Legionnaires' disease following renal transplantation.
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Humans↗
Biomedical subjects
R S Foster
Publications and source records attributed to R S Foster.
Breast self-examination practices and breast-cancer stage.
To determine the relation between breast self-examination performance and the clinical and pathological stage of breast cancer at first diagnosis, we studied 335 patients with breast cancer. Approximately one fourth of the patients reported that they had been practicing monthly breast self-examination, and half that they had never practiced breast self-examination. More frequent performance of breast self-examination was associated with more favorable clinical stage and fewer axillary-lymph-node metastases on histologic examination. On pathological examination, the age-adjusted maximum tumor diameter of patients practicing monthly breast self-examination was 1.97 +/- 0.22 cm (mean +/- S.E.M.) as compared to 2.47 +/- 0.20 for those performing self-examination less often than monthly and 3.59 +/- 0.15 for patients never performing breast self-examination. These data associating more favorable clinical and pathological stages of breast cancer with more frequent breast self-examination need to be extended by determination of the survival rates of the various self-examination groups.
Adult↗
Breast biopsy. A comparison of outpatient and inpatient experience.
Nine hundred ninety-seven breast biopsies that were performed at one hospital over the five-year period from 1971 through 1975 were reviewed because of a changing pattern in the use of breast biopsies on outpatients who were under local anesthesia. In 1971, 17% of all breast biopsies were performed as outpatient procedures; by 1975, the figure was 60%. In 1971, 5% of all malignant neoplasms were diagnosed by the use of biopsies as outpatient procedures and 30% in 1975. Hospital charges for biopsy on an inpatient basis of benign breast disease were 7.2 times higher than for biopsy on an outpatient basis. Interviews of 102 patients clearly suggested that most patients were satisfied with the outpatient breast biopsy experience. Outpatient breast biopsy under local anesthesia is a safe procedure that is more economical in terms of medical cost, surgeons' time, and patients' time away from home and/or job. Preliminary biopsy of malignant lesions using local anesthesia permits more efficient use of diagnostic procedures to stage the extent of disease prior to treatment. Patient acceptance of breast biopsy as an outpatient procedure under local anesthesia was similar to their acceptance of biopsy on an inpatient basis under general anesthesia.
Ambulatory Care↗
Effect of surgery on granulocyte/macrophage colony-stimulating factor.
Eighteen surgical patients were studied to determine the effect of anesthesia (general or spinal) and surgery on serum and urinary colony-stimulating factor(s) (CSF). CSF is a leukopoietin that stimulates proliferation of macrophages and granulocytes from bone marrow precursor cells. CSF was assayed by adding aliquots of serum or urine to semisolid agar cultures of bone marrow cells and scoring the number of colonies developing after 7 days of incubation. In all but 1 case, a 3- to 30-fold increase in the 24 hour excretion of urinary CSF was seen on the day of surgery and the first postoperative day. CSF urinary excretion began declining toward normal by the second postoperative day. A parallel increase in granulocyte count, a delayed rise in monocytes, and a decline in absolute lymphocyte counts were also observed. The data suggest that immediately postoperatively there may be a strong stimulus to granulocyte/macrophage proliferation. More rapidly proliferating cells would be anticipated to have increased vulnerability to toxicity from cell cycle-active chemotherapeutic agents.
Adult↗
Altered toxicity of 5-fluorouracil following treatment with Corynebacterium parvum.
Recent studies have demonstrated that systemic Corynebacterium parvum increases serum granulocyte-macrophage colony-stimulating factor and stimulates the proliferation of granulocyte-macrophage progenitor cells. It was hypothesized that more rapid cycling of granulocyte-macrophage progenitor cells would render the cells more sensitive to a cell cycle-specific chemotherapeutic agent. The colony-forming ability of bone marrow granulocyte-macrophage progenitor cells was assayed in vitro with soft agar cultures. C. parvum given before 5-fluorouracil in C57BL/6 mice increased the granulocyte-macrophage progenitor cell toxicity, the lymphopenic effect, and the lethality of 5-fluorouracil. When C. parvum was given after 5-fluorouracil, there was more rapid rebound of granulocyte counts to normal or supranormal levels.
Animals↗
Increased azathioprine toxicity after ureteral ligation and nephrectomy.
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Animals↗
Morbidity and mortality after thyroidectomy.
To assess the morbidity and mortality of thyroid operations, Professional Activity Study records of the Commission on Professional and Hospital Activities, representing an estimated one-third of all thyroidectomies performed in the United States in 1970, were reviewed. The mortality after a thyroid operation for nontoxic goiter was 0.02 per cent for patients less than the age of 50 years but increased with age to 0.66 per cent for those 70 years and older. No in-hospital deaths followed thyroidectomy for malignant goiter in 766 patients less than 40 years of age. Thyroidectomy for diffuse toxic goiter had a mortality fivefold greater than did operations for a benign nontoxic goiter. Total thyroidectomy was used for the treatment of nontoxic, nonmalignant goiter for one in 12 patients and resulted in greater morbidity than did partial or subtotal thyroidectomy. Rational choice of operation for the treatment of goiter for individual patients should be based upon knowledge of the specific risks of surgical treatment, which vary greatly depending upon the age of the patient, whether or not the goiter is toxic or nontoxic and whether or not subtotal or total thyroidectomy is performed.
Adolescent↗
Effect of Corynebacterium parvum on the proliferative rate of granulocyte-macrophage progenitor cells and the toxicity of chemotherapy.
We have studied the interaction of Corynebacterium parvum and a variety of cell cycle-specific and cell cycle-nonspecific chemotherapeutic agents on granulocyte-macrophage progenitor cells [colony-forming units culture (CFU-c)] in C57BL/6 mice. In vitro tritiated thymidine suicide studies showed an increased rate of proliferation of bone marrow CFU-c 24 hr after C. parvum injection. In vivo toxicity of cell cycle-specific agents but not of cell cycle-nonspecific agents for bone marrow CFU-c was increased 24 hr after C. parvum injections. The increased numbers of CFU-c in the spleen, induced by C. parvum, were also sensitive to a cell cycle-specific agent for up to 7 days after C. parvum injection. The findings suggest differences in the kinetics of proliferation of splenic compared to bone marrow CFU-c. The relative time of administration of chemotherapy and immunostimulants such as C. parvum will have to be carefully considered in the design of clinical trials.
Animals↗
Reduction of azathioprine toxicity by hydrocortisone.
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Azathioprine↗
Bone marrow colony-forming cells in mice with virus-induced lymphoid leukemia: relation to serum colony-stimulating activity and blood granulocytes.
Mice with advanced lymphoid leukemia have elevated peripheral blood granulocytes and elevated serum colony-stimulating activity, which promotes the in vitro growth of granulocyte and/or macrophage colonies. The number of bone marrow precursor cells of the in vitro granulocyte and/or macrophage colonies varied from normal to 10% of normal. The elevation of colony-stimulating activity correlated best with a combination of increased blood granulocytes and a deficiency of bone marrow precursor cells, which suggested that colony-stimulating activity is a leukopoietin that increases the efficiency and rate of production of granulocytes.
Animals↗
Renal ischemia and contrast urography.
Exposure to urographic contrast material, meglumine diatrizoate, in a previously ischemic kidney was investigated for its effect on renal function. Eleven mongrel dogs, 19.8-32.7 kg in weight, having the left kidney ischemic for 90 minutes were given either 4 cc/kg meglumine diatrizoate or control, Ringer's lactate solution. The effect on creatinine clearance of the left kidney was determined acutely and at 72 hours. Statistical analysis of the data reveals no deleterious effect from exposure to meglumine diatrizoate over and above the effect of the ischemic episode. There was no statistically significant effect on recovery of renal function in this animal model.
Animals↗
Chicken embryo as an animal model for gonorrhea.
Parameters of infection of the chicken embryo with Neisseria gonorrhoeae were defined in order to standardize infectious and lethal doses. Virulent (T1) and avirulent (T3) gonococci from two strains were used to infect 7- to 12-day-old White Leghorn chicken embryos via the yolk sac (YS) or chorioallantoic membrane (CAM) route. Infection of embryos was established following YS inoculation of 1 to 10 viable gonococci. Although 8- to 10-day-old embryos were the most susceptible, an inoculum of less than 100 gonococci was sufficient to kill any age embryo via this route. Embryos were less susceptible to infection via the CAM, where an inoculum of from 10(5) to 10(6) colony-forming units was lethal by 42 h. Strain and morphological type had a variable influence on the ability of the gonococcus to infect and kill the chicken embryo by either route; however, agar-grown and broth-grown organisms produced consistently similar mean lethal dose (LD(50)) and mean infective dose (ID(50)) values. LD(50) and ID(50) differences between T1 and T3 gonococci from strain 72H641 were not apparent after either YS or CAM inoculation of 8- or 10-day chicken embryos, respectively. YS and CAM LD(50) values for strain 72H641 T1 and T3 and CDC 9 T3 were also similar; however, these values were slightly lower for CDC 9 T1. In terms of infectivity or colonization, CDC 9 T1 and T3 had higher ID(50) values via the YS and lower ID(50) values via the CAM than 72H641. CDC 9 T1 was slightly more infective via the YS and less infective via the CAM than its T3 counterpart. Although the gonococcal strain used will influence interpretation of results, infection of both YS and CAM was highly reproducible in terms of gross pathology and of LD(50) and ID(50) data for a particular strain and colony type.
Aging↗
Effect of Corynebacterium parvum on colony-stimulating factor and granulocyte-macrophage colony formation.
Because Corynebacterium parvum has tumor-inhibitory properties and stimulates granulocyte-macrophage production, it may have clinical value in combination with chemotherapy. The leukopoietic effect of killed suspensions of C. parvum was studied in mice using the technique of in vitro clonal culture of hematopoietic cells. After C. parvum injection, there was a prompt, sustained elevation of serum colony-stimulating factor followed by an increase in granulocyte-macrophage precursor cells in the spleen and increases in blood mononuclear and granulocyte cells. Colony-stimulating factor production is suggested as a major mechanism of stimulation of granulocyte-macrophage proliferation by C. parvum. Since rapidly proliferating hematopoietic cells may have increased sensititity to cytotoxic agents, the details of hematopoietic stimulation by C. parvum may be critical in the sequential timing of combined C. parvum and chemotherapy treatment to obtain maximal tumor inhibition and minimal hematopoietic toxicity.
Animals↗
Mangement of infantile esotropia.
We evaluated the management of infantile esotropia-constant, alternating esotropia before 6 months of age-in 34 children. Planned one-state surgery for satisfactory mechanical alignment was highly predicatable (79 to 84%), and was obtained at any age. Stable bifoveal motor fusion was also obtained but was more frequent with alignment before 2 years of age. The use of postsurgical spectacle orthoptics (minus lenses or prisms, or both) increased the incidence of bifoveal fusion. Surgery alone resulted in bifoveal fusion in 6% of the cases, whereas an overall incidence of 33% bifoveal fusion resulted after the use of postsurgical spectacle orthoptics by some patients. Of those receiving postsurgical spectacle orthoptics, 53% obtained bifoveal fusion. This study demonstrated a correlation between the incidence of secondary A patterns (after surgery for V esotropia) and the amount of horizontal muscle surgery done in combination with bilateral inferior oblique muscle myectomies.
Age Factors↗
Electrophoretic comparison of endonuclease-digested plasmids from Neisseria gonorrhoeae.
In order to associate virulence in Neisseria gonorrhoeae with an alteration of the nucleotide sequence of its small covalently closed plasmid, plasmid deoxyribonucleic acid was isolated from both virulent (T1) and avirulent (T3) morphological types for two strains. Electrophoretic and contour length measurements of intact plasmids indicated a homogeneous population with a molecular weight of approximately 2.6 x 10(6). Digestion with two restriction endonucleases. Hinf I and Hpa II, generated distinct fragment patterns which in each case were identical for T1 and T3 plasmid molecules from the same strain. The analysis suggests no sequence differences between the plasmids from virulent and avirulent types. For both strains, however, a deletion or addition of about 1.5% of the total deoxyribonucleic acid appeared in the Hpa II C digestion fragment when patterns for gonococci serially passaged 300 times were compared to those for bacteria freshly established from frozen stocks. The significance of the plasmid instability remains undetermined.
Base Sequence↗
Decreased liver and lung drug-metabolizing activity in mice treated with Corynebacterium parvum.
Injections of killed suspensions of Corynebacterium parvum (i.p.) in young male mice were followed by time- and dose-dependent decreases in the drug-metabolizing activity of liver microsomes and lung homogenates. In vitro assays with model substrates [aminopyrine, aniline, p-nitroanisole, and benzo(a)pyrene] were used to quantitate drug-metabolizing activity. It is likely that such decreases in mixed function oxidases activity will act to significantly alter the pharmacokinetics of concurrently or subsequently administered drugs. The results provide a possible mechanism to explain several previously reported immunochemotherapeutic interactions.
Animals↗
The immunostimulant Corynibacterium parvum and hematopoietic toxicity of chemotherapy.
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Animals↗
Strabismus and pseudostrabismus with retrolental fibroplasia.
Three patients with temporal displacement of the macular secondary to retrolental fibroplasia had true strabismus in associations with amblyopia and pseudostrabismus related to a large, positive angle kappa. In one case, a headturn associated with the neutral point of nystagmus was also a presenting problem. Ocular deviation was measured by the light reflex test and the prism cover test, with particular attention paid to adequate cosmetic alignment. Large amounts of prism placed before the fixating eye resulted in loss of visual acuity, while eyes placed in a parallel position by surgical means may not appear to be straight. Thus, surgery can result in parallel ocular alignment while prismatic therapy may be required to center the pupillary light reflex and to provide satisfactory cosmetic appearance.
Accommodation, Ocular↗