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Biomedical subjects

R Buckman

Publications and source records attributed to R Buckman.

At least 37 records · Page 2Linked to original sources
PubMed1988

Reactivity of tumor cells in malignant effusions with a panel of monoclonal and polyclonal antibodies.

A panel of 13 mouse monoclonal antibodies (mAb) and 1 rabbit polyclonal antibody was tested for reactivity with tumor cells in 26 effusions obtained from patients with carcinoma of ovary, breast, or mesothelioma, using an immunoperoxidase staining reaction. Specific staining of tumor cells but not reactive mesothelial cells was demonstrated with some of the mAb in the panel. In 4 of 26 effusions no evidence of malignancy was obtained after routine cytological staining, but this was reversed on the basis of immunoperoxidase staining of tumor cells with the mAb in the panel. Serial effusions were evaluated in 4 patients during the course of chemotherapy, allowing an assessment of effect of therapy on the antigenic characteristics of the tumor cells. In another 4 patients, the results of immunoperoxidase staining of effusions were compared with those obtained by applying the same antibody panel to solid tumor nodules. There was a tendency to develop changes in the pattern of reactivity during therapy, and the pattern of reactivity was more restricted in tumor nodules than in effusions. One of the mAb in our panel (2G3) was consistently shown to produce strong staining of a high proportion of tumor cells in effusions and tumor nodules from patients with ovarian or breast cancer and may be of value in immunocytochemical diagnosis and therapy of epithelial malignancies.

Animals↗
PubMed1987

Re-evaluating the cost of outpatient cancer chemotherapy.

Chemotherapy for common malignant tumours has historically been considered relatively expensive. An examination of costs at the Toronto-Bayview Regional Cancer Centre and Sunnybrook Medical Centre, Toronto, suggests that this perception is not accurate. The cost of chemotherapeutic agents administered on an outpatient basis over 4 to 6 months in established drug protocols ranged from $260 to $5374 (mean $2224). The total cost of outpatient administration was estimated to be $152.53 per dose, compared with $185.39 for inpatient administration of the same protocol, a difference of 22%. The difference was predominantly due to a higher allocated per-diem charge at the medical centre. The results indicate that outpatient administration reduces the overall cost of chemotherapy.

Ambulatory Care↗
PubMed1987

Percutaneous diagnosis and drainage of pylephlebitis: a case report.

Suppurative pylephlebitis is a rare complication of intra-abdominal inflammatory processes, but it carries a high mortality rate. Even in this modern era, diagnosis and treatment are difficult because of the nonspecificity of clinical signs and symptoms, as well as laboratory tests. We present a case in which the diagnosis of pylephlebitis was made in the radiology department by percutaneous needle aspiration of the portal venous system. Computerized tomography is very helpful in the diagnosis of pylephlebitis but requires that the radiologist be familiar with this rare entity. The computerized tomographic findings in this case are described and discussed. This patient was treated with percutaneous transhepatic drainage of the portal venous system and antibiotics only since we thought he would not survive a surgical procedure. To the best of our knowledge, there have been no previous reports of percutaneous therapy of pylephlebitis. The patient had an uneventful recovery.

Biopsy, Needle↗
PubMed1987

The significance of stable patients with sternal fractures.

A retrospective review of patients admitted with sternal fractures without massive trauma to the chest or hypotension was undertaken. Chest pain was present in 59 of 60 patients while external signs of bruising were noted in one-third. The standard anteroposterior (AP) roentgenogram of the chest was diagnostic in all patients. Thirty-four (56.7 per cent) patients had 51 significant noncardiac injuries, an average of 1.5 injuries per patient. Most commonly, these were orthopedic injuries, fractures of the rib and closed head injuries. Sixty-two per cent of the patients with sternal fractures had abnormal electrocardiograms (ECG) at some time, of which 34 per cent had ECG changes consistent with ischemia. The admission ECG was normal in 20 (48 per cent) patients. Three of these patients subsequently had significant ECG changes. Fractures that were comminuted or involved the sternal angle were more likely to be associated with ECG abnormalities than were simple fractures of the sternal body. Only three patients had elevated creatine phosphokinase-myocardial bond fractions. Two dimensional echocardiography and biventricular radionuclide angiocardiography were normal in 11 patients, including five patients with ECG abnormalities. There were no deaths related to the sternal fractures per se or to associated injuries. Sternal fractures result from high energy trauma and should be suspected in patients with chest pain after blunt thoracic trauma. The lateral roentgenogram of the chest is the most useful diagnostic test. There is a high incidence of associated cardiac and noncardiac injuries in these patients mandating close observation with ECG monitoring in the intensive care unit.

Adolescent↗
PubMed1986

Nabilone and metoclopramide in the treatment of nausea and vomiting due to cisplatinum: a double blind study.

Thirty-two patients were entered into a double blind trial of antiemetic support in patients being treated with cisplatin. Patients were allocated to receive either oral nabilone (1 mg 8 hourly) or intravenous metoclopramide (1 mg kg-1 3 hourly) in random order over 4 courses. There was no difference between the two treatments in the overall incidence or severity of vomiting, although a subgroup of patients enjoyed a substantial reduction in episodes of vomiting whilst receiving metoclopramide. Side-effects were predictable from the pharmacology of the drugs.

Antiemetics↗
PubMed1986

In vitro and in vivo effects of a monoclonal antibody-toxin conjugate for use in autologous bone marrow transplantation for patients with breast cancer.

We have devised a method utilizing a monoclonal antibody-toxin conjugate (LICR-LON-Fib75/abrin A-chain) for ridding bone marrow of infiltrating breast cancer cells to rescue patients with autologous bone marrow following high dose therapy. Initially we examined the activity of this conjugate in vitro. Five of seven human breast cancer cell lines were killed following exposure at 10(-8) M for 2 h; this concentration only reduced bone marrow colony formation to 83% (range, 50-100%) of control bone marrow. We then examined the pattern of bone marrow recovery after high dose melphalan (200 mg/m2) in patients with advanced breast cancer who were in remission following combination chemotherapy. To do this we compared the time of recovery of the blood count in three patients who received treated marrow and seven who received untreated marrow. Mean time to recovery of the peripheral white count (greater than 1.5 X 10(9)/liter) was 16.7 days (treated) and 18.3 days (untreated), respectively. Mean time to recovery of peripheral platelet count (greater than 50 X 10(9)/liter) was 23.7 days (treated) and 18.9 days (untreated), respectively. Patients continued in remission for 1-greater than 14 mo after high dose melphalan, and remission duration was similar in patients who received treated (6.2 mo) and untreated (7.3 mo) bone marrow. These findings indicate that treatment of bone marrow with LICR-LON-Fib75/abrin A-chain conjugate does not significantly impair bone marrow recovery, and it is, therefore, possible to rescue breast cancer patients with bone marrow that has been cleansed of infiltrating cancer cells. This may have an application in patients with poor-risk primary breast cancer who have micrometastases and who may benefit from intensive therapy, but it has minimal application in patients with more advanced disease.

Abrin↗
PubMed1985

High-dose cyclophosphamide in small-cell carcinoma of the lung.

Eighteen patients with untreated small-cell cancer of the lung have been treated with cyclophosphamide 200 mg/kg on two occasions at an interval of four weeks. An additional eight patients received etoposide in addition to cyclophosphamide. Measurements of tumor volume were made by thoracic computed tomographic (CT) scan before and after each cycle. When compared with our previous study in which only one cycle of cyclophosphamide was given, the double procedure did not increase response rate, decrease the incidence of local relapse, or prolong the relapse-free interval. Survival after relapse was shorter with two cycles of chemotherapy mainly due to greater difficulty in administering further chemotherapy. The CT scans showed a decrease in tumor volume from 99.2 cc to 21 cc after the first cycle, but a smaller decrease to 14.1 cc after the second. These results show that the rapid emergence of drug resistance imposes limitations on the use of very high-dose cytotoxic chemotherapy.

Adult↗
PubMed1983

Chlorpromazine, placebo and droperidol in the treatment of nausea and vomiting associated with cisplatin therapy.

The use of cisplatin may be associated with severe nausea and vomiting. Two separate, randomized, double-blind trials, comparing the anti-emetic effect of chlorpromazine with placebo and chlorpromazine with droperidol, were conducted in patients receiving cisplatin for ovarian cancer. Chlorpromazine was statistically superior to placebo in the control of nausea and vomiting in those patients treated with chlorpromazine had significantly less nausea than with droperidol, but there were no other significant differences between chlorpromazine and droperidol. Toxicities of chlorpromazine and droperidol were similar. Chlorpromazine shows useful activity against cisplatin nausea and vomiting.

Chlorpromazine↗
PubMed1982

Elimination of carcinoma cells from human bone marrow.

The value of a monoclonal antibody, LICR-LON-Fib-75 (Fib-75), which mediates complement lysis and recognises an antigen present on all epithelial-tumour cells so far studied but not on lymphoid cells or bone-marrow stem cells, in clearing infiltrated bone marrow was assessed. Chromium-51-release and trypan-blue-exclusion assays showed that no tumour cells were viable after exposure to Fib-75 and complement except when large clumps (greater than 500 cells) were present, whereas Fib-75 had no significant effect on bone-marrow cells, as judged by colony-forming-unit and pluripotential-stem-cell assays.

Antibodies, Monoclonal↗