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Biomedical subjects

R Buchanan

Publications and source records attributed to R Buchanan.

At least 55 records · Page 3Linked to original sources
PubMed1986

Depression and social stress among patients with benign breast disease.

One hundred and forty women referred to the Southampton breast clinic had a psychiatric interview at home, before their first clinic attendance. The 107 subsequently diagnosed as having benign breast disease had a high rate of depressive symptomatology in comparison with women in published surveys of the general population. In the year before referral, 25 (23 per cent) had had definite depression and 19 (18 per cent) had had borderline depression: at the time of interview 9 (8 per cent) had major depression and 22 (21 per cent) had minor depression. Depression in these patients was associated with recent life events and social difficulties. Mood disturbance and psychosocial stress may lead to medical consultation about benign breast disease, or even contribute to its development. Severe depression was less common in the 33 patients who turned out to have breast cancer, though more of them had minor depression, and they reported fewer recent life events.

Adult↗
PubMed1984

Combination chemotherapy in small cell lung carcinoma. A randomized study of two intensive regimens.

From April, 1979 to November, 1981, 293 patients with small cell lung carcinoma (SCLC) were entered on a randomized, controlled study comparing the two induction regimens of high-dose CAV (HD-CAV) (cyclophosphamide [CTX] 1200 mg/m2, doxorubicin [ADR] 70 mg/m2 and vincristine [VCR] 1 mg/m2 intravenously (IV) on days 1 and 21) versus, conventional-dose CAV + VP-16 (etoposide) (CAV-VP) (CTX 1000 mg/m2, ADR 40 mg/m2, VCR 1 mg/m2 IV on days 1 and 21 with VP-16 100 mg/m2 on days 1-3, and 21-23). Responding and stable patients were continued on conventional-dose CAV for 5 consolidation courses. Prophylactic brain irradiation delivered after the first consolidation course in responders was optional. Patients were included in the study if they had extensive disease (i.e., beyond one hemithorax), no prior chemotherapy, or radiotherapy and performance status of 50 or above. After 2 induction courses, 215 cases are evaluable. Of these, 76 of 106 (72%) patients treated with HD-CAV have responded (greater than 50% regression), including 13 complete responders (CRs) versus 80 of 108 (74%) patients on CAV-VP, including 15 CRs. Of the 130 evaluable patients who have completed consolidation (HD-CAV, 65; CAV-VP, 65), an additional 22 patients achieved CR (HD-CAV, 12; CAV-VP, 10) for an overall CR rate of 24%. Median duration of remission was 33.6 weeks for HD-CAV and 35.6 weeks for CAV-VP (P = 0.61). Median duration of complete response for HD-CAV was 33.8 weeks and for CAV-VP 36.7 weeks (P = 0.81). Survival curves were similar for the two regimens, with medians of 42.1 weeks for HD-CAV and 42.3 weeks for CAV-VP (P = 0.35). Survival correlated with performance status and quality of response. As anticipated, the major toxicity for both induction regimens was leukopenia. During induction, granulocyte nadirs of less than 500/mm3 occurred in 81% of patients on HD-CAV and 77% of patients on CAV-VP. Thus, dose intensification appears to produce high response rates and modest complete response rates in extensive SCLC, but it does not appear to improve materially survival compared to prior reports of conventional-dose therapy.

Adult↗
PubMed1984

A comparison of two doses of tamoxifen (Nolvadex) in postmenopausal women with advanced breast cancer: 10 mg bd versus 20 mg bd.

In a comparative double-blind trial involving 263 postmenopausal women with advanced breast cancer treated with tamoxifen, the mean objective tumour response rate and duration was 32% and 15 months respectively. No significant difference was found in clinical response and adverse effects between those randomised to 10 mg and those to 20 mg twice daily. Although the mean serum concentration of tamoxifen in the 20 mg bd group was significantly higher no correlation between serum level and clinical benefit was demonstrated.

Adult↗
PubMed1982

Chemotherapy of advanced ovarian carcinoma: initial experience using a platinum-based combination.

Thirty-five previously untreated patients with FIGO Stage III or IV ovarian carcinoma were treated with cis-diamminedichloroplatinum (II), Adriamycin and cyclophosphamide (PACe). Following four or five cycles of PACe, patients were assessed clinically for response. Twenty-one (60%) of the patients attained a clinical complete remission (CCR), seven (20%) a partial remission, and seven (20%) did not respond. The median survival of all patients was 19 months, 6.4 months for partial and nonresponders, and 26.5 months for clinical complete responders. Six patients remain relapse-free for more than two years. Patients entering into the study during the second year underwent a second-look procedure if they attained a CCR. Ten patients in CCR were assessed for second look; two refused, and eight underwent a laparotomy. Three of eight were in complete remission after second look, and a fourth patient who had microscopic disease in one ovary was rendered free of disease by surgery. Subjective toxicity was marked due to severe nausea and vomiting. Renal toxicity was not troublesome and myelosuppression was moderate. Ototoxicity and peripheral neuropathies were seen in seven patients. PACe is a highly effective induction regime but randomized studies are required to show that improved survival will result from it's use.

Adenocarcinoma, Mucinous↗
PubMed1981

Malignant interstitial cell tumor of the testis.

The light microscopic and ultrastructural characteristics of a hormonally active Leydig cell tumor are described. Evidence is adduced that strongly suggests that the Leydig cell tumor was malignant and that functioning metastases were present.

Aged↗
PubMed1981

Assessment of progression of secondary bone lesions following cancer of the breast or prostate using serial radionuclide imaging.

A serial study on 32 patients with bone metastases following cancer of the breast or prostate was performed over three years. Up to ten sets of images (average of four) per patient were obtained during this period using 99Tcm methylene diphosphonate as the radiopharmaceutical. Ninety-three paired serial images of individual lesions were qualitatively assessed for change by three physicians in nuclear medicine and the results were compared with the quantitative results from computer analysis. The reproducibility of the quantitative approach was determined by the analysis of 20 paired lesions by three physicists. It was found that quantitative changes in uptake of less than 20% between images were generally not detected by the medical observers; a change of 41% had only a 95% probability of being identified as change by the physicians. Although much more reproducible in determining changes in individual lesions, the quantitative approach was found to be inferior to the qualitative assessment of overall change in the majority of cases which involve multiple lesions. The basic assumption that uptake varies proportionally with progression of the bone lesion is discussed an is considered in some instances to be untenable. The conclusion is drawn that the determination of progression from changes of uptake in longstanding lesions is uncertain and is subsidiary in importance to the detection of new lesions.

Bone Neoplasms↗
PubMed1981

Alternating non-cross-resistant drug combinations in the treatment of metastatic small-cell carcinoma of the lung.

In a randomized trial of the Southeastern Cancer Study Group, patients with metastatic small-cell lung carcinoma were treated with a combination of cyclophosphamide (500 mg/m2 I.V.), Adriamycin (50 mg/m2 I.V.), DTIC (250 mg/m2 I.V.), and vincristine (1 mg/m2 I.V.) every 4 weeks for three cycles. Complete and partial responders to this induction regimen were then randomized to receive either the same combination every 4 weeks for an additional six cycles versus a non-cross-resistant drug combination of BCNU (100 mg/m2 I.V.), procarbazine (100 mg/m2 p.o. daily x 10 days), methotrexate (25 mg/m2 I.V.), and vinblastine (5 mg/m2 I.V.) every 4 weeks for six cycles versus alternating treatments with the two regimens for a total of six cycles of therapy. Patients who were less than good responders received six cycles of the non-cross-resistant drug combination. Of 202 evaluable patients, 40% responded (complete + partial responses) to induction; the complete response rate for the whole group was low (14%). Patients randomized to the BPMV combination, or crossed over to it, failed to improve upon their response to induction. Patients who responded to induction had a median survival of 41 weeks versus 20.6 weeks for the nonresponders, p less than 0.001. Performance status greater than or equal to 60%, and absence of prior radiotherapy were associated with improved survival (30 and 31.5 weeks, respectively). The toxicity of these regimens was acceptable. Failure to improve on results of our earlier protocol were probably due to the long (weeks) interval between treatments, inclusion of a relatively inactive but toxic drug (DTIC) in the induction combination which limited doses of the more active agents, and the use of a non-cross-resistant drug regimen which was inactive.

Adult↗
PubMed1980

Impaired antigen-specific suppressor cell activity in patients with rheumatoid arthritis.

Antigen-specific suppressor cell activity of peripheral blood mononuclear cells was investigated in 20 patients with rheumatoid arthritis (RA) and 16 age- and sex-matched healthy controls. Suppressor cell activity was generated by priming peripheral blood mononuclear cells with high dose antigen (ovalbumin) and adding the washed primed or control (unprimed) cells to autologous, optimally stimulated, target plaque forming cell (PFC) cultures. The ability of the primed cells to interfere with an optimal ovalbumin specific PFC response in the target culture was used as a measure of antigen-specific suppressor cell activity. The results demonstrated that the mean (+/- SE) PFC response of the rheumatoid patients (669 +/- 76 PFC/10(6) cells) was not statistically different from that of the normal controls (722 +/- 83 PFC/10(6) cells), P = 0.1. However, reduced suppressor cell activity was observed in the rheumatoid patients relative to controls (46.4 +/- 4.2% versus 64.6 +/- 2.7% suppression, respectively; P < 0.001). No correlation was demonstrated between suppressor cell activity in rheumatoid patients and disease activity or therapy.

Adult↗