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Biomedical subjects

H Scher

Publications and source records attributed to H Scher.

At least 73 records · Page 4Linked to original sources
PubMed1988

A randomized trial of etoposide + cisplatin versus vinblastine + bleomycin + cisplatin + cyclophosphamide + dactinomycin in patients with good-prognosis germ cell tumors.

Standard chemotherapy for disseminated germ cell tumors (GCT) cures most patients but causes considerable acute toxicity, including treatment-related death due to septicemia during neutropenia and pulmonary fibrosis. In addition, chronic and delayed toxicities, particularly Raynaud's phenomenon, have been reported in 6% to 37% of treated patients. In an attempt to minimize the acute and chronic effects of treatment which are related primarily to vinblastine and bleomycin, a randomized trial comparing the efficacy and toxicity of vinblastine + bleomycin + cisplatin + cyclophosphamide + dactinomycin (VAB-6) and etoposide + cisplatin (EP) was conducted on 164 eligible patients with good-prognosis GCT. Seventy-nine of 82 (96%) patients receiving VAB-6 and 76/82 (93%) receiving EP achieved a complete remission (CR) with or without adjunctive surgery. Similar proportions of patients in both arms were found at surgery to have necrosis/fibrosis or mature teratoma. With a median follow-up of 24.4 months in the VAB-6 arm and 25.9 months in the EP arm, the total, relapse-free, and event-free survival distributions were similar in the two arms. Patients receiving EP experienced less emesis (P = .05), higher nadir WBC (P = .06) and platelet counts (P = .01), less magnesium wasting (P = .0001), less mucositis (P = .09), and no pulmonary toxicity. No treatment-related mortality was observed. EP is an efficacious and less toxic regimen and is recommended for good-prognosis patients with disseminated GCT.

Adolescent↗
PubMed1986

Males disposed to commit rape.

The hypothesis that the preferential rape pattern belongs among the courtship disorders like voyeurism, exhibitionism, and toucheurism was tested. The study consisted of two experiments. The first compared 11 rape-prone males, who were most likely afflicted with the preferential rape pattern, with 11 sexually normal controls on penile response to narratives that depicted scenes in which the individual engaged in behavior typical of voyeurs, exhibitionists, or toucheurs. Narratives depicting normal tactile interaction (short of intercourse) with a genuinely participating woman, normal intercourse, and sexually neutral scenes were also presented. The rape-prone males responded more to the voyeuristic situations than did the controls. The standing of the normal intercourse situations on the scale of erotic value, relative to the other above-mentioned situations, was lower for the rape-prone males than for the normal controls. A second experiment compared 12 rape-prone males, who most likely demonstrated the preferential rape pattern, with 12 males with (other) courtship disorders and 12 sexually normal controls. Penile response to narratives depicting the individual involved in pretactile erotic activity, in tactile sexual activity short of intercourse, or in having intercourse was compared. Each situation was presented in two modalities depicting either a genuinely participating woman or a woman fearful of the individual. The penile responses of the rape-prone males, as well as those of males with other courtship disorders, differentiated less between sexual interaction with a fearful woman and such interaction with a participating woman than did the penile responses of normal controls. There was no significant difference in this respect between the rape-prone males and males with other courtship disorders.

Adult↗
PubMed1986

Effects of electrode placement on direction of T-wave amplitude changes in psychophysiological studies.

Psychophysiological studies, which measure small changes in T-wave amplitude (TWA) induced by behavioral manipulations, usually employ a single electrode placement for obtaining the ECG. The present study varied electrode placement (EP) within subjects among three EPs that have been reported in the literature (a lead-II limb placement, and two chest placements) to determine whether, as has been claimed, the direction of TWA changes can be changed by varying EP. Both HR and TWA were monitored in 24 males during the Baseline, Listen, and Task phases of an iterative subtraction task. The EP variation did not affect the direction of TWA change. Reliable TWA attenuation accompanied by HR acceleration was observed in all leads.

Adult↗
PubMed1986

Surgical treatment of spinal cord compression in kidney cancer.

Forty-three patients with renal-cell carcinoma underwent treatment for spinal cord compression over a 7-year period. Of these, 32 patients underwent surgery, while 11 patients underwent radiation alone. Before operation, 25 patients had relapsed following prior radiation, while seven others received postoperative radiation. A more aggressive surgical approach, tailored to the site of compression within the spinal canal, was used with the majority undergoing gross total tumor resection by an anterior approach. Immediate stability of the spine was achieved with methyl-methacrylate reconstruction of the resected segments. Preoperative spinal angiography with embolization of hypervascular tumors was carried out in eight patients. Patient parameters in the surgical and irradiated groups were comparable, except that a greater proportion of the radiation alone group had more than one organ system involved (64% v 44%). The median survival of the surgically treated patients was 13 months, compared with 3 months for those treated by radiation alone. In addition, a greater proportion of the surgically treated patients were benefitted neurologically (70%) compared with those treated by radiation (45%). With the development of effective surgical treatment for spinal metastases, early consideration for surgical treatment (before radiation) should be considered in selected patients. Preoperative spinal angiography and embolization are recommended whenever feasible to minimize intraoperative blood loss.

Adult↗
PubMed1985

Increased survival with high-dose multifield radiotherapy and intensive chemotherapy in limited small cell carcinoma of the lung.

From June 1979 through April 1982, we treated 35 patients with limited small cell carcinoma on an intensive chemo-radio-immunotherapy regimen, consisting of induction with cyclophosphamide, doxorubicin, and vincristine, alternately cycled with VP-16 and cisplatin. Patients were stratified by performance status and randomized to thymosin, fraction V, or no thymosin. Induction was followed by consolidation, consisting of prophylactic whole-brain radiotherapy and multifield radiotherapy to the primary and mediastinum with cyclophosphamide and vincristine. Patients who were complete responders (CRs) postconsolidation resumed maintenance immediately. Patients were followed from 1 to 3.8 years (median, 2.2 years) at the time of analysis. After induction, 35% (12/34) had become CRs; after consolidation radiotherapy, an additional 10/34 became CRs for a total CR rate of 65% (22/34). There were only 9/34 local failures (26%), of which all but one were impatients who had not become CRs. A prolonged median survival (21 months) has been obtained in patients with limited small cell carcinoma of lung treated with an intensive combined modality regimen. At 1 year, survival is 83%; at 2 years, 46%. There is a 33% long-term survival (greater than 3 years). There is no difference in survival or recurrence rate between patients treated with or without thymosin.

Adult↗
PubMed1985

Intuitive and factual approaches in the comparison of contractility and repolarization measures of sympathetic myocardial activity.

Obrist (Cardiovascular Psychophysiology: A Perspective, Plenum Press, New York, 1981) has recently argued for the superiority of contractility (e.g. pulse transit time) over ventricular repolarization (e.g. T-wave amplitude) measures as indices of sympathetic myocardial influences on the grounds that the T-wave occurs during the diastolic portion of the cardiac cycle (in contrast to the systolic temporal locus of contractile-based measures). This note suggests that this argument is intuitively rather than factually based because it lacks both logical and empirical validity.

Electrocardiography↗
PubMed1984

The courtship disorders: a further investigation.

The senior author had put forward the hypothesis that voyeurism , exhibitionism, obscene telephone calling, toucheurism - frotteurism , and at least some cases of the preferential rape pattern all distort normal courtship behavior in basically the same manner. An earlier study (Freund et al., 1983) tested part of this hypothesis, namely that voyeurism , exhibitionism, and frotteurism - toucheurism , are closely related. However, the outcome of one of the experiments by which this test was performed could be interpreted as indicating that the relationship between these anomalous erotic inclinations consists simply in that they may be expressions of a disinclination toward intercourse. The present study was conducted to test this interpretation. It compared 16 exhibitionists with 16 sexually normal controls on penile responses to auditorily presented descriptions of the four phases of normal sexual interaction (location of a suitable partner; pretactile erotic interaction; tactile interaction short of intercourse; the situation of intercourse) and sexually neutral situations. These descriptions were narratives about the examined subject's involvement in such interaction. No differences in responding between exhibitionists and normal controls were observed. Both groups responded most to descriptions of intercourse. The second largest response was to tactile interaction (short of intercourse). The third was to situations of partner location and pretactile interaction, which were not differentiated from each other. Responses to sexually neutral situations were smaller than those to descriptions of any category of sexual interaction. This result refutes the hypothesis that exhibitionism develops on the basis of a disinclination toward intercourse. The close relationship between exhibitionism, and voyeurism and toucheurism (or frotteurism ), had been demonstrated earlier.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1984

Phase II trial of doxorubicin in bidimensionally measurable prostatic adenocarcinoma.

Intravenous doxorubicin (30 to 60 mg. per m.2 every 3 weeks) was administered to 52 patients with metastatic adenocarcinoma of the prostate, including 41 with bidimensionally measurable soft tissue lesions. Prior therapy in the measurable disease group included hormonal manipulation in 39 cases, irradiation in 39 and cytotoxic drugs in 19. In 39 of 41 adequately treated patients with soft tissue lesions only 2 (5 per cent, 95 per cent confidence limits 0 to 12 per cent) achieved a partial remission for 12 and 6 months, respectively, 3 had a minor response for 5, 4 and 3 months, respectively, and 1 had stabilization of disease for 4 months. Survival in this group was 16 months versus 5 months for patients with a mixed response and progression of disease. Of 11 patients with evaluable parameters only 1 had stabilization and 5 showed subjective improvement. Recognizing the patient selection bias and treatment schedule in this study, we believe that doxorubicin has marginal activity in soft tissue lesions in patients with advanced prostatic cancer.

Adenocarcinoma↗