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Biomedical subjects

R N Harrison

Publications and source records attributed to R N Harrison.

12 recordsLinked to original sources

Lung cancer in Teesside (UK) and Varese (Italy): a comparison of management and survival.

BACKGROUND: The survival of lung cancer patients in the UK is lower than in other similar European countries. The reasons for this are unclear. METHODS: Two areas were selected with a similar incidence of lung cancer: Teesside in Northern England and Varese in Northern Italy. Data were collected prospectively on all new cases of lung cancer diagnosed in the year 2000. Comparisons were made of basic demographic characteristics, management, and survival. RESULTS: There were 268 cases of lung cancer in Teesside and 243 in Varese. Patients in Teesside were older (p<0.05), were more likely to have smoked (p<0.001), had a higher occupational risk (p<0.001), higher co-morbidity (p<0.05), and poorer performance status (p<0.001). Fewer patients in Teesside presented as an incidental finding (p<0.001) and the histological confirmation rate was lower than in Varese (p<0.01). In Teesside there were more large cell carcinomas (p<0.001), more small cell carcinomas (p<0.05), and fewer early stage non-small cell lung cancers (p<0.05). The resection rate was lower in Teesside (7% v 24%; p<0.01) and more patients received no specific anti-cancer treatment (50% v 25%; p<0.001). Overall 3 year survival was lower in Teesside (7% v 14%; p<0.001). Surgical resection was the strongest multivariate survival predictor in Varese (HR = 0.46) and Teesside (HR = 0.31). Co-morbidity in Teesside resulted in a significantly lower resection rate (p<0.001). CONCLUSIONS: Patients with lung cancer in Teesside presented at a later stage, with more aggressive types of tumour, and had higher co-morbidity than patients in Varese. As a result, the resection rate was significantly lower and survival was worse.

Carcinoma, Non-Small-Cell Lung↗

A bioengineering analysis of human muscle and joint forces in the lower limbs during running.

A two-dimensional, dynamic bioengineering model of the lower limbs was developed in order to estimate muscle and joint forces present during running at 4.5 m s-1. Data were collected from four subjects using a force platform and cine film. Individual X-rays and anthropometric data from the lower limbs were utilized to produce accurate bone models of the subjects' legs. Electromyographic verification of the model was undertaken while a runner was undergoing treadmill running at 4.5 m s-1. Results indicate that peak muscle forces of 22 times subject body weight (22 BW) could be present in the quadriceps muscle group and 7 BW in the gastrocnemius. The anterior shin muscles were found to be active for the first 9% of stance phase only, and compressive loads of 33 BW were found in the knee joint. The relationship between these high forces in the lower limbs and running related injuries is discussed.

Adult↗

Airway response to inhaled salbutamol in hyperthyroid and hypothyroid patients before and after treatment.

For many years the development of thyrotoxicosis has been known to cause a deterioration in asthma but the mechanism is unknown. We have studied the effect of thyroid function on airway beta adrenergic responsiveness in 10 hyperthyroid and six hypothyroid subjects before and after treatment of their thyroid disease. Airway adrenergic responsiveness was assessed by measuring specific airway conductance (sGaw) after increasing doses of inhaled salbutamol (10-410 micrograms). After treatment there was no difference in resting FEV1, sGaw, or thoracic gas volume. FVC increased in the hyperthyroid subjects but did not change in the hypothyroid subjects. In the hyperthyroid subjects there was a significant increase in delta sGaw after 35, 60, 110, and 41 micrograms salbutamol; in sGaw after 60, 110, and 410 micrograms salbutamol; and in the area under the salbutamol dose response curve (AUC) after treatment of the thyroid disorder. In the hypothyroid subjects there was a significant reduction in sGaw after 10 and 60 micrograms salbutamol and in the AUC after treatment. When all subjects were considered, there was a negative correlation between the AUC and serum thyroxine values. These findings suggest that an inverse relationship exists between the level of thyroid function and airway beta adrenergic responsiveness.

Adult↗

Chronic lymphocytic pulmonary infiltrate and Bence-Jones proteinuria.

The clinical and radiological features in a 79-year-old patient with a chronic lymphocytic pulmonary infiltrate are described. The associated findings of Bence-Jones proteinuria, paraprotein bands in the plasma and a monoclonal population of circulating lymphocytes are strong evidence for a pulmonary lymphocytic lymphoma. The differential diagnosis is discussed.

Aged↗

Malignant pleural mesothelioma at St Mary's Hospital, Portsmouth--a review of 29 fatal cases.

The clinical details are presented of 29 fatal cases of pleural mesothelioma in the majority of which there was a history of exposure to asbestos during dockyard work in Portsmouth. Chest pain, breathlessness and weight loss dominated the clinical picture. Analgesia and repeated pleural aspirations provided temporary relief but symptoms invariably progressed. The mean survival time was 39 weeks. Only one patient survived longer than 2 years from hospital presentation. At autopsy, extensive local spread was usual but a high proportion of patients also had metastases at distant sites.

Aged↗

Effect of acute and chronic beta-blockade on carbon dioxide sensitivity in normal man.

The effect of beta-adrenoceptor antagonists on the respiratory response to carbon dioxide rebreathing was studied in eight normal subjects. Propranolol, atenolol, metoprolol, and placebo were given in random, double-blind fashion. Subjects were studied before each treatment period, after one dose, and after eight days of treatment with each drug. A rebreathing method was used to produce progressive hypercapnia and the respiratory response was assessed by measuring minute ventilation and maximum rate of change of inspiratory mouth pressure. Beta-blockade was assessed by the reduction in heart rate during steady state exercise on a cycle ergometer. There was no change in the respiratory response to carbon dioxide after a single dose or eight days treatment of any drug. All three active drugs produced a significant reduction in exercise heart rate. The forced expiratory volume in one second was not altered by any of the drugs.

Adult↗