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Biomedical subjects

T C Brown

Publications and source records attributed to T C Brown.

At least 109 records · Page 6Linked to original sources
PubMed1982

Non-Hodgkin lymphoma of the testis.

Sixteen patients (median age 67 yrs.) with non-Hodgkin lymphoma of the testis were studied. Twelve of these patients had disease that was classified as local (Stages IE and IIE). Eight patients had diffuse histiocytic lymphoma, 6 had diffuse poorly differentiated lymphocytic lymphoma, 1 had both lymphoma and seminoma, and 1 had nodular poorly differentiated lymphocytic lymphoma. The overall median survival was 9.5 months. Para-aortic nodal involvement was the factor that had the strongest prognostic influence with the management methods used. Median survival without para-aortic nodal involvement was 57+ months, but with such involvement it was 6 months (p = 0.002). There is a high probability of generalized disease if lymphoma can be detected in the para-aortic nodes. For patients with Stages IE and IIE disease, radical radiation therapy is the preferred treatment. For those with disseminated disease, chemotherapy, with irradiation reserved for symptomatic and bulky localized deposits, is the recommended method of management.

Adult↗
PubMed1982

Postoperative vomiting in children.

A survey of the frequency of postoperative vomiting in children was conducted over a two-month period. Completed questionnaires were obtained for 1183 patients. The important findings were a lower incidence of vomiting in children under three years of age and a significantly increased incidence of vomiting in patients premedicated with paparveretum and hyoscine. This clinical review highlighted areas where improvements could be made, particularly in the management of patients who vomit frequently. It also provides information which can be used for setting up more detailed controlled studies.

Adolescent↗
PubMed1982

Results of treating Hodgkin's disease without a policy of laparotomy staging.

Results of the treatment of 780 primary patients with Hodgkin's disease at the Princess Margaret Hospital (PMH) between 1968 and 1977 are analyzed. Treatment decisions were based on the evaluation of the extent of disease by clinical methods. A marked improvement in relapse-free survival and overall survival was observed for 1973-1977 as compared to 1968-1972. This improvement did not result from differences in the distribution of important prognostic attributes (clinical stage, pathology, and age) between the two periods, and there was no improvement in our ability to rescue relapsed patients. Improved relapse-free and overall survival during the second period was observed for all stages in patients less than 50 years of age, but not in the older group. The improved survival of patients treated between 1973 and 1977 is attributed to more effective initial therapy, which reduced the fraction of patients who relapsed. These observations provide indirect evidence that relapse has a negative effect on prognosis, and that the initial treatment of patients with Hodgkin's disease should be designed to reduce the risk of relapse to a minimum without causing an unacceptable increase in late complications. The observed/expected incidence of acute leukemia and non-Hodgkin's lymphoma in the PMH series was increased to 41.9 and 13.9 respectively. The question of whether a policy of doing routine staging laparotomies improves the results of treatment of patients with Hodgkin's disease is considered only in general terms by comparing the total PMH series with the total Stanford Medical Center series of patients treated between 1968 and 1977. Relapse-free survival at 10 years is 48.9% and 66.8% respectively, at the two institutions, while overall survival at 10 years is identified.

Adult↗
PubMed1982

Clinico-pathological correlates in ovarian cancer.

Multivariate analysis was performed on prognostic data derived from 810 patients with invasive ovarian cancer treated between 1971 and 1978. An examination of the prognostic significance of grade and pathologic subtype revealed that grade was strongly prognostic for serous tumors. In mucinous and endometrioid tumors however, the effect of grade was quite weak; furthermore, the prognostic significance of mucinous and endometrioid tumors did not differ from each other and was intermediate between well and poorly (or moderately) differentiated serous tumors. The compound pathology-grade classification derived from this analysis as well as the amount of macroscopic tumor residuum and the anatomic stage, were shown to exert a powerful prognostic effect independent of each other. Combining the information derived from all of these variables permits enhanced treatment selection to a degree which is not possible when each factor is considered on its own.

Adult↗
PubMed1981

Clinical estimation of the growth rate of breast cancer.

To test the ability of the patient's history to provide prognostically important information in breast cancer the authors used information prospectively collected by interview from 756 patients enrolled in a randomized controlled trial of adjuvant therapy. Classification of this information according to the principles of rate of growth created groups with substantial and statistically significant differences in survival. The survival differences created by classifying growth rate were comparable to those created by other prognostic factors, and independent of those created by stage, lymph node status or tumor grade. The patient's history in breast cancer is capable of providing reproducible prognostic information when it is suitable classified, and this information represents a useful addition to current methods of estimating prognosis in breast cancer.

Adult↗
PubMed1981

Postreplication repair-defective mutants of Drosophila melanogaster fall into two classes.

Primary cell cultures derived from embryos of a control stock of Drosophila melanogaster respond to ultraviolet light within the first hour after exposure with a decline in thymidine incorporation and a decline in the ability to form newly synthesized (nascent) DNA in long segments. Cells derived from two nonallelic excision-defective mutants (mei-9 and mus201) exhibit the same quantitative decline in both phenomena as do control cells. In contrast, cells from five nonallelic postreplication repair-defective mutants (mei-41, mus101, mus205, mus302 and mus310) respond to ultraviolet light by synthesizing nascent DNA in abnormally short segments. Two of these five mutants (mus302 and mus310) also exhibit unusually low thymidine incorporation levels after irradiation, whereas the other three mutants display the normal depression of incorporation. These results indicate that excision repair does not influence the amount or the length of nascent DNA synthesized in Drosophila cells within the first hour after exposure to ultraviolet light. Of the five mutations that diminish postreplication repair, only two reduce the ability of irradiated cells to synthesize normal amounts of DNA.

Animals↗
PubMed1981

Abnormal recovery of DNA replication in ultraviolet-irradiated cell cultures of Drosophila melanogaster which are defective in DNA repair.

Cell cultures prepared from embryos of a control stock of Drosophila melanogaster respond to ultraviolet light with a decline and subsequent recovery both of thymidine incorporation and in the ability to synthesize nascent DNA in long segments. Recovery of one or both capacities is absent or diminished in irradiated cells from ten nonallelic mutants that are defective in DNA repair and from four of five nonallelic mutagen-sensitive mutants that exhibit normal repair capabilities. Recovery of thymidine incorporation is not observed in nine of ten DNA repair-defective mutants. On the other hand, partial or complete recovery of incorporation is observed in all but one repair-proficient mutagen-sensitive mutant. Irradiated cells from two mutants that display no excision capacity exhibit a gradual arrest of thymidine incorporation within 20 h after the initial decline. This arrest of incorporation is not observed in mutants exhibiting only partial defects in excision repair. Recovery of the ability to synthesize nascent DNA in long segments is normal in cells from the two mutants that display no excision capacity, indicating that recovery does not depend upon the excision of pyrimidine dimers from cellular DNA. Recovery of that ability is not observed, however, in cells from one partially excision-defective mutant, two of three postreplication repair-defective mutants, two of four mutants defective in both excision and postreplication repair, and one of five repair-proficient mutagen-sensitive mutants. These results indicate that recovery of normal DNA replication in irradiated Drosophila cells depends upon the activity of several functions.

Animals↗
PubMed1981

Effects of radiation on the survival of excision-defective cells from Drosophila melanogaster.

The effect of various doses of ultraviolet light and ionizing radiation on the survival of excision-defective Drosophila cells has been determined by cloning treated and untreated cells in agarose. Although excision-defective cells survive moderate amounts of DNA damage, they display a severe hypersensitivity to both types of radiation relative to excision-proficient cells. Exposure of ultraviolet-irradiated cells to fluorescent light results in a reduction of the density of pyrimidine dimers in cellular DNA and a 10-to 20-fold increase in survival. Parallel analysis of dimer density and survival, however, suggests that much of the lethal effect of ultraviolet light is due to nondimer damage. Cell proliferation was monitored in both excision-proficient and excision-defective cells exposed to doses of ultraviolet light that reduced survival by 90%. Under these conditions excision-proficient cells displayed exponential growth whereas excision-defective cells exhibited no cell proliferation for 12 days.

Animals↗
PubMed1981

Combined modality treatment of small cell carcinoma of the lung.

Ninety patients with extensive and 61 with limited small cell carcinoma of the lung were treated with three courses of intravenous chemotherapy (cyclophosphamide, doxorubicin hydrochloride, and vincristine sulfate) followed by radiotherapy to intrathoracic disease, and a second three-drug oral combination consisting of lomustine, procarbazine, and methotrexate for one year. Among the 147 patients who were evaluated, 55 of 66 (83%) with limited disease and 53 of 81 (65%) with extensive disease showed response after three courses of chemotherapy. The complete response rate in patients with limited disease prior to radiotherapy was 24%, but increased to 58% when evaluated following radiotherapy. The median survival was 47 weeks for patients with limited disease and 36 weeks for those with extensive disease. A 24% two-year survival is projected for complete responders. Important prognostic factors for survival are performance status, extent of disease, and sex, with female subjects doing somewhat better than male subjects. Among patients with limited disease, 45% failed within the CNS despite the use of chemotherapeutic agents that cross the blood-brain barrier. The initial induction regimen and radiotherapy were well tolerated; the oral three-drug combination was more toxic and did not prevent CNS metastases.

Adult↗
PubMed1980

Temporary transvenous pacing and femoral vein thrombosis.

The true incidence of thrombosis and pulmonary embolism in patients requiring temporary transvenous pacing via the femoral vein in unknown. Twenty-nine patients, mean age 66.2 years (range 38-79 years) who required temporary pacing were studied by bilateral contrast venography and perfusion lung scanning after removal of the pacing catheter. The patients were subdivided into two subgroups based on hemodynamic status. There was no statistical difference between the two groups with respect to mean age or the time the pacer catheter was in place and all patients were placed on low-dose heparin therapy. Ten patients (34%) had venographic evidence of thrombosis; six of them (60%) showed lung scan evidence of pulmonary emboli. The hemodynamically compromised group consisted of seven patients, six (85%) of whom had thrombosis; three of these six (50%) had pulmonary emboli. Of the 22 patients in the hemodynamically stable group, four (18%) had thrombosis and two of these (50%) had pulmonary emboli. Venous thrombosis, with subsequent pulmonary emboli, is a serious complication of temporary transvenous pacing using the femoral approach, despite the use of prophylactic low-dose heparin.

Adult↗
PubMed1980

Neurogenic pulmonary oedema in man: aetiology and management with vasodilators based on haemodynamic studies.

Acute pulmonary oedema is a rare complication of head injury. A case is reported in which the pulmonary oedema was treated initially by tracheal intubation, constant positive airway pressure, ventilation and isoprenaline. Subsequent treatment was by vasodilation with sodium nitroprusside and phenoxybenzamine and the patient made a good recovery. The findings are discussed in relation to reported experimental work. The aetiology appears to be related to a massive sympathetic discharge leading to systemic vasoconstriction, shift of blood to the pulmonary circulation with left ventricular failure and pulmonary oedema.

Child↗
PubMed1979

Ovarian irradiation and prednisone therapy following surgery and radiotherapy for carcinoma of the breast.

Following mastectomy, patients with operable breast cancer underwent postoperative irradiation of the chest wall and regional lymph nodes. They were then assigned at random to receive no further therapy, ovarian irradiation (2000 rads in 5 days) or ovarian irradiation in the same dosage plus prednisone, 7.5 mg daily. A total of 705 patients received the randomly assigned treatment and were followed for up to 10 years. In premenopausal patients who received ovarian irradiation the recurrence of breast cancer was delayed and survival prolonged, but not significantly. In premenopausal women aged 45 years or more ovarian irradiation plus prednisone therapy significantly delayed the recurrence of breast cancer (P = 0.02) and prolonged survival (P = 0.02); the survival expectancy of these patients was similar to that of the general population of the same age from the third year after the cancer operation. No value was demonstrated for ovarian irradiation with or without prednisone therapy in postmenopausal patients.

Adult↗