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Biomedical subjects

R Stanley

Publications and source records attributed to R Stanley.

At least 19 recordsLinked to original sources
PubMed2001

Radioactive gold-198 seeds for the treatment of squamous cell carcinoma in the eyelid of a cat.

A 19-year-old, speyed, domestic short-hair cat was presented with an eyelid tumour of 3 months duration. Ophthalmic examination revealed a large, raised, ulcerated and bleeding mass affecting the left lower eyelid. The mass was 12 mm x 10 mm in size, extended to the medial canthus and had eroded 10 mm of eyelid margin. Mandibular lymph nodes were not palpably enlarged. A diagnosis of squamous cell carcinoma was confirmed by histologic examination. Due to involvement of more than half the lower eyelid, it was decided that treatment with radioactive gold-198 seeds was appropriate. Nine radioactive gold-198 seeds were implanted, delivering a minimum tumour dose of 65 Gy. Three weeks postoperatively the mass had resolved, with only a small scab remaining. After a further 3 weeks, there was no evidence of the eyelid tumour. Although approximately 7 mm of eyelid margin was absent, this did not cause any clinical signs other than mild conjunctivitis. There was no evidence of the tumour 10 months postoperatively, when the cat was euthanased for unrelated disease.

Animals↗
PubMed1998

Oral malignant melanoma treated with Mohs micrographic surgery by fixed-tissue technique.

We describe a 77-year-old man with stage III oral malignant melanoma (Breslow thickness, 4.0 mm) treated with Mohs micrographic surgery by fixed-tissue technique, elective lymph node dissection, and postoperative radiation therapy. This treatment plan permitted complete excision of the melanomatous field, sparing the need for radical resection. Although the patient later died of widespread metastases, there was no evidence of local or regional recurrence and his quality of life was preserved. We believe that Mohs micrographic surgery by fixed-tissue technique followed by radiation therapy offers a safe and alternative treatment option for deep melanomas in the oral cavity.

Aged↗
PubMed1997

Adult acute leukaemia--a retrospective study of 66 consecutive patients.

BACKGROUND: Advances in therapy and supportive care have improved the outlook for many patients with acute leukaemia, however elderly patients have increased treatment-related toxicity and shorter survival. Most clinical trials have selected patient populations with young median ages and it is therefore difficult to apply results to the general population where the majority of patients presenting with acute leukaemia are over 60 years. There is little information in the literature guiding appropriate treatment of these patients. AIMS: To determine the relationship between age, treatment received, and outcome in patients presenting with acute leukaemia. METHODS: A retrospective analysis was performed on all patients presenting to Prince Henry's Hospital and Monash Medical Centre with acute myeloid leukaemia (AML) or acute lymphocytic leukaemia (ALL) during a five year period. RESULTS: Sixty-six patients (51-AML, 15-ALL) presented with acute leukaemia between March 1989 and April 1994. Median patient age was 63 years; 32% of patients received supportive therapy only; 86% of patients with ALL and 58% of patients with AML commencing remission-induction chemotherapy entered a complete remission. Median survival for patients receiving only supportive therapy was three months. Median survival in patients under 55 years was almost twice as long as patients over 55 years receiving similar treatment (AML-eight vs four months p = 0.023; ALL-3.5 vs seven months p = 0.029). CONCLUSIONS: Median survival for acute leukaemia is inversely proportional to age. Applying results from selected series to elderly patients with acute leukaemia is inappropriate.

Adult↗
PubMed1996

Nurses referred to a peer assistance program for alcohol and drug problems.

Investigation into nurses referred to peer assistance programs for substance abuse is essential to program development and the development of primary prevention strategies. The purpose of this study was to (1) describe the characteristics, substance use, and program participation of 221 nurses referred to a state nursing organization peer assistance program, and (2) identify factors associated with program participation. The highest percentage of nurses (63%) used narcotics; 36% had diverted drugs from patients for their own use. Sixty-four percent of the referred nurses successfully completed the program. This model was found to be effective in addressing substance abuse in nursing.

Adult↗
PubMed1996

The effects of patient suicide on nursing staff.

Attitudes towards patient suicide, and the effects that this has on nursing staff are rather complex, and should not be viewed on a simple negative/positive continuum. Suicide is a difficult but inevitable incident that affects psychiatric units, and the limited literature on nurses' attitudes to suicide, and the effects that patient suicide has on them has highlighted the need for emotional and professional support from their colleagues, including senior nurses, psychiatrists and managers, to cope better after a patient has committed suicide. Furthermore, the importance of regular meetings and reviews of assessment and prevention policies has also been emphasized. The present study looked at the effects that suicide has on nursing staff, their attitudes, and ways of improving their coping skills. Major findings include the lack of emotional support, the need for training, formal assessment of patients at risk, regular multidisciplinary meetings following a suicide and nursing staff's acceptance of suicide as the patient's personal choice. Recommendations for helping nursing staff during the post-suicide period are suggested.

Adaptation, Psychological↗
PubMed1996

A centromere attribute integration approach to centromere identification.

Automated and nonautomated approaches to chromosome classification involves assessing several chromosome attributes. The centromere is an important attribute which provides insight to other features such as chromosome orientation and the banding pattern sequence. Improving the ability to identify the centromere will enhance feature determination and analysis. Techniques to identify the centromere attempt to isolate specific centromere attributes. The centromere can be characterized as possessing the following properties: 1) usually the narrowest region in the chromosome image, 2) usually located in a region containing extreme concavities along the chromosome contour, and 3) usually located in a region of uniform dark grey-level. A centromere attribute integration approach for automated centromere identification has been developed which has a correct identification rate of 93.5% on a diversified data set. This approach determines and evaluates centromere candidates based on quantified centromere attributes. Centromere attribute integration incorporates other commonly used techniques for centromere identification. Some of the techniques integrated into the experimental algorithm include evaluating chromosome curvature, analyzing the shape profile, and inspecting the width profile.

Centromere↗
PubMed1995

Colony-stimulating factor 1 (CSF-1) is involved in an autocrine growth control of rat myogenic cells.

Colony stimulating factor-1 (CSF-1) and the CSF-1 receptor (the c-fms proto-oncogene product) are expressed during the proliferation of the L6 alpha 1 rat myogenic cell line and both are down-regulated during the differentiation to myotubes. Biologically active CSF-1 was shown to be secreted into the culture medium by L6 alpha 1 myoblasts and while they could not bind CSF-1, evidence was obtained for cell surface receptor-CSF-1 complexes. It was not possible to block the L6 alpha 1 proliferation by incubation with anti-CSF-1 antiserum or suramin. However, in L6 alpha 1 myoblasts that were stably transfected with an inducible anti-fms antisense construct, both c-fms protein expression and cell proliferation were more rapidly inhibited under induction and differentiation conditions than parental cells. Furthermore, under these conditions, the c-fms antisense transfected cells also entered myogenic differentiation more rapidly. These results suggest that autocrine regulation by CSF-1 that is intracellular may play a role in the proliferation of muscle cells and that its down-regulation leads to, and may be an obligatory step in, myogenesis.

Animals↗
PubMed1995

Automated chromosome classification limitations due to image processing.

Automated chromosome classification from metaphase spreads has been a difficult research problem over the past 30 years. Numerous techniques have been implemented to address the research problem. Image processing techniques support many methods utilized for automated and/or semiautomated karyotyping. Some current systems correctly classify individual chromosomes at high rates but lack the capability to properly classify chromosomes for entire cells consistently. Most systems attain high classification rates ignoring overlapping metaphase chromosomes for testing purposes. Chromosome classification depends on identifying features common to each chromosome class or number. Some of the common features incorporated into various chromosome classification systems include length, centromere location, banding pattern, and width. To complicate classification, chromosome features tend to vary not only between people but from cell to cell for the same person. Additionally, chromosomes found in metaphase spreads may have any orientation and virtually any degree of overlap with other chromosomes present. Besides the inherent barriers impeding chromosome classification, many systems perform image processing operations to the chromosomes for feature determination. Image processing operations, such as image rotation, that manipulate the chromosome grey-level information may distort the feature calculations utilized in karyotyping. Consequently, feature stability becomes an important issue for improving karyotyping capability.

Chromosomes, Human↗
PubMed1994

Effect of granulocyte-macrophage colony-stimulating factor on oral mucositis after hematopoietic stem-cell transplantation.

PURPOSE: Oral mucositis following high-dose chemotherapy may result in systemic infection and airway compromise, and the severity of oral mucositis may be dose-limiting. Here we investigate the effect of granulocyte-macrophage colony-stimulating factor (GM-CSF), which significantly shortens duration of neutropenia after hematopoietic stem-cell transplantation (HSCT) on oral mucositis. PATIENTS AND METHODS: Thirteen children undergoing HSCT were prepared with etoposide (VP-16), thiotepa (TT), and total-body irradiation (TBI), and 13 with VP-16, TT, and cyclophosphamide (CPM). Following transplantation, 14 patients received GM-CSF at a dose of 125 micrograms/m2/d by continuous intravenous infusion (six prepared with VP-16, TT, and TBI, and eight prepared with VP-16, TT, and CPM), and 12 patients received no growth factor. RESULTS: Mucositis was more severe and persisted longer in patients prepared with the TBI-containing regimen. For this regimen, the duration of severe oral mucositis was shortened by the administration of GM-CSF, although the severity of mucositis was unaffected. No statistically significant effect of GM-CSF could be shown in patients who received VP-16, TT, and CPM. The incidence of positive fungal oral or blood cultures did not appear different whether patients received GM-CSF or not. CONCLUSION: For patients undergoing stomatotoxic HSCT regimens, GM-CSF may reduce the duration of oral mucositis, but is unlikely to effect the severity of oral mucositis or risk of airway compromise, and the severity of mucositis is likely to remain dose-limiting.

Adolescent↗
PubMed1992

Neuropsychological impairment in anorexia nervosa: before and after refeeding.

Neuropsychological measures were administered to 18 patients with anorexia nervosa shortly after admission to hospital and again after substantial weight gain. These patients were compared with a group of 18 normal weight controls, also tested on two occasions, who were matched for age, sex, and estimated premorbid IQ. At low weight, impairment was evident on tests of attentional-perceptual-motor functions and on tests of visuospatial construction and problem-solving. Learning was less affected. Refeeding resulted in significant improvements in performance.

Adult↗
PubMed1992

Umbilical artery velocimetry in predicting perinatal outcome with intrapartum fetal distress.

The aim of this study was to see whether umbilical artery Doppler velocimetry predicts intrapartum fetal distress evidenced by poor perinatal outcome. Umbilical velocimetry was performed on 102 parturients with a presumptive diagnosis of fetal distress based on fetal heart rate (FHR) patterns. A mean systolic-diastolic ratio (S/D) of 3 or more after 30 weeks' gestation was considered abnormal. Poor perinatal outcome was defined by any of the following: small for gestational age, low Apgar score, acidosis, meconium below the vocal cords, prolonged neonatal hospital stay, neonatal intensive care unit admission, and neonatal morbidity. Eighty-two patients had normal S/Ds and 20 had abnormal ratios. Eighteen neonates (90%) in the abnormal-SD group had at least one adverse outcome, compared with only 13 (15.8%) of those with a normal S/D, a statistically significant difference (P less than .001). Umbilical artery S/D used as a screening tool to detect poor perinatal outcome had a sensitivity of 65-100%, specificity of 83-92%, positive predictive value of 20-81%, negative predictive value of 91-100%, and a kappa index of 0.24-0.63. These findings suggest that umbilical artery Doppler velocimetry may be useful as an adjunct in the assessment of intrapartum FHR patterns suggesting fetal distress.

Adult↗
PubMed1991

Lipid peroxidation in electroporated hepatocytes occurs much more readily than does hydroxyl-radical formation.

1. Rat hepatocytes suspended in 0.25 M-sucrose were electropermeabilized. This completely disrupted their plasma-membrane permeability barrier. 2. The endoplasmic reticulum in electroporated hepatocytes appeared morphologically preserved and maintained its permeability barrier as evidenced by electron-microscopic examination and latency measurements on luminal reticular enzymes. 3. Upon aerobic incubation with an NADPH-generating system and iron/ADP, porated hepatocytes peroxidized their membrane lipids at rates similar to those of matched microsomal preparations. 4. When hepatocytes were incubated with iron/EDTA and azide, radical formation detectable with dimethyl sulphoxide (DMSO) was only 10-20% that shown by microsomes. Omitting azide abolished hepatocyte reactivity with DMSO completely. Effects of hydroxyl-radical (.OH) scavengers and of added catalase suggest that the radical detected by DMSO is .OH. 5. Cytosolic inhibitor(s) from hepatocytes seemed to be a major factor limiting .OH formation. These were macromolecular, but showed a degree of heat-stability. Dialysis largely abolished inhibition, but this could be restored again by adding GSH. 6. Since .OH formation in hepatocytes seems to be much more stringently prevented than lipid peroxidation, free-radical damage originating from intracellular redox systems seems more likely to take the form of lipid peroxidation.

Animals↗
PubMed1991

Pectoralis major myocutaneous flap reconstruction in head and neck surgery--experience with 60 cases.

The aim of this paper is to evaluate the results of the use of the pectoralis major myocutaneous flap for reconstruction in 60 otolaryngology--head and neck patients over a five year period. There were 52 patients with Stage III (30%) and Stage IV (70%) untreated squamous cell carcinomas. Of the eight recurrent tumours, three patients had nasopharyngeal carcinoma with extensive post-radiation neck failures requiring extended neck dissections and flap reconstruction. The oral cavity and oropharynx were the predominant sites for reconstruction accounting for 70% of the operations performed. Twenty-eight patients had composite resections, ten with pectoralis osteo-myocutaneous flap incorporating a vascularised split sternum bone graft and titanium plate fixation for immediate mandibular reconstruction. All 52 patients underwent post-operative radiation. Major necrosis did not occur but minor tip necrosis of the skin island occurred in two cases (3%). The mean hospitalisation was 19 days for all patients and 21 days for patients with composite resections. The pectoralis major myocutaneous flap in our experience is not only a versatile flap but also a very reliable and robust flap for single stage immediate head and neck reconstruction.

Adult↗
PubMed1991

An improved spiral electrode applicator system for fetal heart rate monitoring.

A new fetal scalp electrode applicator system uses a guide tube with increased curvature and a plunger mechanism to advance, rotate, and release the spiral electrode. Results of a preliminary survey among house staff who used the system in 51 patients indicated a favorable impression, with 96.1% of the applications rated as "much better," "better," or "same" as compared with the conventional system. The rate for a subset of 26 patients with limited cervical dilatation (1-3 cm) or high station of the presenting part (-1 to -3) was similarly good (92.3%). The characteristics found most favorable were the increased curvature for facilitating applications to high presenting parts, the plunger mechanism for applying the electrode, and better control of the guide tube.

Electrodes↗
PubMed1990

Mouse mesangial cells produce colony-stimulating factor-1 (CSF-1) and express the CSF-1 receptor.

CSF-1 stimulates the survival, proliferation, and differentiation of mononuclear phagocytes and may also play a role in placental development. The expression of CSF-1 and the CSF-1 receptor (CSF-1R) and their regulation were examined in cultures of mouse mesangial cells (MC). The concentration of CSF-1 in the medium of cultured MC increased linearly with time over 24 h. IFN-gamma stimulated and dibutyryl cyclic AMP inhibited CSF-1 production in a dose-dependent manner. MC expression of CSF-1 mRNA was shown by Northern blot analysis, and CSF-1 mRNA levels were increased within 4 h of IFN-gamma addition and inhibited within 4 h of dibutyryl cyclic AMP addition. Indirect immunofluorescence indicated that 90% of the untreated cultured MC expressed CSF-1. In addition, CSF-1R expression by MC was demonstrated by immunofluorescence with anti-receptor antibody, specific binding of [125I] CSF-1, and expression of the CSF-1R mRNA by Northern blot analysis. Thus, mouse MC, specialized pericytes of non-bone marrow origin, not only produce CSF-1 but also express receptors for CSF-1. The effects of CSF-1 on MC may be important in the control of immune function in the glomerulus.

Animals↗
PubMed1990

Drug therapy of heart failure.

While the incidence of cardiovascular disorders has decreased over the past 10 to 20 years, the incidence of congestive heart failure (CHF) has more than tripled. Although much has been learned about the pathophysiology of CHF, the annual mortality rate continues to be high and the impact of medical management is still less than optimal. The goals of therapy are to minimize or eliminate any underlying causes, reduce sodium and water retention, reduce the workload of the heart, and increase contractility. This article reviews the rationale for and clinical use of diuretics, vasodilators, and inotropes in the management of CHF.

Cardiotonic Agents↗