摘要:

AbstractSeventy‐nine patients who had Hickman‐Broviac (H‐B) catheters inserted over a 1‐year period were studied. There were 52 patients in the hematological group and 27 patients in the solid tumor group. Complications associated with the H‐B cathethers were infection and venous thrombosis, with infection being more common. Nine patients experienced local infection, ten had local infection with bacteremia, and 14 had severe infection, respectively. Infectious complications were more prevalent in the hematological group; 13 of the 14 severe infections were found in patients with hematological disorders. Severe infection was more common in patients with two catheters in place as compared to those with only one catheter (P<0.05). In particular, the presence of two catheters significantly increased the risk of infection in hematological patients. The risk of infection may be reduced by using only one catheter with either a single or dou

ISSN:0022-4790    

DOI:10.1002/jso.2930260403

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1984

数据来源: WILEY

摘要:

AbstractA retrospective review of the Roswell Park Memorial Institute experience and literature review of gastric carcinoma in young adults reveals that long‐term survival is rarely achieved. The primary correctable cause of failure is a very long delay in diagnosis, a result of both reluctance to initiate diagnostic studies and inaccuracy of routine upper gastrointestinal series. A high index of suspicion and liberal utilization of gastroscopy and gastric cytology combined with an aggressive surgical approach to gastric pathology would probably lead to improved survival for the young gastric carcinoma patient

ISSN:0022-4790    

DOI:10.1002/jso.2930260404

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1984

数据来源: WILEY

摘要:

AbstractThe problem of activation of cyclophosphamide (CY) for an in vitro chemosensitivity assay was studied using the B16 melanoma. The efficacy of the S9 hepatic microsomal fraction in vitro was compared with activation by passage of drug in vivo. The effect of CY was assayed by inhibition of tritiated thymidine (3HdThd) uptake by B16 tumor cells in vitro, and by its effect in single dose in vivo on the life span of syngeneic C57BL/6 mice injected with B16 tumor cells. In vivo activation of CY that was achieved by injecting 20 mg of CY intraperitoneally (i.p.) into mice and obtaining plasma 20 minutes later was more rapid and more reproducible, while in vitro activation provided a more potent preparation and a better quantitative correlation with the in vivo effect of CY. The activation activity of different preparations of S9 microsomal fractions was found to be directly related to the activity of aminopyrine demethylase, a mixed function oxidase enzyme, in the S9 fraction, rather than to total protein concentration. The S9‐activated drug required 2 1/2 to 3 hours to achieve maximum inhibition of subsequent tumor cell tritiated thymidine (3HdThd) incorporation compared with 20 minutes to achieve maximum inhibition by in vivo activated drug. We conclude that rapid qualitative screening for effectiveness of CY may best be done with in vivo activated drug, whereas quantitative prediction of effective concentration appears to be best achieved with drug activated in vitro by the hepatic S9 fractio

ISSN:0022-4790    

DOI:10.1002/jso.2930260405

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1984

数据来源: WILEY

摘要:

AbstractFrom July 1979 to January 1983, 20 patients with locally advanced head and neck cancer were treated with a combination of chemotherapy and irradiation with or without surgery. A majority of the patients were in the age range of 45 to 54 years. Eighty‐five percent of the patients were male. Seventy‐five percent of the patients had oral cavity lesions, the tongue being the most common site. Eighty percent of the patients had T4lesion and 35% had N3disease in the neck. A majority of the patients had combination chemotherapy, including bleomycin, methotrexate, and cis‐platinum (BMP). All patients received irradiation with megavoltage equipment and 55% of patients received a dose of 5,000 to 6,000 rads in 5–6 weeks time. The tumor was converted to be resectable in ten patients. Nine patients (45%) had the neck and primary tumor completely controlled, while six patients (30%) had partial control. Six of the ten patients who had resection had the tumor controlled at the primary site and neck. The median duration of follow‐up is 12 months (range, 4–32 months). The median survival of the whole group of patients is 12.5 months. A brief review of the current literature is also done in

ISSN:0022-4790    

DOI:10.1002/jso.2930260406

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1984

数据来源: WILEY

摘要:

AbstractBetween July 1975 and June 1979, 194 patients with State II or III breast carcinoma were randomized to receive either L‐phenylalanine mustard (L‐PAM), cyclophosphamide and 5‐fluorouracil and prednisolone (CFP), or CFP and BCG. Sixty‐one patients have recurred despite the adjuvant chemoimmunotherapy trial. Fifty‐three are evaluable for survival and 36 for response to chemo‐hormonal therapy. Those treated with a chemo‐hormonal regimen for their first recurrence exhibited a 53% objective response rate to cytotoxic therapy or a 35% response to hormonal therapy. Prior exposure to L‐PAM, cyclophosphamide, or 5‐fluorouracil did not preclude response to ‘salvage’ therapy regimens containing those agents. Neither menopausal status, estrogen receptor content, size of the primary tumor, adjuvant treatment, nor extent of the recurrence had any effect on subsequent survival. Overall, the entire group exhibitied median survival of 37 months from initial diagnosis and 13 months from recurrence. Unlike recurrent Hodgkin's disease, there was no demonstrable relationship between the length of the disease‐free interval and the likelihood of subsequent response to cytotoxic or hormonal treatment. Comparison is made to the results of ‘salvage’ therapy administered after three other larg

ISSN:0022-4790    

DOI:10.1002/jso.2930260407

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1984

数据来源: WILEY

摘要:

Abstract1,2‐dimethylhydrazine (DMH)‐induced colon cancer in Wistar/Furth (W/Fu) rats is analogous in many ways to human colorectal cancer. As part of our attempt to understand the immunobiology of these tumors, we have utilized the recently available monoclonal antibodies W3/25 and OX8 to monitor helper (Th) and suppressor (Ts) lymphocyte subpopulations. Normal untreated male W/Fu rats of less than 1 year of age were pheno‐typed (n = 43). The mean percentage of Thand Tswas 42 ± 1 (mean = SEM) and 33 ± 1, respectively. The mean Th/Tsratio was 1.3 ± 0.1. A Th/Tsequal to or greater than 1 is considered ‘normal’ in the W/Fu rat. The DMH‐treated rats (20 mg/kg/wk) were evaluated in initial experiments at various intervals after treatment. Rats studied 24 hours after a single DMH injection had no alterations in T cell subsets. Rats studied 28, 32, and 65 weeks after the start of 16 weekly DMH injections were found to have a decrease in the percentage of Thand a relative increase in Ts, with Th/Tsratios of 0.6 ± 0.2, 0.7 ± 0.1, and 0.7 ± 0.1, respectively (eachP<0.01). In a separate experiment in which rats were studied after 4, 8, and 16 weeks of DMH injections, no alterations in T cell subsets were noted. Rats (n = 5) studied at 20 weeks after the start of DMH were found to have 41 ± 3% Thand 36 ± 2% Tsand a Th/Tsratio of 1.2 ± 0.1. Three of five rats were found to have adenocarcinomas. Four of five rats had Th/Tsless than 1. One rat with Th/Tsequal to 0.9 had metastatic disease. Rats studied at 25 weeks (n = 8) were found to have more advanced carcinomas (4/8) that were causing obstruction or bleeding in the animal. There was a significant decrease in Thand Tsin this group, with 24 ± 3% and 26 ± 3% respectively (P<0.001). The Th/Tsratio for this group was 0.9 ± 0.1 (P<0.01). In other experiments, rats were treated with DMH or placebo over a 16‐week period and serially bled during and after treatment. No effect of DMH treatment on T cell subsets was noted. Repeated bleeding alone was noted to cause persistent alterations of T cell subpopulation. In conclusion, DMH treatment does not appear to cause changes in peripheral T cell subset changes prior to the onset of tumor development. Even when small tumors are present, the proportions of Thand Tsare normal unless the animals are bleeding or are obstructed. Likewise, animals with metastatic disease appeared to have T cell population changes. It may be that DMH causes changes in local, ie, gut associated lymphoid tissue that may be causally related to tumor development. This possibility is curr

ISSN:0022-4790    

DOI:10.1002/jso.2930260408

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1984

数据来源: WILEY

摘要:

AbstractReticuloendothelial (RE) function was evaluated by measuring the biokinetics of a standardized99Tcm‐sulphur colloid. Methyl palmitate was administered intravenously on two consecutive days. A statistically significant reduction in the colloid uptake rate of the liver was registered after methyl palmitate administration. Histological examination revealed no signs of destruction of RE cells or microembolization. Inoculation of an experimental nitrosoguanidine‐induced transplantable adenocarcinoma to the liver was performed in 16 rats one day after methyl palmitate administration and in 16 controls. Tumor size was significantly larger in methylpalmitate‐treated animals at 7 and 14 days after inoculation. Survival was significantly decreased in methyl‐palmitate‐treated rats. These rats showed signs of fatty vacuolization and necrosis of liver parenchyma earlier than controls. Analyses of β‐hexosaminidase and lactate dehydrogenase revealed no deviation of enzyme levels either before or after tumor inoculation. The results indicate that a temporary suppression of RE function at the time of tumor inoculation may influence subsequent

ISSN:0022-4790    

DOI:10.1002/jso.2930260409

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1984

数据来源: WILEY

摘要:

AbstractThree patients with unresectable malignant retroperitoneal tumors that invaded and perforated the distal duodenum presented with sepsis unresponsive to antibiotics. A technique of proximal side‐to‐side duodenojejunostomy with stapled occlusion of the distal duodenum resulted in successful diversion and immediate resolution of sep

ISSN:0022-4790    

DOI:10.1002/jso.2930260410

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1984

数据来源: WILEY

摘要:

AbstractProstatic acid phosphatase (PAP) was measured in 70 patients with stage D prostate cancer under different modalities of treatment. PAP was determined by radioimmunoassay (RIA), counter immunoelectrophoresis (CIEP), and enzymatic method using α‐naphthyl phosphate to compare the usefulness of the three methods in follow‐up and assessing the clinical status of stage D prostate cancer. In the regressive state (29 patients), RIA and enzymatic methods correlated well; both gave 17% of abnormal results with a mean value of 4.7 ± 4.6 and 3 ± 1.7. Also, in the progressive state (17 patients) the two methods showed similar percentages of abnormal results with a mean value of 40 ± 38 and 19 ± 17 for RIA and enzymatic method, respectively. There was greater variability in the stable group owing to the difference in the tumour load. Again the two methods correlated well regarding their diagnostic sensitivity and specificity as a parameter for assessing the clinical response. CIEP, used as a qualitative method, showed more positive than negative results and did not correlate with the clinical state. We feel that the conventional enzymatic method is adequate for follow‐up and assessing clinical state of stage D prost

ISSN:0022-4790    

DOI:10.1002/jso.2930260411

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1984

数据来源: WILEY

摘要:

AbstractThis report describes six cases of liposarcoma. The primary sites were the retroperitoneum in three cases, the lower extremity in two cases and the jejunal mesenterium in one case. One retroperitoneum case had the heaviest liposarcoma (40 kg) that has been reported in the literature. One patient with thigh liposarcoma who developed three recurrences and underwent hemipelvectomy has been free from the disease for the past 6 1/2 years. Histologically, all three retroperitoneum cases showed well‐differentiated liposarcoma and two lower extremity cases had myxoid type liposarcom

ISSN:0022-4790    

DOI:10.1002/jso.2930260412

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1984

数据来源: WILEY