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Biomedical subjects

W F Taylor

Publications and source records attributed to W F Taylor.

At least 127 records · Page 7Linked to original sources
PubMed1978

Calcium flux during hemodialysis.

A system of equations has been derived, and examined, to decribed membrane permeability and calcium fluxes within a commonly used hemodialyzer, the Mini-Kiil. By a statistical technique of sequential multiple regression analysis, factors which might influence these variables were tested on data derived from 74 hemodialysis periods in 5 patients. Calcium flux from plasma to dialysate was influenced positively by dialysate calcium concentration and plasma volume flow and negatively by dialysate volume flow. Calcium flux from dialysate to plasma was influenced positively by dialysate calcium concentration and plasma volume flow and negatively by plasma phosphate concentration. Net calcium flux from dialysate to plasma was influenced positively by the calcium gradient (dialysate calcium minus plasma ultrafiltrable calcium) and plasma volume flow and negatively by plasma phosphate concentration (coefficient of multiple correlation =0.970). Because of the magnitude of regression coefficients, manipulations of the dialysate calcium concentration and plasma phosphate concentration were concluded to be the most practical means of adjusting calcium delivery during dialysis.

Calcium↗
PubMed1978

Trends and variability in survival from osteosarcoma.

Survival of patients with primary osteosarcoma who received traditional surgical management has been very poor. Several studies have reported the percentage of patients alive 3 years after first treatment to be between 20 and 25%. In a study of such patients first treated at the Mayo Clinic between Jan. 1, 1963, and July 1, 1974, the survival noted in the first few years was typical of that of other reports, about 25%. However, by 1972 through mid-1974, the 3-year survival had become 50%. This improvement was not the result of adjuvant treatment or any basic change in type of patient treated, yet it is similar to that reported in connection with some of the new adjuvant therapies used in trials depending on historical controls. Our results cast doubt on findings made in the absence of concurrent, randomly selected controls.

Adolescent↗
PubMed1978

Adjuvant therapy for nonmetastatic osteogenic sarcoma: an evaluation of transfer factor versus combination chemotherapy.

A randomized study compared the effects of combination chemotherapy (high-dose methotrexate, adriamycin, and vincristine) with immunotherapy in the form of transfer factor in the adjuvant treatment of patients with nonmetastatic osteogenic sarcoma after apparent complete surgical ablation of the primary tumor. Thirty-two patients were evaluated. Of 22 patients who received chemotherapy, three died of drug-related complications and six were alive without disease recurrence between 260 and 673 days after operation. Ten patients in the transfer factor group converted their markers, and of these, five were alive without recurrence 420--753 days after operation. Neither treatment program was considered superior with respect to disease-free survival.

Bone Neoplasms↗
PubMed1978

Cell-mediated cytotoxicity in chronic active liver disease: a new test system.

An in vitro cytotoxicity system was developed for studying patients with chronic active liver disease using as the target cells 51Cr-labeled avian erythrocytes coated with cell membrane lipoprotein extracted from human liver and, as the aggressors, mononuclear cells from peripheral venous blood. Approximately 50% of 62 patients with chronic active liver disease showed cytotoxicity in this test system as did 5% of 100 apparently healthy controls. In addition, mild cytotoxicity was shown by 2 of 8 patients with the primary biliary cirrhotic syndrome and 2 of 17 persons with other liver diseases. No specific antibody was added to the test system and the cytotoxicity could be inhibited by free lipoprotein, antilipoprotein, and by aggregated Ig. Cytotoxicity also was abolished by the depletion from the mononuclear cells of cells phagocytic for iron filings. The effect of depletion of these phagocytic cells was not restored by the addition of 2-mercaptoethanol. These findings add further evidence that autoimmune responses to liver tissue occur in many patients with chronic active liver disease and, importantly, suggest also that these may occur in some apparently healthy people.

Adolescent↗
PubMed1978

Liver biopsy: complications in 1000 inpatients and outpatients.

We prospectively evaluated risk factors in 1000 consecutive patients who underwent liver biopsy: 829 outpatients and 171 inpatients. The two groups were similar except that the outpatient group had a higher percentage of patients with hepatitis-cirrhosis and a lower percentage with neoplasia when compared with the inpatient group (P less than 0.01). The inpatient group had more relative contraindications (P less than 0.01). Among the 1000 patients, none died and none required laparotomy. If moderate to severe pain or hypotension or both developed (5.9%), they first became manifest during a 3-hr period of observation after biopsy. Forty-four outpatients (5.3%) were hospitalized; 39 were dismissed within 36 hr and 5 within 4 days. Complications were more often experienced by those with relative contraindications (P less than 0.05) and increased number of passes (P less than 0.01). Inpatients with hepatitis-cirrhosis experienced more complications (P less than 0.05) than did patients with other diagnoses (12.8 versus 3.8%). Complications were not related to type of needle, site of entry, or experience of operator. Liver biopsy as an outpatient procedure is safe if facilities are available for 3 hr of observation and hospital support; 5% of patients will require immediate hospitalization.

Adult↗
PubMed1977

A prospective comparison of current diagnostic tests for pancreatic cancer.

In 70 patients suspected of having pancreatic cancer, we prospectively compared results of seven diagnostic tests. Subsequent exploration (of 68) and liver biopsy (of two) demonstrated pancreatic cancer in 30, pancreatitis in seven, nonpancreatic neoplasms in nine and nonpancreatic non-neoplastic disease (or no disease) in 24. For detection of pancreatic disease, the best tests were the pancreatic-function test (cholecystokinin-stimulated enzyme outputs) and ultrasonography. The pancreatic scan was nonspecific (P less than 0.001), and thermography was insensitive (P less than 0.001). Endoscopic retrograde pancreatography and arteriography were significantly more sensitive than cytologic study in diagnosis of pancreatic cancer (P less than 0.001). Therefore, when pancreatic cancer is suspected, abdominal ultrasound should be performed first, and if it is negative, a pancreatic-function test next. A positive result from either test warrants an endoscopic retrograde pancreatography for definitive diagnosis. This sequence identified 88 per cent of patients without pancreatic disease and 89 per cent with pancreatic cancer.

Adult↗
PubMed1977

Cardiac death in mucocutaneous lymph node syndrome.

A 12 year old boy had 4 symptom-free years after hospitalization for acute febrile mucocutaneous lymph node syndrome before he died suddenly from extensive myocardial infarction. Current evidence suggests that many patients with this syndrome have coronary artery disease and that those with significant cardiac findings should be studied with coronary angiography. Serial studies are recommended because of the danger of sudden death.

Autopsy↗
PubMed1977

Abnormalities of endogenous glucagon and insulin in unstable diabetes.

The responses of glucagon, growth hormone, and insulin secretion to the oral administration of glucose and to the intravenous infusion of saline, arginine, and insulin were measured in seven patients who had stable diabetes, eight who had unstable diabetes, and seven healthy volunteers. Hyperglycemia suppressed secretion of glucagon in normal subjects but not in diabetics. The oral glucose and arginine infusion tests demonstrated partial preservation of insulin-secretory ability in stable diabetics and its virxual absence in unstable diabetics. Glucagon responses to arginine infusion were similar in all three groups. In response to hypoglycemia induced by insulin infusion, the concentrations of plasma glucagon increased in normal subjects and, to a lesser extent, in stable diabetics but increased in only two of the unstable diabetics. The impairment in glucagon response during hypoglycemia in diabetics correlated positively with the degree of diabetic instability and insulin deficiency during glucose and arginine testing. The severity of the insulin deficiency also correlated with the degree of diabetic instability. These findings support the hypothesis that inherent abnormalities of insulin and glucagon secretion may account for many of the clinical characteristics of unstable and stable diabetic patients.

Adult↗
PubMed1977

The effect of fixation with intramedullary rods and plates on fracture-site blood flow and bone remodeling in dogs.

Of fifty-seven adult dogs in which standard bilateral mid-ulnar fractures were produced, thirty-four had one side fixed with either a tight-fitting intramedullary Steinmann pin or a four-hole plate while the other side was not fixed, and twenty-three had a plate on one side and an intramedullary rod on the other. The blood flow at the fracture site, as determined by 85Sr clearance, was significantly less on the rod-fixed side than on the plate-fixed side at fourteen and ninety days, while the total ulnar blood flow was significantly higher on the rod-fixed than on the platefixed side at one and fourteen days but was the same on both sides thereafter. When the plate-fixed and rod-fixed fracture sites in the same dog were compared with respect to periosteal and endosteal bone formation as determined by tetracycline labeling anc microradiography, bone formation, like the blood flow, was greater in the callus of the ulnae fixed by plates. However, at ninety days, when healing had advanced to a point when the extent of union could be judged clinically, union had occurred in both ulnae of six of the seven dogs with both types of fixation studied at this time and was delayed in both ulnae of the remaining dog.

Animals↗
PubMed1976

Cancer of the hypopharynx. Analysis of treatment and results in 162 patients.

Between 1962 and 1972, 190 patients with squamous cell carcinoma of the hypopharynx were seen; 162 received primary treatment at our clinic. Of the 162 lesions, 117 (72%) originated in the pyriform sinus. The most frequent symptom was pain in the throat (87 patients, 54%). One hundred twenty six patients (78%) had tumors extending beyond the hypopharynx (T3 lesions), and 108 patients (67%) had cervical metastasis (stage III or IV). Treatment modalities included surgical excision in 82 patients, radiation in 39, planned combination of preoperative radiation followed by surgery in 18, radiation plus neck dissection in 15, and surgery plus postoperative radiation in eight. Sixty-nine patients (43%) had recurrent tumor. Recurrences were equally frequent in the primary site and the neck. Comparison of treatment modalities showed no differences in overall recurrence. Surgery alone or in combination with radiation reduced the incidence of local recurrence; however, when recurrences were analyzed in relation to stage of lesion, preoperative or postoperative radiation and surgery offered no advantage over surgery alone in reducing local or neck recurrence or in overall survival rate. Treatment by radiation alone was associated with a poorer survival. For the entire group, three-year survival was 52% and five-year survival was 47%.

Aged↗
PubMed1976

Transfer factor versus combination chemotherapy: a preliminary report of a randomized postsurgical adjuvant treatment study in osteogenic sarcoma.

Twenty-six patients with classic osteosarcoma were randomized to receive either transfer factor or combination chemotherapy. Eight of 14 patients who received transfer factor converted their skin test markers, evidence of activity of the transfer factor. Of these eight patients, all are alive; four are free of disease. Of the 18 patients who received combination chemotherapy, 14 are alive, 12 of whom are free of disease. The immunologic test procedures performed sequentially reveal that transfer factor appears to enhance cell-mediated immunity, but it is evident that in this study, a control (saline) arm in the protocol could not be included. It is of interest that the chemotherapy regimen used does not appear to suppress such activity permanently. The individual test results, however, are not very helpful for predicting response to treatment. The small numbers of patients and the short duration of this study, combined with the exclusion of parosteal osteogenic sarcomas and jaw tumors, do not permit a meaningful comparison with other published studies.

Antineoplastic Agents↗
PubMed1976

Controlled study of CCNU and radiation therapy in malignant astrocytoma.

The authors report 63 patients with biopsy-proved malignant (Grades 3 and 4) astrocytomas who were randomly placed in one of three treatment schedules within 2 weeks of surgery. One group (22 patients) received radiation therapy alone; the second group (22 patients) received 1-(2-chloroethyl)-3-cyclohexyl-1-nitrosourea (CCNU) orally at intervals of 8 weeks; and the third group (19 patients) received combined radiation and drug therapy. Patients who received radiation therapy, with or without the drug, had a significantly longer survival than did those who received the drug alone. There was no difference in survival between the two groups who received radiation. The nitrosourea derivative CCNU does not seem to be an effective agent in the therapy of primary malignant brain tumors.

Adult↗
PubMed1976

Who responds to sugar pills?

Among 288 cancer patients undergoing controlled trials of oral analgesics there were 112 who received 50% or greater pain relief from placebo formulations. Patients who responded to placebo had a greater response rate to active drugs. They also had a higher incidence of central nervous system side effects to placebo. Patient groups showing as increased placebo response included those with a high level of education, farmers, those with a professional occupation, women working outside the home, and patients who were widowed, separated, or divorced. Those resistant to placebo were patients with a low educational level, unskilled workers, housewives, married women without children, and smokers. It is theorized that placebo response is a type of autohypnosis phenomenon resulting from exaggerated oral-dependency needs. Particularly vulnerable to placebo effect is the very self-sufficient individual with heavy responsibilities who is thrust into the unaccustomed dependency of disabling illness.

Aged↗
PubMed1976

The primary surgical treatment of carcinoma of the breast: a changing trend toward modified radical mastectomy.

To study the effectiveness of a trend at the Mayo Clinic toward modifying the standard radical mastectomy, the 5-year survival of 873 women treated surgically for breast cancer from 1965 through 1968 was evaluated. The observed survival of 534 patients treated by the standard radical mastectomy was 85% when nodes were negative and 56% when nodes were positive. For 339 patients treated by the modified radical mastectomy, the observed survival was 80% and 48% when axillary nodes were negative and positive, respectively. In order to accomplish a more significant analysis of cancer risk and results of the two operative procedures, a relatively homogeneous group of 541 patients was established from the total group. In this homogeneous group, the observed survival of 336 patients treated by the standard radical mastectomy was 86% when nodes were negative and 66% when nodes were positive. For 205 patients treated by the modified radical mastectomy, the observed survival was 84% and 66% when axillary nodes were negative and positive, respectively. When patients were further analyzed and compared according to the extent of axillary-node involvement, age at the time of treatment, grade, size, location, and histopathologic type of tumor, and the use of postoperative irradiation, survival was essentially the same, irrespective of the type of mastectomy performed.

Adult↗
PubMed1976

Hemoccult stool tests: false-negative results due to storage of specimens.

Stoll samples mixed with 0 to 38 mg of hemoglobin per gram of stool were tested for occult blood by the Hemoccult (HO) method when fresh and after storage for 1 to 14 days. The intensity of the HO reaction in fresh stool samples was directly related to the hemoglobin concentration, and approximately 8 mg/g was required for a positive reaction. After samples had been stored on HO cards for 4 days, the intensity of the HO reaction was decidedly less in all. Except at the highest concentrations studied, all became HO-negative or trace within 8 days. In contrast, samples of most concentrations that were stored in tightly capped containers prior to preparation of HO cards maintained a positive reaction intensity for 1 week. Nevertheless, the intensity of the HO reaction decreased significantly (P less than 0.01) with each method of storage. No false-positives were induced by storage during this portion of our study. Samples from 100 stool specimens sent to the clinical laboratory for determination of occult blood were also smeared on separate HO cards for testing immediately and after 4, 7, or 10 days of storage. Only one positive HO reaction was observed on an HO card prepared from a specimen initially classified as HO-negative. In contrast, up to 40% of the stored HO cards prepared from specimens initially classified as HO-positive were HO-negative when analyzed 4 days later.

False Negative Reactions↗