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Biomedical subjects

J Huffman

Publications and source records attributed to J Huffman.

18 recordsLinked to original sources

Analysis of circulating phagocyte activity measured by whole blood luminescence: correlations with clinical status.

The present study was undertaken to determine if measurement and analysis of phagocyte function are useful for diagnosis and staging of infection. Circulating phagocyte activity was measured in healthy volunteers and sequentially in patients with acute infections of different types and severity, including those with diabetes mellitus or human immunodeficiency virus (HIV) infection. Using an automated luminescence system, these phagocyte functions were measured in whole blood: basal and phorbol 12-myristate 13-acetate (PMA)-stimulated oxidase activity, basal and PMA-stimulated simple dioxygenation (e.g., oxidase-driven haloperoxidase activity), and circulating and primed opsonin receptor-dependent dioxygenation. Multiple discriminant analysis of these data showed significant differences between healthy controls, diabetic patients, HIV-positive subjects, and patients with pneumonia or sepsis syndromes. Longitudinally, circulating phagocyte function correlated with clinical condition, severity of infection, and outcome. This methodology provides rapid, objective, and sensitive diagnostic and monitoring information for patients with infections.

Acquired Immunodeficiency Syndrome

The role of radical cystectomy in the management of high grade superficial bladder cancer (PA, P1, PIS and P2)

Between January 1979 and 1987, 411 consecutive patients were considered candidates for bilateral pelvic iliac lymph node dissection and radical cystectomy for the management of bladder cancer. From this group 160 were identified as having pathological stage P2 or less disease, including 11 who also had positive nodes. The 5-year actuarial survival rate for the respective stages at 95% confidence limits was 100% for stage P0/A, 80% for stage P1, 78% for stage P1 with stage PIS, 85% for pure stage PIS, 76% for stage P2 and 87% for stage P2 with stage PIS. Additionally, we identified a group of patients with stage P2 transitional cell carcinoma who were at significant risk for development of metastatic disease. Of 46 patients with stage P2 transitional cell carcinoma 18 had vascular space invasion resulting in 6 of 18 cancer-related deaths (33%). Our study demonstrates that radical cystectomy has been highly effective in curing patients with high grade superficial disease, including those with superficially invasive disease associated with nodal metastases.

Carcinoma, Transitional Cell

Colorectal cancer mortality and incidence in Campbell County, Kentucky.

Previous publications have reported an unusually high colon cancer mortality rate for several Kentucky counties. We investigated these high rates by examining incidence of colorectal cancer in one county with a high mortality. The objective was to determine whether the incidence of colorectal cancer was as high as mortality rates indicated and, if so, to look for possible etiologic factors for the high rates. We found the incidence of colon cancer to be significantly higher in Campbell County than expected. While we expected 162 cases of colon cancer, we actually observed 192 (P less than .01). The number of rectal cancers was no higher than expected (52 expected and 62 observed), in agreement with previously reported mortality figures. A geographic plot of cases by home residence showed a significantly higher rate of colon cancer for urban county regions than for rural regions. In fact, the population of rural Campbell County had a colon cancer rate significantly lower than either the county rate or the national rate. Several factors were analyzed to explain these rate differences. The only consistently associated factor was source of residential drinking water.

Adenocarcinoma

Endoscopic ureteropyelostomy: opening the obliterated ureteropelvic junction with nephroscopy and flexible ureteropyeloscopy.

Endoscopic re-establishment of a totally obstructed ureteropelvic junction was accomplished in 2 patients. The combined use of rigid percutaneous nephroscopy and flexible ureteropyeloscopy provided full visualization of the obliterated segment, and allowed accurate electroincision into the ureter and placement of a wire and catheter into the lumen. This technique demonstrates the potential therapeutic applications of flexible ureteropyeloscopy and should be considered for the initial treatment of the obliterated ureteropelvic junction.

Aged

Monitoring intravesical bacillus Calmette-Guerin treatment of bladder carcinoma with flow cytometry.

Flow cytometry of bladder irrigation specimens was studied in 22 patients with low stage bladder carcinoma who were treated by transurethral resection of visible tumor followed in 3 to 5 weeks by a course of intravesical bacillus Calmette-Guerin. The most informative examinations were just before the first bacillus Calmette-Guerin treatment, 6 weeks after completing a 6-week course of treatment (3 months) and at 9 months. Of the patients 10 had recurrent tumors after therapy; recurrence was anticipated correctly by flow cytometry at the 12-week followup examination in 6 of the 10 patients and suspected in another. Of 12 patients who remained clinically free of disease for a minimum of 15 months after bacillus Calmette-Guerin therapy flow cytometry identified correctly 7 at 12 weeks, while 1 had a partial response and the remaining 4 reverted to a negative status at 9 months. Of interest, only 4 of the 22 patients were free of disease by flow cytometry at the start of bacillus Calmette-Guerin treatment despite attempted ablation of the tumor by transurethral resection, suggesting that intravesical administration of bacillus Calmette-Guerin destroys existing carcinoma in situ in some cases.

BCG Vaccine

Acute abdominal pain caused by spontaneous perforation of the urinary bladder.

Patients with acute spontaneous bladder perforation have the symptoms and signs of an acute condition of the abdomen which, as a surgical emergency, requires prompt operative treatment. Bladder perforation should be suspected as the cause of this abdominal catastrophe if the history and findings indicate a urinary tract disorder. If the surgeon knows preoperatively that the bladder is perforated, he is able to plan and perform the appropriate surgical procedure with greater dispatch and certainty. The correct preoperative diagnosis should be made more frequently if the primary care physician develops a greater awareness of the possibility of spontaneous bladder perforation as the cause of an acute condition of the abdomen. With earlier diagnosis and earlier surgical treatment, the present reported mortality of 25 per cent for those patients with this condition is likely to be reduced.

Abdomen, Acute

Appearance of a partial nephrogram with an absent kidney.

A case is reported of a 16-year-old female who sustained a gunshot wound to the left upper abdomen. Early opacification of a structure in the left upper quadrant on an excretory urogram was suggestive of a nephrogram. The left kidney was absent at operation. The diagnostic limitations of excretory urography in the trauma patient and the alternative diagnostic techniques, radionuclide scanning, arteriography, or tomography, or possibly operative intervention, are recommended. Although not found in our patients, a thorough search for an ectopic kidney should be made.

Abdominal Injuries

Zinc, nitrogen, copper, iron, and manganese balance in adolescent females fed two levels of zinc.

The effect of feeding two different levels of zinc (Diet Z11.5 and Diet Z14.7) on zinc, nitrogen, copper, iron, and manganese balances was determined in 11 girls, 12.5 to 14.2 years, during a 30-day period. Diet Z11.5 provided 11.32 or 11.64 mg zinc daily, levels similar to that determined previously to be consumed by average adolescent females. Diet Z14.7 provided 14.52 or 14.84 mg zinc daily. These levels were just slightly less than the Recommended Dietary Allowance for zinc. When fed Diet Z14.7, subjects lost significantly more zinc in their feces than when fed Diet Z11.5. Regression analyses were applied to the zinc balance data from this study and a previous study with adolescent females. By extrapolation, a dietary intake of 11 mg zinc daily was estimated to compensate for fecal and urinary zinc losses of the average girl in these studies. The standard error of the estimate was 2.18 mg zinc daily. Nitrogen excretion and retention were unaffected by the variations in zinc intake. Copper excretion in the feces was significantly increased when subjects were fed Diet Z14.7 rather than Diet Z11.5. Manganese and iron fecal losses were also significantly correlated to zinc fecal losses.

Adolescent