Biomedical subjects
Publications and source records attributed to W Petty.
We report a patient with squamous cell carcinoma of the cervix metastatic to the duodenum in whom the diagnosis was made at endoscopic biopsy of an obstructing pyloric mass. Failure to consider metastatic disease as the cause of an abnormal appearance of the duodenum resulted in a considerable delay in diagnosis. We present a brief review of cervical carcinoma metastatic to the bowel.
The amount of methyl methacrylate monomer present in bone tissue immediately adjacent to implanted bone cement that has polymerized in vivo has been determined. Poly(methyl methacrylate) was implanted into the distal femoral condyle of the dog and allowed to polymerize. At various times following polymerization, samples were removed and sections adjacent to the cement were cut and subjected to homogenization followed by liquid gas chromatographic determination of the amount of methyl methacrylate monomer present. The highest concentration of methyl methacrylate monomer present in bone tissue was 0.140% in the 1000 micrometers of bone tissue adjacent to bone cement immediately after polymerization of the cement. The concentration was very similar (0.137%) 1 hr after cement polymerization, but dropped off rapidly following that with no free methyl methacrylate monomer present in bone tissue adjacent to cement after 4 hr following cement polymerization.
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We evaluated twenty-one patients, one to eight years after removal of total hip-arthroplasty components because of infection. Sixteen of the patients had moderate to severe pain with either weight-bearing or sitting, and the other five had continuous moderate to severe pain. Twelve patients had an Iowa hip rating of less than 50 points, and the mean for the entire group was 49 points. All but three patients required a walker or crutches for walking. Only three patients were satisfied with the result of the resection arthroplasty. There was a suggestion that the patients with a smooth intertrochanteric line of resection of the proximal end of the femur had better results than those who did not. Patients whose wounds never healed had worse results than those whose wounds healed, but neither the initial treatment of the wound (open packing versus closed-tube irrigation) nor retained cement determined whether healing would occur.
Infection is not a common problem following implant surgery using the bone cement, polymethyl methacrylate. When infection occurs, its often disastrous results makes for major complications. Many methods have been used in an attempt to reduce bacterial contamination at the time of implant surgery, but little attention has been given to the problem of possible effects of implant materials on the immune mechanisms of the host. In the experiments reported here, the in vitro effect of methyl methacrylate monomer on human immunoglobulins was determined using a quantitative gel diffusion technique. When methyl methacrylate monomer was added to serum samples containing immunoglobulin, it caused no statistically significant change in the immunoglobulin concentration of immunoglobulin-G, immunoglobulin-A, or immunoglobulin-M. It is possible that methyl methacrylate could affect other types of antigen antibody reactions which may be important in resisting infection, but the evidence reported here indicates that in low concentrations, methyl methacrylate monomer does not affect the normal reactivity of immunoglobulins of the G, M, or A class.
The effect of methylmethacrylate on chemotaxis of polymorphonuclear leukocytes was evaluated by an in vitro method that involved migration of human leukocytes under agarose. Chemotactic factors produced during growth of Staphylococcus epidermidis, Staphylococcus aureus, and Escherichia coli remained chemotactically active in the presence of a methylmethacrylate concentration of 1.25 per cent, which was the highest tested. The methylmethacrylate also did not alter the activity of the chemotactic factor produced by zymosan activation of normal human serum. However, when methylmethacrylate was added to normal human serum prior to zymosan activation, a methylmethacrylate concentration of 0.312 per cent significantly depressed the subsequent zymosan-induced chemotactic activity and concentrations above 0.312 per cent abolished it. When methylmethacrylate was added to the polymorphonuclear leukocyte suspensions, there was significant depression of the migration of cells at a concentration of 0.312 per cent, and at concentrations of 0.625 and 1.25 per cent no leukocyte migration occurred.
In vitro evaluation of the effect of known concentrations of methylmethacrylate on the bacterial inhibiting properties of normal human serum has been carried out. In low concentrations, methylmethacrylate was found to abolish almost completely the growth inhibition of Staphylococcus epidermidis by normal human serum. Normal human serum did not have an effect on growth of Staphylococcus aureus. It did inhibit growth of Escherichia coli, but there was no reversal of this effect by methylmethacrylate.
The phagocytic and bactericidal activities of human polymorphonuclear leukocytes in the presence of methylmethacrylate were determined by in vitro techniques. It was found that methylmethacrylate in concentrations as low as 0.156 per cent significantly decreased the ability of leukocytes to phagocytose and kill strains of Staphylococcus epidermidis, Staphylococcus aureus, and Escherichia coli. The evidence indicates that methylmethacrylate impairs the killing more than the phagocytosis by the leukocytes.
The effect of methylmethacrylate on the activity of the complement sequence has been investigated in vitro by standard hemolysis techniques. It was demonstrated that concentrations of methylmethacrylate monomer as low as .25% inhibit the reactions of the complement sequence by 50%. Methylmethacrylate concentrations of 2.5 to 5.0% abolished all complement activity. This effect is on the late-acting components of the complement sequence which are important for chemotaxis of polymorphonuclear leukocytes, immune adherence of bacteria to polymorphonuclear leukocytes, phagocytosos of bacteria by polymorphonuclear leukocytes, and bacteriolysis.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.