Search PubMed⌕ Search

Biomedical subjects

J W Fletcher

Publications and source records attributed to J W Fletcher.

At least 55 records · Page 3Linked to original sources
PubMed1975

Brain scans, dexamethasone therapy, and brain tumors.

Eight men with primary or metastatic brain tumors were examined with brain scans before and after the administration of dexamethasone. All patients demonstrated some improvement in their clinical neurologic status during therapy, and two patients had a dramatic response. Seven of the eight patients examined showed a decrease in the apparent size of the original lesion on recent brain scan while receiving dexamethasone. Comparison of immediate scans obtained 15 to 20 minutes following the administration of sodium pertechnetate Tc 99m with those obtained two or three hours later suggests that the change in apparent size of the original lesion results from decrease in peritumor edema.

Adult↗
PubMed1975

67Ga citrate distribution following whole-body irradiation or chemotherapy.

Whole-body retention, organ distribution, excretion, and serum binding of 67Ga were evaluated in rats under normal conditions and following whole-body gamma irradiation, vincristine sulfate, or mechlorethamine. The results suggest that both irradiation and chemotherapy lead to reduced whole-body retention of injected radiogallium, explained in part by an alteration in the serum binding of gallium. Recognition of these findings should be considered in interpreting decreased tumor concentration of gallium in patients following radiotherapy or chemotherapy.

Animals↗
PubMed1975

Liver scanning and the intrahepatic gallbladder: Case report.

Hepatic focal defects identified with 99mTc-sulfur colloid imaging procedures are nonspecific. This report describes a case of an ectopic gallbladder localized by cholecystography and 131I-rose bengal studies in a patient with cirrhosis and suspected intrahepatic neoplasm.

Colloids↗
PubMed1975

Radioisotopic detection of osseius metastases. Evaluation of 99mTc polyphosphate and 99mTc pyrophosphate.

A total of 146 patients were investigated for the presence of osseous metastases with 99mTc polyphosphate or 99mTc pyrophosphate bone scans. Results of bone imaging were retrospectively compared to roentgenographic results surveying similar anatomic areas in 128 patients. This comparison revealed that roentgenographic interpretations were in error in 19% of the cases. Thirty-three patients had bone scans and roentgenograms that were in agreement and considered abnormal, but in more than one third of these cases the patients had multiple abnormalities that were shown by the bone scan but were not recognized roentgenographically. In consideration of the low toxicity, ready availability, economy, shortened procedure time, and low radiation dose associated with the use of these new bone-seeking agents, it is concluded that they are superior to roentgenograms and previously utilized radionuclides for early detection of osseous metastases.

Bone Neoplasms↗
PubMedDate not supplied

Anatomy of a meta-analysis: a critical review of "exercise echocardiography or exercise SPECT imaging? A meta-analysis of diagnostic test performance".

BACKGROUND: Accurate diagnosis of coronary heart disease has the potential to contribute substantially to cost-effective delivery of health services. Recent work by Fleischmann et al (JAMA 1998;280:913-20) represents an effort to summarize the accuracy of exercise echocardiography and exercise single photon emission computed tomography (SPECT). METHODS AND RESULTS: A critique of the previous work was constructed, obtaining the 44 articles used. These articles were reviewed and summarized with established techniques for meta-analysis. The studies summarized by Fleischmann et al were found to be significantly heterogeneous (echocardiography and SPECT, both P<.001). In the SPECT cohort, combination of different radioisotopes and reading techniques, and inclusion of reports using experimental techniques, were sources of heterogeneity. In the echocardiography cohort, experimental techniques and an individual series were identified. When the sample was stratified for sources of heterogeneity, it was found that there was no significant difference in diagnostic accuracy between the echocardiography and SPECT techniques used in current clinical practice. Meta-regression with summary receiver operating characteristic curve techniques, after adjustment of the model for multicolinearity and outliers, revealed that there were no significant differences between SPECT as used in current clinical practice and echocardiography. CONCLUSION: The report by Fleischmann et al contains serious flaws that limit its validity and generalizability.

Echocardiography↗
PubMedDate not supplied

Bone marrow 99m Tc sulfur colloid distribution and marrow cellularity.

The relationship between marrow distribution as imaged with 99mTc sulfur colloid and histologic estimate of bone marrow cellularity was examined in 101 patients. The patients were divided into three groups according to marrow cellularity: normocellular, hypercellular or hypocellular marrow. The marrow distribution of these patients was graded as extended, not extended or not visualized. A general association between marrow cellularity and marrow distribution was found. Seventy-seven per cent of patients with normocellular marrow had limitation of marrow within normal sites and a similar number of patients with reactive hypercellular marrow had marrow extension. On analysis of the patients that were exceptions to this generalization the following observations were made. In patients in whom the marrow is hypercellular and infiltrated with abnormal cells or tissue the marrow distribution may not be visualized with radiocolloid. Stimulation of hematopoiesis may result in marrow hypercellularity without marrow extension beyond the usual sites. Stimulation of one or more hematopoietic cell lines may result in marrow extension without marrow hypercellularity, suggesting an impairment of hematopoietic cell response. Peripheral marrow extension as observed with radiocolloid, therefore, is not simply a reflection of marrow hypercellularity but probably represents a response of the bone marrow stroma to situations in which one or more hematopoietic cell lines is stimulated.

Adult↗
PubMedDate not supplied

Overexpression of MPS antigens by squamous cell carcinomas of the head and neck: immunohistochemical and serological correlation with FDG positron emission tomography.

Survival from advanced primary or recurrent Squamous Cell Carcinoma (SCC) of the head and neck (H&N) is poor. More accurate detection of primary tumors and recurrence may provide ways to improve survival. No standard serum tumor marker is routinely used for surveillance of SCC-H&N. In this paper, we evaluated the performance characteristics of the MPS-H tumor marker test for the quantitative measurement of "MPS-H" heat-generated immunoreactive proteins and assessed the clinical utility of this marker in the detection and monitoring of SCC-H&N. In approximately 92% of the subjects having no evidence of SCC-H&N, the MPS-H levels were lower than 15 ng/mL. In 76% of patients having SCC-H&N at various stages (T1-T4), the MPS-H level was > 15 ng/mL (range: 20-200 ng/mL). In addition, we found a statistically significant correlation between PET positive cases and high MPS-H serum levels in SCC-H&N patients with recurrent disease. These results suggest that MPS-H may provide an initial screening test that would allow for selective PET imaging in these patients. Furthermore, we found that there was greater expression of MPS-1 in tumors of higher histological grades. Thus, in tumors with more histological aggressiveness there is more MPS-1, indicating the potential usefulness of this marker in prognosis for SSC-H&N. Considering the immunohistochemical, serological, and FDG-PET data presented here, and the compelling need to expedite the early diagnosis of primary and recurrent epithelial malignancies of the head and neck, we are further evaluating the system of MPS antigens in a large patient population as a tool for the early serologic and histologic diagnosis of SCC-H&N.

Adult↗
PubMedDate not supplied

Expression of metallopanstimulin and oncogenesis in human prostatic carcinoma.

BACKGROUND: We have previously shown that human metallopanstimulin (MPS-1) is a 9.4-kDa multifunctional ribosomal S27/nuclear "zinc finger" protein which is expressed in a wide variety of actively proliferating cells and tumor tissues. Furthermore, we have shown that detection of MPS-N immunoreactive material in sera corresponding to the NH2 terminus of MPS-1 provides a method for determining the presence of certain types of abnormal proliferative conditions and/or active oncogenic processes in patients. In this study, we investigated MPS-N and MPS-N-like antigens present in the blood of patients with prostatic carcinoma (PC) and their relationship to the clinical status of patients with PC. METHODS: The presence of MPS-N immunoreactive material was determined using a sensitive and specific radioimmunoassay (RIA) which has been developed to measure circulating levels of MPS-N antigen(s). In addition, MPS-N levels were compared to the primary bio-marker used in PC patient management, Prostatic Specific Antigen (PSA). RESULTS: MPS-N concentrations were determined in the blood of 107 males having no evidence of PC, and in 126 patients diagnosed with PC. In patients, not having PC the MPS-N levels were lower than 10 ng/mL. In untreated patients having PC stages T1/T2, the MPS-N level range was 10-30 ng/mL; in stages T3/T4 the MPS-N level range was 30-50 ng/mL; and in stage Mlb (distant metastasis to the bones) the MPS-N levels were extremely high (> 50 ng/mL). In Mlb patients that did not respond to therapy, the MPS-N levels remained very high (> 50 ng/mL). In Mlb patients that went into remission after treatment, the MPS-N levels were dramatically reduced. In addition, a comparison of the test properties of MPS-N and PSA for prostate cancer were evaluated in a total of 231 patients. In both the low and high value range, both MPS-N and PSA appear to be equally effective in modifying the probability of the target condition-prostatic cancer. CONCLUSIONS: These findings show that (1) in untreated PC patients, the increase in serum MPS-N correlated with the stage of the disease; (2) MPS-N tumor marker predicted the degree of aggressiveness of tumor growth and response to therapy. In summary, despite the uncertainties of the relative contributions of the molecules being measured in cancer patients (authentic MPS-1, and MPS-N-like protein sequences), the MPS-N test is a pragmatic test that correlates well with active prostatic malignancy.

Aged↗