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Biomedical subjects

J F Huth

Publications and source records attributed to J F Huth.

30 records · Page 2Linked to original sources
PubMed1984

Abdominosacral resection for malignant tumors of the sacrum.

Malignant sacral tumors present unique problems because of their location deep in the pelvis, their juxtaposition to the ureters, rectum, and iliac vessels, and the need to preserve spinal stability and sacral nerve function after resection. The simultaneous abdominosacral resection circumvents many of these problems since it provides good exposure of the intraabdominal structures, allows precise selection of the level of sacral resection, and avoids damage to the sacral nerve roots. Tolerable control of bladder and bowel functions is possible by preservation of the S1 nerve roots, and spinal stability can be maintained with preservation of the body of the S1 vertebra. Because malignant tumors of the sacrum have a high propensity for local recurrence, we believe that the exposure afforded by the sacroabdominal approach provides an opportunity to obtain a wide margin of resection during initial resection of these tumors.

Abdomen↗
PubMed1983

Utilization of blood recycling in nonelective surgery.

Intraoperative infusion of autologous shed blood is efficacious in elective vascular, cardiac, and orthopedic surgery. Blood recycling has also been advocated for emergency and trauma surgery. We examined 33 candidates for autotransfusion during emergency surgery. Autologous blood accounted for only 11% of the total blood replaced. Only 25 of the patients survived long enough to permit reinfusion. Because of rapid hemostasis, nine of the remaining patients (36%) received less than the 2 units necessary to be cost-effective. No evidence was found for septicemia or coagulopathy caused by autotransfusion. We concluded that, as currently applied, recycling of shed blood during emergency surgery is of value in a limited group of patients. The collection and storage of heparinized shed blood during the preoperative and early intraoperative periods, with later processing and reinfusion in selected patients, may expand its applicability.

Adult↗
PubMed1983

Effect of acute ethanolism on the hospital course and outcome of injured automobile drivers.

Acute ethanolism in automobile drivers is purported to be both protective and detrimental in susceptibility to injury from an accident. The potential influence of acute intoxication (serum ethanol greater than 100 mg/dl) on pattern and severity of injury, hospital course, and long-term outcome, including mortality, was examined in 182 consecutive automobile drivers requiring admission to a regional university trauma center during 1980. Significantly more drivers were intoxicated than not, 61% vs. 39%. Similarly, more than 75% of the intoxicated drivers were young males and more than 80% of the intoxicated drivers were felt to be negligent and at cause for the accident. However in this series, the patterns and severity of injuries, hospital course, and late outcome were unaffected by the patient's blood alcohol level. Acute alcohol intoxication apparently neither protected nor hindered the response to injury in these motor vehicle drivers.

Accidents, Traffic↗
PubMed1983

Prognostic significance of urinary antigen analysis by enzyme-linked immunosorbent assay in melanoma patients.

Urine samples collected from normal donors and melanoma patients were analyzed for the presence of tumor-associated antigen by competitive inhibition in the enzyme-linked immunosorbent assay (ELISA) using an allogeneic melanoma serum as the source of antibody and partially purified urine from the same donor as the target antigen. The results were expressed as antigen units (ng antigen protein/mg creatinine). The antigen levels in urine of melanoma patients (median = 56.5, N = 56) were significantly higher (P less than 0.05) than those of normal donors (median = 1.9, N = 56). The 90th percentile for the normal group was 34.3 antigen units. Using this value as the criterion for positivity, 36 of 56 (64%) urine samples of melanoma group were positive for the antigen as opposed to only 6 of 56 (11%) of normal donors. Subsequently, a retrospective analysis of 58 melanoma patients paired on the basis of disease recurrence and no recurrence after lymphadenectomy revealed a median antigen level of 68 units for the recurrent group and 18.9 for the nonrecurrent group. Eighteen of 29 (62%) melanoma patients who had recurrence of their disease and 9 of 29 (31%) patients who remained disease free were urinary antigen positive. These incidences were significantly different (P less than 0.005). The results of this investigation suggest that assessment of urinary antigen in stage I and II melanoma patients may prognosticate recurrence of the disease.

Antigens, Neoplasm↗
PubMed1982

Relationship between circulating immune complexes and urinary antigens in human malignancy.

Urine samples obtained from patients with histologically proved melanoma and sarcoma were analyzed for the presence of tumor-associated antigens by complement fixation and enzyme immunoassay. Also, serum samples obtained during 24-hour urine collection from these patients were analyzed for circulating immune complexes by the complement consumption method and by the K562 radiometric assay. Of 36 cancer patients who were positive for urinary antigen (UA) by both assays, 28 (78%) were also positive for CIC in the two assays, six (17%) were positive in one of the two CIC-detection assays, and two (5%) were negative in both assays. Of 24 patients that were negative for CIC in both assays, ten (42%) were also negative for UA in both assays, i.e., complement fixation and enzyme immunoassay; 12 (50%) were negative by one of the two assays; and only two (8%) exhibited UA by both assays. This relationship was more striking for melanoma than sarcoma patients. In a melanoma patient whose samples were studied sequentially during his thermochemotherapy, the fluctuations in CIC and UA were parallel. These results suggest that excretion of tumor-associated antigen into urine is not an isolated phenomenon; rather, immune complex deposition in kidneys appears to cause glomerular damage which may allow the passage of the antigens into the urine.

Antigen-Antibody Complex↗
PubMed1982

Application of cultured human myeloid cells (K562) for detection of immune complexes in human sera.

Cultured human myeloid cells (K562) are known to bear Fc receptors that bind with aggregated human IgG (AHG). These cells were used to develop a radiometric assay for detection and quantitation of immune complexes (IC) in human sera. The binding of AHG or in vitro-formed IC between keyhole lympet hemocyanin (KLH) and human anti-KLH to the K562 cells did not require complement. When the K562 radiometric assay was compared to the complement-consumption assay, the K562 radiometric assay could detect IC over a wider range of antibody:antigen ratios. The incidence and mean IC values detected by the K562 radiometric assay in sera from cancer patients and patients with connective tissue diseases (498 +/- 445 and 436 +/- 209 micrograms AHG equ/ml, respectively) were significantly higher than in sera from healthy volunteers (107 +/- 62 micrograms AHG equ/ml). The IC level among sera from cancer patients ranged from 1-3200 micrograms AHG equ/ml. Studies with a limited number of sera from melanoma and sarcoma patients revealed that the mean IC values were significantly higher in patients who had clinically detectable disease than in those with no evidence of disease. Since the K562 cells do not require complement to interact with AHG, the K562 radiometric assay may be potentially useful for detecting IC in pathologic sera which may or may not contain in vivo-bound complement components.

Antigen-Antibody Complex↗
PubMed1981

Development of an enzyme immunoassay to detect and quantitate tumor-associated antigens in the urine of sarcoma patients.

This study describes the development of an enzyme immunoassay (EIA) to quantitate antigen in the urine of sarcoma patients and compares its results with those of the authors' previously reported complement fixation assay. Three populations were studied for the presence of urinary antigen by EIA: (1) sarcoma patients who developed metastatic disease after resection of their primary tumor; (2) sarcoma patients who remain clinically disease-free two years after resection of their primary tumor; and (3) normal volunteers with no history of malignant disease. EAch group consisted of nine individuals. None of the urines from normal volunteers and none from sarcoma patients who remained free of disease for two years had elevated antigen titers detectable by EIA. However, all nine patients who developed pulmonary metastatic disease ahd significantly elevated levels of antigen in their urine prior to clinical evidence of disease recurrence. The day-to-day fluctuations in antigen titer detectable by EIA tended to parallel the levels detected by the complement fixation assay. However, EIA detected a significant elevation in antigen titer one to four months earlier than the complement fixation assay in four of the patients in whom disease recurred.

Antigens, Neoplasm↗
PubMed1980

Pulmonary resection for metastatic sarcoma.

Surgical resection plays an important role in the treatment of sarcoma that is metastatic to the lung. Multiple bilateral metastases are not contraindications to surgery. The rapidity of growth and the response to chemotherapy can be accurately determined by the tumor doubling time. Preoperative chemotherapy provides an in vivo measurement of tumor sensitivity, and the response to chemotherapy correlates with prognosis. Since residual microscopic pulmonary disease appears to be responsible for most failures after thoracotomy, attention should be directed toward delivering more effective adjuvant therapy to the lungs.

Adolescent↗
PubMedDate not supplied

Assessment of in vivo effectiveness of tumoricidal chemotherapy and radiation therapy by serial analysis of tumor-associated urinary antigen titers in patients with sarcoma.

Serial measurements of tumor-associated antigens in the urine of patients with sarcoma who received preoperative intra-arterial doxorubicin and radiation therapy were assayed by microcomplement fixation. Changes in urinary antigen titer as a result of therapy were compared to pretreatment samples and were correlated with clinicopathologic evidence of in situ tumor cell destruction. Of the 53 patients with sarcoma studied, 44 had clinicopathologic evidence of tumor destruction induced by the preoperative therapy, and all 44 had a fourfold or greater rise in the level of urinary antigens during the treatment period. The other nine patients had no evidence of tumor destruction and antigen titers remained unchanged. Results suggested that tumoricidal therapy released tumor-associated antigens which could be detected in urine by microcomplement fixation. This phenomenon may be useful for measuring the in vivo effectiveness of tumoricidal therapy on nonaccessible tumors.

Adolescent↗