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Biomedical subjects

E Bryant

Publications and source records attributed to E Bryant.

At least 55 records · Page 3Linked to original sources
PubMed1993

Senior obstetric-gynecologic residents' perceptions of their surgical training, experiences and skill.

Senior obstetric and gynecologic residents' self-perceptions of surgical skill seem to be unrelated to the kinds of didactic experiences received or to the number of basic gynecologic procedures performed during training. These data offer further support for the need for a comprehensive reevaluation of the components of gynecologic surgical curricula; the cognitive, behavioral and psychomotor educational objectives of such training; and the methods by which the outcomes for these objectives are measured.

Clinical Competence↗
PubMed1992

Immunosuppressive therapy of aplastic anemia: results of a prospective, randomized trial of antithymocyte globulin (ATG), methylprednisolone, and oxymetholone to ATG, very high-dose methylprednisolone, and oxymetholone.

Sixty-eight patients with moderate (n = 15) or severe (n = 53) aplastic anemia were entered into a prospective, randomized, two-arm treatment study comparing antihuman thymocyte globulin (ATG), lower-dose methylprednisolone (LDM) and oxymetholone to ATG, higher-dose methylprednisolone (HDM), and oxymetholone. There were no differences between the two groups when comparing age, sex, etiology of aplasia, disease duration, severity of aplasia, or pretherapy granulocyte counts. Side effects of LDM and HDM were similar. Of the 64 patients evaluable for response to therapy, 12 of 33 (36%) who received LDM had complete, partial, or minimal responses compared with 15 of 31 patients (48%) who received HDM (P = .33). Actuarial survival at 4 years is 43% for patients in the LDM group and 47% for patients in the HDM group (P = .99). Causes of death included hemorrhage, infection, evolution to acute leukemia, and complications of subsequent bone marrow transplantation. Long-term complications included paroxysmal nocturnal hemoglobinuria (n = 3), evolution to myelodysplasia or acute leukemia (n = 6), and recurrent aplasia (n = 6). We were unable to show a significant difference in toxicity, response rate, or survival for patients treated with ATG, oxymetholone, and LDM compared with patients who received ATG, oxymetholone, and HDM.

Adult↗
PubMed1992

Gynaecological teaching associates in the 1990s.

Chairmen of academic obstetrics and gynaecology departments in the USA and Canada were asked if they used gynaecological teaching associates (GTAs) and their opinions of their educational and cost effectiveness. Three-quarters of chairmen used GTAs and were satisfied with the educational aspects of GTA instruction. Departmental discretionary funds provided all or part of the GTA funding in 40% of departments and the medical school all or part of the GTA funding in 72%. As more monies came from departmental discretionary funds, chairmen were increasingly dissatisfied. Because the 1990s will be difficult financially, it was hypothesized that chairmen may eventually cancel GTA programmes as expendable 'luxuries'.

Attitude of Health Personnel↗
PubMed1992

Marrow transplantation for Fanconi anemia with or without leukemic transformation: an update of the Seattle experience.

Between March 1973 and August 1990, 17 patients with Fanconi anemia (FA) underwent bone marrow transplantation in Seattle. Marrow donors were HLA identical siblings (n = 14), phenotypically HLA identical parents (n = 2) and a one antigen mismatched parent (n = 1). Patients with no evidence of leukemic transformation (n = 12) were conditioned with 140-200 mg/kg cyclophosphamide (CY). Of five patients with leukemic transformation, four received CY (120 mg/kg) plus 12 Gy fractionated total body irradiation and one patient received busulfan (14 mg/kg) and CY (100 mg/kg). All patients engrafted; however, one patient whose sibling donor's cells showed variable results when assayed for chromosome instability required two additional marrow infusions. Toxicity associated with the conditioning regimen included severe oral mucositis (n = 14), hemorrhagic cystitis (n = 11) and diffuse erythroderma (n = 3). Seven of the 12 patients without leukemic transformation are surviving 1-17 years (median = 5 years) after transplant, with an estimated survival probability at 5 years of 65% (95% CI 0.31; 0.85). Two patients developed squamous cell carcinoma of the tongue greater than 10 years post-transplant. One of these patients died at 10.3 years as a result of the malignant process, and the other is disease free more than 12 years post-transplant. Of the five patients with leukemic transformation, one is alive at 8 years. These data demonstrate that marrow transplantation can offer long-term survival for patients with FA, engraftment can be achieved with reduced doses of CY in FA patients, and less toxic preparative regimens are needed for FA patients who have developed leukemic transformation.

Adolescent↗
PubMed1991

Allogeneic marrow transplantation in patients with chronic myeloid leukemia in the chronic phase: a randomized trial of two irradiation regimens.

A randomized trial was performed to compare two regimens of total body irradiation in patients with chronic myeloid leukemia treated by allogeneic marrow transplantation while in the chronic phase. All patients received cyclophosphamide 120 mg/kg followed by total body irradiation and marrow from HLA-identical siblings. Cyclosporine and methotrexate were used for prophylaxis against acute graft-versus-host disease. Fifty-seven patients were randomized to receive 2.0 Gy fractions of irradiation daily for 6 days and 59 were randomized to receive 2.25 Gy fractions daily for 7 days. The probabilities of relapse at 4 years were 0.25 for the 12.0 Gy group and 0.00 for the 15.75 Gy group (P = .008). The actuarial probabilities of survival and relapse-free survival at 4 years were 0.60 and 0.58 among the patients who received 12.0 Gy compared with 0.66 and 0.66 for those who received 15.75 Gy. The 4-year probabilities of transplant-related mortality were 0.24 and 0.34 respectively (P = .13) while the probability of moderate to severe acute graft-versus-host disease was 0.33 for the 12.0 Gy group and 0.44 for the 15.75 Gy group (P = .15). The lower relapse probability in the patients receiving the higher dose of total body irradiation did not result in improved survival because mortality from causes other than relapse was increased.

Adult↗
PubMed1988

Idiopathic myelofibrosis in blast transformation with 4;12 and 5;12 translocations and a 7q deletion.

A case of a patient who developed a leukemic transformation following an 8.5-year history of idiopathic myelofibrosis (IMF) with myeloid metaplasia is presented. Surface marker analysis identified the blast cells as myeloid in lineage. The karyotype of unstimulated peripheral blood cells was 46,XY,t(4;12)(q26;15),t(5;12)(q13;q24),del(7)(q22). In the literature, the 7q- has a minor association with IMF, and the t(5;12) translocation has been reported in one case of acute nonlymphocytic leukemia, but neither the t(4;12) nor the combination of these three abnormalities has been reported in IMF.

Aged↗
PubMed1982

Desmoplastic malignant melanoma: a study by conventional and electron microscopy.

A 61-year-old white man presented himself with a mass that had recurred on the chin. Conventional microscopy of sections from this mass showed atypical spindle cells surrounded by abundant collagen and resembled fibrosarcoma. Stains for melanin revealed pigment in the cytoplasms of the atypical spindle cells. Study of sections by electron microscopy demonstrated round, oval, and spindle-shaped cells having desmosomes and containing abundant melanosomes in varying stages of maturation. On the basis of both conventional microscopy and electron microscopy, the diagnosis was desmoplastic malignant melanoma. An unusual finding by electron microscopy was the presence of tubuloreticular intracytoplasmic inclusions in the neoplastic melanocytes.

Chin↗
PubMed1981

Systematic growth studies, cocultivation, and cell hybridization studies of Werner syndrome cultured skin fibroblasts.

The growth of 20 independently derived skin fibroblastlike (FL) cell strains from three individuals with Werner syndrome (adult progeria) was compared with the growth of ten FL cell strains from normal individuals. Population growth rates and total replicative life spans of Werner syndrome strains averaged 53% and 27%, respectively, of the growth rates and life spans of non-Werner strains. In the first few passages, four Werner syndrome strains demonstrated population growth rates in the low normal range, but the longest-lived Werner syndrome strain had only 75% of the total replicative potential of the shortest-lived normal strain. Exponential growth rates, cloning efficiencies, and saturation densities of Werner strains were also reduced, whereas cell attachment was normal. Viable cells (identified by dye exclusion) were maintained in post-replicative Werner syndrome and control cultures for periods of at least 10 months; there was no evidence of accelerated post-replicative senescence of cell death of Werner syndrome FL cells. Cocultivation of Werner syndrome and normal strains did not influence population growth rates of either strain. Two proliferating hybrid clones were obtained from fusions of normal and Werner syndrome FL cell strains and these hybrids displayed the reduced growth potential typical of Werner syndrome FL cells. These studies confirm that low growth rate and sharply reduced replicative life span are characteristic of cultured skin FL cells from patients with Werner syndrome, and they suggest that these characteristics are not affected by complementation with non-Werner FL cells.

Cell Division↗