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Biomedical subjects

W A Robinson

Publications and source records attributed to W A Robinson.

At least 91 records · Page 5Linked to original sources
PubMed1984

Vitamin E improves cell-mediated immunity in the burned mouse: a preliminary study.

Profound immunosuppression occurs after major burn injuries. The ability of vitamin E to prevent post-burn immunosuppression was tested in mice using ear swelling in response to a challenge with 2,4-dinitrofluorobenzene (DNFB) as an in vivo measure of cell-mediated immunity (CMI). Vitamin E was administered to burned mice every other day for 14 days by either the topical or intraperitoneal route. Dimethyl sulphoxide (DMSO) was compared to white petroleum jelly (VAS) as a vehicle for topically administered vitamin E. Mean CMI +/- the standard error of the mean (SEM) was depressed to 55 +/- 4 per cent of normal control in untreated burned mice. Treatment with either parenteral vitamin E in corn oil or topical vitamin E in DMSO improved CMI dramatically compared to burned controls (P less than 0.005) while vitamin E in VAS had a less beneficial effect on CMI (P less than 0.05). We conclude that vitamin E is an effective immunomodulator in burned mice.

Administration, Topical↗
PubMed1984

Septic cavernous sinus thrombosis.

Septic cavernous sinus thrombosis remains a potentially lethal disease, although advances in therapy have lowered the morbidity and mortality substantially. Prevention, early diagnosis, and aggressive treatment offer the best hope for recovery.

Adult↗
PubMed1984

Evaluation of prophylactic oxacillin in cat bite wounds.

A prospective, double-blind, placebo-controlled study was undertaken to determine the influence of prophylactic oxacillin on the frequency of infection in cat bite wounds. Adult patients with uninfected full-thickness wounds presenting within 24 hours of injury were considered. Emergency department management consisted of cleansing, irrigation, debridement, and closure as indicated; no topical antibiotics were applied. Patients were randomly assigned to receive oxacillin 500 mg qid for five days or identically appearing placebo. Home wound care was standardized and patients were observed at least every two days for a minimum of five days, or until wounds were sufficiently healed to allow discharge from the study. Clinical assessment of infection was confirmed microbiologically when possible. Twelve patients were admitted and 11 completed the study. Oxacillin (n = 5) and placebo (n = 6) groups were identical in sex, age, number of wounds per patient, wound location and type, delay to emergency department presentation, length of follow-up observation, medication compliance, and adequacy of home wound care. Four of six patients receiving placebo, but none of the five receiving oxacillin, developed a wound infection (P = .045). Material obtained from three of these four patients yielded Pasteurella multocida as the responsible organism. Prophylactic oxacillin was thus associated with a significant reduction in the frequency of infection following cat bites. We recommend such therapy in the care of these wounds.

Adult↗
PubMed1984

Proliferating cell nuclear antigen in blast crisis cells of patients with chronic myeloid leukemia.

A nuclear antigen associated with cell proliferation [proliferating cell nuclear antigen (PCNA)] and blast transformation is recognized by autoantibodies in the sera of some patients with systemic lupus erythematosus; these autoantibodies are precipitating antibodies and also react in immunofluorescence, a technique that was used to determine if PCNA might be expressed in leukocytes of patients with chronic myeloid leukemia (CML) during certain phases of their disease. At all times, a strong relationship was seen between the percentage of cells stained by anti-PCNA antibody and the percentage of blast cells in peripheral blood leukocytes (r) = 0.865, P less than .001. However, during blast crisis, certain cells that morphologically looked like myelocytes, metamyelocytes, and some cells with segmented nuclei stained with anti-PCNA serum. This staining, which remained nuclear in location, was less intense than in blast cells, suggesting low density of the antigen in these nonblast cells. This phenomenon was not observed in myelocytes or metamyelocytes obtained from patients in remission. These initial studies demonstrated that anti-PCNA can be used as a reagent to detect blast cells in CML crisis and also has the capability to detect PCNA in other cells associated with blast crisis.

Antigen-Antibody Complex↗
PubMed1983

Detection of melanoma cells in bone marrow using monoclonal antibodies. A comparison of fluorescence activated cell sorting (FACS) and conventional immunofluorescence (IF).

Seven different human melanoma cell lines have been tested for the presence of melanoma associated antigen p97. The sensitivity of membrane immunofluorescence assays for the antigen was increased by using a mixture of antibodies to several epitopes of p97. Six of eight melanoma lines were strongly positive. Normal bone marrow was negative. When cultured p97-positive melanoma cells were added to normal marrow, the authors were able to detect 5% contamination, by fluorescence-activated cell sorting (FACS) and immunofluorescence (IF). No melanoma cells were found in one fresh and nine frozen bone marrow specimens of melanoma patients (including two with known positive marrow by routine histologic study) evaluated for autologous bone marrow transplantation after high-dose chemotherapy.

Antibodies, Monoclonal↗
PubMed1983

Schistosomal stimulation of eosinophil production by human bone marrow in vitro.

These studies were undertaken to determine if schistosomal and ragweed antigens incubated with human peripheral blood mononuclear cells (MNC) would stimulate the production of an eosinophil colony stimulating factor (CSF) which was active on human bone marrow. These studies have shown that schistosoma mansoni antigen in a concentration of 5 micrograms/ml incubated with MNC's from unsensitized individuals lead to production of a conditioned medium which did not stimulate an increased number of total colonies but did increase the number of eosinophil colonies (44 to 61 colonies). Ragweed antigen also stimulated increased eosinophil CSF (from 44 to 63 colonies). The granulocyte response to parasitic antigens almost invariably involves the eosinophil system. Eosinophils play a vital role in the control of these diseases in humans. Further understanding of the interaction of parasitic antigens with the granulopoietic system will hopefully give new and important clues as to how such parasites interact with man and how they are controlled.

Antigens↗
PubMed1983

Familial leukemia and aplastic anemia associated with monosomy 7.

A kindred is described in which eight of 14 patients in one generation had acute nonlymphocytic leukemia or aplastic anemia either alone or terminating in acute nonlymphocytic leukemia. The proband and two siblings in one branch of this kindred presented with aplastic anemia, whereas acute nonlymphocytic leukemia was the presenting feature in the other two branches. Karyotypic evolution from a normal karyotype to monosomy 7 was demonstrated in the proband, and group C monosomy was seen in two other patients. The proband's serum sample inhibited in vitro growth of normal bone marrow colonies. The occurrence of hematologic disease in this kindred appears to be the result of a maternally transmitted trait, and persons younger than 30 years of age appear to have the highest risk of hematologic disease.

Adolescent↗
PubMed1983

Bladder carcinoma presenting as a solitary bony metastasis.

Although bony involvement by transitional cell carcinoma of the bladder occurs frequently, its presentation as a symptomatic solitary bony metastasis is rare. Furthermore, presentation as a solitary distal metastasis with osteolytic and osteoblastic components is almost a novelty. We present such a case, which is additionally unusual in that the primary lesion in the bladder and the metastasis were resectable.

Aged↗
PubMed1983

The Hyatt Regency skywalk collapse: an EMS-based disaster response.

The Hyatt Regency skywalk collapse (July 17, 1981) provided the emergency medical services system of Kansas City, Missouri, with its greatest challenge ever. Utilizing an EMS-based, centralized, city-wide disaster plan, the rescue operation encountered 113 dead and 188 multiply traumatized patients. The rescue operation could be divided into three areas: initial response, onset triage, and delayed extrication. Success of the operation was credited to several factors, including the centralized urban location of the collapse, short patient transport times, centralized ambulance dispatch, availability of ALS vehicles and personnel to the scene, and mutual aid response. Short-comings of the rescue that became apparent on critical review of the response included poor communications at the scene, lack of physician bystander control, and the need for identification of key personnel at the site. Success in responding to the health care needs of a disaster included a flexible and well-organized disaster response plan as well as the support of a health care system capable of picking up the pieces of the psychological aftermath.

Disasters↗
PubMed1983

Regulation of granulopoiesis following severe thermal injury.

Neutropenia often accompanies septicemia in burned patients. This paradox suggests a defect in the regulation of granulopoiesis. Colony stimulating factor (CSF) produced by the monocyte-macrophage system is an important regulator of granulocyte production. We followed serial serum CSF levels and peripheral blood leukocyte differential counts in 22 patients with greater than 30% burns. Six patients (mean burn, 58%) developed Gram-negative septicemia and died (Group I). Sixteen patients (mean burn, 38%) had no fatal septicemias (Group II). Nonsurvivors had initially low levels of CSF and developed persistent monocytopenia. Survivors, in contrast, had prompt rises in CSF and developed monocytosis. The presence of monocytopenia and low CSF levels in Group I suggests an abnormality in the stimulatory arm regulating granulopoiesis. Such a defect may play a role in the development of fatal septicemia following severe thermal injury.

Adult↗
PubMed1983

Antinuclear, antinucleolar, and anticytoplasmic antibodies in patients with malignant melanoma.

Immunofluorescence was used to examine antibodies to cellular antigens in the sera of patients with malignant melanoma. Sera from 60 melanoma patients and from 33 control individuals (13 normal subjects and 20 disease controls) were studied. Ninety % of the melanoma sera were found to have antinuclear antibodies when epithelial cell lines or melanoma lines were used as substrates for their detection, compared to 18% in the control group. Antinucleolar antibodies and anticytoplasmic antibodies were present in 32 and 17%, respectively, in malignant melanoma but none in the controls. Antinuclear and antinucleolar antibodies could be classified into different types according to different patterns of staining and susceptibility of antigens to digestion with DNase, RNase, and trypsin. Certain types of antibodies, such as those showing granular nuclear staining, appeared to be associated with less advanced stages of malignant melanoma, whereas those showing nucleolar and large speckled nuclear staining were associated with more advanced stages of the disease.

Antibodies, Antinuclear↗
PubMed1983

Longterm effects of cyclophosphamide on granulocyte colony formation in patients with rheumatoid arthritis.

Longterm cytotoxic therapy, particularly with alkylating agents, is frequently associated with the development of second neoplasms, particularly acute myeloid leukemia. Twelve patients with classic, progressive rheumatoid arthritis (RA), treated with a cytotoxic agent, cyclophosphamide, from 1969 to 1974 at the University of Colorado Health Sciences Center were reassessed for current status of the granulocytic system. Bone marrow biopsies were investigated histologically and the number of granulocyte precursor cells judged using colony forming cells in culture (CFU-C). Control bone marrow biopsies were done on 8 patients with classic, progressive RA who had not taken cyclophosphamide as well as 16 healthy controls. Colony forming cell numbers in patients with RA who had been treated with cyclophosphamide were significantly lower compared to patients with RA who had not received cyclophosphamide and normal controls. These data suggest that cyclophosphamide may cause suppression of the hematopoietic system that does not totally recover even after long periods of time.

Aged↗
PubMed1982

Busulfan versus hydroxyurea in long-term therapy of chronic myelogenous leukemia.

Survival of patients with chronic myeloid leukemia seen in the University of Colorado Leukemia Clinic were reviewed with respect to therapy. A total of 55 patients seen consecutively through mid 1980 were included in this study. Of these patients 30 were treated with busulfan, 14 were treated with hydroxyurea and 11 received under modalities. Busulfan treated patients who are now deceased, have had a median survival of 35 months (range, 13-108) and actuarial analysis shows the total busulfan treated population to have an expected median survival of 48 months. Hydroxyurea treated patients who are still alive have been followed for a median period of 69 months (range, 25-136 months) and a projected median survival for periods of 56 and 90 months, respectively. These data suggest that hydroxyurea may be an important treatment modality in the treatment of chronic myelogeous leukemia.

Adolescent↗
PubMed1982

Vitamin A levels in human bladder cancer.

The following studies were undertaken to determine the levels of serum carotene and vitamin A (retinol) in Egyptian patients with intestinal, urinary, hepatosplenic schistosomiasis, and bladder cancer. These studies have shown that both serum carotene and serum retinol levels are significantly reduced in patients with bladder cancer when compared to controls. These data, when viewed in light of previous animal studies noted, raise the question as to whether vitamin A administration can be beneficial in the prevention and/or treatment of human bladder cancer, particularly that associated with schistosomiasis.

Absorption↗
PubMed1982

Prophylactic oxacillin in dog bite wounds.

This prospective, double-blind, placebo-controlled study was undertaken to determine the value of prophylactic oxacillin in dog bites. Adult patients with uninfected full-thickness wounds presenting within 24 hours of injury were considered. Management consisted of cleansing, irrigation, debridement, and closure as indicated; no topical antibiotics were applied. Patients were randomly assigned to receive oxacillin 500 mg QID x 5 days or identically appearing placebo. Home wound care was standardized an patients were observed at least every 2 days. Clinical assessment of infection was confirmed microbiologically. Sixty-three patients were admitted and 46 completed the study. Oxacillin (22) and placebo (24) groups were identical in sex, age, number of wounds per patient, wound location and type, number of open and closed wounds, delay to presentation, length of follow-up observation, medication compliance, and adequacy of patient wound care. Two infections of the hand occurred in patients receiving oxacillin; no infections were seen among placebo-treated patients (P = NS). Prophylactic oxacillin was not associated with improved outcome. We do not advise the use of prophylactic antibiotics in dog bite injuries treated within 24 hours of accident.

Administration, Oral↗
PubMed1982

On the disulfiram-like activity of moxalactam.

A three-way crossover study was undertaken in 10 healthy subjects to characterize the reported disulfiram-like activity of moxalactam and to assess its influence on ethanol and acetaldehyde metabolism. On different occasions separated by at least 2 wk subjects were given in random order: 0.5 gm/kg ethanol orally, 0.5 gm/kg ethanol followed in 1 hr by 1.0 gm IV moxalactam, and 1.0 gm IV moxalactam every 8 hr for four doses followed by 0.5 gm/kg ethanol. Mean ethanol elimination rates of 13.1 +/- 0.76, 10.1 +/- 1.11, and 10.9 +/- 1.06 mg/dl/hr (mean +/- SEM) were observed in the three protocols, respectively. Corresponding mean estimated acetaldehyde clearance rates were 103.7 +/- 15.55, 92.8 +/- 13.79, and 97.3 +/- 10.41 l/min (mean +/- SEM). While no consistent moxalactam effect on ethanol or acetaldehyde elimination was observed, two subjects experienced mild disulfiram-like reactions to ethanol after moxalactam pretreatment. In one subject this reaction was associated with markedly elevated blood acetaldehyde concentrations. We conclude that moxalactam pretreatment may induce a disulfiram-like reaction after ethanol ingestion in some, probably due to inhibition of aldehyde dehydrogenase, and that alcoholic beverages are contraindicated in patients receiving moxalactam. We suggest, however, that such reactions will not occur when moxalactam is given after ethanol ingestion.

Acetaldehyde↗