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Biomedical subjects

M McCabe

Publications and source records attributed to M McCabe.

At least 55 records · Page 3Linked to original sources
PubMed1993

Phase I study of Taxol, doxorubicin, plus granulocyte-colony stimulating factor in patients with metastatic breast cancer.

The objective of this phase I trial was to determine the maximal tolerated dose (MTD) of Taxol and doxorubicin administered as a simultaneous intravenous infusion over 72 hours every 21 days. Granulocyte-colony stimulating factor (G-CSF) 10 micrograms/kg, was administered on days 4-18 of each cycle. The treated population consisted of metastatic breast cancer patients previously untreated with chemotherapy for metastatic disease, who had not received doxorubicin in the adjuvant setting and who had bidimensionally measurable disease. The MTD was determined to be 75 mg/m2 of doxorubicin and 160 mg/m2 of Taxol. The dose-limiting toxicity of the combination was clinical typhlitis in three of three patients. Other significant toxicities included grade 3 diarrhea at the higher dose levels and grade 4 neutropenia in all patients. Eighteen patients were treated on this initial phase I study. The overall response rate was 62%, with 6% complete responses and 56% partial responses. The combination of doxorubicin and Taxol by 72-hour continuous infusion with G-CSF is an active regimen in patients with metastatic breast cancer.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1993

Common infections complicating lung transplantation.

Infections are the most common cause of early and late morbidity and mortality in lung transplant recipients. Viral infections, in particular, have been linked to acute rejection, chronic rejection, and development of lymphoproliferative diseases.

Diagnosis, Differential↗
PubMed1992

Apparent heterogeneity between leukemic lymphocyte cell lines.

31P-NMR and polarographic techniques were used to investigate glycolytic versus aerobic oxidative activity in normal and leukemic lymphocytes, and to investigate possible heterogeneity in these parameters between two leukemic cell lines. Molt 3 cells showed a 10-fold higher rate of glutamine-dependent respiration than Molt 4 cells, and an increased level of glutamine-uptake. Molt 3 demonstrated a high intracellular buffering capacity, manifested by constant pHi after addition of glucose, while the same treatment applied to Molt 4 cells induced a change in internal pH of up to 1.23 pH units. This data raises the possibility of heterogeneity of leukemic lymphocytes within the patient from whom the isolation was conducted, or of gross metabolic adaptation by the cell lines in culture.

Biological Transport, Active↗
PubMed1992

A technique for postoperative irradiation of carcinomas of the larynx and hypopharynx.

Postoperative radiation is commonly employed for advanced lesions of the larynx and hypopharynx which have undergone a laryngectomy. It is technically difficult to achieve a homogeneous distribution of irradiation throughout the treatment volume because of the marked variation in contour across the treated area. We have described a technique which employs a 15 degrees lateral kick-out of the treatment table and a 15 degrees gantry angle above the horizontal for each of two lateral fields. This technique has certain advantages over other techniques previously described in the literature. By adding a gantry angle of 15 degrees above the horizontal to the kick-out lateral position of the table, we have found that we were able to decrease the amount of irradiation to the shoulder, to improve the dose to the posterior superior mediastinum, to lower the applied dose, and to avoid a hot spot overlying the spinal cord in the superior posterior portion of the field. This technique is particularly useful in patients who lack the flexibility to move their shoulders posteriorly and inferiorly.

Carcinoma, Squamous Cell↗
PubMed1992

Functional characteristics of sperm obtained by electroejaculation.

Sperm obtained by electroejaculation in 32 anejaculatory men were examined for functional characteristics. Raw specimens showed high sperm counts but motility averaged only 11%. Average viability was 10% for antegrade and 5% for retrograde fractions. Bovine cervical mucus penetration was normal (30 mm. or more in 30 minutes) in only 24% of the electroejaculation samples but it was normal in all of the donor samples tested. Processed sperm motility averaged 30% with 71% forward progression. At 20 hours patient samples retained 46% of the original motility, while donor controls retained 81%. In the hamster egg penetration assay patient sperm penetrated 14% of the oocytes while donor sperm penetrated 40%. Therefore, we identified 4 characteristics of sperm obtained by electroejaculation: 1) low viability, 2) poor survival after overnight incubation, 3) moderately impaired cervical mucus penetration and 4) moderately poor fertilizing capability as measured by the hamster egg penetration assay. Poor sperm survival and impaired function may explain the low pregnancy rates from insemination with electroejaculated sperm.

Adult↗
PubMed1992

Fertility of spinal cord injured males: effect of genitourinary infection and bladder management on results of electroejaculation.

Thirty-eight men undergoing electroejaculation (EEJ) procedures for anejaculatory infertility were examined for the presence or absence of infection in urine and semen. In 29 spinal cord injury patients, a high incidence of infected urine and infected semen (41% and 56%, respectively) was seen, in contrast to patients with normal bladder function (0% and 11%). Urinary infection was associated with slightly lower sperm quality and lower pregnancy rates (10% vs 30% in the presence of sterile urine). Semen infection had no effect on sperm counts or pregnancy rates. If intermittent self-catheterization (ISC) was used to empty the neurogenic bladder, slightly better sperm quality was seen, the total failure rate was less, and much better pregnancy rates (44%) resulted than for patients using an alternative bladder management (7%). Antibiotics did not reduce the incidence of urine or semen infection, but did improve sperm counts slightly. Continuous prophylaxis was associated with bacterial resistance to many oral antibiotics and had no advantage over a short course of antibiotics prior to the procedure. Despite the above associations, the sperm quality in our patient population was never normal compared with that of men who ejaculate normally. We conclude that the low sperm quality seen in electroejaculation specimens from spinal cord injured males is not due entirely to infection or to the type of bladder management. Short courses of antibiotics, instead of continuous antibiotic prophylaxis, may be beneficial. Intermittent catheterization is superior to other methods of neurogenic bladder management in maintaining the fertility of spinal cord injured men.

Adult↗
PubMed1992

Mammographic needle localisation of impalpable breast lesions.

Refinements in mammography have led to an increased number of needle localised breast biopsies for impalpable breast lesions. This paper review 139 needle guided biopsies from June 1986 to December 1990 in 132 patients. Forty four patients (32%) biopsied had malignant lesions the vast majority (91%) of which were reported as either non-invasive or invasive less than 2 cm in diameter. Fourteen patients in this group had ductal carcinoma in-situ. When compared with 100 consecutive palpable breast carcinomas during the same period, needle localised biopsies had a higher proportion of non-invasive lesions and fewer were associated with lymph node involvement. Needle guided breast biopsy detects carcinoma at an earlier stage and may reduce morbidity and mortality from breast cancer.

Biopsy, Needle↗
PubMed1991

Electroejaculation following retroperitoneal lymphadenectomy.

Transrectal electroejaculation was performed in 24 men who were anejaculatory from retroperitoneal lymphadenectomy. Of the men 23 had undergone retroperitoneal lymphadenectomy because of testis cancer. Seminal emission was achieved in all patients. In 21 patients greater than 10 x 10(6) progressively motile sperm with normal morphology were obtained. The average sperm count and motilities obtained were 289 x 10(6) and 18%, respectively, for the antegrade fractions, and 2,051 x 10(6) and 13%, respectively, for the retrograde fractions. Of the 3 azoospermic failures 2 had chemotherapy-induced testicular damage and 1 had carcinoma in situ of the remaining testis. A total of 19 couples underwent artificial insemination with electroejaculated sperm. There were 7 pregnancies achieved in 74 insemination cycles (36.8% of the couples conceived for a 9% cycle fecundity). Routine semen parameters could not predict which couples would be successful in achieving pregnancy. There were 2 first trimester spontaneous abortions. Five healthy children have been born. Electroejaculation is an excellent treatment for anejaculation that persists following retroperitoneal lymph node dissection.

Adult↗
PubMed1991

Acute febrile neutrophilic dermatosis in childhood (Sweet's syndrome).

We report a case of Sweet's syndrome in childhood. Our patients suffered from repeated fevers, chest infections and had characteristic erythematous plaques. The severity of his illness increased with age and warranted oral steroid treatment. We review 16 cases reported to date in the literature and comment on the management and prognosis of the disease in childhood.

Fever↗
PubMed1991

Poikiloderma congenitale: case report and review of the literature.

Since birth an 8-year-old girl had a rash on both cheeks, consistent clinically and histologically with poikiloderma. She also had visual impairment to the extent of light perception only, due to microthalmia and dense scleralization of the corneas. These features were considered consistent with a diagnosis of Rothmund-Thomson syndrome.

Cataract↗
PubMed1991

Attitudes of paediatricians to HIV and hepatitis B virus infection.

There is a recent upsurge of interest among health care professionals regarding the risk of accidental occupational exposure to HIV virus. We evaluated knowledge of virus carriage prevalence, needlestick injuries, venepuncture practices, and glove use among paediatricians in Wales and South West Regional Health Authorities. We also attempted to evaluate hepatitis B immunisation uptake in this group. Paediatricians have traditionally been considered a low risk group in the context of accidental occupational exposure to these viruses. We targeted a four point questionnaire at 221 paediatricians. Results suggested that despite recent increasing concern about these viruses, that is reflected in the amount of medical literature recently published, and the issuing of Department of Health guidelines on venepuncture, knowledge of prevalence of HIV and hepatitis B carriage rates, and hence assessment of risk magnitude, was surprisingly poor. Safe venepuncture practices were not widely used. In the 12 months before receiving the questionnaire 55% had suffered a needlestick injury with only 10% reporting the fact. Hepatitis B immunisation uptake was highest in the junior grades (but this does not necessarily mean those at greatest risk). There were many inconsistencies between the clinicians' perceptions of risk and their practices. As the virus attains a firm hold in the heterosexual population paediatricians by virtue of the nature of venepuncture in children will almost certainly see their risk of acquiring HIV/hepatis B viruses secondary to accidental occupational exposure increase over the next decade. Without an improvement in current knowledge of carriage prevalence in high risk areas and alteration in venepuncture practices/hepatitis B immunisation uptake some will unfortunately, though avoidably, contract these bloodborne viral infections.

Child, Preschool↗
PubMed1991

Sports insurance and national governing bodies.

A postal survey was conducted of the attitudes and advice of Welsh governing bodies of amateur sports and their Cardiff-based clubs towards personal sports insurance. Information on 36 of the 39 sports surveyed (92%) was sufficient for analysis. Twenty-two of these 36 sports (61%) organized insurance at a national level, one at club level (3%) and 13 (36%) provided no insurance advice. Only 12 sports (33%) insisted on mandatory insurance cover. Many sportsmen and women are left to search for an appropriate insurance cover themselves or remain uninsured. Owing the lack of advice in 36% of cases it was decided to survey Cardiff-based insurance brokers to establish what type of policy they would recommend. Only 41% of the brokers were able to offer a suitable policy. Club policies recommended by the Central Council for Physical Recreation provide individuals with the same sports cover (but at a lower premium) as is available from a personal accident policy. However, cover is somewhat inadequate and may provide a false sense of security. Sports with mandatory sports insurance are not necessarily those with the highest risk of disabling injury.

Athletic Injuries↗