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Biomedical subjects

R D Craig

Publications and source records attributed to R D Craig.

At least 19 recordsLinked to original sources

Recombinant interleukin-2 (rIL-2) given intrasplenically and intravenously for advanced malignant melanoma. A phase I and II study.

Recombinant interleukin-2 (rIL-2) was used to treat 31 patients with progressing metastatic malignant melanoma. Only three patients had disease confined to non-visceral sites; the median number of organ sites involved was four. The first dose of rIL-2 was given intrasplenically (to stimulate cytotoxic cells in high concentration) via a femoral artery catheter, and four further i.v. doses were given over 6 days. A total of three courses at 21-day intervals was planned. Doses were escalated in 15 patients from 1 x 10(6) to 16.4 x 10(4) Cetus units m-2. The maximum tolerated dose (11.0 x 10(6) U m-2) was used in the other 16 patients. Of the 71 courses, severe but transient toxicity requiring interruption of rIL-2 or additional care occurred on three courses (dyspnoea) and 15 from hypotension, but the patients' performance status improved. Four patients had partial tumour responses although in only one patient did response occur in all sites of disease. However, responses occurred in visceral sites and six patients are alive at 9-16 months. IL-2 is of use in advanced melanoma and does not need complicated ICU facilities.

Adult↗

The functioning of individuals on a drug abuse treatment waiting list.

Using structured interviews and the SCL-90R, study was made of the behaviors of 29 applicants to a residential treatment program for cocaine abuse who had been placed on the program's waiting list for periods ranging from 1 to 6 months. It was hypothesized that applicants waiting treatment for 3 months or less (N = 16) would be more likely to view themselves as treatment candidates and would show behaviors different from those waiting 4-6 months (N = 13). Being on the waiting list a longer period was associated with greater evidence of criminal justice involvement, but with few other differences. Nearly half the total sample (48.3%) reported having significantly reduced drug use in association with their applying for treatment, but most applicants (58.6%) were pessimistic about their long-term capacity to remain free of drug-related difficulty. The pattern of SCL-90R scores for all subjects suggested significant psychiatric symptoms, including depression. Nonetheless, a majority of all applicants (51.7%) reported themselves as having become less interested in entering treatment. Nearly all applicants reported high levels of encouragement for their decision to enter treatment from persons with whom they were living and about half reported encouragement from friends. Of the 23 applicants who were IV drug users, 10 (41.7%) reported knowing someone who had contracted AIDS, 87.0% reported having changed behaviors--chiefly needle sharing--to reduce the risk of infection, and 69.6% reported having obtained HIV testing. The difficulty encountered in locating a random sample of applicants suggests the problem of maintaining a useful waiting list for treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

Acquired Immunodeficiency Syndrome↗

Argon laser therapy for cutaneous lesions.

This paper presents a review of the results of treatment of a series of cutaneous vascular lesions with the argon laser. The lesions were evaluated before treatment, both clinically and histologically. Argon laser therapy appears to be most effective for purple port wine stains on the faces of adults and telangiectatic lesions involving the nose and forehead. Complications seem to be particularly associated with its use in children and about the upper lip and chin.

Adolescent↗

The free latissimus dorsi myocutaneous flap.

The general anatomy and the detailed vascular anatomy of the latissimus dorsi myocutaneous flap is described, and its use as a free flap is illustrated. The speed and ease with which it can be raised, its long vascular pedicle, the large diameter of the donor vessels, and the potentially large size of the flap are emphasized.

Adult↗

Extra-abdominal desmoid of the face involving the orbit.

A case of musculoaponeurotic fibrosis of the face invading the orbit is presented. The need for radical local excision of such lesions to prevent recurrence and the value of adequate prostheses following excenteration of the orbit are emphasized.

Aged↗

Myxoma of the mandible--a fibroblastic tumor.

A case of myxoma of the mandible is described. The tumor was examined by both light and electron microscopy. Histochemistry showed an abundant acid mucopolysaccharide stroma, embedded in which were stellate cells with branching processes. Ultrastructurally, these cells were seen to be fibroblasts. Occasional myofibroblasts were seen in the tumor. No odontogenic epithelium was identified, and this component was not thought to be important in the histogenesis of the tumor.

Adolescent↗

Collagen biosynthesis in normal and hypertrophic scars and keloid as a function of the duration of the scar.

The rates of collagen biosynthesis and the tissue concentrations of collagen in normal scar, hypertrophic scar and keloid were determined as a function of the duration of the lesions. The rate of collagen synthesis in normal scar was approximately constant between 6 months and 20 years after the initial wounding, but in both hypertrophic scar and keloid the rate was initially approximately twice that in normal scar, and 2-3 years after wounding it fell to approximately the same level as in normal scar. The tissue concentration of collagen appeared to be relatively constant in normal scar with respect to the time elapsed after wounding, but in both types of abnormal scar it was initially somewhat lower than normal scar and then rose to values higher than in normal scar after about 2-3 years. Since similar results were obtained for both types of abnormal scar in terms of the rates of collagen biosynthesis with respect to the time elapsed after wounding and also in terms of the tissue concentrations of collagen, this may indicate that the events in the pathogenesis of both abnormal scar types are similar. The results also raise the possibility that the formation of both types of abnormal scar may occur in two phases: an initial phase characterized by abnormally high rates of collagen biosynthesis and a later phase characterized by essentially normal rates of collagen biosynthesis.

Cicatrix↗

Collagen biosynthesis in normal human skin, normal and hypertrophic scar and keloid.

A comparison of the rates of synthesis of collagen in normal skin, normal and hypertrophic scars, and keloids has been made by measuring the rate of incorporation of [14-C]-proline into peptide-bound [14-C]-hydroxyproline by tissue minces in vitro. The rate of synthesis of collagen, as measured by this technique, was significantly higher in skin than in normal scars whether the incorporation of radioactivity into hydroxyproline were expressed in terms of wet weight of tissue, weight of tissue DNA or weight of tissue hydroxyproline. The abnormal scar types exhibited similar rates of collagen synthesis, which were significantly higher than the rate in normal scars. Although the rates in both abnormal scar types appeared to be similar to that in normal skin when expressed in terms of wet weight of tissue, and weight of tissue hydroxyproline, they were seen to be lower than in skin in terms of weight of tissue DNA. The rate of synthesis of proteins generally, as measured by total radioactivity in non-diffusible peptides, was highest in normal skin and hypertrophic scar and lowest in keloid. The ratio of radioactivity in non-diffusible hydroxyproline to total non-diffusible radioactivity was almost twice as high in keloid as in normal scar, with intermediate values being observed in hypertrophic scar and normal skin. This indicated that collagen accounted for a higher proportion of the proteins being synthesised in keloid than in normal scar. The results confirm previous conclusions, from determination of the activity of the enzyme collagen proline hydroxylase, that the excessive accumulation of collagen in hypertrophic scars and keloids may, at least in part, be due to abnormally high rates of collagen synthesis in comparison to normal scars.

Carbon Radioisotopes↗