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Biomedical subjects

R Ragland

Publications and source records attributed to R Ragland.

12 recordsLinked to original sources
PubMed1996

Cerebral demyelination syndrome in a patient treated with 5-fluorouracil and levamisole. The use of thallium SPECT imaging to assist in noninvasive diagnosis--a case report.

BACKGROUND: The use of 5-fluorouracil (5-FU) and levamisole in patients with Stage III adenocarcinoma of the colon has now become standard. There have been several reports of a multifocal cerebral demyelination syndrome following 5-FU and levamisole administration. METHODS: We describe a patient who developed focal neurologic symptoms while being treated with levamisole and 5-FU in whom the diagnosis of central nervous system (CNS) metastases was considered. RESULTS: A magnetic resonance imaging (MRI) scan showed a diffuse, multifocal white matter process. Diagnostic evaluation did not support a diagnosis of CNS metastasis. 201Thallium chloride single photon emission computed tomography (SPECT) study was cold. A stereotactic brain biopsy disclosed demyelination but not tumor. The patient had complete functional resolution of symptoms with 1 month of dexamethasone therapy, although follow-up MRI scans have shown persistent abnormality on T2-weighted images. CONCLUSIONS: In patients receiving 5-FU and levamisole who develop focal neurologic symptoms with an abnormal MRI scan, the diagnosis of CNS metastasis should not be made without a thorough diagnostic evaluation. We suggest the use of 201thallium chloride SPECT imaging to support the diagnosis of multifocal leukoencephalopathy related to 5-FU and levamisole. In atypical cases, a stereotactic brain biopsy may be required for confirmation.

Adenocarcinoma↗
PubMed1994

The effects of rigid fixation on craniofacial growth of rhesus monkeys.

A male infant rhesus monkey model was used to examine the growth effect on the craniofacial skeleton caused by osteotomy and three types of fixation: interfragmentary wiring, microplate and screw fixation, and "extensive" microplate and screw fixation. The animals (n = 12) were allowed to mature until cranial growth was at least 95 percent complete. Direct craniometric measurements were obtained and analyzed for differences in the three treated groups. A group of unoperated male animal skulls also was analyzed as controls (n = 5). A subtle visible and measurable restriction of growth in the operated area occurred in all treatment groups. Significant differences (p < 0.05) were found in only 4 of the 39 craniometric chords measured. Interfragmentary wiring showed fewer growth-restrictive effects than standard use of microfixation plates. Extensive use of rigid fixation devices caused the greatest degree of growth disturbance. Osteotomy and fixation in the infant rhesus monkey affect craniofacial growth, with the degree of growth restriction increasing with the amount of fixation hardware.

Animals↗
PubMed1986

The subacute effects of CNS prophylaxis for acute lymphoblastic leukemia on neuropsychological performance: a comparison of four protocols.

We report an assessment of the intellectual functioning after one year of therapy of 117 children treated for acute lymphoblastic leukemia (ALL) who were assigned to one of four protocols for central nervous systems (CNS) prophylaxis. These protocols were (a) 2400 rad cranial irradiation plus concurrent intrathecal methotrexate (i.t. MTX), (b)i.t. MTX alone, (c) 1800 rad cranial irradiation plus concurrent i.t. MTX, and (d) a protocol for high-risk patients that included intensive systemic chemotherapy plus 2400 rad delayed irradiation. Neuropsychological evaluation consisted of the Wechsler intelligence scales, the Wide Range Achievement Test, and selected tests from the Halstead-Reitan Neuropsychological Battery administered one year after diagnosis. All patients performed in the average range on measures, although the high-risk patients performed marginally worse than did the others. In general, our results do not support previous reports that cranial irradiation results in early adverse neuropsychological sequelae.

Journal Article↗
PubMed1979

Renal function during ticrynafen therapy.

526 patients with essential hypertension or congestive cardiac failure were treated with ticrynafen (250--500 mg/day) or hydrochlorothiazide (50--100 mg/day) for 6 weeks to 6 months. There was no appreciable effect on renal function, as measured by changes in blood urea nitrogen and serum creatinine levels. Both drugs exhibited similar antihypertensive activity and ability to control signs and symptoms of congestive cardiac failure. Side effects were mild and reversible. A notable difference is the marked reduction in serum uric acid in patients treated with ticrynafen, unlike the elevated urate levels occurring after treatment with hydrochlorothiazide.

Antihypertensive Agents↗
PubMed1979

Safety of tienilic acid.

The safety and efficacy of tienilic acid have been evaluated in studies of patients with mild to moderate essential hypertension, salt and water retention states and hyperuricaemia associated with gout. During the course of these studies 675 patients were treated with tienilic acid, 310 were treated with hydrochlorothiazide, 43 were treated with probenecid and 34 were treated with placebo. Overall, adverse reactions characterized as probably drug-related or questinably drug-related were reported in 28% of patients treated with tienilic acid, 24% treated with hydrochlorothiazide, 25% of patients treated with probenecid and 33% treated with placebo. The side effects encountered were mild in severity, reversible and represented extensions of the pharmacological activity of tienilic acid, hydrochlorothiazide and probenecid. These initial studies demonstrate that tienilic acid is safe and effective in the treatment of mild to moderate essential hypertension, salt and water retention states, including oedema associated with congestive cardiac failure or mild to moderate renal dysfunction, and in the management of elevated serum uric acid levels associated with gout.

Clinical Trials as Topic↗