Preliminary clinical study of transferrin-adriamycin conjugate for drug delivery to acute leukemia patients.

Seven patients with acute leukemia were treated intravenously with low doses of transferrin-Adriamycin conjugate. The total amount of drug given each patient was far below known toxicity levels for free Adriamycin. The number of tumor cells in peripheral blood diminished in treated patients, and bone marrow aspirates showed no evidence of disease progression.

System measures ambulatory care quality.

As physician executives, what we need in ambulatory quality assurance is a very carefully thought out system that will enable us to monitor quality in such a way that we will also be able to measure it. Only if we have the capability to measure quality can we begin to manage it.

Rupture of the distal thoracic esophagus following blunt trauma: case report.

Rupture of the distal thoracic esophagus is an unusual injury following blunt abdominal trauma. We recently encountered this injury in a patient following a relatively minor motor vehicle accident. An improperly positioned seatbelt was presumed contributory in this case.

Laxative abuse as a cause for ammonium urate renal calculi.

Nine women with laxative abuse and predominantly ammonium urate renal calculi underwent metabolic studies to identify common chemical abnormalities and determine pathophysiology. The 24-hour urine studies demonstrated marked decreases in volume (902 cm.3), sodium (28 mEq.

Immunohistologic evidence that villitis in human normal term placentas is an immunologic lesion.

Villitis of unestablished origin is a lesion in placentas from normal and high-risk pregnancies. We have studied villitis areas in 25 normal term placentas for immune cells, coagulation components, and endothelial markers. Villitis areas were filled with activated (HLA-DR, HLA-DP, and HLA-DQ reactive) macrophages.

Pathophysiology and treatment of subarachnoid hemorrhage.

The pathophysiology and treatment of acute subarachnoid hemorrhage (SAH) are reviewed. SAH occurs when blood is released into the subarachnoid space, which surrounds the brain and spinal cord. Symptoms of SAH include severe headache, nausea, vomiting, neck pain, nuchal rigidity, and photophobia.

Evaluation methods for intrauterine growth using neonatal fat stores instead of birth weight as outcome measures: fetal and neonatal measurements correlated with neonatal skinfold thicknesses.

Neonatal anthropometry, including timed skinfold measurements, was performed on 55 products of selected pregnancies. These skinfold measurements were compared with published standards of measurements obtained by similar techniques. Values outside the 3rd percentile to 97th percentile range were overlaid on the birth weight/menstrual age relationship of these subjects.

Improved visualization of the internal mammary artery with a new retractor system.

A new sternal retractor system was developed to improve exposure of the internal mammary artery and protect the lung. This retractor can be used for either single or bilateral dissection of the internal mammary artery. It has been used in more than 2,000 cases with excellent results.

Allogeneic recognition and rejection reactions in the placenta.

One of the major questions in medicine is how human extraembryonic tissues escape rejection by maternal immune responses, because these tissues are allogeneic and should stimulate allogeneic recognition and rejection reactions. Evidence for maternal allogeneic recognition of extraembryonic tissues in chorionic villi, basal plate, and spiral arteries is presented. Extraembryonic membranes seem always to stimulate maternal allogeneic recognition and rejection reactions, and abnormal pregnancies appear to be associated with a simple quantitative increase of the same placental immunopathological lesions found in normal pregnancies.

Immunological role for seminal plasma in insemination and pregnancy.

Insemination confronts the female with paternally derived alloantigens and represents an immunological challenge preceding fertilization and implantation. Current evidence suggests a role for seminal plasma in regulating maternal immunity for insemination and pregnancy. In vitro seminal plasma has been shown to suppress T- and B-cell proliferation, neutrophil and macrophage phagocytic activity, as well as killer cell activity.

Human placentae: view from an immunological bias.

Human placentae form a major part of the interface between maternal and embryonic tissues. Placentae are morphologically complex organs that are lined with a trophoblastic tissue that provides anatomical constraints over which flows maternal blood. Maternal antibodies and immune cells thus contact the lining syncytiotrophoblast, and this paper considers some of the antigens that maternal immune components might encounter.

Financial analysis of an inner-city helicopter service: charges versus collections for patients transferred from another acute care facility.

Emergency helicopter services provided by trauma centers are now being perceived as contributing to the financial burden of the hospital because of recent changes in trauma reimbursement under the Medicare Prospective Payment System (PPS) and because of the general perception that collection rates are lower among trauma patients. The use of helicopters to transfer patients from one acute care facility to another may also be concentrating the patients with low collection rates at the receiving hospital. We examined retrospectively the demographic and clinical factors associated with the collection experience in a series of 288 trauma patients transferred by helicopter from another acute care facility to an inner-city hospital.

Alteration in platelet count during early pregnancy in the mouse.

Published reports of pregnancy associated thrombocytopenia in mice have utilized the Quackenbush strain. The inability of some laboratories to verify this observation in other mouse strains prompted us to report our findings by using Swiss Albino ICR mice. In Exp.

Recent advances in cancer research: drug targeting without the use of monoclonal antibodies.

Cancer research in drug targeting has focused on the use of monoclonal antibody conjugates of drugs. This paper discusses the use of ligand conjugates of drugs to deliver to receptors on cancer cells. We have used transferrin coupled to adriamycin, and report these conjugates specifically bind and kill cancer cells in culture.

Sperm antibodies after intraperitoneal insemination of sperm: a preliminary report.

To test the hypothesis that intraperitoneal insemination of sperm induces the expression of anti-sperm antibodies a prospective study was designed. Fifteen women undergoing intraperitoneal insemination (with or without oocyte transfer) were studied with 11 women having evaluation of anti-sperm antibodies. Sperm antibodies were detected by the immunobead test prior to intraperitoneal insemination and after each treatment cycle.

Evaluation of circulating anti-sperm antibodies in fertile and patient populations.

Several reports have demonstrated the presence of anti-sperm antibodies (ASA) in infertile populations; however there is a paucity of information regarding ASA in fertile populations. The purpose of this study was to establish objective criteria for the interpretation of the Immunobead Binding Test (IBT) based on values obtained from fertile individuals. Sera from 20 fertile couples (n = 40) were assayed by using a modification of the IBT previously described by Clarke et al.

Occurrence of ectopic pregnancy among women with recurrent spontaneous abortion.

Ectopic pregnancy is a major health problem accounting for about 10% of all maternal mortality. To determine whether patients with a history of recurrent spontaneous abortion (RSA) have a higher frequency of ectopic pregnancy than the general population, the obstetrical histories of 630 patients with a diagnosis of RSA from two centers were studied. Thirty-eight of 376 USA women, (10%) and 10 of 193 British women (5%) previously had suffered an ectopic pregnancy.

Recurrent spontaneous abortion.

The laboratory diagnosis and clinical management of unexplained recurrent spontaneous abortion (RSA) patients is a controversial issue in contemporary obstetrics. In this report, the results of laboratory investigations and immunotherapy of RSA patients referred to our Center since 1986 are detailed. Our analyses have resulted in grouping RSA patients into primary (1 degree), secondary (2 degrees), and unexplained classifications.

Regulation of immunity to extraembryonic antigens in human pregnancy.

Pregnancy results in the immunologic challenge of the female to a wide variety of allogeneic antigens. Particular attention has been given to antibodies directed to allotypic trophoblast antigens (TLX), for trophoblast form the true allograft interface between mother and fetus. Studies found that antibodies to paternal TLX allotypes are produced in women suffering from secondary recurrent abortions.

Outpatient views on direct access to physical therapy in Indiana.

The purpose of this study was to determine the opinions of outpatients receiving physical therapy in Indiana about physical therapy evaluation and treatment without referral (direct access). Subjects were 361 individuals being treated at one of 25 privately owned clinics. Each subject completed a 15-item questionnaire.

Primary malignant tumors in the small bowel: a comparison of the small-bowel enema and conventional follow-through examination.

Of 71 patients diagnosed with primary mesenteric malignant tumors in the small bowel over a 21-year period in a community/teaching hospital, 14 underwent small-bowel follow-through, 16 underwent small-bowel enema (enteroclysis), and four patients underwent both studies preoperatively. In a retrospective study, the sensitivity of both the small-bowel enema and the conventional small-bowel follow-through examination were compared on the basis of the original radiologic interpretation. The studies were ordered by clinicians in a clinical setting.