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Biomedical subjects

W R Berry

Publications and source records attributed to W R Berry.

27 records · Page 2Linked to original sources

Prognostic factors in metastatic and hormonally unresponsive carcinoma of the prostate.

Eighty-eight patients with hormone-resistant Stage IV prostate cancer were treated with a five-drug chemotherapy program. Patient demographic data, prior therapy, symptoms, extent of disease, and laboratory studies were analyzed statistically to evaluate the association of these parameters with survival from the onset of chemotherapy. Factors associated with short survival included age greater than 65, severe bone pain, poor performance status, presence of soft tissue metastases, anemia, elevation of serum LDH, SGOT, alkaline and acid phosphatases, and prolactin, and hypoalbuminemia. Race, stage at initial diagnosis, prior radiation therapy, prior orchiectomy, and elevation of CEA had no prognostic association. We suggest that clinical trials of new therapies of hormone-resistant prostate cancer take into account the presence of these prognostic factors in the analysis of the results of therapeutic programs.

Aged↗

Treatment of metastatic endocrine-unresponsive carcinoma of the prostate gland with multiagent chemotherapy: indicators of response to therapy.

Eighty-eight patients with metastatic and hormonally unresponsive carcinoma of the prostate gland were treated with a multiagent chemotherapy protocol. Because of the difficulty in evaluating the response of patients to therapy, data were collected in a prospective fashion and analyzed for clinical or laboratory changes that correlated with improved survivorship. Decrease of initially abnormal values of either acid or alkaline phosphotase into the normal range was associated with prolonged survival; weight gain of more than 10% was also associated with improved survival. Thirty-three patients demonstrated a fall of acid or alkaline phosphatase into the normal range or they increased their weight by at least 10%. The median survival time for this group of patients was 76.1 weeks as compared to 28.2 weeks for patients who failed to exhibit these changes. In future studies of the treatment of metastatic prostate cancer, these changes might be used as criteria of response to therapy.

Acid Phosphatase↗

Urea synthesis after protein feeding reflects hepatic mass in rats.

Urea synthesis is an exclusive biosynthetic function of the liver. Since the exact relationship between urea synthesis in vivo and functional liver mass remains unclear, we established an animal model using oral protein loading and measurement of resultant urea synthesis in rats. We studied rats subjected to sham operation, 40% hepatectomy, 66% hepatectomy, portacaval shunt and CCl4-induced cirrhosis. Urea synthesis was calculated as the sum of urinary urea excretion and accumulation of urea in body water during the 6-hr period after oral administration of a casein protein load equivalent to 20 gm per kg body weight. Peak urea synthesis rate in the sham-operated group of rats was 142 +/- 11 mumoles per hr per gm wet liver weight (mean +/- 1 S.D.), 473 +/- 34 mumoles per hr per gm liver protein and 80 +/- 5 mumoles per hr per mg liver DNA. This rate closely matched those of the other groups for each type of liver mass measurement. Marked reduction (p less than 0.01) of urea synthesis on a DNA basis was noted only in the CCl4-cirrhotic livers, related to the significantly higher (p less than 0.01) DNA content of the cirrhotic livers. Similarly, increased (p less than 0.05) liver protein content of the sham-operated rats when compared with the other groups was reflected in slightly lower urea synthesis rates expressed on the basis of liver protein (p less than 0.05) when compared to that of all other groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

Predictors of postoperative ventricular dysrhythmias: a multivariate study.

Postoperative ventricular dysrhythmias were studied to document their incidence after coronary bypass grafting and to identify risk factors for their development with the hope of finding a subgroup of patients who might benefit from postoperative, prophylactic drug therapy. One-hundred-nine patients who were undergoing urgent or elective coronary bypass grafting were studied, prospectively. Twenty-five of 109 patients (23%) developed significant postoperative ventricular dysrhythmias that required counter-shock or drug intervention. Seven of eight instances of sustained ventricular tachycardia, the most serious dysrhythmia, occurred within 36 hours of operation. There was no postoperative mortality related to these dysrhythmias. Serious postoperative complications, such as stroke, hemorrhage, or myocardial infarction, were decreased in patients with ventricular dysrhythmias versus those without (8% versus 16%, p = 0.053 for the Fisher's exact test statistic). Univariate statistical analysis was performed using 15 patient variables and revealed that advanced age (p = 0.008 for the unpaired t test), failure to use an internal mammary artery conduit (p = 0.03 for the two-tailed Fisher's exact test), and development of postoperative atrial dysrhythmias (p = 0.02 for the two-tailed Fisher's exact test) were significantly more common in patients with postoperative ventricular dysrhythmias. Variables such as previous myocardial infarction, ejection fraction less than 50%, prolonged operative time, perioperative myocardial infarction, or fewer number of vessels bypassed were not significantly increased in patients with dysrhythmias (the statistical power for these "negative" results was greater than 0.8).(ABSTRACT TRUNCATED AT 250 WORDS)

Age Factors↗