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Biomedical subjects

C C Rigby

Publications and source records attributed to C C Rigby.

18 recordsLinked to original sources

Atypical presentation of Crohn's disease: severe, recurrent iron deficiency anemia dependent on blood transfusions.

We report an unusual case of Crohn's disease. Our subject, a 43-yr-old lady, presented with severe iron deficiency anemia, hypoproteinemia and lymphocytopenia, but without any clinical manifestations of Crohn's disease either at presentation or during follow-up. She had recurrent episodes of severe iron deficiency anemia, repeatedly requiring blood transfusions (28 units in 20 months). She was found to have a short stricture with ulceration in the ileum due to Crohn's disease, and a blind loop with bacterial overgrowth above it. Resection of the affected area prevented further recurrence of anemia and corrected hypoproteinemia. We postulate that her anemia and hypoproteinemia were due to blood and protein (lymph) loss from the ulcerated area in the ileum. Such a presentation has not been described before.

Adult↗

Ceftazidime: a new approach in the treatment of moderate and severe infections.

Ninety patients with serious infections, including 61 with septicaemia, pneumonia, peritonitis or meningitis, were treated with ceftazidime. Of these patients, 85.6% were clinically cured (73.3%) or improved (12.2%) by the antibiotic. In this study, 57.7% had infections due to Escherichia coli (24.7%), Klebsiella sp. (14.5%) and Pseudomonas sp. (18.5%). Two children with cystic fibrosis and Pseudomonas pneumonia and an adult with Legionella pneumonia responded well to ceftazidime treatment. Seventy patients had fever before treatment and most of them became apyrexial in less than 2 to 3 days. Ceftazidime was given either intramuscularly (42 patients) or intravenously (48 patients), in a dose of 1 g tds in 71 patients or 2 g tds in severe infections in 11 patients, or reduced to suit the renal function (7 patients) or in paediatric doses (2 children). Blood ceftazidime levels were measured in eight patients with normal renal function. The average level one hour post dosing was 45.2 mg/l and the average trough level was 8.1 mg/l. Six patients were suffering from variable degrees of renal insufficiency (serum creatinine 149 to 668 mmol/l). Their average blood level 1 h post-dosing was 68.8 mg/l. In a patient with meningitis, the CSF level was 2.4 mg/l 2 h after a 1 g dose. These levels are several times the ceftazidime MIC values for most clinical bacterial isolates. Ceftazidime is a valuable and safe alternative to aminoglycoside therapy.

Adolescent↗

Prophylactic netilmicin in surgery.

Seventy-seven elective or emergency surgical patients were treated with a prophylactic course of netilmicin. Netilmicin (150 mg intramuscularly) was given 1 hour prior to operation and continued 12 hourly until the patient was free of risk of post-operative infection. There was no microbiological or clinical evidence of post-operative infection in general surgical or orthopaedic patients. Netilmicin seems to be less nephrotoxic than other aminoglycosides. Netilmicin serum levels were within expected values. Netilmicin was found to be an effective and well-tolerated antibiotic, and prophylactic treatment shortened the mean patient bed-stay and hence costs incurred.

Adult↗

Quantitative organ culture: an approach to prediction of tumour response.

Quantitative organ culture provides a simple in vitro method for assessing tumour responsiveness. The value of using 125IUdR incorporation as a reproducible index of DNA synthesis in organ culture has been investigated using human benign prostatic hyperplasia. From a study of the variables affecting the reproducibility, sensitivity and specificity of the method a simple technique was adopted. This method was applied to the study of the hormone-sensitivity of breast tumours, some of which showed a dose-response to 17 beta-estradiol. The criteria which must be applied to make such a test of clinical value are discussed.

Breast Neoplasms↗

Prostate carcinoma: intratumor BCG immunotherapy.

Two groups of patients with advanced cancer of the prostate received adjuvant immunotherapy by direct intra-tumor injection of BCG. The first group had advanced metastatic disease that was failing to respond to conventional hormone therapy. The second group were new cases of stages III and IV tumor who were previously untreated and who had had a transurethral resection of the prostate and orchiectomy followed by BCG immunotherapy. The clinical and pathologic findings for both groups of patients are described.

BCG Vaccine↗

Adjuvant immunotherapy with B.C.G. in carcinoma of the prostate.

8 previously untreated patients with Stage III and Stage IV prostatic cancer who had had the bulk of their primary tumour removed by transurethral resection, and residual tumour suppressed by bilateral total orchidectomy, were given adjuvant immunotherapy by direct injection of B.C.G. into the prostate. The pyrexial reaction to, and the histological changes from B.C.G. have been more marked in the patients whose disease is no longer controlled by conventional therapy. Granulomas have been found in the lungs, liver, myocardium, spleen and bone marrow. Granulomas in carcinomatous areas have been associated with tumour cell degeneration.

Aged↗

Experimental cellular allergic reactions in normal canine and malignant human prostate.

This paper describes the histopathology of chronic tuberculin-type hypersensitivity reactions in the normal canine and malignant human prostate. Seven dogs were sensitized by injection of Freund's complete adjuvant and the histological response to the subsequent intra-prostatic injection of 6 mg tuberculin PPD was documented. A chronic mononuclear cell prostatis persisted for 4 weeks and was accompanied by paracortical distension and follicular hyperplasia in regional lymph nodes. Six patients with carcinoma of the prostate were given multiple intraprostatic injections of BCG, which induced a chronic mononuclear cell prostatitis with some evidence of tumour-cell necrosis. The study indicated that the prostate can support chronic cell-mediated allergic reactions to extrinsic antigens and that intra-prostatic injections of BCG can be administered without harmful effects to patients with malignant prostatic disease.

Adenocarcinoma↗

A human tissue culture cell line from a transitional cell tumour of the urinary bladder: growth, chromosone pattern and ultrastructure.

Cell cultures were made from 18 human bladder tumours. Three cell lines were maintained for seven transfer generations, but all had a "fibroblastic" morphology and a normal diploid karyotype. A fourth line has been maintained for over 80 transfer generations. This was derived from a well differentiated papillary tumour of bladder. Morphologically the light and electron microscopic structure of the cells resembled that of bladder tumours. The cells formed tumour nodules, with a similar structure, when transplanted into hamster cheek pouches. There is a stem line chromosome number of 48. Karyotypes of 60% of the stem line cells had one extra chromosome in Group C and one in Group D.

Animals↗