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Biomedical subjects

J A Butler

Publications and source records attributed to J A Butler.

At least 73 records · Page 4Linked to original sources
PubMed1989

Colorectal cancer in patients younger than 40 years of age.

To assess prognostic factors in patients who develop colorectal cancer before the age of 40 years, a 30-year experience from 1956 through 1985 was reviewed. There were 50 patients ranging in age from 7 to 39 years. Five cases were associated with either ulcerative colitis (2) or familial polyposis (3). The most common presenting symptoms were abdominal pain (66 percent), hematochezia (60 percent), change in bowel habit (41 percent) and weight loss (30 percent). On pathologic staging (N = 44), only 14 of 44 (31 percent) had a Dukes' stage A or B lesion, 20 (45 percent) had Dukes' stage C, and the remaining 10 (23 percent) had distant metastases at the time of surgery. Five-year survival rate was 28 percent with a disease-free survival rate of 18 percent. Median survival was only 28 months. Negative prognostic factors were Dukes' stage C/D (P less than .001), symptom duration of longer than 3 months (P = .01), noncaucasian ancestry (P = .01), and poorly differentiated histology (P = .06). In contrast to older patients with colorectal cancer, only 1 of 30 (3 percent) patients with stage C D disease was disease-free at 5 years. In view of the poor survival rate associated with both delay in diagnosis and the presence of advanced disease, it was concluded that young patients presenting with the symptoms listed above need early, aggressive evaluation for possible colorectal cancer.

Adenocarcinoma↗
PubMed1989

Fine-needle aspiration biopsy in the diagnosis of recurrent and metastatic intraabdominal malignancies.

To evaluate the efficacy of directed percutaneous fine-needle aspiration (FNA) biopsy in the diagnosis of recurrent and metastatic intraabdominal malignancies, we reviewed our experience from 1981 to 1988. Seventy-three aspirations were performed in 73 patients. Forty-six patients with a previously treated malignancy had aspiration to diagnose either locally recurrent or metastatic disease. The remaining 27 patients had liver aspiration to rule out metastases from suspected or unknown primary sites. Computed tomography and ultrasonography were equally effective in providing diagnostic material, which was obtained from 68 of 73 aspirates. No serious morbidity occurred. Fifty-seven patients had a metastatic or recurrent malignancy, and 3 had primary hepatocellular carcinoma. Fine-needle aspiration biopsy correctly identified 51 (85 percent) of these 60 cases. There were no false-positive results and five false-negative results. Aspiration results obviated the need for a diagnostic laparotomy in 49 of the 60 patients with malignancy (82 percent). We conclude that directed percutaneous FNA biopsy is a safe and accurate method of diagnosing recurrent and metastatic intraabdominal malignancies.

Abdominal Neoplasms↗
PubMed1989

Total gastrectomy in the treatment of advanced gastric cancer.

To assess the role of total gastrectomy in the treatment of advanced gastric cancer, we reviewed the records of 27 patients who underwent the procedure from 1979 to 1988. Operative mortality was 4 percent (1 of 27), and postoperative morbidity occurred in 48 percent of the patients. Twenty-five of 26 patients were tolerating solid food at the time of discharge; 21 were able to maintain oral alimentation until just prior to their death. Median survival following the operation was 15 months (range: 2 to 110 months), with a 62 percent absolute 1-year survival rate and a 38 percent 2-year survival rate. On the basis of these results, we conclude that in patients with advanced gastric carcinoma, total gastrectomy with Roux-Y esophagojejunostomy can be performed with an acceptable morbidity and mortality, provides significant palliation by restoring the patient's ability to eat, and should be performed when technically feasible, even in the presence of gross residual disease.

Adult↗
PubMed1989

Hepatic artery versus portal vein and systemic infusion of fluorodeoxyuridine of rabbit VX-2 hepatic implants.

To compare the efficacy of regional and systemic infusions of hepatic tumors, and to correlate this with tumor perfusion, 29 New Zealand white rabbits underwent perfusion of VX-2 hepatic implants. Tritium-labeled fluorodeoxyuridine (H3-FUDR) and technetium-99m-labeled macroaggregated albumin (Tc 99m-MAA) were infused through the hepatic artery, portal vein, and peripheral vein. Hepatic artery infusion resulted in a significantly improved tumor-to-liver ratio of FUDR uptake (p less than 0.001). The increased tumor uptake correlated with a two-fold increase in tumor arterial blood flow as compared with normal liver demonstrated by the MAA infusion. We conclude that infusional therapy is superior to both portal vein and systemic infusions. Portal vein infusion results in no uptake of drug by the tumor. Hepatic artery scintigraphy with MAA may be useful in selecting appropriate patients for this type of therapy.

Animals↗
PubMed1989

Age-related changes in protein phosphorylation by rat hepatocytes.

The qualitative and quantitative changes in the phosphorylation of specific proteins in hepatocyte suspension from 5-, 12- and 22-month-old male Fischer F344 rats were analyzed by two-dimensional polyacrylamide gel electrophoresis. No qualitative changes in phosphorylation of individual proteins were observed with age. In addition, very few quantitative changes (less than 2% of proteins studied) in protein phosphorylation were detected. The phosphorylation of two acidic proteins decreased (50%) with age while the phosphorylation of one basic protein increased (300%) with age. The two acidic proteins and one basic protein that showed quantitative changes with age were found predominately in the microsome and nuclear fractions of hepatocytes, respectively. The effect of dietary restriction on the phosphorylation of proteins in male Fischer F344 rats was also studied. Although, dietary restriction alters the age-related incident of disease and prolongs longevity, it did not have any significant effect on phosphorylation of individual proteins in the liver.

Aging↗
PubMed1989

Influence of dietary methionine on the metabolism of selenomethionine in rats.

To determine the influence of methionine on selenomethionine (SeMet) metabolism, weanling male rats were fed for 8 wk a basal diet marginally deficient in sulfur amino acids, containing 2.0 micrograms selenium (Se)/g as DL-SeMet and supplemented with 0, 0.3, 0.6 or 1.2% DL-methionine. Increased dietary methionine caused decreased selenium deposition in all tissues examined but increased glutathione peroxidase (GSHPx, EC 1.11.1.9) activity in testes, liver and lungs. A positive correlation was found between dietary methionine and the calculated percentage of selenium associated with GSHPx. In a second experiment, 75SeMet was injected into weanling male rats which had been fed the basal diet containing 2.0 micrograms selenium as DL-SeMet with or without the addition of 1.0% methionine. The selenoamino acid content of tissues and the distribution of 75Se in erythrocyte proteins were determined. In comparison to the rats fed the basal diet without added methionine, significantly more 75Se-selenocysteine was found in liver and muscle, more 75Se was found in erythrocyte GSHPx and less 75Se was found in erythrocyte hemoglobin of rats fed 1.0% methionine. These data suggest that methionine diverts SeMet from incorporation into general proteins and enhances its conversion to selenocysteine for specific selenium-requiring proteins, such as GSHPx.

Administration, Oral↗
PubMed1989

Patterns of response in families of chronically disabled children: an assessment in five metropolitan school districts.

Interviews with parents of 1,726 special education students yielded reports of stress that varied significantly by type of disability and by maternal education level; family involvement in the special education process also varied significantly by level of education. Clinically important differences in family perceptions and coping mechanisms are described and the need for better child care provisions and involvement of low-income parents in the education process is highlighted.

Adaptation, Psychological↗
PubMed1988

Efficacy of directed percutaneous fine-needle aspiration cytology in the diagnosis of intra-abdominal masses.

Directed percutaneous fine-needle aspiration (FNA) cytology was performed on 113 patients with intra-abdominal masses. The 47 male and 56 female patients had a median age of 56 years (range, 17 to 83 years). Computed tomography (CT) was used to localize the needle in 90 cases, and ultrasonography was used in the remaining 24 cases. The predominant sites aspirated were the liver (n = 40), pancreas (n = 23), and pelvis (n = 14). Seventy-eight of the 113 patients had a malignant neoplasm. Fine-needle aspiration cytology correctly identified 63 (88%) of the 78 cases. There were no false-positive studies. Computed tomography and UTZ ultrasonography were equally sensitive in detecting malignant neoplasms. In 38 patients with a history of previously treated malignant neoplasm, percutaneous aspiration cytology confirmed the presence of recurrent disease in 24 (75%) of 32 patients. Results of aspiration cytology obviated the need for a diagnostic laparotomy in 51 (65%) of the 78 patients with a malignant neoplasm. There was no serious morbidity or mortality associated with the procedure. We conclude that CT/ultrasonography-directed percutaneous FNA cytology is the procedure of choice in the workup of patients with intra-abdominal masses. The specificity is 100% and sensitivity is 90%. It is particularly useful in patients with extensive disease that would not be palliated by operation.

Abdominal Neoplasms↗
PubMed1988

Phagocytic labeling of leukocytes with 99mTc-albumin colloid for nuclear imaging.

A procedure is described for the phagocytic labeling of white blood cells (WBC) with high specific activity 99mTc--albumin colloid (TAC). The preparation contains approximately equal activities of granulocytes and monocytes. Heparinized whole blood (40 cm3) yields a preparation containing a total of 148-222 MBq (4-6 mCi) TAC-WBC including about 20% free TAC. The complete preparation time is 75 min. Imaging is completed 30 min to 4 h post administration of the TAC-WBC. Quality control methods and imaging protocols are described.

Adult↗
PubMed1988

Cadaveric renal transplantation: surgical results and expectations in the cyclosporine era.

During a 36-month period 100 patients received 104 cadaveric renal transplants with cyclosporine-based immunosuppression. Of the patients 26 required 31 additional operations. Of the 19 secondary operations performed 1 month after transplantation 18 were emergency in nature, whereas beyond this period the majority of the procedures were elective. Both deaths in this series were related to the operation. Only 1 graft loss was directly attributed to a secondary operation. The patient undergoing cadaveric renal transplantation is at significant risk (25 per cent) of requiring at least 1 additional operation. However, despite this high probability of reoperation, graft loss and patient death after such procedures should be rare.

Adult↗
PubMed1988

Appendicitis: evaluation by Tc-99m leukocyte scan.

Diagnosing appendicitis may be difficult. We report the use of a new technetium-99m-albumin colloid white blood cell (TAC-WBC) scan in the evaluation of appendicitis. In a synthesis requiring 75 minutes, autologous neutrophils and macrophages from 40 mL of whole blood were labelled with technetium-99m-albumin colloid and administered to 100 patients with possible appendicitis. The entire process, from labelling the cells to completion of the scan took a maximum of 5 1/4 hours. Two patients had second scans on separate hospitalizations. Twenty-six patients had appendicitis; 12 had perforations, five of whom had an abscess. Eighty-five scans were read as either positive or negative for appendiceal pathology with a sensitivity of 89%, a specificity of 92%, and an accuracy of 92% in diagnosing appendicitis. Seventeen scans were indeterminant; eight of these patients had appendicitis. The value of the TAC-WBC scan in the evaluation of appendicitis lies in its ability to be used emergently, its high negative predictive value for men and women (NPV = 97%), and its high positive predictive value for men (PPV = 93%). At present, the scan does not appear to be reliable in diagnosing appendicitis in women (PPV = 43%). It is most useful in those patients in whom diagnosis is uncertain, and should not be used in patients with clear-cut appendicitis in whom its use will delay definitive surgical care.

Abscess↗
PubMed1988

Effects of feeding selenium deficient diets to rhesus monkeys (Macaca Mulatta).

Pregnant rhesus monkeys (Macaca mulatta) were fed either selenium (Se) deficient or Se supplemented diets with adequate vitamin E. Except for some cardiac irregularities in the first babies born to these females, no physiological disorders due to Se deficiency were seen in a subsequent offspring. Plasma and erythrocyte glutathione peroxidase activities and blood Se levels increased in the Se supplemented monkeys but decreased in the deficient ones. The data indicated that hair Se levels reflect long term exposure to this element. In a very preliminary experiment, evidence was obtained to indicate that dietary protein deficiency along with Se deficiency will generate cardiomyopathic lesions characteristic of Se deficiency. It is hypothesized that, in addition to Se deficiency, another dietary deficiency (or abnormality) is necessary to produce Se deficiency lesions in higher primates. Higher glutathione transferase (or non-Se glutathione peroxidase) activity in tissues of rhesus monkeys may account for this resistance.

Animal Nutritional Physiological Phenomena↗
PubMed1988

Effects of various dietary levels of selenium as selenite or selenomethionine on tissue selenium levels and glutathione peroxidase activity in rats.

Weanling rats were fed a basal diet or this diet plus 0.2, 1.0, 2.0 or 4.0 mg/kg selenium (Se) as either selenite or selenomethionine (SeM). Except at the 0.2 mg/kg Se level, Se accumulated in all tissues at higher levels when SeM was fed than when selenite was given, and the magnitude of difference became more pronounced with increasing levels of dietary Se. This was particularly true for muscle and brain. Se levels in whole blood, testes, kidney and lungs were not significantly different between rats fed 0.2 mg/kg Se as selenite or as SeM, but the Se levels in liver, muscle and brain were higher in rats fed SeM. Although the tissue Se concentrations differed markedly, there were no differences in the glutathione peroxidase (GPX) activity in tissues of rats fed SeM rather than selenite. The percentage of Se associated with GPX was lower in all tissues from rats fed SeM than in those from rats fed selenite. These results indicate that the chemical forms of dietary Se can have a marked influence on biological responses, including bioavailability of dietary Se.

Animals↗
PubMed1988

Dosimetry of leukocytes labeled with 99Tcm-albumin colloid.

Biodistribution, kinetics and dosimetry of 9Tcm-albumin colloid labeled leukocytes (TAC-WBC) is described. A practical method of planar image data acquisition and processing is discussed. This method was used to obtain biodistribution data in 11 patients, two of whom were children. Dosimetry was calculated for fetuses, children and adults. The spleen is the critical organ, receiving 2.5 rad per 5 mCi procedure in adults and 3.6 rad per 2.15 mCi procedure in a 5-year-old child. These absorbed doses are about one-sixth of that absorbed from 111In-leukocytes procedures utilizing one-tenth the administered activity of TAC-WBC. The liver and red marrow are approximately equivalent secondary target organs, each receiving about 20% of the spleen dose. Fetal doses at any stage of gestation are similar, averaging about 14 mrad per mCi of TAC-WBC administered to the mother. The dosimetry of TAC-WBC is favorable enough to permit its use in children, adults and during pregnancy.

Adolescent↗
PubMed1987

Effect of age and dietary restriction on the expression of alpha 2u-globulin.

The effect of aging on the expression of alpha 2u-globulin was studied in liver tissue from 6-30-month-old male Fischer F344 rats. The synthesis of alpha 2u-globulin by suspensions of isolated hepatocytes decreased 90% between 6 and 22 months of age. The levels of alpha 2u-globulin mRNA and the transcription of alpha 2u-globulin genes by isolated liver nuclei decreased 80-85% between 5 and 24 months of age. Because alpha 2u-globulin has been suggested to be a "senescence marker protein," the expression of alpha 2u-globulin was measured in rats fed a diet restricted in calories. This dietary restriction procedure has been shown to increase significantly the longevity of rodents. The expression of alpha 2u-globulin was compared in liver tissue from 18-month-old rats fed ad libitum and a restricted diet (40% restriction of total calories). The synthesis, mRNA levels, and transcription of alpha 2u-globulin were 1.8-3-fold higher for liver tissue from restricted rats compared to liver tissue from rats fed ad libitum. Therefore, dietary restriction alters the age-related change in the expression of alpha 2u-globulin. Our results demonstrate that the changes in alpha 2u-globulin expression that arise during aging or dietary restriction are regulated at the level of transcription.

Aging↗