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Biomedical subjects

R M Briggs

Publications and source records attributed to R M Briggs.

At least 19 recordsLinked to original sources
PubMed1992

Clinical and cytologic aspects of ocular late-phase reaction in the guinea pig.

Conjunctival tissue of 12 guinea pigs (6 experimental animals, 6 controls) was sensitized with IgG1 (PCA titer 1:2,000) antisera to dinitrophenol carrier and challenged topically with hapten. Periorbital swelling, conjunctival edema and conjunctival redness were evaluated clinically at 0.5 h and hourly for 12 h, and again at 24 and 48 h. Tears were collected at each time point for cytology. Results showed an early-phase reaction (EPR) peaking at 0.5 h and a late-phase reaction (LPR) peaking at 5-7 h. Periorbital swelling was minimal 4 h after appearance of the EPR. Conjunctival edema and redness increased in both the early and late phases, but without two distinct peaks. However, individual animals in both groups did show biphasic reactions. Tear cytology showed an abnormal increase in neutrophils and eosinophils in the later time periods and was a significant way to detect ocular anaphylaxis. In conclusion, if the presence of two significant peaks of clinical inflammation after one antigen challenge is taken as the narrowest definition of a late phase in anaphylaxis, our results show an ocular LPR occurring in our animal model.

Animals↗
PubMed1991

Double hapten challenge in guinea pigs undergoing an ocular late-phase reaction.

Clinical and histological profiles of guinea pig conjunctiva undergoing late-phase reaction (LPR) were evaluated before and after additional antigenic challenge. Four groups of animals were passively sensitized with IgG1 antibodies, challenged with the specific hapten di-DNP-lysine, and rechallenged during LPR either with di-DNP-lysine, or with PBS, or with an aspecific antigen to characterize the reactivity of the inflamed conjunctival tissues. The course of the clinical anaphylactic responses was modified slightly only by challenge with a specific hapten during LPR. However, no significant changes in the inflammatory cell profile were observed in conjunctiva undergoing LPR after an additional challenge. This suggests the participation of mechanisms which may mediate the attenuation of the anaphylactic response in physiologic conditions of persistent antigen provocation.

Anaphylaxis↗
PubMed1990

Early and late phases of ocular anaphylaxis in actively immunized guinea pigs.

A model of ocular anaphylaxis with distinct early- and late-phase components was studied in actively immunized guinea pigs. Twenty guinea pigs were injected with dinitrophenylated (DNP) bovine gamma globulin emulsified in Freund's complete adjuvant and challenged topically with di-DNP-lysine. Clinical signs were monitored over a 48 h period. An early-phase reaction (EPR) characterized by conjunctival edema, conjunctival erythema, lid swelling, and lid redness was observed. This reaction peaked at 0.5 h after challenge and subsided to a low point at 3-4 h. Subsequently, a second episode of lid swelling and lid redness was observed at 4-8 h. All animals in both groups exhibited an EPR. In addition, 75% of the animals underwent an EPR and an LPR. No animals exhibited an isolated LPR. Of the animals that underwent a dual response, 47% were biphasic, 6% were prolonged and 47% were multiphasic. The development of an active model of ocular anaphylaxis exhibiting both EPR and LPR components will enable studies of mechanisms which regulate the frequency and magnitude of these ocular allergic responses.

Anaphylaxis↗
PubMed1990

Clinical patterns of ocular anaphylaxis in guinea pigs passively sensitized with IgG1 antibody.

A model of topically induced ocular anaphylaxis in guinea pigs was developed. A guinea pig anti-dinitrophenyl (DNP) bovine gamma-globulin antiserum rich in IgG1 antibodies was injected subconjunctivally; various serum dilutions and latent periods were tested. The anaphylactic response was elicited with di-DNP-lysine applied topically. The response was characterized by rating 11 ocular signs. Although the 4-hour latent period is considered optimal for passive cutaneous anaphylaxis, a 14-hour latent period yielded the strongest ocular reaction and appeared to the most appropriate time for clinical assessment. Both an early-phase reaction (peaking in the 21st hour) and a late-phase reaction (peaking at 6-10 h) were observed. The two signs of the early-phase reaction that recurred in the late-phase reaction were periorbital swelling and lid redness. The anaphylactic reaction displayed different patterns in different animals: protracted, biphasic and multiphasic.

Anaphylaxis↗
PubMed1990

Penetrating the conjunctival barrier. The role of molecular weight.

Dinitrophenyl (DNP) derivatives of various molecular weights were tested for their ability to elicit ocular anaphylaxis after topical application to the eye of immunized animals. Adult male Sprague-Dawley rats were immunized by intraperitoneal injection of DNP-Ascaris suum extracts and alum and were then skin-tested with DNP-bovine serum albumin on day 13 post-immunization to assess their sensitivity to the DNP hapten. On day 14, animals were challenged topically with DNP derivatives in one eye; PBS was applied to the contralateral, control eye. Animals were evaluated clinically, and ocular tissues were processed for histologic evaluation. The compounds used for topical ocular challenge included the DNP derivative of egg albumin (MW 43,500 D), soybean trypsin inhibitor (MW 20,080 D), insulin (MW 5733 D), B-chain insulin (MW 3496 D), and lysine (MW 478 D). Only di-DNP-lysine elicited clinical signs of redness, edema, and tearing and histologic evidence of mast cell degranulation. None of the other compounds, tested in solutions of either equal numbers of milligram per milliliter or equimolar concentrations, elicited ocular anaphylaxis after topical application. A compound of low molecular weight, less than 3496, is needed to elicit ocular anaphylaxis when applied topically.

Administration, Topical↗
PubMed1990

Reducing direct-care staff absenteeism: effects of a combined reinforcement and punishment procedure.

Absenteeism of 130 direct-care staff was reduced by 27% through a mixed consequence procedure consisting of positive reinforcement for reliable attendance and punishment (progressive discipline) for attendance abuse. Reduced rates of absenteeism were maintained over a 12-month period. A 17% reduction in overtime and an increase in annual staff turnover from 34% to 45% also occurred. Results extend the findings of mixed consequence procedures to residential facilities for persons with developmental disabilities. Development of a more powerful positive reinforcement component was discussed.

Absenteeism↗
PubMed1989

Breast reconstruction following a mastectomy for carcinoma of the breast.

Reconstruction of the breast after mastectomy is today totally possible assuming no major medical contraindications. Contemporary surgical and technical refinements no longer allow as adequate creation of a chest mound that must be covered by conservative clothing. Instead, the usual result of a completed reconstructive effort should be viewed as most normal, aesthetic, and pleasing by the patient, the reconstructive surgeon, and the impartial family physician. It is perhaps not too bold to state that there is practically no mastectomy circumstance that does not lend itself to a reconstructive effort where highly acceptable results can be expected. The surgical techniques are widely available in almost every community. The most important component of the reconstructive effort, however, is the careful selection of procedures for the individual patient. This is accomplished only after thorough assessment and open discussions to educate the patient about the realistic available alternatives.

Breast Neoplasms↗
PubMed1983

Cystosarcoma phylloides in adolescent female patients.

Nine cases of cystosarcoma phylloides in adolescent female patients are reported along with an additional 35 cases collected from the literature. Analysis of these 44 cases revealed 37 (84.1 percent) benign lesions, 6 (13.6 percent) malignant tumors, and 1 borderline lesion. Excision was the most common operative procedure and was performed in 35 patients. Nine patients underwent mastectomy. There were three recurrent lesions (one benign and two malignant) for a recurrence rate of 6.8 percent. Wide excision was successful in the treatment of recurrent lesions. On the basis of these data, excision is the preferred initial therapy of cystosarcoma phylloides in the adolescent patient regardless of the histologic classification of the lesion. Malignant cystosarcoma is more likely to recur than a benign lesion but a recurrence can be managed with reexcision. Sacrifice of the adolescent breast at the initial procedure is strongly discouraged.

Adolescent↗
PubMed1983

Anastomotic aneurysms.

Although the incidence of anastomotic false aneurysms decreased precipitously with the cessation of usage of silk sutures for vascular anastomoses, the prevalence of these aneurysms has undoubtedly increased in keeping with an ever-increasing volume of peripheral vascular operations. Most aneurysms occur at femoral anastomoses and are easily diagnosed, since most patients present with a groin mass. Anastomotic aneurysms cannot be considered innocuous. Some may rupture and others have been associated with limb ischemia due to acute thrombosis or embolism. Thus, surgical correction is indicated for most anastomotic aneurysms. Patients at high risk with small aneurysms in accessible locations may, however, be followed if they are asymptomatic and there is no evidence of enlargement of the aneurysm [5].

Adult↗
PubMed1980

High prevalence of cervical dysplasia in STD clinic patients warrants routine cytologic screening.

The results of routine cervical cytology screening at a Planned Parenthood Center (PPC) clinic were compared to those at a nearby sexually transmitted diseases (STD) clinic in Seattle. Cervical cytologic findings were consistent with cervical intraepithelial neoplasia (CIN), grades 1 (mild dysplasia), 2 (moderate dysplasia), or 3 (severe dysplasia to carcinoma in situ) in 502 (5.9 per cent) of 8,504 PPC patients and 87 (11.4 per cent) of 764 STD patients (p = .001). This rate for STD patients is five times that reported for the general population. Sixty-three PPC patients and 31 STD patients with screening smears consistent with CIN 1 or 2 underwent further prospective study by us, including repeated cytologic and colposcopic examinations. Thirty-seven (59 per cent) of 63 PPC patients and 26 (84 per cent) of 31 STD patients (p = .02) had at least on additional smear or colposcopy consistent with CIN and were advised to undergo cervical biopsy. Among those who underwent recommended biopsy, CIN was confirmed histologically in 15 (50 per cent) of 30 PPC patients and 11 (61 per cent) of 18 STD patients. Thus, the proportion of patients who had screening cytologic findings consistent with CIN, the proportion with persistent cytologic or colposcopic findings consistent with CIN on retesting, and the proportion of those biopsied who had histologically confirmed CIN, all were higher for STD than for PPC patients. There is a serious need for cytologic screening in STD clinics throughout the nation.

Adolescent↗
PubMed1980

Midlevel personnel in obstetrics and gynecology practices--cost-effectiveness and consumer benefits.

Two private obstetrics-gynecology practices, in adjacent Northwest cities, which employ midlevel nurse practitioners for routine obstetric and gynecologic care were the subject of this study. At site A fees charged by the practitioner were 44 percent less than those for identical services provided by the physician. This was an attempt to pass cost savings directly to patients. At site B, fees were the same for both physician and practitioner, yielding a significant net income to the practice. At this latter site a proportion of the income was passed to patients by not increasing office fees for the years 1975 (when the practitioner was hired) through 1977, during which time the average fees of ten other physicians increased. The study shows that the use of midlevel personnel in private offices is highly cost-effective and profitable. Ideally, this profit can be passed on to patients by reduced overall office fees.

Cost-Benefit Analysis↗
PubMed1979

Long-term survival in basal cell carcinoma metastatic to bone: a case report.

A total of 97 cases of metastatic basal cell carcinoma have been reported in the literature, 22 of which were metastatic to bone. To date there has been no survival following bone metastasis. A case report of significant long-term survival--over three times the expected--is presented. The treatment described is perhaps a guideline for management of basal cell carcinoma metastatic to bone, though it is presumed the basic biological nature of the tumor determines length and quality of survival.

Adult↗
PubMed1978

Education and integration of midlevel health-care practitioners in obstetrics and gynecology: experience of a training program in Washington state.

The impetus for the development of the Gynecorps Training Program was the identification of medically underserved populations of women in Washington State and their need for preventive health care, the maldistribution of physicians, and the success of a pilot program for training midlevel personnel conducted in 1972 by the Department of Obstetrics and Gynecology, University of Washington School of Medicine. The program trains community-based and -sponsored Registered Nurses and Physician's Assistants as women's health-care specialists, with the goal of delivering preventive care in obstetrics and gynecology to populations of high-risk, low-income, and/or underserved women. A summary of the training program, its curriculum, and the integration of its graduates into community health teams is presented and discussed.

Certification↗
PubMed1978

Cervical cytology. Increased sensitivity with a second cervical smear.

Two consecutive Papanicolaou smears were obtained in 3524 patients during a single clinic visit. The first smear consisted of a combined cervical scrape and vaginal pool sample (Fast smear) while the second smear contained only a cervical scrape. Of the 93 patients with abnormal cytology, 71 (76%) patients were identified by the first smear and 74 (80%) by the second smear. The interpretation of the two smears correlated in 51 patients (54.8%). Of the remaining 42 patients, the cytologic findings were more advanced in the second smear in 19 cases, and in 23 cases the reverse was true. There were 19 instances in which the cytologic findings were suspicious or positive. In 8 (42.1%) of these 19, one of the two smears contained either negative (7) or atypical (1) cytologic findings. The histologic diagnosis corresponded to the more advanced cytologic findings in all cases. The addition of the second cervical smear increased the detection rate of suspicious of positive cytology by 26.3%.

Biopsy↗
PubMed1977

Orientation and lever responding in auditory discriminations in squirrel monkeys.

Head orientation during auditory discriminations was studies in squirrel monkeys using a two-lever trial-by-trial procedure. Animals were studied using auditory discriminations based on the position of the sound and on the spectral content differences between a pure tone and a noise. After the percentage of correct responses reached asymptote, head orientation was measured using videotape recordings. Orientation occurred on virtually every trial and was under the control of the position of the sound under all conditions. Lever responding was controlled by the same parameters of the sound under some conditions, and by different parameters in others. Orientation and lever responding were correlated (a level response could be predicted from the direction of orientation) when both responses were under the control of the same parameters of the sound. The two responses were uncorrelated when they were controlled by different parameters of the sound. Orientation and lever responding were not functionally related.

Animals↗