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Biomedical subjects

C Russell

Publications and source records attributed to C Russell.

At least 73 records · Page 4Linked to original sources
PubMed1996

Report of the Radionuclides in Nephrourology Committee on renal clearance.

The need for simple and accurate methods to measure renal function is self-evident. This need increases as techniques for intervention become available. The demand for evaluation of individual kidney function has increased with its role in the diagnosis and follow-up of unilateral renal disease and in decision making for conservative or surgical treatment based on residual renal function. The role of nuclear medicine in this area has been inhibited by confusion about conflicting methodologies. This report is meant to provide guidance to those centers that would like to initiate clearance procedures but have difficulty in choosing appropriate methodology.

Glomerular Filtration Rate↗
PubMed1995

Congruence of decisions between patients and their potential surrogates about life-sustaining therapies.

Decisions concerning life-sustaining treatments and the congruence in decision-making between patients and potential surrogates were examined. The ability of a patient-chosen surrogate to make decisions reflecting the wishes of that patient was estimated. Thirty patient-surrogate pairs independently responded to vignettes of five treatments. Patients and surrogates made similar decisions on all treatments except cancer chemotherapy, for which surrogates were significantly more likely to choose treatment when patients would have them refuse. The findings can assist patients and clinicians in choosing a surrogate whose decision-making corresponds with patient choices.

Analysis of Variance↗
PubMed1994

Surgical resection in patients with nonseminomatous germ cell tumor who fail to normalize serum tumor markers after chemotherapy.

OBJECTIVE: Patients with high-stage nonseminomatous germ cell tumors treated with platinum-based chemotherapy who have residual radiographic evidence of disease and fail to normalize tumor markers present a difficult clinical dilemma. Some authors feel that these patients are not appropriate surgical candidates. Our practice has been to offer certain patients salvage surgery in an attempt for cure. This report is designed to review that experience and critically analyze the results. METHOD: We report a series of 16 such patients with advanced-stage nonseminomatous germ cell tumors who had persistently elevated alpha fetoprotein and/or human chorionic gonadotropin. All underwent resection of all radiographically evident sites of residual disease following induction or salvage chemotherapy. RESULTS: Ten patients had only retroperitoneal (RP) metastasis. Six patients had more than one site of residual disease--4 RP and lung, 2 RP and liver. There were no postoperative deaths. The mean postoperative stay was eleven days (range 7 to 36 days). Six patients (37%) are alive and free of disease at a mean of seventy-four months following surgery (range 20 to 145 months). Five had RP disease only. Ten patients died of disease at a mean of eight months postoperatively (range 5 to 21 months). CONCLUSIONS: Patients with advanced nonseminomatous germ cell tumor who fail to normalize their serum tumor markers after adequate platinum-based chemotherapy should be considered for surgical resection of all radiographically evident residual disease. In select cases this practice offers the only viable chance for cure.

Biomarkers, Tumor↗
PubMed1994

Paclitaxel (Taxol) in heavily pretreated ovarian cancer: antitumor activity and complications.

OBJECTIVE: To analyze the efficacy and toxicity of Taxol in patients with ovarian cancer who had failed at least two previous chemotherapy treatment regimens. PATIENTS AND METHODS: Sixty-eight patients with advanced pretreated ovarian cancer, with either measurable or evaluable disease who were shown to have disease progression were entered on a National Cancer Institute sponsored 'compassionate' treatment referral center protocol and received intravenous infusion of Taxol over 24 hours 135 mg/m2, (after steroid-containing premedication) repeated every 3 weeks and continued while showing no evidence of progression. RESULTS: Of the 68 patients enrolled, 10 patients (15%) had a partial response and one assessable by marker only had improvement of disease. In addition, 27 others (40%) were stable on continued Taxol for a median time of 6.4 months and CA-125 decreased in 20 patients out of 59 patients with elevated baseline CA-125s. Twenty-seven patients progressed while receiving 1-6 cycles of treatment. Three patients were not evaluable for response. Neutropenia and its complications occurred primarily during the first two cycles of Taxol treatment. Febrile episodes requiring antibiotic treatment occurred in 44% of patients which is a higher incidence than in prior series. CONCLUSIONS: Taxol as a single agent has modest activity in heavily pretreated ovarian cancer patients but appears to be useful and is subjectively well tolerated by many. The high incidence of infection in comparison with other series of patients with ovarian cancer treated with chemotherapy suggests this pretreated patient population has enhanced susceptibility to develop complications from neutropenia. Safer treatment in this advanced setting should include more aggressive use of cytokines and/or less myelosuppressive regimens (e.g. shorter Taxol infusions).

Adult↗
PubMed1993

Intraperitoneal carboplatin and etoposide for persistent epithelial ovarian cancer: analysis of results by prior sensitivity to platinum-based regimens.

Eighteen women with epithelial ovarian cancer and small-volume disease within the peritoneal cavity at reassessment laparotomy after initial treatment with platinum-based regimens received treatment with a combination of intraperitoneal (ip) carboplatin and etoposide administration. The dose of carboplatin was fixed at 200 mg/m2 whereas the dose of etoposide was escalated in cohorts of 4 patients from 50 to 75 and eventually to 100 mg/m2. Hematologic toxicities appeared to be related to decreased renal function, and, in the last cohort of 10 patients, with prior treatment with systemic carboplatin. Because of this shift in patient population, escalations ceased and ip cisplatin was partly substituted for ip carboplatin in 5 patients. The study opened July 1988 and closed on July 1991: 8 patients are alive, with 4 enjoying progression-free survival and no clinical evidence of disease 1 to 4 years after onset of treatment. One patient is alive with no clinical evidence of disease 3+ years after a late relapse was treated with systemic carboplatin. Three other patients are alive with evidence of disease, having experienced improvements with taxol and ip floxuridine. Analysis of this small experience by pretreatment characteristics suggests that patients who are platinum sensitive and not allowed to relapse, have normal baseline CA-125s, and undergo successful secondary cytoreductive surgery may benefit from platinum-based ip therapy.

Adult↗
PubMed1993

When is a mug not a mug? Effects of content, naming, and instructions on children's drawings.

Two hundred seventy 5-year-old children produced a copy drawing of a transparent glass mug with its handle turned away. In a factorial design three factors were manipulated to examine their additive or independent influence on the child's production of either view-specific or canonical (i.e., with the handle at the side) depictions: the content of the mug, the label used to describe it, and the explicitness of instruction. The results showed, first, that each of these variations in task demands exerted an influence on the canonicality/view-specificity of the children's drawings. Second, these influences were both facilitative and prohibitive. So, for example, general instructions prompted canonical drawings, while very explicit instructions elicited view-specific depictions. Third, each factor exerted an independent influence upon whether or not the handle was included--there were no interactions between factors on the production of the two types of picture. These results provide further evidence against simple associations between children's drawings and their cognitive abilities. They suggest that what children produce in studies of "drawing" may well simply inform us about the development of an understanding of adults' communicative intent.

Age Factors↗
PubMed1993

Heart disease risk factors in the Vietnamese community of southwestern Sydney.

Despite low mortality from heart disease in the New South Wales Vietnamese community, the prevalence of risk factors for heart disease has been increasing. This study sought to identify the prevalence of heart disease risk factors in the Vietnamese community in southwestern Sydney. In 1991, 389 randomly selected Vietnamese-born residents of southwestern Sydney (79.2 per cent response rate) were interviewed by telephone about their risk status. Sixty-one per cent of this sample agreed to a second interview in their homes where physical measurements were taken. Smoking prevalence was high in males (53 per cent), whereas raised blood pressure (5.1 per cent), high blood cholesterol (21.1 per cent) and overweight (14.0 per cent) had a low prevalence compared to National Heart Foundation data for the general population. Interventions targeting males about smoking should be a health promotion priority, and the maintenance of the traditional Vietnamese diet should be encouraged.

Adolescent↗
PubMed1992

Intraperitoneal therapy for ovarian cancer: analysis of fluid distribution by computerized tomography.

Nineteen patients with ovarian cancer and minimal residual or persistent disease who were treated with cisplatin or carboplatin-based intraperitoneal (IP) regimens had distribution studies of IP contrast and computerized tomography prior to and during treatment. The distribution pattern was assessed retrospectively and scored for the presence of contrast in each of eight regions: the under surface of right and left diaphragms, the right and left paracolic gutters, the lesser omental sac, the intramesenteric region and the true and false pelvis. Assigning a point to each region with adequate distribution, we classified 10 patients to an excellent pattern (greater than or equal to 7 of 8 regions), 6 to a good pattern (5 to less than 7 regions), and 3 to an inadequate distribution pattern (less than 5 regions). Serial studies were performed in 8 patients after more than 4 cycles of IP therapy. In these patients, all of whom were tolerating treatment without progression, the distribution remained virtually unchanged for those with excellent distribution. One of three with good distribution manifested inadequate distribution on repeat study, and one of two with inadequate distribution improved to show a good pattern. In this small study there was no correlation of distribution patterns with plasma CA-125 at onset of IP treatment and prior surgical procedures or placement of the catheter tip. However, three patients with unsatisfactory patterns had procedures consisting of catheter placement only rather than formal reassessment laparotomies for ovarian cancer. Since satisfactory IP distribution may be required for obtaining a therapeutic advantage from IP therapy, methods for its assessment must be developed.(ABSTRACT TRUNCATED AT 250 WORDS)

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1992

Comparison of Identification Systems for Classification of Bacteria Isolated from Water and Endolithic Habitats within the Deep Subsurface.

One water and three rock samples were taken from a mined tunnel system, U12n, in Rainier Mesa at the Nevada Test Site. Endolithic microorganisms were cultured from ashfall tuff, which was crushed and made into slurries with a formulation of artificial pore water, on R2A agar plates. Microbial counts ranged from 10 to 10 viable cells per g (dry weight) of rock sampled. The cultured water sample yielded 10 viable cells per ml. Many of the isolates were very small (<1 mum) when viewed in the rock matrix and remained small even when cultured. Most were gram-negative rods. Individual isolates were profiled by API-NFT strip number, antibiotic and metal resistance patterns, and colony and cellular morphologies. Three identification systems, API-NFT strips, BIOLOG, and MIDI, were compared. Each system identified only a small percentage of the total isolates, and in only seven cases were the isolates identified the same way by more than one system. The same genus was identified in three of these cases, but different species were indicated. The genus Pseudomonas was the most commonly identified. The isolate profiles and the three identification systems demonstrated that water isolates were considerably different from endolithic isolates.

Journal Article↗
PubMed1992

Technical considerations in 113 percutaneous cholecystolithotomies.

Percutaneous cholecystolithotomy (PCCL) was considered appropriate on the basis of clinical and ultrasound criteria in 220 of 283 patients referred with symptomatic cholecystolithiasis. Contraindications to PCCL were a small, shrunken, thick-walled gallbladder or an intrahepatic gallbladder. PCCL was performed in 113 patients (80 women, 33 men; mean age, 56 years). Local anesthesia was used in 10 patients; general anesthesia, in 103 patients. The average procedure time was 1 hour. Complete stone clearance was achieved in 100 patients. PCCL was successful in 107 patients; in 77 of these, it was completed in a single stage. Six technical failures occurred, and seven patients had persistent cystic duct stones. Acute, nonfatal complications occurred in 15 patients and were managed conservatively. In 12 of 13 patients with stones impacted in the Hartmann pouch, patency of the cystic duct was restored. It is concluded that PCCL is a safe, effective procedure for clearing the gallbladder of calculi regardless of their size, composition, or number. It preserves the gallbladder, enables possible restoration of contractility, and can be performed without general anesthesia.

Cholangiography↗
PubMed1992

Dose fractionation of radiolabeled antibodies in patients with metastatic colon cancer.

Twelve patients with metastatic colon cancer were treated with 131I-chimeric B72.3 (IgG-4) at total doses of 28 or 36 mCi/m2 in two or three weekly fractions. Bone marrow suppression was the only significant side effect. The degree of bone marrow suppression adjusted for whole-body dose was modestly but statistically significantly (p = 0.04) less than that seen with identical doses given as a single infusion for the total dose of 36 mCi/m2. Nine of twelve patients developed an antibody response to ch B72.3, which altered the kinetics of radiolabeled antibody in four patients given a second course of therapy. One patient had a minor response that lasted 4 mo. Fractionation of this particular radiolabeled antibody at the dose schedule used produced a modest increase in the therapeutic window in regard to administered dose.

Adult↗
PubMed1991

Phase I and pharmacologic evaluation of intraperitoneal 5-fluoro-2'-deoxyuridine.

Intraperitoneal (i.p.) 5-fluoro-2'-deoxyuridine (Floxuridine, FUdR, FdUrd) was evaluated in a phase I study at a starting level of 500 mg given on 1 day in 2 I 1.5% dialysate. Escalations within patients were allowed every other cycle. A total of 23 patients (age, 32-78 years) received 108 treatment courses. Local tolerance at all dose levels was excellent, with no cases of drug-related peritonitis being observed. Nausea and vomiting increased in severity in relation to dose and was universal at greater than 3,000 mg x 3 days. One patient each developed grade 1 mucositis as well as diarrhea at a dose of 3,000 mg x 3 days and leukopenia and thrombocytopenia at 5,000 mg x 3 days. Peritoneal fluid (PF) and plasma (PL) FdUrd profiles were monitored by an HPLC method in 13 subjects, with 7 being studied serially at 2-4 increment doses for up to 6 h. Profiles that exhibited apparent linear pharmacokinetics gave PF drug levels 2-4 logs higher than the PL counterparts, with the latter essentially declining in parallel to the former, indicating that the disposition of FdUrd from the peritoneal compartment is rate-determining. The mean terminal half-life for PF FdUrd was found to be 115 min and mean peritoneal clearance was 25 ml/min. The vast differences in drug levels and AUC found between the PF and the PL profiles suggests a high systemic clearance of FdUrd, which was confirmed in two patients receiving 2 g FdUrd by short i.v. infusion. A disproportionate increase in the plasma FdUrd levels and the corresponding AUC values was found with increasing dose, suggesting a disproportionate increase in the systemic partitioning of FdUrd when doses were escalated within a patient. Substantial levels of peritoneal 5-fluorouracil (FUra) were also detected in most of the subjects. Thus, FdUrd was found to have several desirable properties for i.p. administration: (1) a 2- to 4-log pharmacologic advantage. (2) the absence of local toxicities, and (3) a favorable antitumor spectrum and some evidence of antitumor effects in this phase I and pharmacology study. A 3,000-mg dose given in 2 1 1.5% dialysate for 3 consecutive days exhibited antitumor activity and produced no systemic toxicity except nausea and vomiting, which was controlled by antiemetics. This dose schedule is therefore recommended for phase II trials directed against small-volume disease in the peritoneal cavity, such as may be found in some stages of ovarian and gastrointestinal cancers.(ABSTRACT TRUNCATED AT 400 WORDS)

Ascitic Fluid↗
PubMed1991

The effects of false response feedback on human 'fear' conditioning.

This study describes a human electrodermal conditioning experiment in which subjects were given false skin conductance feedback during CS presentation. In comparison with appropriate attentional control groups, subjects who believed they were exhibiting a strong CR did actually emit a greater magnitude CR, while subjects who believed they were exhibiting only a weak CR emitted a significantly lower magnitude CR. When both self-report and behavioural measures of UCS revaluation were taken after conditioning, the evidence suggested that response feedback had not differentially affected subjects evaluation of the aversiveness of the UCS. The results suggest that the response modulating effects of response feedback observed in this and other studies are not caused by response feedback influencing evaluation of the UCS, but they are consistent with the hypothesis that beliefs about the nature of response feedback influence the strength of the UCS representation itself.

Adult↗
PubMed1991

An intragenic suppressor of a calmodulin mutation in Paramecium: genetic and biochemical characterization.

We describe a suppressor of the calmodulin mutant cam1 in Paramecium tetraurelia. The cam1 mutant, which has a SER----PHE change at residue 101 of the third calcium-binding domain, inhibits the activity of the Ca(2+)-dependent K+ current and causes exaggerated behavioral responses to most stimuli. An enrichment scheme, based on an increased sensitivity to Ba2+ in cam1 cells, was used to isolate suppressors. One such suppressor, designated cam101, restores both the activity of the Ca(2+)-dependent K+ current and behavioral responses of the cells. We show that the cam101 mutant is an intragenic suppressor of cam1, based on genetic and microinjection data. The cam101 calmodulin is shown to be similar to wild-type calmodulin in terms of its ability to stimulate calmodulin-dependent phosphodiesterase at low concentrations of free calcium. However, the cam101 calmodulin has a reduced affinity for a monoclonal antibody to wild-type Paramecium calmodulin, as does the parental cam1 calmodulin, and a different mobility on acid-urea gels relative to both wild-type and cam1 calmodulin. We have been able to demonstrate that the isolation of intragenic suppressors of a calmodulin mutation is possible, which allows for the further genetic analysis of structure-function relationships in the calmodulin molecule.

Animals↗