Training in clinical oncology: results of a Junior Radiologists' Forum Questionnaire.
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Medical Oncology↗
Biomedical subjects
A Goodman
Publications and source records attributed to A Goodman.
Sexual addiction: designation and treatment.
While there is general agreement that the pattern of behavior described as "sexual compulsivity" or "sexual dependency" or "sexual addiction" does exist, considerable controversy surrounds the issue of how this syndrome should be designated. The principle candidates--compulsivity, dependency, and addiction--are examined, and addiction is found to be the most suitable term. Addiction is then clearly defined, and diagnostic criteria for addictive disorder are specified. After the definition of and diagnostic criteria for sexual addiction are presented, arguments against the concept of sexual addiction are reviewed and answered. Implications of this concept for treatment are then explored.
Behavior, Addictive↗
Vaginal adenosis and clear cell carcinoma after 5-fluorouracil treatment for condylomas.
Vaginal adenosis and clear cell adenocarcinoma of the vagina occurred in a 44-year-old woman after treatment for condylomata acuminata. She had no known exposure to diethylstilbestrol (DES) in utero. Biopsy-proven vaginal adenosis appeared 8 months after intravaginal 5-fluorouracil application for recurrent urogenital condylomata acuminata. Forty months later, biopsies showed residual adenosis with foci of clear cell adenocarcinoma. Although clear cell adenocarcinoma is associated with vaginal adenosis and cervical ectropion in DES-exposed women, its occurrence in adenosis after 5-fluorouracil therapy has not been reported to the authors' knowledge. In this report, this rare but serious complication of treatment of condylomata acuminata is highlighted, and the literature regarding the development of non-DES-associated vaginal adenosis is discussed.
Adenocarcinoma↗
Clear cell adenocarcinoma of the vagina: a second primary in a diethylstilbestrol-exposed woman?
A clear cell adenocarcinoma of the vaginal remnant in a diethylstilbestrol (DES)-exposed woman developed 20 years after anterior exenteration for a histologically similar stage II vaginal cancer. Arguments favoring a new primary cancer over a late recurrence are presented. This case probably represents the first report of a second primary vaginal clear cell cancer after DES exposure in utero. The implications of a second vaginal primary and the need for long-term surveillance in DES-exposed women are discussed.
Adenocarcinoma↗
Organic unity theory: the mind-body problem revisited.
The purpose of this essay is to delineate the conceptual framework for psychiatry as an integrated and integrative science that unites the mental and the physical. Four basic philosophical perspectives concerning the relationship between mind and body are introduced. The biopsychosocial model, at this time the preeminent model in medical science that addresses this relationship, is examined and found to be flawed. Mental-physical identity theory is presented as the most valid philosophical approach to understanding the relationship between mind and body. Organic unity theory is then proposed as a synthesis of the biopsychosocial model and mental-physical identity theory in which the difficulties of the biopsychosocial model are resolved. Finally, some implications of organic unity theory for psychiatry are considered. 1) The conventional dichotomy between physical (organic) and mental (functional) is linguistic/conceptual rather than inherent in nature, and all events and processes involved in the etiology, pathogenesis, symptomatic manifestation, and treatment of psychiatric disorders are simultaneously biological and psychological. 2) Neuroscience requires new conceptual models to comprehend the integrated and emergent physiological processes to which psychological phenomena correspond. 3) Introspective awareness provides data that are valid for scientific inquiry and is the most direct method of knowing psychophysical events. 4) Energy currently being expended in disputes between biological and psychological psychiatry would be more productively invested in attempting to formulate the conditions under which each approach is maximally effective.
Biological Psychiatry↗
Regulation of lipoxins (LX) and leukotriene B4 (LTB4) production in rat mesangial cells (MC).
In the present studies, an inverse relationship was observed between LTB4 and LXA4 formation when the concentration of LTA4 was increased from 50 microM to 250 microM. LTB4 was the major product at low concentration of LTA4 where as LXA4 was the major product at high concentration. This suggests that LTA4 hydrolase activity is present in MC and activated by low concentrations of LTA4. At high concentrations of LTA4, 15- or 12-lipoxygenase (LO) in MC may participat in LXs formation. Radioimmunoassays on HETEs MC activated with A23187 (3uM) were in the rank order of 15-HETE greater than 12-HETE greater than 5-HETE. Incubations of MC with 15-HPETE failed to produce any LX-like material. These results suggest that 1) 5-LO activity is not expressed in MC under these conditions, but LTA4 hydrolase activity is present in MC, 2) there are major activities of 12-LO and 15-LO in MC that are responsible for the generation of LXA4, LXB4 and HETES, 3) the production of LX and 12- or 15-LO products of AA may counterregulate the production of LTB4 and may modulate the response of the MC to inflammatory stimuli.
Animals↗
The use of minoxidil to attempt to prevent alopecia during chemotherapy for gynecologic malignancies.
Minoxidil 2% topical solution applied twice a day is known to induce hair growth and prevent hair loss in normal male pattern baldness. Based on this potential, this pilot study tested the effect of Minoxidil on hair loss during chemotherapy for gynecologic cancers. Ten women about to start alopecia-inducing chemotherapy protocols were entered into this non-randomized prospective trial. By study design, each patient served as her own control, as only a portion of the scalp was treated with Minoxidil. Four of the ten patients were unevaluable for failing to comply with the twice-a-day Minoxidil application schedule. Of the six evaluable patients, five experienced complete or severe symmetrically diffuse hair loss, all of which occurred within four weeks of initiating chemotherapy. One patient had no hair loss in either the treatment or control area. Application of the topical Minoxidil in all ten patients had no untoward side effects, skin changes or hypotension. Thus, in this pilot study, 2% Minoxidil was non-toxic but showed no benefit in the prevention of chemotherapy-induced alopecia.
Administration, Topical↗
Addiction: definition and implications.
Integration of addiction into the theory and practice of psychiatry has been hampered by the lack of a definition of addiction which is scientifically useful. A definition is proposed, with diagnostic criteria specified in a format similar to that of DSM-III-R. Essentially, addiction designates a process whereby a behavior, that can function both to produce pleasure and to provide escape from internal discomfort, is employed in a pattern characterized by (1) recurrent failure to control the behaviour (powerlessness) and (2) continuation of the behaviour despite significant negative consequences (unmanageability). Some practical and theoretical implications of this definition are then explored.
Alcoholism↗
Chemotactic Responses of Marine Vibrio sp. Strain S14 (CCUG 15956) to Low-Molecular-Weight Substances under Starvation and Recovery Conditions.
The chemotactic responses by starved cells of marine Vibrio sp. strain S14 differed from those elicited by cells that were not nutrient limited. The rate of chemotaxis at different concentrations of several attractants varied for starved and growing cells. Vibrio sp. strain S14 showed positive chemotaxis to leucine, valine, arginine, and glucose at the onset of energy and nutrient deprivation. A continued, though decreased, positive response was demonstrated fro leucine, arginine, and glucose at 10 h of starvation. Cells starved for 3 h displayed a stronger response to glucose than those starved for shorter or longer times. However, cells starved for 5 and 10 h responded more strongly to a lower concentration of glucose than did cells starved for 0 and 3 h. Starvation for 24 h elicited no measurable chemotaxis to leucine, arginine, or glucose. The motility decreased by over 95% in the cell population after 24 h of starvation, which resulted in a low sensitivity in the chemotaxis assay. A switch in the response to valine was observed by 3 h of starvation. The addition of nutrients of 22-h-starved cells elicited a temporary positive chemotactic response to leucine by 2 and 4 h of nutrient recovery, while cells at 1 and 6 h of recovery showed no response. At 2 h of recovery, the greatest response was recorded to 10 M leucine, whereas at 4 h it was to 10 M leucine. Ten to fifty percent of the 22-h-starved cell population regained their motility after 4 h of nutrient-aided recovery. It is possible that two types of chemosensory systems exist in marine bacteria. Starved and growing cells responded to different concentrations of the attractant, and growing cells displayed a saturated chemotactic system with leucine as the attractant, unlike the response during starvation.
Journal Article↗
Obsessive-compulsive disorder: historic review and update on the use of novel antidepressants.
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Antidepressive Agents↗
Comparison of the single breath and volume recruitment techniques in the measurement of total respiratory compliance in anesthetized infants and children.
Total respiratory compliance (Crs) has not previously been measured from the static pressure-volume (P-V) curve during spontaneous breathing in anesthesized infants and children. A single breath test and a volume recruitment maneuver for measuring Crs were applied to 18 infants and children breathing spontaneously during halothane anesthesia in order to determine the usefulness and reliability of these noninvasive tests for measuring static compliance during anesthesia. Crs from the single breath test (Crssb) was determined from the mask pressure plateau (P) during a brief end-inspiratory airway occlusion and the lung volume (V) from the passive expiration following release of the occlusion. Crs from the volume recruitment maneuver (Crsvr) was determined from P and V during a series of expiratory occlusions at progressively higher lung volumes. The P-V curves fit a polynomial curve with the convexity toward the pressure axis in most patients, and Crsvr was the tangent to the curve in the mid-tidal range. The tallest four patients did not show respiratory muscle relaxation during the occlusions with either test, and the single breath test could not be completed in an additional two patients. In the 12 patients (59-89 cm in height) in whom both tests were successful, Crssb correlated with, and was similar to, Crsvr. The intrasubject coefficient of variation was less with the single breath test (9.4 +/- 6.7%) than with the volume recruitment maneuver (15.0 +/- 7.1%). The authors conclude that both tests are simple, reliable, and rapid and give similar results for Crs in spontaneously breathing children (59-89 cm in height) anesthetized with halothane.
Anesthesia, Inhalation↗
Bilateral ureteral necrosis and obliteration secondary to pancreatic pseudocyst.
We report an unusual case of bilateral distal ureteral necrosis and obliteration associated with a pancreatic pseudocyst. After cyst drainage bilateral ureteral obstruction developed, requiring surgical correction. While it is known that a pancreatic pseudocyst can cause extensive damage to contiguous organs, to our knowledge this case represents the first report of ureteral necrosis and obliteration resulting from pancreatic enzyme damage to the ureters.
Fat Necrosis↗
Virus-specific cytotoxic T cells in multiple sclerosis.
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Antigens, Differentiation, T-Lymphocyte↗
Isolation and purification of erythropoiesis inhibitory activity from uremic sera.
In vitro erythropoiesis inhibitory activity (EIA) was isolated and partially purified from sera obtained from a patient with chronic renal failure (CRF). EIA was purified from human sera by ammonium sulfate precipitation, column chromatography and PAGE electrophoresis, and the corresponding biological activity was assayed in erythroid colony (CFU-E) cultures. Ammonium sulfate precipitation revealed that the EIA resided in two high molecular weight fractions which yielded a single peak on G-200 Sephadex. PAGE electrophoresis demonstrated that the EIA fraction separated into 3 bands with a molecular weight range of 12,000-50,000 daltons. Antibody to EIA was prepared in rabbits, and Ouchterlony immunodiffusion assays employing the antibody material revealed that several CRF sera generated intense double precipitin bands when tested in the assay. In contrast, normal sera consistently yielded a weak precipitin band. These results suggest the presence of reduced amounts of EIA-like material in normal humans and elevated levels in CRF sera. The significance of EIA in the anemia of CRF is discussed.
Aged↗
Antibody recognition of substituted ammonium ions. Modulation by the counterion.
Antibodies directed against elliptinium acetate, a quaternary ammonium compound with antineoplastic activity in man, were obtained in rabbits, after conjugation of the drug with haemocyanin. These antibodies are specific for the quaternary ammonium structure. However, the recognition of the drug can be markedly decreased (ten-fold) by changing the associated counterion. These observations were extended to other ellipticine derivatives that exist in two forms: acetate and chloride. In each case, the recognition of the acetate form was 7-11-fold higher than that of the chloride form. These results could be explained by high-energy strengths existing between the cation and the anion, resulting in a paired-ion antigen. This represents the first identification of antibodies directed to a paired-ion structure, with specificity for both the cation and anion used for immunization. Such results are relevant in the construction of immunoassays for quaternary ammonium compounds.
Alkaloids↗
Myelosuppression after methotrexate, mitozantrone, and mitomycin C for treatment of advanced breast cancer.
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Adult↗
Elliptinium, a DNA intercalating agent with broad antitumor activity in a human tumor cloning system.
We have utilized a human tumor cloning system to determine the in vitro antitumor effects of elliptinium, a new DNA intercalating agent. The purpose was to determine which human tumors should be studied in phase II clinical trials with this agent. Eighty-eight out of 282 tumors plated in culture were evaluable for drug-sensitivity assays. The overall in vitro response rate (defined as a less than or equal to 50% survival of tumor colony-forming units compared to control) was 28% at 0.4 micrograms/ml (1/10 of peak plasma level). In vitro activity was noted for elliptinium against breast cancer, renal cell carcinoma, small-cell lung cancer and non small-cell lung cancer. Elliptinium had a higher in vitro activity than adriamycin against this same group of tumors. Six of 25 (24%) adriamycin-resistant tumors were sensitive to elliptimium. Our in vitro response rate in breast cancer correlates with the response rate in phase II clinical trials with this drug. Further phase II clinical trials with elliptinium in patients with renal cell carcinoma, non small-cell lung cancer and small-cell lung cancer are indicated.
Alkaloids↗
Theophylline treatment in the extubation of infants weighing less than 1,250 grams: a controlled trial.
The role of theophylline in weaning infants weighing less than 1,250 g at birth from mechanical ventilation was evaluated. Infants were randomized into control or theophylline treatment groups when they required minimal ventilatory support (peak inspiratory pressure 12 cm H2O, positive end-expiratory pressure 2 cm H2O, rate 12 breaths per minute, and FiO2 less than 0.3), and they were extubated 24 hours later. Infants required reintubation if they had (1) PaCO2 greater than 55 mm Hg and pH less than 7.20, (2) FiO2 greater than 0.5, or (3) apnea associated with a heart rate less than 100 beats per minute that required frequent stimulation (more than 20 episodes during a 16-hour period). Among 32 infants (birth weight less than 1,000 g) who reached minimal ventilatory support before seven days after delivery, 13 of 18 (72%) control infants required reintubation, whereas only four of 14 (28%) theophylline-treated infants required reintubation. On the other hand, among infants (birth weight less than 1,000 g) who reached minimal ventilatory support after seven days following delivery, only one of six (17%) of the control group required reintubation and no improvement could be seen with theophylline treatment. Similarly, among control infants (birth weight 1,001 to 1,250 g), only ten of 45 (23%) required reintubation after reaching low intermittent manditory ventilation settings. In summary, most infants recovering from respiratory distress syndrome who had birth weights (1) greater than 1,000 g or (2) less than 1,000 g and who were older than seven days could be successfully extubated from minimal ventilatory support without theophylline treatment.(ABSTRACT TRUNCATED AT 250 WORDS)
Apnea↗