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Biomedical subjects

S Wallace

Publications and source records attributed to S Wallace.

At least 289 records · Page 16Linked to original sources
PubMed1985

Expandable biliary endoprosthesis: an experimental study.

Expandable stents constructed of stainless-steel wire were inserted in the extrahepatic bile ducts of five animals to determine the effect of the endoprosthesis on the ductal wall. The stents were left in place 4-23 weeks, at which time the bile ducts were inspected. The bile ducts remained patent in all animals. Relatively mild reactive inflammatory changes observed in the wall of the bile ducts were more pronounced in animals with stents in place for the longest periods. A relatively small-caliber catheter (9 French) was necessary for the introduction of the stent, which acquired a much larger diameter once it was released from the catheter. This study suggests that expandable wire stents could be safely used to relieve biliary obstruction.

Animals↗
PubMed1985

Combined intravenous and intra-arterial cyclophosphamide, doxorubicin, and cisplatin (CISCA) in the management of select patients with invasive urothelial tumors.

Twenty-eight patients with unresectable urothelial tumors who had no evidence of distant visceral metastasis were managed with iv CISCA (cyclophosphamide, doxorubicin, and cisplatin) and intra-arterial (ia) CISCA chemotherapy. Ten patients had locally advanced disease only and 18 had locally advanced disease with nodal metastasis (ten in pelvic nodes; seven in pelvic and para-aortic nodes; and one in pelvic, para-aortic, and mesenteric nodes). Eleven patients (39%) achieved a complete remission, with a median duration of 49 weeks (range, 25-108). Seven patients (25%) achieved on objective response and ten patients (36%) failed to respond. Iv and ia CISCA chemotherapy is effective in the management of advanced urothelial tumors. Patients with locally advanced disease with or without the presence of nodal metastasis are a select population in whom frequent complete remissions can be achieved.

Adult↗
PubMed1985

Computed tomography and ultrasonography in splenic infarction.

The computed tomographic (CT) findings in eight patients with splenic infarction are described and correlated with ultrasound (US) in three. The diagnosis was proven in four by splenectomy or autopsy, in three by comparison with CT, having been obtained shortly before infarction, and in two by angiography. In four patients the infarct occurred as a result of hepatic or splenic artery embolization. The CT features of infarction may be difficult to differentiate from those due to trauma, inflammation or tumor, and include either a diffuse, a well circumscribed or an irregularly marginated area of low density within the spleen. Classical wedge-shaped defects are occasionally seen in the periphery of spleen. The ultrasonographic feature is usually that of a hypoechoic or an anechoic area in the spleen. In one patient, it became necessary to perform an ultrasound guided aspiration biopsy to rule out splenic abscess.

Adolescent↗
PubMed1985

Lymphangiography in genitourinary cancer.

No radiographic technique is capable of detecting microscopic disease and so the lymphangiogram must always be expected to have more false-negative results when compared with the results of surgical staging. It is apparent, however, that gross nodal metastases can be detected with a high degree of accuracy for selected genitourinary tumors. In spite of advances in diagnostic imaging, the bipedal lymphangiogram continues to have a place in the staging of genitourinary tumors.

False Negative Reactions↗
PubMed1984

Infusion-embolization.

Transcatheter intra-arterial therapy for the cancer patient encompasses infusion of chemotherapy and embolization. Intra-arterial infusion of chemotherapeutic agents has been resurrected because of the availability of new drugs, combinations of drugs, and the capability of percutaneous selective catheter placement. Intra-arterial infusion has been effective in patients with carcinomas of the liver, bladder, prostate, uterus, ovary, and lung and in bone and soft tissue sarcomas, melanomas, and tumors of the brain. Embolization of the arterial supply, creating ischemia of the neoplasm, has been employed in the therapeutic management of patients with primary and secondary neoplasms of the liver, kidney, and bone. The median survival of 100 patients with neoplasms of the liver from the time of hepatic artery embolization was 11.5 months. In 100 patients with pulmonary metastases from carcinoma of the kidney, 28 experienced a response to renal artery embolization, a therapeutic delay of 4 to 7 days, nephrectomy, and Depo-Provera (medroxyprogesterone). Seven of 12 patients with giant cell tumor of the pelvis and lumbar spine responded to arterial embolization after all other therapy failed. Chemoembolization, the combination of arterial infusion of chemotherapy and embolization, can be accomplished by the use of microencapsulated agents, liposomes, and particulate emboli with drugs. This approach integrates the advantages of infusion and occlusion, and has considerable potential. Intra-arterial immunotherapy has been initiated with bacillus Calmette-Guerin (BCG) administration into renal neoplasms in patients with metastatic disease.

Antineoplastic Agents↗
PubMed1984

Intracarotid infusion of cis-diamminedichloroplatinum in the treatment of recurrent malignant brain tumors.

Thirty-five patients with malignant brain tumors (23 with primary brain tumors and 12 with brain metastases) progressing after cranial irradiation +/- chemotherapy received cisplatin, 60 to 120 mg/m2, into the internal carotid artery by a transfemoral approach. Courses of therapy were repeated every 4 weeks. Therapeutic evaluation was performed monthly using the CT scan of the brain and clinical neurologic examination. Thirty patients were evaluable for response. Of 20 evaluable patients with primary malignant brain tumors, 6 responded to therapy and 5 had stable disease. The median time to tumor progression for responding patients was 33 weeks, for stable patients 16 weeks, and 13 weeks for all patients. Five of 10 evaluable patients with brain metastases responded to intracarotid cisplatin, and 2 patients had stable disease. The estimated median time to progression for responding patients was 30+ weeks and 12+ weeks for patients with stable disease. Side effects included seizures in 5 courses, mental agitation and motor restlessness in 1, and transient hemiparesis in 7. One patient may have had a drug-related death, and one patient appeared to develop encephalopathy after treatment. Five patients had clinical deterioration in vision; in two patients it was bilateral. Intracarotid cisplatin has definite activity in patients with malignant primary brain tumors and in patients with brain metastases. The recommended starting dose for intracarotid cisplatin is 60 to 75 mg/m2. At this dose level side effects are uncommon, but includes the risk of neurologic and retinal toxicity.

Adult↗
PubMed1984

Case report of translumbar renal angiography and embolization.

The translumbar approach was used for renal angiography and transcatheter embolization in a patient whose usual sites of vascular entry were not available because of arteriosclerotic occlusive vascular disease. A description is given of the reasons for embolization and the method used.

Aged↗
PubMed1984

Regional isolation-perfusion: an experimental percutaneous approach tested and compared with arterial occlusion-infusion.

A percutaneous approach was developed for the performance of regional isolation-perfusion, a surgical chemotherapeutic procedure for the intraarterial treatment of neoplasms. This technique was compared with percutaneous transcatheter arterial occlusion-infusion concerning local and systemic drug levels. Floxuridine (FUDR) was administered into a femoral artery of adult mongrel dogs, first by arterial occlusion-infusion, and 4 weeks later by regional isolation-perfusion of the opposite hind limb. Local and systemic plasma samples and local muscle specimens were collected for determination of FUDR levels. Results indicated not only that regional isolation-perfusion could be accomplished percutaneously, using balloon catheters, but also that the technique produced significantly greater local tissue FUDR levels (P less than 0.05) than those achieved with arterial occlusion-infusion.

Angioplasty, Balloon↗
PubMed1984

Tripelennamine and pentazocine alone and in combination: effects on interresponse-time-greater-than-t responding of rats.

The effects of tripelennamine (3, 6, 12, 18, and 24 mg/kg) and pentazocine (5, 10, 20, 30, and 40 mg/kg), given alone and in selected combinations, were determined in rats performing under an interresponse-time-greater-than-15-sec schedule of food delivery. Each drug alone produced statistically insignificant increases in response rates and statistically significant decreases in reinforcement rates. Combinations produced effects identical in direction to, and significantly greater than, those predicted by a simple additive model.

Animals↗
PubMed1984

Computed tomography of juxtacardiac pheochromocytoma.

The diagnosis of juxtacardiac pheochromocytoma was made with the help of three-dimensional computed tomography, angiography, and radionuclide scintigraphy, and was proved at surgery. If findings on adrenal computed tomography are normal and the clinical and laboratory findings support the diagnosis of pheochromocytoma, the patient should be further investigated by computed tomography or radionuclide-guided computed tomography and angiography to determine the extraadrenal location of this tumor. If the abnormal area is in the mediastinum, it is essential to do either direct coronal computed tomography imaging of the suggestive area or to obtain coronal and sagittal reconstruction images to investigate the relationship of the lesion to the great vessels and cardiac chambers.

Adrenal Gland Neoplasms↗
PubMed1984

Defining discipline roles in consultation psychiatry: the multidisciplinary team approach to psychosocial oncology.

Multiple mental health professions are often involved in the management of cancer patients. Psychiatry, psychology, social work, and nursing have all developed entrees to the medical setting that lead to clinical involvement of one or more of these professions at any given time. Much confusion remains about the specific contribution of these different mental health professions, and lack of role definition makes it difficult for programs to logically plan for mental health services or for services already in place to organize themselves in a collaborative manner. While these disciplines have interacted formally and informally in a number of settings for many years, there have been few published attempts to delineate the unique contributions of each and to suggest a model for their collaborative interaction. This paper attempts to define the unique contributions of each of these disciplines in relation to an oncology consultation program in a general hospital setting. The definitions are proposed as a model that can be generalized to other consultation programs.

Adaptation, Psychological↗
PubMed1984

Medical clinic referrals to psychiatric social work: review of 100 cases.

This study examines 100 consecutive patient referrals from a general medical clinic to psychiatric social work. While much has been written from a theoretical or anecdotal perspective on the contribution of social work to medical care, there have been relatively few attempts to look in detail at actual practices. Of the 100 patients, 52 were referred for "concrete services," 30 for evaluation of a psychiatric disorder (such as depression or somatoform disorder), 20 for counseling, and 11 for assistance for a drug or alcohol problem. Although the most frequent referral to psychiatric social work by the medical clinic staff was for concrete services, half of these cases actually involved overlooked psychiatric problems, and no concrete service of any sort was perceived as necessary by the psychiatric social worker in 30% of these cases. Referring medical staff tended to view patient distress in terms of concrete needs and chose to refer to social work even when significant psychiatric diagnostic problems were identified. Analysis of the differences in reasons for referral versus actual clinical problems has implications not only for the training needs of social work in this setting, but also for the relationship between social work and psychiatry, and for the organizational and educational needs of ambulatory medical services.

Adolescent↗
PubMed1984

Phase-I trial of intracarotid BCNU and cisplatin in patients with malignant intracerebral tumors.

Eighteen patients with progressive or recurrent intracerebral malignant neoplasms after cranial radiation therapy were entered in a phase-I trial of intracarotid bis-chloroethylnitrosourea (BCNU) and cisplatin. Thirty-six courses of varying doses of BCNU and cisplatin were infused intraarterially via a percutaneous, trasfemoral approach. Courses were repeated every 4-6 weeks upon patients' recovery from toxicity. Intraarterial cisplatin or BCNU alone was administered if the blood counts were still subnormal. CT scans and neurologic examinations were performed monthly. Major toxic effects included ipsilateral retinal (amaurosis) in 4 patients and neurologic toxicity in 2 patients (minor focal seizure, reversible obtundation in one patient, and transient hemiparesis in one patient). One patient was infused by a catheter inserted into the supraclinoid internal carotid artery and had no further visual deterioration and no major side effects. Tumor regression was observed in patients previously treated with radiation and/or systemic chemotherapy, including 4 of 9 who had recurrent malignant gliomas, and 2 of 9 who had metastatic tumors. Recommended dose for phase-II trials is BCNU 100 mg/m2 and cisplatin 60 mg/m2 every 4-6 weeks. Retinal and neurologic toxicity are possible side effects.

Adult↗
PubMed1984

Computed tomography after partial hepatectomy.

Twenty-two patients with surgically resectable malignant primary liver neoplasm or hepatic metastases were examined by computed tomography both before and after surgery. The anatomic modifications created by the surgery, including right lobectomy, left lobectomy, segmentectomy, and wedge resections were evaluated. Computed tomography depicted changes in the liver contour, usually after right or left lobectomy as well as secondary effects of these changes in the adjacent organs. With knowledge of these postsurgical modifications, the reparative ability of the liver can be appreciated.

Hepatectomy↗
PubMed1984

Abdominal and pelvic computed tomography in leukemic patients.

Fifty-two patients with different types of leukemia [27 chronic lymphocytic leukemia (CLL), 10 acute myeloblastic leukemia (AML), eight acute lymphoblastic leukemia (ALL), four chronic myelogenous leukemia (CML), and three hairy cell leukemia (HCL)] had abdominal and pelvic CT. The radiographic features are reviewed to evaluate the role of CT in diagnosis and management of these patients. The highest incidence of lymphadenopathy was observed in CLL followed by HCL and ALL. Other findings included splenomegaly, hepatomegaly, ascites, pleural effusion, microabscesses in liver and kidney, and visceral involvement, i.e. intestine, bladder, and bone.

Adolescent↗