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Biomedical subjects

W B Jones

Publications and source records attributed to W B Jones.

At least 55 records · Page 3Linked to original sources
PubMed1988

Integration of surgery and other techniques in the management of trophoblastic malignancy.

The role of surgery in the management of gestational trophoblastic neoplasms has changed over the years and warrants continuous re-evaluation. Surgical removal of the bulk of the disease in an attempt to shorten the hospital course and decrease the amount of chemotherapy required appears to be of value. This approach to therapy should therefore be considered in most patients with nonmetastatic disease without regard to the histologic diagnosis if they have completed their families. "Debulking" of primary uterine disease in the presence of metastases may decrease the chemotherapy necessary for cure and removes a potential source of resistant disease. Pulmonary surgery improves survival rates for patients with a solitary, resistant lung tumor and is advisable under the circumstances outlined herein. Craniotomy is rarely of value in the management of tumor in the brain but may be necessary in emergency situations caused by intracerebral hemorrhage. Surgery to control complications of the disease has been proved to be safe with acceptable morbidity even if performed during chemotherapy. Thus, although chemotherapy has replaced surgery as the primary management of patients with gestational trophoblastic disease, there remain a significant number of patients in whom surgery plays a significant role.

Combined Modality Therapy↗
PubMed1988

Weight gain and feeding in the neonate with cleft: a three-center study.

A retrospective investigation was carried out on 202 neonates with cleft from three cleft units to establish mean weight gain per week and to investigate problems with feeding. Results show that the mean weight gain per week was lower than that of children without cleft, the group with only cleft palate showing the lowest weight gain. There were indications that 25% of infants may experience early feeding difficulties and that these could be associated, among other things, with ulceration of the nasal mucosa. These problems arise despite early counseling, and further work regarding the way in which parents are advised is indicated. The results of this survey have allowed the group in Birmingham to set realistic goals for mean weight gain for all cleft types, to reassure parents, and to advise community health workers.

Bottle Feeding↗
PubMed1987

Surgical approaches for advanced or recurrent cancer of the cervix.

The American Cancer Society estimates that in 1987 13,000 women in the United States will develop invasive cervical cancer, and 6800 women will die of this disease. Two groups of patients contribute significantly to mortality from cervical cancer. In the first group are patients who have an advanced stage of cervical cancer at the time of diagnosis. The second group consists of patients who have received unsuccessful primary treatment. Over the past decade the role of surgery in the management of patients with advanced disease has been studied with a view toward a more precise extent of disease evaluation prior to definitive therapy. The potential benefit of pretreatment surgical staging of cervical cancer is considered in this article. The role of pelvic exenteration in the treatment of recurrent cervical cancer has been established for more than 30 years. In this article recent advances in the application of these procedures including better criteria for patient selection, improvement in surgical techniques, and patient rehabilitation are discussed.

Female↗
PubMed1987

Malocclusion and facial types in a group of Saudi Arabian patients referred for orthodontic treatment: a preliminary study.

Dental malocclusion is present in all societies but its prevalence varies. There is a need to identify the occlusal problems, their incidence and the need for treatment so that appropriate manpower arrangements may be made. In this initial survey, patients attending the orthodontic clinic at the Riyadh Armed Forces Hospital were examined for occlusal relationship, crowding, and facial type. There are indications amongst Saudi Arabian patients of a tendency for bimaxillary proclination and a greater proportion of Class III malocclusion, than in Western communities. The need for a comprehensive survey is identified.

Adolescent↗
PubMed1987

Current management of low-risk metastatic gestational trophoblastic disease.

Low-risk metastatic gestational trophoblastic disease is highly curable with single-agent chemotherapy. Careful monitoring of the response to therapy is essential so that one can alter treatment when signs of drug resistance occur. Because some low-risk patients require complex chemotherapy and/or surgery before achieving remission, therapy should be directed by experienced clinicians at facilities where appropriate ancillary services are available.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1987

Clear-cell adenocarcinoma of the lower genital tract: Memorial Hospital 1974-1984.

Seventeen previously unreported cases of clear-cell adenocarcinoma originating in the vagina (13) and cervix (four) are presented. The mean age of the patients was 23.6 years. Four patients with cervical tumors and four patients with vaginal tumors underwent radical hysterectomy, bilateral pelvic lymphadenectomy, and partial vaginectomy. A total vaginectomy, with replacement of the excised vagina with a split-thickness skin graft or a segment of sigmoid colon, was added to the above procedure in five patients with vaginal cancer. In four patients, definitive treatment was radiation. All of the patients in the present series are without evidence of disease, with follow-up ranging from 21 months to more than ten years.

Adenocarcinoma↗
PubMed1986

A review of second-look laparotomy for ovarian cancer.

One hundred twenty-seven patients underwent second-look laparotomies from July 1969 to June 1982. To be included in this report they must have met the following criteria: a documented ovarian neoplasm; previous surgery; adequate chemotherapy for cessation if no disease was found; and no X-ray, chemical, or clinical evidence of disease including an exam under anesthesia. Forty-one percent had residual disease at second-look laparotomy. The original stage and the percentage of tumor debulked at initial surgery were inversely related to the likelihood of finding residual disease. Age, histologic type and grade, and type of chemotherapy did not show a significant relationship with the likelihood of disease persisting. Recurrent tumor was subsequently detected in 16% of patients who had been found to be free of disease at second-look laparotomy. Of thirty stage III and IV patients treated with combinations containing cis-platinum, 10 (33%) had recurrences. This rate of recurrence was significantly greater than the 17.6% recurrence rate in 17 patients with Stage III and IV disease whose chemotherapy consisted of single alkylating agents or with combinations without cis-platinum. Twenty patients underwent a third-look laparotomy after completion of additional chemotherapy. Nine were found to have no residual disease. Two of the nine (22%) subsequently had recurrence of disease. Three of the eleven patients with persistent disease at the time of a third-look laparotomy underwent a fourth-look laparotomy. All were found free of disease and none have recurred. Six (55%) of those with persistent disease at the third-look laparotomy have died despite continued therapy. The ability to successfully treat some patients with persistent disease continues to be a justification for the use of a second-look laparotomy. However, the high rate of recurrence after cessation of treatment following the finding of no residual disease raises the question of whether it is appropriate to discontinue all therapy at this time.

Alkylating Agents↗
PubMed1986

Diagnostic conization of the cervix: review of 460 consecutive cases.

During a five-year period, 460 patients underwent cervical conization on the Gynecology Service at Memorial Hospital. The pertinent medical history of the 393 patients was reviewed as it related to the diagnosis of cervical intraepithelial neoplasia. All patients had repeat Papanicolaou smears and 94.4% had complete colposcopic examination using standard colposcopic procedures, endocervical curettage, and directed biopsies. For the purpose of this review, patients were separated into seven groups according to the primary and most significant indication for conization. The indications for the procedure and the histopathologic findings are discussed for each category. The usefulness of conization in the authors' institution varied according to the indication for which it was carried out. In this series of 393 patients, 18 patients (4.7%) initially diagnosed to have only intraepithelial disease, were found to have invasive carcinoma.

Adenocarcinoma↗
PubMed1985

Late recurrence of gestational trophoblastic disease.

Persistent normal human chorionic gonadotrophin (hCG) levels for a period of 1 year after treatment is considered to be a reliable criterion of complete and sustained remission in patients with gestational trophoblastic disease. This is because such patients rarely require further therapy. Two patients are presented who developed recurrent disease after being in remission for 18 and 21 months. One of the patients initially had metastatic disease in the lungs; the other had tumor in the lungs and brain. Both of the patients have remained clinically free of disease after retreatment; one patient for 31 months and the other patient for more than 4 years. The management of the patients is presented with an emphasis on the requirement for long-term surveillance. Possible mechanisms to account for the reactivation of disease after a prolonged latency period are considered.

Adult↗
PubMed1984

A method for directly establishing short-term cultures of human gestational choriocarcinoma in vitro.

A procedure is described which offers a method for establishing, without recourse to a serial passage within animal hosts, short-term cultures of human gestational choriocarcinoma in vitro. The method involves the use of either post mortem or surgical biopsy tissue from patients with known choriocarcinomas. The tissues are subsequently sectioned on a freezing microtome and viable tumour selected for explantation in vitro. Radioimmuno assays of culture media supernatant confirm the trophoblastic nature of the cells growing in vitro, cytogenetic analyses of these cultures reveal several aneuploid modes.

Cells, Cultured↗
PubMed1983

Metronidazole as a radiosensitizer and high-dose radiation in advanced vulvovaginal malignancies, a pilot study.

Advanced vulvovaginal cancers have a survival of less than 25% in 5 years when treated with radiotherapy alone. The radiosensitizer metronidazole was used with unconventional radiation fractions in 10 patients. Local control was achieved in 9 out of 10 patients treated. Five of 10 patients have remained free of disease 9-30 months postdiagnosis. Two patients died with metastatic disease, but with local control. In only 1 patient did this approach fail to control local disease. The outcome of these 10 patients represents a significant improvement over conventional radiation. A randomized prospective study has been started on the basis of this pilot study.

Adult↗
PubMed1983

Vincristine in advanced bladder cancer: a European organization for research on treatment of cancer (EORTC) phase II study.

Thirty-seven patients with measurable deposits or primary lesions arising from transitional cell carcinoma of the bladder were treated with 1 mg/m2/week of vincristine. One complete response lasting 7 months was seen among the 23 patients with metastatic disease. Two partial responses were seen among the 14 patients with persistent primary tumor. Vincristine is not recommended for further evaluation as a single agent in transitional cell carcinoma of the bladder.

Aged↗
PubMed1982

Evaluation of normal and pathologic ureteral dynamics: comparison of a radioisotopic method with ureteral pressure/flow perfusion study.

The ureteral pressure/flow perfusion study has lately been repopularized and its use demonstrated in many forms of suspected obstructive uropathy. The present study was undertaken to compare the ureteral pressure/flow perfusion study with a radioisotopic method of investigating ureteral obstruction. The 2 methods were evaluated with a mongrel canine laboratory model. Both diagnostic modalities were employed concomitantly on intact renoureteral units; first with the ureter unobstructed, then after submission to varying degrees of ureteral occlusion. Analysis of data from these studies shows that the curve pattern produced by the computer generated 99mTc-DTPA renogram is as accurate as ureteral pressure/flow perfusion study in determining the presence and degree of ureteral obstruction.

Animals↗