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Biomedical subjects

W M Butler

Publications and source records attributed to W M Butler.

At least 19 recordsLinked to original sources
PubMed1997

Prostatic conformal brachytherapy: 125I/103Pd postoperative dosimetric analysis.

Widespread replication of the favorable long-term results of prostatic conformal brachytherapy achieved by the Seattle group requires evidence that the technical quality of their implants is achievable elsewhere. Preplanning with a modified uniform loading algorithm using low activity seeds produces virtually no regions within the planning volume at less than the prescribed dose and no interconnected volumes between seeds at double the dose. The operative procedure stabilizes the prostate and locates the prostate targets, needles, and seeds and their relationship to the bladder and rectum using transverse and longitudinal ultrasound as well as contrast enhanced fluoroscopy. A detailed postoperative dosimetric analysis of patients with clinical T1/T2 adenocarcinoma of the prostate gland who underwent transperineal ultrasound conformal prostatic brachytherapy from March through June 1996 was performed. The analysis involved 7 consecutive patients implanted with 125I seeds and 5 consecutive patients implanted with 103Pd seeds. Median coverage to the full minimal peripheral dose (mPD) was 96% (range 80-99%) of the prostate volume. At 80% of the mPD, median isodose coverage was 100% (range 91-100%) of the prostate volume. Regarding hot spots to critical structures, the median maximal urethral dose was 175% of the mPD (range 115-227%) and the median maximal dose to the anterior rectal mucosa was 105% of the mPD (range 83-133%). Analysis of postoperative dose-volume histograms has shown that our maximal dose surface to any volume greater than 5 cm3 is 203% (range 175-247%). These results indicate that good quality transperineal ultrasound prostatic conformal brachytherapy can be accurately reproduced in a community hospital setting and that biochemical no evidence of disease (NED) results and local control rates will be comparable to those of the Seattle group with no unexpected urethral or rectal complications or side effects.

Adenocarcinoma↗
PubMed1987

Gangliosides fail to enhance behavioral recovery after bilateral ablation of the visual cortex.

Postsurgical injections of GM1 gangliosides (30 mg/kg IP) reduced neither behavioral deficits in rats following bilateral ablation of the visual cortex nor the extent of retrograde degeneration of neurons in the dorsolateral geniculate nucleus that typically accompanies large lesions of the visual cortex. Our findings are in contrast to previous research, in which ganglioside treatments have been shown to enhance the rate of functional recovery after lesions in other parts of the central nervous system. The negative findings in the present experiment may be due to the disruption of normal circadian rhythms caused by occipital cortex injury.

Animals↗
PubMed1985

GM1 gangliosides stimulate neuronal reorganization and reduce rotational asymmetry after hemitransections of the nigro-striatal pathway.

The effects of monosialoganglioside (GM1) injections on neuronal reorganization and behavioral recovery were studied in rats with unilateral transections of the nigro-striatal pathway. In Experiment 1, animals were treated daily with injections of saline or GM1 for not more than 14 days. At 2 days after surgery, GM1-treated animals exhibited less amphetamine-induced rotational asymmetry than did saline treated counterparts. This difference was still apparent at day 12, but vanished at postoperative day 39. Apomorphine-induced rotational asymmetry was equal in both groups at day 15, but by day 42, asymmetries increased in saline controls while remaining unchanged in GM1-treated animals. Rats were killed at either post-operative days 3, 15, or 45 after having received injections of horseradish peroxidase (HRP) into the denervated caudate nucleus. The number of neurons labelled by retrograde HRP-transport were counted in the ipsilateral substantia nigra pars compacta (iSNc), ipsilateral ventral tegmental area (iVTA), frontal cortex, and in the contralateral substantia nigra pars compacta (cSNc). Anterograde transport was also examined in the ipsilateral substantia nigra pars reticulata (iSNr). A significant loss of retrograde labelling in iSNc and iVTA was observed for both groups at post-operative day 3. At day 15, however, GM1-treated animals showed more labelling in these structures as well as in the cSNc. At 45 days after surgery comparable labelling was seen in both lesion groups. The total area of anterograde HRP-labelling in the iSNr significantly increased over time, with no differences between treatment groups. In Experiment 2, rats given the same hemitransections as in Experiment 1, were treated with daily injections of saline or GM1 for 14 days, and then received unilateral injections of 6-hydroxydopamine into the iSNc and iVTA. Nine days later, brain tissue was stained for examination of anterograde degeneration. Significantly more degenerating axons and terminals were found in the caudate nucleus of GM1-terminals were found in the caudate nucleus of GM1-treated rats than in saline-treated controls. We propose that the early reduction of behavioral deficits may be related to a ganglioside-induced reduction of secondary degeneration or edema. The effect of gangliosides on later behavioral recovery is to accelerate neuronal reorganization. This reorganization probably involves terminal proliferation of ascending, intact striatal afferents spared by the hemitransection.

Animals↗
PubMed1984

Skin metastases confined to a field of previous irradiation. Report of two cases and review of the literature.

Two cases of tumor recurrence within a previously irradiated skin area are reported. Typical lesions evolve from an erythematous base and progress to induration and tumor papules. A review of clinical literature indicates that irradiation does not increase the frequency of metastases. Experimental data suggest that irradiation does increase metastases as a result of both local mechanical factors and increased tumor-cell survival.

Adenocarcinoma↗
PubMed1984

Prolongation of thrombin and reptilase times in patients with amyloidosis and acquired factor X deficiency.

A patient with acquired factor X deficiency due to amyloidosis had a prolonged thrombin time. Investigation of this abnormality suggested that an inhibitor of thrombin was present. A review of the literature demonstrated that prolonged thrombin time or reptilase time was present in many of the patients with acquired factor X deficiency due to amyloidosis. We were unable to relate prolongation of the thrombin time or reptilase time to the severity of bleeding. We believe that determination of thrombin and reptilase times should be part of the coagulation profile in all patients with acquired factor X deficiency.

Aged↗
PubMed1983

Methyl-CCNU, 5-fluorouracil, vincristine, and streptozocin (MOF-STREP) in metastatic colo-rectal carcinoma.

Forty patients with metastatic colorectal carcinoma who had received no prior chemotherapy were entered onto a trial of methyl-CCNU, 5-fluorouracil, vincristine, and streptozocin (MOF-STREP). Ten of 40 (25%) responded. Two patients (5%) achieved a complete response and eight patients (20%) a partial response. In addition, 10 patients previously treated with chemotherapy received the MOF-STREP regimen; 1 of 10 (10%) responded. The duration of the complete responses were 5 and 16 mo, respectively. The median duration of the partial responses was 4 mo with a range of 1-16 mo. The median survival of the 11 responders was 14 mo. Median survival of the 39 nonresponders was 5 months. Responders lived significantly longer than nonresponders (p = 0.03, log-rank). Toxicity was severe with nausea and vomiting common after streptozocin and myelosuppression requiring dose reductions in 70% of patients. We compare our findings using this regimen to those of two previously reported trials.

Adult↗
PubMed1983

The effect of bloodletting on exercise performance in a subject with a high-affinity hemoglobin variant.

We studied two young army recruits with erythrocytosis. One had a variant hemoglobin with high affinity for oxygen (hemoglobin Osler, also known as Fort Gordon and Nancy, beta 145 Tyr leads to Asp). The other had normal oxygen affinity and erythrocytosis of undetermined etiology. Both were asymptomatic. We studied exercise capacity on a cycle ergometer before and after hemodilution. In the subject with high oxygen affinity, hemodilution resulted in reduced maximal work and increased heart rate at every work level. In addition, minute ventilation and arterial lactic acid increased, while anaerobic threshold decreased, indicating diminished oxygen supply to tissues. In contrast, the subject with normal oxygen affinity had no significant changes in exercise performance after hemodilution. These results suggest that when blood oxygen affinity is high, loss of efficiency in tissue oxygenation can be expected after phlebotomy or hemodilution. Therefore, it may be useful to measure blood oxygen affinity and exercise performance in polycythemic subjects in whom such procedures are intended to ameliorate symptoms of hyperviscosity.

Adult↗
PubMed1983

Molecular heterogeneity of hereditary pyropoikilocytosis: identification of a second variant of the spectrin alpha-subunit.

In hereditary pyropoikilocytosis (HPP), the red cell membrane skeletons exhibit a mechanical instability that can be correlated to defective self-association of spectrin heterodimers. To determine the underlying molecular defect, we have subjected HPP spectrin to limited tryptic digestion, followed by one- and two-dimensional separations of the peptides. Two of the HPP kindreds exhibited a marked decrease in 80,000-dalton peptide (previously identified as the spectrin dimer-dimer contact domain of the alpha-subunit) and a concomitant increase of the 74,000-dalton polypeptide (presumably derived from the 80,000-dalton domain) and a decrease in a 22,000-dalton polypeptide. We now report tryptic digests of two other HPP kindred that are characterized by a decrease or complete absence of the 80,000-dalton tryptic fragment, with a concomitant increase in fragments at 46,000 and 17,000 daltons. The 46,000-dalton fragment separated into multiple spots on isoelectric focusing, ranging in isoelectric point from 5.25 to 5.35, and the 17,000-dalton fragment focused to a single spot at 5.4. Minor fragments at 56,000 and 22,000 daltons were also decreased, while a 38,000-dalton fragment increased. Limited tryptic digestion of the separated alpha- and beta-subunits revealed that the 74,000-dalton fragment in the first group of patients and the 46,000-dalton fragment in the second group of patients were derived from the alpha-subunit. Both subtypes exhibited a similar defect of spectrin self-association, with 30%-38% of spectrin dimers in O degrees C extracts. The results indicate that at least two distinct forms of structurally defective spectrin may give rise to the clinical presentation of HPP.

Adolescent↗
PubMed1982

Metastatic thymoma with myasthenia gravis: complete remission with combination chemotherapy.

A 29-year-old male developed myasthenia gravis 29 months after resection of a "benign" mediastinal thymoma. Metastatic thymoma was found in the pleura 45 months after the initial surgical resection. Combination chemotherapy with cyclophosphamide and doxorubicin produced a complete remission of the metastatic thymoma which has continued for 13 months. Concurrently, there has been a marked increase in neuromuscular function.

Adult↗
PubMed1982

Idiopathic acquired sideroblastic anemia terminating in acute myelosclerosis.

Acute myelosclerosis is an unusual myeloproliferative syndrome characterized by pancytopenia, absence of massive hepatosplenomegaly, and an absence of tear-drop poikilocytes. The marrow is usually fibrotic with atypical megakaryocytic and trilinear dyspoiesis. Median survival is approximately six months from onset of symptoms. The authors report a case of acute myelosclerosis that evolved in a patient two and one-half years after the onset of idiopathic acquired sideroblastic anemia. A review of the other previously reported case of this unusual transformation and comments on the pathogenesis of the transformation from idiopathic acquired sideroblastic anemia to acute myelofibrosis are included.

Acute Disease↗
PubMed1982

Prolymphocytic leukemia: treatment with combination chemotherapy to include doxorubicin.

Prolymphocytic leukemia (PL) is a clinically distinct leukemic disorder. Cytochemical and surface marker characteristics help to differentiate PL from other types of leukemia, including chronic lymphocytic leukemia (CLL). In contrast to patients with CLL, those with PL frequently require early therapeutic intervention. Standard treatment regimens for CLL as well as splenectomy and splenic irradiation have not been effective in the treatment of PL. Combination chemotherapy with cyclophosphamide, Doxorubicin, vincristine, and prednisone (CHOP) has produced impressive clinical responses in patients with PL. The treatment of a patient with PL is discussed and the literature is reviewed.

Aged↗