Biomedical subjects
Publications and source records attributed to R J Rubin.
A retrospective study was done comparing the rates of local recurrence in cancer of the rectum treated by low anterior resection using the stapling device or hand-sewn. It was found that there was no increase in recurrences when the stapler was used, even though lower lesions were treated.
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Adenosine 3',5'-monophosphate (cyclic AMP), its dibutyryl and monobutyryl derivatives, and a number of other naturally occurring adenine-containing compounds were separated by isocratic ion pair high-performance liquid chromatography. A mobile phase consisting of 30% methanol in 0.1 M KH2PO4 (pH 4.0) containing 1 mM tetramethylammonium hydroxide as the counterion was used to separate the butyryl derivatives. To sufficiently separate cyclic AMP from other adenine-containing compounds, a mobile phase containing 6% methanol in the same aqueous buffer plus counterion was used. Extraction of these cyclic nucleotides from deproteinized biological samples using disposable reverse-phase extraction columns is described. This not only eliminated lipophilic contaminants, but also served to concentrate the samples. The outlined procedures were used to determine the concentrations of the butyryl derivatives in lung tissue and perfusate following a 35-min lung perfusion with 100 microM N6-O2'-dibutyryl cyclic AMP. The role of this technique in the analysis of cyclic nucleotide derivatives as compared with conventional assay procedures is discussed.
One hundren fifty households in a rural Iowa community were surveyed to determine the frequency and reasons for aspirin use, their awareness of aspirin effects, and their sources of aspirin information. Of those surveyed 82 percent used aspirin to some extent and 59 percent used it at least monthly. The frequency of aspirin use was indirectly associated with age. The number of correct aspirin effects mentioned was 1.8 +/- 1.1 with 89 percent mentioning analgesia as an effect of aspirin. Nineteen percent mentioned mental relaxation as an effect of aspirin. The number of correct effects mentioned was associated directly with education and indirectly with age but was not associated with the frequency of aspirin use. The number of information sources mentioned was 1.3 +/- 0.7 with 34 percent mentioning television and radio advertising as a source of aspirin information. Awareness of gastrointestinal irritation and antipyretic effects and the number of correct effects mentioned were each associated with mention of television and radio advertising as an information source. Use of aspirin for fever was associated with mention of physicians as an information source. Seventy-two percent of the respondents indicated a desire for more information with physicians mentioned as the desired source of additional information by 69 percent of respondents.
Presented is the authors' experience with 182 patients treated primarily by the one-stage primary resection or two-stage resection. (Hartmann operation). One hundred thirty five patients undergoing primary resection had an associated mortality rate of 2.2 per cent. Of 44 patients operated upon using the Hartmann operation for complicated diverticulitis (obstruction, perforation, abscess formation, or fistula formation) the mortality rate was 4.5 per cent. Primary resection in an elective setting is associated with the lowest mortality and morbidity; however, marked inflammation, obstruction and/or peritonitis preclude primary anastomosis. In the urgent setting the staged operation is associated with acceptable morbidity and mortality.
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The initial experience of several colonic and rectal surgeons with the EEA stapling device for low colorectal anastomoses is reviewed. It was found that the EEA gives a better anastomosis than is possible by hand and that a surgeon familiar with doing a low anterior resection can perform it on patients for whom it is not possible by hand. However, the results with the EEA are not perfect or guaranteed. The many complications associated with its use are reviewed, and ways to avoid them are discussed.
Sixty-eight patients with rectal cancer treated by electrocoagulation are reviewed. All were followed up for a minimum of 5 years. The survival rate in patients with small exophytic cancers is greater than 70 percent. However, the recurrence rate after electrocoagulation is 40 percent. Electrocoagulation offers an alternative for the primary treatment of rectal cancer, particularly in older patients with small lesions.
The Ames assay was used to investigate the mutagenicity of several phthalate esters as an approximation of their carcinogenic potential. The ortho diesters, dimethyl phthalate (DMP) and diethyl phthalate (DEP) produced a positive dose-related mutagenic response with Salmonella TA100, but only in the absence of S-9 liver enzymes. Dibutyl, di(2-ethylhexyl), mono(2-ethylhexyl), and butyl benzyl phthalate as well as the dimethyl isophthalate and terephthalates and the trimethyl ester, trimellitate, were not mutagenic with TA100 or TA98 in the presence or absence of S-9. In a host-mediated assay, extracts of 24-hr urines of rats injected IP with DMP (2 g/kg) were not mutagenic to TA100 at levels up to 8 equivalent-ml of urine/plate (representing 30% of their daily urinary output). In vitro studies revealed that S-9 associated esterase hydrolyzed DMP to the monoester and methanol and eliminated its mutagenicity. Whole rat skin was shown to have about 1.5% of the DMP-esterase activity of liver, when compared on a wet weight basis. An in vitro binding study indicated that epidermal macromolecules bound DMP at a severalfold greater rate than hepatic macromolecules. Thus, both the mutagenicity and binding of DMP are inversely related to the metabolism of this compound. These results suggest that skin could be at high risk for a mutagenic/carcinogenic insult.
A case is presented in which a very large circumferential villous tumor was totally removed transanally with complete anatomic and physiologic restoration. Large circumferential tumors of the rectum present formidable technical problems. They may be malignant. When they are benign, abdominoperineal resection can be avoided. A less radical procedure that may be employed with complete resection of the tumor and without stricture formation, is described briefly.
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