摘要:

AbstractThis is a 2‐7‐year follow‐up report by 21 institutes in Japan concerning limb‐salvage surgery for osteosarcoma. Between 1980 and 1985, 248 patients with osteosarcoma were treated, and 105 patients had limb‐salvage surgery. The percentage of cases treated by limb‐salvage surgery increased with each year. The cumulative survival rate was 71% at 5 years in the limb‐salvage group, and in the amputation group it was 46%; this indicates that cases for limb‐salvage surgery were carefully evaluated for this procedure. In limb‐salvage patients, tumor resection was classified according to the surgical margin as intralesional excision, marginal excision, wide‐with‐marginal resection, wide resection, and radical resection. Wide resection was performed in most cases as the method of choice. Local recurrence was seen in 13 cases (12%). The overall functional evaluations by Enneking's system showed that the number of results rated excellent or good was relatively high in the early follow‐up period, but this decreased later on, and cases rated fair or poor increased as the years passed. This was mainly due to postsurgical complications (44 cases). We identify a few problems in the functional evaluation system used now and suggest a reform of the system, so that physical and mental factors wou

ISSN:0022-4790    

DOI:10.1002/jso.2930410204

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

年代:1989

数据来源: WILEY

摘要:

AbstractA review of data on 548 patients with primary squamous cell carcinoma revealed that 24 (4.4%) had had gastrectomy. Although the interval of the gastrectomy due to peptic ulcer or gastric cancer and esophageal cancer was 13.4 ± 7.9 and 5.8 ± 4.2 years, respectively, this difference was thought to be due only to the occurrence of each disease. The incidence of the occurrence of the lower esophageal cancer after gastrectomy was 29.2%, not significantly higher than the 22.4% incidence of lower esophageal cancer in overall cases. Histopathological investigation of the 13 resected esophageal cancer tissues from gastrectomized patients revealed a mild esophagitis in some cases, with no significant histologic characteristics. Thus esophageal squamous cell carcinoma and previous gastrectomy may be incidentally relate

ISSN:0022-4790    

DOI:10.1002/jso.2930410205

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

年代:1989

数据来源: WILEY

摘要:

AbstractThe relationship between cholecystectomy and subsequent development of colon cancer was investigated in a case‐control study of 165 patients with histologically proven adenocarcinoma of the colon. These patients were from a community in Iowa where incidence of colon cancer was considered to be higher than average in the United States.The relative risk of developing colon cancer after cholecystectomy was shown to be 2.11 (P= .009) for the entire series and 2.91 (P= .002) for the female group. There was a difference of frequency in developing colon cancer after cholecystectomy between the right‐and left‐sided colons; the relative risk of the right versus the left colon cancer was 2.31 (P= .019). The other factors, including blood group, red cell indices, obesity, serum cholesterol, colonic diverticula, and co‐existence of hyperplastic or adenomatous polyp disclosed no significant relation to colon cancer developed after cholecys

ISSN:0022-4790    

DOI:10.1002/jso.2930410206

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

年代:1989

数据来源: WILEY

摘要:

AbstractThis study reports on a patient with a midgut carcinoid discovered due to the occurrence of a subcutaneous metastasis that caused symptoms. The histopathologic diagnosis of a carcinoid was confirmed by light and electron microscopic and immunocytochemical examination of the metastasis. The primary ileal tumors were only localized after the determination of serotonin in platelet‐poor plasma/whole blood sampled at selective mesenteric vein catheterization. Tumor cells from lymph node metastases were studied in vitro, in intraocular heterotransplants, and in cell cultur

ISSN:0022-4790    

DOI:10.1002/jso.2930410207

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

年代:1989

数据来源: WILEY

摘要:

AbstractPrimary choriocarcinomas of the lung are extremely rare. Like choriocarcinomas elsewhere, they possess rapid growth ability and a high propensity to metastasize. There is minimal information available on the treatment of lung choriocarcinoma. In the case reported herein, neoadjuvant chemotherapy with 5‐fluorouracil (5‐FU) infusion, etoposide, and cisplatin induced a partial response permitting complete excision of a massive tumor of the right upper lobe involving the chest wall and superior vena cava. The patient relapsed with a metastasis to the brain that was surgically excised. Contralateral lung metastases were soon noted and responded well to systemic chemotherapy; yet the patient died of a new brain metastasis. To our knowledge, this is the first example of a primary choriocarcinoma of the lung treated with intensive multimodality therapy. The latter seems to offer a potential benefit if certain guidelines are follo

ISSN:0022-4790    

DOI:10.1002/jso.2930410208

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

年代:1989

数据来源: WILEY

摘要:

AbstractTwo hundred twenty‐eight patients were included in a retrospective study to evaluate the morbidity and feasibility of early discharge after mastectomy. Group I (early discharge, n = 75) patients were given pre‐ and postoperative instruction related to wound and drain care. Group II (concurrent control, n = 44) was given similar postoperative instruction, but received no preoperative teaching. Group III (historical controls, n = 109) underwent surgery during a period of more liberal hospitalization and discharge policies. The groups were similar in age, cultural background, operations performed, and pathologic diagnosis. Length of stay for groups I, II, and III was 5.5 ± 0.4, 3.5 ± 0.2, and 8.6 ± 0.3 days, respectively. Groups I and II had a significantly shorter stay than group III. There was no difference among the groups for the presence of wound erythema, rate of primary healing, seroma formation, or wound infection. The practice of same‐day admission and early discharge to limit length of stay for patients undergoing mastectomy is safe and e

ISSN:0022-4790    

DOI:10.1002/jso.2930410209

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

年代:1989

数据来源: WILEY

摘要:

AbstractSerum carbohydrate antigen (CA) 19‐9 was present at high levels in pulmonary sequestration, mediastinal bronchogenic cysts, and mediastinal mature teratomas. The fluid in the cysts of the lesions contained a high level of CA 19‐9. After operation, the titer of serum CA 19‐9 returned to normal ranges. Histological studies showed that mucosal epithelium stained positively for CA 19‐9. We speculate that CA 19‐9 concentrated in the cystic lesion might flow into the peripheral blood. Carcinoembryonic antigen (CEA) was also present at high levels in the cyst fluid. CEA was positively stained in the epithelial cells using a polyclonal antibody but not a monoclonal antibody. The CEA detected at high concentration in the fluid was considered to be immunologically cross‐r

ISSN:0022-4790    

DOI:10.1002/jso.2930410210

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

年代:1989

数据来源: WILEY

摘要:

AbstractThe effects of 3 h lasting local hyperthermia on immune cell traffic through the normal human skin to afferent lymphatics, cell phenotypes, responsiveness, and stimulatory properties were studied in eight men. Cells were harvested from lymph drained from foot skin. Heating the skin in a water bath of 44°C (skin temperature 2 mm under the surface 39°C) evoked an augmented traffic of mononuclear cells to lymph with preponderance of large, macrophage‐like, Ia‐positive cells, among them Langerhans cells. Lymphocytes obtained from the heated skin lymph revealed in culture increased spontaneous blastic transformation rate, augmented responsiveness to phytohemagglutinin (PHA), and enhanced PHA‐presenting properties to autologous peripheral blood mononuclear (PBM) cells. An increased stimulatory activity on allogeneic mixed lymphocyte reaction (MLR) was also observed. Lymph from heated skin augmented the PBM responsiveness to PHA and showed increased interleukin‐1‐like activity. Local heating of the skin is a potent signal initiating augmented traffic, and enhanced responsiveness and stimulatory activity of “passenger” immune cells. Their rapid nonspecific activation makes them indiscriminately active against a wide range of antigens before the specific respon

ISSN:0022-4790    

DOI:10.1002/jso.2930410211

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

年代:1989

数据来源: WILEY

摘要:

AbstractConservative treatment of infiltrating lobular carcinoma (ILC) has previously been examined only in terms of general breast carcinoma studies. However, this lesion has been shown to differ from the more common infiltrating ductal carcinoma (IDC) in estrogen receptor (ER) status, metastatic patterns, and bilaterality. Therefore, it is necessary for the physician to consider these distinctions when planning both pre‐ and post‐operative treatment. To determine the effectiveness of both segmental and modified radical mastectomies, the medical records of 26 patients with ILC were reviewed, and follow‐up information was obtained. In addition to surgical treatment, hormonal manipulation and/or radiotherapy were used when appropriate. We found the results of a conservative approach in the treatment of this disease to be comparable to the more radical procedures with respect to overall survival and disease‐free intervals. The single factor that most affected a patient's prognosis was involvement of the axillar

ISSN:0022-4790    

DOI:10.1002/jso.2930410212

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

年代:1989

数据来源: WILEY

摘要:

AbstractSerial changes of immunosuppressive activity of serum and cell‐free skin bleb fluid that can suppress the activity of acid a‐naphthyl acetate esterase (ANAE) of lymphocytes and phagocytosis of macrophages were detected by immunoregulatory tests in vitro in 50 lung cancer and 42 esophageal cancer patients. In comparing these tests with those of 53 cases of non‐cancerous thoracic lesion and 69 normal adults, the immunosuppressive activity of serum and skin bleb fluid from cancer patients is significantly higher than that of noncancerous thoracic lesions and normal individuals (P<.01). The activity is related to the stages of cancer, the size of primary tumor, the presence of lymph node metastasis, and tumor resectability, but not to histological classification, sex, and age. The immunosuppressive activity of serum and skin bleb fluid decreased gradually after the removal of the tumor and was eliminated on the 30th postoperative day.These results suggest that serum and skin bleb fluid from cancer patients may contain immunosuppressive factors that can suppress the immune responsive functions of lymphocytes and macrophages in vitro in a manner similar to that seen in vivo. Therefore, complete surgical removal of cancer is likely the most effective immunoth

ISSN:0022-4790    

DOI:10.1002/jso.2930410213

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

年代:1989

数据来源: WILEY