Search PubMed⌕ Search

Biomedical subjects

C B Wilson

Publications and source records attributed to C B Wilson.

At least 469 records · Page 26Linked to original sources
PubMed1980

Randomized comparisons of radiotherapy and nitrosoureas for the treatment of malignant glioma after surgery.

Within three weeks of definitive surgical intervention, 467 patients with histologically proved malignant glioma were randomized to receive one of four treatment regimens: semustine (MeCCNU), radiotherapy, carmustine (BCNU) plus radiotherapy, or semustine plus radiotherapy. We analyzed the data for the total randomized population and for the 358 patients in whom the initial protocol specifications were met (the valid study group). Observed toxicity included acceptable skin reactions secondary to radiotherapy and reversible leukopenia and thrombocytopenia due to chemotherapy. Radiotherapy used alone or in combination with a nitrosourea significantly improved survival in comparison with semustine alone. The group receiving carmustine plus radiotherapy had the best survival, but the difference in survival between the groups receiving carmustine plus radiotherapy and semustine plus radiotherapy was not statistically significant. The combination of carmustine plus radiotherapy produced a modest benefit in long-term (18-month) survival as compared with radiotherapy alone, although the difference between survival curves was not significiant at the 0.05 level. This study suggests that it is best to use radiotherapy in the post-surgical treatment of malignant glioma and to continue the search for an effective chemotherapeutic regimen to use in addition to radiotherapy.

Aged↗
PubMed1980

What can be done to prevent congenital toxoplasmosis?

There is a great deal of confusion within the medical and lay communities regarding Toxoplasma infection in the pregnant woman. Many physicians are not aware of the significance of this infection in pregnant women or of measures that may decrease the likelihood of the birth of an infant with congenital toxoplasmosis. Data regarding the morbidity, incidence, cost, and measures for the prevention of congenital toxoplasmosis are discussed.

Antibodies↗
PubMed1980

Prolactin-secreting pituitary adenomas. III. Frequency and diagnosis in amenorrhea-galactorrhea.

Hypocycloidal tomograms of the sella turcica and serum prolactin concentrations were obtained in 146 women with amenorrhea, galactorrhea, or both to diagnose prolactin-secreting pituitary adenomas. Findings suggesting an adenoma, ie, abnormal tomogram and elevated serum prolactin concentration, were found in 24.6% (16/65) of previously unscreened patients and 59.2% (48/81) of prescreened patients. The combination of an abnormal tomogram and elevated prolactin level was relatively specific for an adenoma, as 91% (42/46) of women with these findings who underwent surgery had histologically confirmed tumors. Tumors occurred in women from 15 to 45 years of age, with amenorrhea or galactorrhea ranging from less than six months to more than 20 years in duration. Some women in this series also had obesity, rapid weight loss, polycystic ovarian syndrome, amenorrhea following discontinuance of oral contraceptive use, or emotional stress.

Adenoma↗
PubMed1980

Supportive management of the patient with malignant brain tumor.

Primary brain tumors constitute nearly 10% of nontraumatic neurological diseases. The incidence of metastatic tumors is increasing and will continue to increase as therapeutic improvements prolong survival. Sooner or later, most of these patients will have major neurological disabilities. The management of the most common of these disabilities, including the care of bedridden or comatose patients, is discussed, along with consideration of the role of the family in caring for the patient's physical and psychological needs.

Brain Neoplasms↗
PubMed1980

Results of surgery in 114 patients with prolactin-secreting pituitary adenomas.

The clinical features and prolactin levels of 114 patients, including five men, who had prolactin-secreting adenomas are presented. The rates of resolution of amenorrhea and galactorrhea following surgery were calculated. Fifteen women became pregnant following surgery. Therapeutic failure tended to occur in patients who had higher preoperative serum prolactin levels and those in whom total tumor resection was not achieved. Although clinical anomographic changes preceded elevation of prolactin values in two cases and, in one case, clinical indications and an elevated prolactin value preceded tomographic changes. The morbidity encountered with the procedure was minimal and there were no deaths.

Adenoma↗
PubMed1980

Failure to trigger the oxidative metabolic burst by normal macrophages: possible mechanism for survival of intracellular pathogens.

As previously reported, normal human monocytes (11) and activated mouse macrophages (9) are able to kill or inhibit intracellular replication of Toxoplasma that are not antibody coated, whereas normal human and mouse macrophages are not (7, 9). Each of these types of mononuclear phagocytes is able to kill antibody-coated Toxoplasma. In our studies, phagocytosis of antibody-coated Toxoplasma stimulated the respiratory burst by each of these types of mononuclear phagocytes, whereas phagocytosis of organisms that were not antibody coated stimulated the respiratory burst only by human monocytes and by activated mouse macrophages. Phagocytosis of Toxoplasma did not inhibit production of reactive oxygen metabolites by normal macrophages; rather, it failed to stimulate their production. Killing of Toxoplasma by monocytes from a child with X-linked chronic granulomatous disease and his heterozygote mother was impaired. Thus, reactive oxygen metabolites, perhaps in conjunction with lysosomal contents, appear to be first-line mechanisms whereby mononuclear phagocytes kill this organism. We were not able to determine the exact mechanisms whereby mononuclear phagocytes inhibit the replication of those Toxoplasma that were not killed, although both oxygen-dependent and other nonlysosomal mechanisms may be involved. The differences we observed in oxidative response to phagocytosis of Toxoplasma appear to be one determinant of the antimicrobial activity of these cells and may account for the ability of some intracellular pathogens to survive within phagocytes. These differences may be membrane related. Further studies of Toxoplasma membranes, phagocyte membrane receptors for Toxoplasma, and membrane-related mechanisms for activation of the respiratory burst are needed to define their true basis.

Adult↗
PubMed1980

Prolactin--added dimension in male genitosexual disorders.

Prolactin-producing pituitary adenomas known to cause amenorrhea and galactorrhea in the female have been implicated recently in male infertility and impotence. Knowledge of the pathophysiology of prolactin and of the choices of treatment for these tumors is an important adjunct to the urologist's armamentarium.

Adenoma↗
PubMed1980

An autoradiographic study of human gliomas: growth kinetics of anaplastic astrocytoma and glioblastoma multiforme.

When 3H-thymidine was administered either intravenously or intra-arterially to 9 patients with gliomas (5 glioblastoma multiforme, 3 anaplastic astrocytoma, and one mixed glioma) shortly before operation, and tissue obtained from the biopsy and, subsequently, at autopsy was examined by autoradiography, it was found that 2 of the glioblastomas diluted out the labelling in the two- to four-month interval between labelling and autopsy, whereas 3 other glioblastomas and the 2 anaplastic astrocytomas retained labelled neoplastic cells in parts of the tumours at autopsy after intervals of from three weeks to five months following labelling. Most patients whose tumours demonstrated foci of labelled cells at autopsy survived longer (1.5 to 7 years). Certain neoplastic cells in anaplastic astrocytomas and some glioblastomas appear either to limit cell division or to differentiate even in an environment favourable to cell proliferation.

Adolescent↗
PubMed1980

Chemotherapy of pediatric posterior fossa tumors.

Results of chemotherapy of recurrent posterior fossa tumors in children are presented. Cerebellar astrocytoma, ependymoma, and brain stem glioma have all shown objectively determined responses to treatment with nitrosourea compounds (BCNU or CCNU). Medulloblastoma has shown objectively determined response to various chemotherapeutic agents; but in our experience the best responses have been obtained with a combination of a nitrosourea (CCNU), vincristine, and procarbazine. Although chemotherapy after recurrence has significantly prolonged the life of the patients, cure has not been achieved. Theoretical considerations regarding the failure of initial therapy and the inadequacy of subsequent chemotherapy are discussed.

Astrocytoma↗
PubMed1980

Percutaneous lumboperitoneal shunt: review of 130 cases.

One hundred thirty consecutive cases of percutaneous lumboperitoneal shunting are reviewed. The efficacy of this procedure in the management of cerebrospinal fluid fistulas and bulging craniotomies is documented. The place of lumboperitoneal shunts in the management of communicating hydrocephalus, with particular emphasis on "normal pressure" hydrocephalus, is discussed.

Adolescent↗
PubMed1980

Role of radiation therapy in the management of craniopharyngiomas in children.

A retrospective study of 32 children treated for craniopharyngioma between 1956 and 1974 was conducted. Twenty-eight patients survived at least 5 years. The length and quality of survival were determined for four treatment subgroups: estimated total resection (8 patients), subtotal resection (4 patients), subtotal resection plus radiotherapy (12 patients), and biopsy and/or cyst aspiration plus radiotherapy (8 patients). The recurrence and survival rates as well as the postoperative morbidity rate for the patients with estimated total resection are comparable to the data from the other modern series. The group receiving radiation therapy after known subtotal resection has done as well as the group with estimated total removal. The excellent response of patients harboring large tumors of a predominantly mixed type to biopsy and/or cyst aspiration followed by radiation therapy provides further evidence of the efficacy and low morbidity of this form of management in selected cases.

Adolescent↗
PubMed1980

Hypoxic cell radiosensitizers in the treatment of malignant brain tumors.

Radiation therapy provides the most effective adjuvant treatment for patients with malignant brain tumors, but brain intolerance to potentially curative doses of radiation is limiting. Solid tumors are thought to contain a substantial population of cells that are hypoxic; because much of the cell kill caused by ionizing radiation is the result of an oxygen-dependent, free radical-mediated attack on deoxyribonucleic acid, hypoxic tumor cells are known to be radioresistant and are therefore a barrier to cure. With the hope of improving the therapeutic ratio of brain tumor radiation therapy, hypoxic cell radiosensitizers are being evaluated. Two nitroimidazoles, metronidazole and misonidazole, have received the most attention. These compounds are thought to mimic oxygen by "fixing" the free free radical-induced damage caused by radiation in tumor cells. Clinical trials ae providing considerable information about the pharmacokinetics and toxicities of these agents. The preliminary results obtained in clinical trials with brain tumor patients are somewhat discouraging; drug toxicity limits the number of radiation treatments with which a sensitizer may be given. The results of ongoing clinical trials with metronidazole and misonidazole and the identificiation of new, less toxic hypoxic cells sensitizers may improve the potential for this modality of therapy.

Animals↗
PubMed1980

Prolactin-secreting pituitary adenomas: correlation of radiographic and surgical findings.

The preoperative hypocycloidal sellar tomograms, angiograms, and pneumoencephalograms of 100 patients being evaluated for prolactin-secreting pituitary adenomas were reviewed and the results correlated with surgical findings at transsphenoidal exploration. The majority (53%) of tumors encountered were microadenomas. Although sellar volume was normal in 72%, sellar shape on tomography was abnormal in 96%; the location of the tumor within the sella could be predicted by means of tomography alone in 88%. Low volume pneumoencephalography was a reliable method for determining suprasellar extension in 19% of cases and in demonstrating arachnoidal diverticulae in 24%, a finding of great importance to the surgeon planning a transsphenoidal exploration. The use of internal carotid angiography to predict lateral tumor extension proved unreliable. Tumor blush was demonstrated only in larger lesions. No vascular anomalies that would contraindicate transsphenoidal exploration were encountered in this group of patients with hyperprolactinemia.

Adenoma↗