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Biomedical subjects

M Coleman

Publications and source records attributed to M Coleman.

At least 271 records · Page 15Linked to original sources
PubMed1983

Eosinophilic meningitis in Hodgkin's disease. Report of a case and review of the literature.

Eosinophilic meningitis is rare in Hodgkin's disease. Five previous cases have been reported. We describe an additional patient whose CSF showed an eosinophilic pleocytosis with Reed-Sternberg cells while in complete systemic remission from Hodgkin's disease. The patient responded to intrathecal administration of methotrexate given by Ommaya reservoir. Six months later, systemic relapse occurred, but the CSF remained normal. Eosinophilic meningitis is a treatable complication of Hodgkin's disease, and prolonged response is possible.

Adult↗
PubMed1983

CO2 responses in infants: on-line display and analysis using a microcomputer and waveform analyzer.

This report describes a new system for measuring and recording ventilatory responses to inspired CO2 in infants, which consists of a nasal pneumotach, microcomputer, and a waveform analyzer. The waveform analyzer measures ventilatory responses on-line and displays them in real-time, breath-by-breath. Thirty-two ventilation studies were performed in 24 normal, full-term infants (3-300 days of age). The mean ratio of delta VE/ delta PACO2 was 44.3 +/- 22.9 (SD) ml/kg X min X mm Hg BTPS (range 15.0-121.2). We believe this new system is a significant improvement over previous methods for measuring and recording ventilatory responses of infants.

Carbon Dioxide↗
PubMed1983

Restoration of responsiveness of chronic myeloid leukemia granulocyte-macrophage colony-forming cells to growth regulation in vitro following preincubation with prostaglandin E.

The ability to modulate granulocyte-macrophage colony-forming unit (CFU-GM) Ia-antigen expression and response to growth inhibition in vitro was investigated in normals and patients with chronic myeloid leukemia (CML). The hyporesponsiveness of CML CFU-GM to inhibition by prostaglandin E and acidic isoferritins in vitro and their associated diminished capacity for Ia-antigen expression could be reversed following suspension culture of bone marrow cells in the presence of prostaglandin E prior to soft agar culture. Suspension preculture with prostaglandin E for 24 hr resulted in the detection of a population of CFU-GM that were equivalent to normal CFU-GM in both response to inhibition by prostaglandin E and acid isoferritins and in their pattern of Ia-antigen expression. Cytogenetic analysis of the progeny of CFU-GM proliferating in cultures established from marrow cells, cultured directly upon isolation or following suspension culture in the absence or presence of prostaglandin E for 24 hr, indicated that the responding cell population belonged to the Ph1-positive leukemic clone. Antigen detection on these CFU-GM resulted both from Ia-antigen reexpression and the induction of noncycling cells into S-phase with coincident expression of Ia-antigens. These studies provide further evidence for a direct regulatory association between Ia-antigen and control of granulocyte-macrophage progenitor cell proliferation, offer a possible explanation for the disordered regulatory responses observed in patients with CML, and indicate that abnormal growth phenotypes can be modulated, at least in vitro.

Cells, Cultured↗
PubMed1982

Treatment of prolymphocytic leukemia.

Prolymphocytic leukemia is characterized by marked splenomegaly, distinctive cellular morphologic characteristics, and a poor clinical course. Five patients with typical PL were treated systematically with vincristine/prednisone, chlorambucil/prednisone, splenic irradiation, splenectomy, and other chemotherapy regimens. No patient responded to vincristine/prednisone. Two patients responded to chlorambucil/prednisone, and four patients had brief responses to splenic irradiation. Two patients underwent splenectomy, one of whom had a prolonged clinical remission. There were no complete remissions. No other chemotherapy combinations were of value. The median survival was 33 months. Recommendations are made to use chlorambucil/prednisone or splenic irradiation as initial treatment. Splenectomy should be considered in patients refractory to these modalities. The course of PL may be more protracted than originally reported.

Aged↗
PubMed1982

Continuous infusion vincristine and bleomycin with high dose methotrexate for resistant non-Hodgkin's lymphoma.

Sixteen patients with resistant non-Hodgkin's lymphoma were treated with continuous infusions of vincristine (1-2 mg/m2 daily X 2 days) and bleomycin (0.25 mg/kg bolus dose, then 0.25 mg/kg/daily X 5 days). Responding patients received high dose methotrexate (1500 mg/m2) with citrovorum rescue on days 15, 22, 29, 36. Treatment cycles were repeated every six weeks in responding patients. The response frequency was 50% (three complete and five partial responses). Median response duration was 29 weeks. Major toxicity included stomatitis (63%) and leukopenia (44%). One episode each of possible hypersensitivity pneumonitis and paralytic ileus occurred. Continuous infusions of vincristine and bleomycin should be studied further in less critically ill patients.

Adult↗
PubMed1982

Whole bone marrow irradiation for the treatment of multiple myeloma.

Nine patients with multiple myeloma were treated with whole bone marrow irradiation. Six had heavily pretreated disease refractory to chemotherapy. Three had stable disease lightly pretreated by chemotherapy. A modification of the "three and two" total nodal radiation technique was employed. Although varying and often severe treatment related cytopenia occurred, infectious complications, clinical bleeding, and nonhematalogic complications were minimal. Five of nine patients showed a decrease in monoclonal protein components, and one showed an increase during treatment. These preliminary results indicate that a reduction of tumor cell burden may occur in patients following whole bone marrow irradiation and that the technique is feasible. Whole bone marrow irradiation combined with chemotherapy represents a new conceptual therapeutic approach for multiple myeloma.

Adult↗
PubMed1982

Vindesine: a phase II study in childhood malignancies-a report for cancer and leukemia group B.

Vindesine, a semisynthetic derivative of vinblastine sulfate, was tested for antitumor activity and clinical toxicity in 36 children. The drug was administered to the initial 13 patients entered into the study a 2 mg/m2/day for five days by IV bolus. Because of severe neurotoxicity and life-threatening gastrointestinal toxicity, the regimen in 23 patients was modified to 4mg/m2 IV infusion over four hours, weekly. This latter regimen was well tolerated, with acceptable gastrointestinal, hematological, and neurotoxicity. One child with acute lymphocytic leukemia resistant to vincristine had a transient M1 remission bone marrow. Improvement or stable disease was noted in one patient each with Ewing's sarcoma, neuroblastoma, and Hodgkin's disease.

Adolescent↗
PubMed1982

Total skin electron beam therapy for cutaneous lymphomas and leukemias.

Total skin electron beam therapy (TSEB) was used in the treatment of 33 patients with lymphoma and 13 patients with leukemia involving extensive segments of the skin surface. Twenty-two of 23 had skin lesions as a primary manifestation of lymphoma (primary cutaneous lymphoma--PCL) and 11 developed cutaneous lesions following disseminated nodal lymphoma (secondary cutaneous lymphoma--SCL). A once weekly fractionation scheme was employed to irradiate the entire skin surface with 3.5 to 4 MeV electron beam from a 6 MeV linear accelerator. During each weekly session, 400 rad were delivered to the entire skin and a complete course consisted of 4-6 consecutive weekly sessions. The majority of patients have been previously treated elsewhere for various periods and all patients have been at risk for a median of 12 months, range from 12-117 months following TSEB. Striking predominance of the diffuse pattern (76%) was demonstrated in both the PCL and SCL. There was extracutaneous involvement in 63% (13/22) of the PCL, nodal or visceral at onset of TSEB; median follow-up was 24 months, range 6-117 months; 20/22 (90%) of all patients obtained prompt relief of symptoms and complete regression of cutaneous lesions. Duration of cutaneous remission ranged from 6-96 months, median 18 months; in general, duration was adversely influenced by the presence of visceral involvement at onset of TSEB. Although cutaneous response among the patients with SCL and leukemia was equally good, many of these patients were treated for palliation because of rapid progression of their disease. Once weekly treatments were highly effective, well-tolerated and no untoward immediate or late effects have been noted in the bone marrow or normal skin irradiated.

Adolescent↗
PubMed1982

Impact of participation in a family practice track program on student career decisions.

Two classes of entering freshman medical students at the University of Utah indicated career preferences prior to the start of preclinical classwork. A group of interested students applied to a special family practice curriculum track. From this group, 20 were randomly selected each year to participate in the track program. The number was limited because of the need for a small student/faculty ratio. Students participating in the program were found to select residencies in family practice at a significantly higher rate than their classmates who expressed an interest but were not selected to participate. Students who stated a preference for family practice as freshmen were also found to select residencies in family practice at a significantly higher rate than freshman not preferring it. Nevertheless, most senior students matched with residencies different from their freshman preferences.

Career Choice↗
PubMed1982

Swamp rice development, schistosomiasis, and onchocerciasis in Southeast Sierra Leone.

Seventy-four villages in eastern Sierra Leone, West Africa, many having a recently developed rice swamp, were surveyed for the presence of schistosomiasis and onchocerciasis, and their vectors. Prevalence rates for Schistosoma haematobium and S. mansoni were low, although the infections were widespread. There is some evidence that S. mansoni is extending its range in Sierra Leone although this is problematical because of the apparent absence of Biomphalaria pfeifferi, the recognized snail vector, from areas where the disease now occurs. The characteristics of rice swamp environment now being created in Sierra Leone are described and results of snail collections, which were with few exceptions small, are presented. Reasons for the apparent unsuitability of the developed rice swamp as a snail habitat are discussed. Onchocerciasis was found in all villages and the prevalence rate, almost 50%, was high. The rice swamp is not a suitable breeding site for Simulium damnosum s.l., but the study area is crossed by several major rivers and all villages in the area are within flying distance of potential breeding sites. There was no positive evidence that expansion of swamp rice farming will increase the incidence of water based/related diseases but a control program for onchocerciasis, which is a major rural health problem, would seem to be a national priority.

Adolescent↗
PubMed1982

Combination chemotherapy of advanced diffuse histiocytic lymphoma with the six-drug COP-BLAM regimen.

A new multiple-drug protocol consisting of cyclophosphamide, vincristine, prednisone, bleomycin, doxorubicin, and procarbazine, known as COP-BLAM, was administered to 48 patients with stage III or IV diffuse histiocytic lymphoma. Twenty-four of the 33 previously untreated patients had a complete remission, and eight patients had a partial response. The median survival for all previously untreated patients has not yet been reached at 23 months. Median survival for complte responders has not yet been attained at 26 months, although survival of partial responders is 12.5 months. There were no patients with a complete response who had a central nervous system relapse. The COP-BLAM therapy is an easily administered outpatient program capable of inducing a high frequency of durable complete remissions in advanced diffuse histiocytic lymphoma, a malignancy formerly considered to have a poor prognosis.

Adult↗
PubMed1982

5-azactidine and zorubicin for patients with previously treated acute nonlymphocytic leukemia: a Cancer and Leukemia Group B pilot study.

Twenty-nine adults with advanced acute nonlymphocytic leukemia were treated with an intensive chemotherapy program consisting of 5-azacitidine and zorubicin. Overall, eight patients (28%) achieved a complete remission. Although only one of 19 patients with refractory leukemia responded, seven of ten patients who were treated immediately following relapse from a prior remission achieved another complete remission. The duration of remission ranged from 5 to 33 weeks (median, 14). Treatment resulted in severe toxic reactions including myelosuppression, renal tubular dysfunction, and elevations in liver enzymes. In addition, each of the 15 patients who died of treatment-associated complications had a severe infection. This combination of 5-azacitidine and zorubicin is relatively ineffective for truly refractory leukemia, but it may be a useful alternative following relapse.

Acute Disease↗
PubMed1982

Chemotherapy and combined modality therapy for Hodgkin's disease: a progress report on Cancer and Leukemia Group B studies.

Between 1974 and 1977, the Cancer and Leukemia Group B (CALGB) initiated four studies which address current major questions in the therapy for Hodgkin's disease. The efficacy of chemotherapy alone as compared with combined modality therapy in patients with poor-prognostic stages I and II is evaluated in CALGB 7751. Currently, both therapies produce very high complete remission rates in asymptomatic patients; the remission rate is better with combined modality therapy in symptomatic patients. Single and combined modality therapies are compared for stage III patients in CALGB 7451. Complete remission rates have been similar, but relapse-free survival is superior for patients treated with local nodal radiotherapy followed by chemotherapy (P = 0.04). In particular, stage IIIA patients with nodular sclerosis seem to benefit from the inclusion of radiotherapy in their initial treatment. In CALGB 7551, the efficacy of chemotherapy alone versus chemotherapy plus radiotherapy to areas of bulky disease is under study in patients with stages IIIB and IV. Currently, a relapse rate of less than 10% has been seen among sites irradiated, and survival is best for patients treated with radiotherapy bracketed by chemotherapy. Finally, the role of two alternating non-cross-resistant combination chemotherapy programs is being studied in CALGB 7552. Relapse-free and overall survival is better with the doxorubicin-containing regimen than with either the alternating or alternate chemotherapy program. At present, the median followup for each of these studies is less than 5 years. Further observation is required to answer the critical questions relating to prolonged disease-free survival and cure.

Adult↗