Left atrial diastolic compression in a patient with a large pericardial effusion and pulmonary hypertension.
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Cardiac Tamponade↗
Biomedical subjects
M R Rose
Publications and source records attributed to M R Rose.
Mammographically detected duct carcinoma in situ. Frequency of local recurrence following tylectomy and prognostic effect of nuclear grade on local recurrence.
Seventy-nine patients with mammographically detected foci of duct carcinoma in situ (DCIS) of histologically confirmed extents of 25 mm or less, were treated by tylectomy without irradiation or axillary dissection. Adequacy of excision was confirmed histologically, by radiographic-pathologic correlation and by postoperative mammographic examination. Eight patients (10.1%) have recurred locally in the immediate vicinity of the biopsy site. Four patients developed recurrent in situ disease identified mammographically, and all were initially treated by reexcision. One of these patients subsequently elected to undergo mastectomy; no residual in situ or invasive disease was detected in the breast or in axillary lymph nodes. Four patients developed recurrent invasive disease; 50% of these recurrences were detected mammographically. All patients were treated by mastectomy with node dissection. Three had confirmed minimal invasive carcinomas and were N0, one patient had a 13-mm invasive lobular carcinoma with a single Group I micrometastasis. All patients, including those treated for a recurrence, are presently free of disease but three patients died of heart disease. Nuclear grade would appear to identify subsets of DCIS more likely to produce local failure after tylectomy alone. Duct carcinoma in situ with high-grade nuclear morphology and comedo-type necrosis was associated with a 19% local recurrence rate after an average interval of 26 months; only one of ten patients with intermediate-grade DCIS developed a local recurrence at 87 months; and none of 33 patients with DCIS of micropapillary/nonnecrotic cribriform type and low-grade nuclear morphology developed local recurrence in the follow-up period.
Breast Neoplasms↗
Genetics of increased lifespan in Drosophila.
Natural selection in the laboratory has been used to produce populations of Drosophila with genetically increased lifespan. These populations have been used to determine the physiological basis of postponed ageing and its pleiotropic concomitants. It appears that many loci and a number of physiological alterations are involved in increased lifespan.
Aging↗
Kids and cocaine--a treatment dilemma.
Despite aggressive efforts to recruit into treatment cocaine users 21 years and younger, we obtained only 12 such clients over a period of 9 months, while recruiting 122 adult cocaine clients during a comparable time frame. An examination of admissions data for the city, state, and nation indicated that our experience was typical. However, data from the most recent national household survey indicate that, to the extent need for treatment is determined by frequency of cocaine use, we should anticipate a much greater proportion of admissions to treatment to come from persons 21 years of age and younger. Yet, there appears to be an under-recruitment of youth into treatment, particularly evidenced by low rates of self-referral for juvenile as compared to older treatment admissions. Younger cocaine users may be less severely impaired and/or dependent, or may be more reluctant to use the treatment resources available. Whatever the barriers are to getting help, it becomes the special task of agencies and individuals in the community to help assure that younger cocaine users will obtain the assistance they need. Four community resources are seen as particularly relevant: family, schools, the medical community, and public agencies in the areas of health, social services, and criminal justice. The capacity of each to take action and possible impediments to that action are discussed.
Adolescent↗
What evolutionary biology can do for gerontology.
Evolutionary biologists have shown mathematically that aging is an inevitable consequence of age-specific natural selection acting on species with somata separate from germ lines. Two specific genetic mechanisms are known which could underlie the evolution of aging under these conditions: age-specificity of gene effects and antagonistic pleiotropy between early and late ages. Comparative evidence indicates that senescence occurs only when the stipulations of the evolutionary theory are met. Laboratory experiments with Drosophila indicate that prolonging the action of natural selection leads to the evolution of postponed senescence. The genetic variation involved in such postponed senescence exhibits both age-specificity and antagonistic pleiotropy. These theories and empirical findings together suggest that the best general theory of aging now available is the evolutionary theory. In addition, this work has yielded Drosophila stocks with postponed senescence that are being used to unravel physiological mechanisms of senescence.
Aging↗
Comparison of the characteristics and functioning of cocaine treatment and cocaine research subjects.
Comparisons were made of the functioning and characteristics of cocaine-abusing volunteers to a research ward (N = 25) and to an outpatient treatment program (N = 33) at the same research facility. It was hypothesized that individuals volunteering for clinical studies and for treatment-related studies would represent different segments of the cocaine-abusing population, and that those differences could be significant to an understanding of study findings. Demographic/background variables were assessed through use of the Addiction Severity Index, risk-taking behaviors relative to HIV infection and AIDS through use of a structured interview schedule, intellectual functioning through use of the Shipley Institute for Living Scale, and psychiatric symptoms through use of the Hopkins Symptom Check List (SCL-90R). Significant differences were obtained for criminal activity, needle sharing, and selected psychiatric symptoms. Marital status was particularly important to an understanding of differences between research and treatment groups in that unmarried treatment subjects showed significantly greater psychopathology than research subjects on 3 of 11 symptom scores. Unmarried treatment subjects showed significantly greater deviance than married treatment subjects on 7 of 11 symptom scores. The findings suggest a relationship between marital status and the psychological functioning of treatment clients and indicates that different segments of the cocaine-abusing population volunteer for different types of research.
Adult↗
Reproductive wastage and the evolution of genetic systems.
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Animals↗
Coronary dissection following chest trauma with systemic emboli.
Coronary artery dissection is a rare entity which occurs following blunt chest trauma, during coronary angiography and coronary bypass surgery, and spontaneously in the peripartum period. We report a young man who presented with recurrent systemic emboli following an asymptomatic anterior wall myocardial infarction associated with dissection of the LAD and mural thrombus three years earlier after sustaining blunt chest trauma.
Adult↗
Males, parthenogenesis, and the maintenance of anisogamous sex.
The problem of the maintenance of anisogamous sex is addressed by considering the effect of fertilization on the fitness of parthenogenetic females when such fertilization yields inviable triploid progeny. We consider four types of parthenogenesis: (i) apomixis, (ii) homogametic amphimixis, (iii) heterogametic amphimixis, and (iv) homogametic automixis. Homozygous sexual populations are genetically stable if males or selection eliminate the excess females produced by heterozygous parthenogenetic genotypes. Homozygous parthenogenetic populations are stable if the parthenogenetic output of homozygotes exceeds that of heterozygotes. In turn, sex can only invade heterozygous parthenogenetic populations when sexual output of parthenogens is larger than their parthenogenetic output. The existence of interior stable equilibria generally requires the instability of at least one boundary and some degree of heterosis. In a two-locus model, we study the evolution of mechanisms protecting either sex or parthenogenesis in reproductively polymorphic populations. We find that males do not respond to the presence of parthenogenesis in such a way as to eliminate it, but parthenogenesis is subject to selective pressures increasing reproductive isolation, and thus the success of parthenogenesis. The results suggest that reproductively polymorphic populations are ephemeral.
Animals↗
Paget's disease of the nipple. Alternative management in cases without or with minimal extent of underlying breast carcinoma.
Six cases of Paget's disease of the nipple without clinical or mammographic evidence of a breast mass are described, two without underlying carcinoma of duct origin, and four with very limited duct carcinoma in situ of the most distal lactiferous ducts. Ultrastructural and immunohistochemical studies on these cases demonstrate that Paget cells arise in situ and invalidate the prevalent "epidermotropic" theory of histogenesis. Paget's disease of the nipple is considered to be an independent in situ carcinoma and part of the general phenomenon of multicentricity in breast cancer. A therapeutic option of conservative surgical intervention and follow-up is described for five of these select patients, all of whom are presently without evidence of disease with an average follow-up of 50 months (range, 30-69 months).
Adult↗
Segmental mastectomy without radiotherapy. Short-term follow-up.
Short-term treatment failures following 43 segmental mastectomies without radiation therapy and 157 total mastectomies for primary operable breast cancer Stages I and II (T1-2, N0-1, M0) are compared. Although not randomized by design, the patients in the two treatment groups were of similar age and had tumors of comparable histologic type, size, grade, and stage. The overall recurrence rates in an average follow-up of 24 months (range, 6-48 months) were 5% for patients treated by standard mastectomy and 19% for those treated by segmental mastectomy. Recurrence rates in patients with the more commonly encountered carcinomas of 11 to 50 mm in size treated by surgery alone were 7.5% for total mastectomy and 28.0% for segmental mastectomy. Nearly all of this difference relates to a higher frequency of local recurrence in the segmental mastectomy group (P = less than 0.005). Recurrent disease in both groups developed at comparable intervals, averaging 17 months for segmental mastectomy and 16 months for total mastectomy. Using a serial subgross technique, which permitted detection of clinically unsuspected involvement of resection margin by microscopic foci of carcinoma, it was noted that such involvement was an important prognostic indicator for local recurrence. Five of eleven breast resections with this feature developed local recurrence, compared with only 3 of 32 without such involvement of the resection margin.
Breast Neoplasms↗
The contagion mechanism for the origin of sex.
The origin of sex is one of the least understood aspects of the evolution of sex. Recently it has been proposed that sex arose as a result of a contagious genetic element which acted so as to foster its own transmission. Two continuous-time deterministic models of this mechanism are analysed. The first model lacks population regulation. With this assumption, sex is always established in the population, predominating if the sexual form is viable. The second model includes population regulation, giving rise to evolutionary dynamics in which sex need not be established in the population. In addition, with the second model, when the sexual form is viable, it need not fix. Thus, the contagion mechanism can give rise to sex, but need not do so.
Biological Evolution↗
Japanese B encephalitis: epidemiological, clinical and pathological aspects.
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Antibodies, Viral↗
A case of Japanese B encephalitis imported into the United Kingdom.
A case of acute encephalomyelitis, serologically proven to be due to Japanese B encephalitis virus, is reported. The patient, a 35-year-old woman, contracted the disease whilst in Hong Kong but presented in the United Kingdom. She required ventilatory support and was given high-dose steroids. She recovered from the illness but died after a period of four months from respiratory/cardiac arrest.
Adult↗
Duct carcinoma in situ. Relationship of extent of noninvasive disease to the frequency of occult invasion, multicentricity, lymph node metastases, and short-term treatment failures.
Fifty-three breasts resected for a biopsy diagnosis of duct carcinoma in situ were studied with a serial subgross and correlated radiographic method of examination designed to permit quantitation of the extent of the noninvasive lesion in the breast. Overall frequencies of occult invasion and multicentricity were 21 and 32%, respectively. Among 24 lesions 25 mm or larger in extent (average, 63; median, 56 mm) 11 showed occult foci of invasion, 13 had multicentric foci and six had nipple involvement. Among 29 lesions less than 25 mm in extent (average, 10; median, 8 mm) there were no instances of occult invasion, four were multicentric and two had nipple involvement (P = less than 0.05 for multicentricity and occult invasion). Twenty patients with lesions averaging 8 mm in extent are being followed after excision only in an experimental program. There have been three local recurrences at an average follow-up of 44 months. All recurrences occurred ipsilaterally, two were within the prior biopsy site. All patients with recurrence are free of disease following local resection in two and modified radical mastectomy in one. For lesions with associated microcalcifications, the distribution of the mammographic microcalcifications closely approximates the extent of disease as confirmed histologically. These findings suggest that an important predictive factor for the presence of occult invasion and multicentricity in the resected breast is the extent of the noninvasive lesion.
Adolescent↗
High-frequency genomic rearrangements involving archaebacterial repeat sequence elements.
Halobacterium halobium is an obligately halophilic archaebacterium of interest to molecular biologists for many reasons, one of which is the unexplained high frequency (10(-4)-10(-2) mutants per cell plated) at which it yields readily identifiable and unstable mutants. We showed previously that the genome of H. halobium contains many (greater than 50) families of repeated sequences whose members are dispersed on both chromosome and plasmid. Here we report that most if not all of the members of most of these repeat sequence families effect or are affected by spontaneous genomic rearrangements. Quantitative analyses show that such repeat sequence-associated rearrangements (which may be of several kinds) occur at high frequencies (greater than 4 x 10(-3) events per family per cell generation), while unique-sequence DNAs are physically stable. The presence of so many families of elements of such great instability in the halobacterial genome gives it an unusual degree of structural and perhaps functional plasticity.
Genes, Bacterial↗
A physiological barrier for the maintenance of anisogamous sex.
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Animals↗
Effect of K3T3 sarcomas on tissue concentrations of vitamin E.
In this study, the effect of tumor presence on the concentration of vitamin E in the liver, spleen, and kidney of BALB/c mice was measured, and the influence of the degree of fat saturation was assessed. In mice fed diets deficient in vitamin E, the presence of a transplanted sarcoma in the thigh significantly increased the concentration of the vitamin in all 3 organs. This was true whether the fat was saturated or unsaturated (hydrogenated coconut oil [HCO] or corn oil [CO], respectively). The tumor itself was generally lower in tocopherol than were other tissues of the tumor-bearing host. In mice fed diets containing vitamin E, the tumor increased the vitamin content in some organs but not others. Only in the kidney of tumor-bearing mice fed the HCO +/- E diet was there a significantly decreased content of the vitamin. A comparison of the spleen tocopherol content with mitogenesis by concanavalin A revealed a positive correlation, which explains why the spleens of tumor-bearing mice fed a diet deficient in vitamin E exhibited higher mitogenic activity than the spleens of normal mice fed the same diet (namely, the spleens from tumor-bearing mice had a higher content of tocopherol).
Animals↗