Showing papers by "Rush University Medical Center published in 1981"

Diet, serum cholesterol, and death from coronary heart disease. The Western Electric study.

Abstract: Over twenty years ago, we evaluated diet, serum cholesterol, and other variables in 1900 middle-aged men and repeated the evaluation one year later. No therapeutic suggestions were made. Vital status was determined at the 20th anniversary of the initial examination. Scores summarizing each participant's dietary intake of cholesterol, saturated fatty acids, and polyunsaturated fatty acids were calculated according to the formulas of Keys and Hegsted and their co-workers. The two scores were highly correlated, and results were similar for both: there was a positive association between diet score and serum cholesterol concentration at the initial examination, a positive association between change in diet score and change in serum cholesterol concentration from the initial to the second examination, and a positive association prospectively between mean base-line diet score and the 19-year risk of death from coronary heart disease. These associations persisted after adjustment for potentially confounding factors. The results support the conclusion that lipid composition of the diet affects serum cholesterol concentration and risk of coronary death in middle-aged American men.

Psychological depression and 17-year risk of death from cancer.

Abstract: Psychological depression, measured in 1957-1958 by the Minnesota Multiphasic Personality Inventory at the baseline examination of 2,020 middle-aged employed men, was associated (p less than 0.001) with a twofold increase in odds of death from cancer during 17 years of follow-up. The association did not vary appreciably in magnitude among the early (1958-1962), middle (1963-1968), and later (1969-1974) years of follow-up, persisted after adjustment for age, cigarette smoking, use of alcohol, family history of cancer, and occupational status, and was apparently not specific to any particular site or type of cancer. This result, predicted in advance on the basis of findings by other investigators, is consistent with the hypothesis that psychological depression is related to impairment of mechanisms for preventing the establishment and spread of malignant cells.

Ultra-rapid high dose irradiation schedules for the palliation of brain metastases: final results of the first two studies by the Radiation Therapy Oncology Group.

Abstract: Between January, 1971, and February, 1976, the Radiation Therapy Oncology Group entered 1902 evaluable patients into two sequential Phase III national cooperative trials to study the effectiveness of different time dose radiotherapy schemes on the palliation of patients with brain metastases. Each trial included an optional arm into which patients were randomized to receive 1000 rad/1 fraction (26 patients, First study) or 1200 rad/2 fractions (33 patients, Second study). Comparisons were made with 143 control patients randomized by the same participating institutions to receive a more protracted course of irradiation (2000, 3000 or 4000 rad/1–4 wks). Response of patients receiving ultra-rapid treatment, as assessed by the percent who had improvement in neurologic function, was comparable to that of patients receiving the more protracted schedules. Promptness of neurologic function improvement, treatment morbidity and median survival were also comparable to those of patients receiving 2000 to 4000 rad. However, the duration of improvement, time to progression of neurologic status and rate of complete disappearance of neurologic symptoms were generally less for those patients who received 1000 or 1200 rad. These results suggest that ultra-rapid, high dose irradiation schedules may not be so effective as higher dose schedules in the palliation of patients with brain metastases.

The reorganization of subcellular structure in muscle undergoing fast-to-slow type transformation. A stereological study.

Abstract: Transformation of fast-twitch into slow-twitch skeletal muscle was induced in adult rabbits by chronic low-frequency stimulation and studied at the ultrastructural level. With the use of stereological techniques, a time course was established for changes in mitochondrial volume, sarcotubular system, and Z-band thickness for periods of stimulation ranging from 6 h to 24 weeks. T-tubules, terminal cisternae, and sarcoplasmic reticulum decreased at an early stage and reached levels typical of slow muscle after only 2 weeks of stimulation. Transformation of Z-band structure took place between 11/2 and 3 weeks after the onset of stimulation. Mitochondrial volume increased several fold over the first 3 weeks of stimulation, and fell rapidly after 7 weeks, although it still remained above the levels typical of slow muscle. Although there was no sign of degradation and regeneration of the muscle fibers themselves, considerable structural reorganization was evident at the subcellular level after 1 week of stimulation. The fibers passed through a less well organized transitional stage in which fibers could not be assigned to a normal ultrastructural category. After 3 weeks all of the stimulated fibers could be assigned to the normal slow-twitch category although some subcellular irregularities persisted even after 24 weeks. The ultrastructural alterations are discussed in relation to functional and biochemical changes in the whole muscle.

System for determining characteristics of blood flow

Abstract: Method and apparatus are disclosed for determination and display of hemodynamic characteristic values of a patient in a variety of statistical forms and in relative or absolute terms, the measurement determination being made by non-invasive impedance plethysmography under control of a central processor. A characteristic value representative of variation of blood vessel cross-sectional area is measured across a patient's body section, blood pressure is measured in the body in simultaneity with the characteristic value, and signals representative of the characteristic value and blood pressure are then processed to obtain the hemodynamic characteristic values.

Clinical, electrocardiographic and follow-up observations in patients having ventricular fibrillation during Holter monitoring. Role of quinidine therapy

Abstract: Ventricular fibrillation occurred during Holter electrocardiographic monitoring in 5 of 3,307 consecutive patients. All five patients had Holter studies for evaluation of antiarrhythmic drug therapy; their ages ranged from 51 to 65 years. No patient had acute myocardial infarction; all had congestive heart failure and severe left ventricular dysfunction. One patient had ischemic and four had nonischemic cardiomyopathy. All patients had recently begun treatment with oral quinidine and had plasma quinidine levels of 1.24 to 5.18 microgram/ml. The Holter monitoring revealed that all had a long Q-T interval and that ventricular fibrillation began during frequent ventricular premature beats and was immediately preceded by ventricular tachycardia of the torsade de pointes type. The coupling interval of the ventricular premature beats initiating torsade de pointes was late (440 to 720 ms) and followed long preceding cycles (840 to 1920 ms). Ventricular fibrillation resolved spontaneously in two patients, but two of the remaining three patients died despite attempted cardiopulmonary resuscitation. It is concluded that (1) left ventricular dysfunction, chronic ventricular arrhythmias and initiation of quinidine therapy were the common findings in these patients; (2) a long Q-T interval, late coupled ventricular premature beats and long preceding cycles facilitate initiation of ventricular fibrillation in quinidine-treated patients; and (3) direct on-line monitoring should be utilized in the management of these patients.

Correlation between numbers of desmosomes and the aggressiveness of transitional cell carcinoma in human urinary bladder.

Abstract: Quantitative electron microscopy has been used to examine the correlation between numbers of desmosomes and the histopathological grade and stage of papillary transitional cell carcinomas in human urinary bladder. Numbers of desmosomes (desmosomal density) per 100 micrometers of cell perimeter were quantitated in 6 examples of normal epithelium, 11 noninvasive papillary transitional cell carcinomas, 8 invasive transitional cell carcinomas arising from papillary lesions, 3 invasive transitional cell carcinomas which had prominent foci of glandular and squamous differentiation, and 1 squamous cell carcinoma. Desmosomal densities were increased in noninvasive transitional cell carcinomas, as compared with normal epithelium, but decreased in invasive transitional cell carcinomas. However, in areas of glandular or squamous differentiation in invasive tumors, desmosomal densities were increased, possibly reflecting the changes in cell phenotype. The decrease in numbers of desmosomes in invasive transitional cell carcinomas may contribute to reductions in cell adhesiveness.

Detection ofABH Tissue Isoantigens by Immunoperoxidase Methods in Normal and Neoplastic Urothelium: Comparison with the Erythrocyte Adherence Method

Abstract: The expression of the ABH blood group antigens (BGAg) by carcarinomas of the urinary bladder at the time of initial biopsy heralds a relatively benign clinical course, whereas antigen deletion in histologically similar tumors is often predictive of tumor recurrences and invasion. The use of BGAg as a tumor marker in the clinical setting has been limited by difficulties in demonstrating BGAg in tissue sections with the erythrocyte adherence test, especially for antigen H. In this study, immunoperoxidase methods were used to detect BGAg in deparaffinized tissue sections of normal and malignant human urothelium, and the results were compared with those of the erythrocyte adherence test performed on adjacent sections. Results with the two methods were similar for antigens A and B; however, a novel lectin-antilectin immunoperoxidase method was clearly superior for detecting antigen H. The immunoperoxidase method significantly reduced false-positive test results for antigen deletion in normal urothelium and more accurately predicted the subsequent clinical course in patients having urinary bladder cancer.

Method and apparatus for measuring mean cell volume of red blood cells

Abstract: Appareil et procede de production de signaux representant le volume moyen des globules rouges d'un echantillon sanguin. Apparatus and signal producing METHOD representing the mean volume of red blood cells of a blood sample. L'appareil comprend des moyens (310) de production de signaux representant la surface des cellules et des moyens (318) de mesure de la densite optique des cellules isolees et de production de signaux representant la teneur en hemoglobine ou la masse des cellules. The apparatus includes means (310) for producing signals representing the surface of cells and means (318) for measuring the optical density of the signal and producing isolated cells representing the hemoglobin concentration or mass of cells. La paleur centrale est mesuree pour les cellules presentant un phenomene de paleur centrale et des moyens (264) produisent un signal representant la paleur centrale de ces cellules. The central pallor is measured for cells presenting a phenomenon of central pallor and means (264) produce a signal representing the central pallor of these cells. Les signaux representant la surface, les signaux representant la teneur en hemoglobine et ceux representant la paleur centrale sont envoyes a des moyens (403, 415) produisant un resultat (430) representant le volume moyen des globules. The signals representing the surface, the signals representing the content of hemoglobin and those representing the central pallor are sent to means (403, 415) producing a result (430) representing the average volume of blood cells.

Antimicrobial properties of iron-binding proteins

Abstract: Iron-binding proteins of the transferrin type occur widely in various biological fluids. Serum transferrins (serotransferrins) are necessary to transport iron into the immature red cells of the bone marrow for hemoglobin synthesis, and to accept iron from the reticuloendothelial system as the latter destroys senescent or damaged red cells and releases iron from hemoglobin. The discovery of the transferrins is, however, closely related to another property thereof, i.e., the inhibition of bacterial growth. Thus, in 1944, Schade and Caroline discovered that raw egg-white was bacteriostatic and that this activity could be abolished by the addition of iron to the egg-white (Schade and Caroline, 1944). Two years later it was shown that the antimicrobial substance present in the egg-whites was a transferrin-type protein called conalbumin (Alderton et al., 1946), which had been discovered half-a-century earlier by Osborne and Campbell (1900), who were totally unaware of either the antimicrobial or the iron-binding properties of the protein. Schade and Caroline (1946) also described the antimicrobial properties of serotransferrin, which could also be abolished by the addition of iron. It is today recognized that serotransferrin has a function in host-defense mechanisms in addition to its function as a mediator of iron-cell interactions.

Integration of chemotherapy into a combined modality treatment plan for head and neck cancer: a review.

Abstract: This review highlights the most important recent advances in the chemotherapeutic management of patients with squamous cell carcinoma of the head and neck. Prior chemotherapy trials must be interpreted with caution in the absence of information concerning important prognostic variables, such as prior treatment, nutritional and performance status, and the heterogeneity of primary sites. In patients who have recurrent or metastatic disease, metbotrexate, platinum, and bleomycin are three active drugs when used as single agents. There is no evidence that high-dose metbotrexate therapy is superior to more conventional weekly intravenous methotrexate in the treatment of recurrent disease. Platinum is a new agent that has demonstrated activity against hemstogenous as well as regional disease. In the absence of evidence of a dose-response curve for platinum, the lower dosage schedules should be used that can be given with acceptable toxicity on an outpatient basis. Combination chemotherapy has resulted in a high proportion of objective responders and approximately 20% complete remissions to any of several platinum-contaialog regimens. However, the median duration of response remains short and none of the combination drug programs has been established as yet as superior to single agent chemotherapy in a randomized trial. Both single agent and combination chemotherapy programs have been used prior to initial surgery or radiation in patients with advanced inoperable but non-metastatic disease. Despite dramatically higher response rates over these obtained with the same drugs used in recurrent disease, there is as yet no evidence that chemotherapy given in this manner has resulted in improved disease-free or overall survival compared with local treatment alone. Similarly, the use of adjuvant chemotherapy following tumor clearance to eradicate potential micrometastic disease is currently under investigation and cannot be recommended in the absence of a controlled trial. This paper reviews the clinical trials currently in a progress both for patients with recurrent squamous cell carcinoma of the head and neck, as well as those with advanced local or regional disease.

Neuroendocrine Carcinomas with Multiple Immunoreactive Peptides and Melanin Production

Abstract: Two primary neuroendocrine skin carcinomas, one bronchial carcinoma, and one typical medullary thyroid carcinoma have been shown by immunohistochemistry and electron microscopy to contain two or more immunoreactive peptides as well as melanosomes and premelanosomes. Of the battery of antisera tested, somatostatin was the only material present in all four tumors; calcitonin and ACTH were present in three of the four neoplasms. Neurosecretory granules on the one hand and melanosomes on the other were more readily identifiable in separate cells. However, in at least 2 cases, individual cells were thought to contain both types of structures.Of the various explanations possible, we choose to interpret these tumors as complex neuroendocrine carcinomas comprising cellular populations capable of synchronous production of immunoreactive peptides and melanin. Since melanocytes are members of the dispersed neuroendocrine (APUD) system, these observations may not appear entirely surprising. Noteworthy, however, is th...

Deficiency of c7 with systemic lupus erythematosus. solubilization of immune complexes in complement‐deficient sera

Abstract: A woman with systemic lupus erythematosus (SLE) was found to have undetectable serum total complement (C) activity with marked reductions in levels of several C components. Recognition of rising C4, C3, and C5 levels coupled with sustained absence of hemolytic activity led to studies of individual C components that identified a persisting selective and complete absence of C7 hemolytic activity. Review of the literature indicated that the frequency of SLE is increased in patients with complete deficiency of a late-acting C component (7% as compared to 0.05% in the general population); however, the disease frequency is less than that observed in patients with complete deficiency of an early-acting C component (41% incidence in patients lacking C1, C4, or C2). In order to explore one possible basis for this association, the capacity of serum from the patient described herein and from patients with other C component deficiencies to mediate in vitro solubilization of immune complexes was studied by using a recently developed assay. The patient's serum had a markedly decreased capacity to induce solubilization of immune complexes, as did sera of other patients with active SLE and sera of individuals with inborn deficiencies of C1, C2, or C3 without SLE. By contrast, the sera of patients with a selective terminal C component deficiency (C5, C6, C7, or C8) but without SLE readily supported immune complex solubilization. These results suggest that patients lacking a terminal C component are predisposed to the development of SLE by a process which is independent of C-mediated immune complex solubilization. Whether the compromised capacity for C-mediated immune complex solubilization contributes to the even greater frequency of SLE in patients lacking an early-acting C component remains to be established.

Toxicology of the 8-aminoquinolines and genetic factors associated with their toxicity in man.

Abstract: In vitro studies on primaquine have been carried out to examine its ability to stimulate the oxidative pathway of glucose metabolism in human erythrocytes and in vivo studies were carried out after ingestion of the drug to determine plasma levels and to investigate the formation of metabolites and the effects of the drug on human erythrocytes. These investigations showed that: 1) Two mechanisms are involved in the stimulation of the oxidative pathway. This was demonstrated by comparing the effects of methylene blue, ascorbic acid, primaquine, and other drugs on normal, glutathione-reductase-deficient, and G6PD-deficient erythrocytes. A start was made towards classifying drugs according to the mechanism by which they stimulate CO2 production. 2) Following oral ingestion of primaquine, three as yet unidentified metabolites were present, two in the plasma and one in the urine. The rapid disappearance of primaquine from the plasma (within 24 hours) was confirmed. 3) Two factors that stimulate glucose oxidation in human erythrocytes were found in plasma; one occurred only in fresh plasma, when EDTA was present, and the other occurred in all plasma and serum samples studied. 4) The erythrocytes of blood drawn 24 hours after the ingestion of primaquine (after primaquine had disappeared from the plasma) showed increased ability to oxidize glucose. It is not yet known whether serum or plasma prepared from blood drawn 24 hours after ingestion of primaquine has the ability to increase the oxidation of glucose.