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Biomedical subjects

A Goldman

Publications and source records attributed to A Goldman.

At least 199 records · Page 11Linked to original sources
PubMed1982

H-2 histocompatibility region: influence on the murine glucocorticoid receptor and its response.

The influence of the H-2 histocompatibility complex on glucocorticoid receptor levels, and the biochemical response of glucocorticoid action measured as the degree of inhibition of prostaglandin production, has been studied in the mouse thymus and lung. The B10A (H-2a) strain of mice has significantly higher glucocorticoid receptor levels and a significantly greater biochemical response to glucocorticoid than the B10 (H-2b) strain, which differs from B10A within the H-2 complex only. Thus, the anti-inflammatory hormone response of glucocorticoids is correlated to hormone receptor level, both of which are influenced by the H-2 locus.

Animals↗
PubMed1982

Tissue culture of chick embryonic choroidal cells: cell aggregation and pigment accumulation.

Cells originating from the chick embryo choroid were grown in culture for up to 1 month. The cells did not form coherent monolayer colonies but rather formed large transparent cell aggregates surrounded by a random, loose network of cells. The cell aggregates avidly took up and retained pigment granules while the individual cells did not. Choroidal cell aggregates were not similar to the "lentoid" bodies described by Okada and coworkers in cultures from other ocular tissues; they did not develop fiber cells and did not synthesize delta-crystallin. Thus aggregation of ocular cells appears to be a necessary but insufficient step for the formation of a "lentoid" body.

Animals↗
PubMed1982

Ewing's sarcoma: treatment with high-dose radiation and adjuvant chemotherapy.

Twenty-nine patients with pathologically proven Ewing's sarcoma without overt metastases at diagnosis were treated with a protocol designed by The Royal Marsden and St. Bartholomew's Hospital Children's Solid Tumour Group. They received megavoltage radiotherapy to the involved bone and adjuvant chemotherapy with a combination of four cytotoxic drugs. Comparison with a historical control group of 19 patients treated with local surgery or radiotherapy but no initial chemotherapy shows a significant improvement in survival for the study group (P = 0.022). Thirteen patients have failed on the protocol: eight at the original site, four in other bones and only one in the lungs. Sixteen patients remain alive and disease free, 11 of these for over 33 months. The treatment regimen was moderately toxic but there were no treatment-related deaths. These results confirm that an improved survival time and, hopefully, cure rate can be expected by treating Ewing's tumour with high-dose megavoltage radiation and combination chemotherapy. Future goals must be better control of primary lesions and eradication of micrometastases in other bones.

Adolescent↗
PubMed1982

Phase I and II study of AMSA in childhood tumours.

Twenty-nine children with tumours that had failed to respond to conventional therapy have been treated with AMSA. There were 16 patients with haematological malignancies in whom treatment was initiated at 25 mg/m2 for 3 days, increasing to 150 mg/m2 for 5 days. There were one complete and four partial remissions in these patients, all of whom had received at least 500 mg AMSA/m2. Thirteen children with solid tumours were treated. They received single doses of 120 mg/m2 initially, increasing to 100 mg/m2 for 5 days. No complete or partial responses occurred, but some antitumour activity was noted in neuroblastoma and retinoblastoma. Dose-related severe bone marrow toxicity occurred, but gastrointestinal and other toxicity was mild. An additional patient with T cell lymphoma, who received AMSA prior to a successful autologous bone marrow transplant, is described. AMSA is an active drug in childhood leukaemia. Further studies at the maximum tolerated dose are needed to assess enough patients with any single solid tumour type. In particular, the response of neuroblastoma warrants further study. Investigation of the use of AMSA either prior to bone marrow transplantation in leukaemia or in association with autologous marrow transplant in neuroblastoma and other solid tumours may be of value.

Adolescent↗
PubMed1982

Marker half-life analysis as a prognostic tool in testicular cancer.

In a retrospective study we compared the actual half-life of the serum tumor markers alphafetoprotein and human chorionic gonadotropin to the clinical course of patients who underwent an operation or chemotherapy for germ cell cancer. Of the 7 patients with residual disease postoperatively 5 had abnormal half-life values and in 3 this knowledge would have been of clinical value. Only 1 of 10 patients with a complete response to chemotherapy had an unfavorable actual half-life compared to 17 of 19 with a less than complete response. Prolonged marker decay rates during the first month of chemotherapy reflected ineffective chemotherapy and appeared to be independent of tumor bulk. Postoperatively, actual half-lives probably are useful prognostically only if the values are abnormal. Similar calculation may be of prognostic value early in the course of induction chemotherapy.

Chorionic Gonadotropin↗
PubMed1982

Metabolic observations on Caucasian men and women aged 17 to 88 years.

Aerobic capacity (VO2 max) and body fat were measured indoors and VO2 was measured at about 36 to 42 degrees C in desert walks or runs in 69 adults aged 17 to 88 years. Eleven were athletic youths, and many of the older adults had participated in jogging programs. Body fat increased and VO2 max decreased with age, although there were notable exceptions. Rates of walking and running were planned to require about 40% of VO2 max. Midway in each walk VO2 (ml O2/horizontal m . kg) served as a measure of skill; skill was high in 10 of 11 youths who did many walks or runs. Each older adult did three walks; skill improved. In four groups with some persons aged 50 and older with body fat up to 40%, skill in their third walk matched that of youths. The least fit women and the least fit men did not attain that level of skill.

Adipose Tissue↗
PubMed1982

Hydroxyurea versus busulfan in the treatment of chronic myelogenous leukemia.

A retrospective analysis of 67 patients with chronic myelogenous leukemia treated with hydroxyurea (41 patients) and busulfan (26 patients) compared the effectiveness of treatment and resulting survival. After 4 days of treatment, the white blood count in the hydroxyurea group fell at a rate of 31% +/- 10% per day compared to 10% +/- 8% for the busulfan group. At 6 months, the hemoglobin was similar, but in the busulfan group, the white blood count was significantly lower (12,500 vs. 29,900) (p = greater than 0.03). The platelet count was lower (311,000 vs. 481,000) in the busulfan group; however, the difference was not significant. When treatment was discontinued because of progression of the disease, the hemoglobin and white blood counts for both groups were similar. The platelet count was higher in the hydroxyurea group (762,000 vs. 269,000) (p greater than 0.02). The duration of therapy for both groups was similar. The median survival was also similar (hydroxyurea = 51 months; busulfan = 45 months). Hydroxyurea was associated with less life-threatening toxicity. Hydroxyurea is as effective as busulfan in treating chronic myelogenous leukemia.

Actuarial Analysis↗
PubMed1982

Acute changes of alpha-fetoprotein and human chorionic gonadotropin during induction chemotherapy of germ cell tumors.

Thirty-seven consecutive patients with germ cell cancers (34 testicular, three extragonadal) and elevated serum levels of alpha-fetoprotein (AFP) and/or human chorionic gonadotropin (HCG) were treated with vinblastine, bleomycin, and cis-diamminedichloroplatinum induction chemotherapy. The AFP and/or HCG normalized in 36 patients. The AFP half-life was 7.9 days between Days 1 and 21 postchemotherapy but 6.0 days between Days 21 and 42 (p less than 0.05). The prolonged AFP half-life between Days 1 and 21 was related to a median increase of 57.5% (range, 22 to 219%) in the AFP level. This increase in the marker value occurred between Days 2 and 9 of therapy (median, Day 5). There was also a median increase of 181% (range, 27 to 600%) in the HCG level at a median of 5 days after the start of therapy. The increase in the AFP and HCG levels occurred in 63 and 70% of evaluable patients, respectively, and correlated with the presence of a large volume of metastatic disease (chi 2 = 8.87). Patients with relapsed or refractory disease had prolongation of the AFP half-life between Days 21 and 42 as compared to nonrelapsed patients. AFP and HCG half-life calculations should be used in the management of patients with germ cell cancers.

Adolescent↗
PubMed1981

Congestive heart failure due to adriamycin cardiotoxicity: its natural history in children.

The congestive heart failure (CHF) associated with Adriamycin cardiotoxicity is frequently fatal. To investigate the course of Adriamycin-induced congestive heart failure, all Adriamycin-treated children who developed congestive heart failure at the Children's Hospital Medical Center and Sidney Farber Cancer Institute were studied. Criteria for Adriamycin-induced congestive heart failure included clinical evidence of left ventricular (LV) failure and echocardiographic evidence of abnormal left ventricular function. Fifteen children fulfilled these criteria. Eleven patients received between 400 and 500 mg/m2 of Adriamycin; four patients received cumulative doses over 500 mg/m2. Twelve of 15 (80%) children survived their acute episode of congestive heart failure. At follow-up, three patients had normalized their echocardiographic parameters of left ventricular function, three had died of their malignancies with compensated cardiac function until death, and six were clinically asymptomatic despite persistence of abnormal LV function on echocardiogram. Only three patients died of Adriamycin cardiomyopathy. In children treated with aggressive medical therapy, congestive heart failure secondary to Adriamycin cardiotoxicity may be reversible in certain cases.

Adolescent↗
PubMed1981

Human chorionic gonadotropin and alphafetoprotein in the staging of nonseminomatous testicular cancer.

Thirty patients with nonseminomatous testicular cancer and no evidence of metastases outside the retroperitoneum were evaluated for discrepancy between the clinical and pathologic stages and also for frequency of elevations of the serum levels of human chorionic gonadotropin (hCG) and alphafetoprotein (AFP). When marker-level data were not considered in the staging, the clinical and pathologic stages differed in 47% of the patients; the inclusion of marker data reduced the staging error to 37%. Seven of ten patients with clinical Stage I, pathologic Stage II disease had normal marker levels (false-negative results). However, there were no false-positive results: abnormal marker levels before retroperitoneal lymphadenectomy always signalled persistent tumor unless the level could be accounted for by the metabolic decay rate of marker produced by the primary tumor. Comparison of marker-level data from these patients with data from 48 patients with Stage III disease demonstrated increasing frequency of elevated marker levels with increasing stage (P less than 0.001). Serial determinations of HCG and AFP are helpful in clinical staging and are necessary in clinical management.

Chorionic Gonadotropin↗
PubMed1981

Lithium carbonate in patients with small cell lung cancer receiving combination chemotherapy.

Lithium administration has been shown to attenuate the leukopenia associated with systemic chemotherapy. The results of a randomized trial of lithium in 45 patients with small cell lung cancer who received combination chemotherapy and radiation therapy are reported. Patients randomized to receive lithium were started on 300 mg three times daily for 18 days of every 21 day chemotherapy cycle. Patients who received lithium experienced significantly less mid-cycle leukocyte and neutrophil count depression and spent fewer days with leukopenia and neutropenia than control patients regardless of age or extent of disease. Patients who received lithium spent fewer days hospitalized and fewer days with fever in the presence of severe neutropenia than control patients. The cumulative risk of fever with signs of infection was greater in control patients regardless of age, disease extent or the presence of marrow involvement. Patients who were given lithium received significantly more chemotherapy than control patients. Patient survival was greatest in those with limited disease, in complete responders and in those who received more than 75 percent of their induction chemotherapy although it did not differ between the two study groups. The majority of patients required either reduction or discontinuation of lithium. Those who received lithium continuously demonstrated a higher objective response rate and longer survival than either patients in whom the lithium had to be discontinued or those randomized to the control group. Infection was an important cause of death in the control group and cardiovascular event occurred frequently in the lithium group, but the major cause of death in this patient population remains progressive malignant disease.

Carcinoma, Small Cell↗
PubMed1981

Mapping of functional activity in brain with 18F-fluoro-deoxyglucose.

The efficacy of using the 18F-fluoro-deoxyglucose (18F-DG) for measuring regional cerebral glucose utilization in man during functional activation is demonstrated. Normal male volunteers subjected to sensory stimuli (visual, auditory, tactile) exhibited focal increases in glucose metabolism in response to the stimulus. Unilateral visual hemifield stimulation caused the contralateral striate cortex to become more active metabolically than the striate cortex ipsilateral to the stimulated hemifield. Similarly, stroking of the fingers and hand of one arm with a brush produced an increase in metabolism in the contralateral postcentral gyrus compared to the homologous ipsilateral region. The auditory stimulus, which consisted of monaural listening to either a meaningful or nonmeaningful story, caused an increase in glucose metabolism in the right temporal cortex independent of which ear was stimulated. These results demonstrate that the 18F-DG technique is capable of providing functional maps in vivo in the human brain.

Adult↗
PubMed1981

Efficacy of argon laser photocoagulation in the treatment of circinate diabetic retinopathy.

We evaluated 115 eyes in 105 diabetic patients with circinate retinopathy and, in most cases, associated macular edema. Of these 115 eyes, 68 were treated with argon laser photocoagulation to leaking vessels, primarily in the center of the circinate ring. Forty-seven eyes that had similar findings but received no treatment were followed up for one year and some patients were followed up for as long as three years. In each year of follow-up the treated eyes did significantly better visually than the untreated eyes. The circinate complex was eliminated in 23 of the 24 treated eyes (96%) followed up for three years, whereas it disappeared in only two of the ten untreated eyes (20%). Complete resolution of macular edema, however, was achieved in only two of the treated eyes (3%) and in none of the untreated eyes. Eyes with initial visual acuities of 6/18 (20/60) or better did significantly better with treatment than eyes treated after visual acuity was less than 6/18 (20/60). The former group was the only one to show a mean improvement in visual acuity.

Diabetic Retinopathy↗
PubMed1981

The long-term outlook for children treated for non-Hodgkin lymphomas. A report of the Children's Solid Tumour Group.

Twentynine children with non-Hodgkin's lymphomas (NHL) were treated between 1974 and 1977 with a protocol based on those used for childhood ALL. 76% of patients had advanced disease by Ann Arbor criteria. All tumours had Rappaport's diffuse histology. 19 patients (65%) achieved complete remission, 14 (65%) remained alive and disease free beyond 42 months from diagnosis. 10 patients failed to enter complete remission, of whom all died. 7 patients relapsed; 5 died, 2 remain disease free and off treatment at 19 and 29 months. Comparison with a historic group of 20 consecutively treated children shows improved survival (P less than 0.01). 18 controls died. Histology was reviewed using the Kiel classification and staging according to Murphy's criteria. These are compared with the methods used initially. The improved outlook for children with NHL using intensive multiple drug regimes and cranial prophylaxis is confirmed. In staging childhood NHL, Murphy's criteria, which take into account the natural history of the disease, have greater prognosis value. Histology and pattern of outcome of the disease suggest basic differences between primary abdominal and primary mediastinal and nodal disease. This is now being confirmed with immunological typing and will be reflected in the development of future protocols.

Abdominal Neoplasms↗