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Biomedical subjects

R Chandler

Publications and source records attributed to R Chandler.

25 records · Page 2Linked to original sources
PubMed1986

Treatment of femoral neck fractures with total hip replacement versus cemented and noncemented hemiarthroplasty.

A prospective study of displaced femoral neck fractures was conducted with patients randomized into three groups: cemented total hip replacement (THR), cemented hemiarthroplasty (UHR-C), and noncemented hemiarthroplasty (UHR-NC). Eighty-nine patients were treated for displaced (Garden type 3 or 4) fracture with a prosthesis; 39 patients had THR, 37 had UHR-C, and 13 had UHR-NC. No difference was found in the level of pain, ambulation, or aids required between the THR group and the UHR-C group, except for active community ambulators, who demonstrated decreased endurance capability when treated with UHR-C. The patients treated with UHR-NC had increased pain and decreased ambulation and required assistive devices. The most significant complication was dislocation, which occurred in 7 patients with THR and 2 with UHR-C. The mortality rate at 2 years was 18%; all but two of the deaths were in patients with one of five different medical diseases: clinically significant cardiac or pulmonary disease, cancer, alcoholism, or psychosis. The mortality rate was insignificant in patients younger than 70 years of age. Roentgenographic review showed only 2 of 76 cemented stems with progressive cement-bone demarcation, with one patient requiring revision for a loose prosthesis. No evidence of protrusio was seen with the use of the bipolar cap. The uncemented hemiarthroplasties demonstrated lucency between the metal and bone in the proximal femur in 9 of 13 stems. The authors make recommendations regarding hip replacement.

Adult↗
PubMed1985

Comparison of the distribution and binding of monoclonal antibodies labeled with 131-iodine or 111-indium.

The distribution of two monoclonal antibodies with reactivity against human leukemia/lymphoma associated antigens (BA-1 antibody) and carcinoembryonic antigen (202 antibody) when labeled with 131I or 111In was studied in normal Balb/c mice. The BA-1 antibody of the IgM subclass was labeled with 131I by the micro iodine monochloride method at a 12:1 molar ratio and with 111In by the cyclic DTPA anhydride method at a 10:1 molar ratio. In vitro, the 131I-labeled BA-1 antibody bound 35.5% to 10(7) KM-3 leukemic cells while the 111In-labeled BA-1 antibody bound 29.9% to the same number of KM-3 cells. In vivo, the 111In-labeled BA-1 antibody showed a higher accumulation in liver, spleen, and kidney than the 131I-labeled BA-1 antibody. The 202 antibody of the IgG1 subclass was labeled with 131I at a 5:1 molar ratio and with 111In at a 7:1 molar ratio. In vitro, the 131I-labeled 202 antibody bound 30.9%, 27.4%, and 30.0% to 10(7) CO-112, WIDR, and LS-174T colon cancer cells, respectively. The 111In-labeled 202 antibody bound 20.5%, 30.2%, and 33.6%, respectively to the same number of colon cancer cells. In vivo, the 131I-labeled 202 antibody showed a higher tissue to blood ratio in liver, spleen, and kidney than the 111In-labeled 202 antibody. The data indicate that the relative distribution of 131I-labeled versus 111In-labeled monoclonal antibody may depend on the immunoglobulin subclass of the antibody and the molar ratio used in labeling.

Animals↗
PubMed1983

Classification and treatment of dislocations of total hip arthroplasty.

A review of 39 dislocations of total hip arthroplasties revealed three causes: positional (Type I); soft tissue imbalance (Type II); and component malposition (Type III). Forty-one percent of hips had a single dislocation, and 59% had multiple dislocations. Reoperation was performed in 42%, with 28%, mostly Type III problems, requiring revision; all had had multiple dislocations. Forty percent of the dislocations resulted in complications that were primarily the result of bedrest for treatment. Based on the cause of dislocation, to reduce complication, component positions are determined by roentgenographic analysis. Positional dislocations (the patient assumes a position that exceeds the mechanical stability of the prosthesis) are treated by four to six weeks' use of the hip brace, which limits flexion and adduction. Soft tissue imbalance, most often a result of failure of fixation of the greater trochanter or an excessive femoral neck cut, can be treated initially by a brace. If recurrent dislocations occur, reattachment of the trochanter and/or revision to a long-neck prosthesis should be considered. Component position errors were successfully treated without revision only if a single acetabular error was present. If the acetabulum is malpositioned in two planes or severe retroversion of the femoral component is present, immediate revision is advisable.

Adult↗
PubMed1981

In-111-labeled leukocytes in the diagnosis of rejection and cytomegalovirus infection in renal transplant patients.

Indium-111-labeled (In-111) leukocytes have been shown to be useful in the localization of inflammatory processes, including renal transplant rejection. Using previously reported labeling methods, 63 studies with this agent have been performed in 53 renal transplant patients. Indications for study included suspected rejection or cytomegalovirus (CMV) infection. Studies were performed in 33 men and 20 women, with ages ranging from 6 to 68 years. Autologous cells were normally used for labeling, although leukocytes obtained from ABO-compatible donors were used in three subjects. Rectilinear scanner and/or scintillation camera images were obtained at 24 hours after intravenous administration of 0.1 to 0.6 mCi of In-111-leukocytes. There was abnormal uptake of In-111-leukocytes in the transplanted kidney in 11 of 15 cases of rejection. In three additional cases of increased transplant uptake, CMV infection was present in two. Abnormal lung uptake was present in 13 of 14 patients with CMV infection. In four additional cases, increased lung uptake was associated with other pulmonary inflammatory disease. Increased lung activity was not seen in patients with uncomplicated transplant rejection. These results suggest that In-111-leukocyte imaging may be useful in the differential diagnosis of rejection versus CMV infection in renal transplant patients.

Adolescent↗
PubMed1977

Anti-"i" antibody and hemolytic anemia associated with spontaneous cytomegalovirus mononucleosis.

Hemolytic anemia occurred in a 23-year-old woman with spontaneous cytomegalovirus mononucleosis who had not received a blood transfusion. The patient's serum gave positive reactions in Coombs' antiglobulin test with human cord erythrocytes but did not react with adult "O" cells. Complement-fixation antibody titers against cytomegalovirus and levels of activity against cord erythrocytes increased as the anemia worsened and remained at high levels when recovery from the anemia occurred.

Adult↗
PubMedDate not supplied

Combined radiation therapy and surgery in the management of advanced head and neck cancer: final report of study 73-03 of the Radiation Therapy Oncology Group.

Between March 1973 and June 1979, patients with advanced operable squamous cell carcinoma of the supraglottic larynx or hypopharynx were randomly allocated to receive either preoperative radiation therapy (5,000 rad) or postoperative radiation therapy (6,000 rad). Patients with oral cavity or oropharynx lesions were randomly assigned either preoperative radiation, postoperative radiation, or definitive radiation therapy (6,500-7,000 rad), with surgery reserved for salvage if residual disease was present 6 weeks after completion of irradiation. Three hundred twenty patients were evaluable with a median follow-up of 60 months. Based on results in 277 patients across all four regions combined, locoregional control was significantly better for patients assigned to receive postoperative radiation therapy (65%) compared with those assigned to receive preoperative radiation therapy (48%, P = 0.04). This was due to a higher rate of both persistent and recurrent local and regional disease in the preoperative group. Survival also showed a trend to be better in the postoperative group (38%) compared with the preoperative group (33%, P = 0.10). Rates of severe surgical and radiation therapy complications were similar overall. Forty-three patients were evaluable for each of the three treatment regimens assigned to patients with oral cavity or oropharynx lesions. Due to the small number of patients available for this portion of the trial, the observed differences for overall survival (4-year percentage 33% overall; 30% preoperative, 36% postoperative, 33% definitive radiation therapy) and for locoregional control (45% overall; 43% preoperative, 52% postoperative, 38% definitive radiation therapy) were not statistically significant. The use of definitive radiation therapy with surgical rescue as an ethically justified alternative treatment for these tumors remains a question for further research.

Carcinoma, Squamous Cell↗