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Biomedical subjects

W Gordon

Publications and source records attributed to W Gordon.

At least 19 recordsLinked to original sources
PubMed1995

Early complications and long-term survival in severely obese coronary bypass patients.

Our objective was to describe the short-term morbidity of coronary artery bypass operations and the effect of surgery plus aggressive cardiac rehabilitation on the long-term prognosis of severely obese patients with coronary artery disease. We investigated an inception cohort of 28 consecutive severely obese patients with three-vessel coronary disease followed on average for 51 months. The patients' age, preoperative and postoperative weight, risk factors, and cholesterol were measured. We performed coronary artery bypass surgery, then began aggressive cardiac rehabilitation programs. We recorded intraoperative data, perioperative deaths, complications, readmissions, and lengths of stay. Also, New York Heart classifications and use of anti-anginal or cholesterol-lowering medications were noted. All patients were followed up. Despite high morbidity, long-term function and survival of severely obese CABG patients compares favorably with that of average patients. However, aggressive behavior modification fails to alter their postoperative weight or risk profile, placing them at risk for both second CABG procedures and continued obesity-related disease occurrences.

Behavior Therapy↗
PubMed1992

Mouse/human chimeric anti-HIV-1 gp120 antibody to the principal neutralizing determinant: tolerability and pharmacokinetics in cynomolgus monkeys, Macaca fascicularis.

In preparing for testing a pharmaceutical grade preparation of chimeric (mouse/human) antibody CGP 47,439 in HIV-1 infected individuals, it was administered to Macaca fascicularis (cynomolgus) monkeys to study tolerability, immunogenicity and pharmacokinetics. Four groups of monkeys, three males and three females per group, received respectively four infusions of 0, 1.43, 4.3, and 14.3 mg of CGP 47,439/kg body weight at one-week intervals. The chimeric antibody induced no fever, was tolerated well throughout the 50-day observation period, elicited no tissue damage and no anti-antibody response. The pharmacokinetic profile was similar at all dose levels with a mean T1/2 alpha of 14.2 h (range 11.8-19.3 h) and a mean T1/2 beta of 172.6 h (range 137.2-220.5h). Following four successive antibody infusions serum concentrations of CGP 47,439 increased without reaching a steady state, and its measured concentrations were comparable to the simulated values. Collectively the study has provided safety and pharmacokinetic data that would allow human studies with this antibody in AIDS patients.

Animals↗
PubMed1992

Heterotopic ossification and other perioperative complications of acetabular fractures.

Thirty-eight operatively treated fractures of the acetabulum were evaluated retrospectively for perioperative complications. Functionally significant heterotopic ossification (Brooker class III or IV) developed in 23% of those patients who did not receive adequate prophylactic irradiation or indomethacin. Irradiation and indomethacin were effective in the prevention of severe heterotopic ossification. The development of severe heterotopic ossification (class III or IV) was associated with increased time from injury to operation. We conclude that prophylaxis against heterotopic ossification is warranted to decrease the incidence of this potentially preventable complication in patients who incur significant time delays prior to surgery. Other significant complications included avascular necrosis (26%), infection (13%), and neural injury (16%). Avascular necrosis developed in one patient who did not have a documented dislocation.

Acetabulum↗
PubMed1991

The management of lung cancer with radiation therapy: where we are now and where we are going.

Cancer of the lung accounts for 14.6% of all new cancers and 35.7% of all cancer deaths. The radiation oncologist is presented with the formidable challenge of trying to deliver high doses of radiation to the malignant lesion while avoiding excessive damage to the surrounding normal tissues. Lung cancer can be classified as either small cell lung cancer or non-small cell lung cancer with respect to its response to therapy. The article reviews the role that radiation therapy plays in the different stages within each classification. Slow progress toward the goal of controlling this disease is being made, and physicians should encourage patients to participate in clinical trials.

Carcinoma, Non-Small-Cell Lung↗
PubMed1990

Monoclonal anti-idiotypic antibody mimicking the principal neutralization site in HIV-1 GP120 induces HIV-1 neutralizing antibodies in rabbits.

A murine mAb BAT123 (Ab1) directing to the principal neutralization site of human T cell leukemia virus (HTLV)-IIIB gp120 (amino acid residue 308-322) was used to generate syngeneic anti-Id mAb (Ab2). Among the Ab2, a mAb AB19-4 was characterized by both serologic and biologic methods to be paratope-specific (Ab2 beta), bearing the internal image of the neutralization site. AB19-4 was found to bind specifically to BAT123 and also to its mouse-human chimeric form in ELISA. The binding of AB19-4 to BAT123 was specifically inhibited by HTLV-IIIB gp120 and the synthetic epitope peptides of HTLV-IIIB and HTLV-IIIMN defined by BAT123. AB19-4 also inhibited the binding of BAT123 to HTLV-IIIB-infected H9 cells in flow cytometric studies. Polyclonal goat and sheep antisera against HTLV-IIIB gp120 reacted specifically with AB19-4, suggesting that AB19-4 may recognize cross-species idiotopes. Rabbits immunized with purified AB19-4 generated anti-anti-Id antibodies (Ab3) that reacted specifically with HTLV-IIIB gp120 and the BAT123-binding epitope peptides of HTLV-IIIB and HTLV-IIIMN. The Ab3 bound to H9 cells infected by HTLV-IIIB or HTLV-IIIMN and inhibited the infection of CEM cells by HTLV-IIIB or HTLV-IIIMN, whereas BAT123 also bound H9 cells infected by HTLV-IIIB or HTLV-IIIMN but neutralized only HTLV-IIIB. Our data suggest that AB19-4 mimics the neutralization site on HIV-1 gp120 defined by BAT123. The induction of immunity to HIV using internal-image Ab2 to HIV-neutralizing antibodies may provide a viable approach for developing effective vaccines for AIDS.

Animals↗
PubMed1990

Concurrent chemotherapy/radiotherapy for limited small-cell lung carcinoma: a Southwest Oncology Group Study.

The Southwest Oncology Group (SWOG) has conducted a phase II study to explore the efficacy and toxicity of initial, concurrent use of radiation therapy with cisplatin, etoposide (VP-16), and vincristine in limited-stage small-cell carcinoma of the lung. Two courses of cisplatin, VP-16, and vincristine chemotherapy were given with concurrent radiotherapy (XRT) to the primary tumor to a total dose of 4,500 cGy. Elective brain XRT was given to all patients concurrent with a third course of cisplatin/VP-16 therapy. Consolidation chemotherapy consisting of vincristine, methotrexate, and VP-16 alternating with Adriamycin (doxorubicin; Adria Laboratories, Columbus, OH) and cyclophosphamide, was given for 12 weeks following the initial induction chemotherapy/XRT program. Patients with a complete response had all therapy discontinued. Among 154 eligible patients treated, the complete response rate was 56%, with a partial response rate of 27%. The median survival is 17.5 months with an estimated 30% survival rate at 4 years from initiation of treatment. Combined modality toxicities were acceptable with the predominant toxicity being moderate to severe leukopenia and mild radiation esophagitis. The results of this treatment program appear superior to any previously reported by our group and compare favorably to those in the literature at large.

Adult↗
PubMed1990

Medicaid versus state funding of community residences: impact on daily life of people with mental retardation.

The unintended effects on quality of life that flow from decisions regarding funding sources used to support community-based residential programs were documented. Results show that community residence program structures play an important role in determining quality of life after deinstitutionalization. Clients living under program structures flowing from the Medicaid ICF/MR funding source were less active and involved in life than were clients living in programs funded by non-Medicaid state sources. We hypothesized that the reason for this differential outcome was the result of Medicaid funding regulations and their interpretation, which create an institutional-like set of program structures leading to restrictive care patterns.

Activities of Daily Living↗
PubMed1989

A chimeric mouse-human antibody that retains specificity for HIV gp120 and mediates the lysis of HIV-infected cells.

Murine mAb BAT123, which was made against the envelope glycoprotein gp120 of HTLV-IIIB strain of HIV type 1 (HIV-1), is capable of neutralizing HTLV-IIIB in vitro. It also inhibits the fusion between uninfected CD4+ cells and HIV-1-infected cells to form syncytia. As a step to explore the potential utility of the anti-HIV antibody in vivo, we have constructed a mouse-human chimeric antibody by rDNA techniques. The chimeric antibody, which bears the variable domains of mouse antibody BAT123 and constant domains Cr1 and C kappa of human Ig retains the Ag specificity of BAT123 as determined by its reactivity with HIV-1-infected H9 cells, gp120 in Western blot analysis, and the oligopeptide recognized by BAT123. The antiviral activities of the chimeric antibody in neutralizing HIV-1 infection as well as inhibiting the syncytia formation are also found identical to those of the parent murine antibody. Moreover, in the presence of human blood mononuclear cells, the chimeric antibody but not BAT123 (mouse IgG1) induces antibody-dependent cellular cytotoxicity. The findings point to the potential usefulness of the chimeric antibody in treating patients infected with HIV-1.

Amino Acid Sequence↗
PubMed1989

Pre-clinical studies on boron neutron capture therapy.

The present report provides an overview of the multidisciplinary research effort on BNCT that currently is in progress at The Ohio State University. Areas under investigation include the preparation of boron containing monoclonal antibodies, the synthesis of boron containing derivatives of promazines and phathalocyanines, the development of a rat model for the treatment of glioblastoma by means of BNCT, the design of an accelerator-based neutron irradiation facility, and 10B concentration measurements using alpha track autoradiographic methods. Progress in each of these areas is described and the direction of future research is indicated.

Animals↗
PubMed1989

Generation and characterization of monoclonal antibodies to the putative CD4-binding domain of human immunodeficiency virus type 1 gp120.

A panel of seven monoclonal antibodies against the relatively conserved CD4-binding domain on human immunodeficiency virus type 1 (HIV-1) gp120 was generated by immunizing mice with purified gp120. These monoclonal antibodies reacted specifically with gp120 in an enzyme-linked immunosorbent assay and Western blots (immunoblots). By using synthetic peptides as antigens in the immunosorbent assay, the epitopes of these seven monoclonal antibodies were mapped to amino acid residues 423 to 437 of gp120. Further studies with radioimmunoprecipitation assays showed that they cross-reacted with both gp120 and gp160 of diverse HIV-1 isolates (HTLV-IIIB, HTLV-IIIRF, HTLV-IIIAL, and HTLV-IIIWMJ). They also bound specifically to H9 cells infected with HTLV-IIIB, HTLV-IIIRF, HTLV-IIIAL, HTLV-IIIZ84, and HTLV-IIIZ34 in indirect immunofluorescence studies. In addition, they blocked effectively the binding of HIV-1 to CD4+ C8166 cells. Despite the similarity of these properties, the monoclonal antibodies differed in neutralizing activity against HTLV-IIIB, HTLV-IIIRF, and HTLV-IIIAL, as demonstrated in both syncytium-forming assays and infectivity assays. Our findings suggest that these group-specific monoclonal antibodies to the putative CD4-binding domain on gp120 are potential candidates for development of therapeutic agents against acquired immunodeficiency disease syndrome.

Animals↗
PubMed1989

First year after stroke: tracking cognitive and affective deficits.

A total of 58 cerebrovascular accident (CVA) rehabilitation inpatients with lateralized brain damage were assessed at two time points (T1 = admission to rehabilitation facility, about 7 weeks post-CVA, and T2 = 10 months post-CVA) in the following domains: hemispatial neglect, reaction time, depression, and affect comprehension. Performance was compared with 22 age-matched control subjects. Repeated measures ANOVAs were performed with patients subdivided into groups by laterality of lesion and visual field status (a strong predictor of psychometric performance, particularly in the hemispatial-neglect domain). During this initial year after stroke onset, significant improvements were observed in hemispatial neglect and affect comprehension in the two right-brain-damaged groups, but not the left-brain-damaged group. There was also a trend for improvement in observer rating of depression in all three groups. However, there was poor resolution of reaction time and self-reported depression in all three groups. These findings suggest that these latter domains should be targeted for more aggressive therapeutic intervention. An important component of such intervention, in addition to direct treatment of deficits, should be education of both patient and family as to the nature of deficits, expectations regarding resolution, and appropriate attributions of changed behavior after stroke.

Affect↗
PubMed1988

Concurrent chemotherapy and radiation therapy for limited unresectable non-small cell carcinoma of the lung. A phase I study.

We treated nine patients diagnosed as inoperable, but localized non-small cell lung cancer with aggressive high-dose radiation therapy and two cycles of concomitant cisplatin and 5-fluorouracil (5-FU) to determine the feasibility of this approach for this disease. This combined modality program was well tolerated by seven of our nine patients. One who had a poor initial performance status died of sepsis. Another could not tolerate the nausea and vomiting. Only one patient has suffered a local failure inside the irradiated areas. Eight have died, and 5 of 9 survived at least 1 year. The survival is at least consistent with that associated with radiation therapy alone.

Adult↗
PubMed1986

A surface mold using iridium-192 seeds.

A radioactive mold for treating skin was constructed by embedding ribbons of iridium-192 seeds in bolus material. The mold was designed to match the treatment area outlined on the patient's skin. Computer-assisted pre-planning was performed to optimize the seed strength, number of seeds, and spacing of ribbons. An outline of the treatment area was transferred to the surface of a uniform slab of tissue-equivalent bolus material 1.3 to 1.4 cm thick and planned locations for the ribbons were marked. Seeds were loaded into the bolus material at a depth to place the sources approximately 1.0 cm from the skin. The resulting mold was flexible enough to conform to the patient's skin and the seeds were so tightly confined within the bolus that there was no possibility of loss. Isodose distributions for the mold on a flat surface agreed well with preplans. A velcro strap and neck collar were used to attach the mold to the anterior portion of the patient's neck. For situations in which radioactive surface applicators are desirable, the use of iridium-192 seeds offers uniform dose within a highly individualized treatment area.

Brachytherapy↗
PubMed1986

Concurrent chemotherapy and radiotherapy for limited small-cell carcinoma of the lung: a Southwest Oncology Group Study.

This pilot study in limited-stage small-cell carcinoma of the lung using concurrent cisplatin (Platinol) and etoposide (VePesid) chemotherapy with radiotherapy has yielded a high complete response rate in 23 of 40 patients evaluable for response. Five of these responders have survived greater than 2 years off all therapy with a stable, high performance status. Median survival of all patients is 18 months. Toxicity has been acceptable, the most common being neutropenia. Radiation toxicities include 17 of 40 patients experiencing mild to moderate esophagitis, with one severe toxicity; and three of 40 patients developing mild to moderate radiation pneumonitis. The high complete remission observed with this program and the long tumor-free interval seen off maintenance therapy deserve further exploration. Toxicities appear only moderately greater than with other programs currently utilized.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1985

The impact of deinstitutionalization on activities and skills of severely/profoundly mentally retarded multiply-handicapped adults.

This study evaluated the change in activity patterns and skills of severely/profoundly mentally retarded, multiply-handicapped residents as they moved from large total care institutions to community living. Twenty-seven individuals were evaluated just before leaving the institution, 3 months post-exit, and 9 months post-exit. In comparison to a nondisabled reference group, residents were less active, mobile, social, and independent both in the institution and community. Residents did show, however, significant changes toward the nondisabled pattern of daily living after moving to the community. Clients improved in 4 of 16 skill areas within 3 months after entering the community: expressive communication, eating, serving meals and washing dishes, and meal preparation.

Activities of Daily Living↗