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Biomedical subjects

G MacLean

Publications and source records attributed to G MacLean.

At least 19 recordsLinked to original sources
PubMed2002

Phase III trial comparing radical radiotherapy with and without cisplatin chemotherapy in patients with advanced squamous cell cancer of the cervix.

PURPOSE: To test the hypothesis that cisplatin (CDDP) administered concurrently with standard radiotherapy (RT) would improve pelvic control and survival in patients with advanced squamous cell cancer of the cervix. PATIENTS AND METHODS: A total of 259 patients with International Federation of Gynecology and Obstetrics stage IB to IVA squamous cell cervical cancer with central disease greater-than-or-equal 5 cm or histologically confirmed pelvic lymph node involvement were randomized to receive RT (external-beam RT plus brachytherapy) plus weekly CDDP chemotherapy (40 mg/m(2)) (arm 1) or the same RT without chemotherapy (arm 2). RESULTS: A total of 253 patients were available for analysis. Median follow-up was 82 months. No significant difference was found in progression-free survival (P =.33). No significant difference in 3- and 5-year survival rates was found (69% v 66% and 62% v 58%, respectively; P =.42). The hazard ratio for survival (arm 2 to arm 1) was 1.10 (95% confidence interval, 0.75 to 1.62). CONCLUSION: This study did not show a benefit to either pelvic control or survival by adding concurrent weekly CDDP chemotherapy in a dose of 40 mg/m(2) to radical RT as given in this trial. Careful attention to RT details is important for achieving optimum outcome for patients with this disease.

Adult↗
PubMed2001

Cloning of a novel retinoic-acid metabolizing cytochrome P450, Cyp26B1, and comparative expression analysis with Cyp26A1 during early murine development.

Tight regulation of retinoic acid (RA) distribution in the embryo is critical for normal morphogenesis. The RA-metabolizing enzymes Cyp26A1 and Cyp26B1 are believed to play important roles in protecting certain embryonic tissues from inappropriate RA signaling. We have cloned the murine Cyp26B1 cDNA and compared its expression pattern to that of Cyp26A1 from embryonic day (E) E7-E11.5 using in situ hybridization. Northern blot analysis shows the presence of two Cyp26B1 transcripts of approximately 2.3 and 3.5 kb in embryonic limb bud. Whereas Cyp26A1 is expressed in gastrulating embryos by E7, Cyp26B1 is first expressed at E8.0 in prospective rhombomeres 3 and 5. Cyp26B1 expression expands to specific dorso-ventral locations in rhombomeres 2-6 between E8.5 and E9.5, whereas Cyp26A1 hindbrain expression is limited to rhombomere 2 at E8.5. No (or very weak) Cyp26B1 expression is observed in the tail bud, a major site of Cyp26A1 expression. Differential expression is seen in branchial arches, with Cyp26A1 being mainly expressed in neural crest-derived mesenchyme, and Cyp26B1 in specific ectodermal and endodermal areas. Cyp26B1 is markedly expressed in the ectoderm and distal mesoderm of the limb buds from the beginning of their outgrowth. Cyp26A1 transcripts are seen later and at lower levels in limb ectoderm, and both transcripts are excluded from the apical ectodermal ridge.

Amino Acid Sequence↗
PubMed2001

Survival patterns in biliary atresia and comparison of quality of life of long-term survivors in Japan and England.

BACKGROUND/PURPOSE: Portoenterostomy is an accepted method of achieving bile drainage in biliary atresia, but there is a paucity of data, including formal quality-of-life (QoL) studies, on long-term survivors. This report includes survival analysis and QoL studies from the world's largest series of cases treated in Japan (1951 to 1998). The Japanese QoL results are compared with a matched group of UK patients from King's College Hospital, London. METHODS: One hundred fifteen Japanese surviving portoenterostomy patients were studied and comparison of trends in survival calculated from 6-year period cohorts. Liver function and hematologic status in a group of 30 long-term survivors (14 to 24 years) were compared with 25 patients from England, (14 to 23 years). Twenty-five Japanese and 21 UK patients (SF-36) completed a QoL questionnaire. RESULTS: Median survival times in Japanese patients before 1975 were less than 1 year but increased to 18 years after 1975. Hematologic and liver function test results did not show any significant differences between the Japanese and UK patients. QoL studies in the UK patients showed no significant difference from normative, general population data. Japanese patients underperformed in general health (P = .01), role emotional (P = .05) and role physical (P = .07) but, overall, there was no significant difference between the Japanese and UK patients except for marginal differences in indices of general health and vitality (P = .06 and .04, respectively). CONCLUSIONS: Long-term survival rate in the Japanese patients increased dramatically from 1 year to 17 years after 1975. The QoL of survivors was comparable in Japan and England. The satisfactory comparison with normative population data suggests that we should continue to use portoenterostomy as the primary treatment for biliary atresia. J Pediatr Surg 36:892-897.

Adolescent↗
PubMed2001

Phase I study of the BLP25 (MUC1 peptide) liposomal vaccine for active specific immunotherapy in stage IIIB/IV non-small-cell lung cancer.

Active specific immunotherapy with liposomal vaccines targeted to the mucinous carcinoma-associated glycoprotein MUC1 have shown promising results in animal models. The aim of this phase I study was to evaluate the safety and immunogenicity of 2 dose levels of the MUC1 liposomal vaccine preparation BLP25. Patients with stage IIIB or IV non-small-cell lung cancer received either 20 microg or 200 microg of the liposomal BLP25 vaccine preparation. Injections were administered subcutaneously at weeks 0, 2, 5, and 9. Immunological responses to vaccination were measured by antibody production, cytotoxic T lymphocytes (CTL), and proliferative T-helper cells. Seventeen patients were entered on study; 12 patients completed the vaccination protocol. Two patients, 1 in each dose group, developed clinically insignificant grade 3 lymphopenia during the study. Nonhematologic toxicities were mild and self-limiting, and there were no significant long-term injection site reactions. Immunological assays revealed the generation of CTLs against MUC1-positive tumor cell lines in 5 of 12 evaluable patients. These patients did not have CTLs prior to receiving the vaccine. No significant humoral response to the vaccination was observed. No objective antitumor responses were observed. Of the 12 patients completing all the vaccinations, 4 had stable disease. Median survival time was 5.4 months in the 20 microg group and 14.6 months in the 200 microg group. In summary, the BLP25 liposomal vaccine was well tolerated and elicited a primarily cellular immune response in these lung cancer patients. This study forms the basis for further clinical exploration of the MUC1 liposomal vaccine, BLP25.

Journal Article↗
PubMed1994

Professional and popular views of chronic fatigue syndrome.

OBJECTIVE: To study the coverage of the chronic fatigue syndrome in the popular and professional press. DESIGN: Search of all original research papers on the chronic fatigue syndrome published in British journals from 1980 onwards and of professional trade papers, national newspapers, and women's magazines. Interviews with six medical journalists. SETTING: British scientific, medical, and popular press. RESULTS: 37 (49%) articles in research journals did not favour organic causes and 23 (31%) favoured organic causes. By contrast 31 (55%) articles in the medical trade press and 118 (69%) in national newspapers and women's magazines favoured organic causes. CONCLUSIONS: Press coverage of chronic fatigue syndrome has amplified and distorted divisions in the research community concerning the chronic fatigue syndrome. Articles in the press concentrate on a simple medical model of illness reinforcing the stigma of psychological illness and dissatisfaction with traditional medical authority.

Attitude to Health↗
PubMed1992

Cisplatin-cyclophosphamide versus carboplatin-cyclophosphamide in advanced ovarian cancer: a randomized phase III study of the National Cancer Institute of Canada Clinical Trials Group.

PURPOSE: Given the potential for improved tolerance, a trial was initiated to compare the toxicity and efficacy of a standard regimen of cisplatin-cyclophosphamide (75 mg/m2 and 600 mg/m2, respectively) with an experimental regimen of carboplatin-cyclophosphamide (300 mg/m2 and 600 mg/m2, respectively) in women with postoperative macroscopic residual ovarian cancer. PATIENTS AND METHODS: Between 1985 and 1989, 447 (417 eligible) patients were randomized. Treatment arms were well balanced; most patients had stage III (82%), grade 3 (54%) tumors with bulky residual (greater than 2 cm in 59%), and good performance status (Eastern Cooperative Oncology Group [ECOG] 0 or 1, 77%). Response was assessed after six 4-week cycles. RESULTS: The treatments were equally deliverable, with 76% of patients completing their allocated regimen. The reported reasons for failure to complete treatment differed; toxicity/refusal predominated on the cisplatin arm, and progressive disease predominated on the carboplatin arm (P = .0092). Cisplatin-treated patients were more likely to develop neuropathy and nephropathy, and carboplatin patients experienced myelosuppression, particularly thrombocytopenia. Efficacy was similar, with no significant differences for the cisplatin and carboplatin arms in clinical response rate (57% v 59% in those with measurable disease), pathologic response rate (52% v 54% in those suitable for relaparotomy), time to progression (median, 56 v 58 weeks), or overall survival (median, 100 weeks v 110 weeks). Time to progression and survival were predicted by residual disease size, performance status, and treatment center (with those treated at centers that accrued more patients doing better). CONCLUSION: Neither regimen is optimal in that relapse remains the norm. It may be inappropriate to expect that any single regimen can be an effective therapy for all patients with advanced ovarian cancer. Both cisplatin and carboplatin are likely to have a role in future treatment strategies.

Adult↗
PubMed1988

MMPI subtypes for chronic phencyclidine (PCP) abusers.

The present study applied empirical clustering procedures to the MMPI protocols of 196 chronic phencyclidine (PCP) abusers. Subjects were randomly divided into two groups, and two methods of cluster analysis, the average linkage method and Ward's hierarchical procedure, were performed. Both cluster methods produced highly comparable results within each group, and the MMPI profiles found in each group were quite similar. Cluster analytic studies of other substance abuse populations are needed in order to replicate the MMPI profile types found in the present study. These investigations would lead to an empirical typology across various substance abuse populations that would depict developmental stages.

Adult↗
PubMed1987

Child psychiatry: one nation.

This essay discusses the position of child psychiatry as a subspecialty in Canada today. Proceeding from a review of a paper written by Dr. Quentin Rae-Grant in 1970 "Adult and Child Psychiatry--One or Two Nations?" the author, using the concept of a nation as a metaphor, explores the evolution of child psychiatry as a subspecialty in Canada. The history of child psychiatry in Canada is reviewed briefly; from its early beginnings to an increased understanding of its uniqueness as a subspecialty, finally through to the formation of the Canadian Academy of Child Psychiatry in 1980. The essay stresses the mutuality of our dependence on the Canadian Psychiatric Association. The author emphasizes our mutual dependence on the greater organizational body of psychiatrists, and encourages a greater participation of child psychiatrists within the Canadian Psychiatric Association. The author also emphasizes the need to have a closer relationship with the Canadian Paediatric Society. In addition, the author discusses in some detail the more complex and controversial relationship between child psychiatry and the Royal College of Physicians and Surgeons of Canada. Finally the author emphasizes the importance of a close working relationship with the American Academy of Child and Adolescent Psychiatry. All of these relationships are emphasized in terms of mutual dependence.

Adolescent↗
PubMed1987

The psychological development of a twin: a case study of the importance of a symptom.

In this paper we focus on the evaluation, assessment, diagnostic conclusions, and individual psychotherapy of a four year old twin who presented with the symptom of encopresis. Of great relevance to this boy is the literature concerning his vulnerability as a twin to develop symptomatology as he starts dealing with separation and individuation issues. Especially relevant are the multiple impacts of attitudes, perceptions and family rearing issues on the psychological development of this twin, and also on the development of this specific symptom choice--encopresis. Incorporating literature with case material, the meaning of the symptom of encopresis to this twin is discussed. The hypothesis defended is that the symptom enabled the twin to attract attention from his somewhat favoured brother, and to promote the process of separation and individuation from his parents and from his twin. It promoted his sense of himself as a separate and unique person in his own right. The child developed a sense of himself despite parental interference. With individual psychotherapy and family therapy, the need for the symptom was neglected.

Anger↗
PubMed1986

A brief story about Dr. Hermine Hug-Hellmuth.

Dr. Hermine Hug-Hellmuth was the world's first practicing child psychoanalyst. From this vantage point of being the first person to apply psychoanalysis to the treatment of children, she was also the first person to make use of systematic child observation from a psychoanalytic point of view. In addition Dr. Hug-Hellmuth was among the very first of the lay adherents to psychoanalysis to practice psychoanalysis. Further, she was one of the first women to obtain a doctorate degree in physics from the University of Vienna. We see that in all these aspects, as a woman, with a lay education, practicing psychoanalysis with children and employing psychoanalytic child observation, she was the first, or among the very first. In this perspective her pioneer status becomes understood to be very important. Others followed and psychoanalysis grew and flourished as did the contributions and the stature of those who would become giants of psychoanalytic history. In part, it was in the shadows of these later giants that the memory of Dr. Hug-Hellmuth has faded.

Austria↗
PubMed1982

A clinical approach to brief dynamic psychotherapies in child psychiatry.

This paper reviews the position of brief psychotherapies in child psychiatry. Brief psychotherapy with children and families has received less attention than similar work with individual adults. After reviewing literature on brief dynamic psychotherapy with children and their families, the authors describe an approach which developed in an outpatient child psychiatry team. After a brief assessment, a focal hypothesis and plan of treatment are concluded. A decision is made as to which unit (the family group, an individual, or a combination of individuals) would be most strategic to treat. The authors coin the phrase "focal treatment unit" to express this concept.

Child↗