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Biomedical subjects

D R White

Publications and source records attributed to D R White.

At least 109 records · Page 6Linked to original sources
PubMed1981

A randomized comparative trial of chemotherapy and irradiation therapy for stage II breast cancer.

One hundred fifty-eight evaluable patients with Stage II carcinoma of the breast with positive lymph nodes were treated either with adjuvant chemotherapy or irradiation therapy followed by chemotherapy. Patients were randomized to test the effectiveness of L-phenylalanine mustard (L-PAM) with and without postoperative irradiation therapy (R.T.) against cyclophosphamide, 5-fluorouracil, and methotrexate (CMF) with and without postoperative irradiation therapy in decreasing the frequency of recurrence. No significant difference was observed between L-PAM as compared with R.T. plus L-PAM (P = 0.85). The difference between CMF and R.T. plus CMF was significant in support of CMF alone (P = 0.04). The frequency of recurrence between R.T. plus L-PAM and R.T. plus CMF showed no difference. A comparison of the chemotherapy only regimens showed an advantage of CMF over L-PAM (P = 0.05). Both the delay in starting chemotherapy and the significant decrease in percent optimal drug dosage during the first six cycles of therapy are factors that may influence the high frequency of relapse observed in the R.T. plus chemotherapy groups. Of the four treatments, CMF has the lowest frequency of recurrence.

Adult↗
PubMed1981

Chemotherapy vs. chemoimmunotherapy with methanol extraction residue of Bacillus Calmette-Guerin (MER) in advanced breast cancer: a randomized trial by the Piedmont Oncology Association.

Effects of the addition of MER, a nonspecific, nonviable immunostimulant, to two combination chemotherapy programs were explored in patients with metastatic breast cancer. Patients were randomized to either CDVFP [cyclophosphamide (C), doxorubicin (D), vincristine (V), fluorouracil (F) and prednisone (P)] or CD alternating with methotrexate (M) and F (CD/MF). Each group was also randomized to receive MER, 0.4 mg S.C. every four weeks or no immunotherapy. The response rates were CDVFP 56%, CDVFP + MER 54%, CD/MF 43%, and CD/MF + MER 43%. No significant differences were noted in response rate. Median durations of response and survival were similar for each group: CDVFP 16.2 and 25.2 months, respectively; CDVFP + MER 14.0 and 23.3 months, CD/MF 12.1 and 26.1 months, and CD/MF + MER 15.5 and 25.6 months. Patients who achieved CR frequently had soft-tissue disease (7/17) and patients with disease in 1 or 2 metastatic sites had a significantly higher response rate than those in greater than or equal to 3 sites. MER did not enhance response rate, duration of response, or survival. Also MER did not diminish myelosuppression.

Antineoplastic Agents↗
PubMed1981

Cyclophosphamide versus cyclophosphamide, methotrexate, and 5-fluorouracil in advanced prostatic cancer: a randomized trial.

Thirty-two evaluable patients with metastatic carcinoma of the prostate were entered into a prospective randomized trial comparing cyclophosphamide (CYC) with a combination of cyclophosphamide, methotrexate, and fluorouracil (CMF). Progressive disease after endocrine manipulation was noted in 97% (31/32) of patients before entry. Stable disease (S) was observed in 9 of 17 patients treated with CYC. One partial response (PR) and seven stable responses occurred in the 15 CMF patients. Median duration of stable response was 4.5 months for CYC and 4.5 months on CMF. Median survival of patients with PR and S receiving CYC was 10.1 and for CMF 8.8 months. Patients with progressive disease survived a median 1.7 and 2.6 months with CYC and CMF, respectively. Toxicity was moderate, and no deaths were attributable to sepsis or bleeding. Almost all patients in this study had bone lesions as the dominant site of disease; this made objective assessment of response difficult. There was no significant improvement in response conferred by the combination regimen. Although patients with metastatic prostatic cancer may benefit from chemotherapy, impressive clinical responses are uncommon.

Aged↗
PubMed1981

A prospective study of histocompatible leukocyte and platelet transfusions during induction chemotherapy of adult acute nonlymphocytic leukemia.

A prospective clinical trial was conducted to test the effectiveness of granulocyte transfusions during induction chemotherapy of patients with adult acute non-lymphocyte leukemia. Thirty-eight patients who received prophylactic granulocyte transfusions from related donors when their phagocyte counts decreased to less than 1000 microliter were compared to twenty-five controls who did not have qualified donors from which to obtain granulocyte transfusions. The frequency of complete remissions (CR) (28/38 versus 7/25) was significantly greater for the granulocyte transfusion group than for controls. Patients older than 45 responded more often in the transfused group (P less than 0.025) when compared to the similar age group in controls. Both duration of complete remission and survival were greater in the granulocyte transfused group. However, these differences were not statistically significant. Survival for all responders (complete plus partial remission) was longer for the granulocyte transfusion group (P = 0.01). No significant difference in frequency or severity of either infection or hemorrhage was noted in the two groups. The advantage noted in this study largely occurred in patients older than 45 and this suggests that this age group is more likely to respond if they have histocompatible donors from which to obtain granulocyte and platelet transfusions. Immune mechanisms may be involved in the beneficial effects observed with HLA compatible granulocyte transfusions.

Adolescent↗
PubMed1981

Externality and locus of control in obese children.

Fifty-nine obese and normal-weight children, aged 8-12 years were compared on two dimensions of "externality," previously examined in obese adults. Significant sex difference indicated that boys generally ate more than girls and held more internal locus of control expectancies. However, obese and normal-weight children were not differentiated by their performance on either a food-related or three nonfood-related measures of external-cue responsiveness, nor by their locus of control expectancies. Furthermore, the various measures were neither strongly nor consistently intercorrelated, providing little support for the notion of a single underlying dimension of "externality." The contribution of physiological, sensory, cognitive-motivational, and sociocultural parameters to the regulation of eating behavior was discussed.

Child↗
PubMed1981

Mammographic practice and dosimetry in Britain.

A survey of mammographic techniques and dosimetry in 61 NHS centres in Britain has been completed. Physical parameters measured at each centre included tube output, half-value thickness, peak kilovoltage, surface dose and percentage depth dose. Ionisation and thermoluminescence dosimetry were employed and image quality was assessed subjectively using a test phantom. Absorbed doses are given at the plane surface of an average-sized, 5 cm thick homogenous breast composed of 50% fat and 50% water. The doses fall naturally into the four combinations of molybdenum (Mo) and tungsten (W) targets and film (F) and xerox (X) receptors. The Mo/X group produced the best images of the phantom but also the highest mean dose of 3.26 cGy (rad) for a cranio-caudad (c-c) view and its use does not seem justified for asymptomatic screening. The Mo/Lo-Dose or MIN-R film combination gave a mean dose of 0.95 cGy(rad) for a c-c view whereas the W/X group gave 0.89 cGy(rad) and superior image quality. The W/F group gave the poorest image quality and its continued use for mammography is questionable.

Female↗
PubMed1981

Evaluating performance characteristics in computerized tomography.

The important radiographic and dosimetric performance parameters associated with computerized tomography (CT) are discussed together with the practical problems encountered when they are being evaluated. The parameters include alignment, slice thickness, noise, low-contrast detectability, spatial resolution, modulation transfer function and patient dose. A set of phantoms for determining these performance characteristics are described. The phantoms are of modular construction permitting measurement of the performance parameters at various sites within a number of 6 cm thick, regular-geometry, and realistic body sections. The regular-geometry sections include 20 cm diameter (skull size) and 33 cm diameter (abdomen size) sections. The realistic anthropomorphic sections include the skull, abdomen and thorax.

Humans↗
PubMed1981

A survey of 29 EMI CT machines in Britain.

During 1978/79 a survey was made of the performance characteristics of 29 EMI brain and body CT scanners in Britain. Comparative data on such performance parameters as noise, uniformity of CT numbers, low-contrast detectability, resolution, modulation transfer function (MTF) and effective photon energy were measured using a set of regular-geometry and anthropomorphic phantoms. In addition, dose profiles were obtained for a single slice using TLD and film. The results of the survey are presented; the dependence of the performance characteristics on the types of machines surveyed and the operating modes employed is discussed.

Brain↗
PubMed1981

An evaluation of CT systems from ten manufactures.

During the past three years, 23 computerized tomography (CT) machines from ten different manufacturers located in Europe and the USA have been evaluated. Using the same set of phantoms and measurement techniques, performance data have been derived including noise, uniformity of CT numbers, low contrast detectability, spatial resolution, modulation transfer function, effective photon energy and linearity of CT numbers. Thermoluminescent and film dosimetry were used to determine single-slice dose profiles at the periphery and centre of specialized anthropomorphic phantoms. The results of this study are presented in tabular and graphical form together with some general conclusions on their implications.

Brain↗
PubMed1981

Pharmacokinetics of vincristine sulfate in adult cancer patients.

Vincristine concentration in serum from 1 min to 72 hr was measured by radioimmunoassay in 14 patients with cancers following i.v. bolus injection of vincristine sulfate at 0.45 to 1.30 mg/sq m. The pharmacokinetic data were analyzed by a nonlinear least-square regression program NONLIN. A three-compartmental open model fitted the raw data better than a two-compartmental model. The mean half-lives of the triphasic decay curves alpha, beta, and gamma were 1.9, 19.2, and 1359 min (22.6 hr), respectively. The apparent volume of the central compartment and the volume of distribution at steady state (Vdss) per 1.73 sq m body surface area were 4.1 and 167.6 liters, respectively. The plasma clearance was 141.9 ml/min/1.73 sq m, and the area under the concentration X time curve from 0 to infinity (AUC0 infinity) for 2 mg vincristine was 21,689 nM.min. Linear regression analysis of the data gave evidence for increasing plasma clearance at higher doses of vincristine. In patients with higher platelet counts, lower AUC0 infinity values were obtained, suggesting a possible interaction of vincristine with blood platelets. Our results, a large Vdss, a long biological half-life, and a low rate-limiting rate constant from Compartment 3 to the central compartment (k31), indicate an avid tissue binding and a slow drug release from the body tissues which may account for drug-related neurotoxicity.

Adult↗
PubMed1980

Advanced epidermoid lung cancer: prolonged survival after chemotherapy.

The charts and pathologic reports for 4 patients seen at our institution with advanced incurable epidermoid carcinoma of the lung, who had prolonged disease-free survival after chemotherapy, were reviewed. All patients had Stage III bronchogenic carcinoma. Our study indicates that patients with epidermoid carcinoma of the lung who achieve a complete response have a better survival than those patients who have a partial response or no response. All complete responses were achieved after two to three months of chemotherapy, and if a response is not seen by then a modification of the treatment program is recommended. We propose that complete response should be considered the most important prognostic factor for therapeutic trials in epidermoid carcinoma of the lung.

Antineoplastic Agents↗
PubMed1980

Visceral herpesvirus infections in leukemic patients receiving cytarabine.

Autopsy evidence of herpesvirus infection was found in visceral organs of four leukemic patients who had received large doses of cytarabine (cytosine arabinoside; Ara-C) shortly before their death. In three of these patients the infection was clinically unsuspected; in the fourth, cutaneous herpes zoster developed after administration of 300 mg of cytarabine daily for the preceding five days. Although cytarabine exhibits pronounced in vitro virucidal activity against herpes viruses and has been successfully used in clinical treatment of severe herpesvirus infections, the present findings and a review of the recent literature cast doubt on the antiviral effectiveness of this drug, particularly in already immunosuppressed patients, and suggest instead that such patients actually have an increased risk for development of disseminated herpesvirus infection owing to further depression of host defenses by the drug.

Adult↗
PubMed1980

Therapy of advanced colorectal carcinoma with 5-fluorouracil and cyclophosphamide in combination with either CCNU or methotrexate.

In a prospective, randomized study a combination of 5-FU, Cyclophosphamide, and Methortrexate (FC-MTX) was compared to a similar combination (FC-CCNU) in which CCNU replaced Methotrexate. Of the 54 patients with metastatic colorectal carcinoma entered, 47 were evaluable. Toxicity was similar for the two regimens and was acceptable. No complete responses occurred. No difference in partial response (PR) 2/24 for FC-CCNU vs. 3/23 for FC-MTX, stable response 16/47 overall, or progressive disease 26/47 overall, was observed. Duration of PR was three to ten months. The overall median survival was six months, three months for non-responders and 11 months for responders. These drug combinations employing 5-FU do not improve upon the results reported with 5-FU alone in the treatment of metastatic colorectal carcinoma.

Adenocarcinoma↗
PubMed1980

Actinomycin D in the treatment of advanced breast cancer.

Actinomycin D is generally administered by serial low-dose injection over 5-10 days. Recent recognition of prolonged serum and tissue half-lives suggests that high-dose intermittent injecton should be equally effective and less toxic. An intermitten single dose schedule was selected for this phase II trial of actinomycin D in 23 patients with advanced breast cancer refractory to standard combination chemotherapy. The drug was given in doses of 0.75-1.5 mg/m2 at 2-week intervals or on days 1 and 8 of 28-day treatment cycles. One patient obtained a partial response with a duration of 5.7 months. Four patients experienced stabilization of advanced disease, with a mean duration of response of 6.4 months. Gastrointestinal toxicity occurred in 47% of patients and mild to moderate myelosuppression in 39%. We conclude that actinomycin D in this dosage and schedule has limited activity in advanced breast cancer. Higher doses might result in increased response rates but would be associated with greater toxicity.

Breast Neoplasms↗
PubMed1980

Arsenic poisoning.

Arsenic poisoning continues to require awareness of its diverse clinical manifestations. Industry is the major source of arsenic exposure. Although epidemiologic studies strongly contend that arsenic is carcinogenic, there are little supportive research data. Arsenic poisoning, both acute and chronic, is often overlooked initially in the evaluation of the patient with multisystem disease, but once it is suspected, many accurate methods are available to quantitate the amount and duration of exposure. Treatment with dimercaprol remains the mainstay of therapy, and early treatment is necessary to prevent irreversible complications.

Acute Disease↗
PubMed1980

The measurement of effective photon energy and "linearity" in computerized tomography.

Two liquid systems have been developed for the measurement of effective photon energy (Eeff) and "linearity" in computerized tomography (CT). A group of sixteen "keV liquids" enables an Eeff to be rapidly determined, by comparing the CT numbers of the specially formulated organic liquid mixtures with similar data for water. The "linearity" of the CT scanner, relating CT nubers to linear attenuation coefficients, may be investigated using 14 selected organic "linearity liquids". Details of these systems, together with some typical results, are presented.

Elementary Particles↗
PubMed1980

A test object for assessing image quality in mammography.

The problems inherent in the design and manufacture of mammographic test objects are discussed and a test object is described which may be used for assessing image quality. Some typical results from both good and bad mammographic machine/film combinations are presented.

Adipose Tissue↗