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Biomedical subjects

B F Rush

Publications and source records attributed to B F Rush.

At least 73 records · Page 4Linked to original sources
PubMed1984

Multimodality preoperative treatment for advanced cancer of the head and neck.

Neoadjuvant induction chemotherapy with cisplatin, methotrexate, and bleomycin appears to improve the results of treatment of advanced stage IV head and neck cancer, compared with results in historical control subjects. Patients treated with induction chemotherapy and radiation therapy had a 29 percent overall survival rate at 3 years, which represents approximately a twofold improvement in the survival rate. Patients who were treated with chemotherapy and radiation therapy followed by surgery had more than a threefold increase in the survival rate (49 percent at 3 years), compared with historical data from our institution and elsewhere for such patients [9-11]. Distant metastases developed in 25 percent of the patients, and it thus appears that long-term, effective consolidation and maintenance chemotherapy [12,13] need to be developed for patients who receive combination therapy before surgery for head and neck cancer.

Actuarial Analysis↗
PubMed1984

Differential diagnosis of hypovolemic shock.

The classic symptoms of hypovolemic shock have probably been recognized since prehistoric times. Clear, written descriptions did not emerge until the 19th century, and the syndrome implied impending, unpreventable death until the 20th century. We now have the tools for resuscitation of the large majority of patients in shock. When the shock syndrome is encountered in the field, away from the hospital and the emergency room, rapid transportation to these areas of more sophisticated diagnosis and treatment is indicated.

Diagnosis, Differential↗
PubMed1984

Protective effect of previous burn on murine endotoxemia.

Major body burns suppress the immune system, at least temporarily. However, it has not been demonstrated that following recovery from burn injury, the burned subject can become immunocompetent. This study was designed to test this hypothesis. Swiss-Webster mice (25 +/- 2 gm) anesthetized with intraperitoneal pentobarbital sodium were given full thickness burns on a depilated area of the lower back with a stainless steel tube (2 cm diameter) at 100 C for 10 seconds. Control mice were anesthetized, depilated in the same manner, but sham burned. Six weeks later, (the burn wound was completely healed, and the mice weighed 33 +/- 4 gm) each animal was given 0.3 mg of Escherichia coli endotoxin (055:B5) in saline intraperitoneally. The 24- and 72-hour survivals for the control animals were 31/45 (69%) and 13/45 (29%), respectively; while the 24- and 72-hour survivals for the post burn mice was 26/27 (96%) and 14/27 (52%), respectively (P less than 0.05). All animals surviving 72 hours recovered. These data clearly demonstrate that the survival from endotoxemia is significantly increased in animals that have been previously burned. This observation indicates that the immune system is stimulated 6 weeks postburn.

Animals↗
PubMed1983

Effect of age and splenectomy in murine endotoxemia.

The protective role of the spleen in gram-positive infections, particularly in infancy and childhood, is well established. Since it is not known whether the spleen is protective in gram-negative sepsis, particularly in elderly individuals as compared to young subjects, the following study was undertaken. Splenectomized and nonsplenectomized Swiss Webster mice, 3 months old (young), or 12 months old (elderly) were utilized. Splenectomy was performed 4 weeks prior to administration of E coli endotoxin. Mortality in elderly nonsplenectomized mice was significantly greater than that of young nonsplenectomized mice. Prior splenectomy significantly increased the mortality in young mice at 48 h, whereas the mortality of E coli endotoxemia (ECE) in elderly mice was not altered by prior splenectomy. The spleen, therefore, appears to have a protective role for young mice but does not protect elderly mice with ECE. It is postulated that this loss of splenic protection reflects deteriorating splenic function with age.

Aging↗
PubMed1983

Interval breast cancer: a more aggressive subset of breast neoplasias.

It has been suggested that interval breast cancer (breast cancer found within 12 months of a negative screening examination) exhibits a more virulent behavior than those found by the screening clinic. To test this hypothesis, 120 new cases of breast cancer were retrospectively reviewed from our Breast Screening Center. These patients were divided into three groups--interval cancer cases, lesions found at initial screening, and lesions found at subsequent screening. Statistically significant differences seen in our interval cancer cases included a higher percentage of positive axillary nodes, higher overall mortality rate, and lower 6-year survival rate as calculated by left table analysis. The remaining data, although not statistically significant, demonstrate a parallel trend toward a more malignant behavior. It is concluded that interval breast cancers are more aggressive forms of breast neoplasias.

Adult↗
PubMed1983

The hemodynamic effect of profound hypercapnia on acute hypoxic respiratory failure.

The effect of profound hypercapnia on acute hypoxic respiratory failure is evaluated. Eight dogs were subjected to oleic acid-induced acute respiratory failure. Four dogs were ventilated normally, and four dogs were made hypercapneic by rebreathing exhaled CO2. In the hypercapneic animals, heart rate and alveolar-arterial oxygen difference were significantly lower than in normocapneic animals, while mixed venous O2 cardiac index, oxygen delivery index, stroke volume index, and left ventricular stroke work were significantly higher. Mean arterial pressure was maintained at preinjury levels. Pulmonary and systemic vascular resistance increased in both experimental groups. There was no significant difference between groups for gravimetric determination of lung water. Cardiopulmonary performance in acute respiratory failure is improved with hypercapnia. This may be related to CO2-induced catecholamine release.

Acute Disease↗
PubMed1983

Regional vs systemic effect of cis-dichlorodiammine platinum (II) on squamous cell carcinoma in rats.

Utilizing a model that compares the effects of chemotherapeutic agents given regionally vs systemically in the same animal, the effects of cis-dichlorodiammine platinum (II) (cis-platinum) were evaluated. Squamous cell carcinoma was implanted at the bases of both ears of Fisher-344 rats. By retrograde cannulation of a branch of the external carotid artery, tumors on the right were treated by intra-arterial infusions of varying doses of cis-platinum while tumors on the left were treated only after systemic circulation of the same drug. The investigators found that cisplatinum is effective in decreasing the rate of tumor growth compared to control animals treated with saline; however, they found no difference in the rate of growth between tumors treated regionally vs systemically and therefore no advantage in the intra-arterial administration of the drug at the doses and rates of infusion tested.

Animals↗
PubMed1982

Hemodynamic effects of prolonged infusion of prostaglandin E1 (PGE1) after hemorrhagic shock.

Although one-hour infusions of prostaglandin E1 to animals suffering from hemorrhagic shock have proved beneficial, there is question as to whether the improved hemodynamics can be sustained over a longer infusion time. Following reinfusion of shed blood, an infusion of PGE1 at a dose of 1 microgram/kg/minute showed a significant elevation in cardiac output and left ventricular stroke work and a decrease in systemic vascular resistance when compared to animals receiving only an equal volume of normal saline. There was no diminution in the hemodynamic activity of the drug over the entire infusion period. These data indicate that the drug might be appropriate for hemodynamic support in the clinical situation, where infusion times of greater than one hour are often necessary.

Alprostadil↗
PubMed1982

Combined therapy in advanced squamous cell carcinoma of the head and neck.

The charts of 102 patients with stage IV squamous cell carcinoma of the head and neck, seen at the East Orange Veterans Administration Hospital between 1975 and 1979, were reviewed. Ninety-one of these patients were submitted to a protocol of high-dose preoperative radiotherapy, followed by surgery. Five-year actuarial survival in patients completing the protocol was 31.6 per cent. All patients who completed radiotherapy and were eligible for surgery, but refusing operation, died of their disease within three years. Historical controls for stage IV head and neck cancer have five-year survival rates of 0-16 per cent, depending on site. A recent review of the literature shows stage IV lesions treated with surgery alone have a five-year survival rate of 6 per cent.

Adult↗
PubMed1981

The effect of ATP-MgCl2 infusion on hepatic cell permeability and metabolism after hemorrhagic shock.

The ability of exogenous ATP-MgCl2 to reverse the inhibition of ATP-dependent intracellular reactions by hemorrhagic shock was studied. Levels of ornithine in the postperfusion fluid were lower in animals receiving ATP-MgCl2 than in placebo-treated control animals (338.6 +/- 167.0 versus 692.1 +/- 67.2 mumol). Arginine levels were higher (399.1 +/- 130.1 versus 34.3 +/- 59.1 mumol) in ATP-MgCl2-treated animals. Ability of in vitro ATP to enter the cell and inhibit lactate formation (Crabtree effect) was significantly less in those animals receiving in vivo ATP-MgCl2 (81.4 +/- 11.1% versus 57.7 +/- 10.1%). Glutamate levels were not decreased by shock but were significantly increased by treatment with ATP-MgCl2 compared to placebo (190.5 +/- 48.8 versus 122.6 +/- 36.3 mumol). These data indicate that exogenously administered ATP-MgCl2 can reverse the inhibition of ornithine metabolism and the changes in lactate inhibition seen in hemorrhagic shock. These are both intracellular ATP-dependent reactions.

Adenosine Triphosphate↗
PubMed1981

The effect of pH of resuscitative fluids in treatment of severe hemorrhagic shock.

Commercially available Ringer's lactate solution has a pH of approximately 6.5. In a situation such as shock, which is normally accompanied by a metabolic acidosis, this additional acid load could have an adverse effect on resuscitation when massive amounts of fluid are required. We prepared a similar solution with a pH of 7.4 and compared the two solutions. Fourteen dogs were shocked according to a Wiggers' hemorrhagic shock model. Six dogs (43%) died during shock, 8 dogs survived the model, 4 were resuscitated over a 150-minute observation period to a pulmonary capillary wedge pressure (PCWP) of 8-12 mmHg with Ringer's lactate with a pH of 7.4. The cardiac output, lactate levels, amount of fluid required to maintain the PCWP, and arterial and mixed venous pH were measured at 30, 60, 90, 120, and 150 minutes. No significant differences were found except for occasionally higher arterial pH values in the group treated with Ringer's lactate with a pH of 7.4. There was no difference between the groups in any measurement at the end of the observation period or in survival. All dogs died within 12 hours of the end of the shock period. Our data indicate that the somewhat acidic pH of standard Ringer's lactate does not adversely affect the adequacy of resuscitation. There is no advantage to using Ringer's lactate with a pH of 7.4.

Animals↗
PubMed1981

Changes in plasma amino acid profiles following abdominal operations.

Plasma amino acid profiles along with hemoglobin, hematocrit, albumin, protein, blood urea nitrogen and serum creatinine values for ten patients undergoing abdominal operations were studied before operation and for 16 days there-after at different intervals. Six patients in the control group were studied in a similar manner. From the observations obtained, we concluded that total amino acid valued are a more sensitive reflection of patient nutrition in both the preoperative and postoperative periods. In future, total amino acid levels may become part of the nutritional assessment of a patient undergoing an operation. The histidine levels in plasma remain low for the longest period of time, an indication of a great need for histidine. Hence, greater attention should be paid to the histidine content of a diet or solution administered parenterally, or both. In addition, branched chain amino acids, alanine, glycine, cystine, arginine, lysine, tryptophan and threonine are required in greater quantity than the other amino acids as a result of the increased catabolism and partial starvation of the patients postoperatively. In formulation hyperalimentation solutions, an increased need for these amino acids should be kept in mind.

Abdomen↗
PubMed1980

The effect of radiofrequency hyperthermia on the Ca755 murine adenocarcinoma.

Radiofrequency (RF) was used to induce hyperthermia in the Ca755 murine adenocarcinoma. Thermal kinetic studies revealed a selective heating of tumors over normal tissues during RF, which occurred in larger but not smaller tumors. Small tumors required a significantly greater RF output than did larger neoplasms for heating to the tumoricidal range of 42 C. Rates of tumor growth were not changed after single RF treatments at 42 C, but tumors receiving three applications of RF were significantly smaller than a control group at 28 days tumor age. RF may be of value in the treatment of large neoplasms by using multiple applications; however, microscopic mitoses may not be affected directly without simultaneously damaging normal tissues in the RF field.

Adenocarcinoma↗