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Biomedical subjects

E Robinson

Publications and source records attributed to E Robinson.

At least 415 records · Page 23Linked to original sources

Effects of two anticholinergic drugs on electroretinograms and visual evoked potentials in healthy human subjects.

A battery of electroretinograms (ERGs) and visual evoked potentials (VEPs) were recorded from 12 normal, male volunteers after the intravenous administration of either biperiden 2.5 mg, atropine 1.5 mg or placebo, at weekly intervals. Self-reports indicated that both drugs caused significantly reduced levels of alertness compared to placebo, but more so with biperiden than atropine. Biperiden was not, however, associated with significant changes to ERGs, while atropine caused a few isolated, significant increases to implicit times. There were no significant treatment effects on pattern ERGs or VEPs. The flash VEP latencies and amplitudes recorded after the anticholinergics did not differ from placebo. These preliminary findings suggest that these anticholinergics do not have marked effects on either ERGs or VEPs.

Adult↗

Treatment of gastric adenocarcinoma with the combination of etoposide, adriamycin and cisplatin (EAP): comparison between two schedules.

The results of two schedules of the combination of etoposide, doxorubicin, and cisplatin (EAP) in gastric cancer are reported. EAP-1 was administered as originally reported and consisted of i.v. doxorubicin (adriamycin) 20 mg/m2 on days 1 and 7, i.v. cisplatin 40 mg/m2 on days 2 and 8 and i.v. etoposide (VP-16) 120 mg/m2 (100 mg/m2 in patients aged 60-65) on days 4-6. EAP-2 consisted of i.v. adriamycin 40 mg/m2 on day 1, i.v. cisplatin 80 mg/m2 (total dose per cycle) given in 3 divided doses on days 1-3 and i.v. VP-16 100 mg/m2 on days 1-3. Cycles of the two regimens were repeated on day 22. Drug doses were reduced in patients over 65 years of age. Twenty patients were treated with EAP-1 and 43 with EAP-2. Forty-five of the 63 patients included in this study had advanced gastric carcinoma, 16 had radically resected stage III disease, and 2 had metastatic signet ring cell carcinoma of unknown primary origin. Thirty-eight patients with advanced gastric adenocarcinoma were evaluable for response. The response rate for EAP-1 (6/13, 46%) was similar to that of EAP-2 (13/25, 52%). The median duration of response was 8 months for EAP-1 and 6.5 months for EAP-2. Myelotoxicity of EAP-1 was much more severe than that of EAP-2. Hospitalization due to granulocytopenic fever was required in 15/78 (19%) EAP-1 versus 20/215 (9%) EAP-2 courses. Toxic deaths occurred in 3/20 treated with EAP-1 and in 1/45 treated with EAP-2. The difference in toxicity between the two regimens could not be attributed to differences in patients' characteristics or to dose intensity. We conclude that the modified EAP regimen (EAP-2) is effective in the treatment of gastric cancer and is less toxic than the original EAP.

Adenocarcinoma↗

Cellular immunity in patients with laryngeal cancer developing additional primary malignant tumors.

Eleven patients with laryngeal cancer associated with additional primary tumors underwent cutaneous delayed hypersensitivity tests and lymphocyte stimulation studies with phytohemagglutinin for evaluation of their cellular immunity. Five of the 11 patients were anergic or hypoergic as shown by skin tests to recall antigens and seven of nine patients had impaired lymphocyte transformation. Depressed immunity was more often observed in patients with an active malignancy. The level of serum immunoglobulins was elevated in two of eight studied patients, and in the remaining patients was within the normal range. All patients had a history of excessive smoking. Most frequently, second tumors were found in the lung, urinary tract and skin. The prognosis seemed to be determined by the additional tumor rather than by the laryngeal cancer.

Aged↗

Occurrence of additional primary neoplasms in patients with laryngeal carcinoma in Israel (1960-1976).

One thousand-six-hundred and sixty cases of laryngeal cancer were diagnosed in Israel during the years 1960-1976. In 98 of these cases another primary cancer accompanied the laryngeal carcinoma. Patients whose second primary cancer was basal or squamous cell carcinoma of the skin were not included in this study. Therefore, the results reported here deal with 84 patients. The prevalence of multiple primary cancer in patients with laryngeal carcinoma was found to be 5%. Lung cancer is the other primary tumor accompanying laryngeal carcinoma most frequently (29% of the additional tumors) followed by colorectal and bladder cancers. Most of the additional tumors (83%) appeared in a metachronic form with an average time interval of six years. In most metachronic tumors laryngeal carcinoma appeared as the first tumor (86%). Eighty percent of the patients were dead by August 1978. The majority (74%) succumbed due to the additional tumor and only 4% died of laryngeal carcinoma.

Adult↗

Endothelial injury of capillaries in the stria vascularis of guinea pigs treated with cisplatin and gentamicin.

The drugs cisplatin and gentamicin are used for treatment of various cancer patients suffering from infection. The authors report a detailed electron microscopic study of blood vessels in stria vascularis of guinea pigs after treatment with cisplatin alone and in combination with gentamicin. The most distinctive features expressing endothelial cellular injury were mitochondrial, including occasional paracrystalline inclusions; electron-lucent foci with depleted organelles; intracytoplasmic vacuole formations; lipid bodies; cytoplasmic extrusions located on the luminal surface; and severe luminal constriction of part of the vessels from animals treated with the combined drugs. The study suggests that the damage to strial capillaries due to treatment with cisplatin alone and in combination with gentamicin may contribute to the injurious effects of these drugs on the strial tissue. Furthermore, the results of this study may enlarge the awareness of the potential vascular damage and vascular complications in additional body systems after medical use of cisplatin alone or in combination with gentamicin.

Animals↗

The use of the MCMI in the personality assessment of head-injured adults.

MCMI (Millon Clinical Multiaxial Inventory) profiles of 79 head-injured patients were compared with self-report of personality change following head injury. Mean MCMI scale scores were highest on Scales D (Dysthymia), A (Anxiety), 6 (Antisocial), H (Somatoform), 5 (Narcissistic) and 7 (Compulsive). Taking only high-point codes above an adjusted base-rate score of 75, the sample showed most frequent elevations on A (Anxiety), D (Dysthymia), H (Somatoform), 5 (Narcissistic), 6 (Antisocial-Aggressive) and 8 (Passive-Aggressive), in order of cumulative frequency. Personality trait scales and clinical scales were compared with self-report of personality changes. Elevated personality trait scales correlated with self-reports of dysfunction and so did clinical scale elevations. There was no relationship between the number of elevated scales and severity of head injury, nor between the number of elevated scales and interval after head injury.

Adolescent↗

Differences in histology between first and second primary lung cancer.

Data from the Surveillance, Epidemiology, and End Results (SEER) Program were used to compare the histological distribution of second lung cancer following an initial cancer of the lung, head and neck, and breast to primary lung carcinoma occurring as a first cancer. Following initial head and neck cancer or initial squamous cell carcinoma of the lung, the proportion of second primary lung cancer which was of squamous cell histology rose dramatically, while the proportion of pulmonary adenocarcinomas rose following initial adenocarcinoma of the lung. The histological distribution of lung cancer following an initial breast cancer in women was similar to the distribution of de novo lung cancer in women. These results persisted as the time interval between diagnosis of the two primaries was increased from 12 to 48 months. We conclude that the histology of a second primary lung cancer following an initial cancer of the lung or head and neck tends to repeat the histology of the initial cancer (field effect), and this observation is not likely to be due to misdiagnosis of a recurrence of the initial cancer.

Adenocarcinoma↗

Transcervical balloon tuboplasty. A multicenter study.

Transcervical balloon tuboplasty represents a noninvasive technique to treat proximal tubal occlusion. In a multicenter study, 77 women with confirmed bilateral proximal tubal occlusion underwent the procedure. In 71 patients (92%), at least one proximally obstructed fallopian tube was recanalized. Concomitant distal bilateral tubal occlusions were diagnosed after successful proximal tubal balloon recanalizations in 13 patients (17%). In the remaining 64 patients, 22 clinical pregnancies (34%) have been confirmed during a median follow-up period of 12 months. Among those, 17 (77%) resulted in normal deliveries and five (23%) resulted in a first-trimester miscarriage. One patient was diagnosed with an ectopic pregnancy. Among 25 patients who had not conceived within 6 months of the procedure, 17 (68%) demonstrated continuing tubal patency on repeated hysterosalpingogram. We conclude that transcervical balloon tuboplasty is a safe outpatient technique that may represent an alternative to in vitro fertilization or microsurgical reanastomosis of fallopian tubes.

Adult↗

Poor survival of treatment-related acute nonlymphocytic leukemia.

Population-based data on more than 1 million patients registered in the Surveillance, Epidemiology, and End-Results Program of the National Cancer Institute, 1973 to 1984, were analyzed to determine the survival of patients with de novo acute nonlymphocytic leukemia (ANLL) and following a first primary tumor treated (with chemotherapy and/or radiation therapy) or untreated. Cases that occurred within 12 months of the first malignant neoplasm were excluded. Survival was estimated using Cox proportional-hazards modeling, with age, sex, and specific type of ANLL as covariates. The 6271 patients with de novo ANLL had an estimated 12-month survival of 30%, while the 107 patients with treatment-related ANLL (radiation therapy, 60; chemotherapy, 29; both, 18) had an estimated 12-month survival of 10%. This is not due to lingering effects of the first tumor since ANLL following solid tumors not treated with chemotherapy or radiation therapy (118 cases) has similar survival (estimated 12-month survival, 36%) as de novo ANLL. We conclude that ANLL that occurs after chemotherapy or radiation therapy is biologically more aggressive and/or resistant to therapy than spontaneous ANLL. This provides a rationale for current studies on treatment-induced cellular changes and on more aggressive therapy for these patients.

Aged↗

Prognostic factors in patients with lung cancer.

The relation of prognostic factors to survival was analyzed in 352 consecutive lung cancer patients referred to the Northern Israel Oncology Center between the years 1978 and 1981. Of these patients 328 died and only 19 (5.5%) were alive with no evidence of disease after a minimum follow-up period of 70 months. Univariate analysis with Kaplan-Meier plots was used to evaluate 63 pretreatment clinical factors. Mode of treatment, the quality of response and time to response were also evaluated for correlation with survival. The following parameters were found to have a significant association with mortality: presence of brain metastases (P less than 0.001), age greater than 60 years (P less than 0.001), Karnofsky performance status less than 80% (P less than 0.001), weight loss (P less than 0.001), and extensive disease (P less than 0.001). Treatment by surgery (lobectomy) was associated with longer survival (P less than 0.001). Other factors were found to have no significant relation to survival. The above data might be of value for patient randomization in future clinical trials.

Adenocarcinoma↗

Clinical characteristics of second primary tumors following breast cancer.

In the Multiple Primary Tumor Registry of the Northern Israel Cancer Center we found 247 patients with breast cancer who developed a second primary tumor. The major sites of the second tumor were mainly the other breast (42%), colon (14%), ovary (8%), and endometrium (7%). Only 24% of the second tumors were diagnosed in asymptomatic patients on a routine follow-up examination; 60% of these patients had contralateral breast cancer and 8% had colon cancer. More patients in this group had localized disease as compared to those diagnosed following appearance of symptoms. The time interval between the first symptoms suggesting malignancy and the diagnosis was longer than 6 weeks in 7%, as compared to 24% in patients diagnosed with a single cancer. In 69 patients (30%), delay was found between the first medical consultation and diagnosis. The agents responsible for the delay were the specialist (32%), the system and normal tests (54%), and the patients (8%). In the diagnosis of a single tumor, the physician and the patient shared a similar percentage of responsibility (29% and 33%). Educational efforts aimed mainly at physicians and patients regarding the early detection of second primary tumors are advocated. Methods that have been proven to detect cancer early, such as mammography, stool for occult blood, and sigmoidoscopy, should be utilized in asymptomatic patients with single tumors in the same way as in the healthy population.

Breast Neoplasms↗