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Biomedical subjects

B Levin

Publications and source records attributed to B Levin.

At least 289 records · Page 16Linked to original sources
PubMed1981

The diagnosis of "early" pancreatic cancer: the University of Chicago experience.

The results of a prospective study designed to investigate patients suspected of having pancreatic cancer are reported. One hundred and two of 238 patients investigated had pancreatic cancer. Ultrasonography, endoscopic retrograde cholangiopancreatography, and cytology were the most reliable tests for the diagnosis of resectable cancer. Computed tomography had a higher sensitivity for unresectable cancer. Factors responsible for delay in diagnosis are discussed. Cancer of the body and tail of the pancreas cannot be diagnosed early by investigating a symptomatic population. Factors influencing mortality in patients who survive over three years following pancreatic resection are discussed.

Adult↗
PubMed1981

Premature chromosome condensation in human large bowel cancer.

Two patients with large bowel cancer are described in whose tumors the presence of cells with premature chromosome condensation (PCC) was encountered. The percentage of PCC In the tumors was 6.9 and 6.6%. We hypothesize that the near tetraploid chromosome number present in the tumor cells in both patients may be the product of fusion of two near diploid malignant cells. Also it is speculated that some colorectal tumors with chromosomes ranging from the hypotriploid to the hypotetraploid levels may be the result of cell fusion.

Adenocarcinoma↗
PubMed1981

Selecting the highest probability in binomial or multinomial trials.

Some sequential procedures are considered for selecting the binomial population with largest success probability or for selecting the multinomial outcome with highest cell probability. Procedures with and without sequential elimination of inferior populations are evaluated with respect to the expected probability of the population selected.

Journal Article↗
PubMed1981

Prevalence of knee chondrocalcinosis in hospital and clinic patients aged 50 or older.

The prevalence of chondrocalcinosis was studied in 574 hospital and clinic patients aged 50 or older who had undergone x-ray examination of the knee. Chondrocalcinosis was found in 9.6 percent of all these patients, in 5 percent of the 50-64 age group, and in 14.6 percent of the 65-94 age group. The prevalence of knee chondrocalcinosis increased in stepwise fashion between the ages of 65 and 80. A review of the literature and of the data on our few patients over the age of 80 suggests the existence of an even higher prevalence among persons of this advanced age group.

Age Factors↗
PubMed1981

Narrowing of knee joint space in patients with pseudogout.

Abnormalities of joint space in knee roentgenograms were compared among 28 symptomatic patients with pseudogout and 2 control groups consisting of spouses of patients and hospital based patients with knee pain. Joint space narrowing was significantly more frequent in the pseudogout patients than in the 2 control groups. Division of patients and controls into 3 age groups revealed a striking degree of joint space narrowing in the youngest patients with pseudogout. Our study suggests that symptomatic patients with pseudogout have joint destruction beginning at a relatively early age. We speculated that this may reflect concurrence of chondrocalcinosis and another disease such as osteoarthritis.

Age Factors↗
PubMed1981

Epidemiologic detection of low dose effects on the developing fetus.

Evaluations of the health effects of exposures in the workplace and environment have broadened to include effects on reproduction, as well as on the development of cancer. Models to assess risks associated with varying doses of exposure rest almost entirely on data about cancer. In this paper we discuss some distinctive features of reproduction which bear on the interpretation of such models, when applied to reproduction, rather than carcinogenesis. Dose-response curves describe the relationship between two exposures (smoking and alcohol drinking) and two outcomes (spontaneous abortion and birthweight) are used to illustrate some of the questions which arise in attempting to determine a "safe" level of exposure.

Abortion, Spontaneous↗
PubMed1981

Effect of pharmacist intervention on the use of serum drug assays.

The results of an investigation to (1) evaluate the use of serum drug assays (SDAs), (2) study the influence of clinical pharmacist monitoring and educational programs on SDA use, and (3) perform drug-related patient-care evaluations for the medical audit committee are reported. The components of the five-month study were a retrospective audit, education of physicians prescribing SDAs, and a concurrent reaudit. The four SDAs audited were digoxin, theophylline, gentamicin, and phenytoin. Criteria for appropriate use were defined by the audit committee and a clinical pharmacist. The criteria specified the indication for each drug, performance data, and dosage adjustments with SDA results. The clinical pharmacist presented two housestaff conferences on the appropriate use of SDAs and distributed educational materials to the attending physicians. An SDA report form was completed each time an SDA was ordered, and, whenever possible, the pharmacist met with the prescribing physician. Appropriate overall use of SDAs increased significantly (p less than 0.05). A significant improvement (p less than 0.05) was noted for each of the criteria. An estimated $2500 in patient charges was saved during the study; the cost of the clinical pharmacist's time was approximately $260. The authors concluded that clinical pharmacists, in conjunction with patient-care evaluations, can provide a cost-effective service in improving therapeutic patient monitoring based on SDA results.

Costs and Cost Analysis↗
PubMed1981

Dysplasia-associated lesion or mass (DALM) detected by colonoscopy in long-standing ulcerative colitis: an indication for colectomy.

In performing colonoscopy over a 4-yr period on 112 patients with long-standing ulcerative colitis, a dysplasia-associated lesion or mass (DALM) was found in 12. This appeared as either a single polypoid mass (5 cases), a plaquelike lesion (2 cases), or multiple polyps (5 cases). In 7 of these 12 cases carcinoma was subsequently found. This was particularly true in the 5 cases of single polypoid masses where all 5 contained invasive carcinoma. In none of the cases associated with malignancy did multiple biopsies of the DALM reveal invasive carcinoma. In only 2 of the 7 patients with carcinoma was the dysplasia "severe," being "mild" or "moderate" in the remaining 5. In the 27 patients with dysplasia found incidentally in random biopsies of flat mucosa only one carcinoma was found, in contrast to the 7 cancers in 12 patients with DALM. This difference leads us to regard the finding of DALM, especially a single polypoid mass, as highly significant in patients with long-standing ulcerative colitis. It carries a sufficiently high risk of cancer, thereby constituting a strong indication for colectomy.

Adult↗
PubMed1980

5-fluorouracil, Adriamycin, and mitomycin-C (FAM) chemotherapy for advanced adenocarcinoma of the pancreas.

Thirty-nine patients with advanced metastatic adenocarcinoma of the pancreas were treated with a combination of 5-fluorouracil, Adriamycin, and mitomycin-C (FAM). Twenty-seven of these patients had measurable disease, and ten (37%) achieved a partial response. An additional three patients had evidence of disease stabilization. The median survival period of responding patients was 12 months, compared with 3.5 months for nonresponders (P < 0.01). The median survival period for all patients was 6 months. Moderate myelosuppression constituted the treatment-limiting toxicity. The FAM combination is an active and well-tolerated regimen for pancreatic cancer and may have an application in the management of patients with less advanced disease.

Adenocarcinoma↗
PubMed1980

Recurrent enteric gallstone obstruction.

Small bowel gallstone obstruction may recur, most often within a few days after surgery, due to an overlooked intraenteric stone or subsequent passage of another gallstone via the cholecystoenteric fistula. In the case reported herein there was a 6-month interval. A critical review of the radiologic signs of gallstone ileus is presented.

Aged↗
PubMed1980

Gastric adenocarcinoma following gastric lymphoma. Role of partial gastrectomy.

Gastric adenocarcinoma developed in a 45-year-old man 13 years after he had undergone resection of a gastric lymphoma (large cleaved cell type, diffuse) and two courses of radiation therapy to the upper abdomen to a total dose of 6300 rad. Three factors involved in possibly increasing risk for the second malignancy, namely lymphoma, extensive radiation therapy, and gastric resection, are discussed. Degenerative and premalignant histologic changes occur in the gastric remnant after partial gastrectomy. These contribute to the pathogenesis of adenocarcinoma after surgical therapy of peptic ulcer or other disorders. Periodic endoscopic surveillance and the use of multiple biopsies are important in achieving early diagnosis.

Adenocarcinoma↗
PubMed1980

Crohn's disease and adenocarcinoma of the bowel.

We present six cases of cancer associated with Crohn's disease and stress the importance of the earlier age of onset than spontaneously arising small-bowel carcinoma, the long period of latency from the time of diagnosis of Crohn's disease to that of carcinoma, and the generally poor prognosis. We emphasize, furthermore, the frequent association with fistulas and the predisposition of bypassed or excluded segments of bowel to undergo malignant transformation. The occurrence of carcinoma in an excluded rectal stump has not previously been reported and stresses the necessity of resecting, rather than excluding, segments of bowel involved with Crohn's disease. These tumors are often not readily apparent by radiographic or endoscopic examination and in fact, may be discovered only after microscopic examination of resected or biopsied tissue.

Adenocarcinoma↗
PubMed1980

Sequential medical trials.

A model for sequential clinical trials is discussed. Three proposed stopping rules are studied by the Monte Carlo method for small patient horizons and mathematically for large patient horizons. They are shown to be about equally effective and asymptotically optimal from both Bayesian and frequentist points of view and are markedly superior to any fixed sample size procedure.

Journal Article↗