Update: Henry Ford Hospital's chronic disease care program.
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Biomedical subjects
Publications and source records attributed to J Shields.
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A total of 14 extensively pretreated patients with advanced and progressive malignancy were given 140 infusions of autologous plasma that had been perfused over staphylococcal protein A bound to an agarose gel (Sepharose). Infusions ranged in volume from 35 ml to 260 ml (mean, 70 ml), and the quantity of protein A used ranged from 1 to 30 mg per 100 ml of plasma (mean, 10 mg). Acute toxic reactions included fever (21%), chills (18%), nausea (17%), vomiting (8%), pain (9%) and bronchospasm (2%). Four patients did not have an acute toxic reaction and no chronic or cumulative toxic effects were identified. In two patients there was objective tumor regression and in five there was stabilization of disease lasting from 4 to 12 weeks. Further study of this treatment modality is warranted.
Constitutional chromosome abnormalities have been associated with retinoblastoma, Wilm's tumor, and a familial form of renal carcinoma. For each tumor type, the particular chromosome segment involved in the observed rearrangements is different: in retinoblastoma, that segment is band q14 on chromosome #13. We now present evidence that in retinoblastoma, structural abnormalities involving the particular chromosome segment identified in the constitutional cases can also occur in the tumors of individuals with normal constitutional karyotypes. Six cases with retinoblastoma in one or both eyes were analyzed; deletions/rearrangements involving 13q14 were found in the tumor cell karyotypes of five of the six. These observations suggest that changes in a gene or genes at a common site (13q14) play a role in tumorigenesis in all forms of retinoblastoma, sporadic as well as heritable.
In this report of banded karyotypes prepared after short-term culture (72 hr) from human retinoblastoma tumor tissue, on del(13)(pter leads to q14:) chromosome and one normal chromosome #13 were found in all of the metaphases examined. Similar deletions (always involving 13q14) have previously been described in the somatic cells of individuals with one form of retinoblastoma. In the present case, however, the constitutional karyotype is normal. The presence of tumors in both eyes suggests that this is the genetic form of retinoblastoma, even though the patient's family history is negative for this tumor. The normal constitutional karyotype argues that the chromosome deletion occurred as a postzygotic event. The modal chromosome number of the tumor cells is 47 and rearrangements involving chromosomes #2, #17, and #20 were also identified.
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Three cases of pelvic lipomatosis are presented. Excretory urogram revealed characteristic elevation and elongation of urinary bladder base and relative hyperlucency of pelvic cavity. Associated varying degrees of hydronephrosis and hydroureters are seen secondary to distal ureteral obstruction. Barium enema showed elongation and elevation of rectosigmoid colon.
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The methods and results of some recent family, twin and adoption studies of childhood behaviour disorders, crime, alcoholism, psychopathic personality and neurosis are briefly described. The data of Slater (1938) on the parents and children of manic-depressives are reanalysed. Bipolar affective illness were more frequent in the families of bipolar than unipolar probands. There was no support for sex-linked inheritance in either group or for further genetic subdivision of the unipolar group according to age of onset or alcoholic or psychopathic family history. It is suggested that for the time being we may have to be satisfied with three broad and aetiologically overlapping clinical types of depression: bipolar, unipolar and reactive.
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