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Biomedical subjects

R E Johnson

Publications and source records attributed to R E Johnson.

At least 307 records · Page 17Linked to original sources
PubMed1977

Radiotherapy results for nodular sclerosing Hodgkin's disease after clinical staging.

Certain features of nodular sclerosing Hodgkin's disease predispose toward achievement of excellent radiotherapeutic results using clinical staging rather than currently advocated surgical staging including laparatomy. These include a distinct pattern of contiguous lymphatic involvement and the infrequent dissemination of disease to extranodal sites in early stage patients. Only three of 58 consecutive Clinical Stage I-III patients initially treated with radiotherapy alone between 1965 and 1969 have died from Hodgkin's disease. The 10-year survival rates corrected for intercurrent deaths are 97%, 90%, and 86% for Stages I-IIA, IIB, and III respectively. The usual prognostic influence of "B" symptoms was not evident following extended prophylactic irradiation. Likewise, there was no discernible influence of the subtype (lymphocyte predominant, mixed cellularity, lymphocyte depletion) on survival with these nodular sclerosis patients. There was a single extension of disease to iliac nodes in 46 patients with supradiaphragmatic involvement for whom prophylactic irradiation did not extend below the aortic bifurcation, providing justification for modified total nodal irradiation. Development of extranodal dissemination was observed in only 4/58(7%) patients, indicating that adjuvant chemotherapy is not warranted or justified in the early stages of nodular sclerosing Hodgkin's disease.

Adolescent↗
PubMed1977

Thermodynamics of cross links.

Comparison of the melting temperatures of native lysozyme and a cross-linked ester derivative of lysozyme (Imoto and Rupley, 1973) yielded a value of 5.5 kcal/mole for the free energy of stabilization developed through forming the cross link and a value of zero for the corresponding enthalpy. There is close agreement between experiment and calculation from the statistical theory of polymers.

Calorimetry↗
PubMed1977

Antiviral activity of some beta-diketones. 1. Aryl alkyl diketones. In vitro activity against both RNA and DNA viruses.

The discovery that 4-[3-ethyl-6-[(3,4-methylenedioxy)phenyl]-3-hexenyl]-3,5-heptanedione (40) exhibited an in vitro inhibitory effect against equine rhinovirus led to a structure--activity study to establish the criteria for optimum activity. Modification of the bridge included removal of the ethyl group and reduction of the double bond. The heptanedione was replaced with hexanedione and pentanedione with a minimal effect. The effect of replacing the heptanedione with beta-keto esters and monoketones was also investigated. Maintaining the hexamethylene bridge and heptanedione, the methylenedioxy group was replaced with various substitutents. In general, most substituents did not adversely affect activity particularly against equine rhinovirus although there was some variation in activity against herpesvirus. Strongly hydrophilic groups significantly reduced activity. Finally, the effect of varying the length of the alkyl bridge was examined in the 4-hydroxyphenyl series, where peak activity was attained with n = 8.

Antiviral Agents↗
PubMed1977

Treated adverse effects of drugs in an ambulatory population.

Adverse drug reactions represent an area of concern in the delivery of medical care. Current data available indicating the nature and extent of the problem of adverse drug reactions are recognized as inadequate for policy making. This study contributes new information about the adverse effects of drugs treated in an outpatient population. The findings showed that the adverse effects of oral contraceptives accounted for a large share of medical care contacts, procedures rendered, and estimated dollars expended. The incidence and prevalence rates indicated relatively few persons among the population were treated for adverse effects of drugs. Annual costs to the medical care system of treating adverse drug effects were estimated to be $.83 per person. Additional information is needed about adverse drug reactions if strategies and approaches to deal with adverse effects of drugs are to be efficient and effective.

Adolescent↗
PubMed1977

Lymphoma presenting in bone: results of histopathology, staging, and therapy.

Lymphoma presenting in bone (that is "reticulum cell sarcoma of bone") is a form of extranodal lymphoma historically described as frequently localized (this is, stage IE or stage IIE). Between 1970 and 1975, 14 patients with this entity were seen at the National Cancer Institute. This group had a variety of histologic subtypes of diffuse lymphoma. Thorough staging showed extensive disease (stage IV) in 12 of these patients (86%). In 10 of these the metastatic disease was unsuspected clinically. Seven patients achieved complete remissions after treatment was combination chemotherapy alone (two patients), irradiation alone (one patient), surgery alone (one patient), and both chemotherapy and irradiation (three patients) and are alive and free of disease 11 + to 70 + months after diagnosis. The other seven patients did not achieve complete remission status and have all died. Although lymphomas presenting in bone may occasionally be localized, careful staging in this series frequently showed extensive disease and altered the therapeutic approach.

Adolescent↗
PubMed1977

Advanced lymphocytic lymphoma: randomized comparisons of chemotherapy and radiotherapy, alone or in combination.

Ninety-nine previously untreated patients with stage III and IV malignant lymphoma were randomized to receive either cyclic combination chemotherapy (50 patients) or extensive "systemic" radiotherapy (49 patients). Histologic classification included nodular poorly differentiated lymphoma (54 patients), nodular mixed lymphoma (21 patients), and diffuse poorly differentiated lymphoma (24 patients). High overall response rates were seen with either approach (90% for radiotherpy; 86% for chemotherapy) and complete remission were relatively common (60%--80%). Overall median survival of all patients in this trial will exceed 5 years regardless of the induction therapy used; however, disease-free survival is not commonly achieved with either regimen. Relapse-free survival rates at 4-year followup, regardless of induction regimen, are 13% for diffuse lymphomas and 24% for nodular lymphomas. The second prospective trial attempts to use a combined approach and compares cyclic combination chemotherapy with total-body irradiation and combination chemotherapy. Initial results on 34 patients indicate high overall response rates (100%) and similar complete remission rates (64%--67%). With 14 months' median followup no patients in either arm of the trial have died but relatively equal numbers have relapsed.

Adult↗
PubMed1977

Radiotherapy as primary treatment for chronic lymphocytic leukaemia.

Conventional chemotherapy and local radiotherapy have failed to reverse the progressive haematological and immunological deterioration that characterizes the natural history of chronic lymphocytic leukaemia. At the National Cancer Institute, we have demonstrated that treatment with fractionated total-body irradiation has induced remissions sufficiently complete to modify the manifestations of disease which affect survival adversely. One-third of patients with active CLL have experienced responses distinguished by complete resolution of symptoms and palpable disease, correction of anaemia, restoration of the leucocyte count and differential to normal, clearing of the lymphocytic bone-marrow infiltration, and recovery from immunological incompetence. A distinct correlation has been observed between the response to therapy and the subsequent clinical course. The quality of life has been improved and the duration of survival prolonged in the group of patients who obtained the most favourable response (Type 1) to treatment. This establishes a rational for future attempts at reducing still further the tumour-cell burden. This view is in contrast to the generally accepted view that treatment has little if any influence upon the course of the disease or its prognosis.

Aged↗
PubMed1977

Sequential staging in non-Hodgkin's lymphoma.

The results of staging in 170 patients with non-Hodgkin's lymphoma have been reviewed; all patients were subjected to a series of sequential procedures, including lymphangiography, bone marrow biopsy, and liver biopsy (performed percutaneously, by peritoneoscopy, or by laparotomy). A high incidence of involvement of bone marrow, liver, and abdominal nodes was found in patients with nodular types of lymphoma and in those with diffuse lymphocytic lymphoma, with less than or equal to 20% remaining in stage I or II at the completion of staging in each of these subgroups. Only in patients with histiocytic lymphoma was there an appreciable percentage (31%) remaining in the stage I-II categories after staging. In this study, 75 patients remained in stage III or less after completing the non-surgical phase of staging, and laparotomy was utilized in only 50 patients (30%). At laparotomy, involvement of the liver or the mesenteric or portal lymph nodes was found in 81% of patients with a positive lymphangiogram but in only 18% of those with a negative lymphangiogram.

Biopsy↗
PubMed1976

Small-cell carcinoma of the lung: attempt to remedy causes of past therapeutic failure.

A regimen of intensive, cyclic chemotherapy (cyclophosphamide, vincristine, doxorubicin administered concurrently with radiotherapy of bulk disease plus prophylactic whole-brain irradiation has been investigated for small-cell carcinoma of the lung. Treatment was completed in 12 weeks, after which patients were observed without maintenance therapy. Complete clinical remissions were noted in twenty of twenty-one patients with unresectable tumours, 10 of whom had distant extrathoracic spread upon admission. Survival has been prolonged and nine of the eleven patients with regional disease (mediastinal adenopathy with or without pleural effusion and/or supraclavicular nodes) have remained clinically disease-free for 6-14 months (median 10) and have resumed normal activities.

Adult↗
PubMed1976

Anorectal disease in patients with non-haematological malignancy.

A frequent and previously uncharacterised association of anorectal inflammatory disease in seven of twenty-two patients undergoing therapy for nonhaematological malignancy is described. Sepsis and secondary pulmonary infection were distant complications of the anorectal lesions. The degree of granulocytopenia induced by chemotherapy appears to be the major predisposing factor. Management includes early surgical intervention, and preventive measures specific for this patient population.

Abscess↗
PubMed1976

National gonorrhea therapy monitoring study: treatment results.

To monitor the efficacy of the 1972 United States Public Health Service recommended treatment regimens for uncomplicated gonorrhea, we studied 9008 patients who were randomly assigned either to aqueous procaine penicillin G, 4.8 million units intramuscularly plus 1 g of oral probenecid, or to one of the three other recommended regimens. Among the 3871 patients re-examined within three to seven days after therapy, the penicillin-probenecid regimen was successful in 96.8 per cent, whereas the cure rates of the ampicillin-probenecid, tetracycline, and spectinomycin regimens were 92.8, 96.2, and 94.8 per cent, respectively. In clinics comparing the regimens, penicillin G-probenecid was as effective as tetracycline, but more effective than ampicillin-probenecid (P less than 0.05) and spectinomycin (P less than 0.01). However, in patients re-examined three to 14 days after treatment, only the ampicillin-probenecid regimen was significantly less effective than penicillin probenecid (P less than 0.01). Despite these differences in results, all four regimens recommended by the Public Health Service provided effective therapy for uncomplicated gonorrhea.

Administration, Oral↗
PubMed1976

National gonorrhea therapy monitoring study: in vitro antibiotic susceptibility and its correlation with treatment results.

To monitor temporal trends and regional differences in antibiotic susceptibility, we measured the minimum inhibitory concentrations for penicillin G, ampicillin, tetracycline, and spectinomycin of 4405 pre-treatment gonococcal isolates from patients with uncomplicated gonorrhea. As compared to isolates studied in 1970-1971, recent United States isolates appeared equally sensitive to penicillin G and more sensitive to tetracycline. Relatively resistant strains were found throughout the country. We also studied 1974 patients, treated for uncomplicated gonorrhea according to the 1972 regimens recommended by the United States Public Health Service, to determine the relation between pretreatment minimum inhibitory concentrations and treatment results. For patients receiving the procaine penicillin-probenecid and ampicillin-probenecid regimens, minimum inhibitory concentrations to the treatment drugs were significantly higher in patients not cured than in those cured (P less than 0.01 fr penicillin and P less than 0.05 for ampicillin). In contrast, spectinomycin-treatment results appeared to be independent of the isolate's susceptibility to spectinomycin and other antibiotics.

Ampicillin↗