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Biomedical subjects

M Brennan

Publications and source records attributed to M Brennan.

At least 109 records · Page 6Linked to original sources
PubMed1986

Adrenocortical carcinoma.

From 1962 to 1985, 47 patients with carcinoma of the adrenal cortex were treated at Memorial Sloan-Kettering Cancer Institute. There were 21 men and 26 women. Seventy-two percent of the tumors were functional and 28% were nonfunctional. Despite the advent of ultrasonography and computerized tomography, these tumors were infrequently diagnosed until they infiltrated adjacent organs or metastasized to distant sites. Only 30% of patients had tumors confined to the adrenal gland; their mean duration of survival was 5.0 years. Seventy percent of the patients had invasion of the kidney, lymph nodes, liver, diaphragm, and/or pancreas at the initial operation; their mean duration of survival was 2.3 years. Eight patients had reoperation for abdominal recurrences; three of the patients with abdominal recurrence and one additional patient underwent thoracotomy to resect localized lung metastases. The mean duration of survival of these nine patients was 3.5 years, not significantly different from the mean overall survival of 3.1 years. The duration of survival of all patients was not significantly correlated with age, sex, adjuvant therapy, or production of hormones by the tumor. Only two patients were deemed unresectable. Wide en-bloc dissection of the primary tumor, resection of contiguous organs for local invasion, and excision of resectable metastases in the liver and lungs remain the basis of therapy.

Adrenal Cortex Neoplasms↗
PubMed1985

Preparation of bispecific antibodies by chemical recombination of monoclonal immunoglobulin G1 fragments.

Preparation of bispecific antibodies by the chemical reassociation of monovalent fragments derived from monoclonal mouse immunoglobulin G1 is inefficient because of side reactions during reoxidation of the multiple disulfide bonds linking the heavy chains. These side reactions can be avoided by using specific dithiol complexing agents such as arsenite and effecting disulfide formation with a thiol activating agent such as 5,5'-dithiobis(2-nitrobenzoic acid). In this way bispecific antibodies were obtained in high yield and free of monospecific contaminants from monoclonal mouse immunoglobulin G1 fragments. The bispecific antibodies were used as agents for the selective immobilization of enzymes.

Animals↗
PubMed1985

A randomized, prospective trial of adjuvant chemotherapy in adults with soft tissue sarcomas of the head and neck, breast, and trunk.

Since 1977, 31 patients were entered in a randomized, prospective study testing the efficacy of adjuvant chemotherapy after aggressive local treatment of high-grade sarcomas of the head, neck, breast, and trunk (excluding retroperitoneal sarcomas). All patients had complete resection of gross tumor and underwent postoperative radiotherapy (6000-6300 rads over 7-8 weeks). Seventeen patients received adjuvant chemotherapy consisting of doxorubicin (less than or equal to 550 mg/m2), cyclophosphamide (less than or equal to 5500 mg/m2), and methotrexate (less than or equal to 1000 mg/kg). Three-year actuarial disease-free survival in the chemotherapy arm was 77%, compared to 49% in the no-chemotherapy arm (P = 0.075). Three-year overall actuarial survivals in the two treatment arms, however, were 68% and 58%, respectively (P = 0.38). Considering only patients with tumors of the trunk (22 patients), 3-year actuarial disease-free survival in the chemotherapy arm was 92%, compared to 47% in the no-chemotherapy arm (P = 0.006). Actuarial 3-year overall survival in the chemotherapy arm was 82%, compared to 61% in the no-chemotherapy arm (P = 0.18). An additional 26 patients were treated in an identical fashion, but were not part of the randomized trial because of contraindications to chemotherapy, refusal to enter the randomized trial, or because they were treated before 1977 in a trial in which all patients received chemotherapy. Considering the entire group of 57 patients, follow-up ranged from 10 to 86 months (median, 35 months). Local control was achieved in 46 patients (81%); 3-year actuarial disease-free and overall survivals were 67% and 77%, respectively. A tendency toward improved disease-free survival was apparent among patients treated with chemotherapy (P = 0.018), but there was no statistically significant improvement in overall actuarial survival (P = 0.46). The subgroup of patients with sarcomas of the trunk (39 patients) demonstrated the greatest benefit from chemotherapy, with regard to disease-free survival (P less than or equal to 0.001). The most significant toxicity associated with chemotherapy was doxorubicin-induced cardiomyopathy, which resulted in clinically apparent congestive heart failure in five patients. Thus, the use of chemotherapy when combined with aggressive local measures appears to improve disease-free survival, but additional patients and longer follow-up are necessary to determine if improved overall survival will result.

Actuarial Analysis↗
PubMed1985

Adverse Drug Reaction Reporting Program of the Ontario Medical Association: the first 3 years.

This paper describes the Adverse Drug Reaction Reporting Program developed and operated by the Committee on Drugs and Pharmaco-therapy of the Ontario Medical Association. Analyses were done to demonstrate some of the trends derived from the reports. Some of the clinical observations based on the reports, which are published quarterly and circulated to physicians and to pharmacy, nursing and hospital organizations, are also reviewed.

Adult↗
PubMed1985

A graduate programme for academic family physicians.

The paper describes a graduate studies programme designed to prepare outstanding family physicians for academic leadership and reports an evaluation of the programme. The programme aims to produce academic family physicians who exhibit certain qualities: outstanding clinical skills, professional interest in the organization and transmission of knowledge, and a scholarly approach through research and skills of leadership. The course includes clinical and teaching practice, formal course work and a scholarly thesis; the emphasis is on teaching and learning, theoretical foundations of family medicine, whole person medicine, research design and techniques, ethical decision making, and administration of organizations. A survey of the first 30 graduates of the programme indicated that the majority did more clinical teaching, small group teaching, research, writing and administration than before the course. The graduates' opinions of the programme indicated the extent to which the programme goals have been met; to provide a coherent learning experience integrating the art, science and technology of the discipline of family medicine.

Canada↗
PubMed1985

Accuracy and reliability of the Del Mar Avionics pressurometer III.

We assessed the accuracy and reliability of the Avionics pressurometer, a fully automated ambulatory blood pressure recorder. Accuracy was assessed in 96 patients against the Hawksley random-zero sphygmomanometer. Two recordings were made with each device in a random sequence. No mean difference was found between methods. However, there was a marked variation in the difference between Avionics and Hawksley recordings. This was not due to variability in blood pressure alone since the agreement between Avionics and pressurometer systolic recordings (r = 0.88) was less than the agreement between sequential systolic blood pressure measurements with the Hawksley (r = 0.976, P < 0.001). In addition, a small degree of inter-device variability was demonstrated between three Avionics recorders, one device giving higher readings. Reliability was assessed in 30 patients during normal daily activities and compared with the Remler M2000. The rate of markedly artefactual recordings was higher with the Avionics. Thus, variability in Avionics recordings makes this device unreliable.

Blood Pressure Monitors↗
PubMed1985

Presurgical serum immunoglobulin concentrations and the prognosis of operable breast cancer in women.

Serum concentrations of IgG, IgA, IgM, IgE, and allergen-specific IgE were measured in presurgical serum samples from 400 women admitted to a multidisciplinary study of primary breast cancer. The relationships between the serum immunoglobulins and patient survival were analyzed with the use of a Cox proportional hazards linear model. After adjustment for TNM stage, tumor histopathologic grade, and estrogen receptor (E2R) status, lower IgM concentrations were associated with longer survival. Lower IgE concentrations were also associated with longer survival, but only in patients whose tumors were E2R positive. IgG and IgA were not related to survival. Serum IgM and IgE concentrations, allergen-specific IgE scores, and the tumor E2R status were combined to construct a three-level risk classification that was more prognostic than any of the individual components. Cox model analysis demonstrated that this combination of immunologic and hormonal variables provided significant new information beyond that obtained from TNM staging and histopathologic grading of the tumors (P = .01). This new information may be useful to physicians in advising patients with primary, operable breast cancer about the relative risks and benefits of adjuvant therapy and in designing clinical trials of adjuvant therapy.

Breast Neoplasms↗