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Biomedical subjects

M S McPhee

Publications and source records attributed to M S McPhee.

At least 37 records · Page 2Linked to original sources
PubMed1989

Primary bladder carcinoma presenting during pregnancy in 3 cases.

We report 3 cases of primary transitional cell carcinoma of the bladder presenting during pregnancy. Only 10 such cases have been reported in the literature. Patient age ranged from 23 to 24 years at 15 to 24 weeks of gestation. Only 1 of the 3 patients presented with gross hematuria and this was initially mistaken as vaginal bleeding. Initial diagnosis in all cases was made with sonography. Diagnosis then was easily confirmed by cystoscopy and treatment was uneventful. Transurethral resection did not present a problem. All patients had single papillary superficial tumors (stage Ta, grades 1 and 2). Pregnancy was not affected in any case. Diagnosis and prompt treatment are emphasized.

Adult↗
PubMed1988

5-Aminosalicylic acid enemas: effective agent in maintaining remission in left-sided ulcerative colitis.

The efficacy of 5-aminosalicylic acid enemas in maintaining remission in left-sided ulcerative colitis was studied. Twenty-five patients in remission for at least 2 mo were randomized to receive either 1-g 5-aminosalicylic acid or placebo enemas daily and were followed up for 1 yr. Eleven of 13 patients randomized to placebo relapsed after a mean of 16 wk. Nine of 12 patients randomized to 5-aminosalicylic acid remained in remission for 1 yr, 2 others in remission withdrew by request, and 1 relapsed at 10 wk. The difference between relapse rate on 1-g 5-aminosalicylic acid versus placebo was significant (p less than 0.005). Seven patients entered the blinded trial a second time. Three of 4 patients randomized to 5-aminosalicylic acid remained in remission and 1 relapsed. Three randomized to placebo relapsed at a mean of 14 wk. One-gram 5-aminosalicylic acid enemas are safe and effective in maintaining remission in patients with left-sided ulcerative colitis.

Aminosalicylic Acids↗
PubMed1988

Neodymium:YAG laser therapy for infiltrating bladder cancer.

There were 32 high risk patients with stages T2 to T4 bladder cancer treated with neodymium:YAG laser irradiation to the tumor base after cautery resection between July 1981 and October 1986. All 12 patients with stage T2 disease followed for 6 to 78 months had no recurrence locally although 4 had stage T1 recurrences elsewhere in the bladder. Of 14 stage T3 cancer patients 8 demonstrated tumor persistence locally but 3 were well 4 to 24 months later without local recurrence (all stage T3a) and 3 were alive 14 to 24 months later with stage T1 recurrences. Of 6 stage T4 cancer patients 4 obtained reasonable hemorrhagic control with laser irradiation used for palliation purposes. A 90-year-old man with stage T3b disease died 5 days postoperatively of a myocardial infarct but no bladder or bowel perforation was documented. We believe that neodymium:YAG laser irradiation is a safe alternative for the treatment of bladder cancer in selected patients.

Carcinoma, Transitional Cell↗
PubMed1988

Five year follow-up of patients with cancer of the bladder--the Northern Alberta experience.

A prospective study of 549 cases of bladder cancer diagnosed in Northern Alberta from 1977 to 1980 shows that after 5 years, 51 patients (9.3%) were lost to follow-up, 318 (57.9%) were alive, and 180 (32.8%) were deceased, of which 98 had died of bladder cancer and 82 of other causes. Of the patients followed for 5 years, 386 had superficial disease at diagnosis. When comparing their survival rates to the expected rates for age/sex matched population, their relative survival rate at 5 years is 84.8% for females and 74.2% for males. For the 112 patients presenting with advanced disease the relative survival rate at 5 years was 32.2% for females and 19.3% for males. Five year recurrence-free interval in patients with superficial lesions was 57.3% when the original lesion was unifocal and 33.5% for patients with multifocal lesions. Survival was affected by stage, age, and sex in patients presenting with invasive disease and also by tumor type and recurrence rate in patients with superficial disease.

Adult↗
PubMed1987

Proctocolitis unresponsive to conventional therapy. Response to 5-aminosalicylic acid enemas.

We report results of a prospective study of daily 5-ASA enema therapy in patients with proctocolitis that was unresponsive to conventional therapy. Forty-seven patients with active colonic inflammation distal to the splenic flexure have been followed for three months to three years. Rapid improvement was noted within three months in 41 of 47 (87%) patients, while six failed therapy. Of the 41 patients responding to therapy, 39 achieved complete remission. Nineteen patients have relapsed at least once following discontinuation of 5-ASA, but 23 of 25 (92%) relapse episodes responded to a course of 5-ASA therapy. Complications of 5-ASA therapy were limited to hemorrhoidal irritation and local perianal injury. We conclude that 5-ASA enema is effective in inducing remission in patients with proctocolitis unresponsive to conventional therapy.

Adult↗
PubMed1986

Primary adenocarcinoma of the bile ducts. Clinical characteristics and natural history.

Primary bile duct carcinoma is a malignancy with a poor prognosis, but recent diagnostic developments allow earlier detection and possibly improved chances for effective palliation or surgical cure. In order to increase the clinical understanding and awareness of this disorder, 43 patients with primary adenocarcinoma of the bile ducts were reviewed. The mean patient age was 63, and symptoms of nausea, abdominal pain, and pruritus were reported in a majority of patients. Documented weight loss, alcoholic stools, cutaneous icterus, and hepatomegaly were each present in a majority of patients. Serum bilirubin and alkaline phosphatase determinations were abnormal in 40 of 43 patients (93%), and cholangiography was the diagnostic study providing the most discriminating information. Locally invasive disease and biliary obstruction was the major cause of morbidity and mortality, and there was only one surgical cure. These data suggest that cholangiography and nonsurgical techniques for biliary drainage should be employed in most patients who are not optimal surgical candidates.

Adenocarcinoma↗
PubMed1986

Factors affecting recurrence rates in superficial bladder cancer.

A prospective study of all patients with superficial bladder cancer diagnosed in Northern Alberta (population 1.2 million) from 1977 to 1983 was performed to establish patterns of recurrence. Of the 761 patients with all stages of bladder cancer at diagnosis, 642 were deemed to be free of disease after primary treatment consisting of transurethral resection, fulguration, or laser surgery. Follow-up of these patients showed that approximately two-thirds of first recurrences occur within 18 months of diagnosis and that more of these patients have died of unrelated causes (n = 73) than of bladder cancer (n = 34). Censored disease-free interval comparisons showed that initial recurrences occurred sooner in patients with multifocal rather than unifocal disease and also sooner in females than in males. Known risk factors (occupational exposure to chemicals and cigarette smoking) and suspected risk factors (coffee consumption and artificial sweetener use) had no effect on disease-free interval and are not related to tumor multiplicity.

Adolescent↗
PubMed1986

Treatment of Dunning R3327-AT rat prostate tumors with photodynamic therapy in combination with misonidazole.

Fischer X Copenhagen rats bearing Dunning R3327-AT tumors were treated with hematoporphyrin derivative and red light (630 nm from an argon-driven dye laser) alone or in combination with the hypoxic cell radiosensitizer, misonidazole (MISO). In vitro studies had suggested that hypoxia might significantly decrease the cytotoxicity of photodynamic therapy (PDT) and labeling with [14C]MISO had revealed a significant fraction of viable hypoxic cells in this tumor. PDT alone resulted in a growth delay of 8.8 days but no tumor cures were observed. The administration of MISO (i.p. at 0.5 mg/g) 33 min prior to PDT resulted in an average growth delay of 15.2 days and tumor cures (local control at 33 days) in 20% of animals treated. If MISO at a similar dosage was administered 30 min after PDT an average growth delay of 16.3 days was measured and tumor cure was observed in 70% of the animals treated. These results suggest that the hypoxic cell fraction in R3327-AT tumors might be a limitation to their curability by PDT. The addition of MISO and/or other hypoxic cell cytotoxic agents to PDT procedures may provide an effective means of treating PDT-resistant hypoxic cells in solid tumors.

Animals↗
PubMed1986

Lasers in the treatment of cancer of the prostate. An overview.

The results of therapy of prostate cancer with laser therapy either in the experimental animal model or in human application are preliminary and rudimentary. Difficulty in access to the prostate, variability in depth of laser penetration and problems in assessment of therapeutic attempts makes it impossible to be dogmatic about re the future application. The tumour does however respond to Nd: YAG and P. D. T. therapy and it is possible that the crude attempts to date will be supplanted in the future by more refinements that will enable laser energy to be harnessed.

Animals↗
PubMed1985

Hepatocellular carcinoma: an unusual course with hyperthyroidism and inappropriate thyroid-stimulating hormone production.

A 61-yr-old woman was found to have multicentric hepatocellular carcinoma associated with clinical hyperthyroidism. Marked elevations in serum thyroid-stimulating hormone, T4, T3, and free T4 were documented. These values increased with tumor progression. It is postulated that this patient's hepatoma produced a substance stimulating thyroid-stimulating hormone synthesis and secretion with resultant inappropriate thyroid-stimulating hormone production and thyrotoxicosis. This unusual association of hepatocellular carcinoma with clinical and biochemical evidence of hyperthyroidism and inappropriate thyroid-stimulating hormone production has not been previously reported.

Carcinoma, Hepatocellular↗
PubMed1985

The radiation sensitivities of R3327-H and R3327-AT rat prostate adenocarcinomas.

Dunning R3327-H and R3327-AT tumors growing subcutaneously in the flanks of Fischer X Copenhagen rats were irradiated with 137Cs gamma-rays at volumes of approximately 300 mm. The effects of various doses of radiation were estimated by measurements of subsequent tumor growth as well as by histological evaluation. The well-differentiated, hormonally-responsive R3327-H tumor was more radiosensitive than the anaplastic R3327-AT tumor. The reasons for this increased radiation sensitivity of the R3327-H tumor include a greater "apparent" radiation sensitivity of tumor cells and the absence of tumor hypoxia. The presence of hypoxic tumor stem cells was inferred from significant radiosensitization of tumor growth delay by 0.5 mg./gm. misonidazole and by a technique which utilizes radioactively-labelled misonidazole as a marker for hypoxic cells. The persistence of a mass of R3327-H tumor tissue after aggressive radiotherapy was not indicative of tumor cells. Furthermore, the rapid increase in volume of R3327-AT cells after aggressive radiotherapy was attributed to limited proliferation of tumor cells which were destined to ultimately die. Possible implications of these findings for the management of human prostatic adenocarcinoma are discussed.

Adenocarcinoma↗
PubMed1984

Interstitial applications of laser irradiation in hematoporphyrin derivative-photosensitized Dunning R3327 prostate cancers.

Two prostate tumour models (Dunning R3327H and AT) were tested in rats to see if they were sensitive to hematoporphyrin-photoradiation therapy (HPD-PRT). The R3327H tumours were irradiated by implantation of a single fiber optic and the R3327 AT tumours were treated with implantation of four fiber optics simultaneously. Thermal measurements made at the tip of the fiber and up to 1 cm from the tip indicated temperature rises from 1.5 degree C to 20 degrees C at the tip and 0 degree to 8 degrees C distal to the tip, with power densities ranging from 100 mW to 500 mW. The R3327H tumour was controlled up to 8 weeks post-HPD-PRT, when the initial tumour size was 400-500 mm3. The R3327 AT tumours also respond to the HPD-PRT but a significant laser-induced thermal rise in the tumour is suspected.

Animals↗
PubMed1984

Narcotic bowel syndrome treated with clonidine. Resolution of abdominal pain and intestinal pseudo-obstruction.

We describe the cases of five patients having a syndrome of chronic abdominal pain, vomiting, weight loss, and features of intestinal pseudo-obstruction associated with prolonged use or abuse of narcotic analgesics. In each patient, abdominal complaints were originally attributed to either mechanical bowel obstruction or an underlying gastrointestinal disorder often involving prior abdominal surgery. Symptoms resolved rapidly in all patients when narcotic administration was stopped. Clonidine therapy was used to alleviate symptoms of narcotic analgesic withdrawal. The narcotic bowel syndrome is a clinically important and frequently unrecognized cause of chronic abdominal pain.

Abdomen↗