Search PubMed⌕ Search

Biomedical subjects

R D Williams

Publications and source records attributed to R D Williams.

252 records · Page 14Linked to original sources
PubMedDate not supplied

MR imaging of Hippel-Lindau disease: value of gadopentetate dimeglumine.

Hippel-Lindau disease is an autosomal dominant disorder characterized by tumors of the central nervous system and abdominal viscera. Frequent multisystem radiologic evaluation of persons at risk is desirable. Twenty-seven patients with Hippel-Lindau disease or a family history of the disease were examined with both unenhanced and gadopentetate dimeglumine-enhanced magnetic resonance (MR) imaging to study the usefulness of the contrast medium in the evaluation of these patients. The MR studies were correlated with computed tomographic (CT) scans in seven patients and cerebral angiograms in five. Twelve patients had hemangioblastomas in the brain, and eight of these patients also had spinal cord lesions (most were multiple), well demonstrated with gadopentetate dimeglumine. Contrast-enhanced MR imaging enabled detection of more central nervous system lesions and provided better delineation than unenhanced MR imaging, CT, or angiography. In addition, four patients with multiple renal cysts seen on CT scans and unenhanced MR images had enhancing lesions that were later proved to be renal cell carcinoma at angiography and/or surgery. Four patients had cystic lesions in the pancreas that did not enhance and were later proved to be pancreatic cysts. The authors conclude that gadopentetate dimeglumine-enhanced MR imaging appears to be a useful method for evaluating and following up patients with Hippel-Lindau disease.

Adolescent↗
PubMedDate not supplied

Immunotherapy of renal cell cancer.

Immunotherapy of metastatic renal adenocarcinoma (RCC) is currently an alternative to cytotoxic chemotherapy. Bacillus Calmette-Guérin has been associated with a 22% response rate in small series, but no large-scale clinical trials have been completed. Transfer factor, in combination with other immunotherapeutic and chemotherapeutic compounds, has a reported 13% incidence of response. Tumor vaccines have caused clinical response in only 5% of patients while monoclonal antibodies have produced partial remission in one of nine patients. Immune RNA has been associated with a 14% overall incidence of response. Tumor necrosis factor has not as yet been studied in any large-scale clinical investigations but preliminary studies are not promising. Leukocyte-derived and recombinant interferons alone have produced responses in 10-20% of patients with tolerable toxicity. Combinations of interferons or with cytotoxic chemotherapy have produced slightly improved responses with short duration and substantial toxicity. Adoptive immunotherapy using Interleukin-2 alone, or with IL-2 plus lymphocyte-activated killer cells, or tumor infiltrating lymphocytes or interferons have produced clinical responses in 10-30% of patients treated. Combinations of specific forms of immune therapy may hold promise for better rates of clinical response in the future.

Carcinoma, Renal Cell↗
PubMedDate not supplied

Breast cancer screening knowledge, attitudes, and practices among Korean American women.

PURPOSE/OBJECTIVES: To describe the knowledge and beliefs about breast cancer and breast cancer screening and practices of clinical breast examination (CBE) and mammography of Korean American women. DESIGN: Cross-sectional survey. SETTING: Two Korean churches in a mid-sized Southeastern U.S. city. SAMPLE: A convenience sample of 107 Korean women ages 40 and older. METHODS: Data were collected using Champion's Health Belief Model instrument (susceptibility, seriousness, benefits, and barriers) and the Breast Cancer Knowledge test through mailed questionnaires. MAIN RESEARCH VARIABLES: Knowledge and beliefs about breast cancer screening and practices of CBE and mammography. FINDINGS: The percentages of Korean American women who ever had a CBE and mammography were 67 and 58, respectively. Among the Health Belief Model variables, women who never had a CBE had significantly lower knowledge scores and higher perceived barriers to CBE than those who had. Women who never had a mammogram reported significantly higher perceived barriers to mammography. Logistic regression analyses demonstrated that husband's nationality, regular checkups, and encouragement from family members and physicians were significant predictors of CBE and mammography use. CONCLUSIONS: The frequency of breast cancer screening practices among Korean American women is below national objectives. IMPLICATIONS FOR NURSING PRACTICE: As healthcare professionals in a culturally diverse nation, nurses need to increase their awareness of cultural variations and provide culturally and linguistically appropriate breast health education. Additional studies with women from a variety of settings are needed to validate present study findings.

Adult↗
PubMedDate not supplied

RN education flexibility utilizing laptop computers.

In a geographic region that is largely rural, baccalaureate faculty teaching RNs needed a program of study that provided flexibility. This article describes a project that incorporates CAI and PCs into RN education. Difficulties and successes of the project are also discussed.

Alabama↗
PubMedDate not supplied

Differential effects of human natural interferon-alpha and mismatched double-stranded RNA against a human renal cell carcinoma xenograft.

The antitumor effects of natural human IFN-alpha and mismatched dsRNA against the human renal cell carcinoma cell line 786-0 were studied both in a clonogenic soft agar assay and in the nude mouse. The 786-0 cells were sensitive in vitro to the antiproliferative effects of IFN-alpha in a dose-response manner, up to 3000 IRU/ml. These cells were also sensitive, in a dose-dependent manner, to mismatched dsRNA in the clonogenic assay. Mismatched dsRNA was effective in inhibiting tumor growth (p less than 0.001) in nude mouse xenografts, with regression of the tumor mass seen in all animals. A significant increase in survival (p less than 0.001) was seen in the mismatched dsRNA treated group. In contrast, IFN-alpha did not inhibit tumor growth in vivo, even though significant titers of IFN-alpha (greater than 3,000 IRU/ml) were found in the serum shortly after treatment. Mismatched dsRNA did not induce the production of human IFNs by the tumor cells in vitro. Assays of mouse IFN induction and their in vitro antigrowth effects indicated that the in vivo antiproliferative effect of mismatched dsRNA was probably not due to potentiation of any direct effects by the induced mouse IFNs. Tumor growth inhibition appeared to occur, at least in part, from the significant augmentation (p less than 0.01) of natural killer cell activity by mismatched dsRNA, as measured in the spleen cells of treated mice. These results suggest that, although both IFN-alpha and mismatched dsRNA can be directly antiproliferative against this tumor, either the IFN-independent antitumor effects of mismatched dsRNA or the mismatched dsRNA-induced augmentation of the host immune response plays a major role in tumor regression. Potentially, both mechanisms may be important in this system.

Animals↗
PubMedDate not supplied

Recalled anxiety: from discovery to diagnosis of a benign breast mass.

PURPOSE/OBJECTIVES: To determine the amount of anxiety recalled by women who have had benign breast biopsies and to describe coping strategies used by these women during the time from discovery of the mass to definitive diagnosis. DESIGN: Descriptive, retrospective. SETTING: Surgical oncology practices, private and academic, treating patients living in five southern states. SAMPLE: 238 women who had excisional biopsies with benign results within the previous two years. Mean age of 52 years, 80% Caucasian, and 20% African American. METHODS: Subjects rated their anxiety from discovery to diagnosis on a 16-point visual analogue scale and answered a short-answer question about the coping strategies used to deal with the anxiety. MAIN RESEARCH VARIABLES: Anxiety and coping strategies. FINDINGS: The mean length of time from discovery to diagnosis was 35 days. No statistically significant relationship was found between the length of time from discovery to diagnosis and the amount of anxiety experienced. However, 58% of the women recalled severe amounts of anxiety during this time. Qualitative analysis grouped coping strategies into five patterns (themes): diversionary, spiritual, interpersonal, hopeful, and avoidance. CONCLUSIONS: The time between discovery of a breast mass and definitive diagnosis is a time of considerable anxiety for many women. Substantial time elapses between discovery and diagnosis, contributing to the possible morbidity associated with severe anxiety. IMPLICATIONS FOR NURSING PRACTICE: Nurses can work to decrease the time occupied by the diagnostic process, counsel women regarding the anxiety being experienced, and present coping strategies that may help.

Adaptation, Psychological↗
PubMedDate not supplied

Method of discovery of breast cancer.

PURPOSE: The purpose of this study was to determine how breast cancers are found according to the frequency of breast self-examination, mammography, and clinical examinations. Additionally, the means of discovery according to age, race, family history, and educational level was determined. DESCRIPTION OF STUDY: The study was a retrospective, descriptive design using a nonprobability sample of 51 women diagnosed with breast cancer during 1991-1992. Anonymous questionnaires were used for data collection. RESULTS: Overall, the most frequent method of discovery was mammogram (n = 20; 39%), followed by breast self-examination (n = 18; 35%), accidental palpation by self (n = 7; 14%), clinical examination (n = 3; 5.9%), and by accidental palpation by another person such as husband/lover (n = 3; 5.9%). Only 10 of the 51 women 40 years of age and older followed all American Cancer Society guidelines for breast cancer detection. Of these, 60% of the cancers were found by breast self-examination. Similarly, breast self-examination was the most frequent method for white women, and for women with a high school education or higher. Mammography was the most frequent means for black women, for women with less than a high school education, and for women with a negative family history of breast cancer. Of particular concern was the fact that of the 20 women having mammograms every 1 to 2 years before diagnosis, half (n = 10) had breast cancer found by palpable means. CLINICAL IMPLICATIONS: All three breast cancer detection methods--breast self-examination, mammography, and clinical breast examinations--should be emphasized by health professionals given that mammography alone is not 100% accurate.

Adult↗