摘要:

One hundred and fifty‐six patients were screened for the presence of urinary melanoma antigen and serum cytoplasmic antibody. It was fuund that 44% of symptomless Stage 1 patients tested five to 15 years after operation had detectable antigen (Ag) in their urine: the urines of 67% of Stage 2A (local recurrence) patients were positive for Ag; while in only 38% of those patients graded 2B (lymph‐node involvement) were these tests positive. Urines of 83% of patients with generalized metastases (Stage 3) were positive. A sequential study was made of 23 patients seen and treated in 1976. Of this group, 14 reverted from a positive state to a negative one following excision of their tumour, while six were negative on first postoperative testing and subsequently became positive. Three out of the 23 remained persistently negative. T lymphocyte levels were assessed in 71 melanoma patients, and a stage‐related fall was noticed. Thymosin (Hoffman LaRoche) onin vitroincubation significantly raised the levels of T lympho

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1978.tb05801.x

出版商:Blackwell Publishing Ltd    

年代:1978

数据来源: WILEY

摘要:

A retrospective review of a series of cases of malignant melanoma is reported. Two hundred and forty‐six records of patients irradiated from 1958 to 1976 inclusive reveal a sex ratio of males to females of 1.59 to 1, with mean ages of 52.4 years and 54.4 years respectively. Three patients are lost to follow‐up. Two hundred and twenty are deceased. Of 23 living, nine are diseased and 14 are well. Of 60 patients treated aggressively, 10 survived five years: one of 26 irradiated only; three of 11 irradiated before surgery; and six of 23 irradiated after surgery. Of 168 treated by radiotherapy for palliation of growth restraint, one died of disease after five years, and two are alive and well after 10 years! The primary site was treated in 20 cases, with three patients surviving five years. Secondary sites were treated in 226 cases, with 10 patients surviving five ye

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1978.tb05802.x

出版商:Blackwell Publishing Ltd    

年代:1978

数据来源: WILEY

摘要:

Endolymphatic isotope therapy had such promising early clinical results that the M.R.C. (Medical Research Council) U.K. set up a clinical trial in 1966. This was to compare the effect of endolymphatic isotope therapy with the results of standard methods in the treatment of lower limb malignant melanoma. The interim report had three groups for analysis; Standard Methods (S); Endolymphatic Satisfactory (ES); and Endolymphatic Unsatisfactory (EU). This third group was a subdivision, as a significant number of patients did not have the correct endolymphatic treatment. The five‐year survival figures expressed as actuarial percentages were ES=78.8%; S=82.3%; and EU = 57.3%. Lymph node recurrence showed a significant difference: ES=2.3%; EU=12%; and S=19%. The conclusions were that endolymphatic isotope therapy was justified in specialized centres where good results could be obtained. Further animal experiments using the VX2 tumour in rabbits indicated that BCG given intracutaneously or intravenously had no therapeutic effect, whereas when applied by intralymphatic injection BCG was successful in treating lymph node metastases. Nineteen patients with poor‐prognosis malignant melanoma have received endolymphatic BCG. The clinical results are recorded in this paper and are sufficiently encouraging to warrant its continued

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1978.tb05803.x

出版商:Blackwell Publishing Ltd    

年代:1978

数据来源: WILEY

摘要:

This study evaluates the effect of adjuvant immunotherapy with BCG alone, or combined with melanoma cell vaccine, on the recurrence and survival rates of patients with metastatic melanoma in the regional lymph nodes who were treated by lymphadenectomy. Patients were prospectively randomized and stratified on the basis of age, sex, site of primary tumour, and clinical estimate of the regional nodes. During the past four years, 134 patients were entered into this trial, and to date, the incidence of recurrence among the two arms mentioned and the control arm is not significantly different; however, patients receiving BCG alone had longer survival than those in either the tumour cell vaccine or control groups. The improved survival in the BCG‐only group was found to be due to the fact that patients survived longer with their recurrent disease than the patients in the other two groups. At the present time, these differences do not appear to be significant enough to justify routine adjuvant immunotherapy in patients with melanoma metastatic to regional nodes. Longer follow‐up will be necessary to evaluate the role of adjuvant immunotherapy of Stage II melan

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1978.tb05804.x

出版商:Blackwell Publishing Ltd    

年代:1978

数据来源: WILEY

摘要:

Chemotherapy for melanoma can be divided into four types: (i) intralesional chemotherapy; (ii) systemic chemotherapy to prevent the development of anticipated metastases; (iii) therapy for established disease; and (iv) combined with immunotherapy. Apart from a few general rules, it is difficult to predict the response to treatment. The smaller the bulk of tumour, the more likely is regression under treatment. Metastases in the skin, and to a lesser extent those in lymph nodes and lung, respond better than those in the liver and brain. Any response in established disease is likely to be temporary, although the patient tends to develop fatal disease at sites different from those involved when he or she was first treated. The best agent at present is imidazole carboxamide (D.T.I.C), and its effect is not enhanced by combining it with other drugs. Combined prophylactic chemotherapy and immunotherapy is still under investigation, but the results are encouraging.

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1978.tb05805.x

出版商:Blackwell Publishing Ltd    

年代:1978

数据来源: WILEY

摘要:

Surgical therapy has been the accepted method for management of most soft tissue sarcomas of the extremities, although it has been associated frequently with local treatment failure. Even when local control was achieved, over 50% of the patients with soft tissue sarcomas eventually developed and succumbed to distant metastases of their disease. Therefore, single modality therapy for soft tissue sarcomas by operation alone results in an unacceptably high incidence of treatment failure. Fortunately, new adjuvant treatment techniques have been developed that seem to have activity against these neoplasms. It is the purpose of this article to discuss our experience with a number of these techniques.

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1978.tb05806.x

出版商:Blackwell Publishing Ltd    

年代:1978

数据来源: WILEY

摘要:

The Melbourne knee prosthesis is an improved hinge prosthesis. Its component parts are constructed of a chrome cobalt alloy and ultrahigh molecular weight polyethylene. The hinge has a range of flexion of 120, and while flexed, can rotate 15° in either direction. Over the past three years a total of 45 prostheses have been inserted in patients with chronic degenerative arthritis of the knee joints. This survey covers the first 35 operations. The most gratifying result has been a dramatic relief of pain in 87.5% of patients. There have been few complications, and no prosthesis has had to be removed. There have been no mechanical failures of the prosthesis itself

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1978.tb05807.x

出版商:Blackwell Publishing Ltd    

年代:1978

数据来源: WILEY

摘要:

The morbidity of the tourniquet is not well documented. The “post‐tourniquet syndrome” is the most common side effect, but is usually unrecognized. The causation of nerve palsy. although this sequela is uncommon, has been documented. Other problems associated with tourniquet use are disc

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1978.tb05808.x

出版商:Blackwell Publishing Ltd    

年代:1978

数据来源: WILEY

摘要:

A review of 35 cases of inflammatory lesions of the intervertebral discs in young children has failed to establish a role for antibiotics in management. There is a tendency to overinvestigate and overtreat this benign, self‐limiting malady, for which a period of six weeks of immobilization in a double hip spica is recommende

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1978.tb05809.x

出版商:Blackwell Publishing Ltd    

年代:1978

数据来源: WILEY

摘要:

The place of antibiotics in the management of postoperative disc space infections is examined on the basis of a review of 14 cases. Whereas the role of antibiotics is clear in acute infections which manifest themselves in the early postoperative period, this is not so for cases which present late with a chronic process. Here, immobilization in a double hip spica is the single therapeutic measure recommended.

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1978.tb05810.x

出版商:Blackwell Publishing Ltd    

年代:1978

数据来源: WILEY