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Biomedical subjects

J R Anderson

Publications and source records attributed to J R Anderson.

At least 361 records · Page 20Linked to original sources
PubMed1984

Central nervous system relapse in unfavourable-histology non-Hodgkin's lymphoma: is prophylaxis indicated?

In 2 randomised, prospective Eastern Co-operative Oncology Group trials, the frequency of central nervous system (CNS) involvement after chemotherapy in 347 adults with stage III and IV unfavourable-histology, non-Hodgkin's lymphoma was 8.4%. The frequency varied from 0% in diffuse mixed lymphoma to greater than 30% in lymphoblastic and diffuse-undifferentiated lymphoma. Of the 42% of patients who achieved complete remission after chemotherapy, CNS involvement developed in 5.4% during relapse, but in only 2.7% was the CNS the sole site of relapse. CNS lymphoma arose in 6.6% of 197 patients with diffuse histiocytic lymphoma, but in only 1 subject (1%) was the CNS the sole site of relapse. Therefore, CNS prophylaxis is not indicated for the common diffuse-histology subtypes of adult non-Hodgkin's lymphoma including diffuse-histiocytic, diffuse-mixed and diffuse poorly differentiated lymphocytic lymphoma. The relatively high frequency of CNS lymphoma in lymphoblastic and diffuse undifferentiated lymphoma justify further studies of CNS prophylaxis.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1984

Studies on the pathology of non-Hodgkin's lymphoma of childhood. I. The role of routine histopathology as a prognostic factor. A report from the Children's Cancer Study Group.

Between April 1977, and August 1980, the Children's Cancer Study Group (CCSG) conducted a clinical trial of childhood non-Hodgkin's lymphoma (NHL), randomizing 256 patients to one of two treatment regimens. A 4-drug regimen (regimen 1, modified cyclophosphamide, Oncorin [vincristine], methotrexate, prednisone [COMP] ) was compared with a 10-drug regimen (regimen 2, modified LSA2-L2). Using the Rappaport classification, the review pathologist diagnosed the 213 evaluable tissue specimens as follows: lymphoblastic (LC), 73; Burkitt's tumor (BT), 40; "undifferentiated" non-Burkitt's type (NB), 67; large cell or "histiocytic" lymphoma (HI), 29; and other types (OT), 4. Concurrence in classification between the review and institutional pathologists was poor when using the above four categories; however, concurrence was 88% between the review pathologist and other hematopathologists, and 99% when classifying the specimens as lymphoblastic or nonlymphoblastic. For patients with nonlocalized disease, this randomized controlled study demonstrated a new important correlation of histopathology with the effectiveness of treatment. When analyzed without stratification into lymphoblastic and nonlymphoblastic types, the two regimens showed identical relapse free survival (RFS) curves for patients with nonlocalized involvement. However, when patients were stratified according to histologic classification, regimen 2 was superior to regimen 1 for patients with lymphoblastic lymphoma, achieving 74% RFS at 30 months compared to 31% for regimen 1 (P = 0.001). Conversely, those with nonlymphoblastic types (BT, NB, HI) treated with regimen 1 had a 58% RFS at 30 months compared to 32% for those treated on regimen 2 (P = 0.01). This study demonstrates that proper, routine histopathologic classification of NHL is the best criterion for choice of therapy in children with nonlocalized involvement. As a result of this study, all patients with nonlocalized disease, diagnosed after August 1980, were no longer randomized but were assigned to the appropriate treatment regimen based on prospective review of histopathology.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1984

Radiation-induced intracranial neoplasms. A report of three possible cases.

The pathologic findings are described in three patients who developed second intracranial neoplasms after irradiation for central nervous system malignancy. The second neoplasms were an astrocytoma, an ependymoma, and multiple meningiomas. All were histologically different from the first neoplasms and appeared in the field of irradiation between 3 and 15 years later. It is suggested that therapeutic irradiation was a causative factor in the development of these tumors.

Adult↗
PubMed1984

A reasoned approach to nasal base surgery.

Although remodeling the nasal base is one of the most demanding and important parts of rhinoplasty, it is usually taught and performed in such a seemingly empirical manner that the entire process becomes bewildering and mysterious to many students. Because the cartilaginous skeleton of the nasal base bears a striking resemblance to a tripod, we have been using remodeling techniques for the past 25 years that employ mechanical principles that could be used if one desired to change the configuration of a tripod.

Esthetics↗
PubMed1984

The face-lift incision.

Numerous variations of the "standard" face-lift incision are used to achieve adequate exposure, skin redraping , and minimal scar deformity. Our incision technique is based on careful study of over 1,000 of our patients who underwent rhytidectomies . We believe that our technique allows the goals of rhytidectomy to be achieved with minimal morbidity.

Cicatrix↗
PubMed1984

A controlled trial of bipolar electrocoagulation in patients with upper gastrointestinal bleeding.

We have assessed the value of the BICAP electrocoagulation probe in reducing the incidence of further bleeding in patients with upper gastrointestinal haemorrhage. One hundred and twenty-nine patients were studied in a prospective randomized controlled trial. There were 85 male and 44 female patients, age range 16-92 years. Forty-five patients had stigmata of recent haemorrhage (visible vessel or spot) and were randomized during endoscopy to 24 control and 21 treatment patients. Seven control patients rebled compared with nine treated patients (Fisher's exact probability test P = 0.44). The transfusion requirements of control patients (3.9 +/- 3.2 units) was not different from that of treated patients (5.7 +/- 3.7 units): Mann Whitney U test, P = 0.06. In the treatment group there was no difference in the operation rate. Also, the number of probe applications between patients with further bleeding and those with no further bleeding was similar (11.6 +/- 5.5 and 11.0 +/- 5.75 respectively). Access with the probe was considered inadequate in 50 per cent of lesions, but this did not correlate with the incidence of rebleeding. Stigmata of recent haemorrhage were significant in predicting rebleeding (P = 0.0019 Fisher's exact probability test). Overall mortality rate of 3.2 per cent was low and was not influenced by electrocoagulation or presence of stigmata of recent haemorrhage. We have not shown that BICAP bipolar electrocoagulation reduces the incidence of rebleeding in upper gastrointestinal haemorrhage.

Adult↗
PubMed1984

The development of self-recognition: a review.

The development of self-recognition has been studied mainly by examining infants' responses to their reflections in mirrors. The definitive test is whether or not the infant is capable of using the reflection to notice and respond to a mark on the face or head by touching the mark. The mark should be inconspicuous to the infant not looking in a mirror. In general, studies agree that this response appears in some infants around 15 months of age and is shown by a majority of infants by 24 months of age. There is less agreement over the existence of a "withdrawal" component in the second year, or the presence of a "social" phase analogous to the reaction of many animals confronted with a mirror. Infants as young as 3 months are differentially responsive to a self-reflection and a live peer. Various "self-conscious" reactions and self-labelling may also indicate self-recognition in the second year, but their validity is not well established. Studies using videotapes of the self and others show that contingency of movement is a salient cue which is learned early, and that attempts to engage in contingent play and to imitate representations of oneself are useful measures of early self-recognition. The validity of the response of turning to look at an object first seen in a mirror as a sign of self-recognition is questioned. The age at which self-recognition in still pictures first appears is less clear. Verbal comprehension of self-relevant labels appears earlier than active self-labelling. A few studies have addressed the question of cognitive correlates of self-recognition, but a variety of behaviors that imply self-awareness and the corresponding ability to impute mental states to others remains to be studied in relation to self-recognition. Continued research into self-recognition and associated abilities in nonhuman primates enhances the overall understanding of the development of self-awareness.

Audiovisual Aids↗
PubMed1984

Adult duodenal webs: a rare cause of obstruction.

Two patients are described with congenital duodenal webs. Both presented with increasing heartburn, an unusual symptom for this condition. The radiological appearances at barium meal examination were misinterpreted in both cases. The radiological features of duodenal webs and their differentiation from intraluminal diverticula are discussed.

Aged↗
PubMed1984

Caecal volvulus: a frequently missed diagnosis?

Fifty-eight patients with acute caecal volvulus are presented. Fifty-five patients had plain abdominal radiographs taken shortly after admission and the diagnosis was suspected in 29 (53%). Forty-five of these radiographs have been reviewed and, in retrospect, the diagnosis could have been made in 40 (89%). The dilated caecum usually assumes a 'comma-shape', retains its haustral markings and may be located anywhere within the abdomen but is most frequently seen centrally or occupying the left upper quadrant. Diagnostic difficulties were found in patients with peritonitis and when there was gross small bowel dilatation. Accurate diagnosis is vital as delay in the surgical treatment of this condition may lead to an increased incidence of gangrene of the caecum and a higher mortality.

Acute Disease↗
PubMed1984

A quantitative study of the effects of several nucleoside analogues on established herpes encephalitis in mice.

Mice with established herpes encephalitis were used to compare the effects of chemotherapy using three different nucleoside analogues. Encephalitis was produced by intranasal inoculation of a type 1 strain of herpes simplex virus. Without chemotherapy all mice died within 5 to 7 days of inoculation. Oral acyclovir (ACV) was a successful preventative measure if commenced within 2 days of inoculation but much less effective if the onset of treatment was further delayed. From the third day, when central nervous system infection had definitely become established, ACV only reduced mortality if given intraperitoneally (i.p.) at regular 6-hourly intervals. Comparison with bromovinyldeoxyuridine (BVdU) and the new nucleoside analogue dihydroxypropoxymethylguanine (DHPG) using the same 6-hourly i.p. regimen revealed that BVdU was poorly effective, despite better activity in vitro, whereas DHPG was the most successful. Virus was rapidly eradicated from all parts of the brain by DHPG therapy, and by day 10, no infectious virus remained in the brains of treated mice, no virus antigens were observed and no trace of virus DNA could be detected in neural tissues by Southern blotting.

Acyclovir↗
PubMed1984

Meta-iodobenzylguanidine in metastatic phaeochromocytoma.

A case of metastatic phaeochromocytoma is presented. Meta-iodobenzylguanidine was used to locate the tumour but failed to show two functioning abdominal metastatic deposits. Although meta-iodobenzylguanidine appears to be highly specific for phaeochromocytoma, a negative scan does not exclude a functioning tumour with confidence.

3-Iodobenzylguanidine↗
PubMed1984

Neuropathological findings in Miller Fisher syndrome.

The neuropathological findings in a fatal case of Miller Fisher syndrome are described. The demyelinating peripheral neuropathy and normal appearance of the central nervous system that were observed support the inclusion of the syndrome within the spectrum of acute inflammatory polyneuropathy.

Aged↗
PubMed1984

Complete rectal prolapse--the results of Ivalon sponge rectopexy.

Forty-two patients with complete rectal prolapse have been treated using the Ivalon sponge rectopexy. There was no operative mortality in this series and only one complete recurrence after an average follow-up of more than 4 years. Pelvic sepsis occurred in one patient and required removal of the sponge. The majority of the patients were satisfied with the results of surgery, despite some remaining incontinent.

Adult↗
PubMed1984

Faecal weight, constituents, colonic motility, and lactose tolerance in the irritable bowel syndrome.

Lactose intolerance and faecal characteristics were compared in 16 patients with symptomatic irritable bowel syndrome and in age- and sex-matched controls. Faecal stool weight was increased in the irritable bowel syndrome patients, whereas faecal bile acids, fat, volatile fatty acids, and neutral sterols were not significantly different. No lactose intolerance was found in irritable bowel syndrome subjects. Measurements of colonic motility showed only modest activity for both basal and food-stimulated activity. There was a weak correlation between the concentration of total bile acids, deoxycholic acid, lithocholic acid and the motility index.

Adolescent↗
PubMed1984

The role of monocytes and responder cells in suppression of antigen-specific T cell proliferation in chronic renal failure.

The response of peripheral blood lymphocytes (PBL) to the antigen tetanus toxoid (TT) in patients with chronic renal failure being maintained on hemodialysis was examined. We have found that: (1) the response of patients' unfractionated PBL to TT is markedly suppressed when compared to the response of control PBL; (2) the response of patients' purified T cells and T4+ cells to TT co-cultured with 5% autologous monocytes is suppressed when compared to the response of comparable control cultures; (3) the response of patients' purified T lymphocytes co-cultured with 5% autologous monocytes is significantly enhanced over the response of patients' unfractionated PBL, and (4) the suppressed proliferation of patients' PBL to TT is not reversed by hemodialysis. Thus, the presence of suppressor monocytes and the inability of the responding T cells and accessory monocytes to react to antigen contribute to the suppressed antigen-specific T cell proliferation observed in chronic renal failure patients. These results are relevant to the suppressed cell-mediated immunity observed in uremia.

Adult↗
PubMed1984

The treatment of localized non-Hodgkin's lymphoma in children: a report from the Children's Cancer Study Group.

Investigators of the Children's Cancer Study Group entered 73 children with previously untreated localized non-Hodgkin's lymphoma on a prospective randomized trial of systemic treatment with either a four-drug program (cyclophosphamide, vincristine, methotrexate, prednisone [COMP]) or a 10-drug (LSA2-L2 modified) program of 18 months duration. All patients received central nervous system prophylaxis with intrathecal methotrexate and most received local or regional radiation treatment. The three-year relapse-free survival rate for all patients (N = 73) was 84%; for COMP (N = 42) was 85%, and for LSA2-L2 (N = 31) was 84%. Of the 12 patients who suffered adverse events eight relapsed and four died of toxicity. Histopathology was reviewed centrally. Of 32 patients with nonlymphoblastic disease treated with COMP only one relapsed. Of 26 patients treated with LSA2-L2, four relapsed. Patients with localized lymphoblastic disease were uncommon. None of three patients treated with LSA2-L2 relapsed compared with three of nine treated with COMP. COMP is an excellent treatment for patients with localized disease of nonlymphoblastic type, but the relative value of the two regimens for patients with localized lymphoblastic disease is uncertain.

Adolescent↗