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Biomedical subjects

J E Harvey

Publications and source records attributed to J E Harvey.

At least 19 recordsLinked to original sources
PubMed1992

The effects of carbamazepine on stuttering.

No pharmacological treatment protocol has proven generally useful for all patients who stutter. Various medications, behavior therapy, relaxation, suggestion, and social-based therapies have been used. For this drug treatment study, two groups of adult stutterers were followed in an 8-week open label protocol. All subjects had in the past received speech therapy; none had been treated previously with medication for stuttering. The first group (N = 12) received a maximum dose of 800 mg of carbamazepine; the second group (N = 8) received a maximum dose of 400 mg of carbamazepine. Each patient served as his or her own control. A series of systematic speech tests was given weekly to determine the variability of fluency for each subject. A statistically significant change occurred for a number of "expectancy to stutter" characteristics. Subjects felt that they stuttered less often while taking carbamazepine. Subjective effects began before medication and continued after patients discontinued the medication. Struggle characteristics also subjectively decreased. However, no objective improvement was found. No change was found in percentage of words stuttered, reading improvement, or improvement in spontaneous speech rate. Interrater reliability showed a correlation of .996. Three carbamazepine serum level therapeutic windows were inspected with negative results. Interestingly, naive listener ratings did show a statistically significant improvement on carbamazepine versus placebo. Future anecdotal reports of pharmacological improvement of stuttering should be subjected to rigorous objective testing before general acceptance.

Adult↗
PubMed1991

Surgical pathology of cancer of the oral cavity and oropharynx.

A study was designed to determine the influence of certain surgical pathologic findings on tumor spread and survival in patients with cancer of the oral cavity and oropharynx. All patients with the histopathological diagnosis of carcinoma of the oral cavity or oropharynx from 1955 to 1983 were included in the study. Using the Head and Neck Tumor Registry of the department of otolaryngology of the Washington University School of Medicine, information was obtained regarding preoperative evaluation, staging, classification, diagnosis, treatment, surgical pathology parameters, and outcome results. The patient populations consisted of 545 patients with oral cavity cancer and 224 patients with oropharynx cancer, all of whom were eligible for 3-year follow-up. Information from a retrospective analysis of the pretreatment examination records regarding site and size of the primary tumor and neck dissection, and specific treatment, and from surgical pathology reports regarding site, size, tumor spread and resection margins, was correlated with treatment outcome. The database file was analyzed using dbase III and its companion program Framework, and SAS PC (Statistical Analysis Systems for personal computers).

Cause of Death↗
PubMed1990

The pharmacokinetics and sputum penetration of ampicillin and amoxycillin following simultaneous i.v. administration.

Five patients with exacerbation of chronic bronchitis received as a single iv injection 500 mg of ampicillin and 500 mg of amoxycillin. Blood and sputum samples were collected at timed intervals following dosing and the concentrations of the two antibiotics present in the samples were determined by HPLC analysis. No statistically significant differences were observed between the serum concentrations of ampicillin and amoxycillin, and the pharmacokinetics of the two drugs were almost identical, with half lives of 93 min (amoxycillin) and 103 min (ampicillin). Sputum amoxycillin concentrations were significantly higher (Student's paired t-test; P less than 0.001) than those of ampicillin, with mean levels two hours after dosing of 2.9 mg/l (range 1.9-4.0) for amoxycillin and 1.4 mg/l (range 0.8-2.4) for ampicillin.

Amoxicillin↗
PubMed1990

Clinical classification and staging for primary malignancies of the maxillary antrum.

A study of 51 patients with primary malignant maxillary sinus neoplasms was conducted. None of the patients had neck nodes and/or metastases, and each had 5-year follow-up. The tumors were staged according to the 1983 and 1988 American Joint Committee on Cancer staging systems for maxillary sinus cancers. There were 13 early stage (T1, T2) and 38 advanced (T3, T4) tumors in both systems. Cox regression analyses of survival curves showed increasingly worse prognoses for advanced tumors in both T-staging systems. Further analyses showed a significant difference in survival between T3 and T4 in the 1988, but not in the 1983 system. There were no significant differences in survival according to treatment modality or histological type of malignancy. We conclude that the 1988 system prognosticates successfully for T-stage (1 to 4) and demonstrates significant improvement in detecting T3 versus T4 differences compared to the 1983 system. The 1988 system applies equally for epidermoid cancer and other malignancies of the antrum.

Adult↗
PubMed1990

Distribution of LCA protein subspecies and the cellular adhesion molecules LFA-1, ICAM-1 and p150,95 within human foetal thymus.

The distribution of leucocyte common antigen (LCA) protein subspecies and the cellular adhesion molecules LFA-1 (CD11a), ICAM-1 (CD54) and p150,95 (CD11c) has been established within frozen sections of human foetal thymus. Whereas over 95% of foetal cortical thymocytes and approximately 85% of medullary thymocytes were CD45RO positive, CD45RA was only expressed by approximately 29% of medullary thymocytes. The majority of foetal thymocytes also expressed CD11a, whereas CD54 was expressed by thymic epithelial and accessory cells and also apparently by some cortical thymocytes adjacent to epithelial cells. The distribution of CD54 and the major histocompatibility complex (MHC) class II molecule HLA-DR, demonstrated with a monoclonal antibody to a monomorphic determinant, was similar. The CD11c molecule was present on a population of dendritic-type accessory cells, but was absent from the large, scavenger, KiM8-positive macrophages occurring throughout the thymic cortex.

Antibodies, Monoclonal↗
PubMed1989

Natural history of treated T1N0 squamous carcinoma of the glottis.

The records of 373 patients with T1N0 squamous carcinoma of the glottis were examined. Of these, 271 underwent initial hemilaryngectomy; 102 had full-course irradiation for cure. While the overall survival rates of the two initial therapies were similar, failure of the initial treatment modality was approximately twice as frequent in the irradiated patients (34.4%) as in the patients undergoing hemilaryngectomy (16.9%). The effect of this difference in initial failure rate on quality of life and on cost of overall therapy will be discussed.

Carcinoma, Squamous Cell↗
PubMed1985

A trial of tiaramide in asthma.

Tiaramide hydrochloride is a new non-steroidal anti-inflammatory agent previously shown to inhibit allergic responses both in vitro and in vivo. Clinical studies in asthmatic adults and children have also shown benefit. We report a double blind cross-over study in 35 adult asthmatic patients comparing oral tiaramide 200 mg four times daily with oral salbutamol 4 mg four times daily and placebo. Symptoms and bronchodilator inhaler usage were recorded in diary cards and morning and evening peak expiratory flow rates were also monitored. Both tiaramide and salbutamol had a significant therapeutic effect compared with placebo. More patients preferred tiaramide than salbutamol and there were fewer side effects during treatment with tiaramide. Tiaramide may be a useful oral therapy in asthma particularly for those patients intolerant of oral beta-adrenergic agonists.

Administration, Oral↗
PubMed1983

A new nasal oxygen mask.

Recent interest in the benefits of long-term oxygen therapy for patients with chronic airflow obstruction and hypoxaemia should lead to an increased use of nasal prongs for prolonged (15 hours/day) oxygen administration. Because some patients find nasal prongs uncomfortable and since they may slip out of position during use, we have devised a new nasal oxygen mask and compared both its performance and comfort with conventional nasal prongs. Changes in end-tidal oxygen concentration were measured after administering oxygen at 2 litres/min through each device for 10 minutes in 15 normal subjects and for 1 hour in patients with chronic airflow obstruction and hypoxaemia. Although the prongs produced larger increases in end-tidal oxygen concentration in normal subjects, there were no significant differences between the two devices in the patients. There was also no difference in the improvement in arteriolized capillary oxygen tensions (mask 3.5 kPa; prongs 4.0 kPa). In a separate study of prolonged (22 hours) use there was no difference in reported comfort. The new mask is a useful alternative to conventional nasal prongs.

Aged↗
PubMed1982

Airway response to salbutamol: effect of regular salbutamol inhalations in normal, atopic, and asthmatic subjects.

This study was designed to determine whether resistance to the airway effects of the beta-agonist, salbutamol, would develop in three groups of subjects while taking large doses of inhaled salbutamol. Six normal non-atopic, six atopic non-asthmatic, and eight atopic asthmatic subjects were studied by an identical technique. The development of resistance was assessed from salbutamol dose-response studies in which the airway response was measured as specific airway conductance (sGaw). Further evidence was sought in the atopic and asthmatic subjects by measuring the airway response to a standard histamine inhalation challenge and the protective effect of 100 micrograms salbutamol on this challenge, and by six-hourly peak flow recordings. Subjects were assessed before and during four weeks in which they took inhaled salbutamol regularly in doses increasing to 500 microgram quid in week 4. Normal subjects showed a progressive reduction in the bronchodilator (sGaw) response to salbutamol during the four weeks, indicating the progressive development of resistance. The atopic subjects, both asthmatic and non-asthmatic, showed no reduction in the response to salbutamol during the four weeks, nor any change in the response to histamine challenge or in regular peak flow readings. These results demonstrate that asthmatic patients do not develop bronchial beta-adrenoceptor resistance easily and suggests that they and atopic non-asthmatic subjects are less susceptible to its development than normal subjects.

Adolescent↗
PubMed1981

Airway and metabolic responsiveness to intravenous salbutamol in asthma: effect of regular inhaled salbutamol.

1. Airway, metabolic and cyclic nucleotide responses to intravenous salbutamol were measured in five patients with mild asthma who had taken no medication in the week before the study. The studies were repeated after the patient had taken regular inhaled salbutamol for 4 weeks, in doses increasing to 2000 micrograms daily in week 4. 2. The pretreatment airway, metabolic and cyclic nucleotide responses to salbutamol were similar to those previously reported in normal subjects. These patients therefore did not show evidence of partial beta-adrenoceptor blockade. 3. After 4 weeks' salbutamol therapy the airway response to intravenous salbutamol was unchanged. 4. The glucose, pyruvate and adenosine 3':5'-cyclic monophosphate (cyclic AMP) responses to intravenous salbutamol were depressed after regular salbutamol administration. The dose-response curve for non-esterified fatty acids and insulin, though displaced downwards, did not indicate an impaired response to salbutamol since the shape was unchanged. There was no significant change in the lactate, glycerol and total ketone response. 5. This study confirms that tissues differ in the ease with which they develop resistance to beta-adrenoceptor agonists. Asthmatic airways appear to be relatively protected from developing assistance when compared with other tissues in asthmatic patients and when compared with the airways of normal subjects.

Adult↗