Free amino acid formula: nitrogen utilization and metabolic effects in normal subjects.

A previous study indicated increased urea production and low nitrogen (N) retention on a free amino acid elemental formula (FAA; Vivonex-HN). The limitations of this earlier study were: irregular nitrogen absorption in the malabsorption patients, high nitrogen intake, and failure to match FAA to control formula (hydrolyzed casein; CAS; Criticare-HN) with respect to kcal/nitrogen. A more critical test of FAA quality was sought in the current study.

Surgical pathologic spread patterns of endometrial cancer. A Gynecologic Oncology Group Study.

The surgical pathologic features of 621 patients with Stage I carcinoma of the endometrium are presented. All patients were treated with primary surgery consisting of total abdominal hysterectomy, bilateral salpingo-oophorectomy, selective pelvic and paraaortic lymphadenectomy and peritoneal cytology. An appreciable number of patients (144-22%) with Stage I cancers have disease outside of the uterus (lymph node metastasis, adnexal disease, intraperitoneal spread and/or malignant cells in peritoneal washings).

Effects of exercise and food restriction on body composition and metabolic rate in obese women.

Obese women (140-180% of ideal body weight) were studied on a metabolic ward during 1 wk of maintenance feeding, followed by 5 wk of 800 kcal/d (liquid formula diet). Five subjects participated in a supervised program of daily aerobic exercise and three subjects remained sedentary. Total weight loss was not different between exercising and nonexercising subjects but significantly more of the weight loss came from fat and less from fat-free mass in the exercising subjects.

Radical hysterectomy and pelvic lymphadenectomy for stage IB carcinoma of the cervix: 21 years experience.

From September 1971 through December 1982, 153 patients with Stage IB carcinoma of the cervix underwent radical hysterectomy and pelvic lymphadenectomy at two of the teaching hospitals of the Uniformed Services University of the Health Sciences. Records were retrospectively analyzed and independent pathologic review was performed. All surgical procedures were performed by fellows or senior residents under the direct supervision of the gynecologic oncology staff of the Walter Reed Army Medical Center or the Naval Hospital, Bethesda, Maryland.

Calyceal rupture with perirenal urinoma in a patient with cervical carcinoma.

A patient is presented with calyceal rupture and perirenal urinoma formation secondary to distal ureteral obstruction by cervical carcinoma. Preoperative diagnosis was established with computed tomography and renal scan. Surgical placement of an indwelling ureteral stent resolved the urinoma.

Retroperitoneal teratoma presenting as an abdominal-pelvic mass.

Nonovarian teratomas are relatively common neoplasms in children, but are rarely seen in adults. A case of a large retroperitoneal teratoma in a 42-year-old woman is presented. The 21.

The treatment of retroperitoneal fibromatosis with medroxyprogesterone acetate.

Wide excision is the recommended primary therapy for retroperitoneal fibromatosis. Radiation therapy and a variety of medications have been used to treat patients with recurrent tumors, but the response to these agents has not been uniform. The patient presented was successfully treated with medroxyprogesterone acetate for recurrent retroperitoneal fibromatosis that was refractory to multiple operative resections and radiation therapy.

Clinical patterns of tumor recurrence after radical hysterectomy in stage IB cervical carcinoma.

We reviewed the cases of 31 patients with International Federation of Gynecology and Obstetrics (FIGO) stage IB cervical carcinoma who developed recurrent disease after radical hysterectomy and pelvic lymphadenectomy between 1961 and 1982. The overall incidence of recurrence was 11.3%.

End colostomy using the end-to-end anastomosis instrument.

Gastrointestinal stapling instruments have achieved wide-spread application in intestinal surgery. Reported advantages of stapled bowel procedures compared to classic hand-sutured procedures include reduced tissue trauma, shorter operating time, and improved blood supply to the stapled bowel segment. A technique for creation of an end colostomy using the end-to-end anastomosis stapler (EEA instrument) is described.

Right hemicolectomy and ileal resection with primary reanastomosis for irradiation injury of the terminal ileum.

Injury to the small intestine from pelvic irradiation increases in frequency when extended treatment fields are utilized and when radiation therapy follows a major abdominal operation. Recommended surgical correction of such injury has been intestinal bypass to avoid the excessive morbidity and mortality from anastamotic leaks associated with primary resection and anastomosis. Since 1980, eight patients with extensive ileal injury secondary to irradiation have been seen at the Naval Hospital Bethesda, Maryland.

Prognostic factors associated with radical hysterectomy failure.

Two hundred seventy-five patients who underwent radical hysterectomy and pelvic lymphadenectomy for FIGO stage IB carcinoma of the cervix between 1961 and 1982 were retrospectively analyzed to identify specific risk factors associated with treatment failure. Patients were classified as high or low risk on the basis of tumor spread to pelvic lymph nodes or surgical margins. Thirty-eight patients had tumor involvement of pelvic nodes or surgical margins.

Identification of glycoprotein components of alpha-agglutinin, a cell adhesion protein from Saccharomyces cerevisiae.

Several glycoproteins which inhibit the agglutinability of Saccharomyces cerevisiae mating type a cells were partially purified from extracts of mating type alpha cells. These proteins, called alpha-agglutinin, were labeled with 125I-Bolton-Hunter reagent. The labeled alpha-agglutinin showed specific binding to a cells.

Clinical response to regional intravenous guanethidine in patients with rheumatoid arthritis.

A novel therapy for rheumatoid arthritis, regional sympathetic blockade using guanethidine, was investigated in 24 patients with active disease. In a randomized double blind short-term (14 days) study, we evaluated the effect of therapy on subjective responses, change in pain, stiffness, and morning stiffness and no objective responses, change in pinch strength, grip strength, and joint tenderness. Compared to placebo, guanethidine produced a decrease in pain (p less than 0.

Single calcium channels in native sarcoplasmic reticulum membranes from skeletal muscle.

Electrical properties of native sarcoplasmic reticulum membranes from rabbit skeletal muscle were investigated using the patch-clamp technique. Bilayers were assembled at the tip of patch pipettes from monolayers formed at the air-water interface of sarcoplasmic reticulum membrane suspensions. The membranes were found to contain a spontaneously active cation channel of small conductance (5 pS in 200 mM CaCl2, symmetrical solutions) that was selective for Ca2+ and Ba2+.

Voluntary and nonvoluntary childlessness: personality vs. structural implications.

"A 'deviant behavior' interpretation of childlessness has led many researchers to view this phenomenon as psychosocial in nature. Married persons who decide to remain childless are seen as having a unique set of personality and behavioral characteristics that go beyond the simple decision not to have children. An alternative explanation for these differences could center around the structural factor of childlessness per se, in that a family with one or more children may be a totally different social system than the dyadic-type relationships which comprise the childless couple.

On the mechanism of Hb F elevations in the baboon by erythropoietic stress and pharmacologic manipulation.

Maximal fetal hemoglobin (Hb F) elevations in the baboon subsequent to phenyl hydrazine-induced hemolytic anemia, bleeding, bleeding plus hydroxyurea (HU), or cytosine arabinoside were two to three times lower than those achieved with bleeding plus 5-azacytidine (azaC). Because, in the baboon, maximal elevations in F cell numbers occurred with bleeding alone, changes in the levels of Hb F in hemolysates and in Hb F per F cell could be considered to be due to the administered drugs. Erythropoietic toxicity of azaC was minimal, making it unlikely that the marked elevations of Hb F were due to shifts in the population of erythroid progenitors and precursors and more likely that they were related to a biochemical effect of the drug on DNA.

Cervical carcinoma found incidentally in a uterus removed for benign indications.

Thirty-five patients with invasive cervical carcinoma discovered in a uterus removed for benign indications were evaluated and treated from 1961 through 1983. Although formal staging was not possible, patients with presumed stage IA disease had a 100% five-year survival rate regardless of the addition of adjuvant therapy. All patients with more advanced disease received radiation therapy.

Persistence of endometrial activity after radiation therapy for cervical carcinoma.

Radiation therapy is a proved treatment for cervical carcinoma; however, it destroys ovarian function and has been thought to ablate the endometrium. Estrogen replacement therapy is often prescribed for patients with cervical carcinoma after radiation therapy. A review of records of six teaching hospitals revealed 16 patients who had endometrial sampling for uterine bleeding after standard radiation therapy for cervical carcinoma.

Total parenteral nutrition in the mouse: body composition and plasma chemistries.

Mice that were maintained in energy and nitrogen (N) balance by total parenteral nutrition (TPN) for 12 days were analyzed for changes in organ weight, carcass and liver N and fat, and plasma glucose, urea N, and total protein. The results are compared with two other groups: (1) PO, which consisted of mice that were given the TPN solution per os in amounts equivalent to the TPN group, and (2) AL, which consisted of mice allowed to consume a stock diet ad libitum. In comparison with group AL, the TPN-fed mice had normal liver, kidney, and lung weights but heavier spleens and hearts.

Repair of vaginal prolapse and perineal hernia after pelvic exenteration.

Perineal hernias have been a significant complication of pelvic exenteration since the inception of this procedure. A variety of natural and artificial materials have been used to support the small bowel to prevent its descent into the lower pelvis with subsequent hernia and fistula formation. More recently, neovagina construction using gracilis myocutaneous flaps has provided both sexual function and support for the small bowel.

Tetrahydrouridine, cytidine analogues, and hemoglobin F.

5-Azacytidine (azaC) has previously been shown to raise Hb F levels in the repeatedly phlebotomized baboon (PCV: around 20%). The administration of tetrahydrouridine (THU), an inhibitor of the enzymatic conversion of azaC to 5-azauridine, made it possible to reduce the amount of azaC and also of 2-deoxy-5-azacytidine (d-azaC) by more than 90% and still achieve maximal Hb F elevations. However, the granulocytopenia, usually occurring after 5-azaC, was not altered by the lowering of the dosages in the presence of THU.