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Biomedical subjects

C Simpson

Publications and source records attributed to C Simpson.

At least 55 records · Page 3Linked to original sources
PubMed1988

Plasma and tissue concentrations of ceforanide and cefazolin in women undergoing hysterectomy.

Thirty-four women who underwent vaginal hysterectomy received either ceforanide or cefazolin as perioperative antimicrobial prophylaxis. Samples of plasma, myometrium, endometrium and fallopian tubes were obtained at various intervals after injection and were assayed for cephalosporin concentration. Following intramuscular injection approximately 1 h prior to surgery, both drugs provided adequate tissue levels at the time of the procedure. Although both antimicrobials achieved similar tissue concentrations, all tissue samples for ceforanide exceeded the MIC90 for Escherichia coli while in the cefazolin group 9/18 myometrial samples and 10/15 endometrial samples fell below the MIC90 for this organism.

Adult↗
PubMed1988

Management of carotid artery trauma.

We have treated 45 patients with carotid artery injuries--33 caused by penetrating wounds and 12 secondary to blunt trauma. Preoperative angiography is useful in stable patients to rule out associated vascular injuries, and it is crucial for operative planning in cases of blunt trauma. Not unexpectedly, the results of carotid artery repair in neurologically stable patients have been excellent, as have been the results of revascularization in patients with equivocal or less-severe neurologic deficits. This has led us to be aggressive in repair of carotid artery injuries in patients with questionable neurologic deficits. In the eight patients with severe preoperative deficits, one death each followed both ligation and repair, but neurologic improvement was noted in several patients. Distal internal carotid injuries at the base of the skull that were not amenable to direct repair were observed with serial angiograms in four patients with either stabilization or improvement in the intimal injury.

Adolescent↗
PubMed1987

A prospective randomized trial of regional versus systemic continuous 5-fluorodeoxyuridine chemotherapy in the treatment of colorectal liver metastases.

Sixty-four patients were entered into a randomized trial that evaluated intra-arterial (I.A.) versus intravenous (I.V.) 5-fluorodeoxyuridine (FUDR) for colorectal liver metastases. There was a significant improved response rate for I.A. (62%) compared with I.V. (17%) treatment (p less than 0.003). However, the improved response rate for patients in whom I.A. therapy was used did not translate to a significantly improved survival rate. The 2-year actuarial survival rates for the groups for which I.A. and I.V. therapy was used were 22% and 15% respectively, with the survival curves not differing significantly (p = 0.27). These results may have been due to the inclusion of patients with tumor in draining hepatic lymph nodes. The presence of tumor in hepatic lymph nodes was associated with a poorer prognosis. Analysis of a subgroup of patients with negative hepatic lymph nodes suggested an improved actuarial survival rate in patients for whom I.A. versus I.V. therapy was used (p less than 0.03). The toxicity of I.A. FUDR was considerable, and side effects included chemical hepatitis (79%), biliary sclerosis (21%), peptic ulcers (17%), and gastritis/duodenitis (21%). The only major effect of toxicity of I.V. FUDR was severe diarrhea (59%). Regional I.A. FUDR allowed more drug delivery to liver tumors, which resulted in increased tumor responses when compared with use of systemic therapy. However, the small gain in survival seen in a select subgroup of patients with negative hepatic nodes appeared to be offset by the toxicity of I.A. FUDR.

Adult↗
PubMed1987

The neuropsychiatric effects of treatment with interleukin-2 and lymphokine-activated killer cells.

STUDY OBJECTIVE: To study the neuropsychiatric manifestations of therapy with interleukin-2 and lymphokine-activated killer cells. DESIGN: Longitudinal survey of consecutive patients who were given the treatment. Each patient was initially interviewed within 5 days before treatment, and a personal and family psychiatric history was obtained during this first session. Cognitive tests and mood self-rating instruments were administered at the beginning and end of interleukin-2 and lymphokine-activated killer cell treatments, before discharge, and at a follow-up visit 2 to 4 weeks after discharge. SETTING: National Cancer Institute inpatient units at the National Institutes of Health. PATIENTS OR OTHER PARTICIPANTS: Sequential samples of 44 patients with metastatic cancer (age range, 28 to 69 years) who were treated systemically with recombinant interleukin-2 combined with autologous lymphokine-activated killer cells between 30 December 1985 and 31 March 1986. MEASUREMENTS AND MAIN RESULTS: Of the 44 patients studied, 15 developed severe behavioral changes that necessitated acute intervention, and 22 patients had severe cognitive changes (all 22 became disoriented and many also had psychometric evidence of cognitive deterioration). The neuropsychiatric side effects were dose and time related, appearing more frequently at the higher dose and almost uniformly at the end of each treatment phase. All 39 patients who were seen at follow-up had a return to their baseline cognitive scores. None of the factors investigated was found to be predictive of the development of neuropsychiatric toxicity. CONCLUSIONS: The development of clinically significant neuropsychiatric changes during the administration of interleukin-2 and lymphokine-activated killer cells was common and may be treatment limiting. A marked latency in the appearance of neuropsychiatric changes after treatment onset was noted in almost all patients. Every patient studied recovered from the neuropsychiatric side effects.

Adult↗
PubMed1986

High-dose recombinant interleukin 2 in the treatment of patients with disseminated cancer. Responses, treatment-related morbidity, and histologic findings.

Experience with the administration of high doses of interleukin 2 (IL-2) alone is described herein. Ten patients with a variety of malignant disorders unresponsive to conventional treatments were treated with at least 30,000 U/kg of IL-2 by bolus administration three times a day. Patients were treated intravenously or intraperitoneally from four to 21 days in a single course, usually interrupted by a week of recovery. Three of six patients with melanoma experienced an objective regression (greater than 50% decrease in volume); there was no response to treatment in patients with colorectal (0/3) or ovarian (0/1) cancer. Two patients with initial objective regressions who subsequently developed progression were re-treated and one sustained a second partial response. Responses lasted 1, 3, and 7 months without additional treatment. Responses in the three patients with melanoma were in visceral sites (lung, liver, and spleen), as well as cutaneous sites in one patient. Progressive shrinkage of tumors for three to six months after the conclusion of therapy has been noted in two patients. Marked lymphocytic infiltrate was noted in a patient with lesions accessible to repeated biopsies. This study demonstrates that the administration of IL-2 can mediate the regression of established cancer in some patients.

Adolescent↗
PubMed1986

Feather and beak dystrophy and necrosis in cockatoos: clinicopathologic evaluations.

Several species of imported and captive-bred southeast Asian cockatoos with feather and beak disease (FBD) were evaluated. In recently emerging stained feathers from affected birds, intracytoplasmic magenta to basophilic inclusions of various sizes were found in macrophages and basophil-like cells within the pulp and feather epidermis. Occasionally, amphophilic intranuclear inclusions were seen within degenerated feather epidermal cells. On the basis of electron microscopic findings, intracytoplasmic inclusions were not membrane bound and consisted of crystalline arrays of viral particles (17 to 22 nm in diameter). On the basis of size and conformation, viral particles most closely resembled those of parvovirus or picornavirus. Consistent hematologic or serum enzyme differences were not found among affected or healthy cockatoos. Compared with findings in healthy cockatoos, cockatoos with FBD had significantly lower serum protein concentrations, and results of serum protein electrophoresis indicated that birds with FBD had significantly lower concentrations of prealbumin and gamma-globulin fractions. Mean pre- and post-ACTH plasma corticosterone concentrations of cockatoos with FBD were not significantly different from those of healthy cockatoos. In 8 of 9 affected cockatoos evaluated, serum T4 concentrations before and after thyrotropin stimulation were considered normal.

Animals↗
PubMed1986

A new approach to the therapy of cancer based on the systemic administration of autologous lymphokine-activated killer cells and recombinant interleukin-2.

A new approach to cancer therapy has been developed based on the adoptive transfer of autologous lymphokine-activated killer (LAK) cells and recombinant interleukin-2 (IL-2). Forty-one patients with advanced cancer who have failed all standard treatments were treated in this experimental protocol. Fourteen patients experienced an objective regression of cancer, including one patient with metastatic melanoma who underwent a complete regression. Objective responses were seen in patients with colorectal cancer, renal cell cancer, melanoma, and lung adenocarcinoma. The sites of tumor regression included subcutaneous tissue, lung, and liver. The major side effect of therapy resulted from the administration of high-dose IL-2 and was manifested primarily as fluid retention, resulting in a generalized capillary permeability leak syndrome. This approach to adoptive immunotherapy represents a promising approach to the therapy of patients with metastatic cancer. Attempts to increase the potency and decrease the toxicity of therapy and extend this treatment to patients with smaller tumor burdens are in progress.

Cell Separation↗
PubMed1985

On the interpretation of mouth asymmetry.

Greater right-side mouth opening during propositional speech has now been observed in at least eight studies. All current data are consistent with the interpretation that left-hemisphere control of articulation of propositional speech results in greater activity of the right-side lip opening muscles. In addition, expression of automatic speech such as singing, emotion, and possibly prosody can also influence mouth asymmetry, but in the opposite direction, suggesting a relatively greater right-hemisphere role for these types of expression. Further work is needed to confirm these interpretations and to elaborate on the exact neuro-muscular mechanisms and task dependencies responsible for mouth asymmetry.

Facial Expression↗
PubMed1984

Infusion cholecystography in the early diagnosis of acute gallbladder disease.

The value of infusion cholecystography 99mTc HIDA cholescintigraphy and ultrasonography was compared in 51 patients presenting with a clinical diagnosis of acute cholecystitis. Of the 35 patients with proven gallbladder disease, the presence of gallstones was correctly predicted in 31 (88 per cent) by infusion cholecystography, 32 (90 per cent) by 99mTc HIDA cholescintigraphy and 27 (77 per cent) by ultrasonography. There were no false positive investigations. Infusion cholecystography may be of particular interest to surgeons with no ready access to isotope scanning techniques.

Acute Disease↗
PubMed1978

17 beta-Estradiol biosynthesis in cultured granulosa and thecal cells of human ovarian follicles: stimulation by follicle-stimulating hormone.

Cellular sites and gonadotropic control of human follicular estrogen secretion have been assessed by culturing the theca and granulosa components separately under different hormonal conditions. Granulosa cells from human follicles were grown in chemically defined media containing gonadotropins and/or testosterone (T) for 24 h. The production of 17 beta-estradiol (E2) by cells cultivated in T-free media with or without FSH was very low during the culture period. There was a highly significant increase (P less than 0.001) in E2 production when T alone was added and a more marked increase was consistently noted in the presence of FSH and T. In all cases, hCG failed to exert any significant effect on E2 production by granulosa cells in the presence or absence of T. No treatments examined altered the E2 production of thecal cells during a 24-h culture period and the amounts of E2 released into media were negligible when compared with levels produced by granulosa cells from the same follicles. It is concluded that granulosa cells but not thecal cells are the prime site of follicular estrogen production and that FSH regulates estrogen secretion by nonluteinized granulosa cells of the human follicle.

Adult↗
PubMed1977

The effect of penicillamine on growth as height in juvenile chronic polyarthritis.

When the disease state improves during penicillamine therapy, resumption of growth occurs; if activity persists despite therapy, the expected fall-off in growth due to active Still's disease continues. Penicillamine does not interfere with the growth spurt after withdrawal of corticosteroid therapy or with the maintained slow growth during alternate-day steroid therapy.

Arthritis, Juvenile↗
PubMed1976

Neoplasms of the central nervous system. incidence and population selectivity in the Washington DC, metropolitan area.

During the period 1960 through 1969, 990 primary neoplasms of the central nervous system were diagnosed in hospitals in the Washington, DC, Standard Metropolitan Statistical Area (SMSA). All cases were identified according to age, race, sex, histologic type, and date of diagnosis. A West African composite of 253 cases was used for comparison. In the Washington SMSA, the age-adjusted incidence rates were: for Caucasians 5.5 in males and 3.6 in females and for Negroes 4.8 in males and 3.4 in females per 100,000 annual population. Caucasians in the Washington SMSA had a higher relative proportion of gliomas than Negroes in the same area and in Africa (p less than 0.005). The relative proportion of pituitary adenomas was higher in American Negroes (p less than 0.005) and in Africans than in Caucasians. The comparable pattern of CNS tumors in American and African Negroes, relative to Caucasians, suggests that in the development of neoplasms of the central nervous system racial factors may be of importance.

Africa, Western↗