Descriptive models of social response attempt to identify the conceptual dimensions necessary to define and distinguish various types of influence. Building on previous approaches, the authors propose a new response model and demonstrate that a minimum of 4 dimensions is necessary to adequately provide for such influence phenomena as conformity, minority influence, compliance, contagion, independence, and anticonformity in a single model. In addition, the proposed model suggests 5 potential types of response that have not been previously identified. These new types suggest directions for future research and theoretical development. Selected empirical evidence is reviewed in support of the validity and integrative power of the proposed model.
We confirmed that the risk of metastatic renal cell carcinoma is stage dependent. Therefore, surveillance protocols should be based on the pathological stage of the primary tumor. We recommend an annual chest x-ray, and serum liver function and alkaline phosphatase level tests for patients with pT1 disease. These studies are indicated beginning at 6 and 3 months for pT2 and pT3 disease, respectively, continuing every 6 months for 3 years and then annually. Surveillance computerized tomography should be performed at 24 and 60 months in patients with pT2 and pT3 disease or earlier when the results of any routine study are abnormal or clinical symptoms are present. Bone and brain surveillance studies should be prompted by site specific symptoms, elevated alkaline phosphatase levels or the diagnosis of metastasis at another site.
Pathological stage of the penile tumor, vascular invasion and greater than 50% poorly differentiated cancer were independent prognostic factors for inguinal lymph node metastasis. Prophylactic lymphadenectomy in compliant patients with pT1 lesions without vascular invasion and 50% or less poorly differentiated cancer does not appear warranted.
A B S T R A C T We had found previously that children with ragweed hay fever were somewhat less symptomatic after preseasonal immunization with large doses of ragweed pollen extract than were placebo-treated children. To study further the immunologic changes which accompany immunotherapy, these children were treated again the following year. Each patient served as his own control.Serum blocking (IgG) antibody, measured by inhibition of antigen-induced leukocyte histamine release, was increased 20-to 40-fold after therapy. The anticipated postpollen season increase of serum reaginic (IgE) antibody, measured by passive sensitization of leukocytes from nonallergic donors, was suppressed. Instead, the mean titer was decreased after treatment. Total serum IgE levels, measured by radial radioimmunodiffusion assay, were higher than normal; were correlated with reaginic antibody titers; and also did not increase in the pollen season after treatment. The concentration of both IgE and reaginic antibody was lower in the older children, irrespective of treatment.Leukocyte response to ragweed antigen E and guinea pig anti-IgE antiserum was assessed by means of in vitro histamine release techniques. After treatment, the leukocytes of 21 patients were less sensitive (11 cases), or less reactive (10 cases), to antigen E. Response to anti-IgE antibody also was diminished after treatment. In four cases, neither anti-IgE nor antigen E induced histamine release, although both IgE protein and ragweed-specific IgE antibody were present in the patients' own sera. Clinical improvement was correlated best with decreased leukocyte sensitivity and leukocyte reactivity to ragweed antigen E. It appeared that decreased cell sensitivity was related to lower serum reaginic antibody levels. Decreased cell reactivity, in the presence of both IgE protein and IgE antibody in the serum, may indicate a change in cellular response mechanisms. These studies suggest that clinical improvement following specific immunotherapy must be the result of complex changes in the immunologic and cellular components of allergic disease.
INTRODUCTIONImmunotherapy has long been the major form of treatment for pollen allergy. In recent controlled studies, it has been shown to result in at least partial amelioration of the symptoms of hay fever in adults and children (1-4). Previous studies of the immunologic parameters of pollinosis have demonstrated that immunization with pollen allergen stimulates the production of blocking antibody (5, 6), reduces the serum titer of reaginic antibody (7-9), and also decreases the in vitro allergen-induced release of histamine from the patients' leukocytes (4, 10, 11).In recent studies, reaginic antibodies, which are responsible for the sensitivity of allergic individuals to specific allergens, have been identified as IgE immunoglobulins (12). Immunoglobulins of this class are present in the serum and on the histamine-containing cells of both allergic and nonallergic individuals. The mean concentration of IgE in serum from allergic ...
We confirmed that the risk of metastatic renal cell carcinoma is stage dependent. Therefore, surveillance protocols should be based on the pathological stage of the primary tumor. We recommend an annual chest x-ray, and serum liver function and alkaline phosphatase level tests for patients with pT1 disease. These studies are indicated beginning at 6 and 3 months for pT2 and pT3 disease, respectively, continuing every 6 months for 3 years and then annually. Surveillance computerized tomography should be performed at 24 and 60 months in patients with pT2 and pT3 disease or earlier when the results of any routine study are abnormal or clinical symptoms are present. Bone and brain surveillance studies should be prompted by site specific symptoms, elevated alkaline phosphatase levels or the diagnosis of metastasis at another site.
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