ISSN:0022-4790    

DOI:10.1002/jso.2930570402

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

年代:1994

数据来源: WILEY

摘要:

AbstractA retrospective review of 27 patients (21 males and 6 females) with chondrosarcoma of bone was performed to evaluate the oncologic and functional results. The average age of the patients was 48 years (range: 17–76). The tumor sites were pelvis in 10 cases, distal femur in 2, proximal tibia in 3, rib in 2, and other in 10. One patient with Ollier's disease had chondrosarcoma at two different sites simultaneously. Surgical stages were I A in 8 cases, IB in 8, II A in 1, and II B in 10. Two patients had no surgical treatment. Amputation was performed in 5 cases and en bloc resection in 20. An uncontaminated radical or wide surgical margin was achieved in 13 of 25 cases. Additional surgery was performed in seven cases; for deep infection in one case and for local recurrence or metastasis in six. Local recurrence developed in seven patients (26%). At follow‐up, four patients had died of disease (15%), one patient had died of another cause, and two patients were alive with disease (7%). No evidence of disease was found in 20 patients (74%). The oncologic results of limb salvage and amputation in chondrosarcoma of the limbs were good, although there was one failure of limb salvage, caused by infection. Due to surgical inaccessibility, results of the management of chondrosarcoma of the pelvis were poor. The average functional evaluation of 16 patients (average follow‐up: 104 months) was 75% (range: 30–100). The Musculoskeletal Tumor Society ratings were excellent in four cases, good in seven, fair in four, and poor in one. © 1994 wiley

ISSN:0022-4790    

DOI:10.1002/jso.2930570403

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

年代:1994

数据来源: WILEY

摘要:

AbstractThe effects of preoperative chemotherapy on gastric and colonic cancers have yet to be evaluated fully. In this study, its effects were assessed by studying DNA ploidy patterns, cell cycles, and histological findings in such patients. Thirty‐nine patients with gastric or colonic cancer were given preoperative chemotherapy with UFT (an admixture of tegafur and uracil). Biopsy specimens for analysis were obtained before chemotherapy through a gastroscope or colonoscope and after chemotherapy from resected tumors. The DNA ploidy patterns and cell cycles were evaluated using a flow cytometer and the tissues were examined histologically. The DNA ploidy pattern was diploid (D) in 12 gastric and 13 colonic cancer patients and aneuploid (A) in 10 and 4 patients, respectively. After chemotherapy, the pattern changed in nine gastric (A→D: 7, D→A: 2) and six colonic cancer patients (A→D: 3, D→A: 3) and was unchanged in the remaining patients. Cell cycle analysis showed decreased Gl‐ and increased S‐phase fractions in 10 of 12 patients with gastric and 6 of 10 patients with colonic cancer. Histologically, decreased tumor cellularity, increased fibrosis, and/or cytological changes were observed in both cancers after chemotherapy. Gastric and colonic cancers in which the DNA ploidy pattern changed from aneuploid to diploid, G1‐ decreased and S‐phase increased, and/or histological changes were observed, were considered to have responded to preoperative UFT administration. © 19

ISSN:0022-4790    

DOI:10.1002/jso.2930570404

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

年代:1994

数据来源: WILEY

摘要:

AbstractThe anticancer agent neocarzinostatin (NCS) was bound covalently to human/mouse chimeric Fab fragments of the monoclonal antibody A7 to form the conjugate chA7Fab‐NCS.The antitumor effect of chA7Fab‐NCS was tested by measuring the inhibition of3H‐thymidine incorporation into human pancreatic carcinoma cells. The chA7Fab‐NCS was approximately 2.3 times as effective as free NCS against human pancreatic carcinoma cells which reacted with the monoclonal antibody A7. The antitumor activity of chA7Fab‐NCS was inhibited by excess chA7Fab. ChA7Fab‐NCS had an antitumor effect equivalent to free NCS on human pancreatic carcinoma cells which did not react with the monoclonal antibody A7. ChA7Fab‐NCS appears to be a potentially useful conjugate for immunotargeting chemotherapy against pancreatic carcinoma. © 1994 W

ISSN:0022-4790    

DOI:10.1002/jso.2930570405

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

年代:1994

数据来源: WILEY

摘要:

AbstractThyroid diseases and surgery for thyroid neoplasms are both very common. Several complications of thyroidectomy are well known. Some of these are quite disturbing, such as recurrent laryngeal nerve injury and permanent hypoparathyroidism. However, postoperative hematoma often in the recovery room may be fatal. Close observation and early intervention are of utmost necessity in the post‐thyroidectomy period. In a series of 600 thyroidectomies performed over a period of 11 years, eight patients developed postoperative hematoma. Seven of them underwent re‐exploration, while one patient was treated conservatively. Two patients had second re‐exploration for hematoma reaccumulation. All patients recovered very well after re‐exploration except one elderly patient who required ventilatory support due to poor pulmonary reserve; after a week of ventilatory support and a tracheostomy, she too recovered well. One patient had the hematoma re‐explored as late as 24 hours after the operation, while the remainder were re‐explored within 4–6 hours after the initial procedure. Because of the extent of edema of the larynx and pharyngeal wall, it is very important that a senior, experienced person perform intubation in these patients. It is also very important to recognize that when the patients lie down flat, they may develop acute airway distress; hence, one must be prepared to intubate them emergently. We recommend close recovery room observation after thyroidectomy and early exploration and evacuation of hematoma in all patients who develop postoperative hematoma. A conservative approach may be considered in selected patients with minimal hematoma and no progression. However, it generally takes a long time for the hematoma to resorb. A better understanding of the complications of thyroidectomy will minimize morbidity and make thyroidectomy a safer procedure and a surgical triumph. © 1994 W

ISSN:0022-4790    

DOI:10.1002/jso.2930570406

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

年代:1994

数据来源: WILEY

摘要:

AbstractIn this prospectively random study, the effect of oral Ftorafur as an adjuvant chemotherapy was compared with that of oral placebo in patients with Stage II and Stage III gastric cancer. Patients had undergone a subtotal gastrectomy with a resection margin that should have been free of tumors. Ftorafur (10 mg/kg) was given daily to 59 Group A patients. Multiple vitamins were given twice a week to 56 Group B patients. We found that there was no statistical significance in Stage II patients with regard to survival. In Stage III patients, those treated with oral Ftorafur had better ‐3‐year and 5‐year survival rates than those receiving oral placebo. This preliminary report on this ongoing study seems to indicate that long‐term postoperative Ftorafur treatment may be beneficial to Stage III gastric cancer patients. © 1994 Wiley

ISSN:0022-4790    

DOI:10.1002/jso.2930570407

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

年代:1994

数据来源: WILEY

摘要:

AbstractGiant cell tumor of bone is a challenging surgical problem due to its mostly aggressive growth with tendency to recur locally, to develop in rare instances pulmonary metastases without histologic evidence of malignant changes, and due to its potential to dedifferentiate into a frankly malignant tumor in a limited number of patients. It is treated in many different ways because of the difficulties in finding a type of treatment with the best functional results without compromising oncologic results.This paper describes 19 patients with giant cell tumor of bone. Following 19 procedures (including 6 intracapsular resections [curettage]) in 17 patients in our hospital only 2 recurrences (10.5%) occurred, both after curettage. Functional results after curettage without recurrence were favorable. Marginal or wide resections did not result in any recurrence, but were functionally inferior to curettage; an exception to the latter was the resection‐arthrodesis of the distal radius in one patient. © 1994 Wiley‐Liss,

ISSN:0022-4790    

DOI:10.1002/jso.2930570408

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

年代:1994

数据来源: WILEY

摘要:

AbstractThis study is a retrospective analysis of 248 thyroid cancer patients who received their primary treatment in the Chang Gung Memorial Hospital during the period January 1979 to December 1992. Among these cases, there were 173 papillary thyroid cancers (69.8%), 52 cases of follicular thyroid cancer (21%), 7 cases of medullary thyroid cancer (2.8%), and 16 cases of anaplastic thyroid cancer (6.5%). The subjects included 184 female patients with a mean age of 40.7 ± 14.3 years and 64 male patients with a mean age of 49.2 ± 14.3 years. Most of the cases had a nearly total thyroidectomy after the diagnosis was confirmed by frozen section during the operation. During the follow‐up period, 19 (8.2%) patients diagnosed with well‐differentiated thyroid cancer died of thyroid cancer in contrast to 12 patients (75%) with anaplastic thyroid cancer. The 1‐year Greenwood survival probabilities after the disease is diagnosed in papillary, follicular, and anaplastic thyroid cancer are 0.98, 0.86, and 0.25, respectively. For the analysis of prognostic variables in well‐differentiated thyroid cancer patients, 16 factors were entered for univariate and multivariate analysis. Using a log‐rank univariate analysis, survival was significantly associated with the cell type of the primary tumor, age, clinical staging, postoperative131I pattern, tumor size, postoperative thyroglobulin (Tg) level and postoperative x‐ray results. In the Cox multivariate regression analysis the combination factors that gave the best prognostic value were the association of x‐ray finding (P=.004), age (P=.017), and Tg level (P=0.19).In conclusion, thyroid cancer is not an unusual disease in Taiwan. As previously reported anaplastic thyroid cancer has a poor prognosis. In this limited period of follow‐up study, the patients' age with postoperative first positive x‐ray finding and Tg level may provide the prognostic factors for patients with well‐differentiated thyroid cancer.

ISSN:0022-4790    

DOI:10.1002/jso.2930570409

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

年代:1994

数据来源: WILEY

摘要:

AbstractPerforming a conventional radical inguinal orchiectomy for suspected testicular cancer has three important deficiencies: 1) A benign lesion can unnecessarily and unknowingly be treated by orchiectomy. 2) Alternate routes of tumor dissemination (superficial external pudendal veins) are not clamped or destroyed before the tumor‐bearing testis is brought up through the external inguinal ring. 3) The act of squeezing the testis through the external inguinal ring may be an important cause of tumor spread.Presented in this paper is a transscrotal approach that eliminates these three deficiencies. It is advocated for critical clinical evaluation. © 1994 Wiley‐Liss,

ISSN:0022-4790    

DOI:10.1002/jso.2930570410

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

年代:1994

数据来源: WILEY

摘要:

AbstractStapling devices for end‐to‐end anastomoses (EEA) have facilitated more rapid and reliable reestablishment of esophagogastric continuity following esophageal resections. Despite their ease of use, various intraoperative problems can arise, especially with the esophageal pursestring or the insertion of the anvil into the fragile, commonly contracted lumen. This paper describes various technical details that are useful adjuncts to allow creation of rapid, consistently successful EEA stapled esophagogastic anastomoses. These techniques are of particular value in the resident teaching setting. © 1994 Wiley‐Lis

ISSN:0022-4790    

DOI:10.1002/jso.2930570411

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

年代:1994

数据来源: WILEY