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Biomedical subjects

J Boland

Publications and source records attributed to J Boland.

At least 73 records · Page 4Linked to original sources
PubMed1983

An analysis of the role of radiotherapy alone and in combination with chemotherapy and surgery in the management of advanced breast carcinoma.

One hundred-eight consecutive patients with Stage III breast carcinoma received radiotherapy as the primary method of treatment. Of these, 53 had prior chemotherapy and 47 had a postirradiation mastectomy as planned adjunct modalities. The overall actuarial survival probability is 40 +/- 6% at five years and 14 +/- 6% at ten years. The corresponding probabilities of freedom from metastases are 27 +/- 5% and 14 +/- 5%, while those of local control are 58 +/- 8% and 52 +/- 8% respectively. The patients receiving chemotherapy show both increased five and ten year probabilities of metastatic control of 38 +/- 7% and 22 +/- 8% and also a five and ten year local control rate of 73 +/- 8%. The patients with additional mastectomy exhibit an improved five year local control rate of 80 +/- 8% but the probability of remaining free from metastatic disease is unaltered being 31 +/- 7% at five and 12 +/- 7% at ten years. The 23 patients receiving chemotherapy prior to radiotherapy, without a subsequent mastectomy have the highest metastatic control of 41 +/- 12% at five years. In this group, eight patients treated with time-dose factors (TDFs) of over 80 have had only one local failure with a preliminary five year local control probability of 80 +/- 18% and metastases-free rate of 58 +/- 19%. Based on these results recommendations are made for minimum tumor doses of 6000 rad and adjuvant chemotherapy. This should be delivered before radiotherapy, since with this sequence of treatment both local control and survival are improved.

Adenocarcinoma, Mucinous↗
PubMed1983

The limitations of the digitalized pulse timing oculoplethysmography in the diagnosis of bilateral significant carotid stenosis.

To critically analyze the accuracy of the Zira-OPG unit in the diagnosis of carotid stenosis, 161 patients (309 carotid arteries) out of 2500 patients tested were reviewed in comparison with angiogram. For practical purposes these patients were divided into several groups: 92 out of 101 normal arteries by OPG were confirmed by angiogram (91% true negative). Fifty-three out of 61 arteries with significant unilateral stenosis by OPG were confirmed by angiogram (87% true positive). Thirty-two out of 40 patients with significant stenosis on one side and mild on the other were picked by the OPG (80% true positive). Fifteen out of 27 patients with bilateral significant stenosis were confirmed by OPG (56%). Twelve out of 13 completely occluded arteries were confirmed by OPG. This unit is practical in detecting normal arteries, unilateral significant stenosis and bilateral disease if one side is mild but very limited in bilateral significant stenosis.

Adult↗
PubMed1982

Critical evaluation of serum uric acid levels in acute myocardial infarction.

Serial measurements of serum uric acid were performed on patients suffering from acute myocardial infarction. Nearly 80 percent of the cases demonstrated a fall in uric acid concentrations during the first two days of hospitalization and a subsequent return to initial levels within six to eight days. There was a relationship between the decrease in uric acid levels and the serum lactate dehydrogenase activity. No evidence could be found that male patients were hyperuricemic as compared to control subjects. However, female patients between 40 and 60 years of age demonstrated significantly higher uric acid levels than healthy women of corresponding ages, even after adjustment for diuretic use.

Aged↗
PubMed1982

The management of breast carcinoma by primary radiotherapy at Mount Sinai Hospital from 1962--1979.

Two-hundred eight patients with carcinoma of the breast were treated with megavoltage irradiation as the primary method of local management at Mount Sinai Hospital between 1962--1979. The effects of treatment volume, technique, and other parameters are discussed for the Stage I and II patients, together with the importance of tumor size and nodal status in control of local disease and distant metastases. In this series the cumulative probability of freedom from metastases is 93 +/- 5% when the irradiation is confined to the breast and axilla as compared with 72 +/- 9% when extended fields are used, with no difference in local control. Based on these results it was decided to confine irradiation to the breast and axilla alone in the majority of early stage cancer patients. Recommendations are made for radiation techniques and dosages to optimize control of the disease, minimize complications, and facilitate systemic therapy in patients with positive nodes.

Adult↗
PubMed1982

Patients with myocardial infarction and normal coronary arteriogram.

Eighteen patients who survived an acute myocardial infarction were found to have a normal coronary arteriogram. Seven patients were younger than 35 years and six were female. The myocardial infarction was nontransmural in 11 cases. The mean follow-up was 21.6 months. Eleven patients developed residual chest pain at rest early after myocardial infarction. One, treated by beta-blockers, suffered a recurrent myocardial infarction. Eight became asymptomatic, and two improved under antispastic therapy. Another patient developed a severe form of variant angina three months after myocardial infarction; she died following plexectomy. Finally, two patients experienced rare episodes of angina at rest. The stress ECG was negative in all cases. Provocative test for spasm was positive in three out of nine patients. Diffuse narrowing associated with chest pain was demostrated in two patients at angiography. Thus, myocardial infarction and subsequent normal coronary angiogram are mainly found in young female patients, and infarction is often nontransmural. Clinical evidence of vasospastic phenomena and increased vasomotor tone are found in most patients. Whenever residual chest pain is controlled by antispastic therapy, the follow-up course seems benign.

Adult↗
PubMed1982

[Short- and medium-term hemodynamic effects of prazosin in chronic refractory cardiac failure].

The hemodynamic effects of prazosin, a post-synaptic alpha blocker, were studied in 10 patients with chronic stable cardiac failure, in Classes III and IV of the NYHA classification, resistant to digitalis and diuretic therapy. The measurements of pressure and cardiac output were carried out by right heart catheterisation and thermodilution. The administration of the first dose (1 to 3 mg) led to a 38% reduction in mean right atrial pressure, a 22% reduction in mean pulmonary artery pressure, a 22 ù reduction of wedge pulmonary artery pressure and a 15% reduction of systemic vascular resistance. The systolic index rose by 20%, systemic blood pressure and heart rate remained unchanged. After 7 days, treatment with 3 to 12 ng/day of prazosin mean right atrial pressure had fallen by 54%, mean pulmonary artery pressure by 37%, and wedge pulmonary artery pressure by 48%. The systolic index increased by 27%. The blood pressure was unchanged, but the heart rate decreased by 10%. The patients lost an average of 2,7 Kg in weight. These results show that in the short term, prazosin had a mixed vasodilator effect on both arteries and veins. In the medium term the arterial vasodilator action appears to be significantly smaller but remains detectable with doses greater than 8 mg/day, whilst the venous vasodilator effect persists, unchanged.

Adult↗
PubMed1980

Intracellular action potential changes induced in both ventricles of the rat by an acute right ventricular pressure overload.

Eleven open chest, artificially ventilated rats were used to observe and compare the intracellular potential changes induced in the right and left ventricles by an acute right ventricular overload. Graded right ventricular hypertension was produced by external constriction of the main pulmonary artery. Transmembrane potentials were obtained using floating glass microelectrodes filled with 3 mol X litre-1 KCl and connected to a cathode follower through a silverchloride-silver junction. Following right ventricular overload, the level of resting potential was depolarised by 20% on the right ventricle and by 4% on the left (P less than 0.001). The repolarisation was not significantly affected. A significant correlation (P less than 0.01) was observed between the increase of right ventricular pressure and the depolarisation of resting right ventricular potential. The right ventricular distension which occurs in our experimental model thus induces a diastolic depolarisation of right ventricular muscle cells which cannot be neglected in the interpretation of the peripheral ECG changes.

Action Potentials↗