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Biomedical subjects

J Casper

Publications and source records attributed to J Casper.

At least 109 records · Page 6Linked to original sources
PubMed1984

Motor disorders of voice and speech in Reye's syndrome survivors.

Disorders of voice and speech were studied in 43 survivors of Reye's syndrome (RS). During hospital convalescence 26 (60%) of 43 were aphonic, hoarse, or had other alterations of speech production. These disorders occurred in those patients with the worst severity of RS. Four patients (9% of survivors) had a persistent motor voice or speech disorder at follow-up examination 1 1/2 to five years after recovery. All of the patients have breathy, low-intensity voice quality, whereas three of the four exhibit rapid and slurred speech. These four children have no difficulty with the symbolic aspects of language and their motor voice and speech impairment cannot be ascribed to global intellectual deficit. Although other neurologic deficits are present in three of these four children, the disorders of voice and speech are the major permanent disabling handicap in our RS survivors.

Adolescent↗
PubMed1982

Bone marrow and extramedullary variations of cell membrane antigen expression in childhood lymphoid neoplasias at relapse.

To increase our knowledge of the pathogenesis of tumour recurrence, cell membrane phenotypes were determined on bone marrow and extramedullary tumour cells at diagnosis and at relapse in 24 children with lymphoid malignancies. There were 19 patients with acute lymphoblastic leukemia and five with non-Hodgkin's lymphoma. Membrane characteristics used for classification were E-rosetting, T antigen, surface immunoglobulin (sIg) and Ia antigen. Twelve patients were phenotyped as non-T, non-B, five as T-like and seven as B-like leukemia/lymphoma. Eighty-eight tissue samples were assayed for cell surface markers at the time of relapse(s). Lymphoblasts from 18 children (75%) demonstrated no variation in membrane marker expression. Six patients (25%) showed alteration of antigen expression on lymphoblasts obtained during relapses. This was manifested by loss of Ia antigen in two patients, loss of E-rosetting in one patient and loss of sIgD in one patient. Lymphoblasts from two patients, initially non-reactive with the four membrane markers utilized, expressed Ia antigen on subsequent relapses. Despite these variations no patient was categorized differently (i.e. T-like becoming non-T, non-B). Simultaneous lymphoblast phenotype determination from multiple body sites in 13 children showed no variation in marker analysis. A lymphoblast's phenotype remains stable throughout repeated relapses and is not influenced by relapse site in most children with lymphoid neoplasias. This information may be helpful in designing protocols where cytotoxic monoclonal antibodies are used as a treatment modality in patients with recurrent disease.

Antigens, Surface↗
PubMed1981

Clinical evaluation of sequentially scheduled cisplatin and VM26 in neuroblastoma: response and toxicity.

Cis-dichlorodiammineplatinum (CDDP) and VM26, both of which have been proven efficient in treating neuroblastoma, were combined in a sequential schedule and administered to 22 children with disseminated neuroblastomas resistant to treatment with cyclophosphamide and doxorubicin (Adriamycin). During this same study, 14 children were prospectively evaluated for the effect of CDDP on magnesium metabolism and the effect of the induced hypomagnesemia on parathyroid function. Complete or partial tumor responses were achieved in six and nine cases. Respectively and were of prolonged duration (longer than six months) in eight of the 15 responding. It was also shown that CDDP-induced hypomagnesemia is the result of excessive renal loss and is severe enough to interfere with the normal parathormone response to hypocalcemia.

Bone Marrow↗
PubMed1981

Association between human tumor colony-forming assay results and response of an individual patient's tumor to chemotherapy.

An in vitro tumor colony-forming assay was utilized to measure the sensitivity of 800 individual patients' tumors to a variety of antineoplastic agents. Thirty-six separate histologic types of cancer were represented. Only 199 of the 800 patients' tumors (25 percent) both formed colonies in vitro and had enough cells in the biopsy or fluid specimen to perform drug sensitivity assays. In 123 instances the drug tested in vitro against the tumor was also used clinically to treat the patient. The clinician caring for the patient did not know the results of the in vitro test. When analyzed in a retrospective manner, the probability of a positive prediction from the assay, given the patient responded clinically, was 0.88. The probability for a negative prediction of the assay given the patient did not respond, was 0.94. Associations of in vitro and in vivo results in the 123 correlations were highly significant (p less than 0.001). We conclude that, as now constituted, the human tumor colony-forming assay can provide useful sensitivity information for only about 25 percent of the general oncology patients. Secondly, a prospective clinical trial of the assay is needed to insure that the assay is indeed predictive of which drug will produce a patient response and that it is not merely an indicator that a particular patient's tumor is highly responsive in vivo.

Antineoplastic Agents↗
PubMed1980

Extraosseous uptake of 99mtechnetium methylene diphosphonate: neuroblastoma or radiation therapy.

A child with a ganglioneuroblastoma and tumor uptake of 99mtechnetium methylene diphosphonate (99mTc-MDP) is presented. After surgical removal of an encapsulated tumor and radiation therapy, an interval bone scan demonstrated the same presurgical abnormality. Awareness of abnormal uptake of 99mTc-MDP in irradiated renal tissue prevents interpreting radiation nephritis as recurrent tumor.

Bone Neoplasms↗
PubMed1980

Failure of daily lumbar punctures to prevent the development of hydrocephalus following intraventricular hemorrhage.

A prospective study of 48 infants with periventricular-intraventricular hemorrhage was carried out to evaluate the role of daily lumbar punctures, instituted from the time of diagnosis of the hemorrhage, in prevention of posthemorrhagic hydrocephalus and improvement in immediate outcome. The data lead to the following conclusions: (1) minor hemorrhage (Grade I) is associated with minimal risk of death or hydrocephalus; (2) moderate hemorrhage (Grade II) is associated with low risk of death and intermediate risk of hydrocephalus, and serial lumbar punctures do not reduce these risks; and (3) severe hemorrhage (Grade III) is associated with high risks of death or hydrocephalus or both, and serial lumbar punctures also do not reduce these risks.

Brain↗
PubMed1980

Direct cloning of human neuroblastoma cells in soft agar culture.

An in vitro soft agar technique was used in an attempt to culture neuroblastoma cells from 71 bone marrow, 3 lymph node, and 2 solid tumor specimens from 18 patients with neuroblastoma. One-half of each specimen was sent for routine pathology studies and one-half was cultured in the soft agar system. Colonies appeared within 10 days in histologically positive bone marrows. Light microscopy, electron microscopy, catecholamine secretion, and karyology provided evidence that the colonies were composed of neuroblastoma cells. There were 38 instances in which histological study of the specimen demonstrated neuroblastoma cells. The soft agar system showed colony growth in 30 of these samples (79%). There were a total of 38 specimens that were histologically negative for neuroblastoma. Thirty of these 38 specimens showed no growth in the stem cell assay. Eight histologically negative specimens from 6 patients formed colonies in the soft agar system. Five of these 6 patients showed tumor histologically on prior or subsequent marrow examinations. In addition to a significant correlation between histological and soft agar culture results (p < 0.001), there exists a highly significant positive correlation between the number of colonies per plate and the histological status of the specimen (p < 0.005). Serial marrow samples were cultured on 7 patients. There appears to be an association between the number of colonies that develop in the plate and the clinical course and prognosis of the patient. Decreasing plating efficiencies (number of colonies per number of cells plated) correlated with tumor response. Increasing plating efficiencies indicated tumor relapse. A plating efficiency of greater than or equal to 0.1% portended a particularly poor prognosis. Neuroblastoma grows well in this soft agar culture system. This excellent growth provides a good model for both clinical and basic science studies of neuroblastoma.

Abdominal Neoplasms↗
PubMed1979

Toward the total rehabilitation of the alaryngeal patient.

Rehabilitative efforts directed toward the total laryngectomee are receiving increasing interest. Fifteen to 50% of laryngectomees fail to develop speech, and 50% do not return to full employment. Many make poor psychological adjustment. A study was designed wherein laryngectomees and their families were individually interviewed. These people suggested that their rehabilitation could have been facilitated had they been better informed preoperatively. Many expressed a desire for exposure to a speech pathologist and a successfully rehabilitated laryngectomee preoperatively. A total of 1,276 otolaryngologists were surveyed regarding the substance and amount of information they believed patients should receive prior to laryngectomy. Otolaryngologists, in the main, feel that they do fully and adequately inform their patients. Speech pathologists and rehabilitated laryngectomy patients are often called to see patients preoperatively. Nevertheless, we deduce that improvements need to be made to insure that the preoperative patient patient does in fact receive the information and counselling intended.

Counseling↗
PubMed1975

Fiber-optic video study of the post-laryngectomized voice.

Simultaneous video-fluoroscopy and fiber-optic video laryngoscopy was carried out on a series of eight laryngectomees. Previous concepts supported by an earlier report1 indicated that the folds of the rebuilt cricopharyngeal sphincter were seen to represent the primary source of sound vibration for voice production. Fold vibration was envisioned as an essential for sound production. Present findings present a challenge to the older concept. The fluoroscopic studies showed a considerable variation in the vertical thickness of the sphincteric area--from several millimeters to as many as 10 centimeters. Mucus bubbles in rapid motion were easily visible immediately above the narrowest portion of the reconstructed cervical esophagus. Ingestion of barium only enhanced the visualization of this bubbling. Vibration of a long vertical area of the thin anterior and thicker posterior esophageal walls well above and well below this point was regularly noted. Fiber-optic visualization failed to show actual fold vibration at any time. Momentary opening of the food tract during air injection or intake, immediately prior to the onset of phonation, was seen on many occasions. During phonation, routinely, the anticipated pseudoglottic opening was obscured by bubbles of mucus or barium. These findings suggest that the air, when accumulated below the narrowest spot in the hypopharyngeal-esophageal tract and when forced upward through a narrow opening, sets the accumulated mucus, not the mucous membrane, into vibration; further, that this vibration is of sufficient amplitude to transmit itself to both the anterior wall and the posterior wall of an extensive vertical portion of the neck.

Adult↗