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Biomedical subjects

J B Golden

Publications and source records attributed to J B Golden.

8 recordsLinked to original sources

Efficacy of high-dose therapy and autologous hematopoietic stem cell transplantation for non-Hodgkin's lymphoma in adults 60 years of age and older.

High-dose therapy (HDT) with autologous stem cell transplantation (ASCT) is the optimal treatment for patients with relapsed aggressive non-Hodgkin's lymphoma (NHL). HDT, however, is often reserved for relatively younger patients due to limited data in older adults. We treated 53 patients aged 60 years and older (median age 62 years, range 60.3-67.7 years) with HDT and ASCT for NHL at our centers. Forty-four patients (83%) had aggressive histology, 75% had chemosensitive disease and all had failed anthracycline therapy. Conditioning regimens included busulfan, melphalan, and thiotepa (45%); cyclophosphamide (CY), etoposide (VP-16), and total body irradiation (TBI) (30%); CY and TBI (15%); and other regimens (10%). Estimated 4-year overall survival (OS), progression-free survival, and treatment-related mortality (TRM) were 33%, 24% and 22%, respectively. A multivariable analysis demonstrated that patients with chemosensitive disease (P = 0.03) and < or =3 prior regimens (P = 0.03) had superior survival. Four-year OS in patients with chemosensitive disease was 39% vs 15% in patients with chemoresistant disease. Reduced TRM was associated with the CY, VP-16 and TBI regimen (P = 0.02). HDT therapy with ASCT may result in prolonged survival and potential cure for about a quarter of elderly patients, and for almost 40% with chemosensitive disease. Optimal conditioning regimen selection may further improve outcome by reducing TRM. Age alone should not be used to exclude patients from receiving myeloablative therapy with ASCT.

Aged↗

Use of horizontal ultrathin gel electrophoresis to analyze allelic deletions in chromosome band 11p15.5 in gliomas.

The prognosis for most patients with astrocytic glioma is poor, and postoperative life expectancy has not significantly improved in the last decade despite advances in diagnosis, surgery, and adjuvant therapy. Progress has been made, however, in cataloging the genetic alterations that occur in these tumors. Studying the allelic changes using loss of heterozygosity analysis has proven to be a reliable and rapid way of identifying genetic alterations fundamental to the pathology of this disease. In this study, we used a series of fluorescent-labeled markers and a new horizontal ultrathin gel electrophoresis technology (HUGE; GeneSys Technologies, Inc.) to analyze loss of heterozygosity on 11p15 in a series of 24 matched normal/tumor glioma pairs that included both anaplastic astrocytomas and glioblastomas. These studies significantly narrowed the region harboring a putative 11p15.5 glioma-associated gene and further suggest that a second gene involved in the pathogenesis of brain tumors may exist, centromeric, in bands 11p15.5-p15.4.

Alleles↗

Pattern recognition for automated DNA sequencing: I. On-line signal conditioning and feature extraction for basecalling.

The massive scale of DNA sequencing for the Human Genome Initiative compels efforts to reduce the cost and increase the throughput of DNA sequencing technology. Contemporary automated DNA sequencing systems do not yet meet estimated performance requirements for cost-effective and timely completion of this project. Greater accuracy of basecalling software would minimize manual review and editing of basecalling results, and facilitate assembly of primary sequences to large contig(uous) arrays. In this report we describe a neural network model for photometric signal conditioning during raw data acquisition with an automated DNA sequencer. This network supports on-line extraction and evaluation of informative arrays of oligomer separations and yields, as a feature table for accurate, real-time basecalling.

Automation↗

An automated medical record system, 10 years later.

An automated medical record system (AMRS) at the Harvard Community Health Plan supports medical records membership and the management needs of the 146,000-member health maintenance organization. The ARMS is fully integrated into the operation of HCHP's health centers and into the clinical practice of the medical staff. User interviews conducted as part of a systems planning effort revealed a high level of satisfaction with the system. The acceptance of and enthusiasm for the AMRS was coupled with a variety of ideas for improvement and enhancements to the system. Most of these suggestions were not uniquely related to the automated technology supporting the system but rather addressed medical records issues familiar to conventional paper systems. While this distinction is subtle, it further confirms the viability of an automated system and suggests directions for future growth.

Boston↗

Symptomatic Rathke's cleft cysts. Report of two cases.

Two unusual cases of symptomatic Rathke's cleft cysts are described. The first patient was a 47-year-old man who presented with recurrent aseptic meningitis in addition to visual symptoms, panhypopituitarism, and hydrocephalus. The second patient was a 41-year-old man presenting with increasing headache, and a large, nonenhancing sellar cyst showing suprasellar extension on computerized tomography. The similarities between Rathke's cleft cysts and craniopharyngiomas are discussed.

Bone Neoplasms↗

The angiographically occult cerebrovascular malformation. Report of three cases.

Three cases presenting with hemiparesis, headache, or seizures gave no history suggestive of subarachnoid or intracerebral hemorrhage. Carotid arteriograms were performed, and in each case failed to demonstrate a vascular malformation. In all three cases cerebral lesions were shown by either computerized tomographic (CT) scan, radionuclide scan, or both. Surgical exploration and biopsy revealed a vascular malformation in each case. The CT scans in two of the cases showed dense lesions that could suggest vascular malformation as a diagnostic possibility.

Adult↗

Physician fee patterns under medicare: a descriptive analysis.

To describe physician fee patterns under a national program, we analyzed physician reimbursement rates for 39 medical procedures for 292 local Medicare reimbursement areas. The results indicate that the maximum prevailing charge for each procedure generally ranged from three to 10 times the minimum charge. Prevailing charges, however, clustered around the mean (coefficient of variation less than 0.50) in 37 of the 39 fee distributions for general practitioners and specialists. Although differences (P less than 0.05) existed between mean general practitioner and specialist charges for 27 of the 39 procedures, these differences were generally less than 10%.

Clinical Laboratory Techniques↗