Early municipal bacteriology in Brighton, Aberdeen and Bristol: blessing or burden?

In contrast to the idea that bacteriology was introduced as a tool for the diagnosis and management of the individual patient, this review highlights the work of the municipal bacteriological laboratory in the United Kingdom to illustrate how bacteriological laboratories were introduced as means to control community epidemic disease. Using the examples of municipal laboratories in Brighton, Bristol and Aberdeen, it shows how public health considerations of community infectious diseases such as diphtheria and typhoid dominated the early development and workload of the municipal laboratory, rather than examination of patients with pathological states of uncertain aetiology. It argues that this public health focus of the Medical Officer of Health limited the range of diagnostic tests carried out in such laboratories for over two decades. The growing number of pathogenic microbes being discovered in the late 19th century appears to have had little impact on the tests being carried out in the municipal laboratory. Municipal bacteriological facilities in three towns, a central municipal laboratory (in Brighton), a central university pathological department (Aberdeen) or a combination of both (Bristol) all provided the same limited set of tests. This restricted set of bacteriological examinations is likely to have diminished the value and status of bacteriology in what should have been a period of increasing scope.

Chemical and hematological screening in patients with malignant and non-malignant conditions.

The value of multiphasic automated laboratory tests in differentiating stages of malignancy and in detecting recurrence of cancer was studied. Chemical SMA-12 tests (including calcium, phosphate, glucose, BUN, uric acid, cholesterol, total protein, albumin, total bilirubin, alkaline phosphatase (AP), lactic dehydrogenase (LDH) and SGOT) and hematological SMA-4 tests (including hematocrit, hemoglobin, WBC and RBC counts) were performed in 1,578 patients. Baseline data obtained from 582 patients with benign, and 996 patients with malignant, lesions were subdivided according to age, sex, primary site, and extent of cancer. With advancing stages of cancer, there was a significant increase of AP and LDH, but decrease of albumin and hemoglobin. Among patients who had sequential tests, there was a significant decrease of uric acid and LDH with control of cancer, and increase of AP with development of distant dissemination.

Statistical methods in cancer research.

This chapter has presented and elaborated upon some of the more fundamental statistical methods that can be applied to medical data and that appear most frequently in the present literature. Familiarity with these concepts is necessary for understanding information so analyzed and is the foundation for critical evaluation of a variety of medical data.

Carcinoma of the penis.

This study updates the experience at our hospital with cancer of the penis, which now includes 122 consecutive cases seen between 1940 and 1974 with 100 per cent followup. Historical, clinical, pathological, therapeutic and followup data were extracted for all cases in a digital code for transfer to computer storage. Life tables giving cumulative survival rates through 10 years with standard deviations and age corrections were calculated for each variable. The data were tabulated for publication to emphasize the prognostic significance of individual variables for the purpose of prospective research planning. The data were then evaluated regarding indications for prophylactic inguinal lymph node dissections, if any.

A profile of patients with intractable blepharospasm.

Of those patients seeking surgical correction for intractable blepharopasm, the spasm was more commonly bilateral than unilateral by a ratio of about 7:1 and the bilateral form was more common in women than men by a ratio of about 3:1. The unilateral disease had an equal sex incidence. The disease seemed to be the same in men and women. The median age of onset was 59 years old, and the median interval between onset of symptoms and surgery was three years. Most of these patients had seen many physicians, and all prior medical and surgical treatments had been unsuccessful.

Analysis of variance and covariance for colorectal adenocarcinomas in man as a logical prelude to "staging".

This study reports initial experience at the Ellis Fischel State Cancer Hospital (EFSCH), Columbia, Missouri, with the analysis of variance and covariance as applied to the ability to predict the lethality associated with colorectal neoplasms as influenced by tumor,host, and treatment variables considered individually and as multivariate clusters. The application of the methods to the clinical setting is based on the fact that each patient has one survival time. However, in the mathematical sense, each patient is composed of many different variables interacting simultaneously in highly complex ways to determine this uniqueness. The feasibility of determining the prognostic score or weight of many variables is illustrated. The combinatory effect of these scores can provide prognostic scores for clusters of variables providing a tool of much greater specificity than is provided by traditional staging systems such as the TNM.

Staging carcinoma of the penis.

Presently there are six clinical staging systems in use for carcinoma of the penis. We propose a method which compares these systems by means of a check list type of format. With the aid of this device, any penile carcinoma can readily be staged in terms of all six systems. Advantages of multiple system staging include comparing series of patients which have been discussed only in terms of a single staging system and selecting the appropriate therapeutic modality in terms of the stage of disease.