ISSN:0038-4348    

出版商:OVID    

年代:1981

数据来源: OVID

ISSN:0038-4348    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

Seventy-seven cases of adenocarcinoma of unknown origin were studied retrospectively. Pain was the most common presenting symptom and lymphadenopathy was the most common finding on physical examination. Tumor involved several organs in two thirds of the patients, the lung being the most frequently involved. Complete surgical resection was possible in only four of 27 patients with single organ involvement. All four patients had lymph node dissections and remain free of disease after one to three years. Four patients with tumor confined to the liver received infusion of antitumor agents through the hepatic artery which resulted in objective tumor regression in all, and regression of >50% in two. Forty-three trials of systemic intravenous chemotherapy were administered to 38 patients with nonresectable tumor resulting in >50% tumor regression in eight. Responses were more frequent with regimens containing adriamycin plus either cyclophosphamide or cis-platinum. Median survival of all patients in the study was 31 weeks. Patients who received chemotherapy survived significantly longer (median 41 vs 26 weeks,P= 0.005). Similarly, patients who responded to chemotherapy survived significantly longer than nonresponders (median 54 vs 27 weeks,P< 0.02). Our results indicate that early treatment of patients with adenocarcinoma of unknown origin improves their prognosis.

ISSN:0038-4348    

出版商:OVID    

年代:1981

数据来源: OVID

ISSN:0038-4348    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

Carcinoma of the colon occurring to the right of the middle colic vessels is usually described as morphologically and clinically distinctive from cancers occurring in the left colon. Cancers of the right colon are characterized as polypoid tumors that are discovered in the search for occult blood loss, whereas carcinomas of the left and sigmoid colon are described as scirrhous and often annular in configuration, giving rise to obstruction as the characteristic clinical presentation. A personal experience with constricting annular lesions of the right colon that were considered atypical has led to a review of the total experience in colonic resections for cancer (excluding abdominoperineal resections for carcinoma of the rectum) at one metropolitan university medical center. Of 152 colonic resections for cancer within a 39-month interval, 57 resections were for cancer of the right colon and 95 for cancer of the left colon. One half of the cancers of the right colon were annular, whereas only one third of those of the left colon were so described by operative, pathologic, and radiologic criteria. Differences in clinical presentation of cancers of the right and left colon are probably attributable more to the form and function of the colon in each anatomic region than to any characteristic configuration of the tumor itself.

ISSN:0038-4348    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

Pharmacokinetics is a relatively new field in the health sciences. It is receiving more interest and utilization as patients' serum drug levels are being correlated with clinical response and drug side effects and toxicities. Many variable factors influence serum drug levels, consequently affecting the interpretation of these levels and possibly altering therapy. We discuss some of these variables in relation to proper timing for serum sampling, and suggest times for peak level serum sampling of some commonly monitored drugs.

ISSN:0038-4348    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

Through three related programs, 9,675 individuals were screened for hemoglobinopathy. The studied population was predominantly black (58%) and male (91%). Identified were 333 variants (3.4%), 90.7% of them in blacks. Two hundred occurred in hospitalized patients. Laboratory results were entered in medical charts in all but three instances. Annotation of the abnormality by a physician in the progress notes, discharge summary, or final coded diagnosis was made in 14.4% of the reviewed records. This included 46.7% of 15 patients with clinically manifested disease related to the hemoglobinopathy.

ISSN:0038-4348    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

We undertook this study to evaluate the efficacy of bone marrow aspiration as compared with trephine needle biopsy. In the 50 consecutive cases reviewed, simultaneous aspiration and biopsy yielded significant morphologic findings in either or both. A comparison was made between the morphologic findings in the aspirate and the corresponding biopsy, with quantification of these findings when feasible. The aspiration technic and method of processing used differ significantly from the so-called clot preparation currently in widespread use. For coring the marrow, a regular (adult) 11 gauge Jamshidi needle was used. More lymphoid nodules, nodular lymphoid hyperplasia, and lipid granulomas were found in the aspirate.

ISSN:0038-4348    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

We analyzed 305 patients with either single or multiple vessel disease, as demonstrated by coronary arteriography, to determine risk factor and sex differences. Women accounted for more than one fourth of the patients with single vessel disease (group A), but for only one seventh of the individuals with multiple vessel disease (group B). Group A patients were younger and had fewer risk factors, and fewer abnormalities on chest roentgenogram, ECG, and stress test than those in group B. The better reported prognosis for patients with single (versus multiple) vessel coronary artery disease may be due to (1) slightly younger age, (2) greater representation by women, (3) fewer functional abnormalities as assessed by noninvasive tests, and (4) a lower incidence of cardiac risk factors. The presence of hypertension and diabetes seemed most likely to defeat the biologic advantage enjoyed by women over men in resistance to the development of atherosclerotic heart disease.

ISSN:0038-4348    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

The role of mitral valve prolapse in producing transient ischemic attacks and completed strokes remains controversial despite scattered clinical reports indicating such an association. Among 96 patients admitted to our neurology service because of TIAs or strokes in the past 12 months, five were found to have mitral valve prolapse as the presumed cause after careful investigation excluded other potential causes.

ISSN:0038-4348    

出版商:OVID    

年代:1981

数据来源: OVID