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Biomedical subjects

T Anderson

Publications and source records attributed to T Anderson.

At least 217 records · Page 12Linked to original sources
PubMed1986

Successful high-dose intravenous cytarabine treatment of parenchymal brain involvement from malignant lymphoma.

A patient with systemic recurrence of large-cell malignant lymphoma developed radiologic evidence of parenchymal brain metastasis. Treatment with systemic high-dose cytarabine resulted in complete regression of peripheral adenopathy and complete radiologic response in the central nervous system, with normalization of the brain computed tomographic scan. This case further demonstrates the ability of high-dose cytarabine to penetrate the blood-brain barrier and achieve therapeutic drug concentrations in the central nervous system, an area that might otherwise remain a pharmacologic sanctuary for tumor cells.

Brain Neoplasms↗
PubMed1985

Combined methotrexate and high-dose vincristine chemotherapy with radiation therapy for small cell bronchogenic carcinoma.

The addition of methotrexate to a previously described regimen of cyclophosphamide, Adriamycin (doxorubicin), and high-dose vincristine (VAC) was tested in 50 evaluable patients with small cell bronchogenic carcinoma. Prophylactic whole brain radiation therapy was given during the first chemotherapy course and consolidation radiation therapy was given to the mediastinum and primary site after achieving partial or complete remission. The addition of methotrexate did not improve the incidence of complete remission as compared to a previous regimen without it. The addition of radiation therapy improved the local control rate. The high-dose vincristine in this and a previous CAV study improved the incidence of complete remission in both limited and extensive disease presentation as compared with the authors' previous experience and induced an acceptable and reversible neurotoxicity. Moderate dose consolidation radiotherapy to the lung primary and mediastinum was effective in improving local control. The distinction between limited and extensive disease was found to be vague, as 22% of the patients could be shifted from one group to the other depending on definition. The evaluation of the various staging procedures indicates that bone scan gave a small number of truly abnormal tests. Isotopic brain and liver-spleen scan could be duplicated by computerized axial tomography (CAT). CAT scan of abdomen disclosed unexpected extension to the retroperitoneal nodes and adrenals. It is concluded that radionuclide studies of brain, liver-spleen, and bone can be eliminated and can be replaced by CAT scan of brain, chest, and abdomen. Site of recurrence indicate that most intrathoracic recurrences took place outside the radiation therapy field and in the pleural space. An incidental finding was the high incidence of intramedullary spinal cord recurrence.

Adult↗
PubMed1985

Intravenous gammaglobulin in refractory immune thrombocytopenic purpura: efficacy with or without concomitant steroid therapy.

Two patients with immune thrombocytopenic purpura (ITP) refractory to conventional management with steroids and splenectomy were treated with 5-day courses of intravenous gamma globulin (Gamimune-Cutter), 400 mg/kg/day. Improvement was observed in both cases even while steroids were being tapered. In each case when thrombocytopenia subsequently recurred or worsened, further therapy with IV gamma globulin without concomitant steroids was followed by definite increase in platelet numbers. These observations confirm that the Cutter preparation of IV gamma globulin is efficacious in the management of refractory ITP and suggest that in this clinical setting response to IV gamma globulins can occur without concomitant administration of corticosteroids.

Adult↗
PubMed1985

Isolation of a purified mitochondrial fraction from viable clonal insulin-producing cells (RINm5F) by Percoll density gradient centrifugation.

A Percoll density gradient was employed for selecting large numbers of viable insulin-producing RINm5F cells. Homogenates of these cells were then subjected to gradient centrifugation and two clearly visible bands were obtained. The light fraction was essentially composed of mitochondria banded at a density of about 1.06 g/ml. The heavier fraction banded at 1.09 to 1.10 g/ml and contained lysosomes and a small number of secretory granules. The distribution of Percoll particles was restricted to the extracellular space and there was no adsorption to any membrane structures. The distribution pattern of marker enzymes for the mitochondria and lysosomes was similar to that of normal pancreatic beta-cells. With the use of a Percoll density gradient it was thus possible to isolate a purified mitochondrial fraction from viable RINm5F cells.

Animals↗
PubMed1985

Multiagent chemotherapy, prophylactic neuraxis irradiation, and consolidative irradiation for small cell carcinoma of the lung.

Between 6/81 and 6/83, 73 patients with small cell carcinoma of the lung were treated according to a prospective protocol in which cyclophosphamide, doxorubicin, and vincristine (CAV) were given concurrently with prophylactic craniocervical irradiation to the level of C5. Both limited and extensive disease patients with normal computed tomography of the brain received 25 Gy in 10 fractions in 2 weeks. Complete responders to CAV received consolidative thoracic irradiation (CTI) to the local-regional primary (37.5 Gy in 15 fractions in 3 weeks), the first 25 Gy in 10 fractions serving as prophylaxis of the C6 to T12 spinal cord. The neuraxis from L1 to S2 then received 25 Gy in 10 fractions in 2 weeks. Consolidative irradiation of localizable metastatic sites was given in extensive disease patients. Partial and nonresponders to CAV received 50-60 Gy in 5-6 weeks to local-regional disease. With a median followup of 29 months, survival was significantly better (p less than .01) in patients receiving CTI to the chest after complete response to CAV (both limited disease and extensive disease) than without CTI. Of 41 patients completing the protocol and without central nervous system (CNS) involvement at presentation, four (9%) failed initially in the CNS (two brain, two spinal axis); CNS failure was the cause of death in all four patients with no other sites of metastases at death in two of these. Failure to complete protocol treatment was due to disease progression during chemotherapy in 25/73 (34%) and chemotherapy related complications (three sepsis, one gastrointestinal bleed) in four of 73 (5.5%) patients. CTI and prophylactic neuraxis irradiation did not increase morbidity or result in mortality in the sequence utilized; prophylactic neuraxis irradiation appears to reduce the CNS relapse rate, and CTI benefits survival.

Actuarial Analysis↗
PubMed1985

What is the lowest effective biologic dose for prophylactic cranial irradiation?

Between January 1974 and September 1984, 327 consecutive patients with small cell carcinoma of the lung (SCCL) free of clinical and brain scan (radionuclide or computed tomography) evidence of brain metastasis were treated at the Medical College of Wisconsin Affiliated Hospitals. All patients received single agent chemotherapy, consisting of cyclophosphamide or methotrexate (1974-1975), or combination chemotherapy with cyclophosphamide, doxorubicin, and vincristine with or without methotrexate and leukovorin (1976-1984). Between January 1974 and December 1974, 82 patients were treated with chemotherapy without prophylactic cranial irradiation (PCI). Between 1978 and 1984, all patients received PCI during the first week after diagnosis, simultaneous with their first cycle of chemotherapy. Chest irradiation was given to the complete responders to the chemotherapy. During the first 31/3 years of the study with PCI (January 1978-May 1981), 51 patients received 30 Gray (Gy) in 10 fractions in 2 weeks and five of them (10%) developed brain metastasis. Thereafter, 25 Gy in 10 fractions was consistently administered for PCI. Six of 194 patients (3%) developed brain metastasis. The cumulative (time corrected) probability of brain metastasis was approximately 10% at 1 year and was similar for patients who received 25 Gy and those who received 30 Gy. Although detailed neuropsychological testing has not been performed, clinically apparent late sequelae that might be attributed to PCI have not been seen. Nonetheless, the dose fractionation regimen of 25 Gy in 10 fractions with combination chemotherapy, cyclophosphamide, doxorubicin (or methotrexate), and vincristine is as effective in eliminating subclinical metastasis to the brain. It can be recommended for future trials until more data become available about late sequelae of treatment of SCCL and the patient characteristics and treatment factors that may contribute.

Actuarial Analysis↗
PubMed1985

Malignant histiocytosis resistant to anthracycline. Response to intensive treatment with etoposide and amsacrine.

A 36-year-old woman, presenting with fever, pancytopenia, hepatosplenomegaly, and striking effacement of the bone marrow by true malignant histiocytes, was found to have no benefit from the systemic administration of cyclophosphamide, vincristine sulfate, doxorubicin, prednisone, and high-dose methotrexate with calcium leucovorin rescue. Striking histologic and clinical improvement was noted after the administration of two cycles of etoposide and amsacrine, each cycle consisting of 100 mg/sq m/day of each agent for five days. We believe that this therapy should be considered for future patients demonstrating aggressive presentations of malignant histiocytosis.

Adult↗
PubMed1985

Failure to suspect and diagnose thalassemic syndromes. Interpretation of RBC indices by the nonhematologist.

A three-year review of the medical records of 76 patients with apparent thalassemic syndromes (mean corpuscular volume, greater than 75 cu micron; RBC count, greater than 5 X 10(6)/cu mm) was performed to assess overall physician response to this information at a midwestern teaching institution. Abnormal indices were recognized in only 50% of the cases; in only 32% of cases was a thalassemic syndrome considered in the differential diagnosis. Residents in internal medicine failed to recognize microcytic indices and to consider thalassemic syndromes 42% and 59% of the time, respectively. Even though hemoglobin electrophoresis was performed in 25 patients, in only 15 (56%) of the 25 cases was beta-thalassemia proved or alpha-thalassemia presumptively diagnosed. In 17% of all cases, the patients were treated with iron without diagnostic findings on iron studies and/or in spite of data suggesting a thalassemic syndrome. The RBC indices are an underused portion of the complete blood cell count, and readily apparent thalassemic syndromes are often not considered.

Erythrocyte Indices↗
PubMed1984

Hodgkin's disease with leptomeningeal involvement. Report of a case with long survival.

A 30-year-old white man with Stage IV B Hodgkin's disease, mixed cellularity type, developed leptomeningeal involvement shortly after relapsing on nitrogen mustard, Oncovin (vincristine), procarbazine, and prednisone (MOPP), and while receiving Adriamycin (doxorubicin), bleomycin, Velban (vinblastine), and dacarbazine (ABVD). Whole brain irradiation and intrathecal methotrexate were successfully incorporated into his treatment program. The patient has now been in complete remission for more than 40 months. A review of this rare complication of Hodgkin's disease is presented.

Adult↗
PubMed1984

Benign mesothelial proliferation with effusion. Clinicopathologic entity that may mimic malignancy.

The clinical and pathologic features of five cases of a previously poorly defined syndrome, benign mesothelial proliferation with effusion, are described. Although this is a benign process, both the gross and the microscopic findings may mimic metastatic papillary adenocarcinoma. Three of five patients had dysynchronous involvement in more than one body cavity developing over intervals of one, two, and six years. The clinical course is unpredictable and is usually associated with a good prognosis, but two of three patients with pericardial involvement required pericardectomy for pericardial tamponade. The entity of benign mesothelial proliferation with effusion and its distinction from true malignant conditions are discussed.

Adult↗
PubMed1984

Surgery following chemotherapy and radiotherapy for advanced carcinoma of the cervix.

Ten patients with advanced squamous carcinoma of the cervix have been treated with both radiotherapy and monthly cyclical chemotherapy. All patients have subsequently undergone a simple hysterectomy and bilateral salpingo-oophorectomy with para-aortic and pelvic node biopsy. Six patients were found to be histologically free of disease, 2 patients had residual cervical disease completely excised, and 2 patients had persistent intra-abdominal disease. Eight patients have survived 24-43 months one of whom has recurrent disease. The addition of chemotherapy to standard radiotherapy appears to have improved the results of treatment, however, in view of the high complication rate (50%) it is considered that surgical assessment of response is not justified and that surgery should only be undertaken where there is good evidence of persistent but operable disease.

Adult↗
PubMed1984

Psammoma bodies in malignant carcinoid tumor metastases.

A clinically and histopathologically well-documented case of malignant carcinoid tumor (with carcinoid syndrome) is described. The presence of numerous psammoma bodies in metastatic carcinoid tumor deposits, confirmed by histochemical and ultrastructural analyses, represents a heretofore unreported finding.

Carcinoid Tumor↗
PubMed1984

Underwater weighing using the Hubbard tank vs the standard tank.

The purpose of this study was to determine whether underwater weighing in the Hubbard tank is a valid and reliable method for estimating body composition. Thirty healthy subjects were weighed underwater for four separate trials; each trial consisted of five weighings. The first trial was completed in a standardized sit-in underwater weighing tank, and the last three trials were completed in a Hubbard tank. Validity was determined by calculating Pearson's correlation coefficient across the four underwater trials, which resulted in r = .077 or higher. The coefficient of variation was found to be 1.22 percent for the sit-in tank and 1.23 percent for the Hubbard tank. A paired t test between the two methods was significant at the .001 level. Reliability for the Hubbard tank method was determined by the repeated measures analysis of variance across the three trials and found not to be significant. The intraclass correlation for the three Hubbard tank trials resulted in R = .997. In addition, the interrater reliability between the two researchers who made independent observations of the weight scale resulted in r = .999 for the standardized sit-in tank and r = .998 for the Hubbard tank. Therefore, the Hubbard tank appears to be valid, reliable, and equally effective as the standardized sit-in underwater weighing tank for determining body composition. Because the paired t test was significant, however, the two methods should not be interchanged; one or the other method should be used, but not both.

Adipose Tissue↗
PubMed1984

Successful treatment of meningeal leukemia using systemic high-dose cytosine arabinoside.

Conventional therapy for leukemic meningitis includes cranial irradiation and intrathecal chemotherapy administered by repeated lumbar punctures or direct intraventricular instillation via an Ommaya reservoir. Several clinical reports have indicated that high doses of cytosine arabinoside (ara-C) are effective in the treatment of acute leukemia refractory to standard induction therapy. Pharmacokinetic studies have demonstrated that high doses of ara-C given intravenously obtain sustained therapeutic drug concentrations in the cerebrospinal fluid, suggesting that this approach may be useful in the treatment of systemic disease associated with meningeal involvement. Five consecutive patients with overt meningeal leukemia were treated using only systemic chemotherapy containing high-dose ara-C. In all patients there was prompt resolution of neurologic symptoms and signs accompanied by cytologic clearing of leukemic cells from the cerebrospinal fluid.

Acute Disease↗
PubMed1984

Effect of medroxyprogesterone and an aorta-derived cell growth inhibitor on B16 melanoma in mice.

An aorta-derived inhibitor of endothelial cell and tumor cell growth and medroxyprogesterone, which depresses collagenase expression in vivo, were tested alone and in combination against B16-F10 melanoma in C57BL/6 mice in such doses that either agent alone had little effect. Together, these agents retarded growth of subcutaneously transplanted tumor cells and reduced the number and size of pulmonary tumors after iv tumor cell injection. Of the treatments used, only the aortic factor administered alone prolonged life in mice with pulmonary tumors.

Animals↗
PubMed1984

Effects of furosemide on the plasma and urinary concentrations and the excretion of fentanyl: model for the study of drug interaction in the horse.

The effects of furosemide (0.55 mg/kg IV) on the plasma and urinary fentanyl (PFE UFE) concentrations were studied during steady-state conditions. The PFE during the steady-state period was 0.31 +/- 0.027 ng/ml, with no significant changes occurring, even though the rate of excretion of fentanyl (EX) increased during the 1st hour from 112.0 +/- 21.6 to 534.5 +/- 82.9 ng/minute. The EX returned to control levels within 3 hours, as did the UFE. The injection of furosemide increased glomerular filtration rate from 1.97 +/- 0.21 to 3.81 +/- 0.75 ml/kg/min. The fractional reabsorption decreased from a control of 70.3 +/- 6.2% to 25.2 +/- 2.3% during the 1st hour, returning to control levels at 3 hours after furosemide was given. The total body clearance of fentanyl increased slightly during the peak period of diuresis. The return of EX, fractional reabsorption, UFE, and clearance of endogenous creatinine to control levels occurred before the return of urine specific gravity, indicating the ability of the kidney to concentrate fentanyl before its water concentrating capacity had returned.

Animals↗