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Biomedical subjects

R M Hansen

Publications and source records attributed to R M Hansen.

At least 109 records · Page 6Linked to original sources
PubMed1983

Ocular toxicity from high-dose cytosine arabinoside.

A patient with refractory acute myelogenous leukemia was treated with high-dose cytosine arabinoside (3.0 g/m2 every 12 hours). Following ten doses over five days the patient developed excessive tearing, photophobia, burning ocular pain, and blurred vision. Ophthalmologic examination revealed conjunctival injection, central punctate corneal opacities with subepithelial granular deposits, and decreased visual acuity. Symptoms gradually resolved over the following four days; however, impaired visual acuity persisted for two weeks and corneal opacification did not disappear until four weeks following therapy. Prior and subsequent administration of cytosine arabinoside according to the same dose schedule for only four doses over two days and eight doses over four days were well tolerated and did not produce ocular toxicity. It is suggested that ocular toxicity results from inhibition of corneal epithelial DNA synthesis and is related to both drug dosage and duration of drug exposure. Strategies should be explored to eliminate this treatment-limiting adverse effect of potentially effective therapy.

Cornea↗
PubMed1983

Diagnosis of malignant lymphomas of the nasal cavity, paranasal sinuses and nasopharynx.

The diagnosis of non-Hodgkin's malignant lymphoma of the nasal cavity, paranasal sinuses, and nasopharynx was made in 15 patients over a 7 year period (nasopharynx, 9; nasal cavity, 3; maxillary sinus, 2; frontal sinus, 1). A wide variety of head and neck symptoms, often characteristic of benign disease, was reported ranging from 2 weeks to 4 months prior to presentation. Of the 15 cases, the original diagnosis was inconclusive in 6; 4 of the 6 required rebiopsy, while the diagnosis in the other 2 was confirmed on further pathologic consultation. Tissue marker studies, which have recently become available, were performed in 7 cases and were crucial in the diagnosis of 2. B-cell lymphoma was diagnosed in the 7 patients who had tissue marker studies. Five patients had palpable cervical nodes, and none had distant adenopathy or masses. With further staging, 4 of the 15 patients were found to have disseminated disease. The paper emphasizes the need for early biopsy of suspicious lesions presenting in areas in which physical examination is limited. Recommendations are made for handling the biopsy specimen when malignant lymphoma is suspected, as well as for the evaluation of local and distant sites. The role of surgery is primarily diagnostic in patients with malignant lymphoma.

Adolescent↗
PubMed1983

Retinal sensitivity and adaptation in pediatric patients.

A two-alternative forced-choice preferential looking psychophysical procedure was used to measure dark-adapted thresholds of 79 patients whose medical and ophthalmological conditions raised the possibility of scotopic retinal disorders. The average dark-adapted threshold first obtained from 48 patients, who eventually manifested diseases affecting the scotopic retina, was higher than the average threshold of the 31 patients without scotopic disease. Among the 48 patients with scotopic disease, most (40 out of 48) had abnormal electroretinographic b-wave amplitudes; in 23 scotopic b-waves were present but attenuated to less than or equal to 30% of the normal mean; no scotopic b-wave responses could be elicited from 17. In only 6 of the 40 patients with abnormal scotopic b-waves were the psychophysical thresholds elevated greater than 2.5 log units. That is, the scotopic b-wave is often sensitive to the effects of the retinal disorders of our patients, but the wider range of psychophysical responses permits investigation and analysis of retinal function. In the 13 patients for whom b-wave thresholds could be determined, b-wave and psychophysical thresholds were not correlated, further suggesting that electroretinographic and psychophysical data provide complementary information about retinal function. Thus the psychophysical techniques are suitable for investigation of the functional organization of diseased pediatric retinas. In patients with retinal disorders psychophysical procedures have enabled description of temporal and spatial summation and adaptation to steady background lights. Examples of results of spatial summation and background adaptation studies are presented in this report.

Adolescent↗
PubMed1982

The role of thoracic and cranial irradiation for small cell carcinoma of the lung.

Since 1974, 120 previously untreated patients with small cell carcinoma of the lung seen in Therapeutic Radiology at The Medical College of Wisconsin have been entered into one of 4 successive studies. Study I used thoracic irradiation (TI) alone (4500-6000 rad in 3-6 weeks) with chemotherapy at progression. Study II randomized patients with limited disease to TI (3000 rad in 2 weeks) plus either cyclophosphamide, doxorubicin, vincristine (CAV) or total body irradiation (TBI); patients with extensive disease received TI + CAV. Study III employed prophylactic cranial irradiation (PCI) plus CAV and withheld TI unless there was incomplete response or recurrence. Of 93 evaluable patients from the first three studies, 55 had limited and 38 extensive disease. Study I (37 patients) showed a 62% complete response (CR) rate; 43% failed in the chest, 14% had brain metastases, and the median survival was only 22 weeks in spite of a preponderance of limited disease patients. Study II (27 patients) showed a CR of 59%; 30% had brain metastases and the median survival was 48 weeks. Study II patients (29) had a 69% rate; 72% failed in the chest, 4% with PCI developed brain metastases, and the median survival was 50 weeks. In March, 1979, Study IV was initiated; patients receive PCI (2500 rad in 2 weeks) plus high dose CAV, methotrexate and leucovorin. After 6 cycles, consolidation TI (3750 rad in 3 weeks) is given to patients with complete response. Preliminary results with 27 patients treated on this study show a 67% CR rate, a 41% chest failure rate (but only 11% for the patients who received thoracic irradiation) and no intracranial failures, but a 13% extracranial CNS failure rate. PCI, TI and spinal irradiation may be necessary to maximize the probability of long term disease free survival.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1982

The relation of myopia and astigmatism in developing eyes.

The relation of astigmatism and myopia was analyzed in 298 myopic children, ages birth to 10 years. The mean spherical equivalent, determined by cyclopentolate retinoscopy, for the entire group was--2.9 diopters and did not change significantly with age. However, in 3-year-old children and younger, myopia progressed in eyes with greater than or equal to 1 diopter of cylinder and tended to increase through age 8 years in those having greater than or equal to 3 diopters of cylinder. Also, astigmatic errors greater than or equal to 1 diopter, especially of oblique orientation, were associated with higher degrees of myopia than nonastigmatic errors. These data from myopic children suggest that uncorrected astigmatism during a period of visual immaturity influences the course of myopia. Thus, naturally occurring astigmatic errors, that are frequent among infants and young children, appear to have a role similar to the vision blurring perturbations that trigger the development of myopia in young animals. Ascertainment and full correction of these refractive errors in young children may be important in assuring the best possible vision.

Age Factors↗
PubMed1982

Scotopic thresholds and plasma retinol in cystic fibrosis.

Patients with cystic-fibrosis (CF) often have low plasma concentrations of vitamin A. We have measured dark-adapted scotopic thresholds of 56 patients with CF, ages 4 to 34 years, either with a two-alternative forced-choice procedure or as the final threshold after a full dark-adaptation curve. Fasting plasma vitamin A alcohol (retinol) was measured in 34 of the 56 patients. The average thresholds were higher and retinol values lower in patients than in controls. In two patients with very low (less than 7 micrograms/dl) initial retinol levels and elevated thresholds, decreased rhodopsin densities were observed; rhodopsin density and thresholds returned to normal after treatment with oral vitamin A. Rhodopsin density and log sensitivity were linearly related. Only marked decreased in plasma retinol were associated with elevations of dark-adapted threshold and decreases in rhodopsin density, suggesting that the tissues of patients with CF sequester vitamin A to maintain retinal function.

Adolescent↗
PubMed1982

Preferential looking acuity obtained with a staircase procedure in pediatric patients.

Visual acuity of infants and young children with ophthalmologic disorders was assessed by adapting a transformed up-down staircase to preferential looking (PL) procedures. Eighty-five percent of pediatric patients between 11 days and 5 years of age were tested successfully. Acuity of infants and young children with normal eyes obtained by the PL staircase procedure agreed well with acuities obtained previously by the method of constant stimuli. In children with anisometropia, differences in acuity between eyes varied systematically with the amount of anisometropia. Monocular acuities of untreated patients with strabismus did not always agree with fixation preference. In general, test results from pediatric patients with structural ocular abnormalities were consistent with the severity of the disorder. By means of serial measurement of PL acuity, the therapy of patients with amblyopia was monitored. In our young patients, anisometropic amblyopia affected grating acuity differently than did strabismic amblyopia, as others have reported in older patients with these conditions. Our results indicate that the PL staircase procedure provides a useful measure of visual acuity in pediatric ocular disorders that can complement the clinical evaluation of infants and young children.

Age Factors↗
PubMed1981

Cone pigments in acute posterior multifocal placoid pigment epitheliopathy.

We measured cone pigment density and kinetics with a reflection retinal densitometer during the evolution and resolution of posterior pole lesions in a 17-year-old patient with acute posterior multifocal placoid pigment epitheliopathy. Three weeks after onset, density was markedly reduced and regeneration complex and nonexponential. Pigment density increased, and kinetics returned to normal as the disease resolved.

Acute Disease↗
PubMed1981

Behavioral measurement of background adaptation in infants.

Thresholds for detecting blue test flashes in the dark-adapted condition and on steady red background fields were measured in 2- to 18-week-old human infants by a two-alternative forced-choice preferential looking method. The results show that dark-adapted sensitivity increases and background adaptation develops during the early postnatal weeks. Thus, the retinal mechanism that underlie (1) detection of brief flashes and (2) neural processing in background adaptation appear to mature postnatally.

Age Factors↗
PubMed1981

Marked congenital fissure masquerading as splenic laceration: report of a case.

A 26-year-old white woman fell from a ladder striking her back. Clinical evaluation indicated a left renal contusion with microscopic hematuria, and a liver-spleen scan suggested a splenic laceration. The patient was initially stable but evidence of ongoing blood loss forced exploratory laparotomy on the third hospital day. A large, retroperitoneal perirenal hematoma was found but the spleen was intact, with multiple marked congenital fissures. The problem of congenital fissures as a cause of abnormal spleen scan is discussed.

Accidents↗
PubMed1980

Cycloplegic refractions in infants and young children.

We studied groups of normal infants and infants with amblyopia and esoropia to determine the incidence of infantile astigmatism. Under cycloplegia, 19% of normal infants had astigmatism; this was at least twice the incidence in adults, but less than one-hale that found by noncycloplegic refractions of infants. During the first three postnatal years the incidence of astigmatism and distributions of spherical equivalents and anisometropia did not distinguish normal patients from most of those with esotropia and amblyopia.

Adult↗
PubMed1980

Gastric carcinoma in young people. A case report and review of the literature.

A 25-year old woman presented with microangiopathic hemolytic anemia, a leucoerythroblastic peripheral blood picture and a benign appearing gastric ulcer. Bone marrow trephine biopsy revealed metastatic mucin producing adenocarcinoma and gastroscopy with biopsy confirmed a gastric primary. Combination chemotherapy provided temporary symptomatic improvement but the patient expired seven months later. A review of gastric carcinoma in patients less than 30 years old is given. Symptoms of peptic ulcer disease are common and radiographs may demonstrate benign appearing gastric ulcers. Carcinoma is infrequently suspected and delays in diagnosis may contribute to a poor prognosis.

Adenocarcinoma↗
PubMed1978

Remission of chronic lymphocytic leukemia after smallpox vaccination.

A 78-year-old man with untreated chronic lymphocytic leukemia (CLL) was revaccinated for smallpox. A severe local reaction and generalized rash followed that responded to treatment with vaccinia immune human globulin. After recovery, the leukocyte count fell to normal and all evidence of CLL disappeared. He remains in complete remission three years after smallpox vaccination.

Aged↗