics. In a retrospective review of all of our transplant patients, we identified 14 cases of Legionnaires' disease after 101 renal transplants. The patients characteristically had high fever, polymorphonuclear leukocytosis, dyspnea and an unproductive cough accompanied by radiographic changes of consolidating pneumonia. Legionnaires' disease can be diagnosed by direct immunofluorescent antibody staining, culture on special media or increases in serum titers of legionella antibodies in surviving patients. Since the recognition of Legionnaires' disease in 1977, we have successfully treated seven renal transplant patients using erythromycin with or without rifampin.

Adolescent↗
PubMed1981

Systemic amyloidosis involving two renal transplants.

Two patients with primary amyloidosis, each of whom had received a renal transplant for chronic renal failure, developed amyloid in their allografts. In one patient amyloid was present primarily in glomeruli and to a lesser extent in the interstitial tissue. This patient developed renal failure necessitating retransplantation. In the second patient amyloid was seen in the interstitium and interlobular blood vessels. Minimal amyloid was present in the glomeruli. This patient died of cardiac amyloidosis with good graft function at the time of death. Of the several patients recorded in the literature with amyloid in renal allografts, our first patient is the only one to exhibit glomerular amyloid and failure of the graft. Amyloid in areas other than the glomerulus does not appear to be incompatible with satisfactory graft function.

Amyloid↗
PubMed1980

Anterior urethral polyps.

The second reported case of an anterior urethral polyp is presented. The etiology, pathology and treatment of urethral polyps are discussed.

Child↗
PubMed1979

Effect of ureteral ligation and nephrectomy on granulocyte-macrophage progenitor cells and azathioprine toxicity.

Using an in vitro quantitative clonal culture technique of bone marrow granulocyte-macrophage progenitor cells (colony-forming units culture (CFU-c)), we studied the hematopoietic toxicity of azathioprine after unilateral and bilateral ureteral ligation, unilateral and bilateral nephrectomy, and splenectomy in C57BL/6 mice. Analysis of femoral bone marrow 18 hr after i.p. injection of azathioprine (300 mg/m2) revealed increased CFU-c toxicity in comparison to controls as follows: (1) bilateral ureteral ligation, P less than 0.01; (2) bilateral nephrectomy, P less than 0.01; (3) unilateral ureteral ligation, P greater than 0.05 less than 0.1; (4) unilateral nephrectomy, P, not significant; and (5) splenectomy, P, not significant. Extrapolation from a dose-response curve for the toxicity of azathioprine on the bone marrow CFU-c indicated that bilateral ureteral ligation and bilateral nephrectomy had the effect of a 25 to 50% increase in the azathioprine dose. After bilateral ureteral ligation, serum granulocyte-macrophage colony-stimulating factor levels were increased and in vitro tritiated thymidine suicide studies showed an increased proliferative rate of the CFU-c. Since azathioprine is a predominantly cell cycle-specific agent, we suggest that increased sensitivity to azathioprine is related to the increased proliferative rate of the CFU-c. The findings provide a rationale for a clinical policy of azathioprine reduction when there is depressed renal function.

Animals↗
PubMed1979

Legionnaires' disease in patients with associated serious disease.

Of nine patients with Legionnaires' disease, seven were receiving corticosteroids, and all nine had serious underlying diseases. Direct immunofluorescent examination of respiratory secretions, including sputum and transtracheal aspirates, showed the Legionnaires' disease (LD) bacterium in five of seven patients who seroconverted and in a sixth patient with a single elevated titer to the LD bacterium. All nine patients received erythromycin therapy, and five survived. Two patients showed persistence of their infection after receiving 2 weeks of erythromycin therapy, and two patients developed pulmonary abscesses. These cases of Legionnaires' disease show the occurrence of pulmonary abscesses, the possibility of relapse after giving only 2 weeks of erythromycin therapy, and the utility of direct immunofluorescence for early diagnosis.

Adrenal Cortex Hormones↗