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Biomedical subjects

M Link

Publications and source records attributed to M Link.

At least 55 records · Page 3Linked to original sources
PubMed1986

Chronic infectious mononucleosis syndrome, pancytopenia, and polyclonal B-lymphoproliferation terminating in acute lymphoblastic leukemia.

A 17-year-old previously healthy girl is reported who developed acute infectious mononucleosis followed by progressive ill health over 20 months, associated with pancytopenia and a polyclonal B-lymphoproliferation, terminating in acute lymphoblastic leukemia (ALL). Epstein-Barr virus (EBV) was recovered from the patient's nasopharyngeal secretions; serologic titers of antibodies to EBV-associated antigens were compatible with a chronic persistent EBV infection. Plasma interferon levels were markedly elevated. EBV-specific cell-mediated immunity, as well as Natural killer (NK) cell activity were markedly deficient. Other studies of cell-mediated immunity revealed notable abnormalities, including abnormalities in T-cell subset ratios, and a serum blocker of autologous mitogen-induced lymphoproliferation. Humoral (plasma)-mediated, but not cell-mediated, suppression of hemopoiesis was demonstrated using in vitro erythroid and myeloid colony culture techniques. Immunophenotyping of the patient's bone marrow cells preterminally was consistent with ALL. Autopsy revealed pathologic changes of ALL in marrow and multiple organs. We conclude that our patient developed an EBV-driven lymphoproliferative disorder, with associated defective cell-mediated immunity and hemopoiesis. Ultimately, the patient's documented polyclonal lymphoproliferative state was superimposed by acute lymphoblastic leukemia.

Adolescent↗
PubMed1986

Mediastinal nonlymphoblastic lymphomas in children: a clinicopathologic study.

The records of 25 pediatric patients with mediastinal nonlymphoblastic lymphoma (NLBL) were reviewed. These patients comprise approximately 5% of all patients with non-Hodgkin's lymphoma (NHL) in the pediatric age group. There were 15 females and ten males. The median age was 13.5 years (range, 2 to 19). Most patients presented with symptoms attributable to a large mediastinal mass, and superior vena cava syndrome was a common feature. Disease was localized to the supradiaphragmatic area in 17 patients (71%) at diagnosis. Pathologic review revealed 22 of these lymphomas to be diffuse histiocytic type in the Rappaport classification, and 20 were large-cell immunoblastic type in the Working Formulation. Treatment regimens were not uniform, but included multiagent chemotherapy in 23 patients and radiation to the mediastinum in 20 patients. Twenty-three patients (92%) attained a complete remission (CR). Of these, 17 (74%) remain disease-free 13 to 65 months from diagnosis (median, 43 months). No CNS relapses have been observed. Mediastinal NLBL in the pediatric age group has distinctive clinicopathologic features that warrant special consideration in the design of treatment protocols.

Adolescent↗
PubMed1986

[Initial results of perioperative antibiotic premedication with halospor and gentamycin in cesarean section].

The perioperative application of antibiotics in prophylaxis of infections is disputed. In a preliminary prospective study the infections morbidity of 44 patients after caesarean section was determined to investigate the effect of short term prophylaxis with halospor and gentamycine. A control group of 104 patients remained without any antibiotic prophylaxis. The patients of the prophylaxis group showed a statistically significant reduction of postoperative infectious morbidity. The costs are equalized by reduction in therapeutic applications of antibiotics.

Cefotaxime↗
PubMed1986

[Uterine ruptures--diagnostic problems following previous cesarean sections].

There are 16 ruptures of the uterus in a total of 28,391 deliveries, adequate a frequency of 0.59% or one rupture in 1774 cases. Whereas the fetal mortality is 43.7%, the maternal one amounts to 0%. Previous cesarean sections could be observed in 56.2%. The problems of ruptures of cicatrical uterus without symptoms and the complications will be referred to.

Adult↗
PubMed1985

Immunologic selection of hemopoietic precursor cells utilizing antibody-mediated plate binding ("panning").

We utilized the property of antibody adherence to plastic to separate and obtain enriched fractions of human myeloid (CFU-GM), erythroid (BFU-E) and pluripotent (CFU-GEMM) hemopoietic precursor cells. Nonadherent buoyant human marrow cells coated with mouse anti-human HLA-DR monoclonal antibody (Mc ab), an anti-pan T lymphocyte Mc ab (Leu 1/17F12) or a granulocyte--monocyte-specific Mc ab (MCS2) were incubated on polystyrene Petri plates coated with affinity purified goat anti-mouse immunoglobulin G (IgG). Cells bound to the coated plates and nonbound cells were separately recovered ("panned") by differential elution. Analysis of the nonadherent buoyant marrow cells demonstrated 12% to possess HLA-DR, 6% T, 40% MCS2 antigens on their surface by indirect immunofluorescence (IMF). After panning, 15% +/- 8%, 14% +/- 4% and 8% +/- 6% cells were plate-bound by their respective antibodies, demonstrating differing binding efficiencies. A substantial degree of purity of the recovered cell fractions was shown for bound 74% +/- 6% and 75% +/- 5% IMF positive cells) and nonbound cells (3% +/- 1% and 0.1% +/- 0.8% positive cells) coated with anti-HLA-DR or anti-T Mc ab respectively, with lesser purity for MCS2 panned cells. Seventy-three percent to 126% CFU recovery was noted, with a sevenfold enrichment of the HLA-DR bound cells for CFU-GM and CFU-GEMM, and 3.5-fold enrichment for BFU-E. Sequential panning, obtaining T nonbound-DR bound-surface immunoglobulin nonbound fractions, resulted in tenfold CFU-GM enrichment (107/10(4) cells, approximately equal to 1/100). Anti-MCS2 antibody was ineffective for panning, but use of this antibody in fluorescence-activated cell sorting (FACS) indicated the absence of the MCS2 antigen on the vast majority of CFU-GM. This study describes a relatively rapid and inexpensive method for obtaining enriched antigenically defined hemopoietic precursors in high yield. These techniques should prove useful for more clearly evaluating cellular and humoral interactions with hemopoietic precursor cells.

Animals↗
PubMed1984

Pan-leukocyte monoclonal antibody L3B12. Characterization and application to research and diagnostic problems.

In this report, the authors describe a murine anti-human monoclonal antibody, L3B12, which defines a pan-leukocyte cell surface antigen of approximately 180,000 m.w. Extensive screening against a variety of tissues indicates that L3B12 is sensitive and specific for leukocytes, related cells of bone marrow lineage, and their corresponding neoplasms. Unlike many lymphoid antigens that are not detectable following routine fixation and embedding, those recognized by L3B12 and related antibodies are variably preserved. L3B12 has proven useful in studying the antigen expression of normal leukocytic elements, lymphomas, and related disorders, and in enriching or depleting leukocytes from heterogeneous cell populations. From a diagnostic standpoint, L3B12 staining of tissue sections or cell suspensions is useful for distinguishing large cell lymphomas from undifferentiated carcinomas and in distinguishing lymphomas and leukemias from other small round cell tumors of childhood.

Adult↗
PubMed1984

Prognostic significance of complete surgical resection of pulmonary metastases in patients with osteogenic sarcoma: analysis of 32 patients.

Between 1972 and 1981, 93 patients with extremity osteogenic sarcoma without detectable metastatic disease were treated with surgery and adjuvant chemotherapy. Fifty-two patients remain continuously free of disease. Thirty-two of the 41 patients who relapsed had pulmonary metastases only and 26 underwent thoracotomy to remove all metastatic disease. Complete resection was possible in 11 of 26 patients as defined by the removal of all macroscopic disease, no microscopic disease at resection margins, and no histologic evidence of pleural disruption by tumor. Nine of 11 patients are currently free of disease with a median duration of most recent remission of 42 months (range, 3-72 months). Four of these nine patients have had only one relapse. Only two of 15 patients with incomplete resection of metastatic disease defined by the above criteria are currently free of disease for 57 and 101 months. A significant difference in survival from initial relapse for patients made surgically free of disease using this stringent criteria was observed even when the result is stratified for time to first relapse and number of pulmonary nodules (p = 0.005). A subgroup of patients within the group undergoing thoracotomies who can be expected to have an improved survival has been defined.

Adolescent↗
PubMed1983

The assessment of physical activity in older women: analysis of the interrelationship and reliability of activity monitoring, activity surveys, and caloric intake.

The interrelationship and reliability of three different activity measures were examined in 76 postmenopausal women. The women wore Large Scale Integrated (LSI) activity monitors, completed the Paffenbarger Activity Survey, and completed 3-day food logs for determination of caloric intake/expenditure. The Paffenbarger survey was assessed twice, a year apart. The results indicated that caloric intake was a very poor index of activity. The LSI activity monitoring and Paffenbarger survey were both effective, reliable measures of physical activity. However, they appeared to measure somewhat different aspects of physical activity. The LSI measured physical activity associated with movement, whereas the surveys measured the intensity component of energy expenditure. The research indicated that it is important to evaluate the characteristics of the activity of interest in order to select a physical activity tool for assessing activity patterns in older women.

Aged↗
PubMed1983

Methotrexate-induced renal impairment: clinical studies and rescue from systemic toxicity with high-dose leucovorin and thymidine.

Four separate groups of patients have been studied: (1) The effect of high-dose methotrexate (MTX) administration on glomerular filtration rate was determined by pre- and posttreatment inulin and creatinine clearances in nine patients. Measurements were made prior to and 24-40 hr after drug administration. Inulin and creatinine clearances both decreased a mean of 43%. No signs of systemic toxicity occurred. (2) Three other patients given high-dose courses of MTX developed MTX toxicity. Their creatinine clearance decreased an average of 61%. (3) In a separate group of five patients undergoing weekly MTX treatment, comparison of serum MTX pharmacokinetics with and without alkalinization of the urine demonstrated no significant difference in peak serum MTX levels or serum MTX decay. (4) Eight additional patients with severe renal dysfunction secondary to MTX were treated with increased doses of leucovorin and a continuous infusion of thymidine (8 g/m2/day) once renal failure was recognized. When high-dose leucovorin and thymidine were begun 48-72 hr after the MTX infusion, severe toxicity in the form of leukopenia, thrombocytopenia, diffuse mucositis, stomatitis, or skin rash was averted. We concluded the following: (1) high-dose MTX causes a subclinical decrease in glomerular filtration rate with each administration, even in nontoxic courses; (2) alkalinization of the urine with sodium bicarbonate does not alter plasma MTX decay, while volume expansion (hydration) is maintained constant; and (3) rigorous monitoring of serum creatinine and serum MTX levels 24-48 hr after MTX administration allows for the institution of rescue measures, including leucovorin and thymidine, which will abort the systemic toxicity that accompanies MTX-induced renal failure.

Adolescent↗
PubMed1983

[Prevention of preoperative infection with metronidazole].

We practiced a preoperative prophylaxis with 1.5g metronidazole daily starting three days before operation because of the increasing knowledge about the importance of anaerobic microorganisms, causing nosocomial infections. By this regime we saw a significant decrease of postoperative morbidity, detected by means of postoperative febrile temperatures and laparotomy wound abscesses. Bacteriological examinations before and after prophylaxis revealed a relatively high elimination of anaerobic isolates without influence on the aerobic and physiologic flora. In 66% of the cases with infections we isolate anaerobic strains. In cases of pelvic inflammatory diseases metronidazole is to be recommended both prophylactically and therapeutically. There is no resistance against metronidazole.

Abscess↗
PubMed1983

[Rare urethra-induced causes of urinary incontinence].

Diverticula and prestenotic dilatations of the urethra are rare causes of urinary incontinence. By means of two case reports symptoms, diagnose and treatment are discussed. The right interpretation of anamnesis and results of investigations, often misinterpreted because of the rarity of these kind of urinary incontinence, is of special importance.

Adult↗
PubMed1983

A single monoclonal antibody identifies T-cell lineage of childhood lymphoid malignancies.

Immunophenotyping studies with monoclonal antibodies have revealed the heterogeneity of childhood acute lymphoblastic leukemia (ALL) and non-Hodgkin's lymphoma (NHL). The lymphoid malignancies of T-cell lineage are particularly heterogeneous and, until now, no single monoclonal antibody has been found to identify all cases of T-ALL and T-NHL. A monoclonal antibody, 4H9, recognizes an antigen of 40,000 molecular weight on normal and malignant T cells. Thirty-six cases of childhood T-ALL and T-NHL were tested, and in all cases, the malignant blast cells were reactive with 4H9, whereas malignant cells from 61 cases of non-T ALL and NHL were not reactive with 4H9. Monoclonal antibody 4H9 is a sensitive and specific reagent for the identification of childhood T-cell ALL and NHL and should be extremely useful in immunophenotyping studies of lymphoid malignancies.

Antibodies, Monoclonal↗
PubMed1983

[Serum uric acid as a prognostic parameter in prenatal monitoring of gestoses].

A correlation between gestosis and increase of serum uric acid level has been known for a longtime. From the 6th month of pregnancy we found significantly increased values in all hypertensive pregnant women. In the 7th and 8th month of pregnancy there was a high significant deviation in gestoses second degree (classification of the organisation gestosis). In the two last months of pregnancy all gestoses deviated high significantly from the uric acid level in serum of the normal collective. There is a correlation between pathologically increased mean uric acid values in the 9th and 10th lunar month and increased systolic and diastolic blood pressure values. The uric acid level in pregnant women with gestosis, whose illness or its consequences led to cesarean section, is significantly higher than in patients with normal delivery. In accordance with literature we could not find a limit above the fetus dies. In our opinion determination of plasma uric acid in late pregnant hypertensive women is one additional parameter calculating both maternal prognosis and fetal risk.

Female↗
PubMed1982

Secretion of insulin or connecting peptide: a predictor of insulin dependence of obese "diabetics".

Ninety obese "diabetic" patients, including 55 treated with insulin injection, were characterized by measurement of levels of insulin or connecting peptide of proinsulin (C peptide) induced during oral glucose tolerance testing. After reduction of body weight to ideal values, patients whose peak serum insulin levels were initially 64 microunits/mL or greater had reductions of blood glucose values from 227 +/- 24 to 122 +/- 10 mg/dL (fasting) and from 400 +/- 49 to 160 +/- 11 mg/dL (two hours postprandial); at C-peptide peaks of 6.0 ng/mL or greater, these blood glucose values fell from 244 +/- 30 to 118 +/- 12 mg/mL and from 400 +/- 51 to 160 +/- 16 mg/dL, respectively. Patients with peak values of less than 60 microunits/ml for insulin or less than 6.0 ng/mL for C peptide did not normalize the blood glucose concentration after weight loss. This critical level of insulin secretory reserve separating these groups was similar to that previously reported for avoidance of diabetic retinopathy and neuropathy. These results suggest that levels of insulin or C peptide induced during glucose tolerance testing distinguish between two types of hyperglycemic obesity-insulin-dependent diabetes mellitus and insulin-resistant obesity. Blood glucose levels alone did not identify these groups. Among consecutive hyperglycemic obese patients, 36% achieved normoglycemia by weight loss alone, including 33% of those previously treated with insulin injection.

Adult↗
PubMed1981

High-dose methotrexate in osteogenic sarcoma adjuvant chemotherapy and limb salvage results.

This communication provides a description and update of the three adjuvant regimens utilized at the Sidney Farber Cancer Institute. The disease-free survivals are: Study I--42% at 4 years; Study II--58% at 3 years; and Study III--currently 78%. In the limb salvage experience, among the evaluable patients, 6 of 12 treated with preoperative chemotherapy are disease free (median 32 months) and 12 of 14 (86%) treated without preoperative chemotherapy are disease free (median 13 months).

Amputation, Surgical↗
PubMed1981

[Free fat in amniotic fluid - a criterion for prenatal assessment of foetal maturity (author's transl)].

Smears were made and stained with nile-blue sulphate following sedimentation of 235 amniotic fluid samples which had been obtained by amniocentesis. An assessment was made of the amount of free fat and of the various cell shapes involved. Free fat was found to occur in higher quantity in advanced pregnancy. These data were compared with postnatally estimated pregnancy age. The method proved to enable objective assessment of foetal maturity over the last weeks of pregnancy, and it seemed to be very useful in differentiating between hypotrophy and immaturity.

Amniocentesis↗