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Biomedical subjects

A Evans

Publications and source records attributed to A Evans.

At least 379 records · Page 21Linked to original sources
PubMed1981

The treatment of Wilms' tumor: results of the Second National Wilms' Tumor Study.

One-hundred-eighty-eight children up to 16 years of age were randomized in the second National Wilms' Tumor Study (NWTS) with tumors that were confined to the kidney and that had been totally excised (Group I). Most fared well whether treated for six or for 15 months with both actinomycin D (AMD) and vincristine (VCR). No postoperative radiation therapy (RT) was given. The two-year relapse-free survival (RFS) and two-year survival rates were 88 and 95%, respectively. Two-hundred-sixty-eight randomized patients with more advanced local lesions (Groups II and III) and 57 with distant metastases (Group IV) had postoperative RT and were scheduled for 15 months treatment with either AMD and VCR (Reg. C) or AMD plus VCR plus Adriamycin (Reg. D). The 77% two-year RFS rate for Reg. D was significantly different from the 63% with Reg. C. As in the first NWTS, patients with tumors of unfavorable histology (UH) had a significantly worse prognosis than those with favorable histology (FH), as did those with positive nodes. Survival rates at two years were 54% for UH vs. 90% for FH, and 54% vs. 82% for those with and without lymph node involvement.

Adolescent↗
PubMed1981

Phase II evaluation of mitomycin C (MMC) in children with refractory solid tumors using the single high-intermittent-dose schedule.

Nine evaluable patients with refractory solid tumors received mitomycin C as a single intravenous injection at a dose of 20 mg/m2 at 6- to 8-week intervals. Toxicity was tolerable. One patient with Wilms' tumor had a transient decrease in liver size. Pharmacokinetic data on three patients have suggested that the disposition of mitomycin C were comparable to those obtained in adults.

Adolescent↗
PubMed1981

Immotile cilia syndrome: a new cause of neonatal respiratory distress.

Kartagener's syndrome is a condition that consists of situs inversus, bronchiectasis, and sinusitis. Some patients have respiratory symptoms that date from early infancy, and electron microscopical examination has shown that adults with this condition lack dynein arms in ciliary microtubules. It has been suggested that an inherited defect in ciliary ultrastructure, the immotile cilia, is the basis for the syndrome. We report 6 patients who presented within the first 24 hours of life with tachypnoea, retraction, rales, and dextrocardia. Five of them had situs inversus. They all responded to physiotherapy after antibiotics had failed to improve their condition. Electron microscopical examination of the cilia in 2 of the infants confirmed deficiency of dynein arms. All 6 infants had recurrent respiratory infections. Four went on to develop recurrent otitis media, 2 had sinusitis, and 1 now has bronchiectasis. The immotile cilia syndrome should be added to the list of causes of respiratory distress in newborn infants. The condition is worth diagnosing because of the good response to physiotherapy, and because of the likelihood of recurrent respiratory problems.

Cilia↗
PubMed1980

Immune complexes in transitional cell carcinoma.

Bladder cancer patients from 2 different medical centers were examined to establish whether such patients have circulating immune complexes. Four methods of analysis were used: 1) polyethylene glycol precipitation, 2) double crossed immunoelectrophoresis, 3) Raji cell and 4) Clq binding assays. In the first group of 24 patients 17 had positive results on cystoscopy for pathologically defined tumors at the time of the serum sample. Two tested positive for the presence of circulating immune complexes by all 4 techniques and an additional 1 tested positive by 3 of the 4 techniques. In the second group of 54 patients (41 of whom had pathologically definable tumors at sample date) 9 were judged possibly positive by the Raji cell assay, the polyethylene glycol and double crossed immunoelectrophoresis techniques. When tested by the Clq binding assay 8 of the 9 patients were positive, most being in the range of 260 to 320 microgram/ml. immune complex. Combining all data from the 78 patients with bladder cancer the results in 10 cases definitely were positive by all 4 techniques and an additional 2 were positive by 3 techniques. Our data indicate that a low percentage (13 to 15 per cent) of patients with bladder cancer has circulating immune complexes. Of interest is that the complexes, as judged by our assay procedures, bind Clq, contain aggregated IgG and can be dissociated into antigen and antibody. Thus, the immune complexes are similar to those found in immune complex diseases.

Aged↗
PubMed1980

A new Pk phenotype in the P blood group system.

A healthy 22-year-old woman was noted to have erythrocytes of the Pk phenotype: a strong Pk antigen, no detectable P antigen and anti-P antibody in her serum. Her erythrocytes contained four to six times as much Pk glycolipid (globotriaosylceramide or CTH) and approximately half as much P glycolipid (globotetraosylceramide or globoside) as normal red cells. The structures of CTH and globoside were characterized by analysis of permethylated sugars and complement fixation, in addition to chromatographic mobility and sugar composition. Inasmuch as the erythrocytes of two Pk individuals that were analysed previously (Marcus et al., 1976) contained no detectable globoside, these abnormalities appear to represent a new phenotype in the P blood group system.

Adult↗
PubMed1980

Treatment of heroin addicts: is the client--therapist relationship important?

The purpose of this paper is to examine one variable in the treatment of heroin addiction, ther therapist-client relationship. Eighty-six individuals who were discharged from the Tulane NARA Drug Abuse Program were examined on 20 social and personality variables. The variable of the counselor--patient relationship was found important in the final outcome of treatment. Clients who had a single counselor throughout the entire course of treatment did significantly better (p less than .002) than their peers who were transferred from one counselor to another, suggesting that a stable client--therapist relationship greatly enhances the chances of the patient reaching drug abstinence and being rehabilitated.

Adolescent↗
PubMed1979

Tumors of the pineal and suprasellar region: Childrens Cancer Study Group treatment results 1960--1975: a report from Childrens Cancer Study Group.

Tumors of the pineal and suprasellar region form a rare and interesting group of lesions with germinomas accounting for over 50% of all lesions in this anatomic region. The Brain Tumor Committee of Childrens Cancer Study Group (CCSG) recently surveyed all CCSG member institutions to determine treatment parameters and assess the techniques. A total of 140 patients were seen during the period from 1960 to 1975; 118 patients were evaluable, having adequate treatment records. One hundred and one patients were less than 30 years of age with a 2:1 male predominance. Thirty-six of the 57 biopsied patients (63%) were found to have germinomas. The survival of patients in the germinoma group (72%) was comparable to that of the patients without biopsy (71%). The overall survival rate for all patients (biopsied and unbiopsied) was 65% with follow-up times ranging from 2 to 15 years. Nine patients developed spinal cord metastases (8%), two of whom also had simultaneous primary recurrence; none of these patients had received adjunctive spinal irradiation.

Adolescent↗
PubMed1979

The polystyrene vacuum wheelchair cushion.

A polystyrene bead vacuum wheelchair cushion has been tried with several patients with abnormal postural reflex activity. Excess spasticity can be reduced by this means and sitting comfort enhanced.

Humans↗
PubMed1979

Evaluation of intramuscular versus intravenous administration of L-asparaginase in childhood leukemia.

A study was done to evaluate intramuscular versus intravenous administration of L-asparaginase in childhood leukemia. The results of this study demonstrate that the intramuscular method of administering L-asparaginase is as effective, but less toxic, than the intravenous method for children with advanced leukemia. The utilization of L-asparaginase in the initial induction of children with lymphoblastic and undifferentiated leukemia should be investigated. Its addition to the standard inducing agents may increase the percentage and ease of remission without significantly increasing toxicity.

Asparaginase↗
PubMed1978

Treatment of advanced Hodgkin's disease in pediatric patients.

From 1970 to 1976, twenty patients with stage II E or II B to IV B Hodgkin's disease were treated at Children's Hospital of Philadelphia. Initially, four of the stage II or III patients received planned total nodal irradiation (TNI) alone; three patients developed progressive disease during irradiation, and one relapsed after 18 months. These results with TNI led to the use of combined modality therapy. Sixteen patients (4, stage II E or B; 8, stage III; 4, stage IV) were treated with COPP (cyclophosphamide, Oncovin, prednisone, and procarbazine) and radiation therapy. In 14 patients treatment was started with COPP. Patients with disease below L2 received TNI; the rest received involved field (IF) or extended field (EF) irradiation. No patient treated with combination therapy encountered life-threatening toxicity. Relapse-free survival in 12 stage II or III patients is 100% with a median follow-up of 28 months (range, 24 to 91 months). Only one of four stage IV patients is alive. Combined modality therapy is effective, tolerable therapy for children with stage II B--III Hodgkin's disease. No relapses occurred in 10 patients given less that potentially curative radiation. Smaller radiation fields and lower doses are planned for the future.

Adolescent↗
PubMed1978

Central nervous system lesions in childhood leukemia.

Central nervous system (CNS) lesions were found in 85 of 91 children with acute leukemia. Cerebral atrophy was the most common lesion, occurring in 65 percent. Atrophy was most severe in children treated with intrathecal methotrexate alone or in combination with radiation therapy, in children youngest at time of onset of leukemia, and in children in whom duration of leukemia was shortest. Longer duration was the determining factor among children who were older at onset. Lesions previously reported by other investigators, such as leptomeningeal infiltration of leukemic cells, infection, hemorrhage, degenerative grey and white matter disease and leukoencephalopathy were also seen. Central pontine myelinolysis occurred in four children.

Age Factors↗