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Biomedical subjects

J B Aust

Publications and source records attributed to J B Aust.

At least 37 records · Page 2Linked to original sources
PubMed1986

Pancreatic cancer: continuing diagnostic and therapeutic dilemma.

Improved survival for patients with cancer of the pancreas awaits future therapeutic advances. A more immediate objective for these patients is to provide accurate diagnosis and effective palliation. Adherence to a diagnostic strategy should provide an accurate diagnosis with the least number of tests, minimizing cost to the patient in terms of both money and discomfort. Effective palliation using a variety of available techniques can and should be accomplished expeditiously in order to extend useful survival.

Adult↗
PubMed1986

The value and cost effectiveness of abdominal roentgenograms in the evaluation of stab wounds to the abdomen.

The value of roentgenograms of the abdomen in the evaluation and management of stab wounds to the abdomen has not been well documented. This retrospective study demonstrates that the overwhelming majority of patients with injury requiring repair have normal roentgenograms. We also found that, even when abnormal, abdominal roentgenograms make a negligible contribution to the evaluation in these patients. These findings indicate that abdominal roentgenograms are not cost effective in patients with stab wounds to the abdomen and should not be obtained on a routine basis.

Abdominal Injuries↗
PubMed1985

Hemicorporectomy.

Translumbar amputation (hemicorporectomy) was first successfully performed in 1961 after cadaver feasibility dissections. It is useful for certain slow-growing malignancies of the pelvis and perineum and for patients with advanced sepsis involving pelvic bony structures. As indicated by our 20-year experience, the operation may be rewarded by control of a malignant process (two patients) and/or relief from chronic pelvic sepsis (four patients), survival and discharge from the hospital after lengthy rehabilitation (six patients).

Adult↗
PubMed1985

Glucagon enhances growth of cultured human colorectal cancer cells in vitro.

Early passage in vitro cultures of colorectal adenocarcinoma cells were used to determine if glucagon exerts a direct effect on growth of human colon cancer cells. Growth response assays indicated that glucagon generally stimulated growth between 2 and 10 micrograms/ml, with peak responses at 5 to 10 micrograms/ml. When glucagon-treated and control cultures were compared, 12 of the 14 cultures (86 percent) were stimulated by glucagon, with an increase in cells from 41 to 100 percent. The other two cultures did not respond to glucagon. These in vitro results suggest that glucagon may enhance growth of most colon cancer cells. Further studies on responsiveness to glucagon may help elucidate mechanisms of oncogenesis and suggest new therapeutic protocols for patients with colorectal cancer.

Adenocarcinoma↗
PubMed1984

Human colon cells: culture and in vitro transformation.

Normal human colon mucosal epithelial cells were cultured in vitro and treated with the oncogenic simian DNA virus (SV40) and the chemical carcinogen azoxymethane. Both SV40 and azoxymethane altered a number of phenotypic characteristics of the normal human colon cells, including their morphology, culture longevity, growth in soft agar, substrate adherence, and peanut agglutinin binding. The SV40 transformants synthesized intranuclear T antigen. These data indicate that normal human colon mucosal cells were transformed toward the malignant phenotype.

Antigens, Viral, Tumor↗
PubMed1984

Operative management of thyroid disease. Technical considerations in a residency training program.

Experience with 294 thyroid operations at Medical Center Hospital as performed by resident housestaff in general surgery has been reported. Operative results were consistent with the morbidity and mortality figures from large reviews. The importance of an active role for surgical housestaff in the operative management of thyroid disease is emphasized. With close supervision and attention to intraoperative identification of the recurrent laryngeal nerves and parathyroid glands, satisfactory results can be achieved.

Adult↗
PubMed1983

Isolated cystic dilatation of the cystic duct.

Presented was an unusual case of congenital cystic dilatation of the extrahepatic biliary tract in which the cystic changes were confined solely to the cystic duct. There was concomitant common bile duct obstruction secondary to inflammation and mass effect from the cyst. Management consisted of cholecystectomy, excision of the cyst, common bile duct exploration, examination of the ampullary region by duodenotomy, and choledochoduodenostomy.

Bile Duct Diseases↗
PubMed1982

Traumatic splenic injury: its management in a patient population with a high incidence of associated injury.

Nonoperative management of splenic trauma is receiving increasing support following delineation of the spleen's role in infection. Controversy regarding the proper management of this injury led us to study retrospectively 236 consecutive patients with splenic trauma. Blunt trauma occurred in the majority (161); the remainder suffered penetrating abdominal injury secondary to gunshot or stab wounds. Diagnostic peritoneal lavage was accurate in establishing splenic injury in blunt trauma (no false-positive, but three false-negative findings). Associated intra-abdominal injury occurred in 48% and 92% of patients with blunt and penetrating trauma, respectively. Diagnostic peritoneal lavage is an accurate method for establishing an intra-abdominal injury and the need for abdominal exploration in patients with blunt abdominal trauma. Because of the high rate of associated intra-abdominal injury in splenic trauma, nonoperative management can be expected to result in a disturbing incidence of missed intra-abdominal injury in patients with abnormal peritoneal lavage findings.

Abdominal Injuries↗
PubMed1981

Simple closure of perforated peptic ulcer. Still an effective procedure for patients with delay in treatment.

Sixty patients (mean age, 50 years) underwent simple closure of a perforated peptic ulcer. For 56 patients, average delay in treatment was 21.6 hours. Postoperatively, 21 patients (treatment delay, 30 hours) had either pulmonary or abdominal complications. Ten patients (treatment delay, 34 hours) died. Acute onset of ulcer symptoms prior to perforation was associated with a threefold increase in mortality compared with patients with chronic symptoms. Seven patients subsequently underwent vagotomy and partial gastrectomy without complications. This study demonstrates that in patients with peptic ulcer disease, perforation is an unusually frequent indication for operation; advanced age, treatment delay of 30 hours or more, and acute ulcer symptoms are associated with increased morbidity and mortality; and simple closure of the perforation remains an effective procedure in patients who have delayed seeking treatment.

Adolescent↗
PubMed1979

Combination chemotherapy for soft-tissue sarcomas: a phase III study.

A total of 144 patients with advanced sarcomas were entered into a randomized prospective protocol with four treatment arms utilizing different combinations of chemotherapeutic agents. Of these, 120 patients (83%) were judged acceptable. Treatment 1: actinomycin-D (Act-D), 0.01 mg/kg IV, days 1--5; phenylalanine mustard (L-PAM), 4 mg PO, days 1--10 every six weeks. Treatment 2: Act-D, 0.01 mg/kg IV, days 1--5; L-PAM, 4 mg PO, days 1--10; vincristine, 1 mg IV, days 1, 8, 15, 22, 29, 36, repeat every six weeks. Treatment 3: Act-D, 0.01 mg/kg IV, days 1--5; L-PAM, 4 mg PO, DAYS 1--10; NSC-1026, 200 mg/kg IV, days 1--6. Treatment 4: Adriamycin, 0.4 mg/kg IV, days 1, 2, 3, 8, 9, 10, then 2XWK starting day 15 (max. 1,200 mg). There was a provision that upon progression of the disease in the first three treatment regimens, patients would be crossed over to Treatment 4. Responses were as follows: 1 - Partial Response (PR) 1/25; No Change (NC) 9/25 (36%). gF2 - NC 17/26 (65%). 3 - NC 13/25 (52%). 4 - Complete Response (CR) 1/41; PR 6/41; (15%); NC 27/41 (66%). Clearly Treatment 4 was the best arm, with a 17% response rate and an initial progression rate of 17%. The only other response was a partial in 1. The difference is statistically significant (H = 17.247, P = 0.0006). If the responders to Adriamycin were analyzed without crossovers, the response rate would be 22% (6/27). (H = 14.079, P = 0.003). Median times to progression were 12.5, 8.7 weeks for 1 and 2, and 5 weeks for 3 and 4. There was no significant difference in the median survival times among the four treatment arms. It appears that Adriamycin as a single drug is superior to the drug combinations and would probably be even more effective used in combination with known active agents.

Antineoplastic Agents↗
PubMed1979

5-FU versus combination therapy with tubercidin, streptozotocin, and 5-FU in the treatment of pancreatic carcinomas: COG protocol 7230.

From May 1972 until May 1976, 105 patients were entered on Central Oncology Group protocol 7230 to compare the combination of streptozotocin, tubercidin, and 5-fluorouracil (5-FU) versus 5-FU alone in the treatment of adenocarcinoma and islet cell carcinoma of the pancreas. Twenty-nine were not evaluable. Thirty-six evaluable cases received 5-FU, and 40 received the combination, with no significant difference in time to progression or survival. Toxicity in the two regimens was somewhat different but was essentially similar in magnitude. Results indicate no benefit in the treatment of adenocarcinoma of the pancreas with the three-drug combination over 5-FU alone. All of the islet cell tumor patients benefited from the combination by response or arrest of progression of disease. Further study should be directed toward the use of this combination in the treatment of functioning and non-functioning islet cell tumors of the pancreas.

Adenocarcinoma↗
PubMed1979

Results of a prospective randomized study of hepatic artery infusion with 5-fluorouracil versus intravenous 5-fluorouracil in patients with hepatic metastases from colorectal cancer: A Central Oncology Group study.

In a controlled, prospectively randomized trial, 74 patients with hepatic metastases from colorectal cancer were randomized to either intra-arterial hepatic artery infusion with 5-fluorouracil (5-FU) or systemic chemotherapy with 5-FU. In 61 acceptable patients, there was no significant difference in terms of response rate, time to progression, duration of the response, and survival rate. Though the response rate for the intra-arterial infusion arm was slightly higher than for the systemic arm, the difference was not significant, and the intra-arterial infusion arm was associated with a greater incidence of nausea, vomiting, diarrhea, in addition to complications of femoral-arterial thrombosis, bleeding, and infection at the catheter site not seen in patients treated by systemic chemotherapy. Patients with an objective response to chemotherapy on either treatment arm survived twice as long as the nonresponders. Long-term survival in one patient, 77 months, can occasionally be achieved in patients with hepatic metastases.

Adenocarcinoma↗