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Biomedical subjects

H White

Publications and source records attributed to H White.

At least 145 records · Page 8Linked to original sources
PubMed1987

Adjuvant aminoglutethimide therapy for postmenopausal patients with primary breast cancer.

Three hundred and twenty-two postmenopausal patients with primary breast cancer and ipsilateral axillary node involvement were randomized to receive aminoglutethimide and hydrocortisone or placebo for 2 years in a double blind randomized trial between April 1980 and March 1985. Two hundred and eighty-six patients were eligible for the study of whom 145 received active drug and 141 received placebo. At the present time significantly fewer patients have relapsed or died without previous relapse in the treatment arm (P = 0.002); 43 of 145 (30%) patients receiving aminoglutethimide have relapsed or died compared with 63 of 141 (40%) of those receiving placebo. Local recurrence is also significantly reduced (P = 0.002) since only 6 patients receiving active treatment developed local recurrence compared to 21 receiving placebo. Side effects were severe enough to necessitate complete withdrawal or reduction of therapy in 27 of 145 (19%) in the treatment arm of the study compared with 21 of 141 (15%) in the placebo arm. A single treatment-related death occurred, due to agranulocytosis. Aminoglutethimide and hydrocortisone therefore delay relapse after surgery for primary breast cancer in postmenopausal women. It is too early to assess any effect on overall survival.

Aged↗
PubMed1987

Establishment and characterization of three new malignant lymphoid cell lines.

We have established 3 new EBV-negative cell lines, designated Sc-1, Ri-1 and Ci-1, from patients with B-cell lymphoma/leukemia. We characterized them by cytogenetics and by study of surface membrane antigens with a panel of monoclonal antibodies (MAbs), surface and cytoplasmic immunoglobulin (Ig) expression and Ig heavy- and light-chain genes. All 3 lines had a 14q+ abnormality. Ri-1 also had translocations involving chromosomes 2, 8 and 18. Ci-1 also had abnormalities involving chromosomes 2, 8 and 22 and its karyotype was 46, XX, t(2;8), t(14;22). The t(2;8) had the same breakpoints as those reported in some cases of Burkitt's lymphoma. We also studied a classical Ph1-positive cell line previously established by Pegoraro et al. (1983) and designated BV173. The phenotypes of these 4 lines based on Ig expression and marker studies correlated well with their respective genotypes. Our results are in keeping with the notion that leukaemic cell populations are clonal expansions of cells "frozen" at a particular stage in their differentiation. Specifically, BV173 cells are at an early stage of B-cell differentiation, Ri-1 and Ci-1 cells are at intermediate stages and Sc-1 cells are at a relatively late stage in the B-cell lineage.

Adult↗
PubMed1987

Prognostic factors related to survival and groin recurrence following therapeutic lymph node dissection for lower limb malignant melanoma.

A retrospective analysis was carried out of 133 patients undergoing therapeutic lymph node dissection for malignant melanoma of the lower limb. A radical ilio-obturator dissection (RID) was performed in 106 patients and a superficial femoral dissection (SFD) in the remaining 27. On univariate analysis five factors were found to be significant indicators of prognosis. These were: Clark level of the primary (P = 0.02); primary melanoma thickness (P = 0.04); total number of positive nodes (P less than 0.001); number of positive femoral nodes (P less than 0.001); and number of positive ilio-obturator nodes (P less than 0.001). On multiple regression analysis only the number of positive nodes in each compartment remained a significant independent factor (P less than 0.001). The morbidity associated with RID was not significantly greater than after SFD. RID was, however, associated with a reduction in subsequent groin recurrence. Radical nodal clearance is the operation of choice. This technique provides maximum prognostic information, reduces the likelihood of local untreatable disease and possibly improves overall survival rates--especially when only one iliac node is involved.

Adolescent↗
PubMed1987

Semantic priming in young and older adults: evidence for age constancy in automatic and attentional processes.

Automatic and attentional components of semantic priming and the relation of each to episodic memory were evaluated in young and older adults. Category names served as prime words, and the relatedness of the prime to a subsequent lexical decision target was varied orthogonally with whether the target category was expected or unexpected. At a prime-target stimulus-onset asynchrony (SOA) of 410 ms, target words in the same category had faster lexical decision latencies than did different category targets. This effect was not significant at a 1,550-ms SOA and was attributed to automatic processes. Expected category targets had faster latencies than unexpected category targets at the 410-ms SOA, and the magnitude of the effect increased at the 1,550-ms SOA. This effect was attributed to attentional processes. These patterns of priming were obtained for both age groups, but in a surprise memory test older adults had poorer recall of primes and targets. We discuss the implications of these results for the hypothesis that older adults suffer deficits in selective attention and for the related hypothesis that attentional deficits impair semantic processing, which causes memory decrements in old age.

Aged↗
PubMed1987

Drug interactions with cardiac glycosides: evaluation of a possible digoxin-ethmozine pharmacokinetic interaction.

Problems in studying pharmacokinetic interactions with digoxin were evaluated using as a test model the examination of a possible interaction between digoxin and ethmozine in a group of 11 patients with cardiac disease. A single-blind, placebo-controlled, nonrandomized protocol design was used. Considerable intrapatient variability in day-to-day serum digoxin levels was documented that could not be accounted for by laboratory variability in digoxin assay measurements (mean coefficient of variation 10.1%) or alterations in blood urea nitrogen (BUN), serum creatinine, or body weight during the course of the study. No consistent, statistically significant alteration of mean serum digoxin levels occurred when the baseline, placebo, and ethmozine phases were compared, although the study design would have permitted detection of a 0.29-ng/ml alteration in mean serum digoxin levels. A discussion of the sources of variability in digoxin levels is provided.

Aged↗
PubMed1987

Epilepsy-aphasia syndrome in children: an unusual presentation to psychiatry.

This paper describes the psychiatric and clinical manifestations of the epilepsy-aphasia syndrome which occurs in children. In 1957, Landau and Kleffner reported the development of receptive and expressive aphasia at 5 to 6 years of age, in six children with normal language development at that time. Since this first report, further accounts of acquired language disabilities associated with EEG abnormalities have appeared. However, the clinical syndrome remains ill defined and its pathophysiology is poorly understood. There are no reported cases of this syndrome presenting initially to psychiatry. This paper reports a child who presented to psychiatry with severe aggression associated with the clinical syndrome of epilepsy-aphasia. The discussion examines the relationships between the aggressive behavior and the EEG findings and aphasia.

Aphasia↗
PubMed1986

Effect of nifedipine on left ventricular function in patients with angina pectoris.

Calcium channel blocking agents function as negative inotropic agents when they are administered in vitro directly to the myocardium. In patients with coronary artery disease, however, such direct effects are attenuated by a number of other factors, including decreased afterload and resultant reflex sympathetic stimulation, increased coronary blood flow with improved myocardial perfusion, and protection of mitochondria. Nifedipine has not been observed to cause significant left ventricular depression in patients with angina pectoris; this is primarily due to peripheral arteriolar vasodilatation, which reduces impedance of left ventricular ejection. In addition, the relief of myocardial ischemia by nifedipine plays a major role in improving systolic and diastolic function. The clinical response to calcium channel blockers may differ in patients with idiopathic dilated cardiomyopathy, for whom the factor of fluctuating ischemia is less important.

Administration, Oral↗
PubMed1986

Sex differences in presentation of cutaneous malignant melanoma and in survival from stage I disease.

To explain the improved survival rates of females with malignant melanoma compared with that of males in this region of the United Kingdom (a recognized low incidence area for melanoma), clinicopathologic differences between the sexes of 477 patients presenting with primary melanoma at all stages, were examined between 1961 and 1976. The survival of 356 males and females presenting with Stage I melanoma were also compared, taking death from melanoma as the critical event. The data were analyzed using the Cox multivariate model, which allows several prognostic variables to be considered simultaneously, and enabled the assessment of the effect of, and interactions between, these variables. Female superiority in survival was due to: more lesions on the female lower limb, a site associated with a good prognosis; thinner lesions at presentation in the female; an interaction with age in which females between the age of 50 and 79 years fare significantly better than a similar age group of males. This age/sex interaction has not been observed in high incidence areas. It suggests, therefore, that melanoma may behave differently in different geographical areas.

Arm↗
PubMed1986

Development of an aerosol model of murine respiratory mycoplasmosis in mice.

Animal models of murine respiratory mycoplasmosis due to Mycoplasma pulmonis provide excellent opportunities to study respiratory disease due to an infectious agent. The purpose of the present study was to develop and characterize an aerosol model for the production of murine respiratory mycoplasmosis in mice. The exposure of mice for 30 min to aerosols generated with a DeVilbiss 45 nebulizer in a nose-only inhalation chamber consistently reproduced typical lesions. The chamber was operated with a nebulizer air flow of 5.3 liters/min at 5.0 lb/in and a diluting air flow of 20 liters/min, with the nebulizer containing 5 ml of a suspension of viable M. pulmonis organisms (a concentration between 6 X 10(5) to 6 X 10(10) CFU/ml). Infective aerosol particles of less than a 4.0-micron median aerodynamic diameter with a geometric standard deviation of approximately 2.0 reached the lungs and were evenly distributed among the different lung lobes. A minimum 1.5-log loss of viability in the M. pulmonis suspension was demonstrated. With the exception of the 50% lethal dose, all of the parameters previously established by intranasal inoculation could be examined with the aerosol model. The major advantages of the aerosol model were excellent reproducibility of exposure (both between different experiments and between animals in a given experiment), the avoidance of anesthetization, and the ability to immediately deposit the majority of the organisms in the lung. The only disadvantage was the requirement for large volumes of mycoplasmal cultures.

Aerosols↗
PubMed1986

Rearrangement of the bcr gene in Philadelphia chromosome-negative chronic myeloid leukemia.

We studied the clinical, hematologic, cytogenetic, and molecular biologic features of seven patients with Philadelphia (Ph1) chromosome-negative chronic myeloid leukemia (CML). In five cases the hematologic findings were indistinguishable from those of patients with classical Ph1-positive disease. Myeloid cells were studied by chromosome-banding techniques. One patient had a masked Ph1 chromosome (with translocation t(4;9;22)), one had a deletion involving chromosome 16, and one had a small minority population of 22q- cells without 9q+ but otherwise normal metaphases; metaphases from the other four patients were entirely normal. DNA prepared from the myeloid cells was digested with the restriction enzymes EcoRI, HindIII, BamHI and BglII. Southern analysis using a 0.6-kb fragment of the breakpoint cluster region (bcr) gene showed the presence in each patient's DNA of a germline fragment together with a rearranged fragment or fragments with at least one of the restriction enzymes. We conclude that genomic changes in the bcr gene characteristic of CML can be present in the absence of a Ph1 chromosome.

Adult↗
PubMed1986

Omental transposition for recurrent breast carcinoma following limited surgical excision and radiation therapy.

Failure to control local disease following limited surgical excision and radiotherapy for primary treatment of breast carcinoma often precludes the use of conventional mastectomy techniques. This series reports the use of mastectomy and omental transposition on a gastroepiploic pedicle and delayed skin grafting in 17 such patients. The transposition of omentum permits removal of neoplastic and secondarily infected tissue including sternum, ribs and chest wall muscles if necessary. Fourteen patients underwent hormonal manipulation and 8 patients chemotherapy before surgical referral, which was often as a last resort for ulcerated and secondarily infected masses. Three patients required concomitant chest wall excision. There was no mortality and no long-term morbidity. Local disease was completely eradicated in 9 patients, although 2 now have distant disease; 4 patients had marked symptomatic improvement despite failure to control local disease and 4 patients had poor results. Dermal lymphatic involvement and failure to resect all macroscopic disease accounted for all of the local failures. Omental transposition can provide a safe, effective and occasionally curative surgical means of dealing with these difficult local recurrences in irradiated breasts.

Adult↗
PubMed1986

Damsels in distress: dependency themes in fiction for children and adolescents.

In a study of dependency themes in 113 recently published fictional books for children and adolescents, females and males were compared in situations where one character helped or influenced another. Regardless of the context in which help was given, and regardless of whether it was of an active or passive nature, females were more likely to receive than to give help, and males were more likely to give than to receive help. Males were even more likely to provide emotional support or encouragement, a stereotypically female virtue. The cultural stereotype of the dependent female, however, was reflected in the girl and women characters.

Adolescent↗