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Biomedical subjects

S A Gall

Publications and source records attributed to S A Gall.

At least 91 records · Page 5Linked to original sources

The effects of prophylactic management and therapeutics on hypertensive disease in pregnancy: preliminary studies.

A controlled prospective evaluation of pregnancy complicated by chronic hypertension is proposed and preliminary data on population selection and pregnancy outcome are presented. Sixty-three women with evidence of underlying hypertensive disease were followed prospectively throughout pregnancy. Twenty-three patients were followed in a protocol of intensified prenatal care and randomized assignment of antihypertensive agents: placebo, hydralazine, or methyldopa. Forty patients were followed in the high-risk pregnancy clinics at Duke University. The incidence of preeclampsia in the randomized prophylactic antihypertensive group was statistically lower than that in the nonrandomized group (8.7 versus 32.5%; P less than .01). There were no other statistically significant differences between the groups. The 63 hypertensive women had a high incidence of diabetes mellitus diagnosed during pregnancy (49.2%) as compared to the authors' general obstetric population (8.1%).

Adult↗

Analysis of amniotic fluid, maternal plasma, and cord blood for a human breast gross cystic disease fluid protein.

Amniotic fluid was analyzed for the presence of the 15,000 monomer molecular size glycoprotein found in human breast gross cystic disease fluid (GCDFP-15). From 24 weeks' gestation a log-linear increase in levels of GCDFP-15 was noted. The levels of GCDFP-15 doubled every 16 to 28 days, and the highest value recorded was 7,200 ng/ml. At delivery, levels of GCDFP-15 in cord blood plasma were in a background range (mean, 8 ng/ml). Maternal plasma levels of GCDFP-15 were one to tenfold higher in the third trimester of pregnancy when compared to those in nonpregnant women. Since saliva is known to contain high concentrations of GCDFP-15 (10 to 70 micrograms/ml), it is proposed that the levels in amniotic fluid originate from saliva and tracheobronchial secretions.

Amniotic Fluid↗

High-dose cefamandole therapy in obstetric and gynecologic infections.

Increased understanding of bacterial infections of the pelvis has led to the frequent administration of double and triple antimicrobial chemotherapy for polymicrobial infections in hospitalized patients. This study evaluated the use of high-dose cefamandole as a single agent in the treatment of obstetric and gynecologic infections. Cefamandole was administered by intravenous infusion of 2 gm every 4 hours or, less often, every 3 hours. Twenty patients were entered into the study, 11 with postpartum endometritis and nine with pelvic inflammatory disease. Seventeen of the 20 patients (85%) were successfully treated; all failures were in the endometritis group. The aerobic organisms and the gram-positive anaerobic organisms isolated from these infections were susceptible in vitro to cefamandole at attainable serum concentrations. The bacteroides isolated were more resistant. The data suggest that high-dose cefamandole therapy is effective as a single agent for the majority of moderate obstetric and gynecologic infections.

Bacteria↗

Intravenous metronidazole in the treatment of ruptured amebic liver abscess.

Intravenous metronidazole was administered to a patient with peritonitis caused by a ruptured amebic liver abscess. The medication was well tolerated and the patient had a remarkable recovery. The intravenous administration of metronidazole was safe and efficacious therapy for this often fatal disease process.

Adult↗

Premature rupture of the membranes: maternal and neonatal infectious morbidity related to betamethasone and antibiotic therapy.

A retrospective study of patients delivering in 1976-77 at Duke University Medical Center was performed to assess the impact of betamethasone and prophylactic antibiotics on infectious morbidity in mothers with premature rupture of the membranes (PROM) at 26 to 34 weeks' gestation and in their neonates. Ninety-five records were reviewed for evidence of maternal and neonatal infection and perinatal mortality. Betamethasone had no impact on maternal or neonatal infection. Antibiotics given concurrently with betamethasone significantly reduced the incidence of maternal and/or neonatal infection (18.0% vs. 0). Perinatal mortality increased when the duration of the latent period was 72 hours and greater because of factors other than infection.

Anti-Bacterial Agents↗

Inhibition of human lymphoblastoid cell line proliferation by ascites fluids from ovarian cancer patients.

Ascitic fluids from ovarian cancer patients which contained a component (lymphocyte-inhibitory activity) that inhibited the blastogenic responses of normal lymphocytes were tested for their effect on established lymphoblastoid cell lines. These ascites fluids inhibited proliferation as measured by [3H]thymidine uptake and cell growth in vitro of two different B- (SB and IM-1) and two different T- (HSB and CEM) lymphoblastoid cell lines but were not cytotoxic. No difference in the sensitivity of T- and B-lymphoblastoid cell lines to the active component in the ascites fluids could be demonstrated. In contrast, established nonlymphoid cell lines (HEp-2, oligodendroglioma, and bladder tumor cell lines) were unaffected by the ascites fluids. Two different preparations of partially purified lymphocyte inhibitory activity from these ascites fluids also inhibited lymphoblastoid cell line proliferation. In addition, both B- and T-lymphoblastoid cell lines absorbed and/or metabolized the lymphocyte-inhibitory activity at 37 degrees but not at 4 degrees. These data suggest that the inhibition of lymphoblastoid cell line proliferation and the inhibition of the blastogenic responses of normal lymphocytes by the ascites fluids are attributable to the same or similar factors.

Ascites↗

Study of secretory component in patients with metastatic breast cancer.

A radioimmunoassay was developed for secretory component, a glandular epithelial cell product secreted as an accessory protein with dimeric immunoglobulins A and M. Forty-four normal women between the ages of 40 and 70 had plasma concentrations of secretory component of 7.195 microgram/ml +/- 3.590 (+/-2 SD). Of the patients with metastic breast cancer of epithelial origin, 34 (91.9%) had plasma concentrations greater than 8.990 microgram/ml; 29 (78.1%) had plasma concentrations greater than 10.785 microgram/ml; 10 (27%) had concentrations greater than 15.000 microgram/ml; and 3 (8.1%) had concentrations greater than 22.710 microgram/ml. Serial plasma concentrations (averaging 3.48 per patient) of 35 (94.6%) of these patients reflected the clinical course of the disease. All patients had some combination of surgery, radiation therapy, and chemotherapy. No direct correlation was noted between the type of therapy and concentration of secretory component. However, plasma secretory component served as a marker in the systemic circulation of a change in the status of the metastatic breast cancer. The impact of this research may lie in its incorporation into clinical management.

Adenocarcinoma↗

The efficacy of prophylactic antibiotics in cesarean section.

The objective of this investigation was to determine the effectiveness of cefazolin-cephalothin administration as a prophylactic regime in patients undergoing cesarean section. The study was to randomized, double-blind, placebo-controlled investigation. Cefazolin, 1.0 gm or placebo was administered intramuscularly on call to the operating room, and cephalothin, 2.0 gm, or placebo was administered intravenously at 6, 12, and 24 hours postoperatively. Ninety-five patients were included in the study with 49 in the placebo group and 46 in the drug group. Nineteen patients developed 28 infections in the placebo group while eight patients developed eight infections in the drug group (P = less than 0.05). Eight patients in the placebo group developed infections at two or more sites whereas no patient in the drug-treated group developed multiple infections. No infant developed infection and no overgrowth of bacteria occurred. This study supports the concept of preoperative antibiotic administration being beneficial to the obstetric patient.

Anti-Bacterial Agents↗

Growth of type 2 herpes simplex virus in newborn and adult mononuclear leukocytes.

Growth of type 2 herpes simplex virus (HSV) in newborn and adult human mononuclear leukocytes (MNL) was compared. Phytohemagglutinin stimulation of cultures for 3 days yielded comparable peak titers in newborn (10(5.3) PFU) and adult (10(5.1) PFU) MNL. Unexpectedly, 3-day cultures of unstimulated newborn MNL also substantially replicated HSV (10(4.7) PFU), whereas similarly treated unstimulated adult cells did not. Growth of HSV in freshly isolated human MNL was next investigated. MNL from 4 mothers and 6 nonpregnant adults showed no evidence of virus growth; however, leukocytes from 11 of 24 newborns (46%) supported replication. Newborn MNL manifested an increased ability to replicate HSV within 1 day of culture, whereas comparable growth in adult MNL was not achieved until the 4th day of culture. The significance of the above observations as it relates to visceral dissemination of HSV in the neonate is discussed.

Adult↗

Facilitated light microscopic cytochemical diagnosis of acute myelogenous leukemia.

Hydroperoxidase-positive Phi bodies and rods are much more prominent and prevalent than rods visualized with a Romanovsky-type stain (Auer rods) in immature leukocytes of patients with active acute myelogenous leukemia (AML). They are readily observed with the light microscope in peripheral blood or marrow films of AML patients stained to show their peroxidatic activity. In many of these patients, Auer rods, which apparently constitute only a small subpopulation of the hydroperoxidase-positive Phi bodies and rods, were detected with difficulty, if at all. The hydroperoxidase-positive Phi bodies and rods were observed in 92% of 36 patients with active disease. They were never observed in leukocytes of patients with other hematopoietic disorders or of normal individuals. Thus, they facilitated the distinction of AML from acute lymphocytic leukemia and chronic granulocytic leukemia in blast crisis. They were absent in full clinical remission after chemotherapy and were greatly diminished in partial remission. They were present in disease relapse and reappeared in five patients who had been in full remission. These results suggest that these hydroperoxidase-positive enlarged particles are pathognomonic of AML and that monitoring them with the light microscope may aid in guiding its clinical management.

Adolescent↗

Toxicity manifestations following intravenous Corynebacterium parvum administration to patients with ovarian and cervical carcinoma.

Manifestations of clinical toxicity were evaluated following 341 courses of intravenous Corynebacterium parvum adjuvant immunotherapy in patients with ovarian and cervical carcinoma. Most patients exhibited symptoms of minor toxicity, which decreased in intensity as subsequent courses of therapy were administered. Temperature elevations to 38.5 degrees C. were the most objectively measured signs of toxicity but temperature elevations greater than 38.5 degrees C. occurred following only 20.5 per cent of the infusions. Blood pressure alterations were not a serious problem and no serious central nervous system or renal toxicity was noted. The minor side effects should not preclude the use of C. parvum as an immunopotentiating agent if it is shown to be beneficial in the treatment of human malignant disease.

Blood Pressure↗

Quantitation of secretory component levels in cyst fluids, ascitic fluids, and sera from ovarian adenocarcinoma patients.

A secretory component (SC) was detected by radioimmunoassay in the cyst fluids, ascitic fluids, and sera from patients with ovarian adenocarcinomas. Serous cyst fluids and ascitic fluids showed lower levels (expressed as means +/- SE) of SC (1.37 +/- 0.37 and 1.24 +/- 0.24 microgram/ml, respectively) than mucinous cyst fluids (181.50 +/- 50.40 microgram/ml). SC levels in the sera of all patients with ovarian adenocarcinoma were high (12.67 +/- 1.43 microgram/ml) when compared to SC levels in the sera of normal individuals (2.34 +/- 0.41 microgram/ml). Sera from patients with ovarian cancers diagnosed as serous, mucinous, papillary, and poorly differentiated adenocarcinomas showed SC levels of 9.93 +/- 1.68, 22.44 +/- 3.24, 7.35 +/- 1.13, and 10.10 +/- 1.58 microgram/ml, respectively.

Adenocarcinoma↗

Immunologic studies on the cystic effusions of ovarian epithelial neoplasms.

Cystic effusions from 12 epithelial tumors of the ovary and pooled normal ovarian tissue were studied by immunodiffusion for the presence of immunoglobulins G (IgG), M (IgM), and A (IgA) and free secretory component (FSC). In pooled normal ovarian tissue, IgG was the only immunoglobulin detected. In the neoplastic samples studied, IgG was detected in each of the 12 samples (100%), IgM was found in 10 of the 12 samples (83%), and IgA was detected in 11 of the 12 samples (92%). There was no discernible correlation between the immunoglobulins detected and the composition of the effusions or the pathologic classification of the tumors. FSC was detected in all mucinous samples studied, malignant as well as benign. This substance was not detected in any of the nonmucinous samples or in pooled normal ovarian tissue. The data suggest a correlation between the presence of FSC and the mucinous composition of the tumor effusion. Possible use of FSC assays in the study of mucinous tumors of the ovary is discussed.

Adolescent↗