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Biomedical subjects

D Buckner

Publications and source records attributed to D Buckner.

13 recordsLinked to original sources
PubMed1997

Allogeneic stem cell transplantation for multiple myeloma.

High-dose chemotherapy (with or without total body irradiation) followed by allogenic marrow transplantation is curative for some patients with advanced multiple myeloma. A relatively high transplant-related mortality, however, limits the wider application of this approach. The challenge for future studies will be to develop less toxic preparative regimens, more efficient ways to prevent infection and graft-versus-host disease, and methods to enhance the graft-versus-leukemia effect of allografts.

Bone Marrow Transplantation↗
PubMed1993

Long-term follow-up of patients with invasive fungal disease who received adjunctive therapy with recombinant human macrophage colony-stimulating factor.

Mortality of bone marrow transplant (BMT) patients who develop invasive fungal infection is greater than 80%. Long-term follow-up of 46 consecutive BMT patients who received recombinant human macrophage colony-stimulating factor (rhM-CSF) as adjunctive therapy with standard antifungal treatment who were entered into phase I/II trials at The Fred Hutchinson Cancer Research Center is reported. rhM-CSF (100 micrograms/m2 to 2,000 micrograms/m2; Chiron/Cetus Corporation, Emeryville, CA) was administered from day 0 to 28 after determination of progressive fungal disease. Results of long-term follow-up of fungal infection, relapse, and survival were compared with 58 similar historical controls. Multivariable analysis of the patients who received rhM-CSF showed two factors that significantly correlated with poor survival: Karnofsky score < or = 20% and Aspergillus infection. Overall, survival of patients who received rhM-CSF was greater than that of historical patients (27% v 5%) and was entirely because of a 50% survival rate in patients with Candida infection and Karnofsky scores greater than 20%. Prospective, randomized, controlled trials to determine efficiency of rhM-CSF are indicated and should be directed at patients with invasive candidiasis.

Adult↗
PubMed1992

Long-term followup with the use of lyophilized dura mater for abdominal wall closure in children: report of 3 cases.

We report our experience with 3 children treated during infancy by abdominal wall reconstruction using lyophilized dura mater. Followup has been 36, 46 and 96 months postoperatively and they demonstrated adequate abdominal wall healing. One child has mild muscular diastasis, while 1 has completely healed. In 1 child a small defect developed in the repair, which was closed at a secondary procedure. Wound infection, dehiscence or herniation did not occur. There has been no evidence of Creutzfeldt-Jakob disease, which has been reported when allogenic dura was not obtained from registered tissue banks. Our experience with dura mater suggests that the material may be a useful adjunct in the repair and closure of complex abdominal defects.

Abdominal Muscles↗
PubMed1991

Toward a methodology for moral decision making in medicine.

The failure of medical codes to provide adequate guidance for physicians' moral dilemmas points to the fact that some rules of analysis, informed by moral theory, are needed to assist in resolving perplexing ethical problems occurring with increasing frequency as medical technology advances. Initially, deontological and teleological theories appear more helpful, but criticisms can be lodged against both, and neither proves to be sufficient in itself. This paper suggests that to elude the limitations of previous approaches, a method of moral decision making must be developed incorporating both coherence methodology and some independently supported theoretical foundations. Wide Reflective Equilibrium is offered, and its process described along with a theory of the person which is used to animate the process. Steps are outlined to be used in the process, leading to the application of the method to an actual case.

Bioethical Issues↗
PubMed1986

Experience with a totally implantable venous device in children.

Venous access was attained in 15 children by use of a totally implantable central venous catheter and reservoir. Catheters were in place from 28 to 581 days, giving a cumulative experience of 4,094 days. Although they were well accepted by physicians, parents, and the children, they were not without major complications. These included extravasation of a chemotherapeutic agent in one, migration of the catheter tip to an unacceptable location in another, and catheter thrombosis and catheter-related sepsis in two each. The malpositioned catheter, one of the thrombosed catheters, and both infected catheters were removed. Ease of care, freedom from protruding tubing, and compatibility with normal activities are major positive features of the implantable devices that should be considered when deciding on the type of prolonged central venous access for use in children being treated with cancer.

Adolescent↗
PubMed1981

Omphalocele: treatment options.

The charts of 62 infants born with an omphalocele were reviewed to determine both the timing and type of treatment that yielded the most satisfactory result. Infants born with an omphalocele can be divided into prognostic groups based on physical examination and simple roentgenograms. No single treatment method is applicable to or optimal for all types of omphalocele. Treatment options can be selected based on the presence or absence of conditions requiring emergency operation, the presence of complicating anomalies, and the size of the omphalocele. Although urgent evaluation of all infants born with an omphalocele is essential, emergency operation should be avoided in selected cases.

Abnormalities, Multiple↗
PubMed1978

Immunotherapy of verrucae vulgares with dinitrochlorobenzene.

A study using daily topical applications of dinitrochlorobenzene on recalcitrant verrucae vulgares demonstrated this to be of practical value. Complete resolution of lesions occurred in 66% of 35 patients, with a complication rate of 24%. The results of other studies are reviewed and recommendations for use of this medication are given. DNCB therapy should, however, be reserved for use on recalcitrant lesions because of the complications associated with its usage.

Adolescent↗