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Biomedical subjects

G C Hoffman

Publications and source records attributed to G C Hoffman.

At least 37 records · Page 2Linked to original sources
PubMed1980

Acute nonlymphocytic leukemia in patients receiving chemotherapy for nonmalignant diseases.

The occurrence of acute leukemia in patients receiving chemotherapeutic agents for malignant disease has been well established. Recent reports have suggested that chemotherapeutic drugs used to treat inflammatory conditions may have an oncogenic potential. From 1969 to 1977, 11 patients with a variety of collagen-vascular diseases who developed acute nonlymphocytic leukemia were seen at the Cleveland Clinic. Rheumatoid arthritis was the most common underlying disease, in addition to giant cell arteritis, polyarteritis nodosa, chronic glomerulonephritis, and scleroderma. All patients were treated with alkylating agents, and 10 of the 11 received multiple cytotoxic agents. According to the French-American-British classification there were six examples of M4 (myelomonocytic leukemia), with single examples of M1 (myeloblastic leukemia without maturation), M2 (myeloblastic leukemia with maturation), M5a (monocytic leukemia, poorly differentiated), M5b (monocytic leukemia, differentiated), and M6 (erythroleukemia). Cytogenetic studies were abnormal in five patients studied, showing varying degrees of aneuploidy. All patients died, and the mean duration of time from the diagnosis of leukemia to death was four and one-half months, with only one complete remission.

Arthritis, Rheumatoid↗
PubMed1979

The gastroesophageal scintiscan. Comparison of methods to demonstrate gastroesophageal reflux.

The gastroesophageal (GE) scintiscan method of detecting GE reflux was evaluated in a series of 54 patients. Twenty-nine patients had evidence of GE reflux by fluoroscopically monitored barium swallow, esophagogastroscopy, or esophageal biopsy. The pH reflux study showed pathological reflux in four patients. The GE scintiscan demonstrated reflux in only four of these 29 patients. Although the GE scintiscan is a safe, noninvasive technique, in our experience, GE reflux was demonstrated only in those patients in whom reflux was easily verified by barium swallow, esophagoscopy, or esophageal mucosal biopsy. This study indicates that the GE scintiscan, like the pH reflux study, is too insersitive to be of consistent value in the diagnosis of GE reflux.

Barium Sulfate↗
PubMed1979

Prognostic factors affecting remission, remission duration, and survival in adult acute nonlymphocytic leukemia.

The medical records of 94 consecutive patients with acute nonlymphocytic leukemia (ANLL) were reviewed to identify significant prognostic factors. The data were analyzed using 1) Cox's linear hazard and linear logistic models, 2) chi-square comparison of the groups living longer than 2 years and those living less than 2 years, and 3) the Gehan-Breslow test of equal survival curves. The only statistically significant finding was that the presence of promyelocytic cell type and complete remission correlated with increased survival (p less than .05), but this was negated by the small number of patients with this cell type. There was a suggestive association between higher initial hemoglobin and survival (p = .09). The Gehan-Breslow test revealed a possible difference in survival between those patients more than 51 years of age and those less than 51 (p = .10). Thus none of the commonly accepted prognostic factors in acute nonlymphocytic leukemia was definitely shown to be useful. The findings of this study support an aggressive approach toward all patients with this disease.

Adolescent↗
PubMed1979

Fibrinolysis in familial pulmonary hypertension.

Although an autosomal dominant mode of inheritance has been documented for many cases of primary pulmonary hypertension, the pathogenesis of the disease remains unclear. A report of abnormal fibrinolysis in familial pulmonary hypertension has raised the possibility that the pathogenesis may be related to an impaired ability to lyse recurrent pulmonary microemboli. Primary pulmonary hypertension was diagnosed in three of ten members of a kindred. The pattern of inheritance was compatible with an autosomal dominant gene. Eight members of the kindred were available for study, one of whom has primary pulmonary hypertension. The results of coagulation studies, caseinolytic determinations of plasminogen and antiplasmin, and fibrinolytic titers of antiurokinase did not differ significantly from those of the control group. These findings suggest that a deficient fibrinolytic system is not the cause of primary pulmonary hypertension, although differences in methodology may explain our inability to demonstrate abnormal circulating fibrinolysis in this kindred.

Blood Coagulation↗
PubMed1978

Diagnostic problems involved in detection of metastatic neoplasms by bone-marrow aspirate compared with needle biopsy.

Diagnostic problems involved in detection of metastatic neoplasms by bone-marrow aspirate compared with needle biopsy. Am J Clin Pathol 70: 623--627, 1978. Comparison of a large series of bone marrow aspirations with simultaneously performed Jamshidi needle biopsies showed 75% correlation between the two procedures for detection of metastatic neoplasms. In cases where the two methods disagreed, false-negative aspirations resulting from perineoplastic desmoplasia was the usual reason for the discrepancy. Cytologic criteria for the evaluation of suspected neoplastic cells in aspirate preparations are discussed.

Biopsy, Needle↗
PubMed1975

Microangiopathic hemolytic anemia in renal allotransplantation. Repart of a successfully treated case and review of the literature.

The development of microangiopathic hemolytic anemia after renal transplantation in a 17 year old white boy is reported, and the literature is reviewed. In this patient microangiopathic hemolytic anemia developed 6 weeks after renal transplantation during a second episode of rejection. Light, fluorescence and electron microscopy demonstrated the renal vascular lesion associated with this syndrome. In contrast to the other four previously reported cases of microangiopathic hemolytic anemia associated with renal allotransplantation, this patient had complete resolution of the microangiopathic hemolytic anemia with heparin therapy and improved allograft function, presumably with diminution of the vascular lesion. He survived a complicated early period after renal transplantation and has shown no recurrence of microangiopathic hemolytic anemia in the 18 months since transplantation. Special red blood cell and fibrinogen studies are discussed.

Adolescent↗
PubMed1973

Carcinogen-induced chromosomal breakage decreased by antioxidants.

Blood leukocyte cultures were incubated with antioxidants and the carcinogens sodium cyclamate and 7,12-dimethylbenz(alpha)anthracene in different combinations. There were 17.4% more chromosomal breaks in the group of cells treated with dimethylbenzanthracene only than in the untreated controls. The reductions in chromosomal breaks by the antioxidants were as follows: ascorbic acid, 31.7%; butylated hydroxytoluene, 63.8%; Na(2)SeO(3), 42.0%; and dl-alpha-tocopherol, 63.2%. Multiple chromosomal breaks were distributed equally throughout the experimental groups. Sodium cyclamate had only slightly more chromosomal breaks than the controls (11.6 compared to 10.9%). In the cyclamate groups treated with Na(2)SeO(3), 11.2% of chromosomes were broken. More acrocentric-type chromosomal breaks (21.7%) were seen in the untreated cells than the cells treated with cyclamate (3.4%) or dimethylbenzanthracene alone (4.8%). The carcinogen-treated groups had a higher percentage of meta breaks than the untreated controls.

Adult↗