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Biomedical subjects

H Sutton

Publications and source records attributed to H Sutton.

9 recordsLinked to original sources
PubMed1992

Practical applications of Beam's Eye View-based treatment planning to head and neck sites.

Because of the complex anatomy of the structures involved by tumor as well as of the critical normal structures, treatment planning for advanced or spatially irregular cancers of head and neck sites is often extremely challenging. Computerized axial tomographic scanning is frequently invaluable in delineating tumor extension into areas inaccessible to physical examination. Our Beam's Eye View Planning (BEVP) capability allows us to incorporate this radiographic information accurately into actual plans used in the clinic. Over the past 2 1/2 years, we have applied this technique to 31 selected head and neck cancer patients at Michael Reese/University of Chicago Center for Radiation Therapy. Tumors were chosen on the basis of anatomical complexity: most involved multiple head and neck sites including orbit, skull base, paranasal sinuses and cavernous sinus. In all cases, radiation tolerance of critical normal structures including spinal cord, brain stem, optic chiasm, and eye had to be considered. With careful use of rigid immobilization devices and the outlining of several normal structures for purposes of alignment, we had no difficulty applying our BEVP technique to clinical simulations. Oblique field blocking was especially facilitated by BEVP. We found the BEVP technique very useful to assure that tumor coverage was adequate and tolerance of normal tissues not exceeded.

Computer Simulation↗
PubMed1992

A dosimetric study comparing three-, four-, and six- field plans for treatment of carcinoma of the prostate.

We present a three-dimensional dosimetric analysis of 3-, 4-, and 6-field plans using 24 MV photon beams for treatment of carcinoma of the prostate. We compare isodose distributions on a transverse plane through the center of the target as well as differential and integral dose volume histograms for the target and critical structures, respectively. An extensive study on a representative case led to the development of a technique where two complementary 3-field daily plans deliver the same daily target dose as the standard 4-field box while affording sparing of the bladder and rectum similar to that achieved with a 6-field plan. This technique was shown to yield the same results on a sample of four additional patients representing a range of target and patient sizes. We conclude that the combined two-day, 3-field method for treatment of the prostate may be a better choice than the standard 4-field box or the 6-field daily plan for dose escalation studies.

Humans↗
PubMed1991

Efficacy of polyacrylamide vs. sodium hyaluronate in cataract surgery.

A prospective randomized study was conducted in 137 patients who underwent cataract surgery and implantation of a polymethylmethacrylate intraocular lens with either polyacrylamide (Orcolon) (68 patients) or sodium hyaluronate (Healon) (69 patients) as the viscoelastic material. Both viscoelastics were aspirated at the end of surgery. Patients were examined before surgery and 1 and 14 days after surgery. Endothelial cell counts were obtained before surgery and 3 months after surgery in 34 patients (16 in the polyacrylamide group and 18 in the sodium hyaluronate group). There were no reports of a flat or shallow anterior chamber intraoperatively in either group. There was no statistically significant difference between the two groups in the incidence of corneal edema or iritis on any visit or in endothelial cell loss. Although there was a significant reduction in intraocular pressure across postoperative visits for the overall sample, there was no significant difference in pressure between the polyacrylamide and sodium hyaluronate groups. The results indicate that no untoward effects on corneal edema, endothelial cell count, iritis or intraocular pressure are to be expected when polyacrylamide is used as an aid to cataract surgery.

Acrylic Resins↗
PubMed1990

Radiation therapy in the treatment of cervical cancer: the University of Chicago/Michael Reese Hospital experience.

A retrospective analysis was conducted on 307 patients referred for radiation therapy at The University of Chicago and Michael Reese Hospital between 1971 and 1986. Median follow-up was 6.4 years. Treatment techniques varied during the time of the study. Actuarial disease-free survivals were 78%, 64%, 55%, 33%, 41%, and 60% for stage IB, IIA, IIB, IIIA, IIIB, and IVA, respectively. Stage, size of the cervical lesion, and hemoglobin level during treatment were prognostic factors. Treatment technique as well as time dose factors were analyzed with respect to survival, failures, and complications.

Adult↗
PubMed1990

Effect of external beam radiation therapy on serum prostate-specific antigen.

The effect of external beam radiation on serum prostate-specific antigen (PSA) was determined in 20 patients with nonmetastatic carcinoma of the prostate. An abnormal PSA was measured in 91 percent and 93 percent, respectively, of the samples collected prior to or during radiation therapy. By seven months, 8/15 men still had an abnormal PSA level. Four of 5 men with an elevated PSA at least twenty-three months after radiation therapy had a positive prostatic biopsy, and 3/3 patients with a normal PSA had a negative ultrasonically guided biopsy. The rate of decline of serum PSA after radiation therapy is variable. These preliminary data suggest that serum PSA may be useful for assessing the local response of prostate cancer to radiation therapy.

Adenocarcinoma↗
PubMed1990

Lens opacity as a predictor of visual field impairment due to cataract.

The contribution of cataract to the decrease of visual field in patients with glaucoma is difficult to ascertain. To attempt to quantitate the change in visual field due to cataract, we examined 27 eyes of 26 patients before and after cataract extraction. The examination consisted of measurement of best refraction with visual acuity, visual field testing with the pupil dilated, measurement of lens opacity, determination of the intraocular pressure, and evaluation of the character of the cataract before surgery and of the posterior capsule after surgery. The results reaffirmed the detrimental effect that cataract may have on the visual field but also showed that the heterogeneity of cataracts limits the usefulness of the lens opacity meter in quantitating the extent of visual field loss due to cataract.

Adult↗
PubMed1989

Functional assessment of colonic interposition with 99Tcm-labeled milk.

A prospective study was performed to evaluate the use of radionuclide imaging in the assessment of patients who have undergone esophageal reconstruction. Dynamic radionuclide imaging was performed on ten patients aged 11 months to 11 years who had undergone colon interposition via the normal esophageal route for esophageal atresia. Patients were considered clinically unsatisfactory if at the time of imaging feeding was troubled, or if weight gain had fallen to below the third centile before operation and remained below after operation. Each patient underwent erect imaging with a small milk feed labeled with 10 to 20 MBq (250 to 500 muCi) 99Tcm DTPA adjusted according to body surface area; supine studies were subsequently performed on five patients. All five clinically unsatisfactory patients showed conduit emptying delayed beyond 45 minutes and/or spontaneous reflux, significantly different from the clinically satisfactory patients (X2 = 6.4, P less than .02). Conduit complications were subsequently identified in three of the five clinically unsatisfactory patients. Radionuclide imaging with radiolabeled milk was found to be well tolerated, and obtained results that were clinically useful. These results suggest that dynamic radionuclide imaging can be more widely applied in the assessment of esophageal substitutes.

Alanine↗