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Biomedical subjects

J Gluckman

Publications and source records attributed to J Gluckman.

18 recordsLinked to original sources
PubMed1999

Human herpes virus 8 (HHV8) serology in allogeneic bone marrow transplant recipients.

Human herpes virus 8 (HHV8) may be sexually transmitted, but transmission via blood cells has not yet been excluded. We used a modified immunofluorescence assay to detect Ab to HHV8 latency-associated nuclear Ag in sera of 200 allogeneic BMT recipients and their related donors. In control subjects, Ab were found in 85% of patients with AIDS-related Kaposi sarcoma (n = 52), 34% of HIV-1 infected subjects without Kaposi sarcoma (n = 56) and 9. 5% of blood donors (n = 42). Among BMT donors, 14.5% were HHV8+, while 10% of recipients were positive before, and 18% after BMT. In the 176 HHV8-negative recipients at BMT, there was no relationship between post-BMT seroconversion, which occurred in 26 cases (15%), and the donor's serological status. Of note, 10 HHV8+ recipients before BMT became negative post-BMT. Outcome of BMT was not influenced by prior HHV8 seropositivity, seroconversion or seroreversion of recipients. That HHV8 seropositivity among blood donors from the Paris area was comparable to that of BMT donors and recipients before BMT indicates that these patients had not been at risk of HHV8 by blood products received before BMT, although post-BMT HHV8 seroconversion probably corresponded to contamination by blood transfusions rather than by the BMT.

Acquired Immunodeficiency Syndrome↗
PubMed1992

Prophylactic antibiotics for head and neck surgery with flap reconstruction.

The leading cause of postoperative morbidity in patients undergoing major head and neck surgical procedures is postoperative infection. This prospective randomized multi-institutional clinical trial was designed to compare the effectiveness of clindamycin phosphate and high-dose cefazolin sodium therapy in preventing postoperative wound sepsis in patients undergoing contaminated head and neck surgical procedures in which flap reconstruction was required. Either clindamycin phosphate (900 mg) or cefazolin sodium (2 g) therapy was instituted intravenously prior to surgery and continued every 8 hours, for a total of 24 hours. The patients received postoperative follow-up, and the wounds were graded according to the worst condition observed. One hundred cases were evaluated. Fifty-one patients received clindamycin and 49 patients received high doses of cefazolin; wound infection developed in 10 patients (19.6%) and 11 patients (21.6%), respectively. This difference was not statistically significant. The average duration of surgery was approximately 8 hours for both the infected and the noninfected groups of patients. High-dose cefazolin and clindamycin have similar efficacy when administered prophylactically under these circumstances. Reconstruction with free vascularized tissue may aid in reducing postoperative wound infection.

Cefazolin↗
PubMed1992

Quantitative DNA measurements in malignant and benign lesions of the upper aerodigestive tract.

Thirty-six patients underwent biopsy of clinically suspicious lesions of the mucosa of the upper aerodigestive tract. The biopsy material was evaluated histologically and cytologic smears out of the same lesion underwent quantitative DNA analysis using a numerical index derived from the single cell DNA content. In 30 patients, histologically diagnosed squamous cell cancer was confirmed by DNA analysis with the malignancy grade correlating with the morphologic differentiation of the tumor. Six lesions were histologically benign: i.e. dysplasia (n = 3), hyperplasia (n = 2) and chronic inflammation (n = 1). DNA analysis confirmed the benign nature in 4 cases, but in 2 cases of dysplasia, a diagnosis of malignancy was made. From these results, there appears to be an excellent correlation between DNA analysis and the histologic diagnosis of malignancy. It remains to be proven if this technique of DNA analysis will prove to be a more accurate determinant of malignant potential in premalignant conditions and a method to determine aggressiveness of behavior. An added advantage is that this technique can be performed on cytologic smears, without the need for incisional biopsy.

Adult↗
PubMed1988

Prevention of stomal recurrence in patients requiring emergency tracheostomy for advanced laryngeal and pharyngeal tumors.

Since 1976, patients requiring emergency tracheostomy for advanced laryngeal and hypopharyngeal cancer at the University of Cincinnati have been treated with a short course of prelaryngectomy radiation in an attempt to decrease the incidence of stomal recurrence. Twenty-one patients were treated after emergency tracheostomy with a course of radiation that usually consisted of 20 Gy in five fractions followed by laryngectomy 1 or 2 days later. Most patients also received postoperative radiotherapy of some type. The follow-up of 18 evaluable patients revealed only two (11%) stomal recurrences--a quite acceptable rate for this high-risk population. Overall, however, local recurrences were seen in ten patients (56%), which is higher than reported in most series of similar tumors. The most likely explanation for this seems to be that the short course preoperative radiation prevented the administration of adequate postoperative radiation for residual disease, which was usually present. An alternative treatment policy would be a planned course of moderate- to high-dose postoperative radiation, which could sterilize tumor in the entire locoregional area including the stoma.

Aged↗
PubMed1987

Measuring marketing effectiveness.

The most frequent question about the marketing function in hospitals today is, What are we getting for our money? To answer this, marketing directors must convince the board first of the need for marketing, then of marketing's effectiveness. To measure marketing effectiveness, some basic needs are a staff, equipment, cooperation between departments, utilization data, and a research budget. Some steps to be followed include developing a marketing data base--consisting of demographic projections, demand projections, and market share--testing a marketing strategy through experimentation, documenting the expected results and measurement techniques, and calculating the expected return on investments. In dealing with those "impossible-to-measure" cases, such as a physician who is not advertising but finds that a competitor is, a decision tree can help determine whether to advertise and how much to spend by indicating what the return on investment might be.

Cost-Benefit Analysis↗
PubMed1984

Laser fluorimetry for capillary column liquid chromatography: high-sensitivity detection of derivatized biological compounds.

A high-sensitivity, low-dead-volume laser-induced fluorescence detector has been designed for use in capillary column liquid chromatography. This detector exhibits femtogram detection limits and a linear dynamic range spanning five orders of magnitude. Derivatization schemes were utilized to add a fluorescent moiety to biologically important compounds such that their excitation maxima corresponded well with the output wavelength of the laser. Sample chromatograms are presented for picogram amounts of standard bile acid and steroid hormone derivatives. In addition, a high-efficiency separation of picogram amounts of the solvolyzable steroid hormones from human serum is illustrated.

Bile Acids and Salts↗
PubMed1982

Midline granuloma syndrome: a clinicopathologic study of 13 patients.

Thirteen patients with the clinical features of the midline granuloma syndrome are reported. Seven of the patients were determined to have Wegener's granulomatosis and had segmental necrotizing glomerulonephritis in their renal biopsies. Eighteen upper aerodigestive trace mucosal biopsies were available for review from the seven patients, and nine of these biopsies had a granulomatous angiodestructive inflammatory cell infiltrate considered "diagnostic" of Wegener's granulomatosis. The remaining nine biopsies lacked the specific histologic features of Wegener's granulomatosis but were considered consistent with mucosal involvement by the disease. Five of the remaining six patients had upper aerodigestive tract biopsies that were characterized by lymphocytic infiltrates. Three of the five patients had appreciable numbers of "atypical" cells in their biopsies and presented with radiologic evidence of lung involvement. It is our impression that patients with "significant cellular atypia" in their lymphocytic infiltrates have a disease indistinguishable from lymphomatoid granulomatosis, and these patients have a high propensity for either the presence or development of systematic disease that may require chemotherapy. Two patients had lymphocytic infiltrates with only minor degrees of cytologic atypia and no evidence of multisystem disease, and both of these patients responded to local radiation therapy. The remaining patient had a nonspecific histologic pattern in her numerous biopsies and was diagnosed as idiopathic midline destructive disease. She also had an adequate response to radiation therapy.

Adult↗
PubMed1977

The cavernous haemangioma of the frontal bone. A case report.

A case of haemangioma of the frontal bone is presented. The clinical presentation and the radiological features, which are diagnostic of this very rare condition, are given. Treatment is complete excision of the tumour, the macroscopical and microscopical appearances of which are discussed.

Adult↗
PubMed1977

Immunological studies of patients with asbestosis. I. Studies of cell-mediated immunity.

A variety of cancers have been documented in patients exposed to asbestos dust. Since a deranged immune system may play a rôle in cancer development, the general level of immunocompetence was studied in a group of twenty-six patients with radiographically defined asbestosis, who might be at risk of developing asbestos-related neoplasms. Statistical comparisons were made with a comparable control group. A disproportionate number of the patients displayed cutaneous energy to certain recall antigens and to 2,4-dinitrochlorobenzene. In vitro studies of cellular immunity, as evaluated by phytohaemagglutinin-induced proliferative and cytotoxicity assays, showed significantly lower values amongst the patient group. Serum inhibitors of mitogen-induced lymphocyte transformation were also detected in several of the patients. The possible significance of these findings is discussed.

Adult↗
PubMed1975

The effect of aging and acute illness on delayed hypersensitivity.

A group of standard antigens (monilia, mosquito, mumps, purified protein derivative [PPD], staphylococcus toxoid, streptokinase-streptodornase [sk-sd] and trichophyton) were applied to 321 normal volunteers, 60 patients admitted to a medical ward, and 41 patients in an intensive care unit (ICU) to evaluate their delayed hypersensitivity skin test response. Eighty-eight per cent of the normal subjects reacted with at least 5 mm. induration to one or more skin tests without any decrease in reactivity occurring with increasing age. In the hospitalized group, only 62 per cent of the ward and 63 per cent of the ICU patients reacted to the same skin tests. All (8/8) anergic ICU patients tested after discharge regained normal reactivity. Acute illness but not increasing age will impair the delayed hypersensitivity skin test response.

Acute Disease↗
PubMedDate not supplied

Squamous-cell carcinoma of the floor of the mouth.

Among the histologic parameters described by Jakobsson, only the stage (depth) of invasion appears to be of value in predicting lymph node metastases. Early carcinomas of the FOM examined in our institution (T1 and some T2) grew in a superficial or horizontal manner and none developed metastases or local recurrence. Larger neoplasms (some T2 and all T3 and T4) had extensive submucosal and deep soft tissue infiltration and a corresponding high frequency of regional lymph node metastases. T1 and T2 neoplasms with only superficial or microinvasion of the submucosa have little or no propensity for lymph node metastases while T2 cancers with nodular or vertical in filtration into the submucosa have a substantial frequency of metastatic disease (44%). If the biopsy sites are carefully selected, these growth patterns can be identified by the pathologist. In addition, our experience is that clinical assessment of cervical lymph nodes for the presence of metastatic disease is often erroneous. Rates of 56% false positives and 24% false negatives were observed, which were similar to rates reported in other series. Biopsy evaluation of the extent and growth pattern of the primary neoplasm is as important as physical examination in determining the type of surgery to be done and whether lymph node dissection should be performed.

Carcinoma, Squamous Cell↗
PubMedDate not supplied

Sinonasal undifferentiated carcinoma: a 10-year experience.

PURPOSE: Sinonasal undifferentiated carcinoma (SNUC) is a rare and aggressive malignancy of the paranasal sinuses and nasal cavity. Of the few reported series, most indicate a dismal prognosis. In this report, the clinical presentation, histopathologic criteria used for diagnosis, mode of treatment, and outcome are evaluated in seven patients with SNUC. MATERIALS AND METHODS: Seven patients with SNUC treated at the University of Cincinnati between 1983 and 1993 were analyzed retrospectively. RESULTS: Most of the patients presented with extensive local disease, and two patients also had cervical metastases. All except one were treated using a multimodality approach. Four of the seven patients died of disease (DOD), with a mean survival of only 11.5 months following treatment. Inability to eradicate local disease was responsible for treatment failure in all cases. Three patients have achieved short-term control of disease following combined therapy, but one is at high risk for recurrence. CONCLUSION: SNUC was associated with an overall poor prognosis in our series despite aggressive treatment. Control of local disease was the central therapeutic consideration. Intensive multimodality therapy is recommended for all patients with SNUC.

Adult↗