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Biomedical subjects

R M Scott

Publications and source records attributed to R M Scott.

At least 163 records · Page 9Linked to original sources
PubMed1983

Solitary plasmacytoma.

A retrospective review is presented of nine patients presenting with solitary plasmacytoma. Between 1963 and 1980, these patients were treated with radiation at the Department of Radiation Oncology, University of Louisville. Criteria for admission to this particular study include (1) a solitary focus of plasmacytoma proven by biopsy, (2) normal bone marrow findings (less than 10% plasma cells), and (3) no evidence of disseminated disease. In six patients the primary site was osseous, and in three extramedullary, two of which were located in the nasopharynx and nasal cavity and the third in the stomach. All of the extramedullary plasmacytomas are disease free for periods ranging from 4 to 10 years. Of the six patients with osseous lesions, two developed multiple myeloma in 2 and 3 years, two are NED (No Evidence of Disorder) after 9 years, one died of intercurrent disease, and the remaining patient was NED for 2 years, after which he was lost to follow-up. These results suggest the more favorable prognosis of extramedullary plasmacytoma and support the theory that the solitary plasmacytoma of bone and extramedullary plasmacytoma are distinct disease entities.

Adult↗
PubMed1983

Dengue 2 vaccine: dose response in volunteers in relation to yellow fever immune status.

A live dengue 2 vaccine was tested in 38 volunteers in an evaluation of the safety, infectivity, and immunogenicity of doses of 10(1.8)-10(5.5) plaque-forming units. Twenty yellow fever-immune and 18 yellow fever-nonimmune individuals received 0.5 ml of vaccine sc. Immunization was dose related in yellow fever-immune volunteers, with a 50% immunizing dose of 10(3.3) plaque-forming units. In the group not immune to yellow fever, some but not all recipients of each vaccine dilution were immunized, and no 50% immunizing dose could be estimated. Volunteers immune to yellow fever developed adequate titers of neutralizing antibody to dengue 2 virus and maintained them for at least three years; those not immune to yellow fever developed lower antibody titers that disappeared within six months in half of the cases. More than 40 isolates of dengue 2 virus from 12 volunteers retained the in vitro growth characteristics of the vaccine virus; this result affirmed the genetic stability of the virus. Common clinical signs in immunized individuals were leukopenia (55%), macular rash (15%), and fever (10%).

Adolescent↗
PubMed1983

Surgical treatment of incidental intracranial aneurysms.

A 6-year retrospective analysis of incidental intracranial aneurysm surgery was conducted at 12 medical centers (1975-1981). The surgical facilities and techniques were comparable at the institutions surveyed. From a total of 1671 aneurysms operated upon, 119 in 107 patients were unruptured and were discovered incidentally. Among these 107 patients, there was no operative mortality. Operative morbidity occurred in 7 cases (6.5%). Surgical treatment of large aneurysms in less accessible locations incurred the greatest operative morbidity. Presenting symptoms of cerebral ischemia seemed to be associated with increased operative morbidity, whereas repair of aneurysms incidental to other ruptured aneurysms had a uniformly low morbidity. These surgical results compare favorably with the risks of hemorrhage from unruptured intracranial aneurysms as defined by recent reports. The low morbidity without mortality supports a recommendation for surgical management of incidental aneurysms in the anterior circulation at centers equipped for modern aneurysm surgery.

Adult↗
PubMed1982

Radiation treatment of carcinoma of the cervix with extension into the endometrium: a reappraisal of its significance.

During the period from 1969--1974, 561 patients with proven invasive squamous cell carcinoma of the cervix were treated by irradiation only in the Department of Radiation Therapy, University of Maryland Hospital. Of these, 82 patients were identified as having D & C positive for squamous cell cancer present in the curettings with or without endometrial tissue. Clinical staging was done using FIGO guidelines and the treatment of endometrial extension was the same as with regular cervical cancer. Of 82 cases who are eligible for a minimum five-year follow-up, the absolute five-year survival is as follows: Stage I, 68%, (17/25); Stage II, 62% (18/29); Stage III, 40% (10/25); Stage IV, 0% (0/3). The most interesting features are the local and distant failures in Stage I and II disease. Local failure in Stage I and II in this study is in line with other series. Distant metastasis, however, occurs at the rate of 20% in Stage I between 1--2 years after treatment (as compared to the control of 5%). In Stage II, the distant disease increases to 24% with a substantial number of local failure with distant metastasis. Based on our findings and others, it seems appropriate to suggest D &nd C be done routinely in order to identify the extension of cancer into the endometrium and treat them properly. Also it appears appropriate to re-examine our policy of the treatment to minimize both local and distant failures with suggestions outlined in Schema I and II along with possibility of a future chemotherapeutic management to minimize the distant disease.

Adult↗
PubMed1982

Value of multi-planar CT images in interactive dosimetry planning of intracavitary therapy.

A method of intracavitary treatment planning and dosimetry analysis which uses multi-planar reconstructed computerized tomography (CT) images is presented. The aim of the method is to improve ability to precisely locate clinical reference points, to fully define pertinent anatomic structures and to provide dose distributions and their relationship to these structures in multiple planes. Our approach is based on interactive treatment planning and point dose display on sagittal and coronal reconstructed CT images as well as the usual transaxial image. The advantages of clinical evaluation of isodoses directly on multi-planar CT images are assessed. These include precise anatomic and dose relationships between the cervix and paracervical structures, the bladder, rectum and pelvic node-bearing sites. Problems of image magnification, blurred images and inadequate resolution attendant to orthogonal radiographs, which are the basis of current techniques, are minimal. Analysis and results of the method and a comparison with the technique of orthogonal radiographs are presented for a demonstration case.

Adenocarcinoma↗
PubMed1982

Rupture of a previously unruptured giant middle cerebral artery aneurysm after extracranial-intracranial bypass surgery.

The fatal rupture of a previously unruptured giant middle cerebral artery aneurysm occurred 13 days after an extracranial-intracranial bypass had been carried out, before definitive aneurysm surgery. Alterations in blood flow adjacent to the aneurysm after the bypass may have led to the fatal hemorrhage. After a preliminary extracranial-intracranial bypass procedure, there should be no undue delay in the direct attack on a giant aneurysm, regardless of its mode of presentation.

Cerebral Revascularization↗
PubMed1982

Dengue-2 vaccine: infection of Aedes aegypti mosquitoes by feeding on viremic recipients.

Colonized Aedes aegypti mosquitoes were fed on voluntary recipients of an experimental, live, attenuated, dengue type 2 (PR 159/S-1) vaccine to estimate the frequency of vector infection and the stability of the virus in mosquitoes. Two volunteers were viremic at the time of mosquito feeding, but only two of 114 mosquitoes that took a viremic blood meal became infected with the vaccine virus. Strains of virus recovered from the bodies of the mosquitoes and the volunteer's blood retained the temperature sensitivity and small plaque growth characteristics of the vaccine virus. Dengue viral antigen was not detectable in any of the mosquito heads by direct immunofluorescence and in vitro virus transmission by droplet feeding was not observed. This experiment showed that vector mosquitoes can be infected with vaccine virus by feeding on viremic vaccinees. Furthermore, the virus is sufficiently stable to retain the in vitro growth characteristics associated with the vaccine virus.

Aedes↗
PubMed1982

Clinical local heating by microwaves.

The advantages and limitations of microwave heating in clinical thermotherapy are reviewed on the basis of the clinical experiences of various investigators who used microwave-induced hyperthermia. Also discussed are the clinical engineering system requirements necessary for conducting controlled clinical trials, as well as appropriate thermal treatment planning. Lastly, we present the future prospects for complex antennas and treatment control systems.

Clinical Trials as Topic↗
PubMed1982

Mild head trauma in children: When is a roentgenogram Necessary.

Review of 354 infants and children who had skull roentgenography for head trauma over a 21/2-year period revealed a low incidence of fractures (4.2%) and no serious intracranial complications. With the exception of one patient with an elevated surgically depressed skull fracture, treatment was not changed because of the detection of a fracture. Thus, in the usually mild head trauma sustained by most children, routine skull roentgenography is inefficient. To make efficient use of resources, clinical criteria are necessary to select patients for skull roentgenography. Criteria previously defined for adult patients are, however, less useful in children. On the basis of the present study, additional criteria were identified so that fractures may be detected among children with mild head trauma, at much reduced cumulative cost and exposure to radiation. Nevertheless, the clinical importance of detection of skull fractures remains uncertain.

Accidents, Traffic↗
PubMed1981

Management of early glottic cancer.

A detailed retrospective analysis of 136 patients with early glottic cancer treated at the University of Louisville, Radiation Center from October, 1953 to December, 1975 was done. Majority of the patients were in the age range of 55 to 74 years. Of them, 89% were male and 85% were Caucasian. The most common histological type was squamous cell carcinoma. The adjusted 5-year survival rate was 84%, with a standard error of 3%. Of these patients, 18% had local failures, and 68% of which were salvaged by surgery. The overall local control rate was 93%. The median time to recurrence was 23 months. There was no case of laryngeal necrosis, and a good function of larynx was achieved in a majority of the patients. Eighteen second cancers were diagnosed in 17 patients during the follow-up. A brief review of the literature is also done in the paper.

Adult↗
PubMed1981

Heparin and small caliber polytetrafluoroethylene grafts in the carotid arteries of rats.

Polytetrafluoroethylene (PTFE) grafts having an internal diameter of 1 mm were implanted in the common carotid arteries of rats with or without the simultaneous application of various heparin regiments. Graft patency was determined from postoperative angiograms, and grafts were patent 40 days after surgery were harvested for light microscopic examination. The level of anticoagulation produced by the various heparin regimens was measured in separate groups of rats and found to be clinically therapeutic. All of the grafts from rats that did not receive heparin were occluded at 24 hours. In the two groups of rats that received high doses of heparin, 5 of 10 and 4 of 11 grafts were patent 40 days postoperatively. There were no patent grafts three days postoperatively in the group receiving low doses of heparin. The grafts that were patent 40 days postoperatively had lumens that were completely lined with presumptive endothelial cells. Further laboratory experimentation is needed before PTFE small caliber grafts can be recommended for use in humans.

Animals↗