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Biomedical subjects

K N Johnson

Publications and source records attributed to K N Johnson.

4 recordsLinked to original sources

Proton irradiation of malignant melanoma of the ciliary body.

This is our first case of malignant melanoma of the ciliary body treated with proton beam irradiation, a technique that we developed for irradiating choroidal melanomas. After 21 months of follow-up no growth of the tumour has been observed, and shrinkage of the tumour was noted on the follow-up photographs and by ultrasonography. The 32P uptake test, which was positive before treatment, turned negative 14 months after irradiation. The described technique of proton beam irradiation might offer an alternative for the treatment of ciliary body melanomas when the present techniques of iridocyclectomy cannot be applied because of the size of the lesion.

Ciliary Body

Proton irradiation of choroidal melanomas. Preliminary results.

Choroidal malignant melanomas in nine patients were treated with proton beam irradiation at the Harvard Cyclotron Laboratory, Cambridge, Mass. Each patient received five proton beam treatments in eight to ten days, totalling 4,730 to 8,570 rads at the tumor. No complications occurred during the treatment or follow-up period, which, at the time of this writing, ranges from one to 24 months, with an average of 12 months. No further growth of the tumor has been observed in any patient. Different signs of tumor regression have been noted. Resolution of the serous retinal detachments that accompanied some tumors is the earliest finding. Pigment changes over the surface of the tumor and adjacent pigment epithelium is a usual initial tumor response. Fluorescein angiography initially showed decreased leakage of dye; later, destruction of the tumor's vasculature and elimination of fluorescein leakage became evident. Only large choroidal vessels remained patient. Ultrasonography revealed decreased height of the tumors postirradiation, and the radioactive phosphorus (32P) uptake test, repeated in one patient, turned negative on postirradiation measurements.

Aged

28. The nursing home project of the Iowa Health Services Data System.

The long-term care project of the Iowa Hospital Association has demonstrated the feasibility and utility of a multipurpose data system for nursing homes and related institutions. Important features of the Iowa system are emphasis on the needs and constraints of those providing care and collecting the data; prior establishment of specific criteria for the content of the system; the use of three related forms (admission, evaluation, and discharge) to produce current reports; and ease, flexibility, and transferability. A significant byproduct of the demonstration project was improved record keeping and patient care planning by the 14 participating facilities. Major problems encountered were lack of experience on the part of nursing homes and external regulatory agencies in defining their data needs and using data effectively, and financial support. Contribution to cost by external agencies in return for data and a major commitment to educational programs, both initial and continuing, are seen as essential to the success of long-term care data systems.

Health Occupations