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Biomedical subjects

S R Baker

Publications and source records attributed to S R Baker.

At least 163 records · Page 9Linked to original sources
PubMed1984

The operation of a ward-based radiology consultation service.

A radiology consultation service, consisting of an attending radiologist and a senior radiology resident, functioned for ten months on an acute care medical ward in a teaching hospital. The consultants conducted daily conferences during which they discussed, approved, and scheduled all imaging tests. During the study interval, there were significantly fewer procedures performed on patients in the consultation ward than were performed on patients in three other medical wards of the hospital. The service was well accepted by the medical staff. Early and sustained participation by a radiologist who functions as an advisor during diagnostic evaluations can help limit inappropriate or redundant imaging examinations.

Hospitals, Teaching↗
PubMed1984

A phase I-II trial of cisplatin and dichloromethotrexate in squamous cell cancer of the head and neck.

Dichloromethotrexate, a dihalogenated analog of methotrexate, is excreted and metabolized by the liver; therefore, blood levels are not dependent on renal function. The possibility that dichloromethotrexate could be given at its maximally tolerated dose in combination with high-dose cisplatin has been evaluated in 30 patients with advanced squamous cell cancer of the head and neck. Overall, this regimen was well tolerated, and 13 of 24 evaluable patients had an objective response to therapy (25% complete response and 29% partial response). The maximum dose of dichloromethotrexate that could be delivered was related to the serum albumin. Patients with an albumin less than 3.8 g/100 mL rarely tolerated doses of 500 mg/m2 or greater. Cisplatin plus dichloromethotrexate is an active drug combination in squamous cell cancer of the head and neck, and deserves further evaluation in randomized studies and in an adjuvant setting.

Adult↗
PubMed1984

Leukotrienes (LTB4 and LTD4): in vitro effects on human lymphocyte proliferation and transformation.

The effects of leukotrienes LTD4 and LTB4 on cell proliferation were assessed in a human in vitro lymphocyte transformation assay in the presence of optimal concentrations of PHA, Con A and PWM. Leukotriene D4 and LTB4 (10(-6) to 10(-11) M) did not alter the basal or mitogen-stimulated response. We therefore conclude that these two agents do not play a role in the modulation of human lymphocyte blastogenesis.

Humans↗
PubMed1984

Intramural pseudodiverticulosis of the esophagus.

Two cases of esophageal intramural pseudodiverticulosis are presented. A brief review is made of previously published reports. This entity, first described in 1960, is still rarely diagnosed. Its etiology is still debatable. However, as more cases are published, it becomes more apparent that esophageal intramural pseudodiverticula can be found as part of a distinct syndrome with diffuse intramural pseudodiverticulosis, as originally described by Mendl, or localized in a limited extension of the esophagus as a response to esophageal obstruction.

Aged↗
PubMed1984

Phase II trial of ICRF-187 in squamous cell carcinoma of the head and neck.

A phase II trial of ICRF-187 (1.0 g/m2/48 hours by continuous infusion every 3 weeks) was conducted in 25 patients with advanced squamous cell cancer of the head and neck. There were two partial responders for an overall response rate of 8%. Sixteen of the patients had not received prior chemotherapy and both responding patients were in this group. The major side effect of ICRF-187 was reversible leukopenia.

Aged↗
PubMed1984

Surgical reconstruction after extensive skull base surgery.

Skull base surgery is a rapidly expanding surgical subspecialty bringing together the sophisticated surgical skills of the neurotologist-head and neck surgeon and the neurosurgeon. Newly described surgical approaches to the skull base have made possible greater surgical ablation of the skull base region, resulting in large defects and thus heightening the need for reconstructing these regions. Prevention of cerebrospinal fluid leaks is the most important aspect of reconstruction and is achieved most readily when possible by dural patch grafts of fascia lata, coverage of the dura with soft tissue, and preservation of the soft tissue utilizing skin or split thickness skin grafts. Soft tissue may be in the form of free fascia lata grafts, pedicled galeal flaps, or local or regional skin flaps. Defects of the skull base larger than a few square centimeters are best reconstructed with local or regional skin flaps or musculocutaneous flaps. These flaps lend sufficient structural support so that bone support is not usually required. Subsequent cranioplasty, when necessary, can provide protection to those regions of the brain that are more susceptible to blunt trauma.

Cranial Fossa, Posterior↗
PubMed1983

Management of nasal cutaneous malignant neoplasms. An interdisciplinary approach.

Standard methods of managing large or recurrent cutaneous nasal malignant neoplasms are often inadequate, leaving extensions of the tumor that are clinically invisible. Conventional methods may also allow considerable amounts of normal tissue to be sacrificed in an attempt to ensure the removal of all carcinoma. Through partnership of the dermatologic surgeon and the reconstructive surgeon, a more effective method of curing and rehabilitating patients with nasal skin cancer can be achieved. The dermatologic Mohs' surgeon can perform microscopically controlled excision of malignant neoplasms, providing the highest cure rates obtained by any method. This method is particularly suited for basal cell carcinomas that are recurrent, larger than 1 cm in size, or are of the morpheaform histologic subtype. Total microscopic excision allows nasal reconstruction to proceed with the highest degree of confidence of tumor control. The location and extent of the malignancy dictate the surgical approach for nasal reconstruction.

Basal Cell Carcinoma↗
PubMed1983

Management of osteoradionecrosis of the mandible with myocutaneous flaps.

Involvement of large areas of the mandible or the entire mandible with osteoradionecrosis may result in severe functional disability and cosmetic deformity. The use of a well-vascularized pectoralis major myocutaneous flap from outside the original field of irradiation has been successful in obtaining functional and cosmetic goals. Myocutaneous flaps provide bulk for contour and tissue support, and their rich vascular supply promotes healing of the heavily irradiated soft tissue and bone. Successful bone grafting for mandibular reconstruction may follow control of the osteoradionecrosis.

Carcinoma, Squamous Cell↗
PubMed1983

Intensive sequential chemotherapy with bleomycin, Oncovin, mitomycin C, and methotrexate followed by adriamycin, cisplatin, and cyclosphosphamide in squamous cell cancer of the head and neck.

Twenty-six patients with advanced squamous cell cancer of the head and neck were treated with bleomycin, Oncovin, mitomycin C, and methotrexate (BOMM) for ten weeks. Partial and nonresponders then received adriamycin, cisplatin, and cyclophosphamide (APC) in a planned sequential program. The response rate to BOMM was 65% (19% complete remission, CR). The overall response rate to APC was 20%. Only three of eight nonresponders to BOMM could receive APC and non responded. Six of seven partial responders received APC and only one responded. One complete responder to BOMM received APC at relapse and attained a partial response. The major side effects of BOMM were mucositis and myelosuppression. Patients receiving methotrexate 60-72 hours following the bleomycin infusion had less myelosuppression than patients who were treated 36-42 hours after bleomycin. The toxicities with APC included nausea, vomiting, and myelosuppression. Including a prior series, a total of 45 patients have been treated with BOMM with a 71% response rate (69% in previously irradiated patients). Twenty-eight percent of previously treated patients achieved complete remission, and two of these patients are disease free at 31 and 37 months. Methotrexate dose-rate alteration to low dose twice weekly followed by a single dose of oral leucovorin did not improve the complete or partial response rate when compared to weekly methotrexate administration. The complete remission rate and response duration were also not improved by the planned sequential use of this cisplatin-containing regimen.

Adult↗
PubMed1983

Diffuse pulmonary gallium accumulation with a normal chest radiogram in a homosexual man with Pneumocystis carinii pneumonia. A case report.

A homosexual man with A.I.D.S. (acquired immunologic deficiency syndrome) and pneumocystis infestation was found to have diffuse Ga-67 uptake in the lungs with a coincident negative chest x-ray. While Ga-67 accumulates diffusely in the lungs in a variety of conditions, the present case is the first described in a patient with A.I.D.S. in which Ga-67 was positive before roentgenographic abnormalities were demonstrated. Thus, the use of Ga-67, when A.I.D.S. is suspected, could help establish a diagnosis more promptly.

Acquired Immunodeficiency Syndrome↗
PubMed1983

Antibodies to human squamous cell carcinoma.

We are studying membrane antigens of human squamous cell cancer with the use of naturally occurring autologous antibodies from patients' sera, along with a set of other serologic reagents and monoclonal antibodies raised against cultured squamous cell lines. Twenty-eight squamous cell carcinoma cell lines have been established in our laboratory from tissues obtained from 23 patients. Antibody reactivity has been found against the autologous tumor cell line in 13 of 23 patients. One of these is of sufficient titer for detailed analysis. Four cell lines are available from this patient. UM-SCC-17A is derived from the primary laryngeal carcinoma, and UM-SCC-17B is derived from a lymph node metastasis removed during the same surgical procedure. Fibroblasts have been cultured from normal mucosa, and a B-lymphoblastoid line has been developed by Epstein-Barr virus transformation of the patient's peripheral blood lymphocytes. Antibody from this patient reacts with the UM-SCC-17A and -17B tumor cell lines but does not react with the normal fibroblasts (UM-NF-17).

Antibodies, Monoclonal↗
PubMed1983

Ultrastructural and functional studies of cilia from patients with asthma, aspirin intolerance, and nasal polyps.

"Triad" asthmatics often have sinus disease, nasal polyps, and obstructive airways disease. This presentation is reminiscent of the symptoms of persons afflicted with various forms of ciliary dyskinesia. Therefore, we examined tissues from seven "triad" asthmatic patients for ciliary structural or functional abnormalities. Transmission and scanning electron microscopy revealed no specific abnormalities. Cultures of nasal epithelia were maintained for up to 20 weeks. They showed normal ciliary activity which was not influenced by perfusing the tissue with medium containing aspirin. In contrast, control tissue from a patient with situs inversus and sinusitis showed the expected structural and functional ciliary abnormalities. In culture, the ciliary function of tissue from this patient could be partly restored by perfusion with ATP or ATPase.

Adenosine Triphosphatases↗
PubMed1982

The operation of a radiology consultation service in an acute care hospital.

The operation of a radiology consultation service in an acute care teaching hospital is described. The radiologist acts as an active advisor in the structuring of diagnostic evaluations in three disease categories; biliary tract disease, nonemergency gastrointestinal tract bleeding, and abdominal mass. There was a 64% reduction in the time needed to establish a diagnosis and a 32% decrease in the number of studies for each patient on the consultation ward compared with a control group, which consisted of patients with similar clinical presentations. A formal partnership between clinician and radiologist serves two important functions in teaching hospitals. It can simultaneously expedite diagnostic evaluations and teach the best utilization of imaging examinations.

Abdominal Neoplasms↗