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Biomedical subjects

P Abrams

Publications and source records attributed to P Abrams.

At least 163 records · Page 9Linked to original sources
PubMed1989

Technetium-99m labeled monoclonal antibodies in the detection of metastatic melanoma.

Twenty-six stage II/III malignant melanoma patients with 321 measurable metastatic lesions were imaged using Fab fragments of an IgG murine monoclonal antibody labeled specifically with 10-30 mCi Tc-99m with a bi-functional chelating method (NeoRx, Seattle, WA). There were no side effects or adverse reactions. Immunoscintigraphy demonstrated 66.6% of lesions larger than 1 cm and 92.5% of lesions larger than 3 cm. Most frequently detected metastases were in lymph nodes, subcutaneous areas, and bone. Of lesions less than 1 cm, 23.6% were detected if superficial cutaneous lesions were excluded. The smallest detectable lesion was 4 mm. Twenty-one additional clinically unsuspected sites were visualized in 12 of the 26 patients studied. Of these, 56% were confirmed as metastasis by other tests. There were apparent nonspecific localizations owing to other causes, including fracture, varicosities, skin abscess and pneumonitis. Increased experience in image analysis facilitates correct interpretation of these localizations. This study demonstrates that imaging with Tc-99m labeled antibody fragments detects melanoma lesions in organs routinely surveyed and in other areas not routinely assessed by other imaging techniques. The procedure is readily performed and safe. The principal advantage of the test is its ability to survey the entire body and all organs with a single test. Its principal limitation, in common with other diagnostic imaging procedures, is its poor sensitivity for detecting lesions less than 1 cm.

Adult↗
PubMed1987

Mechanisms of continence during raised intra-abdominal pressure.

Patients undergoing Stamey endoscopic bladder neck suspension were investigated urodynamically to ascertain the contribution of passive and active components in the maintenance of continence. Transmission of pressure to the proximal urethra was improved by the procedure even under muscular paralysis. This suggests that passive effects due to intra-abdominal replacement of the urethra are most significant.

Abdomen↗
PubMed1986

Dose titration in clinical trials. An example using emepronium carrageenate in detrusor instability.

Seventy-two women with proven detrusor instability completed a novel clinical trial of the new anticholinergic emepronium carrageenate (Cetiprin novum), which allowed for dose titration. The tolerated dose has been shown to correlate with the severity of symptoms. Statistically significant improvement was achieved in symptomatic and urodynamic parameters without serious side effects.

Adult↗
PubMed1985

An alternative health care setting for children with cancer: a residential summer camp.

Increasing concern for the psychosocial needs of children with cancer has paralleled increasing survival rates. This paper discusses the way in which a summer camp program can help to meet many social needs of children with cancer. Also discussed is the proposal of a campsite to be operated year-round for families of children with cancer, and the way in which such a program can help to meet many needs of these families.

California↗
PubMed1985

Urodynamics of the female lower urinary tract.

The symptoms associated with voiding disorders and incontinence in female patients are notoriously misleading. Even experienced urodynamicists are unable to achieve a 50 per cent success rate for predictive diagnosis based on symptoms and physical examination in any group except pure stress incontinence. Urodynamic studies are an essential part of the investigative sequence required to make an accurate diagnosis. If this is not made, then treatment will be empirical and the success of therapy correspondingly disappointing. The advent of urodynamic investigations has allowed a more rational approach to treatment with documented improvement in the success of therapy. However, our precise understanding of the pathophysiology of incontinence and voiding disorders remains incomplete. Nevertheless, a systematic scheme of investigation using standardized record-keeping and urodynamic techniques allows an accurate diagnosis in most patients. It is essential that additional testing should be performed when the urodynamic investigations fail to explain the patient's complaints. It is hoped that advanced techniques and in particular the electrophysiologic approach may provide the explanation for phenomena as yet ill-understood, such as bladder instability. This article has outlined the importance of a thorough basic assessment of each female patient with a symptomatic inquiry guided by urodynamic insight and a careful physical examination. The basic techniques of flow studies, cystometry, both filling and voiding, and urethral profilometry were described, and the more complex and difficult electrophysiologic tests were outlined.

Adult↗
PubMed1985

Urodynamics of the lower urinary tract.

The symptoms associated with voiding disorders and incontinence in female patients are notoriously misleading. Even experienced urodynamicists are unable to achieve a 50% success rate for predictive diagnosis based on symptoms and physical examination in any group expect pure stress incontinence. Urodynamic studies are an essential part of the investigative sequence required to make an accurate diagnosis. If this is not made, treatment will be empirical and the success of therapy correspondingly disappointing. The advent of urodynamic investigations has allowed a more rational approach to treatment, with documented improvement in the success of therapy. However, our precise understanding of the pathophysiology of incontinence and voiding disorders remains incomplete. Nevertheless, a systematic scheme of investigation, using standardized record-keeping and urodynamic techniques, allows an accurate diagnosis in most patients. It is essential that additional testing should be performed when the urodynamic investigations fail to explain the patient's complaints. It is hoped that advanced techniques, and, in particular, the electrophysiological approach, may provide the explanation for phenomena as yet ill understood, such as bladder instability. The chapter outlines the importance of a thorough basic assessment of each female patient with a symptomatic enquiry guided by urodynamic insight and a careful physical examination. The basic techniques of flow studies, cystometry, both filling and voiding, and urethral profilometry are described. The more complex and difficult electrophysiological tests are outlined.

Electromyography↗
PubMed1984

Human tumour-induced inhibition of interferon action in vitro: reversal of inhibition by beta-carotene (pro-vitamin A).

Inhibitors of human interferon action that might be relevant to tumour resistance or escape mechanisms were investigated in a macrophage system. The effects of IFN on macrophage Fc gamma receptor expression were inhibited by three preparations: (1) a low-molecular-weight component of normal autologous serum; (2) a low-molecular-weight component of carcinoma supernatant; and (3) physiological concentrations of retinol and retinoic acid. Since human carcinoma tissue contains abnormally high levels of retinoic acid-binding protein, the possibility that a tumour-associated retinoid contributes to tumour-induced inhibition in vitro was investigated. Inhibition of IFN action in vitro by retinoic acid (vitamin A acid) was found to be reversed by beta-carotene (pro-vitamin A). When tested in the tumour system beta-carotene also reversed inhibition by the human-carcinoma-derived signal. These data are consistent with the view that at least one of the tumour-derived signals inhibitory towards IFN is a tumour-associated retinoid, although firm evidence for this must await further physicochemical characterization of the inhibitory signal(s). The present data clearly show, nevertheless, that human tumour-induced inhibition of IFN in vitro can be reversed by the pro-vitamin beta-carotene.

Carotenoids↗
PubMed1984

Bladder instability: concept, clinical associations and treatment.

Bladder instability is a term that describes the occurrence of detrusor contractions whilst the patient is attempting to inhibit micturition. Bladder instability has enormous importance in the pathogenesis of many symptoms associated with lower urinary tract dysfunction. Although bladder instability may be suspected from the patients' history, absolute diagnosis depends on cystometry. The treatment of bladder instability is difficult and characterised by frequent patient relapses. Simple measures such as bladder training may be employed. Drug treatment is often effective but current therapies frequently result in unwanted side effects. Many surgical techniques have been developed to treat bladder instability. The unfortunate characteristic of most of these operations is that following an initial excellent response the patients' symptoms recur. It is essential that research should continue into the aetiology and treatment of this important condition.

Electric Stimulation Therapy↗