Biomedical subjects
Publications and source records attributed to M Adams.
The use of tunnelled central venous catheters in children with malignant disorders is an effective and safe way of giving out-patient chemotherapy and supportive care. The benefits include ready venous access, ease of administration of chemotherapy, decreased time spent in the out-patient clinic, and less anticipatory vomiting and emotional trauma for patients, parents, and staff.
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Thirty-eight patients with an advanced ovarian cancer (FIGO stage III and IV) were randomly allocated to treatment, either with melphalan (M) or a combination of adriamycin, 5-fluorouracil and cyclophosphamide (CAF) to determine the effect on survival. Actuarial survival of the two treatment groups was the same but the combination was more toxic.
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To assess the advantages of more complete angular sampling and of more views in the tomographic reconstruction process, tomographic imaging with a 12-pinhole (12PH) collimator has been compared with 7-pinhole tomography (7PH). The 12PH system gives a 50% increase in sensitivity but resolution degrades more rapidly with depth. The 7PH and 12PH systems provide similar accuracy of detection of lesions in a myocardial ring phantom. The 7PH images, however, demonstrated more noise and "ripple" artifacts. The 12PH system offers a larger reconstruction volume and generates fewer artifacts when the collimator is misaligned with the myocardial long-axis, thus making patient positioning less critical than with 7PH. A disadvantage is that individual views are minified by the 12PH collimator, and a 256 X 256 image matrix should be used during image acquisition to limit digital sampling errors.
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Four ion exchange resins and 9 enzyme preparations are evaluated for use in the official AOAC thiamine method because Decalso and Clarase or Mylase P either are no longer available or are available in a form that is not suitable for use in the assay. The enzymes are prepared in the same manner described for Clarase or Mylase P in the AOAC method and are compared with Clarase T300 for their effectiveness in releasing thiamine from thiamine phosphate, and their ability to produce similar results on samples. Rhozyme S is 90-100% as effective as Clarase T300 in both of these respects. The other enzymes tested were not satisfactory. Further study is necessary because Rhozyme S also is no longer manufactured. The ion exchange resins are prepared for use in the manner described for Decalso in the AOAC method. Recoveries of thiamine range from 95 to 100%, using Bio-Rex 70 (hydrogen form) ion exchange resin. The other resins tested were not satisfactory.
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In two randomized double-blind controlled trials on 63 depressed female in-patients subject to recurrent affective disorder (bipolar and unipolar manic-depressive psychosis) lithium was shown to have major acute antidepressant effects. At the end of three weeks lithium produced more uniform improvement than did imipramine; lithium in combination with tryptophan (in the form of Optimax) was superior to tryptophan alone--the latter drug having no discernible antidepressant activity in this group of patients. Lithium did not produce an antidepressant effect until the second and third week of both trials.
Levels of plasma amino acids and muscle concentrations of energy substrates and metabolites after shock in the Macaca mulatta Rhesus monkey were investigated. The hemodynamic response to shock is similar to that of previously reported studies of primates in shock. Plasma glucose and ASAT increased significantly, while levels of ALAT and pyruvic acid did not change. Lactic acid was elevated. Muscle glycogen and concentrations of lactic acid were increased, and levels of pyruvic acid, creatine phosphate, and malate fell during shock. Levels of ATP in muscle were unchanged. Nine of the 23 arterial plasma amino acids analyzed decreased significantly. Aspartic acid was increased during shock. The increased levels of tissue carbohydrates and decreased concentrations of plasma amino acids observed in this study differ from results previously reported for other animal shock models. Changes in amino acid levels are similar to the results of some clinical studies.
A group of twelve patients with a history of infertility lasting at least 2 years despite evidence of regular ovulatory cycles, were selected from an Infertility Clinic after thorough investigation had revealed no other obvious cause for their infertility. Daily plasma gonadotrophin and steroid concentrations were measured in twenty cycles from these women and the results compared with the hormonal profiles obtained from a group of eleven control 'normal' women. No significant differences were found in the concentrations of LH, FSH or oestradiol although plasma progesterone concentrations were significantly lower in the infertile women, particularly during the first half of the luteal phase. In the absence of any other demonstrable defect, it was assumed that the decreased progesterone secretion was directly or indirectly implicated in the pathogenesis of their infertility, and a number of therapeutic regimes (progesterone supplementation of the luteal phase or additional stimulation by either anti-oestrogens or exogenous gonadotrophins) were assessed for their efficacy in correcting this defect. Although plasma progesterone concentrations after most of these regimes were significantly increased, none of the patients in this series conceived.
The problem of assessing outcome in psychotherapy is considered by examining the experiment conducted by Bloch et al (1977). The experimental design and statistical considerations in investigating psychotherapy outcome are briefly examined. Tt is argued that attention should be directed towards assessing the severity of patients' problems rather than improvement after treatment.