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Biomedical subjects

E Robinson

Publications and source records attributed to E Robinson.

At least 217 records · Page 12Linked to original sources

Moderate hyperthermia and low dose rate irradiation.

Moderate hyperthermia (4 h at 40 degrees C) enhances V-79 cell radiosensitivity at low irradiation dose rates with a maximum thermal enhancement ratio (TER) of 1.38. In comparison, the TER measured at acute dose rate is 1.13. Heat treatments given before and during irradiation are equally effective, and more so than postirradiation hyperthermia. Hyperthermia-induced inhibition of sublethal damage repair is a probable cause of the observed effect.

Animals↗

Splenomegaly and solitary spleen metastasis in solid tumors.

Metastasis to the spleen from various neoplasms is very rare. Most of the splenic metastases are found at autopsy, and are part of a widespread disease. Four patients had cervical cancer (1 patient), endometrial cancer (1 patient), lung carcinoma (1 patient), and malignant melanoma (1 patient). All patients had splenic involvement without pathologic evidence of lymph node metastasis, and all underwent splenectomy. Three of the four presented with painful splenomegaly. The time from diagnosis to the development of splenic metastasis varied from 20 to 24 months. Two of the four patients had postoperative radiotherapy, one patient received intraperitoneal chemotherapy, and the patient with the melanoma received adjuvant chemotherapy. The rarity of solitary spleen metastasis from solid tumors and the treatment modalities are discussed.

Adult↗

Multidrug chemotherapy using bleomycin, methotrexate, and cisplatin combined with radical radiotherapy in advanced head and neck cancer.

Thirty-one patients with Stage III-IV head and neck squamous cell cancer were treated by three courses of combination chemotherapy using bleomycin, methotrexate, and cisplatin followed by a radical course of radiation and in two cases by surgery. Of 29 evaluable patients, 4 (14%) achieved complete remission (CR) with chemotherapy and 13 (45%) had a partial response (PR). With the addition of radiotherapy and surgery, the CR rate increased to 72%. At 30 months the actuarial survival of all evaluable patients was 61% and of complete responders, 76%. Patients with nasopharyngeal cancer had an actuarial survival of 80% at 30 months, whereas patients with squamous malignancies at other sites in the head and neck region had an actuarial survival of only 37%. Side effects were tolerable. It is concluded that complete responders to combination chemotherapy and radiotherapy have a survival benefit at 30 months. The combined approach is most effective in nasopharyngeal cancer.

Actuarial Analysis↗

Leptomeningeal involvement by epithelial ovarian carcinoma: a case report.

A patient with epithelial ovarian carcinoma, who developed meningeal carcinomatosis, is hereby presented. A review of the literature revealed that only a few cases of this entity have been reported. With the prolonged survival of ovarian cancer patients treated by combination chemotherapy, it is expected that meningeal involvement will be found more often.

Cystadenocarcinoma↗

The relationship between median nerve somatosensory evoked potential latencies and age and growth parameters in young children.

Median nerve somatosensory evoked potentials (SEPs) were recorded in a group of 35 normal children aged 6-36 months and related to body length, body weight and head circumference. Recordings were made while the child was awake using the following derivations: ipsilateral clavicle--Fpz; seventh cervical vertebra (CV7)--Fpz; contralateral C'--Fpz. The clavicular-Fpz response was bilobed in 77% of the recordings, the initial negativity being designated CL1 and the following negativity, CL2. Early negativities, coincident in latency with CL1 and CL2, were often present in CV7-Fpz recordings, however, a negativity longer in latency than CL2 was always present, was designated CVN, and preceded a prominent positivity. A scalp-recorded early negativity (N1) and a following positivity (P1) were well defined in all recordings. The latency of CL1, CL2 and CVN increased with an increase in age and stature. In contrast, significant negative correlations were found between the latency of N1, P1, age and stature. The CL1-CVN interpeak latency did not correlate significantly with age, while the central conduction time (CVN-N1) declined significantly with an increase in age and stature. These findings confirmed the complexity of SEP absolute and interpeak latency changes with an increase in age and stature in young children.

Aging↗

Labeling of sarcoma associated monoclonal antibody with 111In, 67Ga and 125I.

Labeling of human sarcoma-associated murine monoclonal antibody (MAb) 23H7 with 67Ga and 111In by the bifunctional ligand method is reported. 67Ga was chelated to the MAb via desferrioxamine B and 111In via the cyclic anhydride of DTPA. Higher specific activity was obtained with 67Ga (4-5 microCi/micrograms) as compared with 111In (2 microCi/micrograms). The binding capacity of the MAb was confirmed by repeated indirect immuno-fluorescence assays performed before and after labeling. A fast blood clearance was observed: 33% recovered dose (R.D.) blood level 3 h post-injection as compared with 56% after injection of control polyclonal IgG. Preliminary results on chemically induced sarcoma bearing mice showed a relatively high tumor uptake of the labeled antibody.

Animals↗

Medications and diagnoses in relation to falls in a long-term care facility.

The association between falls, drugs, and diagnoses in elderly residents of a long-term care facility was explored using case-control methodology. The odds of being a faller rather than a control were significant (P less than .01) for those taking antidepressants, sedatives/hypnotics, or vasodilators, and for those with osteoarthritis or depression. When drug/diagnosis subgroups were examined, these same drug classes and diagnoses had high-odds ratios in the largest numbers of subgroups. In general, risk of falling appeared to be more strongly associated with drugs than with diagnoses.

Accidental Falls↗

Treatment of advanced gastric cancer with DDP (cisplatin), adriamycin, and 5-fluorouracil (DAF).

Sixteen evaluable patients with advanced gastric cancer who had no prior therapy were treated intravenously with cisplatin (DDP) 20 mg/m2/day on days 1-5 and with Adriamycin 40 mg/m2 and 5-fluorouracil 600 mg/m2 on day 1 (DAF) every 3 weeks. There were five objective partial responses, giving a response rate of 31%. Five patients had minor responses, and 5 others achieved disease stabilization. The median duration of response for responders was 10 months, and the median time to tumor progression in nonresponders was 6 months. The overall median survival was 12 months (responders 14 months, nonresponders 9 months; NS). Most patients had a subjective improvement, including disappearance of abdominal pain (7/9) and gastrointestinal bleeding (5/7). The drug toxicity was moderate to severe. The primary nonhematologic toxicities were nausea and vomiting (in all patients), severe weakness (44%), and parasthesias (31%). Eight patients (50%) experienced significant bone marrow suppression. The DAF combination appears to have some activity in patients with advanced gastric cancer. However, further efforts in new drug development and other combinations are needed to improve the results of chemotherapy in stomach cancer.

Adenocarcinoma↗

Novel approach to MER/BCG administration in cancer patients.

Forty-four patients with previously untreated advanced lung cancer were randomized to receive radiochemotherapy (RC) or radiochemotherapy plus MER/BCG (RCM). Prior to immunotherapy administration cutaneous reactivity to 5 log dilutions of MER/BCG was determined starting at 100 micrograms per injected site to 10 sites. Reactive patients were injected with 10, 1.0, or 0.1 micrograms while anergic patients were given 200 or 100 micrograms to each of 10 cutaneous sites, the dose being inversely related to the strength of the pretreatment reaction. Injected doses were subsequently further increased or decreased to achieve tolerable local erythema and induration. This modification resulted in a marked reduction in cutaneous toxicity previously observed, and made it possible to nearly double the mean number of MER courses per patient. It is suggested that intradermal MER/BCG may prove to be a considerably more useful therapeutic agent if doses are adjusted to patients' individual cutaneous responsiveness.

Aged↗

Human sarcoma-associated murine monoclonal antibody labeled with indium-111, gallium-67, and iodine-125.

Monoclonal antibody (MAb) 23H7 is a hybridoma-derived IgG that is generated following fusion of mouse myeloma cell line P3U1 and spleen cells from BALB/c mice hyperimmunized with a human fibrosarcoma. It detects a mesenchymal antigen of 23KD expressed on human sarcoma tissues and other neoplasms, including myeloid leukemias, but it rarely binds to normal tissues. The MAb 23H7 was labeled with 67Ga and 111In using the bifunctional ligand method. The 67Ga was chelated to the MAb via desferrioxamine B, while 111In was chelated via the cyclic anhydride of diethylenetriamine pentaacetic acid. Higher specific activity was obtained with 67Ga than with 111In (4.5 and 2 muCi/microgram, respectively); both gave stable complexes. When 23H7 was labeled with 125I, considerable breakdown was observed. This, together with the physical shortcomings of this isotope, emphasizes the advantages of labeling with 111In and 67Ga. The rapid blood clearance of the labeled sarcoma-associated MAb may be beneficial for early tumor uptake and for imaging shortly after injection.

Animals↗

Involvement of the central nervous system by ovarian carcinoma.

Ovarian carcinoma rarely metastasizes to the central nervous system (CNS). Of 110 patients with epithelial ovarian carcinoma treated at the Northern Israel Oncology Center between the years 1979 and 1985, only five (4.5%) had CNS involvement. The median age of the patients with 54.5 years. All of them had treatment with cisplatin and Adriamycin (doxorubicin). The median duration from diagnosis to the development of brain involvement was 17 months. The median survival time was 28 months from diagnosis of carcinoma and 2 months from diagnosis of CNS disease. The increased incidence of this kind of metastasis in patients achieving local control of their advanced disease suggests that a change in the pattern of metastatic spread or the prolonged survival permits occult CNS metastases to become apparent. A routine computerized axial tomography (CAT) scan of the brain should therefore be performed on patients with ovarian carcinoma with prolonged survival.

Antineoplastic Combined Chemotherapy Protocols↗

The treatment of nonseminomatous testicular tumors: 15 years experience.

Thirty-two patients with nonseminomatous germ cell tumors of the testis were treated at the Northern Israel Oncology Center during the years 1968-1983. The patients were divided into two groups. Group I included 18 patients treated from 1968 to 1976; in group II there were 14 patients treated with combination therapy containing cis-platinum in the years 1977 to 1983. The actuarial survival rate at 38 months from diagnosis is 47% in group I patients and 86% in group II patients. The development of modern radiological techniques, biochemical markers for accurate staging, and the use of cis-platinum-containing combination chemotherapy made this disease curable. New treatment modalities are needed for patients with bulky disease at presentation.

Adolescent↗

Correlations of dose and time-dose-fractionation factors (TDF) with treatment results and side effects in cancer of the uterine cervix.

Treatment results and side effects were analyzed for 57 patients with stage IB-IIIA cancer of the uterine cervix who received external beam radiotherapy combined with intracavitary insertion of cesium-137 sources. The total dosage and time-dose-fractionation (TDF) factors were calculated at point A and at points of maximum exposure in the rectum and bladder. The overall 5-year survival was 62%, and 78% of the complete responders were free of disease at 5 years. A total of 12 patients (21%) developed rectal complications. Two patients (4%) had rectal fibrosis and proctitis; seven cases of rectal bleeding occurred (12%), and 3 patients (5%) developed rectovaginal fistulas. There was no correlation between dose and TDF at point A and treatment failure or appearance of rectal complications. However, the occurrence of radiation damage in the rectum was consistently associated with high values of TDF when they were calculated in the region of maximal exposure in the rectum. The results suggest that TDF may be a useful parameter for predicting radiation damage in combined external beam and intracavitary treatment of cervical cancer.

Female↗

Colorectal cancer: incidence, delay in diagnosis and stage of disease.

In a study of 445 patients with colorectal cancer referred to our center during a 3-yr period, we investigated the following parameters and their interrelationships: sex, marital status, ethnic origin, place of residence, stage of disease, delay in diagnosis and factors responsible for delay. Localized disease was found in 52% of the patients, regional disease in 29% and metastatic disease in 19%. The incidence of colorectal cancer was significantly higher in Jews of European (occidental) descent than in Jews of Asian or North African (oriental) descent or in Arabs. The median and mean ages were significantly higher in the occidental than in the oriental Jewish group and significantly lower in the Arabs than in the oriental Jews. Diagnosis was delayed for more than 6 weeks in 52% of the patients. Responsibility for the delay could be attributed to the patient in 54% of these cases and to the physician in 47%. Administrative factors were responsible for the delay in 26%. (In 27% of the above delayers there was more than one agent responsible for the delay.) On average, patients in whom diagnosis was delayed had more advanced disease than those without delay. Also, patients with advanced disease had a longer delay on average than those with localized disease. The stage of disease at diagnosis was more advanced in the oriental than in the occidental Jews. No correlations were found between delay in diagnosis and either age or sex. There were more widowers with delay (21%) than with no delay (16%). In patients living outside Haifa delay was more prolonged than in those residing in the city. Educational programs aimed at the population at risk of developing neoplasm and especially at those likely to undergo delay in diagnosis are recommended. Postgraduate courses should be designed to instruct physicians on how to minimize delay in diagnosis.

Adult↗

Lymphocyte subpopulations in peripheral blood and malignant effusions of cancer patients.

The percentage of total T lymphocytes and helper and suppressor cells was determined in the peripheral blood and pleural and abdominal effusions of patients with advanced cancer. The ratio of helper to suppressor cells in the peripheral blood and in the effusions was calculated in each case. The percentage of total T lymphocytes and suppressor cells was found to be in a normal range. The percentage of helper cells in patients' peripheral blood and in ascites was slightly lower than normal. However, the percentage of helper cells in the pleural effusion was significantly higher than in the blood. The ratio of helper to suppressor cells in the pleural effusion was 1.46, compared to 0.82 in the blood (P less than 0.01). In patients with ascites the ratio in the blood was 1.05 and in the effusion 1.28. The ratio of helper to suppressor cells of all patients in the peripheral blood was 0.94, as compared to 1.36 in the effusion fluid (P less than 0.05). The imbalance in the T cell subsets found is most probably due to immunodepressions in the peripheral blood and immune reactivity in the effusions.

Ascitic Fluid↗

Oral side effects of head and neck irradiation: correlation between clinical manifestations and laboratory data.

Salivary flow rate and composition, oral microflora and clinical manifestations of radiation damage were studied in 32 patients treated with external irradiation to head and neck areas. Several parameters were investigated: field arrangement, amount of salivary glands irradiated, clinical manifestations such as dryness of the mouth, taste impairment, dysphagia, salivary secretion and composition, and oral yeast flora. The salivary glands have a greater sensitivity to radiation damage than the gustatory tissues. The decrease in salivary secretion is accompanied by a rise in salivary sodium concentration, and in oral yeast flora. The clinical symptomatology was correlated with the amount of salivary glands irradiated. We found that most of the parotids have to be outside of the treated volume, when the rest of the major salivary glands are irradiated, to prevent severe dryness phenomena.

Candidiasis, Oral↗

Brainstem auditory evoked potentials in severely malnourished children with kwashiorkor.

Brainstem auditory evoked potentials (BAEPs) were recorded in a group of 22 children hospitalized for the treatment of severe malnutrition (kwashiorkor). Recordings were repeated after three weeks of treatment. The control group consisted of age- and sex-matched healthy infants. Abnormal BAEP interpeak-latencies (IPLs) were found in 32% of the kwashiorkor group in the initial recording and in 40% of this group in the follow-up recording. Abnormalities were evenly distributed between the I-III, III-V and I-V IPLs and in the majority of cases were unilateral. The influence of increasing stimulus rate was investigated. The findings may reflect defects in myelination of auditory brainstem pathways, however, BAEP abnormalities were not related to several indices of growth retardation or to serum albumin and hemoglobin levels.

Auditory Pathways↗