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Biomedical subjects

J K Weick

Publications and source records attributed to J K Weick.

66 records · Page 4Linked to original sources
PubMed1978

Ovarian suppression and breast cancer.

Castration by radiation or oophorectomy may cause regression of tumor metastasis. Patients who will benefit are those whose estrophile protein concentration in breast tissue is high. The use of castration as an early adjunctive method (prophylactic castration) delays the onset of recurrence, although it may take 10 to 15 years to verify these observations. Difficulty in analyzing these data is due to the smallness of the sample, and the frequent use of hormones in control patients. Effective castration may be observed with radiation or surgery. The choice is dependent on the patient's wishes and the need for an immediate effect. Combination therapy with steroids, chemotherapy, or adrenalectomy may potentiate the effect of castration. Premenopausal castration may markedly decrease the incidence of new breast cancers, particularly when followed for 20 or more years.

Antineoplastic Agents↗
PubMedDate not supplied

The anemia of chronic renal failure. Overview and early erythropoietin experience.

One of the most important deficiency states associated with chronic renal failure is profound anemia. While it has been possible to identify differing types of anemia in patients receiving dialysis support, and thus correct the secondary causes, most patients continue to exhibit symptoms and signs of the anemic state. This review of the anemias associated with renal failure explores the diagnostic and therapeutic possibilities that may help the physician in evaluating the anemic patient with chronic renal failure. Also described is the early clinical experience with a new genetically engineered hormone, recombinant human erythropoietin (r-HuEPo), which has been under investigation for nearly two years at The Cleveland Clinic Foundation as part of a multi-center trial. An orderly approach to the anemic patient with renal dysfunction is suggested, and conjectures about the impact of newer therapies are made.

Anemia↗
PubMedDate not supplied

The development of a palliative care program.

Palliative care, which neither hastens death nor prolongs life, provides comfort through the final stages of life. The focus is on comfort for the patient and quality of life for both patient and family. A three-month pilot project used the team approach, involving a physician, nurse, and social worker, to assess how the palliative care needs of the terminal cancer patient were being met at the Cleveland Clinic. Data are presented to demonstrate that such needs exist and are not currently being met by existing services, as perceived by the patient population surveyed. During the pilot project, the palliative care team was in compliance with the Joint Commission on Accreditation of Hospitals hospice standards.

Adult↗
PubMedDate not supplied

Familial polycythemia vera.

The occurrence of polycythemia vera in a father, mother, and two sons is reported. Thirteen kindreds with familial polycythemia vera in 31 members are reviewed. Comprehensive records were available for all four patients as well as other family members, since all were diagnosed and treated at the author's institution over a period of nearly 50 years. The mean age at diagnosis, sex predominance, symptoms, and incidence of chromosomal abnormalities, leukocytosis, thrombocytosis, and elevated leukocyte alkaline phosphatase levels were similar to those of nonfamilial cases. The mean RBC volume at diagnosis and the incidence of splenomegaly appear to be higher in familial than nonfamilial cases. The mode of inheritance is unclear, but genetic factors may be involved in the pathogenesis of this myeloproliferative disorder.

Aged↗
PubMedDate not supplied

Phase II evaluation of teniposide and ifosfamide in refractory adult acute lymphocytic leukemia: a Southwest Oncology Group Study.

The Southwest Oncology Group undertook a phase II study of teniposide (VM-26) and ifosfamide in refractory adult acute lymphocytic leukemia. The 49 evaluable patients were heavily pretreated; 15 of these had received only one prior induction attempt. Two treatment regimens were used. Eighteen patients received VM-26 (30 mg/m2) on Days 1-5 and ifosfamide (1000 mg/m2) by continuous iv infusion on Days 1-5. When acceptable toxicity was observed, the dose of VM-26 was increased and 30 patients received VM-26 (50 mg/m2) on Days 1-5 in addition to ifosfamide. Complete remission (CR) was observed in two patients who received the lower-dose VM-26 regimen and in six patients who received the higher-dose regimen. Of the eight patients who achieved CR, six were found among the 15 patients who had received only one prior induction therapy. Hematologic toxicity was the major toxic effect observed, with 41 patients (84%) having wbc counts less than 1000/microliter during induction therapy. Nonhematologic toxicity was dose-limiting in seven patients for the following reasons: hematuria (four patients), neurological disturbance (one), and mucositis (two). The combination of VM-26 and ifosfamide is capable of producing CR in refractory acute lymphocytic leukemia in adults with manageable toxicity. Inclusion of the combination in a multidrug consolidation regimen for newly diagnosed patients is an appropriate avenue for further study.

Adolescent↗
PubMedDate not supplied

Treatment of recurrent lymphomas with vincristine, BCNU, doxorubicin, and prednisone (VBAP): a Southwest Oncology Group Study.

Chemotherapy with vincristine, BCNU, doxorubicin, and prednisone (VBAP) was administered to 75 patients with malignant lymphoma, including both Hodgkin's disease and non-Hodgkin's lymphoma. All patients had prior chemotherapy with or without radiation therapy. Remissions were achieved in 41% of all patients, with only minor toxicity. The median duration of remission for Hodgkin's disease and non-Hodgkin's lymphoma was 51 and 22 weeks, respectively. The median survival for all patients was 34 weeks. The VBAP program is effective palliative chemotherapy for advanced malignant lymphoma.

Adult↗
PubMedDate not supplied

Vindesine, carmustine, doxorubicin, and prednisone (EBAP) in recurrent lymphomas: a Southwest Oncology Group study.

Seventy-eight patients with Hodgkin's disease and non-Hodgkin's lymphoma who had failed prior chemotherapy or radiation therapy were treated with a combination of vindesine, carmustine, doxorubicin, and prednisone (EBAP). Outpatient therapy was administered at 21-day intervals. Complete and partial responses were seen in 32 patients (41%). The response rate was higher for Hodgkin's disease (59%) than for non-Hodgkin's lymphoma (31%). The median duration of response was 31 weeks in both groups, with a median survival of all patients of 35 weeks (responders, 122 weeks; nonresponders, 16 weeks). Myelotoxicity was greater using EBAP than in the earlier reported program with vincristine, carmustine, doxorubicin, and prednisone, and in the absence of higher response rates does not support the use of vindesine over vincristine in combination programs using nitrosoureas, anthracyclines, and prednisone.

Adolescent↗
PubMedDate not supplied

Simultaneous treatment with cisplatin and radiation therapy for advanced solid tumors: a pilot study.

To study the toxicity and efficacy of simultaneous cisplatin chemotherapy and radiation therapy, 13 patients with metastatic solid tumors were treated with cisplatin on a weekly, outpatient basis during palliative radiation therapy. The dose of cisplatin ranged from 20 to 50 mg/m2 weekly, with most patients receiving 40 mg/m2. Radiation therapy was administered in a variety of dose-fraction schedules. Toxic effects were moderate and consisted of emesis (12 patients), transient elevation off BUN (three patients), myelosuppression (three patients), and radiation reactions (two patients). Twelve of 13 irradiated lesions (91%) responded with at least a 50% reduction in biperpendicular diameter. Four of the six patients with metastatic melanoma had complete regression of treated lesions; another melanoma patient had a partial response. Responses were also seen in patients with mesothelioma, bladder cancer, squamous cell carcinoma of the head and neck, and oat cell lung cancer. Only one responding patient has had disease progression in the treated field after 2+ to 7+ months of followup; two other patients have died of disseminated disease. Weekly cisplatin administration during radiotherapy deserves further evaluation, especially in the primary management of unresectable tumors that are responsive to cisplatin alone.

Cisplatin↗