Search PubMed⌕ Search

Biomedical subjects

J Hanson

Publications and source records attributed to J Hanson.

At least 199 records · Page 11Linked to original sources
PubMed1987

Malignant pneumomediastinum: successful tube mediastinostomy in the neonate.

Five critically ill neonates underwent tube mediastinostomy in the neonatal intensive care nursery for tension pneumomediastinum. All of the neonates showed immediate clinical improvement, with a decrease in peak airway pressure and elevation of arterial oxygen pressure levels. There were no complications directly attributable to the procedure. We believe that pneumomediastinum in association with severe hypoxia, metabolic acidosis, and high ventilation pressures indicates clinically significant tension in the mediastinum. This results in a decrease in systemic blood pressure and pulmonary venous return that is not amenable to conservative management. Needle aspiration is inadequate because of the dynamic nature of the air leak. Tube decompression of the mediastinum is the treatment of choice in these circumstances.

Humans↗
PubMed1987

Critical evaluation of a pressure-sensitive capsule for measurement of esophageal varix pressure. Studies in vitro and in canine mesenteric vessels.

The accuracy and reliability of a noninvasive pressure-sensitive capsule for the endoscopic measurement of esophageal varix pressure was evaluated. Capsule pressure was correlated with direct intraluminal pressure measurements. The influence of vessel wall tension on capsule pressure was also assessed. In vitro studies demonstrated an excellent correlation (r greater than or equal to 0.94; p less than 0.001) between the pressure obtained with the capsule and intraluminal pressure over a range of vessel diameters and wall thicknesses. In vivo correlation of pressures obtained with the capsule with direct venous pressure measurements was excellent (r = 0.85). However, this correlation decreased with a decrease in vessel diameter (group 1 diameter greater than or equal to 10 mm, r = 0.95; group 2 diameter greater than or equal to 5 mm but less than 10 mm, r = 0.75; group 3 diameter greater than or equal to 3 mm but less than 5 mm, r = 0.81). This decrease in accuracy was significant (p less than 0.001) between group 1 and groups 2 and 3. In vitro and in vivo, capsule pressure variability was significantly greater (p less than 0.001) in vessels of smaller diameter. Wall tension significantly influenced capsule pressure (p less than 0.05), although this effect was only seen in large "vessels" with a diameter beyond a clinically relevant range. Therefore, despite obtaining technically acceptable capsule pressure measurements in ideal experimental conditions, the accuracy and variability of these measurements are limited by vessel size.

Animals↗
PubMed1987

Adjuvant chemoimmunotherapy after regional lymphadenectomy for malignant melanoma.

Thirty patients with malignant melanoma metastatic to regional lymph nodes who underwent either a full or partial node dissection were treated with adjuvant chemoimmunotherapy (CIT). In this pilot study, 11 patients were given intravenous (i.v.) DTIC plus intradermal (i.d.) BCG (D/BCG), 19 patients received i.v. DTIC, BCNU, and hydroxyurea plus oral BCG (DBH/BCG). Their overall survival (OS) and disease-free interval (DFI) following node dissection and CIT were compared with 33 historical control (HC) patients from the preceding 4 years, matched for the known prognostic factors in melanoma. The D/BCG group received a median of five courses, the DBG/BCG group six courses. Minimum follow-up of all patients is in excess of 7 years. No significant differences were observed in either DFI or OS from diagnosis between the two treatment groups or between CIT patients and HC patients. A highly significant difference was observed in DFI and OS in favor of the partial node dissection (PND) group when compared with full node dissection (FND) group. No other known variables in the PND group accounting for their improved survival are noted. Five patients in DBH/BCG and three in D/BCG group are still alive 84-114 months after completing therapy.

Adjuvants, Immunologic↗
PubMed1987

Mice transgenic for a vasopressin-SV40 hybrid oncogene develop tumors of the endocrine pancreas and the anterior pituitary. A possible model for human multiple endocrine neoplasia type 1.

The authors have used transgenic mice to study the activity of a hybrid oncogene made up of 1.25 kb of 5' upstream sequences, derived from the bovine vasopressin gene, promoting the expression of the large T-antigen coding sequences of the early region of simian virus 40. Rather than promoting tumorigenesis in vasopressinergic cells of the hypothalamus, expression and activity of the hybrid oncogene, and consequent tumor formation, were confined to insulin-producing beta cells of the endocrine pancreas and to cells in the anterior pituitary. These observations suggest that the specificity of vasopressin gene expression normally results from an interaction between several regulatory elements, some of which are absent from the hybrid oncogene. The possible relationship between the endocrine tumor syndrome found in the vasopressin-SV40 transgenic mice and familial human multiple endocrine neoplasia is discussed.

Adenoma, Islet Cell↗
PubMed1987

Methylphenidate associated with narcotics for the treatment of cancer pain.

Thirty-two patients with chronic pain due to advanced cancer were treated with methylphenidate (10 mg with breakfast and 5 mg with lunch) for 3 days, versus placebo, in a randomized, double-blind, cross-over study designed to evaluate the capacity of methylphenidate to potentiate the analgesic effect of narcotics and/or to decrease sedation induced by narcotics. In 28 evaluable patients, the intensity of pain (visual analogue 0-100) and intake of extra doses of analgesics (number of doses/day) were 43 +/- 27 and 2.2 +/- 2.4 during methylphenidate, versus 55 +/- 24 (P less than 0.02) and 2.9 +/- 2.9 (P less than 0.002) during placebo, respectively. Activity and drowsiness (visual analogue 0-100) were 57 +/- 25 and 58 +/- 24 after methylphenidate, respectively, versus 41 +/- 26 (P less than 0.05) and 45 +/- 27 (P less than 0.02) after placebo. Upon completion of the study, the investigator and the patient chose methylphenidate blindly as a more useful drug in 23 cases (83%) and 20 cases (70%), respectively (P less than 0.02). No cases of severe toxicity were observed. We conclude that methylphenidate can increase the analgesic effect and decrease sedation of narcotics in this population.

Adult↗
PubMed1986

Hospital stay following biliary tract surgery. A comparison of two community hospitals.

An apparent difference in length of postoperative hospitalization following biliary tract surgery at two university-affiliated community hospitals led to a retrospective review of 200 consecutive patients at each hospital. Patient characteristics and surgical practices that potentially affected hospital stay were compared. A highly significant difference was identified in the length of hospitalization between the two institutions. Statistically significant differences in variables that seemed to affect length of stay included the use of nasogastric tubes and abdominal drains and the time interval to the institution of postoperative feedings. Cumulative hospitalization was 517 days shorter at one institution. This was accomplished despite a high percentage of emergent procedures and more frequent involvement of surgical residents. Since hospital stay accounts for the majority of expenditure for surgical treatment of biliary tract disease, shortening postoperative hospitalization can significantly reduce the overall costs.

Adolescent↗
PubMed1986

Medical Communication Behavior System. An interactional analysis system for medical interactions.

The study assessed the psychometric properties of the Medical Communication Behavior System. This observation system records time spent by the physicians and patients on specific behaviors in the categories of informational, relational, and negative situation behaviors by using hand-held electronic devices. The study included observations of 101 genetic counseling sessions and also assessed the outcome measures of patient knowledge and satisfaction. In addition, 41 of the sessions were rated using the Roter Interactional Analysis System, and 20 additional control subjects completed the post-counseling information without being observed to examine the effects of recording the session. Results showed good interobserver reliability, and evidence of concurrent, construct, and predictive validity. No differences were found between the observed and unobserved groups of any of the outcome measures.

Behavior↗
PubMed1986

Study of cardiovascular autonomic insufficiency in advanced cancer patients.

To determine the incidence of cardiovascular autonomic insufficiency (CAI), 43 patients with advanced breast cancer and 20 normal controls were evaluated using electrocardiographic tests (heart rate variation during deep breathing and Valsalva maneuver and upon standing) and clinical tests (blood pressure variation during hand grip tests and upon standing). Nutritional status, tumor mass, Karnofsky performance status (PS) score (0-100), and peripheral reflexes were also determined. Tests for CAI were abnormal in 43 patients (52%), versus seven of 100 in 20 controls (7%, P less than 0.001). In cancer patients, tests for CAI were more frequently abnormal in patients with PS less than 60 (P less than 0.01), basal heart rate greater than 100 (P = 0.05), and malnutrition (P less than 0.01). We conclude that CAI is a frequent finding in patients with advanced breast cancer and should be suspected mainly in patients with a low PS, tachycardia, or malnutrition. It is probably a multifactorial syndrome, and malnutrition, drugs, decreased activity, or paraneoplastic syndromes are all possible causes for CAI.

Autonomic Nervous System↗
PubMed1986

Stress and caffeine: effects on central adenosine receptors.

The effects of two different kinds of stress (social and physical) on central adenosine receptors were investigated in mouse whole brain membranes using 1,3-diethyl-8-[3H]phenylxanthine ([3H]DPX) as a ligand. Chronic but not acute social stress induced an increase in the number of adenosine receptors similar to that induced by chronic, nontoxic doses of caffeine. Acute but not chronic social stress also induced an increase in the number of benzodiazepine receptors labeled by [3H]beta-carboline-3-carboxylate ethyl ester. The group submitted chronically to both stress and caffeine showed an increase in [3H]DPX binding relative to that found with either of these factors alone. The adenosine uptake site, labeled by [3H]nitrobenzylthioinosine, was not modified by either stress or caffeine administration.

Animals↗
PubMed1985

Analysis of "time to second primary" in patients with gynecological cancers.

Lifetable survival curves have been adapted to measure "time to second primary" and used to compare incidence of second primary in all patients in the Alberta Cancer Registry with a primary malignancy in cervix, endometrium and ovary. Comparisons were also obtained within each diagnostic category between patients treated or not treated with radiation. Results show that there are no statistically significant differences in the 25 years following diagnosis of the first primary in "time to second primaries" in patients with cancer of the cervix, endometrium or ovary. Similarly, within each diagnostic category, there are no differences between radiation treated patients and those not treated by radiation, when adjustments for age differences are made and when patients are selected by length of survival.

Adolescent↗
PubMed1985

Response to treatment and its influence on survival in metastatic breast cancer.

The clinical response to first systemic therapy of 381 patients with metastatic breast cancer was assessed; the influence of the category of this first response on eventual survival from diagnosis of first distant metastasis was analyzed. Survival from diagnosis of first distant metastasis was found to be similar whether the patient had a complete response, a partial response, or stable disease; only when progressive disease occurred with first systemic treatment was survival significantly shortened. This similarity in survival whatever the category of response from diagnosis of first distant metastases was found whether the patient received chemotherapy or hormone therapy as first systemic treatment, and whether the patient was premenopausal or postmenopausal; there was some suggestion on analysis of premenopausal patients treated with hormone therapy as first systemic therapy that a complete response conferred a survival advantage, but the numbers were small in this group. When complete responders to first systemic therapy as well as any other subsequent systemic therapy were analyzed for survival from diagnosis of first distant metastasis, again, no survival advantage could be found compared to the other response categories, but the complete response rate was low owing to the unselected nature of this group of study patients. It is concluded that the categories of complete, partial, or stable response to therapy have no great significance in terms of survival; the category of progressive disease to first systemic therapy is, however, associated with a shorter survival in all the analyses performed. We suggest that assessment of a treatment's worth should be based as much on the patient's subjective feeling of well-being as on the magnitude of the tumor response, since with currently available therapies, provided some form of response is obtained, the magnitude of the response does not appear to translate into any major survival advantage. This study points up the disparity between research-oriented criteria of response (survival, response rate, and its magnitude) and patient care criteria of response (survival and quality of life).

Adult↗
PubMed1985

Factors influencing the survival of patients with cancer of the stomach.

During the period 1969 through 1973, 332 male and 135 female patients diagnosed with stomach cancer were registered with the Cross Cancer Institute in Edmonton, Alberta. These patients were followed up to December 31, 1981. Therefore, we were able to observe eight year survival times for all patients. Rates for one to eight years of survival were calculated using the Kaplan-Meier method. The results showed poor survival experience for male and female patients, similar to survival reported in other countries. Stomach cancer in Alberta belongs to the ten most common cancers and a search for factors influencing survival is therefore important. A large number of environmental factors and factors pertaining to the patients' lifestyle, as well as clinical factors related to stage of disease and treatment were examined using Cox's proportional hazard model. Surgical treatment and the presence of metastases were found to be important determinants of survival for both sexes. In males, increased age and British ethnicity were associated with poor survival prospects. Relative hazards of dying are presented for various combinations of factors.

Adult↗
PubMed1985

Hypoglossal high threshold afferents projecting to the secondary somatosensory area in the cat.

Recording with microelectrodes in the anterior ectosylvian area of the cerebral cortex in cats showed responses on stimulation of the hypoglossal nerve. The responses persisted after cutting the hypoglossal rootlets close to the brainstem but disappeared after cutting the glossopharyngeal and vagal roots. The responses were high threshold and probably mediated by "pain fibers".

Animals↗
PubMed1984

Adjuvant BCG immunotherapy for malignant melanoma.

A total of 199 patients with stage I malignant melanoma at Clark's level 3 to 5 of invasion were entered into a prospectively controlled randomized clinical trial that attempted to assess the value of local and systemic immunotherapy with BCG (bacille Calmette-Guérin) after surgery. The patients were randomly assigned, with stratification by Clark's level, to receive either routine follow-up or immunotherapy with BCG, administered intradermally with a Heaf gun around the site of wide excision and then given orally for 2 years. Intradermal administration of BCG was repeated after 1 year's oral therapy with BCG. Of the 99 patients in the treatment group 66 had Clark's level 3, 28 had level 4, and 5 had level 5 invasion. Of the 100 patients in the control group, 61 had level 3, 36 had level 4, and 3 had level 5 invasion. Other prognostic factors, such as sex, depth of invasion, histologic features, site of disease and type of surgery, were evenly distributed. There were 57 recurrences of the melanoma, 24 in the treatment group and 33 in the control group. However, this trend was not statistically significant (p = 0.194). The suggestion that BCG may reduce the likelihood of local/regional recurrence has not been confirmed with longer follow-up. There were 13 such recurrences in the BCG group, compared with 21 in the control group; the proportions of patients in each group who had such a recurrence were not significantly different. Of the 199 patients 41 died, 24 in the control group and 17 in the treatment group; again, this difference was not significant. While there may be minor activity in selected patients, there appeared to be no benefit from this form of adjuvant BCG therapy in patients with malignant melanoma.

Administration, Oral↗