bluuebunny/crossref_metadata_2025 huggingface dataset:
Hepatic intra‐arterial adriamycin in metastatic leiomyosarcoma: Exploiting the steep dose‐response curve
Authors: Khansur Tawfiq , Patel Vipin , Newcomb Martin , Balducci Lodovico
Published: February 2007

We report a case of extensive leiomyosarcoma of the liver that failed on systemic Adriamycin. Hepatic intra‐arterial chemotherapy with Adriamycin has resulted in a lasting clinical remission. This report illustrates the importance of the dose‐response curve of drug to tumor in regional chemotherapy as with Adriamycin used in sarcoma, and the need to further explore such therapy in moderately chemosensitive tumors that are surgically unresectable for anatomic reasons.
Intracavitary bleomycin and tetracycline in the management of malignant pleural effusions: A randomized study
Authors: Kessinger Anne , Wigton Robert S.
Published: February 2007

Both bleomycin and tetracycline have been suggested as the sclerosing agent of choice in the management of malignant pleural effusions. To determine if one drug is superior to the other in this role, patients with malignant pleural effusions were randomly assigned to receive either bleomycin or tetracylcine in the previously evacuated pleural space through a thoracostomy tube. Following instillation of the assigned agent, the tube was clamped for 8 hours and then reattached to suction. When the chest tube drainage had slowed to less than 40 ml in a 24‐hour period or if 7 days had passed, the tube was removed. Pleural sclerosis was attempted 42 times in 34 patients. No statistically significant differences were found between the two treatment groups when prevention of effusion reaccumulation and time to removal of the chest tube (efficiency) were compared. Side effects including pleural pain and fever, occurred with both agents, but were manageable. Since one drug was not clearly superior to the other, and bleomycin is more costly, we suggest that tetracycline rather than bleomycin be used when pleural sclerosis is needed to manage malignant pleural effusions.
Surgical treatment of intestinal radiation injury
Authors: Mäkelä Jyrki , Nevasaari Kaisu , Kairaluoma Matti I.
Published: February 2007

A review of 43 consecutive patients requiring operation for serious intestinal radiation injury was undertaken to elucidate the efficacy of surgical treatment. The most common site of radiation injury was the rectum (19 cases), followed by the small bowel (13 cases), the colon (7 cases), and the combination of these (4 cases). The overall operative mortality was 14%; morbidity, 47%; and the postoperative symptom‐free period, 18 ± 30 months. Colostomy (N = 20) carried the lowest risk of mortality, 0%, as compared with resection (N = 17) and bypass procedure (N = 6), which were accompanied by the mortalities of 24% and 33%, respectively. During the follow‐up (3–13 years) 12 patients (28%) died or recurrent cancer and 9 patients (21%) of persistent radiation injury, which yielded an overall mortality of 65% after resection and 50% and 65% after bypass and colostomy procedures, respectively. Continuing radiation damage led to 15 late reoperations. Ten of these were performed after colostomy, four after resection, and one after bypass. We conclude that colostomy cannot be regarded as a preferred operative method, because it does not prevent the progression of radiation injury and because it is, for this reason, associated with a higher late‐complication‐rate. A more radical surgery is recommended but with the limitation that the operative method must be adapted to the operative finding.
Primate endocrine function after pancreatico‐duodenal‐splenic allotransplantation
Authors: Du Toit Don F. , Heydenrych Jacobus J. , Smit Ben , Louw Gabriel , Zuurmond Theuns , Els Daniel , Weideman André , Wolfe‐Coote Sonja , Toit Lorraine Du , Gonin René , Davids Henry
Published: February 2007

In this study the endocrine function following intraperitoneal hetero‐ and orthotopic pancreatico‐duodenal‐splenic allotransplantation (PDS) in hemipancreatectomized, non‐immune‐suppressed chacma baboons was assessed. Significantly reduced K‐values and insulin release together with glucose intolerance during IVGTT were observed in hemipancreatectomized recipients (HPS) without grafts. Orthotopic and heterotopic PDS transplantation improved the glucose intolerance of HPS recipients; orthotopically sited grafts rendering the best curves. Normal glucose tolerance was not achieved. Both orthotopic and heterotopic PDS transplantation rendered suboptimal insulin release during IVGTT; heterotopically draining grafts released significantly more insulin than orthotopic grafts. Hyperglucagonaemia during IVGTT was a constant feature in both groups, heterotopic grafts releasing the most glucagon during stimulation. C‐peptide release was significantly lower in orthotopic grafts compared to normal animals or heterotopically drained insulin. It is concluded that glucose tolerance was not directly related to insulin or glucagon release in this study as orthotopic grafts rendered near‐normal IVGTT curves in the presence of hypoinsulinaemia, hyperglucagonaemia, and reduced C‐peptide values. The hormonal response after PDS transplantation was variable and the advantages of portal vs systemic insulin drainage remain to be defined.
Improved survival of patients with stage II melanoma of the extremity using hyperthermic isolation perfusion with 1‐phenylalanine mustard
Authors: Hartley Jack W. , Fletcher William S.
Published: February 2007

Between 1964 and 1983, 65 patients with Stage II extremity melanoma were treated in a nonrandomized fashion with wide local excision, lymph node dissection, and hyperthermic perfusion with 1‐phenylalanine mustard at 1.0–1.5 mg/kg. Southwest Oncology Group Stage II criteria were used, including IIA (node positive), IIB/C (recurrent local/regional), or both. During the study interval, literature reports of 5‐year survival for Stage II melanoma ranged from 6% to 50% and averaged approximately 26% to 30%. In this study group, 40% of patients had recurrent disease confined to regional lymph nodes, 33% had recurrent cutaneous disease, and 26% had recurrent disease in both locations. Survival for all Stage II patients at 5 years was 56.6%, and 40% at 10 years. When recurrent disease was confined to regional nodes only (IIA), survival at 5 years was 70.5%, and 40% at 10 years. Survival for patients with Stage IIB/C disease at 5 and 10 years was 58% and 43.7%. When recurrent melanomà was present in both skin and nodes, 5‐year survival was 29%. The present study indicates that aggressive treatment of Stage II extremity melanoma, which includes hyperthermic isolation perfusion, can prolong survival in these high‐risk patients.
Mesenteric artery embolization by an unsuspected aortic tumor: Diagnostic evaluation and operative management
Authors: Guyton Daniel P. , Grosen Elizabeth , Al‐Moasses Ghassan , Archer Bernard , York Charles , Peralta Modesto , Schreiber Helmut , Foulis Philip
Published: February 2007

Malignant tumor embolus recovered at the time of superior mesenteric artery embolectomy is an uncommon experience. A report of such a case is presented and the literature is reviewed. In this clinical setting, guidelines for further diagnostic evaluation are not well defined. We suggest an algorithm for the evaluation and management of these patients. In the near future, use of intraoperative angioscopy and the intravascular laser to eradicate the tumor may represent the optimal method of treatment.
Adjuvant treatment of malignant melanoma with DTIC + estracyt or BCG
Authors: Karakousis Constantine P. , Emrich Lawrence J.
Published: February 2007

Eighty‐two patients with invasive malignant melanoma and no distant metastases were prospectively randomized following their surgical treatment to 1) observation; 2) chemotherapy with Dacarbazine (DTIC) 200 mg/M2 I. V. daily x5 every 4 weeks and Estracyt 15 mg/kg orally daily for 1 year; and 3) immunotherapy with TICE BCG 1 ml to an area of scarification near the primary site, every 4 weeks for 1 year. At a median follow‐up of 73.4 months 31 patients (38%) have relapsed. There was no significant difference in survival according to the treatment, but a weak effect on the course of the disease by either of the treatment protocols cannot be ruled out due to the small sample of patients. Survival and disease‐free interval varied significantly according to the histologic status of the regional nodes. The estimated 5‐year disease‐free rate of patients with negative nodes was 85% and for those with positive nodes it was 35% (P <0.0001).
A genetic influence on alveolar cell carcinoma
Authors: Paul Sindy M. , Bacharach Benjamin , Goepp Carla
Published: February 2007

Analysis of three siblings with alveolar carcinoma is presented. HLA markers were performed on the index cases and on a normal sibling control. The three affected patients shared HLA‐A 28, which was absent in the control sibling. A familial recessive trait may have contributed to the development of alveolar cell carcinoma in this family. This family represents the first reported group of three siblings with alveolar carcinoma.
Flow cytometric analysis for assessing the malignant potential of breast cancer
Authors: Abe Rikiya , Ueki Hamaichi
Published: February 2007

Flow cytometric analysis was performed on 60 patients with breast cancer to investigate the relationship between DNA histogram and the malignant potential of breast cancer. DNA aneuploidy of breast cancer tended to increase with increasing stage and degree of nodal metastasis. The percent of cells in the S phase was significantly increased in the patients with metastasis compared to those without metastasis. Patients exhibiting percent S phase value of more than 20% showed a high frequency of metastasis even when breast tumors were small (T1, < 2.0 cm in diameter). Thus, flow cytometric analysis may give additional information on biological characteristics and may be useful for predicting the prognosis of breast cancer in some patients.
Sarcomatoid carcinoma of the pancreas presenting as gastric carcinoma: Clinicopathologic and ultrastructural findings
Authors: Cresson David H. , Reddick Robert L.
Published: February 2007

The clinicopathologic and ultrastructural features of a sarcomatoid carcinoma of the pancreas presenting initially as gastric carcinoma are described. By light microscopy, the tumor contained cellular patterns similar to those present in tumors of mesenchymal origin. Spindle cell areas arranged in a storiform pattern were present. Ultrastructurally, bundles of cytoplasmic microfilaments were present in the cell cytoplasm and were similar in distribution to those found on fine structural examination in tumors of mesenchymal origin. Rows of desmosomes were found between cells supporting an epithelial origin for this tumor. Following initial therapy, metastatic tumor produced polypoid lesions in the small intestine resulting in recurrent small bowel intussuceptions. Our findings indicate that sarcomatoid carcinoma of the pancreas, by both light and ultrastructural examination, is a heterogenous tumor at the cellular level and may be a cause of repeated intussuception when intraluminal compromise occurs.
Preoperative chemotherapy for fungating breast cancer
Authors: Kumar Anand , Shah L. L. , Khanna Sushila , Khanna N. N.
Published: February 2007

Thirty cases of fungating breast cancer (stages III and IV) were treated preoperatively by combination chemotherapy using cyclophosphamide (Endoxan), methotrexate, 5‐fluorouracil, and prednisone. Mastectomy was performed after 2 cycles of preoperative chemotherapy followed by 6 more cycles postoperatively. Of 30 patients, 25 (83.3%) were made operable and had better disease‐free survival. Preoperative chemotherapy has an advantage as regards improvement in quality and longevity without much toxicity, and provides a better palliation.
Phase II evaluation of sequential hepatic artery infusion of 5‐fluorouracil and hepatic irradiation in metastatic colorectal carcinoma
Authors: Miller Robin L. , Bukowski Ronald M. , Andresen Steve , Gahbauer R.
Published: February 2007

Twenty‐seven patients with measurable with measurable liver metastases from colorectal carcinoma were entered on a protocol of intermittent hepaticartery infusion (HAI) of 5‐fluorouracil (5‐FU) followed by consolidation with hepatic irradiation. Five partial responses were observed in 23 evaluable patients. Median duration of response was 3.5 months. A response was evident after chemotherapy alone in four of five responders. Hepatic irradiation converted one patient with stable disease after chemotherapy to a partial responder. Median survival for all patients was 9.0 months (range 1.5–34.0). Combined modality treatment with HAI of 5‐FU followed hepatic irradiation was well tolerated but did not appear to be synergistic.
Inhibition of macrophage‐ and neutrophil‐mediated cytotoxicity by verapamil
Authors: Cameron Deborah J. , Majeski James A.
Published: February 2007

Peripheral blood monocyte‐derived macrophages and polymorphonuclear leukocytes (PMNs) obtained from normal donors kill tumor cells in vitro. However, if verapamil is added to the macrophages or neutrophil tumor cell suspensions in microgram concentrations (0.1 μg to 0.1 mg), there is marked inhibition of tumor cell killing. The inhibitory effect for the macrophages resulted from an effect of verapamil on both the effector and target cells. When either the effector cells or target cells were preincubated with verapamil, they became resistant to the effects of the cytotoxic macrophages. Cytotoxicity was also inhibited when 0.1 mg of verapamil was added to the macrophages monolayers either at the time of addition of the tumor cells or 15–30 min after addition of the tumor cells, whereas no inhibition of cytotoxicity occurred when verapamil was added more than 30 min after the initiation of the cytotoxic reaction. For the neutrophils it was observed that the inhibitory activity resulted from and effect of verapamil on the effector cells rather than the target cells. When the effector cells were preincubated with verapamil they became incapable of killing the tumor cells, whereas preincubation of the target cells with verapamil had no effect on their ability to be killed by the neutrophils. Cytotoxicity was also inhibited when 0.1 mg of verapamil was added to the neutrophil monolayers either at the time of addition of the tumor cells or 15–60 min after addition of the tumor cells, whereas no inhibition of cytotoxicity occurred when verapamil was added more than 60 min after the initiation of the cytotoxic reaction.
Immunohistochemical study of carcinoembryonic antigen (CEA) in gastric tumors: Correlation with preoperative serum levels, histologic type, and grade of anaplasia of the tumor
Authors: Santeusanio Giuseppe , Peronace Laura , Castagna Giancarlo , De Muro Giancarlo , Santi Donatella , D'Orazio Alfonso , Amanti Claudio , Midiri Giuseppe , Campisi Costantino , D'Ambra Giancarlo , Paola Manuele Di
Published: February 2007

The occurrence of carcinoembryonic antigen (CEA) was studied in 45 cases of gastric tumors by the immunoperoxidase technique. CEA‐positive staining was found in 48.8% of tumors. A correlation was found between preoperative CEA values and tumor CEA staining. All patients with serum CEA values below 2.5 ng/ml showed CEA‐negative staining of tumor. In patients with serum CEA values between 2.6 and 10 ng/ml, the tumors showed a minority of CEA‐positive cells; but in patients with serum CEA values above 10 ng/ml, the tumors contained a majority of CEA‐positive cells. CEA‐positive staining was found in 34.4% of tumors of the diffuse type, and in 75% of tumors of the intestinal type. A high percentage of CEA positivity was seen in well‐differentiated tumors (87.7%) compared to the moderately differentiated (69.2%), and to the undifferentiated (28.7%). A faint CEA‐positivity was observed in intestinal metaplasia, while normal gastric mucosa was CEA‐negative.
Primitive neuroectodermal tumors of the chest wall
Authors: Stefanko Jerome , Turnbull Alan D. , Helson Larry , Lieberman Philip , Martini Nael
Published: February 2007

Primitive neuroectodermal tumor (PNET) is a rare, highly malignant small‐cell neoplasm that most often arises from the chest wall or paravertebral region. A patient is described from whom resection, intensive chemotherapy, and bone marrow transplant were unsuccessful. Eleven patients were treated between 1975 and 1985; there was only one long term survivor (48 months) despite intensive multidisciplinary treatment. The median survival of 49 published cases was 9 months. Conservative resection minimizing disability, radiotherapy, and intensive chemotherapy remain valid options, but use of experimental agents as part of intial therapy seems justified. The role of autologous marrow transplant remains unclear.
Influence of surgery on the responsiveness of blood lymphocytes in patients with advanced cancer
Authors: Grzelak I. , Olszewski W. L. , Engeset A.
Published: February 2007

The effect of surgery on peripheral blood mononuclear cell responsiveness to mitogens and supressor cell (SC) activity assessed in a concanavalin A (ConA) assay were studied in patients with stage O and stage III‐IV cancer. Patients were exposed to a similar surgical trauma the same type of anaesthesia, and to no pre‐ and early postoperative radio‐or chemotherapy. A more pronounced postoperative decrease in the lymphocyte count, responsiveness to phytohemagglutinin (PHA) and ConA, and in the SC activity was found in the nonadvanced than advanced cancer group. These findings point to an impaired mobilization and distribution capacity of circulating lymphocytes in patients with advanced neoplastic disease.
Primary breast cancer in patients with previous endometrial or ovarian cancer
Authors: Doberneck Raymond C. , Garcia Joseph E.
Published: February 2007

The incidence of primary breast cancer is known to be increased in patients with previous endometrial or ovarian cancer, but the behavior of the breast cancer and the ultimate outlook for such patients is unknown. To provide data concerning these two questions, a group of 123 patients treated for breast cancer alone (Group I) served as a control for comparison with ten patients who had endometrial cancer (Group II) and six patients who had ovarian cancer (Group III) prior to diagnosis of breast cancer. The interval between the diagnosis of endometrial cancer and breast cancer averaged 4.6 yr, and between ovarian cancer and breast cancer averaged 4.6 yr, and between ovarian cancer and breast cancer, 5.4 yr, Age at diagnosis of breast cancer in Groups I, II, and III was 56, 66 (P = 0.05) and 56 yr, respectively. The incidence of patients with stage I, II, and III breast cancer was similar in Groups I, II, and III as was tumor size and number of metastatic nodes in each stage in each of the three groups. Average duration of follow‐up after diagnosis of breast cancer was 3, 3.1, and 2.8 yr in Groups I, II, and III, respectively, with 70%, 60%, and 33% of patients living and free of either breast cancer, endometrial cancer, or ovarian cancer. Two of four deaths in Group II were due to endometrial cancer, and all four deaths in Group III were due to ovarian cancer. The remaining two deaths or recurrences in Group II were due to breast cancer. We conclude that 1) the behavior of breast cancer is similar in patients with or without previous endometrial or ovarian cancer; 2) breast cancer develops at an older age in patients with previous endometrial cancer than in patients with or without previous ovarian cancer and 3) death or recurrent cancer in patients with breast cancer and previous ovarian cancer is due to ovarian cancer, whereas, death or recurrent cancer in patients with breast cancer and previous endometrial cancer is due equally to breast cancer and endometrial cancer.
Histopathological effects of intraoperative radiotherapy on pancreas and adjacent tissues: A postmortem analysis
Authors: Hoekstra Harald J. , Restrepo Carlos , Kinsella Timothy J. , Sindelar William F.
Published: February 2007

Intraoperative radiotherapy (IORT) has been utilized in the treatment of resectable and unresectable pancreatic carcinoma at the National Cancer Institute. Detailed autopsy analyses of the radiation effects on the pancreas and adjacent tissues were performed on 13 patients dying at various times following therapy. IORT can induce a progressive retroperitoneal fibrosis and fibrosis of the porta hepatis in patients with resectable pancreatic carcinoma. In unresectable pancreatic carcinoma, the major expression of intraoperative irradiation with external beam irradiation is a progressive fibrosis of the pancreas with vascular sclerosis, nerve degeneration, atrophy of acinar cells, and atypical changes in the ducts of the pancreas, as well as degenerative changes of the pancreatic tumor.
Surgical implications of hepatic venocclusive disease following bone marrow transplantation
Authors: Gottesman Lester , Turnbull Alan D. , O'Reilly Richard J.
Published: February 2007

Hepatic venocclusive disease occurs with a spectrum of severity in an estimated 21% of bone marrow transplant patients. Clinical features include severe right upper quadrant pain, ascites, weight gain and initially minimal derangement of liver function. In contrast to hepatic graft versus host disease, venocclusive disease usually occurs within the first three weeks of engraftment and in autologous grafts. Urgent surgical consultation is requested when these features are prominent enough to mimic common acute processes requiring laparotomy. This condition must be included in the differential diagnosis in order to avoid an unnecessary laparotomy in this select group of patients who are usually severely thrombocytopenic and leukopenic. Clinical diagnosis alone is very reliable.
Late recurrence of benign pheochromocytomas: The necessity for long term follow‐up
Authors: Sparagana Mario
Published: February 2007

Two patients who had removal of seemingly benign pheochromocytomas had recurrences 10 and 14 years later despite normal catecholamine excretion for 7 and 9 years postoperatively. The first patient returned with a myocardial infarction and an apparently solitary recurrence; the second patient with a stroke and metastatic disease. Both patients had recurrence of hypertension and increased catecholamine excretion. They were given phenoxybenzamine and are doing satisfactorily 7 and 9 years after their recurrences. Such patients should be followed after surgery for 15 or more years for early detection of recurrences. Prompt therapy should reduce the risk of undesirable complications.
Surgery in papillary thyroid carcinoma: A review of 730 patients
Authors: Høie Johan , Stenwig Anna Elisabeth , Brennhovd Ivar Olav
Published: February 2007

Between 1956 and 1978, 1143 patients with thyroid cancer, nearly half of all patients with thyroid carcinomas in Norway in this period, were seen in our hospital. Of 730 papillary cancer patients, 447 were operated with total thyroidectomy (TT), 179 with hemi‐thyroidectomy (HT), while 104 patients had minor thyroid resections (RT). Survival and recurrence rates were similar in the TT‐ and HT‐groups. Local recurrences were seen in 15.2% of the patients following total thyroidectomy and in 16.2% following hemi‐thyroidectomy; distant metastases were seen in 10.7% and 11.2%, respectively. Beyond the seventh year of follow‐up the cumulative survival was similar following total thyroidectomies, hemi‐thyroidectomies, and thyroid resections. Unless grossly malignant residues were left behind, the impact of the surgical procedure on prognosis in papillary thyroid cancer seems minor.
Pilomatrix carcinoma
Authors: Lineaweaver William C. , Wang To‐Nao , Leboit Philip L.
Published: February 2007

Pilomatrixomas are uncommon tumors of hair matrix origin. They are characteristically benign, calcifying lesions. Eleven cases of aggressively invasive pilomatrixomas have been reported, and this variant has been termed pilomatrix carcinoma. This report presents the first known case of a cervical pilomatrix carcinoma. Modified radical neck dissection was necessary for tumor extirpation. Pilomatrix carcinoma behaves similarly to an aggressive basal cell carcinoma. These lesions require definitive, anatomic resection, careful histological examination of margins, and systematic follow‐up examinations.
Papillary thyroid cancer in identical twins
Authors: Chandler James J. , Schwartz Michael J. , Stahl Theodore J. , Lee Leung
Published: February 2007

The cases of a set of 19‐year old monozygotic twins are presented‐the first report of thyroid cancer of follicular origin occurring in identical twins. This report includes a brief review of reports of cancer of various sites in twins. Several studies and reports emphasize genetic factors influencing the concurrence of cancer. Other reports downgrade the likelihood of genetic influence in cancer.
Diaphragmatic neurilemoma
Authors: McHenry Christopher R. , Pickleman Jack , Winters Gayle , Flisak Michael E.
Published: February 2007

The fourth case of diaphragmatic neurilemoma reported in the English literature is presented from our institution. Diaphragmatic tumors are usually benign and most are symptomatic. Utilizing CT scanning, these tumors can today be accurately localized. Excision via thoracotomy or celiotomy is easily accomplished and is the only reliable way to establish the identity of these lesions.
Laparotomic eventration or colonic prolapse after chemotherapy‐induced emesis
Authors: Martin‐Jimenez Miguel , Diaz‐Rubio Eduardo , Sangro Bruno , Marote Rosa
Published: February 2007

Four cases of patients suffering from abdominal scar injuries (laparotomic eventration and colonic prolapse through the site of previous colostomy) associated with antineoplastic chemotherapy‐induced emesis are presented. The hypothesis of emetic strain as the main cause of eventration of prolapse is discussed. The authors suggest the need of a routine prophylactic antiemetic treatment in patients submitted to abdominal surgery and subsequent antineoplastic chemotherapy in order to avoid these accidents.
Effect of cyclosporine and irradiation on experimental pancreatic allografts in the primate
Authors: Du Toit Don F. , Heydenrych Jacobus J. , Smit Ben , Zuurmond Theuns , Louw Gabriel , Els Daniel , Baker Lida , Wlideman André , Wolfe‐Coote Sonia , Du Toti Looraine , Davids Henry , Groenewald Wilhelm , Van Der Merwe Emuel , Pistorius Stephen
Published: February 2007

The present study assessed the effectiveness of cyclosporine (CSA) and subtotal marrow irradiation (TLI) alone, and CSA in combination with TLI in a primate segmental pancreatic allotransplantation model. Continous administration of CSA 25 mg/kg/day and 50 mg/kg/day resulted in mean graft survival of 21.5 days and 24.5 days, respectively. Administration of fractionated TLI 800 rad (8 Gy) and 1,000 rad (10 Gy) alone resulted in mean graft survival of 13.3 days and 14.5 days, respectively. Of 20 animals that received TLI 1,000 rad (10 Gy) and CSA 25 mg/kg/ day orally for 5 days then 10 mg/kg/day intramuscularly indefinitely, 3 had graft survival of > 100 days. likewise, of a group of 15 animals that received TLI 800 rad (8 Gy) and combined indefinite administration of CSA, 6 had graft survival of > 100 days. Although CSA and TLI administration alone produced modest panceratic allograft survival, a combination of IL 1 (800 or 1,000 rad) and CSA resulted in highly significant segmental pancreatic allograft survival in the primate.
Prognostic significance of estrogen and progesterone receptors in stage ii breast cancer
Authors: Rydén Stefan , Fernö Mårten , Borg Åke , Hafström Larsolof , Möller Torgil , Norgren Allan
Published: February 2007

Estrogen (ER) and progesterone receptors (PgR) were evaluated in samples from primary tumors in 539 patients with stage II breast cancer participating in a randomized multicenter controlled clinical trial on adjuvant therapy. At the cut‐off points of 10 fmol ER/mg protein and 30 fmol PgR/mg protein, no significant difference in recurrence‐free survival (RFS) existed between premenopausal patients with receptor‐positive and negative tumors, respectively. After recurrence, premenopausal patients with receptor‐positive tumors had a significant longer survival than patients with receptor‐negative tumors. In postmenopausal patients not treated with adjuvant tamoxifen, no correlations between RFS and receptor status were found. Patients with ER + tumors survived longer than patients with ER–tumors. In postmenopausal patients treated with adjuvant tamoxifen, highly significant differences in RFS and in survival were observed when receptor‐positive patients were compared with receptor‐negative patients. No differences in survival after recurrence were registered among these patients.
Biochemical and ultrastructural differences between muco‐epidermoid and carcinoid tumors of the bronchus
Authors: Feldman Jerome M. , Benning Timothy L. , Saltzman Herbert
Published: February 2007

Bronchial adenomas have been classified into three types: carcinoid tumors, cylindromas (adenoid cystic carcinomas), and mucoepidermoid tumors. Studies from our laboratory have demonstrated that the quantitative measurement of monoamine oxidase (MAO) in homogenates of carcinoid tumors of foregut origin is different than the activity enzymes in other tumors of neural crest origin. In this study we compared the biochemical composition of 12 bronchial carcinoid tumors with the biochemical composition of a rare mucoepidermoid adenoma of the bronchus. Electron microscopy revealed that some cells of the mucoepidermoid adenoma contained mucin and tonofilaments; none of the cells contained neurosecretory granules. The MAO activity of the bronchial carcinoid tumors was much higher than the MAO activity of the mucoepidermoid adenoma. Thus, there are distinctive ultrastructural and biochemical differences in these two types of bronchial adenomas.
Germ cell tumors in Indian children
Authors: Khanna Sushila , Arya N. C. , Gupta I. M. , Gupta Saroj , Singhal G. D.
Published: February 2007

The present paper is a retrospective study of one hundred and thirty five germ cell tumors seen in children at the University Hospital, Varanasi during a period of 21 years. These tumors constituted 7.5% of all solid tumors in the pediatric age group. Histologically 89 tumors (65.9%) were benign and 46 (34.1%) were malignant. Eighty percent of ovarian and all the testicular germ cell tumors were malignant. Thirty per cent of the tumors were located in the sacrococcyx. The ovaries were the next common site. There were 80 girls, 53 boys, and 2 cases in which the sex was not recorded. The predominance amongst girls was mainly due to the more frequent involvement of ovaries as compared to the testes. Twenty nine of the children were in the first year of life. The factors probably responsible for the higher incidence of malignancy, the differences in anatomic location, and the sex distribution in comparison to other reports have been examined and discussed.
Correlation of estrogen receptor protein and carcinoembryonic antigen with lymphnodal metastasis in breast carcinoma
Authors: Khemani Anil K. , Kapila Kusum , Sundaram K. R. , Verma Kusum
Published: February 2007

Estrogen receptor protein (ERP) content and carcinoembryonic antigen (CEA) positivity were analysed in 50 cases of primary breast carcinoma. Relationship of pathological features known to be of prognostic significance and combined CEA and ERP status were examined. It was found that CEA + ERP − tumours had significantly higher frequency of axillary lymphnodal metastasis in comparison to CEA − ERP + cases. Presence of CEA − or ERP + status showed significant lower frequency of metastasis in comparison to CEA + ERP − tumours.
Experimental continent diversion
Authors: Drago Joseph R. , Nesbitt John A. , Dowell Gladstone Mc , Cirulli Christopher , Geraniotis Evangelos , Smith Jeffrey
Published: February 2007

Urinary diversion utilizing a continence‐maintaining ileal valve has been performed in 12 canines. This procedure offers a simple surgical procedure and uses the diversion's internal fluid pressure to maintain continence. Of 12 canines with this continence‐maintaining ileal valve, 11 remained continent at sacrifice. Operative complications were minimal and late complications occurred in 2 dogs. Histological evaluation of the diversionary tissues revealed slight changes in the mucosa of the ileal valve, with some flattening of the villi. This procedure may have a clinical role in urinary diversion for patients with pelvic malignancy or patients who need urinary diversion for other reasons.
Evaluation of N‐acetylneuraminic acid, carcinoembryonic antigen, and alpha‐fetoprotein as markers for advanced carcinoma
Authors: Khanderia Ujjaini , Grossman H. Barton
Published: February 2007

Sialic acid (N‐acetylneuraminic acid, NANA), carcinoembryonic antigen (CEA), and alpha‐fetoprotein (AFP) were measured in a group of patients with advanced carcinoma (primarily colorectal). The percent change of NANA was less than that with CEA, and more reliably separated patients with stable disease from those with tumor regression or progression. AFP was a good predictor of clinical course in the few patients in which it was measured.
Pyridoxine: A potential local antidote for mitomycin‐C extravasation
Authors: Rentschler Robert , Wilbur David
Published: February 2007

Two cases are presented which suggest that pyridoxine injected into a Mitomycin‐C extravasation site may slow or prevent necrosis, and may decrease the pain associated with the chronic ulceration of extravasation.
Focal intestinal heating with regional abdominal hyperthermia
Authors: Spanos William J. , Thrasher Thais , Thompson Joe , Torrey Robert R.
Published: February 2007

The effect of regional abdominal heating on the small and large bowel was evaluated in three female research pigs. The BSD Annular Phased Array was used for heating. Blind‐end catheters and a free peritoneal probe were surgically attached to small bowel, large bowel, liver, and kidney. Each pig underwent 4–8 heating sessions and was subsequently autopsied. There was no histologic evidence of acute bowel, liver, or kidney damage. There were significant differences in temperatures at the various sites. The average small bowel temperature was significantly higher than predicated by the free peritoneal probe or than seen in the liver or kidney. The large bowel temperatures averaged higher than the free peritoneal probe temperatures, but the difference was not significant. Liver and kidney temperatures approximate whole body temperature due to extensive vascular network. Although the elevated small bowel temperatures may be due in part to different position in relation to isotherms, the frequent occurrence of a large temperature difference suggests focal heating of fluid pockets in the small bowel.
A new site for totally implanted central venous access system in patients with malignancy: Long‐term results of 10 cases
Authors: Appelqvist P. , Pantzar P.
Published: February 2007

In this study of 10 patients with central venous access system, the reservoir body was implanted in the lower limb. Only one complication was observed per 1,560 days of function time. The anterolateral distal half of the thigh is a good alternative site for the injection port in cancer patients whose jugular veins and veins in the arms are not available owing to a tumour or previous treatments.
Hematoporphyrin derivative uptake and photodynamic therapy in pancreatic carcinoma
Authors: Schroder Tom , Chen I‐Wen , Sperling Matthew , Bell Richard H. , Brackett Kim , Joffe Stephen N.
Published: February 2007

Little information is currently available concerning the uptake of porphyrins by pancreatic tumors, or the effect of photodynamic therapy (PDT) on pancreatic cancer. In Syrian golden hamsters (n = 33), the organ distribution of 125I‐labeled dihematoporphyrin ether (DHE) was studied in a pancreatic cancer model. In the same animal model the effect of PDT was studied using a gold vapor laser for energy delivery 3 hr after the injection of DHE (n = 7). DHE was 2.4 times more concentrated in the pancreatic tumor than in the nontumorous pancreas at 3 hr. Simultaneously there was a considerable accumulation of DHE in the surrounding gastrointestinal tract, causing perforation of the duodenum and jejunum with resultant death in four (57%) animals after PDT. Photodynamic therapy caused extensive tumor necrosis without any obvious effect on the nontumor‐bearing pancreas. Damage to the surrounding tissue in the hamster indicates that precautions should be taken if PDT is to be used clinically in pancreatic cancer. Intratumoral injection of DHE may give higher drug concentrations with greater specificity for tumor treatment.
Factors influencing survival in 242 cases of primary gastric carcinoma
Authors: Secco G. B. , Fardelli R. , Campora E. , Rovida S. , Percivale P. L.
Published: February 2007

Two hundred and forty‐two patients who underwent curative surgery for primary gastric cancer between 1965 and 1979 were reviewed, and the influence on survival of the type of surgical treatment, primary tumor location, operative mortality, and stage of disease was analyzed. Operative mortality was significantly increased in patients with multicentric primaries compared to all other sites (P < 0.001) and in patients undergoing total gastrectomy versus subtotal gastric resection (P < 0.001). Stage III‐IV lesions had a significantly worse prognosis than stage I–II tumors (P < 0.001). Our data confirm that early diagnosis could lead to increased survival.
The immunological aspects of keloid tumor formation
Authors: Kazeem A. A.
Published: February 2007

This study considered possible immunological alterations that may be associated with keloid tumor formation. Laser immunonephelometry was used to quantitate circulating immune complexes and complement C3 and C4 among keloid formers. IgG complex level was significantly higher, while C3 and C4 were lower, than in the control population. The raised IgG was positively correlated with C4 (r = 0.15). When considered with reports of earlier workers, keloid genesis could result from genetic predisposition, environmental trigger, or localized and systemic immune complex formations. The relationship of these factors to a disequilibrium between fibroblast synthesis of collagen and turnover degradation still remains unclear.
Cure of advanced gastric cancer by combined chemotherapy with cisplatinum, mitomycin C, and 5‐fluorouracil
Authors: Tanemura Hiromi , Kawata Ryo , Suzuki Masao , Shimokawa Kuniyasu , Azuma Shuji , Furuta Tomohiko , Saji Shigetoyo , Ohashi Hirofumi , Sakata Kazuki
Published: February 2007

A 55‐year‐old female, in which an unresectable Borrmann II‐type gastric cancer (moderately differentiated adenocarcinoma) extending from vicinity of the cardia to the lower portion of the corpus, with direct invasion into the pancreas and extensive lymph node metastases, confirmed by laparotomy, was treated postoperatively by 3 courses of chemotherapy with cisplatinum in combination with mitomycin C and 5‐fluorouracil. A complete response was confirmed by roentgenography and endoscopy, and, at 4 months after the first operation, a total gastrectomy with radical lymphadenectomy was performed successfully. Cancer cells were not detectable histologically in the stomach specimen and in all the lymph nodes removed. One year and 5 months after the second operation she is well, showing no sign of recurrence.
Plasma thromboxane A2 and prostacyclin concentrations in squamous cell carcinoma of the head and neck
Authors: Slotman Gus J.
Published: February 2007

Circulating prostaglandins, including thromboxane A2 and prostacyclin, have been implicated as possible facilitative agents in the growth and dissemination of squamous cell carcinomas of the head and neck. The purpose of this study was to evaluate the relationship of plasma concentrations of these compounds to tumor stage and the effect of surgical resection on plasma prostaglandin levels. Blood samples were obtained from 40 patients with head and neck cancer. Ten treated patients were clinically disease‐free (NED), and 30 patients with active disease were previously untreated at the time of this study. Plasma concentrations of thromboxane A2 and prostacyclin were measured by radioimmunoassay of their stable metabolites thromboxane B2 (TxB) and prostaglandin 6‐keto‐F1 (PGI). Platelet aggregation was performed with normal donor platelets (PRP) and normal control or patient plasma (PPP). TxB and TxB/PGI ratios were increased in T1N0M0 patients, compared with NED and with T4N0M0 primary lesions versus all other groups. With lymphatic and hematogenous metastases, TxB and TxB/PGI ratios fell to NED levels. ADP‐induced platelet aggregation was significantly increased in head and neck cancer patients, compared with normal controls, and with T4N0M0 lesions, compared with NED. There were no significant differences in PGI levels. TxB, PGI, TxB/PGI, and platelet aggregometry did not change significantly with curative surgery. TxB and TxB/PGI interactions are involved in head and neck cancer. Changes in TxB and TxB/PGI may be related to increased platelet aggregation.
Primary lymphoma of the head of the pancreas
Authors: Shtamler Benjamin , Bickel Amitai , Manor Eli , Shahar Menachem Ben , Kuten Abraham , Suprun Harry
Published: February 2007

Primary and isolated lymphoma of the head of pancreas with secondary involvement of the lungs and obstructive jaundice, in a 31‐year‐old post‐partum woman, is described. The histological diagnosis was diffuse histiocytic lymphoma. Chemotherapeutic treatment resulted in complete remission of the tumor. During therapy a pseudocyst of the pancreas developed and a gastrocystostomy was performed. This is the second reported case of primary pancreatic lymphoma in the English medical literature.
The pentagastrin test as an indicator of a cure in surgically treated patients with advanced carcinoid disease
Authors: Ahlman H. , Nilsson O. , Dahlström A. , Tisell L.‐ E.
Published: February 2007

A unique case of midgut carcinoid with advanced disease, engaging lymphnodes and liver but still accessible to curative surgery, is reported. Besides elevated urinary levels of 5‐hydroxyindoleacetic acid, the diagnosis was based on a positive provocation test with pentagastrin, i.e., basally elevated levels of serotonin in peripheral whole blood increased twofold 3 min postinjection related to the appearance of carcinoid symptoms. After removal of primary and secondary lesions in a two‐step procedure carcinoid symptoms disappeared completely. Biochemically, urinary excretion of 5‐hydroxyindoleacetic acid and serotonin levels in peripheral blood before and during provocation with pentagastrin were both normalized after surgery and have remained so during 27 months of follow‐up. Computed tomographies of the abdomen at regular intervals do not indicate recurrent disease. Histologically, the carcinoid lesions displayed a mixed growth pattern and signs of local aggressiveness. Immunocytochemically, the majority of the tumour cells (positive against neuron specific enolase) showed a positive reaction with serotonin antisera. Substance P‐like immunoreactivity was also found in a large proportion of these cells.
Expression of the human transferrin receptor in subrenal capsule assay in the mouse
Authors: Lindholm Marja‐Liisa , Lindberg Lars‐Axel , Vilja Pekka , Puolakka Veli‐Matti , Nordling Stig , Schröder Tom , Schröder Jim
Published: February 2007

The expression of a cell proliferation marker, the human transferrin receptor, was studied in ten human gastrointestinal tumors prior to and after implantation under the renal capsule in the mouse (1–6 days). These data were compared to the increase in tumor size in situ, and to the infiltration of inflammatory cells. All tumors studied expressed the transferrin receptor prior to implantation. Forty of 47 implants expressed the receptor, the strongest expression occurring on day 4, accompanied by a reorganization of tumor tissue to a morphology similar to that before implantation. On days 5 and 6 the expression of the transferrin receptor declined. Implants showed maximal increase in size on days 1 and 2, decreased in size on days 3 and 4, and increased again on days 5 and 6. The increase in the size of the implants on days 5 and 6 was accompanied by considerable infiltration of inflammatory cells, and was probably mostly a result of invading host cells and inflammation. If size alone is used as a criterion for tumor proliferation in this subrenal capsule assay, day 4 seems to be the most appropriate for evaluation. This is supported by a strong expression of a proliferation marker, the human transferrin receptor, during this time.
Postoperative radiation as adjuvant treatment for carcinoma of the oral cavity larynx, and pharynx: Preliminary report of a prospective randomized trial
Authors: Kokal William A. , Neifeld James P. , Eisert Donald , Lipsett James A. , Lawrence Walter , Beatty J. David , Parker George A. , Pezner Richard D. , Riihimaki Daniel U. , Terz Jose J.
Published: February 2007

A prospective randomized trial was performed in patients with advanced squamous cell carcinomas (SCC) of the oral cavity, larynx, and pharynx to examine the effect of adjuvant postoperative radiation therapy on locoregional recurrence and survival following “curative” resection. Fifty‐one patients with stage III or IV SCC treated from 1981 through 1984 were randomized to receive either surgery alone (n = 27) or surgery with postoperative radiation (n = 24). Five patients were excluded from the study after randomization because of ineligibility or protocol violations. Overall recurrence rates of 55.6% and 36.8% were noted in the surgery and surgery with adjuvant radiotherapy arms, respectively (p = NS). This trend towards a higher recurrence rate in the surgery only arm was in part due to the development of lymph node metastases in the contralateral, nonoperated neck. Thus far, no significant differences in either locore‐gional or overall survival have been noted between the two treatment arms. In this preliminary analysis, adjuvant postoperative radiotherapy does not appear to improve disease‐free or overall survival.
Endoscopic surveillance of patients following a curative resection for colorectal cancer
Authors: Md Goran Carlsson , Petrelli Nicholas J. , Herrera Lemuel , Nava Hector , Mittelman Arnold
Published: February 2007

From 1974 to 1985, 161 patients were followed by at least one colonoscopy following a polypectomy for an adenomatous polyp. These patients had had a previous curative resection performed for colorectal carcinoma. The median follow‐up time after surgery was 54 months. A polyp within 65 cm from the anal verge or from a permanent colostomy was considered detectable by the flexible sigmoidoscope. Seventy‐one patients (44%) were found to have adenomatous polyp(s) within 65 cm during the followup period. This incidence was influenced by the type of colorectal resection performed. In 36 of 41 patients (88%) undergoing a right hemicolectomy, the adenomatous polyp(s) was found within 65 cm from the anal verge. This was an incidence statistically and significantly higher than the incidence in patients undergoing other types of surgical resections. There were no differences in age, sex, or Dukes' stages according to the type of surgical resection performed. In summary, the present study demonstrates that there is a role for postoperative surveillance by the 65 cm flexible sigmoidoscope. This surveillance can be performed with great safety especially in patients following a right hemicolectomy; significantly more of these patients have adenomatous polyps within reach of the 65 cm flexible sigmoidoscope.