bluuebunny/crossref_metadata_2025 huggingface dataset:
Renal cell carcinoma: Comparison of the tnm and robson stage groupings
Authors: Guinan Patrick , Saffrin Robert , Stuhldreher David , Frank Walter , Rubenstein Marvin
Published: February 2007

This review compares the two major staging systems for renal cell carcinoma: the TNM and Robson systems. For purposes of worldwide clinical and scientific consistency, the TNM system is recommended. However, the primary tumor size cutoff of 2.5 cm. does not prognostically differentiate between stages I and II. A review of 337 patients with renal cell carcinoma, of whom 122 had stage I or II disease revealed that a 2.5‐cm cutoff did not predict survival differences, while cutoffs of 5.0, 7.5, and 10.0 cm did. Because 7.5 cm most closely approximates the mean renal cell cancer diameter as noted by SEER data, it is recommended that the TNM primary tumor cutoff be changed to 7.5 cm.
Tumor necrosis factor alpha stimulates gluconeogenesis from alanine in vivo
Authors: Blumberg David , Hochwald Steven , Burt Michael , Donner David , Brennan Murray F.
Published: February 2007

An increase in gluconeogenesis contributes to the cachexia seen in severe injury, sepsis, and malignancy by converting amino acids from skeletal muscle to glucose. Since tumor necrosis factor α (TNFα) may mediate this cachexia, we examined the effect of this cytokine on gluconeogenesis. Twenty‐eight male Fischer rats were injected intraperitoneally with TNFα (250 μg/kg) or saline, and after 4 hours, isolated hepatocytes were obtained by in situ collagenase liver perfusion. Hepatocytes were incubated with alanine (10 mM), and rates of gluconeogenesis were determined. Plasma lactate, glucose, insulin, glucagon, cortisol, and amino acids were measured. TNFα administration resulted in a 50% increase in gluconeogenesis from alanine (P <0.05) and a three‐fold increase in plasma glucagon (P = 0.01). Total and glucogenic plasma amino acids decreased with TNFα injection (P < 0.05). In vivo TNFα causes an increase in hepatic gluconeogenesis associated with increased plasma glucagon.
Vocal cord paralysis in patients with thoracic esophageal carcinoma
Authors: Tachimori Yuji , Kato Hoichi , Watanabe Hiroshi , Ishikawa Tsutomu , Yamaguchi Hajime
Published: February 2007

Of 478 consecutive patients with intrathoracic esophageal carcinoma, 5% had vocal cord paralysis. In two thirds of the patients with vocal cord paralysis, the paralysis was caused by a metastatic lymph node located along the recurrent laryngeal nerve. These findings indicate that the possibility exists for radical surgery by esophagectomy and resection of the metastatic lymph node infiltrating the recurrent laryngeal nerve, even in patients with vocal cord paralysis. However, in only two patients was radical surgery accomplished. None of the 24 patients with paralysis survived without disease for more than 1 year. Thus, in patients with vocal cord paralysis, the need for combined therapy should be emphasized.
Characteristics of non‐small cell lung cancer 3 cm or less in diameter
Authors: Tateishi Masahiro , Fukuyama Yasurou , Hamatake Motoharu , Kohdono Satoshi , Mitsudomi Tetsuya , Ishida Teruyoshi , Sugimachi Keizo
Published: February 2007

We retrospectively investigated 308 cases of non‐small cell lung cancer of ≥3 cm diameter. There were 204 adenocarcinomas, 78 squamous cell carcinomas, 15 large cell carcinomas, and 11 other carcinomas. According to TNM staging, there were one case stage 0, 208 stage I, 22 stage II, 49 stage IIIA, 15 stage IIIB, and 13 cases stage IV. T1 disease was seen in 262 cases, T2 in 19, T3 in 10, T4 in 16, and Tis in 1. No disease was seen in 217 cases, N1 in 30, N2 in 60, and N3 in 1. The 5‐year survival rate of all case was 63%. There were statistically significant differences amont T status (T1 vs. T3, T4), N status (N0 vs. N1, N2), and M status (M0 vs. M1) (P < 0.01). The 5‐year survival rates of cases with adenocarcinoma and squamous cell carcinoma were 60% and 64%, respectively. In 204 cases of adenocarcinoma, T3 disease was found in one case, T4 disease in 15 (7%), and nodal involvement (N1 + N2) was present in 69 (34%). In 78 cases of squamous cell carcinoma T3 was seen in 6 (8%), T4 in 1, and nodal involvement in 14 (18%). The incidence of T3 disease, T4, and N(+) varied significantly according to histology (P < 0.05). Our investigation suggested that cases of small‐sized lung cancer were often at an advanced stage at detection, and that the spread of disease differed according to histology. The patient with small‐sized lung cancer should be offered a standard operation regardless of histology.
Primary gastrointestinal lymphoma: 30‐year experience at the cancer institute, madras, india
Authors: Ramesh Chandran R. , Hemanth Raj E. , Chaturvedi Harit K.
Published: February 2007

A retrospective study was conducted of 49 patients with primary gastrointestinal lymphoma to analyze clinicopathological features, prognostic factors, and results of treatment. Intestinal lymphomas (63%) were more common than gastric lymphomas (29%). Endoscopic biopsy was diagnostic in 64% of gastric lymphomas, while 97% of intestinal lymphomas required laparotomy for diagnosis. Lymphoblastic (35%) and diffuse large cell (33%) lymphomas were the most frequent histologic types. Complete remission (CR) was achieved in 61% of patients, with a 5‐year survival of 72% in those who achieved CR. The overall 5‐year survival and disease‐free survival were 47% and 40%, respectively. All disease‐related mortality occurred within 2 years of diagnosis, with 79% occurring in the first year. There was no overall significant difference in survival between the different treatment groups. Stage, extent of surgical resection, response to treatment, serosal involvement, multimodality treatment, and performance status were significant prognostic factors. Achievement of complete remission and complete surgical resection were the most favorable independent prognostic factors on multivariate analyses. © 1995 Wiley‐Liss, Inc.
Overexpression of p‐glycoprotein in untreated AFP‐producing gastric carcinoma
Authors: Dhar Dipok Kumar , Nagasue Naofumi , Yoshimura Hiroshi , Tachibana Mitsuo , Tahara Hideki , Matsuura Hiroshi , Abe Shun'Ichi , Chang Yu‐Chung , Nakamura Teruhisha
Published: February 2007

P‐glycoprotein (P‐gly), which is responsible for the phenotypic expression of multidrug resistance in cancerous tissue was stained immunohistochemically in previously untreated α‐fetoprotein (AFP)‐producing (n = 20) and nonproducing gastric cancers (n = 20). P‐gly, AFP, and carcinoembry‐onic antigen(CEA) were stained in formalin‐fixed paraffin‐embedded tissue sections immunohistochemically using the monoclonal antibody JSB‐1, anti‐AFP, and anti‐CEA, respectively. DNA ploidy pattern was determined by Fluorescence Activated Cell Sorter (FACS) analyzer.

P‐gly was significantly overexpressed in AFP producing gastric cancers (60%) than in AFP nonproducing ones (20%) (P < 0.01). When the result of P‐gly staining was analyzed among the AFP‐positive cases, P‐gly positivity did not emerge either as a significant prognostic factor or as a predictor of the metastatic potentiality of the tumor. The intrinsic overexpression of P‐gly in AFP producing gastric cancers proves its biological and morphological similarities to hepatocellular carcinoma. The significantly (P < 0.05) higher incidence of P‐gly in diploid tumors indicate that expression of this phenotype might be related to the differentiation of the tumor.

P‐gly was overexpressed in AFP producing gastric carcinoma and the existing drug resistance, frequent recurrence, and poor prognosis might be explained by presence of P‐gly in this carcinoma. © 1995 Wiley‐Liss, Inc.
Treatment of breast cancer in elderly patients
Authors: Van Dalsen Annette D. , De Vries Johannes E.
Published: February 2007

The objective of this study was to analyze the treatment and its results in breast cancer of the elderly. Special attention was given to the primary treatment with tamoxifen alone. We reviewed 210 patients over 70 years old with breast cancer treated between 1980 and 1992. Mean follow‐up time was 41 months. Tamoxifen was given as primary treatment in 34 patients without distant metastases; 147 patients without distant metastases underwent surgery. Local or regional recurrence occurred in 6% of the patients who had surgery. Local progressive disease was reported in 27% of those treated with tamoxifen (P < 0.005). These patients had further surgery. There was no difference between the two groups in overall survival of patients and occurrence of metastases. We concluded that optimal treatment of breast cancer in the elderly should include surgery. Only patients with very limited life expectancy should receive tamoxifen alone. © 1995 Wiley‐Liss, Inc.
Typical medullary carcinoma of the breast: A clinical and pathological analysis of 52 cases
Authors: Reinfuss Marian , Stelmach Andrzej , Mitus Jerzy , Rys Janusz , Duda Krzysztof
Published: February 2007

Fifty‐two women with typical medullary breast carcinoma, diagnosed according to criteria of Ridolfi et al. [Cancer 40:1365–1385, 1977] are described. At the time of diagnosis, 90% of the patients were stages I and II. The primary tumor size was ≦ to 4 cm in 46 (88.5%) and > 4 cm in 6 (11.5%) patients. Axillary lymph nodes were microscopically negative in 35 (67.3%) and positive in 17 (32.7%) patients. All 52 women underwent the Patey operation. Seventeen patients with microscopically positive axillary lymph nodes received postoperative irradiation. Of the 52 treated patients, 44 (84.6%) survived 10 years NED. The only prognostic factor was the microscopical axillary lymph nodes status. In the group of pNO patients, 97.1% survived 10 years NED, pN+ 58.8% only. The sole causes of unsuccessful treatment were distant metastases to lungs, hepar, and bones. Typical medullary carcinoma is a favorable histological type of breast carcinoma with very good prognosis for pNO patients. © 1995 Wiley‐Liss, Inc.
Collagen promotes perianastomotic tumour growth in an experimental animal model
Authors: Reinbach Diana , McGregor John R. , Dahill Steven W. , Docherty James G. , O'Dwyer Patrick J.
Published: February 2007

Local application of growth factors promote wound healing and may find clinical application for use in high‐risk intestinal anastomoses such as that following anterior resection. Since viable tumour cells are present in the bowel lumen and circulation after curative colorectal cancer surgery, it is unclear what effect such factors may have on tumour recurrence. The aim of this study was to examine the effect of epidermal growth factor (EGF) and basic fibroblast growth factor (bFGF) in a collagen suspension on perianastomotic tumour growth in an animal model. Significantly (P < 0.05) more animals in the collagen treated groups developed anastomotic tumours. The area of tumour growth at the anastomosis was also significantly greater for the collagen (median 14.7 mm2) and collagen + EGF (median 10.8 mm2) groups compared with controls (median 0.78 mm2). We were unable to demonstrate any promotion of tumour by growth factors alone. Collagen promotes perianastomotic tumour growth in this model and is not a suitable vehicle for growth factor application in colorectal cancer surgery. © 1995 Wiley‐Liss, Inc.
Intraoperative radiation therapy for locally advanced recurrent rectal or rectosigmoid cancer
Authors: James Iii H. Wallace , Willett Christopher G. , Shellito Paul C. , Coen John J. , Hoover Herbert C.
Published: February 2007

Recurrent rectal or rectosigmoid cancer is a difficult therapeutic problem. A treatment program of external beam irradiation, surgery, and intraoperative irradiation has been used for 41 patients. The 5‐year actuarial local control and disease‐free survival of all 41 patients was 30% and 16%, respectively. Subset analysis demonstrated differences in outcome by extent of surgical resection. The 5‐year actuarial local control and disease‐free survival of 27 patients undergoing complete resection was 47% and 21%, respectively. By contrast, the outcome of 14 patients undergoing partial resection was poor, with a 5‐year actuarial local control and survival of 21% and 7%, respectively. Late complications included soft tissue or peripheral nerve injury, with many of these resolving within 4–18 months. Local control and disease‐free survival rates are favorable in comparison with the results achieved by aggressive surgery. Patients who achieve a gross total resection at intraoperative irradiation have a markedly better prognosis than that of patients with residual gross disease. © 1995 Wiley‐Liss, Inc.
Sinus histiocytosis mimicking metastatic melanoma in lymph nodes of a patient with a large joint prosthesis: Case report and review of the literature
Authors: Charny Caleb K. , Jacobowitz Glenn , Melamed Jonathan , Tata Mona , Harris Matthew N.
Published: February 2007

Malignant melanoma metastases to regional lymph nodes may be mimicked by several non‐neoplastic processes, including sinus histiocytosis induced by fragments shed from joint prostheses. A patient who had an elective lymph node dissection for malignant melanoma and was found to have “post‐prosthesis lymph node histiocytosis” resembling metastatic disease is described. Knowledge of the patient's past history of a total shoulder joint replacement along with the use of polarized light microscopy to identify birefringent particles of prosthetic debris allows for an accurate histologic diagnosis. © 1995 Wiley‐Liss, Inc.
Analysis of proliferative activity using antiproliferating cell nuclear antigen antibody in colorectal cancer
Authors: Nakae Shiro , Nakamura Takeshi , Shirono Junko , Yoshioka Hiroshi , Ikegawa Ryuichiro , Miyamura Kazuo , Kawasaki Kentaro , Saitoh Yoichi , Tabuchi Yoshiki
Published: February 2007

Using anti‐PCNA antibody (PC10), an immunohistochemical study of the expression of PCNA in formalin‐fixed and paraffin‐embedded materials of colorectal cancer patients was performed and correlation of PCNA expression with clinicopathological findings and DNA ploidy pattern was studied. PCNA labeling rate (PCNA LR) was estimated in the advancing margin of the tumor and ranged from 23.8% to 77.9%. There was a significant difference in lymphatic vessel invasion, liver metastasis and Dukes' stage between the groups with high (>48.7) and low (<48.7) PCNA LR (P < 0.05). No differences were seen in tumor size, histological type, lymphnode metastasis or DNA ploidy pattern. In patients with younger age, infiltration to neighboring organs, a high degree of venous invasion, and peritoneal dissemination, the frequency of high PCNA LR tended to be higher (P<0.1). The results above suggest that a high proliferative activity as defined by evaluation of the PCNA LR at the advancing margin of the tumor may be one of the parameters of malignant potential and helpful as a predictor of liver metastasis in colorectal cancer. © 1995 Wiley‐Liss, Inc.
Venous gas embolism during cryosurgery for bone tumors
Authors: Bart Schreuder H. W. , Van Beem Herman B. H. , Veth René P. H.
Published: February 2007

Cryosurgery using liquid nitrogen is a method for treating benign‐ and low‐malignant skeletal tumors. The advantage of preserving the supportive function of bone should be compared to the risk for its complications; postoperative fracture is well known, but less so the occurrence of intraop‐erative venous gas embolism. This paper describes 17 patients: 2 patients who had serious hemodynamic complications during cryosurgery and a study of 15 patients in whom end‐tidal N2 tension was measured in an attempt to investigate the clinical incidence of venous gas embolism during cryosurgery. In the 15 cases analyzed, we did not detect any exhaled N2 during cryosurgery. © 1995 Wiley‐Liss, Inc.
Substernal goiter
Authors: Newman Elliot , Shaha Ashok R.
Published: February 2007

The management of a substernal goiter is a problem which has challenged surgeons since its first description in 1749. While the overall incidence in the United States has decreased with the routine use of iodized salt, the development of large multinodular substernal goiters in the rest of the world is still common. In addition, even in those regions where they are less common, knowledge of their treatment is important as they can represent up to 7% of mediastinal tumors. Certainly, the majority are large, benign masses found in the superior and anterior mediastinum, although from 3 to 15% can be malignant in nature. The presenting symptoms generally relate to the compressive nature of the mass on nearby structures. Up to 90% of patients report some form of respiratory symptoms in association with these masses. Diagnostic evaluation should include chest x‐ray and computed tomographic (CT) scan. Needle aspiration biopsy should be avoided due to its dangerous substernal location. The treatment is surgical, as medical therapy is generally unsuccessful. Perioperative management should include careful evaluation of the airway as the extent of compression and deviation caused by the mass can lead to a difficult intubation. The vast majority of substernal goiters can be removed via a cervical incision; occasionally sternotomy or thoracotomy is necessary. Although rare, tracheomalacia secondary to prolonged compression of the trachea by the mass needs to be watched for postoperatively. Overall, the results of surgical treatment are excellent, as morbidity and mortality are minimal and patients can expect full relief of symptoms secondary to these mediastinal masses. © 1995 Wiley‐Liss, Inc.
Clinical significance of cathepsin D assay in breast cancer tissues
Authors: Itoh Yukashi , Kobayashi Shunzo , Iwase Hirotaka , Yamashita Hiroko , Kuzushima Tatsuya , Iwata Hiroji , Yamashita Toshinari , Naitoh Akihiro , Itoh Kazuko , Masaoka Akira
Published: February 2007

Cathepsin D was assayed in 74 primary breast cancer specimens by enzyme immunoassay (EIA) and immunohistochemical assay (ICA). Of the 74 specimens, 38 (51.4%) were scored positive by ICA, and 25 (33.8%) were scored positive by EIA. The coincidence rate between ICA and EIA was 71.6% (53/74). There was no significant correlation between cathepsin D and menopausal status, tumor size, number of metastatic lymph nodes, histologic type of the tumor, or steroid receptor status. Cathepsin D status designated by EIA or ICA predicted neither disease‐free survival (DFS) nor overall survival (OAS). Subset analysis with estrogen receptor, menopausal, and lymph node status revealed no association between cathepsin D and survival. Univariate analysis revealed no association between cathepsin D and DFS or OAS. Therefore, cathepsin D is not an independent prognostic factor in breast cancer. © 1995 Wiley‐Liss, Inc.
Antitumor activity of cis‐diamminedichloroplatinum (II) depends on its time × concentration product against human gastric cancer cell lines in vitro
Authors: Kurihara Naoto , Kubota Tetsuro , Hoshiya Yasunori , Otani Yoshihide , Kumai Koichiro , Kitajima Masaki
Published: February 2007

A pharmacodynamic study of cisplatin (DDP) was conducted using the gastric cancer cell lines MKN‐45 and MKN‐74 in vitro. Ten thousand tumor cells were incubated with 0.4–500 μg/ml DDP for 1–25 h, followed by recovery culture for a further 48 h. At the end of incubation, cell viability was detected by the MTT end‐point, and the inhibition rate was compared in relation to the incubation time, DDP concentration, and the time × concentration product (area under the curve in vitro: AUC vitro). In both of the cell lines, the IC50 and IC90 values decreased as the exposure time increased, going a linear curve with a slope of almost — 1, and showing a typical log‐log AUC vitro‐dependent curve. These results indicate that the antitumor activity of DDP is dependent on its AUC vitro, suggesting the clinical usefulness of this drug when administered daily in small divided doses. © 1995 Wiley‐Liss, Inc.
Ewing's sarcoma of bone: Oncologic and functional results
Authors: Renard Auke J. S. , Veth René P. H. , Pruszczynksi Maciej , Hoogenhout Jaap , Bökkerink Jos , Van Der Staak Frans J. M. , Wobbes Theo , Lemmens Josef A. M. , van Hoesel René , Van Horn Jim R.
Published: February 2007

This paper describes 29 patients with Ewing's sarcoma of bone treated between 1975 and 1990 at the University of Nijmegen Hospital, Nijmegen, The Netherlands. Osteomyelitis was the primary diagnosis in 24%.

Treatment consisted of chemotherapy in combination with surgery and/or radiotherapy. Nine patients received radiotherapy only; five of them died of disease. Five patients underwent an intralesional excision; four of them died of disease. Twelve patients underwent a wide excision; there is no evidence of disease in any of them. Three patients underwent a radical disarticulation; all died of disease. The disease‐free survival at 1.5 years was 66%. This figure at 5 years was 55%. After wide excision and reconstruction in tumors of expendable, femoral or radial bones good functional results were obtained in all cases. © 1995 Wiley‐Liss, Inc.
Intraoperative brachytherapy using gelfoam radioactive plaque implants for resected stage iii non‐small cell lung cancer with positive margin: A pilot study
Authors: Nori Dattatreyudu , Li Xilian , Pugkhem Tretorn
Published: February 2007

Complete surgical resection of stage III non‐small cell lung cancer (NSCLC) is at times impossible. Adjuvant radiation therapy is required to sterilize the residual tumor. This study is to investigate the safety, reproducibility, and effectiveness of intraoperative I–125 or Pd‐103 Gelfoam plaque implant technique as an adjuvant treatment for resected stage III NSCLC with positive surgical margin. Between 1989 and 1993, 12 patients with stage III NSCLC received intraoperative lung implant with radioactive I–125 or Pd‐103 pellets. All 12 patients underwent tumor resection, but either gross or microscopic positive margin was found during operation. Radioactive I‐125 or Pd‐103 seeds were embedded in the Gelfoam plaque. After surgical resection was completed, the radioactive Gelfoam plaque was secured onto the tumor bed either by clips or suture. Either preoperative or postoperative external beam radiation of 45–60 Gy was given to all of the 12 patients. Four patients received chemotherapy. No patient has developed any early or late complications attributable to implant procedure or radiation. The local control rate at last follow‐up is 82%. The 2‐year overall and cause‐specific survival rates are 45% and 56%, respectively. The intraoperative Gelfoam I‐125 or Pd‐103 planar implant technique is a safe, reproducible, and effective technique of treatment for stage III NSCLC with positive surgical margin. Encouraging local control and survival are achieved in patients treated with this technique. This technique will compliment standard adjuvant treatments to further improve local control in resected stage III lung cancer. © 1995 Wiley‐Liss, Inc.
Thyroid carcinoma metastasized to the sternum: Resection of the sternum and reconstruction with acrylic resin
Authors: Ozaki Osamu , Kitagawa Wataru , Koshiishi Haruya , Sugino Kiminori , Mimura Takashi , Ito Kunihiko
Published: February 2007

Recently we resected and reconstructed the sternum in two female patients with thyroid carcinoma metastatic to the sternum. Histological diagnosis of the metastatic lesion was follicular carcinoma in the first case and papillary carcinoma in the second case. Reconstruction of the sternum was accomplished by using an acrylic resin plate alone in the first case and an acrylic resin plate sandwiched between layers of Marlex® mesh (Marlex sandwich procedure) in the second case. In the first case the acrylic resin plate was directly fixed to the ribs with metallic wires, most of which snapped off later, and a small amount of exudate accumulated around the plate for a short period of time. In contrast, the postoperative course in the second case was uneventful and the Marlex® sandwich procedure seemed superior in chest wall reconstruction following resection of the sternum. © 1995 Wiley‐Liss, Inc.
Laser surgery of port wine stains using local vacuum pressure: Changes in skin morphology and optical properties (Part I)
Authors: Childers Michael A. , Franco Walfre , Nelson J. Stuart , Aguilar Guillermo
Published: February 2007

Background and Objectives

In a recent case study, the use of a suction device to aid in port wine stain (PWS) laser treatments showed favorable results. It is our objective to further understand the mechanisms of vacuum‐assisted laser therapy by analyzing the mechanical and optical changes of the skin and musculoskeletal tissues during the application of mild vacuum pressure from a suction cup.

Study Design/Materials and Methods

A mathematical model of tissue deformation was used to determine the changes in tissue morphology that affect the underlying laser‐tissue interactions, such as epidermal stretching and thinning, blood vessel dilation, and change in blood vessel depth. Video imaging experiments were used to verify the bulk tissue deformation and skin surface stretching computed by the mathematical model. Additionally, visible reflectance spectroscopy was used to determine the changes in the optical characteristics of tissue, including blood vessel dilation and epidermal absorption coefficient.

Results

At a vacuum pressure of 50 kP
a, the epidermis at the center of the suction cup was measured to stretch 4% and was calculated to be thinned approximately 6%. Blood vessels embedded in the dermis were measured to dilate up to two times their original size. However, these vessels were calculated to be displaced toward the skin surface by a very small amount, approximately 1–3 µm. The absorption coefficient of the epidermis was also measured to be reduced significantly by approximately 25% at a wavelength of 585 nm.

Conclusions

Mild vacuum pressure applied to the skin surface causes considerable changes in the morphology and optical properties of the tissue. These changes may be used for more efficient photothermolysis of small PWS blood vessels. Lasers Surg. Med. 39:108–117, 2007. © 2007 Wiley‐Liss, Inc.
The new‐generation, high‐energy, 595‐nm, long pulse‐duration pulsed‐dye laser improves the appearance of photodamaged skin
Authors: Bernstein Eric F.
Published: February 2007

Background and Objectives

Chronic sun‐exposure results in five main changes to exposed skin: telangiectasia, hyperpigmentation, rhytides, enlarged pores, and sagging skin. Various laser and non‐laser modalities have been used to improve sun‐damaged skin. The pulsed‐dye laser (PDL) has an unparalleled safety record and an ideal wavelength for treating the signs of photodamage. In this study, we investigate the ability of the long pulse‐duration PDL to improve the appearance of photodamaged skin.

Study Design/Materials and Methods

Ten subjects with cutaneous photodamage were treated with the high‐energy, long pulse‐duration PDL using fluences ranging from 8.0 to 10.0 J/cm2, a 10‐mm spot, and a 10‐millisecond pulse‐duration. Five subjects judged to have discrete solar lentigos or ephiledes were also treated to these lesions using a compression handpiece. Improvement was determined by blinded evaluation of photographs taken before and after the final treatment, and by subjects' self‐evaluation 8 weeks following the final treatment.

Results

Subjects rated overall improvement as 65%, facial veins as 72% improved, hyperpigmentation 65% improved, enlarged pores 65% improved, and wrinkles 62% improved. Improvement was also determined by 3 physicians rating digital photographs and blinded as to which photos were pre‐ or post‐treatment. They rated wrinkles as improved in 50% of photographs, veins as improved in 82%, diffuse redness as improved in 80%, pigmentary alterations as improved in 61.4%, and pore size as improved in 25%.

Conclusions

The high‐energy, long pulse‐duration PDL improves photodamaged skin using non‐purpuric settings. Lasers Surg. Med. © 2007 Wiley‐Liss, Inc.
In vivo histological evaluation of a novel ablative fractional resurfacing device
Authors: Hantash Basil M. , Bedi Vikramaditya P. , Kapadia Bhumika , Rahman Zakia , Jiang Kerrie , Tanner Heather , Chan Kin Foong , Zachary Christopher B.
Published: February 2007

Background and Objectives

A novel carbon dioxide (CO2) laser device employing ablative fractional resurfacing was tested on human skin in vivo for the first time.

Study Design/Materials and Methods

An investigational 30 W, 10.6 µm CO2 laser system was focused to a 1/e2 spot size of 120 µm to generate an array of microscopic treatment zones (MTZ) in human forearm skin. A range of pulse energies between 5 and 40 mJ was tested and lesion dimensions were assessed histologically using hematoxylin & eosin. Wound healing of the MTZ's was assessed immediately‐, 2‐day, 7‐day, 1‐month, and 3‐month post treatment. The role of heat shock proteins was examined by immunohistochemistry.

Results

The investigational CO2 laser system created a microscopic pattern of ablative and thermal injury in human skin. The epidermis and part of the dermis demonstrated columns of thermal coagulation that surrounded tapering ablative zones lined by a thin eschar layer. Changing the pulse energy from 5 to 30 mJ resulted in a greater than threefold increase in lesion depth and twofold increase in width. Expression of heat shock protein (hsp)72 was detected as early as 2 days post‐treatment and diminished significantly by 3 months. In contrast, increased expression of hsp47 was first detected at 7 days and persisted at 3 months post‐treatment.

Conclusion

The thermal effects of a novel investigational ablative CO2 laser system utilizing fractional resurfacing were characterized in human forearm skin. We confirmed our previous ex vivo findings and show for the first time in‐vivo, that a controlled array of microscopic treatment zones of ablation and coagulation could be deposited in human skin by varying treatment pulse energy. Immunohistochemical studies of heat shock proteins revealed a persistent collagen remodeling response lasting at least 3 months. We successfully demonstrated the first in‐vivo use of ablative fractional resurfacing (AFR™) treatment on human skin. Lasers Surg. Med. 39:96–107, 2007. © 2007 Wiley‐Liss, Inc.
Blood‐vessel neoplasms in children: Epidemiologic aspects
Authors: Chabalko John J. , Fraumeni Joseph F.
Published: February 2007

In a search for etiologic leads to blood‐vessel neoplasms, we examined 111 death certificates of U.S. children who died from 1960 to 1968 of angiosarcoma, hemangioendothelioma, and hemangiopericytoma and 127 medical records of similar cases from 12 institutes. The available data provided no leads to environmental agents (vinyl chloride, thorotrast, arsenic) that can produce vascular liver tumors in adults, but one infant, who died from a hepatic tumor, lived within a mile of an industrial source of polyvinyl chloride. About half of the children with hepatic hemangioendotheliomas had associated skin hemangiomas, which may aid in the differential diagnosis of liver tumors in infancy. Hepatic hemangioendotheliomas also predominated in girls, a possible clue to the origin of the tumor. A familial influence was suggested by one sibling aggregation of cutaneous hemangioendotheliomas.
Intravenous catheter infection study: A prospective trial in patients with neoplastic disease
Authors: Feld R. , Leers W. D. , Curtis J. E. , Bergsagel D. E.
Published: February 2007

This study was designed to determine the frequency and significance of infection at the site of indwelling intravenous catheters. Eligible patients were randomly assigned to have an intravenous infusion utilizing either a plastic cannula or a short metal needle. Both of these groups were further randomly divided into two groups, one having the intravenous catheter removed every 48 hr and the other having the catheter changed only when necessary.

One hundred and eighty‐seven catheters from 50 patients were cultured. Eleven (5.9%) of the catheters were found to be colonized by organisms. Metal needles and plastic cannulas were infected with similar frequency. The incidence of local infection was not influenced by concurrent antibiotic therapy, local phlebitis, or the level of the granulocyte count during the period of intravenous infusion. Six of 31 catheter tips in place for longer than 56 hr were colonized by organisms, compared with 5 of 156 catheter tips in place for less than 56 hr (p < 0.001). The study indicates that indwelling intravenous catheters should be changed at least every 48 hr in order to prevent colonization of the tip of the intravenous catheter.
Mononuclear cell content of human solid tumors
Authors: Hersh Evan M. , Mavligit Giora M. , Gutterman Jordan U. , Barsales Petronilo B.
Published: February 2007

The mononuclear cell content and mononuclear cell function of human solid tumors were determined. Twenty‐eight primary, and 17 metastatic solid tumors, including 6 lymph node metastases, were obtained from 45 patients. Cells were released from the tumors by mincing, scraping, and sieving. Analysis of the cellular content was determined by light microscopy, and tumor lymphocyte function was determined by stimulation of blastogenesis with PHA, PWM, Con‐A, MLC, and SLO. A median of 3.3 × 107 tumor cells with 12.5% viability was obtained per gram of tumor, and a median of 7.8 × 106 lymphocytes with a viability of 96% and 0.35 × 106 macrophages with a viability of 85% was also obtained per gram of tumor. Significant lymphocyte responses to various mitogens and antigens were obtained in 31–40% of the tumor lymphocyte preparations. From 9.4% to 23% had vigorous responses with a stimulation index greater than 10. Primary tumors contained significantly more lymphocytes than metastatic tumors; thus, the percent lymphocytes in primary tumors was 13.5% compared to 5% for metastatic tumors. In contrast, some of the lymphocyte responses were significantly greater for metastatic tumors than primary tumors. These data suggest that the direct study of lymphocytes infiltrating primary and metastatic tumors may be a useful approach to understanding tumor immunity in man.
Combination chemotherapy with adriamycin (NSC‐123127) and dimethyl triazeno imidazole carboxamide (DTIC) (NSC‐45388) in children with metastatic solid tumors
Authors: Cangir Ayten , Morgan Samuel K. , Land Vita J. , Pullen Jeanette , Starling Kenneth A. , Nitschke Ruprecht
Published: February 2007

Combination chemotherapy with adriamycin and DTIC was used in 102 evaluable patients under 15 years of age who had previously treated metastatic solid tumors. Responses, defined as 50% or more reduction in all tumor masses, occurred in 10 out of 27 patients with neuroblastoma, 3 out of 8 patients with Wilms tumor, 7 out of 15 patients with Ewing sarcoma, 2 out of 6 patients with osteosarcoma, 5 out of 13 patients with rhabdomyosarcoma, and 15 out of 33 patients with miscellaneous tumors which included a patient who had a complete regression of an extensive juvenile angiofibroma. Response rate to combination chemotherapy with adriamycin and DTIC in patients with Ewing sarcoma was significantly superior to the response rate obtained with adriamycin alone in another Southwest Oncology Group Study. Major toxicity included nausea, vomiting, myelosuppression, high incidence of pneumocystis carinii pneumonia (5 patients) and congestive heart failure (4 patients). There were 7 drug‐associated deaths due to sepsis (1), pneumocystis carinii pneumonia (4), and congestive heart failure (2).
Cytogenetic studies in acute lymphocytic leukemia: Special emphasis in long‐term survival
Authors: Whang‐Peng Jacqueline , Knutsen Turid , Ziegler John , Leventhal Brigid
Published: February 2007

Cytogenetic studies were performed in 331 patients with ALL diagnosed at the National Institutes of Health between January 1961 and January 1976. Four patients had constitutionally abnormal genotypes, three had Down's syndrome, and one had a D/G translocation. Aneuploidy was observed in the pretreatment bone marrow in 49/115 (42.6%) of the patients and at some stage of disease in 54.1% of the patients. Aneuploidy in this series exhibited several general characteristics: aneuploid cells usually coexist with normal stem cells, hyperdiploidy is predominant, and wide ranging aneuploidy clusters around a major cell line. The most common chromosomal group involved in aneuploidy is the G group (p = 0.001) and the next most common is the B group (p = 0.01). Aneuploidy disappeared after successful achievement of remission, and new clones developed in 12 patients during relapse. Two of the four patients originally thought to have a Ph1 chromosome, on trypsin Giemsa banding were proved to have a 21q‐ chromosome. A higher incidence of aneuploidy was noted in patients under one year or more than 20 years of age and was also higher in patients with low or elevated WBCs at diagnosis. The appearance of aneuploid cells in the bone marrow at the onset or later in the disease is of no prognostic significance but persistence of these lines and the development of total aneuploidy signals a poor prognosis. Eradication of aneuploid cells is therefore essential for the achievement of a long remission and progress to a permanent cure.
Cicatricial ectropion secondary to 5‐fluorouracil therapy
Authors: Straus David J. , Mausolf Frederick A. , Ellerby Richard A. , McCracken Joseph D.
Published: February 2007

Four cases of cicatricial ectropion secondary to prolonged systemic administration of 5‐fluorouracil are described. In 1 patient ectropion resolved with conservative treatment and discontinuation of 5‐FU. Another patient developed the ectropion terminally and died before its resolution. In 2 patients surgical repair of the ectropion was unsuccessful in relieving conjunctival symptoms while 5‐FU was continued. With prolonged adjuvant chemotherapy programs utilizing 5‐FU, this complication may be seen with increasing frequency. Conservative management should be attempted, and patients with this problem should be reassured that symptoms will resolve when 5‐FU is stopped.
Prognosis in children with metastatic rhabdomyosarcoma
Authors: Okamura Jun , Sutow Wataru W. , Moon Thomas E.
Published: February 2007

Distant metastases were documented in 83 of 161 children with rhabdomyosarcoma seen between 1953 and 1974. Of these, 31 had metastases at diagnosis (Group IV) and 7 were noted to have metastases only at autopsy. Only 6 are living with no evidence of disease activity at 6, 20, 77, 85, 105, and 112 months from time of metastasis. One child is living with disease at 98 months. Late deaths occurred in 2 at 31 and 41 months after metastasis. Sixty‐four of the 66 deaths occurred within 24 months. The median durations of life after metastasis were less than 9 months in Groups I and II patients, less than 6 months in Group III patients, and about 12 months in 31 Group IV patients. The median time to metastasis in Groups I, II, and III patients was 9 months.
Clinical trial of nafoxidine in advanced breast cancer
Authors: Steinbaum Fred L. , de Jager Robert L. , Krakoff Irwin H.
Published: February 2007

Forty‐nine postmenopausal patients with advanced breast cancer were treated with a nonsteroidal antiestrogen, Nafoxidine. The drug was generally well tolerated with dermatitis being the major toxic effect. A partial response in 12 of 40 patients, or 30%, was achieved with a median duration of response of greater than five months.
Nonsystemic treatment of metastatic tumors of the liver—a review
Authors: Lee Yeu‐Tsu N.
Published: February 2007

Hepatic metastasis is usually quite resistant to conventional systemic chemotherapy. Nonsystemic treatment of metastatic tumors of the liver include surgical resection; infusion of chemotherapeutic agent(s), either via hepatic artery or portal vein; ligation of hepatic artery; radiotherapy; and other more investigative approaches (isolation perfusion, cryosurgery, liver transplantation, etc). The relative applicability, results, and limitations of each of these therapeutic modalities are reviewed.
Vincristine (NSC‐67574), cytosine arabinoside (NSC‐63878), 6 thioguanine (NSC‐752) and daunorubicin (NSC‐82151) (VAT‐D): A pilot study of combination chemotherapy for remission induction in acute myeloid leukemia in adults
Authors: Sartiano George P. , Pfrimmer Wayne J. , Turner A. Robert
Published: February 2007

Fifteen newly diagnosed unselected adult patients with acute nonlymphocytic leukemia were treated in a pilot study of the combination of vincristine, cytosine arabinoside, 6‐thioguanine, and daunorubicin (VAT‐D) for remission induction therapy. Eleven of fifteen (75%) achieved a remission bone marrow. Median duration of remission was seven months in all responders (11 patients). The 11 patients achieving initial remission reached a median survival of 14 months. Twelve of seventeen attempts at reinduction of remission with VAT‐D were successful. The total amount of daunorubicin required for induction was less than that required in the majority of reported acute leukemia treatment regimens utilizing daunorubicin.
Daunomycin, cytosine arabinoside and 6‐thioguanine (DAT) vs vincristine, cytosine arabinoside and 6‐thioguanine (VAT) in the induction treatment of acute nonlymphocytic leukemia: A randomized collaborative study
Authors: Mandelli F. , de Lipsis E. , Grignani F. , Martelli M. , Liso V. , Amadori S.
Published: February 2007

One hundred patients were entered in a cooperative study comparing the efficacy of two different regimens in the induction treatment of acute nonlymphocytic leukemia (ANLL). Patients were randomly allocated to receive either the DAT or VAT combination; half of the patients were also randomized to receive CNS prophylaxis including intrathecal methotrexate + prednisone and cranial irradiation. Consolidation and maintenance therapy were uniform in responding patients. Out of 82 evaluable patients 41 (50%) attained complete remission (CR) with no significant difference between the two regimens.

Median remission duration was slightly longer in the DAT group (32.5 vs 22 weeks); median survival was 34 weeks for all evaluable patients with no difference between the two schedules. Meningeal relapse occurred only in two patients after 19 and 99 weeks of continuous remission. Fourteen patients are still alive after 61 to ≥ 155 weeks, of whom seven are in their initial remission (six in the DAT and one in the VAT group). We conclude that 1) DAT and VAT are equally effective in inducing CR in a high proportion of ANLL patients; 2) until marrow remission can be prolonged significantly, preventing CNS leukemia will not have any significant impact on the course of ANLL.
Meningeal relapse of orbital rhabdomyosarcoma
Authors: Fusner June E. , Pizzo Philip A. , Poplack David G. , Freeman Charles
Published: February 2007

A 4‐year‐old boy with orbital rhabdomyosarcoma developed central nervous system (CNS) metastases as a meningeal disease without clinically apparent local recurrence. Abnormal cells in the cerebrospinal fluid (CSF) antedated the symptoms and signs of increased intracranial pressure. This suggests that the CSF of patients with rhabdomyosarcoma should be monitored and that prophylactic therapy of the CNS might be indicated, especially in those patients with head and neck or metastatic disease.
Sarcoma with myelophthisic anemia: Report of two cases
Authors: Juméan Hani G. , Lester Eric , Stein Richard S.
Published: February 2007

Two cases of sarcoma complicated by pathologically confirmed myelophthisic anemia are presented. Although marrow involvement may occur in childhood rhabdomyosarcoma, complete marrow replacement in adult patients with sarcoma has not been previously described.
Meningeal seeding from rhabdomyosarcoma of the head and neck with base of the skull invasion: Recognition of the clinical evolution and suggestions for management
Authors: Gerson James M. , Jaffe Norman , Donaldson Milton H. , Tefft Melvin
Published: February 2007

Rhabdomyosarcomas of the head and neck may spread by diffuse local invasion, resulting in erosion of the base of the skull with possible extension to the leptomeninges, brain, and cranial nerves, as well as invasion of the ventricular system with possible intradural, extramedullary metastases anywhere along the neuraxis. Meningeal spread of tumor is difficult to eradicate, and nearly all patients reviewed died soon after meningeal disease was evident. Patients with erosion of the base of the skull or abnormal cranial nerve findings seem to have a risk of seeding the meninges with tumor. The clinical evolution of this pattern of metastatic spread is reviewed, diagnostic studies are recommended, and therapeutic considerations are discussed. Tentative treatment guidelines are also offered.
Echocardiographic assessment of anthracycline cardiotoxicity in children
Authors: Lewis Alan B. , Pilkington Ronald , Takahashi Masato , Siegel Stuart E.
Published: February 2007

Adriamycin and daunomycin are highly effective anti‐tumor agents but have been known to be cardiotoxic in dosages > 500 mg/m2. Echocardiograms were performed in 54 pediatric patients with a variety of malignant diseases in an attempt to detect early evidence of anthracycline‐induced cardiac toxicity. Thirty baseline studies were performed while 81 studies were done during and/or following anthracycline chemotherapy. Baseline left ventricular (LV) function was normal; shortening fraction = 34 ± 1% and percent heart rate predicted velocity of fiber shortening = 109 ± 3%. No significant reduction in LV performance occurred until cumulative doses exceeded 250 mg/m2. Between 250 mg/m2 and 450 mg/m2 mean shortening fraction = 30 ± 1% (p < 0.025) and percent of predicted shortening velocity = 93 ± 4% (p < 0.005). Above 450 mg/m2 a further significant decrease in LV function was noted: shortening fraction = 21 ± 3% and percent of predicted shortening velocity = 63 ± 10%. Two of the five patients in this group developed congestive heart failure. We currently recommend that echocardiograms be performed prior to the start of anthracycline therapy and repeated every 80 to 120 mg/m2 until a cumulative dose of 250 mg/m2 is reached. Thereafter, echocardiograms should be performed prior to each additional dose. Therapy should be discontinued when shortening fraction < 20% and percent of predicted shortening velocity < 50%. However, selected patients with satisfactory LV performance who have received dosages of 500 mg/m2 may be considered for continued chemotherapy.
Fungal peritonitis and malignancy: Report of two patients and review of the literature
Authors: Kopelson Gene , Silva‐Hutner Margarita , Brown James
Published: February 2007

Two patients developed isolated Candida albicans peritonitis in association with intraabdominal malignancy. Although additional factors predisposing to the development of fungal peritonitis were present, we postulate that tumor‐related local factors permitted fungi to cross the gut wall and to enter the peritoneum, where the host immune status determined whether the infection spread. These two cases are the sixth and seventh reported cancer patients who developed fungal peritonitis, but the first two who had the fungal infection localized to the peritoneum; and this is the first report known to us specifically associating intraabdominal malignancy and fungal peritonitis. Patients who develop fungal peritonitis may have a primary or metastatic intraadbdominal malignancy, and fungi should be considered as a cause of peritonitis in cancer patients.