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Biomedical subjects

J M Hamilton

Publications and source records attributed to J M Hamilton.

139 records · Page 8Linked to original sources
PubMedDate not supplied

Serial plication facelift.

In over 3,700 facelifts in the last 40 years, the author has evolved a simple technique with a natural look. All cases were done with conscious sedation and local anesthesia. Patients are ambulatory immediately following surgery and have a rapid recovery with little edema or ecchymosis. Nerve injuries are avoided, and the temple hairline and earlobe clefts are preserved. There are no ridges, dimples, or "joker lines." The superficial musculocutaneous system (SMAS) is tenuous or absent in older patients and one has difficulty in elevating heavy jowls and outer canthal tissues with the usual SMAS technique. Therefore, a serial plication starting low in the jowl and extending up the cheek, spaced 12-15 mm apart, laces the face up just like lacing a shoe, making the entire face firm and youthful. Neck plication pulls the tissues up behind the ear and a platysmal sling keeps the earlobe up in its normal position (Figs. 1-2). The deep tissues are tightened in the temple, the temple hair flap can actually be pushed forward and preserved. This adapts well with ancillary procedures and most patients return to work in 7-10 days.

Aged↗
PubMedDate not supplied

The utility of monitoring carcinoembyronic antigen during systemic therapy for advanced colorectal cancer.

To determine if pre-treatment serum carcinoembryonic antigen (CEA) levels or changes in CEA values during treatment have prognostic value, we reviewed five prior fluorouracil/leucovorin-based trials and identified 125 colorectal cancer patients with no prior chemotherapy for metastatic disease in whom CEA values were available. Although pre-treatment serum CEA values did not predict for clinical response or time to progression, serial monitoring of CEA appeared to be useful in patients with an elevated pre-treatment CEA, particularly when a decrease in CEA occurred in concert with radiographic evidence of disease response. The CEA nadir was a strong prognostic variable with respect to time to disease progression. A consistent rise in CEA values over the minimum value signals the need for radiographic re-assessment of the patient's disease status to rule out disease progression.

Adult↗
PubMedDate not supplied

Thymidylate synthase protein expression: Association with response to neoadjuvant chemotherapy and resection for locally advanced gastric and gastroesophageal adenocarcinoma.

PURPOSE: A phase II study of neoadjuvant fluorouracil, leucovorin, and interferon alpha-2a was conducted to determine the feasibility of this regimen's use and the response rates in patients undergoing resection for locally advanced gastric or gastroesophageal adenocarcinoma. Also, tumor protein expression of free, total, or bound thymidylate synthase before and after initial exposure to fluorouracil was quantitated to determine if thymidylate synthase expression is associated with response in this treatment setting. PATIENTS AND METHODS: Twenty-two patients with T3-4N0-2M0 gastric or gastroesophageal adenocarcinoma were treated with three cycles of neoadjuvant fluorouracil (370 mg/m2 intravenously on days 2 through 6), leucovorin (500 mg/m2 intravenously on days 2 through 6), and interferon alpha-2a (5x106 U/m2 subcutaneously days 1 through 7), followed by resection and three cycles of consolidation therapy. Endoscopic tumor biopsies were done in 13 patients before therapy and during cycle 2 of the 5-fluorouracil/leucovorin/interferon regimen, and total thymidylate synthase, free thymidylate synthase, bound thymidylate synthase, and percent complexed thymidylate synthase were quantitated by Western blot. Tumor protein expression was evaluated for its association with response to neoadjuvant therapy and patient survival. RESULTS: Eight of 21 (38%) evaluable patients had a partial response, and another 5 of 21 (24%) had a minor response (25% to 49% tumor reduction) after three cycles of neoadjuvant fluorouracil/leucovorin/interferon. The pretreatment total thymidylate synthase level was significantly higher in five nonresponders than in eight responders. After exposure to fluorouracil, levels of free thymidylate synthase were significantly lower and the percent bound thymidylate synthase was higher in responders than in nonresponders. The median potential follow-up period is 24 months, and 11 of 21 patients have died from disease. CONCLUSIONS: These preliminary results indicate that a response to neoadjuvant fluorouracil-based therapy may be associated with decreased levels of total thymidylate synthase before therapy and free thymidylate synthase after exposure to fluorouracil in patients with locally advanced gastric cancer. Quantification of thymidylate synthase protein expression before and after exposure to fluorouracil may provide a method to select patients for fluorouracil therapy in the neoadjuvant, adjuvant, or advanced-disease setting based upon the fundamental sensitivity of the tumor.

Adenocarcinoma↗