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Biomedical subjects

J F Wilson

Publications and source records attributed to J F Wilson.

At least 235 records · Page 13Linked to original sources
PubMed1983

Breast cancer treatment--current status. 3. Simple excision with irradiation.

Although radical dissection has been standard treatment for breast cancer for over 80 years, sharp controversy persists regarding the best management for early breast cancer. The trend over the past 20 years has been toward progressively limited surgery followed by irradiation. Recently, results of several retrospective series of early breast cancer in which simple excision of a small tumor was followed by aggressive irradiation showed that tumor control and relapse-free survival rates were equivalent to those achieved by other therapies. Further confirmation of these findings is needed before this breast-sparing technique can become the treatment of choice in early breast cancer.

Axilla↗
PubMed1983

Comparison of assay methods used to measure antiepileptic drugs in plasma.

The various techniques used to measure the concentration of antiepileptic drugs in plasma have been compared using data from the HEATH-CONTROL external quality control scheme. Assay methods were categorized as gas-liquid chromatography with and without derivatization (GLC + D, GLC-ND), radio- and enzyme multiplied immunoassay (RIA, EMIT), thin-layer and high-pressure liquid chromatography (TLC, HPLC), and spectrophotometry and colourimetry. The accuracy of the methods was determined from differences of measurements from the levels of drugs spiked into the samples. Most methods significantly underestimated the spiked drug concentrations. Comparisons of assay precision were made with the standard deviation of measurements or from the performance of individual laboratories in a ranking procedure. Comparable significant differences were found in both analyses. RIA followed by GLC-ND were the least variable methods for phenytoin; EMIT and then GLC-ND were the best for both phenobarbitone and primidone. Spectrophotometric measurements of phenobarbitone were unacceptably variable. TLC and colourimetry performed well for carbamazepine, whereas the GLC methods were the most variable. HPLC topped the list for ethosuximide, whereas EMIT had difficulty with this drug. Methods used for valproic acid were similar in precision. GLC + D was consistently less effective for all drugs when compared with GLC-ND.

Anticonvulsants↗
PubMed1983

Internal mammary lymphoscintigraphy in patients with breast cancer. Correlation with computed tomography and impact on radiation therapy planning.

Twenty patients with Stage I or II breast cancer, all of whom had undergone radiation therapy planning, were examined with internal mammary lymphoscintigraphy (IMLS) and computed tomography (CT). Based on the results of IMLS, radiation fields were revised in 12 cases (60%). The mean number of nodes identified by IMLS in each patient was 7.8, which is in agreement with previously published autopsy and scintigraphic data. CT identified 243 possible nodes of normal size, but only 49 of them were within 10 mm of regions shown to be positive on the scintigram. The authors conclude that IMLS is the method of choice for defining parasternal lymphatic drainage and identifying those internal mammary nodes that are normal in both size and function.

Adult↗
PubMed1983

Serologic tests for diagnosis and post-treatment evaluation of patients with alveolar hydatid disease (Echinococcus multilocularis).

The indirect hemagglutination (IHA) and immunoelectrophoresis (IEP) tests were used for diagnosis and follow-up evaluation of 17 patients with alveolar hydatid disease caused by Echinococcus multilocularis. Follow-up periods ranged from 2 to 22 years. At the time of diagnosis 16 (94%) patients' sera gave IHA titers greater than or equal to 1:128. Serum specimens from 13 patients were examined by IEP; nine (69%) revealed the arc 5, and three of the four arc 5-negative sera revealed one or more non-characterized bands. Titers declined markedly during the first year following radical surgical resection of the larval lesions; in three cases clinical evidence of recurrence was preceded by rising serologic titers. Antibody has persisted at high levels in non-resected patients treated continuously with high doses of mebendazole.

Adolescent↗
PubMed1982

Local control and survival after external irradiation for adenocarcinoma of the prostate.

From 1966 through 1978, 128 patients with biopsy-proven adenocarcinoma of the prostate underwent external irradiation to the entire pelvis followed by additional irradiation with a field that encompassed the entire prostate with generous margins. Local recurrence was diagnosed when palpable regrowth occurred and was confirmed by biopsy. Eighteen patients (14%) had local recurrence. Actuarial (life table) local recurrence rates, however, were 24% for both for Stage B and C patients. Actuarial five year survival was 100% for the 10 Stage A patients, 91% for the 25 Stage B, and 78% for the 93 Stage C patients. Actuarial five year disease-free survival was 59% for Stage B and 69% for Stage C patients. Local recurrence was affected by the total dose to the whole pelvis and the dose at the center of the prostate. Disease-free survival was influenced by differentiation. High dose external irradiation to the prostate and regional lymph nodes offers the greatest probability of long-term disease-free survival for patients with localized disease. Late bowel complications were seen in 14 patients (11%), two of whom required colostomies. Late urinary tract complications were observed in five patients (4%).

Adenocarcinoma↗
PubMed1982

Behavioral preparation of patients for gastrointestinal endoscopy: information, relaxation, and coping style.

The effectiveness of two techniques for preparing patients to undergo a stressful medical examination was assessed using observer self-report, and physiological measures of distress during gastrointestinal endoscopy. Patients were either informed about expected sensations, trained in systematic muscle relaxation, or received normal hospital procedures. The influence of coping styles on the effectiveness of information and relaxation techniques was examined for measures of fear, avoidance, emotional control, arousability, and independence. Information and relaxation interventions reduced heart rate increases and observer ratings of distress during tube insertion. Relaxation training also increased positive mood change following the procedure. Interactions between coping styles and recovery measures suggested patients benefited most from preparation that matched their preferred coping style, but were not harmed by preparation that did not match their preferred style. Discussion focuses on how coping styles may interact with preparation procedures and suggests that the use of coping styles as criteria for excluding patients from certain preparation techniques is inappropriate.

Adult↗
PubMed1982

The surgical management of childhood bronchiectasis. A review of 96 consecutive pulmonary resections in children with nontuberculous bronchiectasis.

In 195 children with nontuberculous bronchiectasis, periodic bronchography and clinical examinations were conducted over a period of 16 years (average 9.4 years). This was provided a critical assessment of surgical accomplishments in 96 consecutive resections and a parallel observation of 111 cases not submitted to resection. The final clinical assessment of the surgical cases shows 75% to be well or much improved, 22% to be improved, and 4% unchanged, while patients not submitted to resection have remained largely unchanged (69%) or have become worse (23%). The isolated superior segment can be preserved in children with good results, provided there is clear bronchographic evidence that the segment is entirely free of disease. When partially diseased segments are retained and required to fill a large volume, there is a tendency for even slightly altered bronchi to deteriorate postoperatively. Serial bronchography has proved helpful in determining when the disease has reached a mature, stable state and in planning the extent of resection.

Adolescent↗
PubMed1982

Levels of alpha-melanotrophin in the human fetal pituitary gland throughout gestation, in adult pituitary gland and in human placenta.

alpha-Melanotrophin was detected by radioimmunoassay in the human fetal pituitary gland from 11 weeks of gestation. The peak hormone concentration of 3.4 nmol/g pituitary tissue was reached at 17-20 weeks. From 17 to 36 weeks of gestation the total gland content rose gradually from 28 to 102 pmol. During this latter period, the pituitary gland grew some 10-fold, with the result that the alpha-melanotrophin concentration declined steadily to 1.3 nmol/g. In the final month of gestation, both the total gland content and the concentration of alpha-melanotrophin rose significantly to 254 pmol and 2.4 nmol/g respectively. The variations in pituitary gland content of alpha-melanotrophin were consistent with a role for pars intermedia peptides in the fetus. alpha-Melanotrophin-like peptides were not demonstrated in human placental tissue.

Adult↗
PubMed1982

Recovery from surgery and scores on the Defense Mechanisms Inventory.

The validity of a shortened form of the Defense Mechanisms Inventory was examined in a population of adult females undergoing abdominal surgery. Recovery was measured by behavioral, self-report, and endocrine responses. High scorers on REV and low scorers on PRO, TAO, and DMI-AGG, a summary measure of DMI subscales, reported better moods and physical recoveries, used fewer medications for pain, and made less use of medical services during the month after discharge from the hospital. Low scorers on PRO, TAO, and DMI-AGG responded to surgery with increases in epinephrine and norepinephrine. High scorers on PRO, TAO, and DMI-AGG responded to surgery only with increased levels of norepinephrine. Little evidence was found to support interpreting the DMI as a measure of five defensive styles. A single dimension, aggressiveness, was hypothesized to account for variance in recovery explained by the DMI.

Adaptation, Psychological↗
PubMed1982

Dynamic body forces on axillary crutch walkers during swing-through gait.

By means of dynamic analysis and a series of experiments, peak dynamic forces on subjects ambulating with axillary crutches are evaluated. For swing-through times of about one second, the subjects needed to support from 1.1 to 3.4 times their body weight at their hands; but the horizontal loads at their axilla were much less, varying from 3 to 11 percent of body weight. Such data can be useful in selecting axillary crutches with sufficient padding at the axilla to minimize pressure on the sensitive nerves and blood vessels in this area; and in predetermining whether a patient is strong enough to use crutches, since he must support more than his own weight.

Biomechanical Phenomena↗
PubMed1981

Stage III nodular lymphoreticular tumors (non-Hodgkin's lymphoma): results of central lymphatic irradiation.

Since 1969, 29 previously untreated patients with Stage III nodular malignant lymphoreticular (MLT) have received total central lymphatic (TCL) irradiation. The volume irradiated included the entire abdomen, Waldeyer's ring, and preauricular nodes in addition to the usual regions encompassed by total nodal irradiation. Doses of 2000--3000 rads in three to six weeks were delivered to the nodal regions, liver, and spleen; fraction sizes ranged from 100 to 180 rads. Patients have been followed from one to ten years (median six years). The actuarial survival is 78% at five years, and the disease-free survival is 61%. There is no difference in disease-free survival of the patients with poorly differentiated lymphocytic vs. those with "histiocytic" or mixed cytology. Men and women had disease-free survivals of 82% and 43%, respectively. The long-term follow-up of these patients indicates that prolonged disease-free intervals are common after TCL irradiation, and some patients may be cured.

Abdominal Neoplasms↗
PubMed1981

Premalignant lymphoid hyperplasia preceding and coexisting with malignant lymphoma in the skin.

A primary malignant lymphoma of the skin had concurrent and antecedent lesions showing histologic changes of completely benign lymphoid hyperplasia. The malignant lymphoma itself evolved during a few years, although specimens from repeated biopsies had previously exhibited benign lymphoid hyperplasia. We urge that persistent benign lymphoid hyperplasia in its many clinical forms in the skin be recognized as a long-term premalignant lesion. Awareness of such a continuum of benign to malignant change aids in the interpretation of the histologic findings in these growths and alerts the clinician to the need for years of careful surveillance. Histologic assessment should indicate whether the specimen shows benign, indeterminate, or malignant change.

Female↗
PubMed1981

Behavioral preparation for surgery: benefit or harm?

Elective surgery patients were prepared for surgery with training in muscle relaxation or with information about sensations they would experience. Relaxation reduced hospital stay, pain, and medication for pain and increased strength, energy, and postoperative epinephrine levels. Information reduced hospital stay. Personality variables (denial, fear, aggressiveness) were associated with recovery and influenced patients' responses to preparation. Less frightened patients benefited more from relaxation than did very frightened patients. Nonaggressive patients reacted to information with decreased hospital stay along with increased pain, medication, and epinephrine. Aggressive patients responded to information with decreased hospital stay along with decreased pain, medication, and epinephrine. Patients using denial were not harmed by preparation. A catharsis/moderation model is proposed to explain the benefits of relaxation. This study suggests that behavioral preparation benefits even frightened, aggressive, or denying elective surgical patients.

Adaptation, Psychological↗
PubMed1981

Disappearance of immunoreactive alpha-melanotrophin from rat plasma following occlusion of different regions of the vascular bed.

The half-life for the disappearance of immunoreactive alpha-melanotrophin in plasma following intravenous injection of synthetic hormone was measured before and after occlusion of the blood supply to certain organs in the anaesthetized rat. Occlusion of the blood supply to the liver, gut, spleen and pancreas, and of the renal circulation caused non-significant increases in half-life of 2.8 and 10.7% respectively. The importance of peripheral tissues in the clearance of alpha-melanotrophin was demonstrated by the significant 63.4% increase in half-life caused by occlusion of the blood supply to sections of skeletal muscle, fat and skin.

Adipose Tissue↗