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Biomedical subjects

J S Welch

Publications and source records attributed to J S Welch.

At least 37 records · Page 2Linked to original sources
PubMed1986

The postirradiated breast.

High-energy irradiation is used increasingly as a part of breast conservation treatment of malignant disease. The response of the breast tissue encompassed by the treatment fields varies considerably, even in well-conducted therapeutic programs. Early and late changes in the tissues include redness, edema, pigmentation, fibrosis, and retraction. Fibrosis and retraction may cause suboptimal cosmetic results and occur most frequently in obese patients, large breasts, and breasts from which a large (greater than 4 cm) primary tumor has been excised. Combinations of treatment modalities, such as adjuvant chemotherapy, surgical excision, and irradiation, seem to produce fewer excellent cosmetic results than single-modality treatment. In patients who have undergone breast conservation treatment, careful follow-up is necessary for detection of possible local, regional, or distant recurrence of the malignant disease, as well as of other diseases related or unrelated to the earlier treatment.

Breast Neoplasms↗
PubMed1986

An aborted, prospective, randomized trial of sclerotherapy for prolonged drainage after mastectomy.

Annually, approximately 100 of the 400 postmastectomy patients we studied have persisting serous drainage. Sclerotherapy with the use of tetracycline has been advocated to decrease serous drainage and the formation of seromas. Reports in the literature suggest that the use of tetracycline for treatment has been efficacious and that it is not painful. We devised a prospective, randomized controlled trial to study the effects of tetracycline on patients with prolonged persisting drainage. Six patients in the control group had the drains left in place until the drainage diminished. One of these patients had a seroma develop after the drains were removed. Eight patients were treated with tetracycline. Four of these patients had seromas develop after the drains were removed. Three of the eight patients had severe reactions of pain when the tetracycline was introduced into the drains. Because of the severe pain associated with sclerotherapy treatment and the lack of demonstrable benefit in those treated, we terminated the study. We did not find tetracycline to be of help in treating patients with prolonged drainage after mastectomy and some of those patients had severe pain develop from the treatment.

Drainage↗
PubMed1986

Surgical considerations after chemotherapy and radiation therapy for inflammatory breast cancer.

Eighteen patients seen between 1974 and 1982 with the clinical diagnosis of inflammatory breast carcinoma underwent modified radical mastectomy after preoperative chemotherapy and radiation therapy. In 17 of the 18 patients (94%), residual carcinoma was detected in either the resected breast or the axillary nodes. All mastectomies were accomplished without major technical difficulty. Seven wound complications, including three infections, occurred. Local recurrence was noted in 29% (five of 17 patients) and distant metastasis was detected in 89% (16 of 18 patients). Only three patients are presently alive without evidence of disease 19, 21, and 21 months since the onset of symptoms. Eleven patients have died, the median survival being 23 months since the development of symptoms, and four are alive with distant metastasis. Modified radical mastectomy can be accomplished in patients with inflammatory breast cancer after preoperative chemotherapy and radiation therapy and may have a role in reducing local tumor burden.

Adult↗
PubMed1985

Monoclonal antibodies directed against Brucella abortus cell surface antigens.

A panel of monoclonal antibodies (MAb) has been raised against Brucella abortus cell surface antigens from mice immunized with either heat/phenol treated or UV killed bacterial suspensions of B. abortus. The hybridomas were screened by either a microagglutination procedure or by an indirect enzyme immunoassay (EIA) on sonicated bacterial preparations. From a large number of MAb generated by various procedures, two distinct types of MAb emerged. The most numerous type was capable of agglutinating B. abortus and reacting with a soluble preparation of lipopolysaccharide (LPS). A second type was not capable of agglutinating the bacterial suspensions or of binding to the soluble LPS preparation but reacted with an antigen present in bacterial sonicates. Two MAb of this type react differentially with sonicates prepared from virulent and avirulent strains of B. abortus. There appeared to be sufficient evidence from our analysis of the relative degree of cross reaction with antigens present on a range of B. abortus strains and Brucella and xenogenic bacterial species to conclude that each of the seven MAb was recognising a separate antigenic site on the B. abortus cell surface.

Animals↗
PubMed1985

Carcinoma of the breast associated with pregnancy.

Sixty-three pregnant patients were treated for primary carcinoma of the breast at the Mayo Clinic between 1950 and 1980. These patients had a greater incidence of nodal metastasis and scirrhous histopathologic factors than did non-pregnant patients with a malignant condition of the breast. The five year survival rate of pregnant patients with localized malignant growths of the breast was 80 per cent. Improved survival time was not demonstrated for patients who terminated the pregnancy.

Abortion, Therapeutic↗
PubMed1984

Angiostrongylus cantonensis in East New Britain, Papua New Guinea.

The first case of angiostrongyliasis (eosinophilic meningitis) to be diagnosed in Papua New Guinea in 1977, led to a survey of adult Melanesian residents of East New Britain province where the case occurred, to assess the level of immunological responsiveness to Angiostrongylus cantonensis. In 104 subjects tested using an indirect fluorescent antibody test, the serum antibody titres to A. cantonensis equalled or exceeded 1:16 in 50.7% and ranged from 1:32 to 1:64 in 17.3% of subjects. No individual tested showed evidence of active or recent angiostrongyliasis but in a patient suspected to have ocular angiostrongyliasis, the antibody titre of A. cantonensis was 1:128 in the single serum specimen obtained. In a programme to determine the distribution of this parasite in the natural hosts, 19 rats were trapped; one had adult A. cantonensis in its pulmonary arteries. Examination of 200 Achatina fulica snails revealed Angiostrongylus larvae in 62 (31%) and when these larvae were fed to laboratory rats, adult A. cantonensis were subsequently recovered from their pulmonary arteries.

Adult↗
PubMed1983

Nobody asked me!

Explore the source record for details and available documents.

Drug-Related Side Effects and Adverse Reactions↗
PubMed1981

Immunodiagnosis of parasitic zoonoses: sensitivity and specificity of in vitro lymphocyte proliferative responsiveness using nematode antigens purified by affinity chromatography.

The sensitivity of in vitro lymphocyte proliferative responsiveness using antigens purified by affinity chromatography, was greater than that of three serological tests and allowed the specific identification of Dirofilaria immitis, Toxocara canis, Angiostrongylus cantonensis and Ascaris lumbricoides in animals sensitized with parasite antigens, and the diagnosis of natural (D. immitis, T. canis and Angiostrongylus cantonensis) and zoonotic nematode infections. Lymphocytes remained viable in whole blood suspensions in RPM 1640 in a polystyrene insulation box at air temperature for at least 12 hours and reacted in the cell-mediated immunity test (CMIT) without loss of response. The CMIT proved useful in the early immunodiagnosis of nematode infections and showed that parasite antigens purified by affinity chromatography retained a high degree of specificity and sensitivity in both the CMIT and serological tests.

Animals↗
PubMed1980

Immunodiagnosis and seroepidemiology of Angiostrongylus cantonensis zoonoses in man.

The development of serum and cellular assays to measure responses to Angiostrongylus cantonensis antigen, purified by affinity chromatography, formed the basis of this study. The specificity and sensitivity of these techniques were established in immunized rabbits and in naturally and laboratory-infected rats. The assays were then used to determine levels of immunological responsiveness to A. cantonensis in four Australian populations. There was a direct correlation between the prevalence of the parasite in rodents and the proportion of human reactors to A. cantonensis antigen in each population studied. Five patients with similar clinical histories and presenting symptoms suggesting eosinophilic meningitis were investigated; three were admitted to hospital. Haematological examination demonstrated hypereosinophilia in all five while three had, in addition, a cerebrospinal fluid eosinophilia. Serological tests and assays of cell-mediated responses to A. cantonensis antigen showed elevated immunological reactivity during the acute phase of illness with a subsequent decrease in reactivity corresponding with the progressive recovery of the patient.

Adult↗
PubMed1980

The surgical management of bleeding stress ulcers.

The series included 52 patients with acute bleeding stress ulcers of the stomach and duodenum seen at the Mayo Clinic during a 25-year period. All patients underwent operation for control of massive bleeding that was unresponsive to intensive medical therapy. All ulcers were superficial and occurred during clinically stressful circumstances. No patient had a history or findings suggestive of pre-existing peptic ulcer disease or imbibation of ulcerogenic substances. Overall operative mortality was 54%, and this rate seemed to be related to multiple factors acting together; patients with multiple predisposing stress factors and those requiring large transfusion volumes (greater than 17 total units) were at greatest risk of death. Fifty-two patients underwent 60 operative procedures for control of hemorrhage. Of the 60 procedures, 23 (38%) failed to prevent rebleeding. Of the 28 patients who died, six (21%) died of hemorrhage and five (18%) died of hemorrhage as one of many contributing factors. Of eight different procedures performed, near-total to total gastrectomy was the single procedure that was most effective in controlling hemorrhage. The authors support the selection of rapid intervention and generous extirpative surgery once intensive medical measures fail to control hemorrhage.

Adolescent↗
PubMed1980

Levels of glycolytic enzymes in the red blood cells of Australian Aborigines.

Blood samples wer collected from three populations of full-blood Aborigines, and twelve different enzymes were assayed in red blood cells. These results were compared with those of Caucasian controls. In the majority of enzymes studied significant differences were observed between the Aboriginal populations and also between individual Aboriginal populations and the Caucasian controls.

Alcohol Oxidoreductases↗
PubMed1980

Linitis plastica caused by metastatic lobular carcinoma of the breast.

We describe herein the syndrome of linitis plastica caused by metastatic lobular carcinoma of the breast. In 14 of our 31 patients, gastric involvement, alone or concurrent with other metastasis, provided the first sign of tumor dissemination. The distinction of primary and secondary gastric malignancies in patients with a history of breast cancer is most important for successful management of patients. At a time when primary gastric carcinoma is decreasing nationally, an awareness of the association of lobular breast tumors with linitis plastica due to metastases may modify diagnostic evaluation and treatment planning in patients who present with symptoms of this syndrome.

Adenocarcinoma, Scirrhous↗
PubMed1980

Proximal gastric vagotomy. Initial experience.

Proximal gastric vagotomy was performed in 223 patients with chronic duodenal ulceration between 1973 and 1977. The follow-up ranged from 6 to 78 months with a mean of 39 months. There was no operative mortality. Adverse postoperative sequelae, including delayed gastric emptying, dumping, diarrhea, and reflux gastritis, were seen in less than 3% of patients. Ulcers recurred in 11 patients (4.9%). We conclude that proximal gastric vagotomy is an effective, safe, and satisfactory operation for chronic duodenal ulcer over the short term.

Chronic Disease↗
PubMed1979

Clean air bench. Use for sterile maintenance of unwrapped surgical instruments.

Microbiologic sterility of unwrapped surgical instruments has been maintained for long periods by the use of an operating room instrument cabinet that continuously circulates high-flow, "particle-free" air. Use of this clean air bench has had excellent acceptance by operating room nurses and by surgeons because fewer instrument storage procedures are needed and setup time, takedown time, and case turnover time in the operating room are diminished. It has been found to be effective in operating rooms having busy schedules for both elective and emergency procedures.

Air Microbiology↗
PubMed1978

Treatment of intestinal amoebiasis and giardiasis; efficacy of metronidazole and tinidazole compared.

Aboriginal children who were aged from six to nine years and living in Cherbourg Community were treated for Giardia Lamblia and Entamoeba histolytica infection with either the manufacturer's recommended dose of metronidazole (Flagyl) or with tinidazole (Fasigyn), at two-dose levels. Tinidazole successfully cleared both protozoans from stools, a single dose being as effective as the longer regimens which were studied. The obvious advantage of single-dose administration is that it should permit more effective treatment of these intestinal parasites, especially in Aboriginal populations.

Child↗