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Biomedical subjects

M Cohen

Publications and source records attributed to M Cohen.

At least 1,243 records · Page 69Linked to original sources
PubMedDate not supplied

Results of a phase II protocol for evaluation of new chemotherapeutic regimens in patients with inoperable non-small cell lung carcinoma (EST-2575, generation I).

Two hundred and eighty-four patients with inoperable non-small cell lung carcinoma were randomized by the Eastern Cooperative Oncology Group to receive one of seven primary chemotherapy regimens: cyclophosphamide and methotrexate; Baker's antifol; vincristine, bleomycin, and methotrexate; melphalan; cyclophosphamide and CCNU (control arm); 5-FU procarbazine; and hexamethylmelamine, doxorubicin, and methotrexate (HAM). Patients with disease progression were eligible for treatment with VM-26 or ascorbic acid. HAM resulted in higher response rates than cyclophosphamide and CCNU in patients with adenocarcinoma (32%) and large cell carcinoma (23%). It was not tested in patients with squamous cell carcinoma. In terms of survival, HAM was significantly better than cyclophosphamide and CCNU in patients with limited disease. Its toxicity was predominantly hematologic and gastrointestinal. This regimen is being further evaluated by the Eastern Cooperative Oncology Group in patients with inoperable non-small cell lung carcinoma. Crossover therapy with VM-26 or ascorbic acid had no therapeutic benefit.

Adenocarcinoma↗
PubMedDate not supplied

Chemotherapy for inoperable, non-small cell bronchogenic carcinoma: EST 2575, generation II.

Between 1976 and 1978 the Eastern Cooperative Oncology Group tested ten regimens in 415 patients with histologically documented, inoperable non-small cell bronchogenic carcinoma. Most patients were ambulatory (69%) and had extensive disease (69%). Patients were stratified by cell type: squamous cell carcinoma (SQ), large cell anaplastic carcinoma (LC), or adenocarcinoma (AD). Ineffective single agents (including cell types tested and percent complete and partial responses) were dactinomycin (SQ, 6%), dianhydrogalactitol (SQ, 0), ftorafur (AD and LC, 3%), and piperazinedione (AD and LC, 7%), Ineffective combination regimens included the contemporary standard regimen cyclophosphamide (CYT) plus CCNU (SQ, AD, and LC, 9%), methotrexate plus doxorubicin (ADR) plus CYT plus CCNU (MAC) (SQ and AD, 12%), and mitolactol plus ADR (AD and LC, 8%). When compared to CYT plus CCNU the following regimens demonstrated significant activity: CYT plus bleomycin plus cisplatin (SQ, 23%; P = 0.02) and ADR plus 5-FU plus cisplatin (AD and LC, 24%; P = 0.006). Mitomycin demonstrated marginal activity in squamous cell cancer (19%, P = 0.06). Neither "active" regimen improved survival although responders to any regimen had a significant prolongation of median survival (31.6 vs 15.7 weeks, P = 0.002). The MACC regimen, piperazinedione, and mitomycin were substantially more toxic than the two effective regimens, which were adequately tolerated. Ambulatory performance status, limited disease, and prior surgery were significant positive prognostic variables whereas prior radiation and pretreatment weight loss adversely affected response or survival.

Adenocarcinoma↗
PubMedDate not supplied

Bacterial concentration and blood volume required for a positive blood culture.

We attempted to define the minimum blood volume and bacterial concentration required to obtain a positive blood culture with the use of placental blood and an in vitro technique. Known amounts of either Escherichia coli or group B beta-hemolytic streptococci were added to heparinized placental blood specimens. Blood samples of 0.25, 0.5, and 1.0 ml containing bacteria were inoculated into 30 ml of a commercially available broth culture medium, incubated for 24 hours, and examined for bacterial growth. Samples of at least 0.25 ml blood containing more than 10 colony-forming units of bacteria per milliliter resulted in a positive blood culture for 131 of 132 samples. On the basis of these data, we suggest that if 0.25 ml of blood is sampled and the specimen contains more than 10 colony-forming units per milliliter of E. coli or group B beta-hemolytic streptococci, the blood culture is almost certain to be positive.

Bacteriological Techniques↗
PubMedDate not supplied

The pattern of serum melatonin levels during ovarian stimulation for in vitro fertilization.

OBJECTIVE: To characterize the relationship between the pineal gland hormone, melatonin, and gonadal hormones. METHODS: We studied the pattern of serum melatonin at the time of ovarian stimulation for in vitro fertilization. Blood samples were obtained every morning, from 20 healthy women during the in vitro fertilization cycle. RESULTS: A progressive rise in serum estradiol and prolactin was noted in all IVF cycles, while serum melatonin levels remained unchanged throughout the cycles. In two of the subjects the circadian rhythm of serum melatonin was assessed at 4-hour intervals for 24 hours. In both subjects the melatonin rhythm was remarkably consistent in terms of phase, amplitude, and total melatonin secreted during the treatment cycles. CONCLUSIONS: These results indicate that endogenous estradiol, progesterone, and prolactin do not affect the levels or circadian phase of melatonin secretion in humans.

Adult↗
PubMedDate not supplied

Totally implanted direct current stimulator as treatment for a nonunion in the foot.

Nonunions and delayed unions are postoperative complications with which the podiatric surgeon must be concerned. Although the incidence is infrequent, their treatment methods vary, and can range from bone grafting to internal and external fixation of fragments, arthrodesis, and/or the use of indirect and direct bone stimulation. This manuscript details a case of a nonunion of the first metatarsal cuneiform joint 8 months after attempted Lisfranc's joint fusion for Charcot arthropathy of the midfoot. The nonunion was treated with bone grafting, internal fixation, and the use of an implanted direct current bone stimulator. Although implanted bone stimulators are commonly used for the treatment of failed unions of the posterior spine, tibia, and humerus, to date, the authors submit this is the first reported case of implementing a totally implanted direct current stimulator for treatment of a nonunion in the foot.

Arthropathy, Neurogenic↗
PubMedDate not supplied

The crescentic shelf osteotomy.

The authors describe a new surgical technique for the correction of a hallux abducto valgus deformity. The crescentic "shelf" osteotomy combines a dorsal-to-plantar crescentic osteotomy with a medial-to-lateral transverse osteotomy at the first metatarsal base. This technique allows triplanar correction, stable open reduction with internal fixation, and precise intermetatarsal reduction. This article discusses alternate base osteotomies, anatomical considerations of the first metatarsal, and data predicting frontal and sagittal plane motion of the distal fragment. Also included is a procedural guide followed by examples and possible complications. An analysis of 22 procedures are presented. The article briefly introduces the capital crescentic shelf osteotomy with review of the procedure.

Adolescent↗
PubMedDate not supplied

Prospective evaluation of factors associated with intraaortic balloon rupture.

The authors undertook a prospective analysis of all intraaortic balloon catheter (IAB) insertions at Hahnemann University Hospital during an 18 month period. Attention was directed to balloon rupture and factors associated with this complication. A total of 384 insertions were attempted in 363 patients: 19 patients (5.2%) experienced balloon rupture. The mean time to rupture was 2.1 +/- 3.3 days (range 0-15 days). All ruptured IAB catheters were removed percutaneously without subsequent complications. Ten balloons were subjected to leak testing and scanning electron microscopy. All but one rupture appeared to be the result of balloon abrasion against atherosclerotic plaque. The puncture site occurred at variable distances from the proximal end of the balloon at 9.4 +/- 8.3 cm. Comparison of patients with and without balloon rupture revealed several significant (p < 0.04) differences by univariate analysis (Table 1). No procedure related variables (IAB catheter size 9 versus 11 Fr, sheathless insertion, duration of counterpulsation) were associated with rupture. Stepwise logistic regression analysis revealed body surface area as the only independent predictor of balloon rupture (p = 0.007). Intraaortic balloon rupture with 40 cc balloons, is directly related to the size of the patient. Evaluation of smaller balloons in patients with body surface area < or = 1.8 m2 appears warranted to minimize IAB rupture.

Aged↗
PubMedDate not supplied

Quality assurance in brachytherapy: the role of the ICRU in achieving uniformity in dose and volume specification for reporting.

A quality assurance programme in brachytherapy implies a general consensus on the method of dose and volume specification for reporting. This in turn implies a consensus on certain definitions of terms and concepts. For several decades, the ICRU (International Commission on Radiation Units and Measurements) has been actively involved in an effort to reach a consensus between different brachytherapy centres worldwide, and to improve uniformity in reporting. The ICRU has prepared two reports containing recommendations for reporting brachytherapy treatments. The first, report #38 published in 1985, deals with intracavitary therapy in gynecology. The second deals with interstitial therapy, and is now in press. A summary of these two ICRU reports is presented here. Some definitions of terms and concepts are first recalled and discussed: Total Reference Air Kerma (TRAK), gross tumor volume (GTV), clinical target volume (CTV), treated volume, mean central dose, dose uniformity parameters, etc. Specific recommendations for reporting interstitial and intracavitary brachytherapy are then presented.

Brachytherapy↗