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Biomedical subjects

W Walsh

Publications and source records attributed to W Walsh.

At least 37 records · Page 2Linked to original sources
PubMed1994

Is patient satisfaction your office team's goal?

As competition for patients increases, patient satisfaction will become more and more crucial for your practice. Are you in this necessary game or watching from the sidelines? A key success factor is recognizing that every member of your office team is important in creating satisfied patients.

Attitude of Health Personnel↗
PubMed1993

Surgical salvage of chemorefractory germ cell tumors.

PURPOSE: Patients with disseminated germ cell tumors who relapse after salvage chemotherapy, or who progress during cisplatin-based therapy, have chemorefractory disease and a very poor prognosis. A subset of these patients will have chemorefractory but resectable disease. We have therefore evaluated the role of salvage surgery in this patient population. PATIENTS AND METHODS: We performed a retrospective review of all patients with disseminated germ cell tumors who were felt to have chemorefractory disease and underwent salvage surgery from 1977 to 1990 at Indiana University. All patients had elevated serum markers or other signs of progressive carcinoma. A total of 48 patients underwent surgery (33 retroperitoneal lymph node dissections [RPLNDs], six thoracotomies, three thoracoabdominal resections, and multiple asynchronous procedures in six patients). RESULTS: Thirty-eight of 48 patients (79%) were rendered grossly free of disease and 29 (60%) obtained a serologic remission. Ten patients (21%) remain continuously disease-free with no postoperative treatment with a median follow-up of 46 months (range, 31 to 89). Six additional patients who relapsed after salvage surgery are currently disease-free with further treatment (four with repeat surgery and two with high-dose chemotherapy and autologous bone marrow transplantation [ABMT]). CONCLUSION: Selected patients with chemorefractory but resectable germ cell tumors have definite potential for cure with salvage surgery.

Adolescent↗
PubMed1990

Phase I and pharmacology study of intravesical mitoxantrone for recurrent superficial bladder tumors.

A phase 1 study of intravesical mitoxantrone was done in patients with superficial bladder tumors recurrent after previous intravesical therapy. Mitoxantrone (5 to 10.5 mg.) was instilled in the bladder via catheter and was left in situ for 2 hours. Each patient received 6 treatments at 1-week intervals. Pharmacology studies were conducted in a subset of consenting patients. Dysuria, urinary frequency and hematuria were dose-limiting at 10 to 10.5 mg., the dose recommended for our phase 2 studies. One patient treated with 7.5 mg. mitoxantrone had bladder contracture after severe bladder injury caused by the drug. The interval free of recurrence increased in 5 of 8 patients treated with 10 to 10.5 mg. mitoxantrone and in 6 of 19 treated at lower dose levels. One patient who had residual evaluable tumor in the bladder at treatment experienced a complete remission for 16 months. Only 1 of 18 patients who underwent pharmacology studies had any mitoxantrone detectable in the blood after intravesical administration. This patient had severe irritative symptoms at treatment. No systemic toxicity was noted in any patient. Of the mitoxantrone instilled into the bladder 33 to 100% (mean 75%) was recovered in the specimen voided at the end of treatment. In summary, intravesical mitoxantrone is reasonably well tolerated and should be studied further at a dose of 10 mg. per week for 6 weeks. Caution should be exercised, since bladder contracture was seen in 1 patient. Systemic absorption and toxicity are negligible.

Administration, Intravesical↗
PubMed1987

Enhanced expression of Harvey-ras oncogene in FANFT-induced transitional cell carcinoma.

The level of mRNA expression and DNA structure of c-H-ras were examined in a transitional cell carcinoma (TCC) induced in C3H/He mice and Fisher rats by N-(4,5-nitro-2-furylthiazolyl)formamide (FANFT) and carried as serially transplanted tumors. Neither amplification nor gross rearrangements were detected by Southern analysis in the FANFT tumor. Increased expression of c-H-ras was detected by Northern and in situ hybridization in both the FANFT-induced mouse and rat TCC, as compared to normal urothelium. No expression of six other cellular oncogenes was detected in the tumor. It appears that the increase in H-ras expression in the FANFT tumor is specific to this oncogene and that increased expression of the H-ras gene may play a role in bladder carcinogenesis.

Animals↗
PubMed1983

Silicone plesiotherapy molds.

Plesiotherapy, the treatment of superficial lesions by radioactive molds has largely been replaced by teletherapy techniques involving high energy photon and electron beams. There are, however, situations for which a short distance type treatment, in one form or another, is superior to any other presently available. Traditionally, molds have taken the form of rigid devices incorporating clamps to attach them to the patient. This ensures a reproducible geometry about a localized region since the molds are applied on a daily basis. To make such devices requires considerable skill and patience. This article describes an alternative method that eliminates the use of cumbersome devices in many situations. Silicone molds made from a plaster cast model have been found suitable for the treatment of surface lesions and especially for lesions in the oral and nasal cavities. With the use of radioactive gold seeds the molds may be left in place for a few days without fear of them moving.

Adult↗
PubMed1980

Clinical value of early exercise testing after myocardial infarction.

The clinical utility of predischarge exercise ECGs was assessed prospectively in 47 patients 17 +/- 2 days after myocardial infarction. The graded-interval ergometric exercise protocol was terminated at 450 kilopond-m/min (kpm/min), a heart rate greater than 75% of predicted maximum, or for established clinical indications. Prior to testing, the attending physician and resident indicated their clinical impressions with regard to anticipated (1) angina, (2) exercise capacity, (3) arrhythmias during limited exercise, as well as anticipated discharge medications and activity prescriptions. Ratings were compared to exercise results and consequent alterations in management noted. No complications were noted during the evaluations. Nine patients noted anginal pain during exercise; five were unsuspected by the attending physician or resident. Ten patients demonstrated significant ventricular arrhythmias. Four were receiving antiarrhythmic therapy. Severe limitation of exercise capacity (< 300 kpm/min) was noted in six patients, unanticipated in four. Where not contraindicated, routine use of predischarge exercise ECG testing is recommended.

Angina Pectoris↗