Search PubMed⌕ Search

Biomedical subjects

J Hollander

Publications and source records attributed to J Hollander.

At least 19 recordsLinked to original sources
PubMed1995

Ultrasound-guided high dose rate conformal brachytherapy boost in prostate cancer: treatment description and preliminary results of a phase I/II clinical trial.

PURPOSE: To improve results for locally advanced prostate cancer, a prospective clinical trial of concurrent external beam irradiation and fractionated iridium-192 (Ir-192) high dose rate (HDR) conformal boost brachytherapy was initiated. METHODS AND MATERIALS: Between November 1991 and February 1994, 99 implants were performed on 33 patients with prostatic adenocarcinoma at William Beaumont Hospital. Using AJCC staging criteria, 9 patients had T2b tumors, 17 patients had T2c tumors, and 7 patients had T3 disease. Patients were treated with (a) 45.6 Gy whole pelvis external irradiation and (b) three HDR fractions of 5.5 Gy each (18 patients) or 6 Gy each (15 patients) to the prostate. Transperineal needle implants using real-time ultrasound guidance with interactive on-line isodose distributions were performed on an outpatient basis during weeks 1, 2, and 3 of external irradiation. Acute toxicity was scored using the Radiation Therapy Oncology Group (RTOG) morbidity grading system. RESULTS: This technique of concurrent external pelvic irradiation and conformal HDR brachytherapy was well tolerated. No significant intraoperative or perioperative complications occurred. Three patients (9%) experienced Grade 3 acute toxicity (two dysuria and one diarrhea). All toxicities were otherwise Grades 1 or 2 and were primarily as expected from pelvic external irradiation. Persistent implant-related toxicities included Grades 1-2 perineal pain (12%) and hematospermia (15%). Median follow-up time was 13 months. Serum prostatic-specific antigen (PSA) levels normalized in 91% of patients (29 out of 32) within 1-14 months (median 2.8 months) after irradiation. PSA levels were progressively decreasing in the other three patients at last measurement. Prospectively planned prostatic rebiopsies done at 18 months in the first 10 patients were negative in 9 out of 10 (90%). CONCLUSIONS: Acute toxicity has been acceptable with this unique approach using conformal high dose rate Ir-192 boost brachytherapy with concurrent external irradiation. The initial tumor response as assessed by serial PSA measurement and rebiopsy is extremely encouraging. Dose escalation will proceed in accordance with the protocol guidelines. Further patient accrual and longer follow-up will allow comparison to other techniques.

Adenocarcinoma↗
PubMed1991

Clinical evaluation of stenosis of the carotid bifurcation with magnetic resonance angiographic techniques.

We evaluated the images of 60 carotid artery bifurcations in 31 patients suspected to have carotid artery disease who underwent invasive carotid angiography and combined two-dimensional, phase-sensitive and a gradient-echo magnetic resonance angiography. The phase scans consisted of seven serial projections that were obtained at 20 degrees intervals (11.0 minutes) around the carotid bifurcation; the gradient-echo (GRASS) scans were composed of 11 axial images (2.4 minutes) acquired through the bifurcation. The two magnetic resonance angiographic techniques yielded complementary pieces of information and were used together to compare magnetic resonance angiography with invasive angiography. Comparison of magnetic resonance and invasive angiograms of the 60 carotid arteries shows that the sensitivity (86%) and specificity (92%) of the magnetic resonance angiographic techniques we used to diagnose clinically significant carotid stenosis approach but do not reach those of invasive angiography.

Aged↗
PubMed1988

Vertebrobasilar dolichoectasia: assessment using MR.

We evaluated six patients with vertebrobasilar dolichoectasia (VBD) comparing clinical presentation with magnetic resonance (MR) and computed tomography (CT) imaging. MR diagnosed the condition as well as CT in all cases, but proved superior to CT in delineating the anatomical relationship of the vessels to the neural structures. MR proved especially useful in cases of VBD-associated hydrocephalus and posterior fossa masses. A coexisting tumor was diagnosed by MR in one case.

Aged↗
PubMed1987

Dizziness.

Explore the source record for details and available documents.

Dizziness↗
PubMed1985

Management of perirenal hematoma found during laparotomy in patient with multiple injuries.

The medical records of 158 patients with perirenal hematoma found during laparotomy for intra-abdominal injury from external trauma were analyzed. Small perirenal hematomas were usually associated with renal contusions and renal artery thrombosis, while large perirenal hematomas often were present with large renal lacerations, renal ruptures, and renal pedicle injuries with rupture of the renal vein, renal artery, polar artery, or branch of the renal artery. The management of the perirenal hematoma found during laparotomy depends on the degree of the underlying renal injury and not on the size or extent of the perirenal hematoma.

Adult↗
PubMed1983

Cardiobacterium hominis: an elusive cause of endocarditis.

Cardiobacterium hominis is a fastidious bacterium of the normal mouth flora. It has rarely been recognised in the past as a human pathogen and has been difficult to recover from the bloodstream. Mistaken diagnoses and delays in therapy have been common. We report a 29-year-old man with C. hominis endocarditis who was initially treated for a presumed collagen-vascular disorder with anti-flammatory drugs. The organism was eventually recovered in brain-heart infusion medium after prolonged incubation, and cure was accomplished with parenteral penicillin. Special blood culturing methods should be used if endocarditis caused by a fastidious organism is clinically suspected.

Adult↗
PubMed1983

A high protein, low calorie liquid diet in the treatment of very obese adolescents: long-term effect on lean body mass.

The use of Optifast-70, a high protein liquid diet, when used in the range of 500 to 700 cal over 5 months in very obese adolescents, was associated with weight loss of 20 to 25% of initial weight of which 70 to 75% of the loss was due to fat. No significant side effects were noted. Twenty-four hour electrocardiographic monitoring showed no significant changes, and linear growth continued. Lean body mass loss was 36% of the weight lost during the first 5 wks, but was only 10% of the weight lost during the next few months. Two adolescent males had negative phosphorus and nitrogen balances over the first 4 wk, implying that males may have slightly higher phosphorus, nitrogen, and calorie requirements.

Adolescent↗
PubMed1983

Diuretic-induced azotemia: unmasking the role of increased peripheral catabolism through evisceration-hepatectomy.

By abolishing the large splanchnic uptake of amino acids, evisceration-hepatectomy unmasks the tendency for peripheral tissues to release increased amounts of amino acids into the extracellular fluid during sodium depletion. The increase in amino acid delivery to the liver may stimulate hepatic urea synthesis both by providing more substrates for conversion to urea and perhaps also by stimulation of the activity of urea cycle enzymes.

Amino Acids↗
PubMed1981

Renal involvement in Refsum's disease.

Renal hemodynamic and tubular functions were measured in a patient with Refsum's disease before and after 12 weeks of twice-weekly plasmaphereses. Percutaneous renal biopsy was performed before initiation of plasmapheresis. These studies were performed to (1) define the nature of the renal lesions and the effects of phytanic acid accumulation on renal functions, and (2) assess the effects of lowering the plasma phytanic acid level on renal functions. The patient, a 39 year old woman, had lipiduria, glycosuria, cylindruria, minimal proteinuria and mild azotemia initially. Renal lesions consist of extensive vacuolization and mitochondrial changes of the tubular epithelial cells, vacuolization of the visceral epithelial cells of the glomeruli, and slight to moderate mesangial sclerosis. The impaired renal hemodynamic function and various tubular functions improved following plasmaphereses associated with reduction of plasma phytanic acid. Over-all clinical improvement was also evident.

Adult↗
PubMedDate not supplied

Ecological transition: using Bronfenbrenner's model to study sexual identity change.

Bronfenbrenner's (1979) ecological transition model provides a framework to study coming out in lesbians. The model takes into account activities such as sexual behavior, perceptions of the behavior, and social context in which behavior takes place. The importance of context makes this model useful in identifying possible connections between sexual identity alterations and larger social forces. Interventions based on this framework can reduce stress and promote health during coming out.

Female↗