Biomedical subjects
Publications and source records attributed to G Anderson.
The combination of adriamycin, 5-fluorouracil and methotrexate with folinic acid reversal was used to treat patients with advanced bronchogenic carcinoma. Twenty-one of 30 patients showed an objective response. This combination appears to produce useful remissions in patients with non-squamous lung cancer.
Regiospecific syntheses of the three monomethylthio analogues of 1-(2,4,5-trimethoxyphenyl)-2-aminopropane are described. The three isomeric amines were evaluated for potential psychotomimetic potency using the rabbit hyperthermia assay. Enantiomeric compositions and time-concentration curves in rat brains were determined following intraperitoneal administration of each compound. The biological data are contrasted with the corresponding results obtained with the potent human psychotogen 1-(2,5-dimethoxy-4-methylphenyl)-2-aminopropane (DOM).
Clenbuterol is a beta 2-sympathomimetic bronchodilator. In a double-blind cross-over trial in 19 asthmatic patients with reversible airways obstruction, oral administration of both clenbuterol (40 microgram) and salbutamol (4 mg) caused significantly greater increased in peak expiratory flow rate (PEFR) than placebo, that of clenbuterol lasting longer. The patients' subjective assessment also suggested the relief of their symptoms by the active drugs. Side-effects were minimal.
Single unit activity from chronically implanted squirrel monkeys was analyzed to evaluate the effect of acupuncture stimulation on limbic and thalamic structures associated with pain. Extracellular recordings and computer-generated interspike interval histograms (ISIH) were obtained from n. parafasicularis and n. ventralis posteromedialis of the thalamus and the laternal septum, basal amygdala and anterior cigulate cortex. Thalamic activity remained unchanged while limibc units demonstrated statistically significant alterations in both cell firing rate and the ISIH in response to acupuncture stimulation. Although pain thresholds in response to tooth pulp stimulation were increased by morphine (37-51% +/- 2.1), acupuncture proved totally ineffective. This may be interpreted as a selective response to acupuncture in CNS structures primarily concerned with the affective component of pain.
A mobile hearing program was developed to detect and alleviate deafness and rehabilitate deaf individuals in rural Manitoba. The first project was established in central Manitoba in December 1973 for children, whose school performance can be affected by minimal hearing loss. Volunteers from the community, trained by an audiologist, conduct screening procedures, and children with possible hearing impairment receive audiologic and otolaryngologic assessment. Close clinical liaison between audiologist and otologist is important.
To further define and determine the usefulness of CEA, 1100 CEA determinations have been made over the past two years at The Ohio State University Hospitals on patients with a variety of malignant and nonmalignant conditions. Correlation of CEA titers with history and clinical course has yielded interesting results not only in cancers of entodermally derived tissues, for which CEA has become an established adjunct in management, but also in certain other neoplasms and inflammatory states. The current total of 225 preoperative CEA determinations in colorectal carcinomas shows an 81% incidence of elevation, with postoperative titers remaining elevated in patients having only palliative surgery but falling to the negative zone after curative procedures. An excellent correlation exists between CEA levels and grade of tumor (more poorly differentiated tumors showing lower titers). Left-side colon lesions show significantly higher titers than right-side lesions. CEA values have been shown to be elevated in 90% of pancreatic carcinomas studied, in 60% of metastatic breast cancers, and in 35% of other tumors (ovary, head and neck, bladder, kidney, and prostate cancers). CEA levels in 35 ulcerative colitis patients show elevation during exacerbations (51%). During remissions titers fall toward normal, although in 31% still remaining greater than 2.5 ng/ml. In the six colectomies performed, CEA levels all fell into the negative zone postoperatively. Forty percent of adenomatous polyps showed elevated CEA titers (range 2.5-10.0) that dropped following polypectomy to the negative zone. Preoperative and postoperative CEA determinations are important in assessing the effectiveness of surgery. Serial CEA determinations are important in the follow-up period and in evaluation of the other modes of therapy (e.g., chemotherapy). These determinations of tumor antigenicity give the physician added prognostic insight into the behavior of the tumor growth. Rectal examination with guaiac determinations, sigmoidoscopy, cytology, barium enema, and a good clinical evaluation remain the primary tools for detecting colorectal disease. However, in the high-risk patient suspicious of developing cancer, CEA determinations as well as colonoscopy are now being used increasingly and provide additional highly valuable tools in the physician's armamentarium.
To clarify the association between chest pain and significant coronary artery disease in patients who have aortic valve disease, 76 consecutive candidates for aortic valve replacement were evaluated prospectively with use of a historical questionnaire and coronary arteriography. Of the 76 patients, 19 (25 percent) had no chest pain, 21 (28 percent) had chest pain that was not typical of angina pectoris and 36 (47 percent) had chest pain typical of anigina pectoris. In 18 of 19 patients the absence of chest pain correlated with the absence of coronary artery disease. The single patient without chest pain who had coronary artery disease had evidence of an inferior myocardial infarction in the electrocardiogram. Thus, absence of chest pain and the absence of electrocardiographic evidence of infarction predicted the absence of coronary disease in all cases. The presence of chest pain did not predict the presence of coronary artery disease, but the more typical the pain of angina pectoris the more likely were patients to have significant coronary artery disease. Of the 21 patients with atypical chest pain, 6 (29 percent) had coronary artery disease, but of the 36 patients with typical angina pectoris 23 (64 percent) had significant coronary artery disease. In addition, when patients with chest pain not typical of angina pectoris also had coronary artery disease, the diseased vessels usually supplied smaller areas of the left ventricle than when the pain was typical of angina pectoris. In 21 of 23 patients (91 percent) with typical angina pectoris and significant coronary artery disease, lesions were present in the left coronary artery. There was no systolic pressure gradient across the aortic valve that excluded the presence of coronary artery disease, although all patients with a calculated aortic valve area of less than 0.4 cm2 were free of coronary artery disease. Patients with severe left ventricular dysfunction were more likely to have normal coronary arteries.
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Thirty patients with an advanced bronchogenic carcinoma were treated with a combination of adriamycin and 5-fluorouracil; in eight the size of the tumour or its metastases was reduced by over 50%, and eight further patients experienced useful relief of symptoms. This drug combination is useful in the magagement of lung cancer.
Lymph nodes from guinea pigs inoculated with Mycobacterium tuberculosis were fixed in buffered formalin, then treated for the recommended times in Gooding and Stewart's fluid, EDTA, aqueous nitric acid, von Ebner's fluid, and rapid decalcifier (RDC). The blocks were processed to paraffin wax and sections were stained by the Ziehl-Neelsen technique. Only in sections of the blocks treated with RDC were no acid alcohol fast bacilli demonstrable. Hydrochloric acid is a known constituent of RDC and it was found that Myco. tuberculosis is altered by treatment with 2-5M solutions of hydrochloric acid and above and cannot subseuqently be demonstrated by the Ziehl-Neelsen stain. From these results it is recommended that calcified tissue from patients in whom there is a suspicion of tuberculosis should be decalcified with an agent other than RDC.
The incidence of paramalignant disorders was studied in 280 consecutive patients with early lung cancer confirmed histologically. The commonest disorders were weight loss exceeding 6.4 kg (30.7 percent of the series), finger clubbing (29 percent), fever (21.1 percent), and endocrinopathies (12.1 percent). Paramalignant diseases are common even in early lung cancer and all patients should have investigations for their detection.
Storage of concentrated suspensions of Bordetella pertussis organisms at 5 C for long periods of time in the presence of 0.02% thimerosal as well as heating at 56 C for 30 minutes cannot be relied upon to detoxify the vaccines. Our data show that the toxic thimerosal-killed vaccines can be rapidly detoxified by adding formalin to a final concentration of 0.025-0.05% and incubating at temperatures of 5-20 C for from one to three months. These formalin-detoxified vaccines are protective and meet present potency requirements for pertussis vaccine. Addition of larger amounts of formalin at higher temperatures may detoxify the vaccine but may also reduce the protective effect.
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