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Biomedical subjects

A C Templeton

Publications and source records attributed to A C Templeton.

At least 19 recordsLinked to original sources

The role of ultraviolet B-irradiated leukocyte transfusions and cyclosporine in intestinal transplantation.

To explore the efficacy of ultraviolet B-irradiated donor-specific leukocyte transfusions (UV-DSLT) with short-term cyclosporine to control intestinal allograft rejection, 75 adult Lewis (RT1l) rats underwent total small-intestinal transplantation from Brown-Norway (RT1n) donors. Recipients were randomly divided into ten treatment and control groups utilizing various combinations of donor-specific and third-party (Wistar-Furth, RT1u) leukocyte transfusions (TPLT), with or without transfusion UVB irradiation, and either alone or in combination with short-term cyclosporine administration (5 mg/kg intramuscularly on days -7, 0, 1, and 2 relative to transplantation). Leukocytes (10(8) cells) separated from a spleen cell suspension were infused on day -7. Certain transfused leukocytes were treated with 12,000 joules/m2 of UVB irradiation. Groups were monitored for mean survival time (MST) and cause of death. UV-DSLT alone (MST = 19.8 +/- 4.6) or in combination with cyclosporine (UV-DSLT+CsA, MST = 53.1 +/- 22.5) significantly (P less than 0.003-0.0002, Mantel-Cox) prolonged recipient survival when compared with appropriate controls (i.e., no treatment, MST = 11.2 +/- 3.4; CsA, MST = 17.2 +/- 9.0; UV-TPLT, MST = 12.4 +/- 4.0; and UV-TPLT+CsA, MST = 25.1 +/- 9.7) No significant increase in graft-versus-host disease occurred in any group, with 85% (64/75) of the recipients dying of acute rejection. Conversely, the UV-DSLT+CsA group had a significant increase (9/11; chi-square, P less than 0.0001) in chronic rejection. Because UV-DSLT+CsA improved survival as compared with third-party controls, a limited donor-specific unresponsiveness may have been induced. Furthermore, this treatment produces a consistent, chronic rejection rodent intestinal allograft model.

Animals

Radiation-induced sarcoma of the thyroid.

A 23-year-old white man presented with a thyroid mass 12 years after receiving high-dose radiotherapy for a T2 and N1 lymphoepithelioma of the nasopharynx. Following subtotal thyroidectomy, a histopathologic examination revealed liposarcoma of the thyroid gland. The relationship between sarcomas and irradiation is described and Cahan and colleagues' criteria for radiation-induced sarcomas are reviewed. To our knowledge, we are presenting the first such case of a radiation-induced sarcoma of the thyroid gland.

Adult

Femoral capital osteonecrosis: MR finding of diffuse marrow abnormalities without focal lesions.

Six painful hips in five patients were examined with magnetic resonance (MR) imaging and were found to have diffuse signal abnormalities in the marrow of the femoral head and neck, which extended into the intertrochanteric area in five cases. The abnormal regions were low in signal intensity on images obtained with a short repetition time (TR) and a short echo time (TE) and were isointense or hyperintense on long TR/TE images--findings that have been attributed by others to bone marrow edema. Edema was also seen in marrow just above the acetabulum in two cases. No focal abnormalities characteristic of osteonecrosis were seen. Osteonecrosis was subsequently shown to be present in all six femoral heads at core biopsy (three cases) or by subsequent development of focal MR abnormalities reported to be highly specific for osteonecrosis (three cases). The affected hips had been radiographically normal or subtly osteopenic and had shown intense radionuclide uptake in the femoral head at scintigraphy, with lesser abnormality in the neck and intertrochanteric region. Follow-up MR examinations of five of the six femoral heads showed the diffuse abnormalities to have been transient. Although diffuse MR abnormalities in the proximal femur are not specific, they may indicate the presence of osteonecrosis of the femoral head.

Adult

The size of breast masses at presentation. The impact of prior medical training.

Five hundred and sixty-nine patients with breast cancer presenting for treatment at a community hospital were studied. The results showed no significant change in tumor size at presentation or reported patient delay over a 12-year span. This was in spite of considerable national discussion and increasing public concern about this disease during this period. We compared this patient group with a group of 27 cancer patients with training in health professional fields: seven of these 27 women reported delays of more than six months between discovery of a mass and reporting to a physician. Their masses were somewhat larger than those of women not medically trained (3.82 versus 3.47 cm). These results suggest a need for re-evaluation of the impact of medical education on an individual's reaction to personal health care.

Attitude of Health Personnel

Neurocristopathies in African subjects.

The distribution of neural crest cells is briefly reviewed. The behaviour of neural crest derivatives in Africans is different from that seen in Caucasians, both in terms of physiology and pathology. The most obvious variation is in the depth of pigmentation of the skin, but most diseases of neural crest derived tissues show differences between Black and White subjects. The reason for these differences are not readily apparent but appear to be of genetic rather than environmental origin.

Ameloblastoma

Tumour of the sciatic nerve.

A malignant neurilemmoma of the sciatic nerve is described. The requisites for making this diagnosis are discussed. It is pointed out that such tumours are commonly misdiagnosed as lumbar intervertebral discs and that local examination of the leg along the course of the sciatic nerve should be carried out on every patient complaining of sciatica.

Adult

Changing pattern of residual tumor in Burkitt lymphoma: findings at autopsy.

Autopsies were performed on 47 patients who died of Burkitt lymphoma in Uganda between 1967 and 1971. The patients were separated into four groups based on the duration of survival from the time of diagnosis. Twenty patients survived less than three weeks; all had massive tumors. Six patients died between 10 and 16 weeks after diagnosis, usually from side effects of drug therapy. Of 16 patients who died between 24 and 52 weeks after diagnosis, 13 showed involvement of the central nervous system. Five patients died one year or more after diagnosis; two had a late relapse following a disease-free interval of one and four years, respectively; the other three had survived with clinically apparent tumor that was not responsive to therapy. In recent years, there has been a steady reduction in the proportion of patients showing residual systemic involvement at autopsy. This reduction is balanced by an increase in the proportion of patients with lesions of the central nervous system.

Autopsy

Prognosis in Kaposi's sarcoma.

We studied and followed up 112 African patients with Kaposi's sarcoma for at least 3 years or until death to determine what features of the disease at presentation most accurately predicted the prognosis. The clinical pattern of disease at presentation was most important. All patients with generalized disease died of their disease; the only deaths among those with nodular disease were due to intercurrent illness. The 3-year survuval rate among patients with locally aggressive lesions with 64%. We could obtain greater refinement of prognosis by noting the response to a dinitrochlorobenzene challenge, the presence of nodal involvement, and the histologic pattern of the tumor. The age and sex of the patient influenced the pattern of disease likely to be found, but the prognosis for a given clinical pattern was the same in both sexes and at different ages.

Adolescent