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Biomedical subjects

S Kramer

Publications and source records attributed to S Kramer.

At least 199 records · Page 11Linked to original sources
PubMed1978

The value of computerized tomography in delineating suprasellar extension of pituitary adenoma for radiotherapeutic management.

Radiotherapy plays a major role in the management of pituitary adenomas, either as a surgical adjunct or as the primary form of treatment. Small field precision techniques are utilized. The ability to employ limited field therapy and produce local control rates of 80--90% demands precise tumor localization. The extrasellar extension of pituitary adenomas has classically been demonstrated on angiographic and pneumoencephalographic examinations. Direct superior extension is accurately delineated by these examinations; lateral extension, however, is not and the total anterior-posterior extent of the tumor may be underestimated. The addition of computerized tomography significantly increases the information available in the assessment of tumor extension and the subsequent accuracy of treatment planning for radiotherapeutic purposes.

Adenoma↗
PubMed1978

Participation of the anterior hypothalamus in the regulation of arterial blood pressure.

Bilateral electrolyte lesions of the Anterior Hypothalamus (AH) were placed in rats to determine the extent to which this area participates in the regulation of Arterial Blood Pressure (ABP). Experiments were performed in two groups of rats; in one ABP was measured continuously for 44 hr subsequent to the lesion, and in a second group ABP was measured 24 hr after the placement of the lesion. The destruction of this area results in a rapid development of arterial hypertension, hypermotility and hyperexcitability. 24 hr later these effects are attenuated. We conclude that arterial hypertension is probably due to a disinhibition of sympathetic activity through central interruption of baroreceptors reflexes.

Animals↗
PubMed1978

The Radiation Therapy Oncology Group: a progress report.

The Radiation Therapy Oncology Group (RTOG), founded in 1971, comprises 35 university hospitals which are participating in 21 active protocols, four registries and eight pilot studies, including Phase I/II studies. Case accession has grown to over 1000 in 1977 with 19,801 patients being entered in the RTOG initial registration. Goals of the RTOG include: advancing knowledge of the role of radiation therapy in disease management; improving control of primary and regional disease; reducing morbidity and complications from treatment; and collaborating with other oncology disciplines to obtain data on multimodality therapy.

Clinical Trials as Topic↗
PubMed1978

Adjuvant radiotherapy--preoperative, postoperative, or both: a proposal for a new approach.

A new approach to adjuvant radiotherapy is presented using a "sandwich technique" of low-dose preoperative irradiation (500 rads) and high-dose postoperative irradiation (4500 rads in 5 weeks) in the treatment of operable carcinomas of the rectum and bladder. The rationale for this approach and the preliminary results of a pilot study in 28 patients (19 with carcinoma of the rectum and nine with carcinoma of the bladder) are presented. This appears to be a very feasible and logical approach to treatment, with very few complications and excellent local control of disease.

Humans↗
PubMed1977

Radiation therapy as initial treatment for early stage cancer of the breast without mastectomy.

This report describes 150 patients with clinical stage I and II carcinoma of the breast treated at four institutions--Yale University School of Medicine, Harvard Medical School-Joint Center for Radiation Therapy, Hahnemann Medical College, Jefferson Medical College--with radiotherapy only following excisional biopsy. Closely similar treatment policies were followed at all four centers, 4500-5000 rads minimum tumor dose being delivered to the entire breast and axillary, supraclavicular and internal mammary nodes. Forty-six of 49 stage I patients treated are alive without disease, the actuarial relapse-free survival being 91% at 5 years. Of the 101 stage II patients, 75 are alive without disease with a relapse-free actuarial survival of 60% at 5 years. Local failure has occurred in 10 patients (9 stage II and 1 stage I, 6.6%) 5 of whom are disease-free following mastectomy. The results obtained in this study are comparable to those of conventional surgery. It is our conclusion that mastectomy is not a necessary part of the treatment of small breast cancers, that radiation without mastectomy is an acceptable alternative with far superior cosmetic and functional results. Adjuvant chemotherapy should be considered particularly in stage II patients in view of their 40% relapse rate.

Antineoplastic Agents↗
PubMed1977

The neurological manifestations of porphyria: a review.

The hereditary hepatic porphyrias, PV, AIP and HC, are characterized biochemically by increased excretion of porphyrins and the porphyrin precursors ALA and PBG. They are characterized clinically by episodes of acute neurological involvement. The increased production of porphyrins and porphyrin precursors has been shown to be due to partial enzyme blocks along the heme biosynthetic pathway which results in secondary depression of the key enzyme ALA-synthetase. The neurological manifestations could therefore be related to either a decrease in essential heme-proteins or other heme-containing compounds within the nervous system, or to a toxic effect of the over-production of the porphyrin precursors ALA and PBG. There is evidence for and against both theories. Recent work from a number of research groups has shown the porphyrin precursors to have potent pharmacological effects on the nervous system, and these are possibly related to the GABA receptor and binding site-porphyrin precursor interactions. Current studies on therapy of the acute attack have concentrated on suppression of ALA-synthetase activity, and consequently, on reduced ALA and PBG production. A number of such methods of therapy have met with remarkable success and hold promise for the future treatment of the acute attack.

Acute Disease↗
PubMed1977

Reduced ferrochelatase activity: a defect common to porphyria variegata and protoporphyria.

Erythroid ferrochelatase activity has been studied in the normoblasts of patients with porphyria variegata and protoporphyria. Two methods were used for the investigation: one using intact cells and the other lysed cells, each measuring the amount of haem synthesized by normoblasts. In patients with porphyria variegata, ferrochelatase activity estimated by both methods was approximately 50% of the normal, and in protoporphyria the ferrochelatase activity was normal in intact normoblasts but was 20% of the normal in sonicated normoblasts (marrow lysates). It is suggested therefore that in porphyria variegata a dominantly inherited structural gene mutation results in an active ferrochelatase whereas in protoporphyria the genetic mutation results in an unstable ferrochelatase. The mechanism of the enzyme instability is not known though a number of postulates are discussed.

Adolescent↗
PubMed1977

Therapeutic trials in the management of metastatic brain tumors by different time/dose fraction schemes of radiation therapy.

Two consecutive studies have been performed by the Radiation Therapy Oncology Group on patients with metastatic brain tumors. Approximately 1,000 patients were entered into each trial. Treatment schedules of varying dose-time fractionations were used. Results were evaluated on the basis of improvement in general performance and neurologic function status. Survival also was recorded. Patients who received corticosteroids in conjunction with radiation therapy experienced a more rapid improvement in neurologic function than patients who did not receive steroid therapy. This was noted particularly in patients with poor neurologic function status. However, by the 4th week this difference had disappeared. Survival times were not altered by the addition of steroid therapy. Preliminary results of the second study suggest that ultra-short fractionation schedules are less effective than the longer ones used in the first study. A dose of 3,000 rads given in 10 equal fractions for a period of 2 weeks appeared to be the most satisfactory schedule for most patients with intracranial metastases.

Adrenal Cortex Hormones↗
PubMed1976

Adjuvant methotrexate in the radiotherapeutic management of advanced tumors of the head and neck.

Oral methotrexate (MTX) was administered to a group of 48 patients with advanced head and neck tumors prior to radiation therapy in a nonrandomized manner. A second group of 75 similar patients were randomized to intravenous (i.v.) MTX plus radiation or radiation alone. Three-year survival rates by life table analysis show no significant statistical difference between i.v. MTX plus radiation or radiation alone. Those treated with oral MTX plus radiation have a statistically significant improved survival. The degree of tumor regression in the oral MTX group was correlated with survival. No similar correlation could be found in the intravenous MTX group. The use of either form of MTX correlated with a lower rate of distant metastasis.

Administration, Oral↗
PubMed1976

Further observations on tuberculin reactions in active tuberculosis.

One hundred patients with active tuberculosis were tested for tuberculin reactivity within 24 hours of their admission to the hospital. Commercial intermediate tuberculin, Tween stabilized intermediate tuberculin and the Tine test as well as a mumps antigen were applied simultaneously. False negative reactions were obtained in 28 per cent with Tine testing and in 21 per cent with Tween stabilized as well as plain tuberculin. These nonreactors were clinically identifiable as seriously ill with manifestations primarily attributable to protein depletion as a result of their illness. This is not specifically related to the effects of tuberculosis itself, but can be demonstrated in patients suffering the same sequelae of other debilitating illness. After two weeks of protein supplementation via a high calorie, high protein, hospital diet, skin reactivity was restored in the vast majority of these nonreactors. It is concluded that the lack of tuberculin reactivity on hospital admission probably results from impaired lymphocyte function in patients suffering serious protein depletion as a result of their illness; it is not attributable to deficiencies in the tuberculin test itself.

Adult↗
PubMed1976

On the girl's entry into the Oedipus complex.

Detailed child observational study reveals variable pathways by which the girl enters her Oedipus complex. The data of three normal girls are briefly detailed to demonstrate the path each took. The data reported do not support the generalizability of the 1925 postulate that the girl enters her Oedipus complex by way of her castration complex. It is hypothesized that the girl, as well as the boy, enters the Oedipus complex--given a favorable-enough "expectable environment"--from about two and a half years of age on, compelled by a psychobiologically determined gender-related change in her libido and inherited ego dispositions.

Child, Preschool↗