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Biomedical subjects

G Gill

Publications and source records attributed to G Gill.

At least 127 records · Page 7Linked to original sources
PubMed1986

Analysis of a prospectively randomized comparison of doxorubicin versus 5-fluorouracil, doxorubicin, and BCNU in advanced gastric cancer: implications for future studies.

A multi-institutional cooperative study of patients with locally advanced, recurrent, or metastatic gastric adenocarcinoma who had not previously received chemotherapy was conducted, prospectively randomizing patients to receive either doxorubicin or the three-drug combination, 5-fluorouracil (5-FU), doxorubicin (Adriamycin; Adria Laboratories, Columbus, Ohio), and BCNU (FAB). The 187 evaluable patients were initially stratified according to the presence of measurable or evaluable disease and performance status. There was a significantly higher response rate observed for FAB (40%) compared with doxorubicin (13%) among the 145 measurable-disease patients. Duration of response and survival were significantly longer for FAB in the measurable-disease group, but for the total patient population an early advantage for FAB in time to disease progression and survival was lost with continued follow-up. Median survival was 33 weeks for patients receiving FAB and 19 weeks for those receiving doxorubicin. Significant pretreatment factors adversely affecting survival included poor performance status, weight loss of greater than 10%, and more than two sites of metastases. Toxicity was not severe in either treatment arm, and only thrombocytopenia occurred significantly more often with FAB. It is contended that in the treatment of advanced gastric cancer, chemotherapy only exerts a relatively short-term and modest beneficial effect, most apparent in patients with intermediate tumor bulk. 5-FU remains the most active single agent, and combination chemotherapy has not yet proven its overall worth. Further studies are indicated comparing the most active combinations with 5-FU using optimal doses and schedules, and consideration must be given to the incorporation of no-treatment controls.

Adenocarcinoma↗
PubMed1985

A case of 'essential' hypernatraemia due to resetting of the osmostat.

We describe a 24-year-old short, obese girl who has bizarre episodic neurological abnormalities related to hyperosmolality due to hypernatraemia. Investigation of osmoregulation by water loading and infusion of hypertonic saline revealed (i) hypodipsia with thirst onset raised to plasma osmolality of 332 mmol/kg and (ii) elevation of the threshold for vasopressin release (plasma osmolality 320 mmol/kg) but normal slope of the plasma vasopressin-plasma osmolality curve. Baroregulated vasopressin release was also grossly subnormal. Other hypothalamo-pituitary investigations showed deficiencies of releasing hormones for gonadotrophins and growth hormone, but prolactin response to combined hypoglycaemia and TRH was blunted She demonstrated other anomalies including hyperlipoproteinaemia and defective lymph drainage of the legs. Skull X-rays, together with computerized tomography and nuclear magnetic resonance scans of the hypothalamo-pituitary region and the rest of the brain were normal. We believe that this is the first case of essential hypernatraemia documented with direct evidence of resetting of the osmostat.

Adult↗
PubMed1984

Spread of carcinoma of the base of the tongue as detected by computer tomography.

21 patients with histologically proven carcinoma involving the base of the tongue were studied with computer tomography utilizing a high dose of intravenous infusion of contrast material. Computer tomography demonstrated not only excellent visualization of the primary carcinoma at the base of the tongue, but also its traditional means of spread to contiguous soft tissues of the pharyngeal walls and lymph node metastasis. Computer tomography also demonstrated the unusual spread to the retropharyngeal lymph nodes and nasopharynx. Computer tomography with high-dose intravenous contrast is the best radiographic modality for the evaluation of carcinoma of the base of the tongue.

Adult↗
PubMed1983

Computed tomography of palatine tonsillar carcinoma.

Twenty-five patients with surgically and histologically proven squamous cell carcinoma of the palatine tonsil were studied with computed tomography (CT) using a high dose intravenous contrast enhancement technique. With this technique, CT demonstrated the primary carcinoma within the palatine fossa as well as its contiguous spread to the base of the tongue, mobile tongue, lateral pharyngeal wall, supraglottic larynx, and nasopharynx and metastasis to local deep cervical lymph nodes.

Adult↗
PubMed1983

Computer-tomographic appearance of branchial cleft and thyroglossal duct cysts of the neck.

The usefulness of computer tomography (CT) in the evaluation of a congenital neck mass has received little attention in the literature. We present the CT findings in two relatively common congenital neck masses - the thyroglossal duct cyst and the branchial cleft cyst. These cysts present a relatively common CT appearance of a mass with an enhancing capsule and a lucent center measuring between 20 and 35 Houndsfield Units. The branchial cleft cyst commonly occurs along the lateral border of the neck, anterior to the sternocleidomastoid muscle, while the thyroglossal duct cyst occurs along the midline of the neck. CT is excellent for determining the location, size, extent and character of these two common congenital neck masses.

Adolescent↗
PubMed1982

Release of lymphotoxin by control and chemical carcinogen-treated lymphocyte cultures derived from black healthy subjects and cancer patients.

In an age-adjusted comparison with white men, black men have a significantly higher increase in esophageal and other types of cancer associated with environmental causes. The basis of this increase in cancer rates in blacks over the last two decades is unknown. Since cancer patients generally show an impairment in cell-mediated immune (CMI) functions, we measured certain CMI reactions in cultured lymphocytes derived from black healthy subjects and cancer patients. We also determined the levels of aryl hydrocarbon hydroxylase (AHH) induced in these lymphocytes. AHH catalyzes the activation of polycyclic aromatic hydrocarbons (PAH) to intermediates which might alter CMI functions.Lymphocytes from 33 black patients with squamous cell carcinoma and 22 healthy volunteers were mitogen-activated with phytohemagglutinin and concurrently treated with the environmental carcinogen, 3-methylcholanthrene (MCA). Measurements were made of the effects of MCA (0.5 to 3.0 μM on blastogenesis, T-cell growth, lymphotoxin (LT) release, and AHH induction in these lymphocyte cultures. MCA treatment depressed blastogenesis but had no depressive effect on T-cell growth in cultures. Blastogenesis and T-cell growth were mitogen dose-dependent, while LT release was independent of mitogen concentration. There was a significantly lower LT release by lymphocytes from lung cancer patients, compared to those from healthy and head/neck cancer subjects. The reduced levels of LT release in lung cancer patients might reflect an impairment in this CMI function. Studies on the role of lymphocyte subpopulations in CMI functions are in progress.

Adult↗
PubMed1981

Hypersensitivity to tobacco glycoprotein in human peripheral vascular disease.

One hundred and sixty-four patients with peripheral vascular disease (PVD) were skin tested with a purified tobacco glycoprotein (TGP). A basophil degranulation test (BDT) was also performed to assess in vitro reactivity to TGP. Immediate skin test hypersensitivity to TGP was found in 18 of 164 (11%) patients with radiologically demonstrable PVD. BDT was positive in 25/42 (60%) smokers as opposed to 6/23 (24%) nonsmokers (p less than 0.01). Twenty-one of 49 (43%) skin test-negative and 10/11 (91%) skin test-positive patients wih PVD had a positive BDT (p less than 0.02). Only 1/34 (3%) patients with negative BDT had a positive skin test. Skin test-positive patients had significantly higher BDT at 0.01 and 0.001 microgram/ml TGP in vitro compared to skin test-negative patients (p less than 0.01). When PVD was graded by arteriography, one of 11 patients with "mild," 11/87 with "moderate" and 4/20 with "severe" PVD were skin test-positive to TGP (p less than 0.01 "mild" vs "moderate"; p less than 0.05 "mild" vs. "severe"). These differences could not be attributed to age, sex, atopy or smoking status. Reactivity to TGP exists in a proportion of patients with PVD and may be causally related in such cases to the development of atherosclerotic vascular disease.

Adult↗
PubMed1980

Hydrothorax with peritoneal dialysis: radionuclide detection of a pleuro-peritoneal connection.

Unilateral hydrothorax occurring during peritoneal dialysis is well described and has been presumed to be secondary to a pleuroperitoneal communication. Diagnosis of these communications usually requires invasive procedures. A non-invasive method of confirmation of abnormal pleuro-peritoneal communication using radionuclide scanning is outlined. The occurrence of this complication has usually meant cessation of this type of dialysis. However, this patient illustrates that continuation of peritoneal dialysis is possible.

Female↗
PubMed1980

Estramustine phosphate: plasma concentrations of its metabolites following oral administration to man, rat and dog.

Estramustine phosphate, a nitrogen mustard derivative of estradiol used for the treatment of advanced prostatic cancer, was administered orally to man, rat and dog and the plasma concentrations of its unconjugated metabolites were determined by high performance liquid chromatography. In all species the drug was rapidly and completely dephosphorylated prior to reaching the peripheral circulation. In man and the rat, the 17-keto analogue of estramustine (estromustine) was the mamor metabolite found in plasma with considerably lesser amounts of estramustine itself. In the dog, significant concentrations of both estramustine and estromustine were present. Highly elevated levels of both estrone and estradiol, as a result of cleavage of the nitrogen mustard from the steroid, were observed in all species. Chronic administration of therapeutic doses of estramustine phosphate to man did not result in any apparent accumulation of circulating metabolites. The study suggests that the metabolite, estromustine, in addition to estramustine, may play an important role in the therapeutic efficacy of estramustine phosphate.

Administration, Oral↗
PubMed1979

Diurnal variation in the quality and outcome of newborn intensive care.

Variables related to both the process and the outcome of neonatal intensive care were studied to compare care given during the day (0901-2100 hours) with that at night (2101-0900 hours). At night, intravenous infiltrations occurred more often, and the tidal volume of respirator-treated infants was verified less often. Blood pH values less than 7.20, excluding values within 12 hours of admission, were recorded more often and in more patients at night. During a 12-month period, there were significantly more deaths among infants less than 1,500 gm during the night than during the day. The deterioration of infants at night may result in part from current nursery staffing practices.

Birth Weight↗
PubMed1979

The effect of irradiation upon the bacterial flora in patients with head and neck cancer.

Twenty-two consecutive patients with cancer of the head and neck, who were to receive a full tumoricidal dose of irradiation to a field that included the oral cavity and pharynx, were studied to determine the effect of the irradiation on their local bacterial flora. Aerobic cultures were taken prior to, at the completion of, and one month after the completion of their irradiation. The percentage of patients with potentially pathogenic organisms increased dramatically as the effect of the irradiation increased. This change in the local flora has obvious implications concerning the increased incidence of postoperative wound infections in patients who have received prior irradiation.

Bacteria↗
PubMed1979

Reversal of postoperative immunosuppression in man by vitamin A.

The effects of therapy with vitamin A on immune responsiveness after extensive surgical treatment were studied in vitro. Postoperatively, in control patients, there was depression of the total lymphocyte count and the response in the mixed lymphocyte reaction to a pool of stimulating cells. Treatment with pharmacologic dosages of vitamin A prevented depression of these parameters in the postoperative period. The mitogenic response to phytohemagglutinin and monocyte mediated hemolysis was not consistently altered by operation in control patients, but there was a trend toward increased activity in those receiving vitamin A. Thus, vitamin A appears to be an immunostimulant in man.

Adjuvants, Immunologic↗