Search PubMed⌕ Search

Biomedical subjects

J Miles

Publications and source records attributed to J Miles.

At least 145 records · Page 8Linked to original sources
PubMedDate not supplied

The management of carcinoma of the nasal vestibule.

Forty-two patients with squamous cell carcinoma of the nasal vestibule were reviewed. The patients were treated at either the Southern California Permanente Medical Group or the UCLA Medical Center. Thirty-eight patients (90%) had early lesions and 4 (10%) had late disease (involving the nodes or bone). The following conclusions were formed from this study: (1) Patients without bone destruction or lymph node metastases will do well with either irradiation or surgery. Those with bone destruction or lymph node metastases will do poorly in spite of radical treatment. (2) Early lesions can often be cured with either partial rhinectomy or irradiation. (3) A surgical recurrence following partial rhinectomy can be salvaged with irradiation. (4) A radiation recurrence of an early lesion can be salvaged with surgery. (5) The routine use of total rhinectomy for early carcinoma or radiation failure is unwarranted. (6) Other primary cancers are not uncommon when followup is extended to the 5- to 10-year interval.

Adult↗
PubMedDate not supplied

Local control of T1 vocal cord cancer with radiation therapy: the importance of tumor character vs. treatment parameters.

Ninety-one patients with T1 vocal cord carcinoma received primary irradiation treatment. The 5- and 10-year determinate disease-free survival was 80%; the 5- and 10-year determinate survival including surgical salvage was 92%. Tumors involving more than one-half of a vocal cord or involving the anterior commissure or exhibiting an exophytic growth pattern had numerically, but not statistically, higher local failure rates than tumors without these characteristics. Precise radiation treatment technique appears more important for local control (LC) than tumor character. The crucial treatment factors for high LC with few radiation complications are reproducible daily patient positioning, use of contour-compensating devices (wedges), field size of 5 X 5 cm, and a radiation prescription with a time-dose fractionation value of 101 to 106.

Carcinoma, Squamous Cell↗
PubMedDate not supplied

Electrical spinal-cord stimulation for painful diabetic peripheral neuropathy.

BACKGROUND: Conventional treatment for painful peripheral diabetic neuropathy is largely symptomatic and often ineffective, with unacceptable side-effects. We tested electrical spinal-cord stimulation for the management of chronic neuropathic pain. METHODS: Ten diabetic patients who did not respond to conventional treatment (mean age 51 [SD 9.3] years, six with type II diabetes, mean duration of diabetes 12 [6.3] years, mean duration of neuropathy 5 [2.1] years) were studied. The electrode was implanted in the thoracic/lumbar epidural space. Immediate neuropathic pain relief was assessed by visual analogue scale (VAS) after connecting the electrode, in a random order, to a percutaneous electrical stimulator or to a placebo stimulator. Exercise tolerance was assessed on a treadmill. FINDINGS: Eight subjects had statistically significant pain relief with the electrical stimulator (p < 0.02) and were therefore converted to a permanent system. Statistically significant relief of both background and peak neuropathic pain was achieved at 3 months (n = 7, p = 0.016), at 6 months (n = 7, p = 0.03), and at the end of the study (14 months, n = 7, background pain p = 0.06, peak pain p = 0.03). One patient died 2 months after the start of the study of unrelated cause while continuing to benefit from treatment and another patient ceased to benefit at 4 months. McGill pain questionnaire scores with the stimulator turned off did not change significantly from baseline scores, indicating that the severity of the underlying pain was unaltered. However, with the stimulator turned on, there was a statistically significant (p < 0.05) improvement in all four components of the score, by the end of the study. At the end of the study, six patients continued to gain significant pain relief and used the stimulator as the sole treatment for their neuropathic pain. For example, median background and peak pain scores at the end of study, were, respectively, 77 and 81 with the stimulator off and 23 and 20 with the stimulator on. Exercise tolerance significantly improved at 3 months (n = 7, median % increase 85 [IQR, 62-360], p = 0.015) and at 6 months (n = 6, 163 [61-425], p = 0.0007). Electrophysiological tests, vibration perception-threshold, and glycaemic control were unchanged. INTERPRETATION: Electrical spinal-cord stimulation offers a new and effective way of relieving chronic diabetic neuropathic pain and improves exercise tolerance. The technique should be considered in patients with neuropathic pain who do not respond to conventional treatment.

Chronic Disease↗
PubMedDate not supplied

An introduction to attenuation correction.

Attenuation correction techniques have demonstrated improved diagnostic accuracy and quality of myocardial perfusion SPECT images in limited studies. The future success of these methods relies largely on understanding the characteristics of the images and their interpretative meaning, as well as their limitations. It will be important to define the impact on patient management decisions, quantitation, laboratory efficiency physician confidence, and communication of important findings. Advances in these areas will help position nuclear cardiology to compete with other imaging modalities. As this technology matures, the technologist has an essential role in ensuring efficient use of these techniques and maximizing the quality of this promising new way to image patients.

Artifacts↗
PubMedDate not supplied

Substrate metabolism in humans: 1995 A.S.P.E.N. research workshop.

BACKGROUND: The 1995 A.S.P.E.N. Research Workshop was held at the annual meeting in Miami Beach, Florida, on January 15, 1995. The workshop focused on substrate metabolism in humans. METHODS: State-of-the-art presentations on the regulation of energy, carbohydrate, lipid, and protein metabolism during health and disease were made by the preeminant leaders in the field. The presentations concentrated on in vivo studies performed in humans and included both recently published and unpublished data. RESULTS: Using sophisticated research methodology, such as nuclear magnetic resonance spectroscopy, compartmental modeling, stable isotope tracers, microdialysis, and abdominal vein catheterization, the investigators presented data that clarified unresolved issues, challenged many previously held dogmas, and raised new questions for future investigations in human intermediary metabolism. CONCLUSIONS: This workshop demonstrated that in vivo investigation remains the best approach for providing physiologically relevant data in humans. An understanding of normal human physiology and the metabolic alterations caused by disease is critical for optimal nutritional and metabolic management of patients.

Carbohydrate Metabolism↗
PubMedDate not supplied

A randomized phase III trial of cisplatinum, methotrexate, cisplatinum + methotrexate, and cisplatinum + 5-fluoro-uracil in end-stage head and neck cancer.

In a previous phase III trial of chemotherapy for patients with end-stage squamous cell carcinoma of the head and neck we have shown that Bleomycin shortened the survival period, compared with untreated controls. The survival of patients treated with Cisplatinum and Bleomycin did not differ significantly from untreated patients, but Cisplatinum significantly prolonged survival. A further similar trial is reported here, the four treatment arms were Methotrexate alone, Cisplatinum alone, Cisplatinum + Methotrexate, and Cisplatinum + 5-Fluoro-uracil. The response rates were: Methotrexate alone 19%, Cisplatinum alone 40%, Cisplatinum + Methotrexate 31%, and Cisplatinum + 5-Fluoro-uracil 33%. The median survival time for the Cisplatinum alone group, 260 days, was significantly longer than the 80 days for the Methotrexate alone group. The median survival times for Cisplatinum + Methotrexate (160 days) and for Cisplatinum + 5-Fluoro-uracil (200 days) did not differ significantly from that for Cisplatinum alone.

Antineoplastic Combined Chemotherapy Protocols↗