PubMed Health⌕ Search

Biomedical subjects

W Temple

Publications and source records attributed to W Temple.

17 recordsLinked to original sources
PubMed1998

Benefit of aggressive multimodality therapy with autologous stem cell support for intra-abdominal desmoplastic small round cell tumor.

A case is described of a 19-year-old man with poor prognosis intra-abdominal desmoplastic small round cell tumor, who achieved a durable complete remission after aggressive multimodality treatment. He was diagnosed with a large peri-rectal mass and bulky metastases to the peritoneum, omentum and liver. He achieved a partial response to six courses of chemotherapy with VAC (vincristine, adriamycin, actinomycin, cyclophosphamide) and VIP (VP-16, ifosfamide, cisplatin). This was followed by resection of the omentum and cryotherapy to six of the liver lesions. He then achieved a complete response following high-dose busulfan 16 mg/kg and melphalan 140 mg/m2 with autologous stem cell support. Finally, pelvic radiotherapy was given to consolidate the remission. Twenty-six months following his diagnosis, and 19 months after the transplant, he remains well with no clinical or radiologic evidence of recurrent disease. This case report suggests a role for autologous stem cell transplantation as part of multimodality therapy for this unusual and aggressive malignancy.

Abdominal Neoplasms↗
PubMed1998

Reinforcer efficacy in a delayed matching-to-sample task.

Five domestic hens were exposed to a delayed matching-to-sample task. Conditions 1, 5, and 8 were variable-delay conditions in which five delays (0.25, 1, 2, 4, and 8 s) from the red or green sample to the presentation of the red and green comparison stimuli were presented a number of times during each session. In the fixed-delay condition (Condition 3), each delay was presented for 15 sessions under a Latin square design across birds. When improvements in accuracy across the variable-delay conditions are taken into account, the data were similar under both the variable and fixed delays. In Conditions 2, 4, 6, and 7 sample-reinforcer intervals were held at 8, 8, 4, and 2 s, respectively, while sample-choice intervals were varied within these during each session. With increasing sample-reinforcer interval, both initial discriminability (i.e., with sample-choice delay = 0) and rate of decrement in discriminability decreased. Although the former would be predicted if accuracy depends of the average sample-reinforcer interval, the latter would not. These data show that increasing the sample-choice interval had less effect on matching accuracy than increasing the sample-reinforcer interval did.

Animals↗
PubMed1998

Concordance in communication between surgeon and patient.

OBJECTIVES: To examine (1) the capability of using interactive voice response (IVR) system technology for clinical research studies involving assessment of clinician-patient interactions and (2) the concordance of surgeons and their breast cancer patients about the content of a postbiopsy pre-treatment decision meeting. DESIGN: A descriptive comparison of the perceptions of 2 volunteer groups--surgeons and their patients--using interactive voice technology. SETTING: Surgeons' offices. PARTICIPANTS: Twenty-six dyads of surgeons and their patients with newly diagnosed breast cancer. OUTCOME MEASURES: Concordance as determined through a 15-item patient questionnaire and a parallel 11-item surgeon questionnaire addressing surgical and psychosocial aspects of breast cancer treatment. RESULTS: Fifty-four percent to 100% of the 26 dyads indicated concordance about treatment preference, treatment choice, how treatment was chosen, preference for how treatment was chosen, time for discussion about treatment, and discussion about lymph-node removal. Only 27% to 50% of dyads agreed about patient understanding of lymph-node removal, the thoroughness of discussions about adjuvant treatment, the thoroughness of discussion about emotional coping, and the sufficiency of time for the discussion of patient's concerns. In these areas of disagreement surgeons often underestimated the patient's ability to understand and underestimated the patient's perception of the thoroughness of discussions about the psychosocial aspects of the illness (concerns and coping). CONCLUSION: Surgeons and patients demonstrated concordance on their perceptions of the type of treatment desired and needed but were discordant on their perceptions of the degree of patients' understanding about post-treatment and psychosocial issues.

Breast Neoplasms↗
PubMed1996

Concurrent-schedule performance in dairy cows: persistent undermatching.

Performance of dairy cows responding under concurrent variable-interval variable-interval schedules of food delivery was examined, with results analyzed in terms of the generalized matching equation. In Experiment 1, bias measures indicated that crushed barley was preferred over meatmeal when these foods were available under the alternative schedules. For whole-session data, substantial undermatching of response and time-allocation ratios to obtained reinforcement ratios was evident. Postreinforcement pause time ratios approximately matched obtained reinforcement rates. Subtracting these times from total time-allocation values yielded net time-allocation ratios that undermatched obtained reinforcement ratios to a greater degree than did whole-session time-allocation ratios. In Experiment 2, substantial undermatching was evident when the same foods (hay for 2 cows, crushed barley for 2 others) were available under the alternative schedules. Food-related activities and other defined behavior not related to food were quantified by direct observation, and were found to occupy a substantial proportion (roughly 40% to 80%) of experimental sessions. Subtracting the time spent in these activities from the time allocated to each component schedule did not reduce the degree of undermatching obtained. Across all conditions in both experiments, slopes of regression lines relating behavioral outputs to environmental inputs characteristically were below 0.6, which agrees with prior findings and suggests that, contrary to suggestions in the literature, undermatching in dairy cows is not the result of using different foods under alternative schedules or differential pausing under those schedules.

Animals↗
PubMed1996

High-dose melphalan +/- total body irradiation and autologous hematopoietic stem cell rescue for adult patients with Ewing's sarcoma or peripheral neuroectodermal tumor.

The role of high-dose therapy and autologous stem cell transplantation (ASCT) in the treatment of patients with Ewing's sarcoma (EWS) remains uncertain. From November 1985 to September 1994, 13 patients aged 16-30 years (median 20.5) received high-dose melphalan (HDM) 140-200 mg/m2 +/- 500 cGy TBI followed by ASCT for relapsed/refractory (n = 4), metastatic (n = 2), or non-metastatic (n = 6) EWS, or for peripheral neuroectodermal tumor (PNET) (n = 1). This regimen was well tolerated with no transplant-related mortality and no toxicity requiring life sustaining measures. Three of the four patients treated for relapsed/refractory EWS had progression-free survivals (PFS) less than 5 months. The only long-term survivor of these four patients received HDM while in complete remission following pulmonary irradiation. Both patients with pulmonary metastases at presentation died just 5 and 6 months post-ASCT. All four patients with non-metastatic, bulky (> 8 cm) osseous EWS progressed at a median of 11 months (range 7-22 months) while the two patients with non-bulky EWS remain progression-free 25+ and 28+ months post-HDM/TBI + ASCT. The 19-year-old patient with a PNET of the thoracoabdominal wall relapsed 4 months post-ASCT. Overall, only three of these 13 patients remain progression-free at 25+, 28+, and 108+ months following HDM +/- TBI and ASCT. In conclusion, HDM +/- TBI did not obviously improve the outcome of these 13 patients relative to that expected following conventional dose therapy alone.

Adolescent↗
PubMed1995

CT of the liver after cryotherapy of hepatic metastases: imaging findings.

Cryotherapy is the in situ destruction of abnormal tissue using subzero temperatures (Fig. 1). Recent studies have demonstrated the technical feasibility, safety, and effectiveness of hepatic cryotherapy in the treatment of liver tumors [1, 2]. Such treatment can be precisely focused on the tumor, thereby preserving surrounding normal tissue. In addition, because major vessels with flowing blood are protected from cryoablation, tumors adjacent to these vessels can be treated without sacrificing vasculature. Hepatic cryoablation is therefore particularly suitable for patients who do not qualify for surgical resection because of multiple metastases involving both lobes of the liver, or because of lesions close to major blood vessels. After the procedure, CT during arterioportography is of little value in distinguishing cryolesion from malignant tumor (Fig. 2), and CT with IV contrast enhancement is recommended for follow-up. It is important to distinguish CT findings of successful and unsuccessful treatment, treatment complications such as abscess and cholestasis, and recurrent tumor. The purpose of this essay is to illustrate the findings on CT with IV contrast enhancement in various situations, emphasizing features that are useful in making accurate differential diagnosis.

Aged↗
PubMed1994

HIV-1 seroprevalence in an inner-city public hospital.

In a hospital-based seroprevalence survey for human immunodeficiency virus type 1 (HIV-1) infection, a stratified sampling method based on age and gender was used to collect 5429 blood samples at an inner-city hospital. Sentinel Hospital Surveillance System (SHSS) criteria developed by the Centers for Disease Control and Prevention were used to classify patient diagnoses into two categories by the likelihood of being associated with HIV-1 infection. The two categories were those with high likelihood of association with HIV-1 (SHSS-ineligible) and those with low likelihood of association with HIV-1 infection (SHSS-eligible). Of the 5429 blood samples, 4262 were SHSS-eligible and 1167 were SHSS-ineligible. After personal identifies were removed, specimens were tested by ELISA and confirmed by Western blot analysis. The overall prevalence rate of HIV-1 infection was 0.98%. The seroprevalence rate was almost 2.6 times higher in high-association patients compared with low-association patients (1.89% versus 0.73%, P < .001). Results from this study indicate a high unsuspected HIV-1 seroprevalence rate in a subpopulation (SHSS-eligible) considered to have diagnoses with low likelihood of association with HIV-1 infection. These patients may better approximate HIV-1 seroprevalence in the general population of the area served by the hospital than would a sample of all patients. Monitoring HIV-1 seroprevalence in the SHSS-eligible group will be a useful measure for community serosurveillance for HIV-1 infection.

Acquired Immunodeficiency Syndrome↗
PubMed1993

The effect of increased response requirements on discriminative performance of the domestic hen in a visual acuity task.

Six domestic hens were trained in a spatial discrimination task. A controlled reinforcement procedure insured that the ratio of scheduled and obtained reinforcement remained equal. Gray stimuli and gratings ranging in spatial frequency from 1 to 10 cycles per millimeter were presented in seven descending series of probes. The response requirement to the sample key was varied from fixed ratio 1 to fixed ratio 40 in seven experimental conditions. An increase in response requirements from fixed ratio 1 to fixed ratio 5 and fixed ratio 10 resulted in significantly higher accuracy at discriminable grating values. Further increases in response requirements did not consistently improve performance. Generally, response biases increased and occasionally became extreme for probes at finer gratings with increased response requirements.

Animals↗
PubMed1992

Arm function after axillary dissection for breast cancer: a pilot study to provide parameter estimates.

Sixty-three women participated in a study in Calgary, Alberta to assess the rate of arm recovery and factors affecting it up to one year after axillary node dissection for breast cancer. Outcomes included objective measures of swelling, mobility, and strength, and subjective assessments of pain (at rest and with movement) and stiffness. Approximately 42% of women had residual impairment of at least one type one year after surgery, the most common problems being pain (16%) and reduced grip strength (16%). Except for lymphedema, measurements one year after surgery showed little change from measurements at 6 months, suggesting that the shorter follow-up may be appropriate for assessing the long term effects of axillary dissection. Lymphedema was the only sequela which increased over time. The results provide parameter estimates for designing studies to evaluate the role of physiotherapy after axillary dissection.

Arm↗
PubMed1992

Systemic infusion versus bolus chemotherapy with 5-fluorouracil in measurable metastatic colorectal cancer.

From January 31, 1986 to January 31, 1989, 184 eligible patients were enrolled in a randomized study of either infusional or bolus 5-fluorouracil (5-FU) for the treatment of metastatic measurable colorectal cancer. Infusion was administered at an escalated dose schedule starting at 350 mg/m2 per day for 2 weeks with a 2-week rest period on a monthly basis, while bolus 5-FU was started at 400-450 mg/m2 for 5 days every 28 days. In these chemotherapy-naive patients with good performance status, the infusion arm produced a response in 11 of 88 patients versus 6 of 82 in the bolus arm (p = 0.384). Progression free survival was significantly longer (p = 0.0139) in the infusion group (3.8 versus 2.3 months), but no significant difference in survival was observed (p = 0.207). As expected, the toxicities of the regimens were different in character, but each had approximately a 20% incidence of significant toxicities. Neither of these methods of administering fluorouracil results in an exceptional response rate, nor does the infusion have an impact on survival as compared to the bolus route. If this type of complicated infusional approach is to continue, especially with increasing dosage (which could be accomplished on our schedule), randomized studies with survival as an endpoint must remain the gold standard.

Adult↗
PubMed1987

Characterization of a novel neuroglandular antigen (NGA) expressed on abnormal human melanocytes.

Murine monoclonal antibodies (MAbs) were produced with reactivity to human malignant melanoma. Six MAbs, 3 of the IgGI (LS113, LS140, LS152) and 3 of the IgG2a (LS59, LS62, LS76) subclasses, were selected for their binding, with an identical pattern of reactivity, to a novel melanoma-associated antigen. As characterized by the enzyme-linked immunosorbent assay (ELISA), these MAbs were found to be positive on n-octyl-beta-D-glucopyranoside extracts of all 10 melanoma cell lines tested and on extracts of 22 metastatic melanoma tumors. The antibodies had minimal reaction with a panel of 14 normal adult tissue extracts. A degree of cross-reactivity was observed with 50% of 39 non-melanoma tumor extracts. The results obtained with the ELISA on cell line and tissue extracts were duplicated using the ABC method of peroxidase staining. The pattern of cross-reactivity, as demonstrated by the intense staining of paraffin-embedded and frozen tissue sections of normal, benign and malignant tissues, defines the recognized protein as a neuroglandular antigen (NGA). Immunoadsorbents made with the antibodies were used to purify the antigen shed from cultured melanomas. All 6 MAbs recognized this purified antigen while 5 other antimelanoma antibodies did not react with it. On gel electrophoresis this antigen is a highly glycosylated glycoprotein with a protein core of 21 kDa.

Animals↗
PubMed1985

Spirometric "lung age" estimation for motivating smoking cessation.

Motivation for smoking cessation benefits from physician counseling. To further improve this educational process, spirometry can demonstrate ventilatory impairment to the smoker. In addition to comparing a person's spirometric results with predicted reference values for normal subjects, estimation of "lung age" can be used to demonstrate the effects of cigarette smoking. Equations were developed from reference linear regression equations permitting lung age estimation in terms of ventilatory function. This age can then be compared with the individual's chronological lung age. Normal and abnormal groups determined by a respiratory health questionnaire and pulmonary function testing were used to compare the value of single and combination spirometric tests. The forced expiratory volume at 1 sec proved superior to any other single test or combination for best separation of the two groups and had the lowest standard error for estimated lung age. Both spirometry and estimated lung age calculation may be useful for motivating cessation of cigarette smoking.

Adult↗
PubMed1984

Gestational macromastia.

Gestational macromastia is a rare entity. Causes are many and include excess hormonal production, hormonal imbalance, and decreased hormonal catabolism. Documentation of elevated serum prolactin levels and tissue hormonal receptor levels brings new light to this pathologic condition. Pharmacologic measures are not recommended because of lack of effectiveness and possible teratogenic side effects. Primary therapy should consist of local measures, such as breast support, bed rest, and analgesics. If this fails and progression is inevitable, we recommend total mastectomy with provision made for reconstruction and nipple banking. Skin flaps must be thin, and all breast tissue must be removed, otherwise the pathologic condition will continue during the ensuing months of the pregnancy and will recur with each successive pregnancy. Abortion is feasible, but this leaves the patient in need of a reduction or total mastectomy at a later date, and thus is not recommended as a primary line of therapy. If the patient progresses to delivery without complication, a reduction mammoplasty can be considered but only if no future pregnancies are planned.

Adolescent↗
PubMed1984

Behavioural estimates of auditory thresholds in hens.

Six hens were trained in a trial-by-trial auditory discrimination in which trials were signalled by the lighting of two key lights. Correct responses (left-key pecks when a tone was presented and right-key pecks when it was not) produced intermittent deliveries of food. Following training at one tone frequency and intensity, testing sessions at lower intensities were carried out. Training and testing were repeated for 10 frequencies between 260 Hz and 8000 Hz. Derived measures of detection performance allowed estimates of the intensities at which no discrimination would have occurred. The threshold measures are presented and suggest that the range of most sensitive hearing was between 3000 and 5000 Hz.

Animals↗