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Biomedical subjects

R Ginsberg

Publications and source records attributed to R Ginsberg.

49 records · Page 3Linked to original sources
PubMed1988

Adjuvant chemotherapy following surgical resection for small-cell carcinoma of the lung.

Surgery alone is inadequate therapy for limited small-cell lung cancer (SCLC), resulting in less than 5% long-term survival. Since 1976, we treated patients undergoing surgery for SCLC with adjuvant chemotherapy in an attempt to prolong survival and increase cure. Seventy-seven patients who underwent surgery as their primary treatment were identified, and of these 63 (46 male and 17 female) received chemotherapy. Fifteen patients had a pneumonectomy, 46 a lobectomy, and two had wedge resections. Six patients had positive microscopic resection margins. Pathologic staging showed tumor, node, metastasis (TNM) involvement as follows: T1N0, eight; T2N0, ten; T1N1, six; T2N1, 18; T1N2, five; T2N2, nine; T3N0, three; T3N1, one; and T3N2, three. All patients received cyclophosphamide, Adriamycin (doxorubicion; Adria Laboratories, Mississauga, Ontario), and vincristine; four also received etoposide (VP-16) and cisplatin, one VP-16, and four methotrexate, procarbazine, and lomustine (CCNU). Forty-nine patients received prophylactic cranial irradiation, and 35 received radiotherapy to the mediastinum and primary site. The overall median survival of the 63 patients is 83 weeks, and the projected 5-year survival is 31%. Patients with T1 or T2 tumors without nodal involvement had a median survival of 191 weeks, and projected 5-year survival of 48%. Stage II (T1N1, T2N1) and stage III (any T3 or T1-2N2) patients had median survivals of 72 weeks and 65 weeks, and projected 5-year survivals of 24.5% and 24%, respectively. Thirty-three patients have relapsed and died of disease. Only two patients had an isolated relapse at the primary site. Seven other patients have died without recurrent disease. Adjuvant chemotherapy after surgery results in prolonged survival and cure for a significant number of patients with stage I SCLC, although nodal involvement at any level is associated with shorter survival.

Adult↗
PubMed1986

African sleeping sickness presenting in an American emergency department.

A 27-year-old American man who had returned recently from East Africa presented with African sleeping sickness, probably of the Rhodesian (East African) type. High fever, malaise, and watery diarrhea were his predominant symptoms. No trypanosomal chancre was noted. Treatment for malaria in Africa had not been effective. In the emergency department, diagnosis was established by demonstrating trypanosomes on blood smear. Treatment with an IV course of Suramin was successful.

Adult↗
PubMed1984

Prognostic factors in patients with resected stage I non-small cell lung cancer. A report from the Lung Cancer Study Group.

The authors present prognostic information on recurrence and survival for resected Stage I lung cancer patients with squamous cell carcinoma, adenocarcinoma or large cell carcinoma. The data derive from 392 carefully staged patients and include results from the history and physical examination, preoperative laboratory tests, nature of the surgery, complications, initial pathologic findings following surgical resection, and final pathologic review. A simple multivariate model of recurrence, which is used to classify patients into low, intermediate, and high-risk groups, is based on tumor size and location (T1, T2), histologic type (squamous, nonsquamous/mixed) and nodal status (N0, N1). To model survival, the performance status and the presence of empyema, pneumonia, or wound infection were added to the previous factors. Not all factors associated with increased mortality are associated with increased risk of recurrence, and, in particular, postoperative empyema, pneumonia or wound infections carry an increased risk of death only. Serial measurements of performance status and leukocyte count have the potential for monitoring for increased risk of recurrence and death.

Adenocarcinoma↗
PubMed1984

Effect of moricizine hydrochloride in reducing chronic high-frequency ventricular arrhythmia: results of a prospective, controlled trial.

The antiarrhythmic efficacy of moracizin HCl (Ethmozine), a new oral phenothiazine derivative, was evaluated in 20 patients with chronic high-frequency ventricular arrhythmia confirmed by multiple ambulatory electrocardiographic recordings. Comparison with 72 +/- 24 hours (+/- standard deviation) of ambulatory recordings on moracizin treatment (average dose 295 +/- 58 mg 3 times daily or 9.8 +/- 1.0 mg/kg/day) was made. Maximal treadmill exercise provocation of arrhythmia and echocardiographic studies to detect effects on left ventricular function were also compared. The group had an average of 378 +/- 97 ventricular premature beats (VPBs) per hour while receiving placebo, with a mean VPB grade of 3.4 +/- 1.1 (modified Lown). When the patients received moracizin HCl, VPB frequency was reduced 53% (p less than 0.01), to a mean VPB grade of 2.2 +/- 1.4 (p less than 0.05). Seventy percent of the patients (14 of 20) showed a reduction in VPB frequency that exceeded the maximal expected variation; in 3 the frequency did not change and in 3 it increased with moracizin HCl. Resting electrocardiographic changes consisted of modest prolongations of PR interval (0.03 second) and QRS duration (0.02 second); however, QT prolongation was not observed. Heart rate and blood pressure at rest and peak exercise, exercise-related arrhythmia, exercise durations and echocardiographic measures of left ventricular function were unchanged by moracizin HCl compared with placebo. Side effects of moracizin++ HCl at these dosages were minimal (diarrhea in 1 patient, dizziness in 1 and diaphoresis in 1), although 2 patients tested at higher dosages had sustained ventricular tachycardia that may have been related to moracizin HCl.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1980

A case of lymphogranuloma venereum of 20 years' duration. Isolation of Chlamydia trachomatis from perianal lesions.

Chlamydia trachomatis was isolated from perianal lesions in a patient in whom lymphogranuloma venereum had been diagnosed 20 years previously. Treatment with tetracycline resulted in a pronounced improvement. Although C trachomatis is known to persist for a long time in the host, isolation of the micro-organism from infected tissues after such a prolonged period has not previously been reported.

Aged↗
PubMed1972

Amphetamine and conditioned 'anxiety'.

1. Rats pressed a bar for milk reward at a steady rate, but this baseline responding was suppressed in the presence of an auditory stimulus associated with electric shock (conditioned suppression). The effects of (+)-amphetamine sulphate on this conditioned suppression were studied in two experiments.2. (+)-Amphetamine sulphate (0.5, 1.0 or 2.0 mg/kg) reduced the baseline rate of responding and also reduced the conditioned suppression, i.e. responding in the presence of the auditory stimulus was partially restored. Both these effects were dose related.3. In a further experiment the effects of 1.0 mg/kg on two levels of conditioned suppression were studied. Regardless of its degree, (+)-amphetamine attenuated suppression.4. The results were compared to previous research which found that amphetamine increased baseline responding and exaggerated conditioned suppression. It was concluded that the conditioned suppression procedure should be used with caution as an animal model of anxiety in psychopharmacological investigations.

Amphetamine↗
PubMed1972

The effect of carbohydrates on ammonium and ketoacid excretion during starvation.

The metabolic effects of oral ingestion of minute quantities of carbohydrate during prolonged starvation were studied in nine obese subjects. Measurements were made during a control period of total starvation, during the ingestion of 7.5 g carbohydrate daily, and finally during the ingestion of 15.0 g carbohydrate daily. Daily ketoacid excretion fell after carbohydrate ingestion and was significantly correlated (r = 0.62, P < 0.01) with the amount of carbohydrate administered. Despite this fall in ketoacids, the concentration of blood ketoacids, plasma free fatty acids, and serum insulin remained constant throughout the study. Urinary ammonium excretion, closely correlated with ketoacid output (r = 0.95, P < 0.001), also fell significantly after carbohydrate ingestion. No significant changes were present in extracellular or urinary pH. Urea nitrogen excretion did not change when urinary ammonium output fell. These results indicate that: the excretion of ketoacids and ammonium in starving man is exquisitely sensitive to minute amounts of ingested carbohydrate; the change in ketonuria appears to be due to increased renal ketoacid reabsorption after carbohydrate ingestion; and the nitrogen-sparing effect of reducing renal ammonium output in starvation can be dissociated from nitrogen sparing occurring because of changes in urine urea excretion.

Adolescent↗
PubMedDate not supplied

Final report of the 70.2-Gy and 75.6-Gy dose levels of a phase I dose escalation study using three-dimensional conformal radiotherapy in the treatment of inoperable non-small cell lung cancer.

PURPOSE AND OBJECTIVE: Three-dimensional conformal radiotherapy (3D-CRT) is a mode of high-precision radiotherapy designed to increase the tumor dose and decrease the dose to normal tissues. This study reports the final results of the first two dose levels (70.2 Gy and 75.6 Gy) of a phase I dose-escalation study using 3D-CRT for the treatment of non-small cell lung cancer. PATIENTS AND METHODS: Fifty-two patients were treated with 3D-CRT without chemotherapy. The median age was 67 years (range, 39-82 years). The majority of patients had locally advanced cancer. Tumor was staged as I/II in 10%, IIIA in 40%, and IIIB in 50%. Radiation was delivered in daily fractions of 1.8 Gy, 5 days a week. A radiation dose level was considered complete when 10 patients received the intended dose without unacceptable acute morbidity. Toxicity was scored according to the Radiation Therapy Oncology Group grading scheme. RESULTS: Twenty patients were initially assigned to the 70.2-Gy level; 14 of them received the intended dose. Three patients experienced severe acute toxicity, two with grade 3 (requiring steroids or oxygen) and a third with grade 5 (fatal) acute radiation pneumonitis. Because of the grade 5 pulmonary toxicity, the protocol was modified, and only patients with a calculated risk of normal tissue complication of less than 25% were eligible for dose escalation. Patients who had a normal tissue complication probability (NTCP) of greater than 25% received a lower dose of radiation. An additional 18 patients were entered on the modified study; 11 of them received 70.2 Gy. One patient experienced grade 3 acute pneumonitis. Despite dose reduction in four patients because of an unacceptably high NTCP, two additional patients developed grade 3 pulmonary toxicity. Fourteen patients were accrued to the 75.6-Gy dose level, and 10 received the intended dose. One of the 10 patients experienced grade 3 pulmonary toxicity and one developed grade 3 esophageal toxicity. Three patients were treated to lower doses as a result of their calculated NTCP without toxicity, and one patient refused treatment. The 2-year local control, disease-free survival, and overall survival rates were 37%, 12%, and 24%, respectively. The median survival time was 11 months. DISCUSSION: Treatment to 70.2 Gy and 75.6 Gy using 3D-CRT was delivered with acceptable morbidity when NTCP constraints were observed. Local control was encouraging in these patients with locally advanced disease. Patients are currently being accrued to the 81-Gy level of the study.

Adult↗