bluuebunny/crossref_metadata_2025 huggingface dataset:
Influence of surgical stress on bactericidal activity of neutrophils and complications of infection in patients with esophageal cancer
Authors: Shigemitsu Yuji , Saito Takao , Kinoshita Tadahiko , Kobayashi Michio
Published: February 2007

The association between surgical stress‐related depression in bactericidal activities of neutrophils and the occurrence of postoperative infections was investigated. Bactericidal activities of neutrophils were measured in 19 patients undergoing esophagectomy, 15 gastrectomy, and 16 cholecystectomy. Five patients had complications of infection following esophagectomy. In 45 patients with no postoperative infections, intracellular killing index (KI) and superoxide anion production (SOP) levels decreased on postoperative day 1 while myeloperoxidase (MPO) activity increased on days 1–3. In 5 patients with esophageal cancer and postoperative infections, decreases in KI and SOP were less prominent, as compared to findings in 14 esophageal cancer patients without such problems but the MPO activity decreased on days 1–3. This evidence suggests that postoperative septic complications are not directly associated with surgical stress‐related transient depression of bactericidal activities immediately after surgery but rather with neutrophil‐mediated tissue injuries based on degranulation. © 1992 Wiley‐Liss, Inc.
Transsternal thoracotomy for bilateral pulmonary metastasis
Authors: Shimizu Nobuyoshi , Ando Akio , Matsutani Takashiro , Maruyama Shuichiro , Date Hiroshi , Teramoto Shigeru
Published: February 2007

Advances in the surgical treatment of primary malignancies and the recent chemotherapy have led to an expansion of the surgical treatment of met‐static lung tumors. However, multiple pulmonary metastases are often found and may affect both lungs. It is difficult to reach tumors in the posterior parts of the lung when using a common midsternal approach, especially lesions located in the left lower lobe. We performed transsternal simultaneous bilateral thoracotomy on 10 patients with bilateral lung tumors (9 bilateral metastatic pulmonary tumors and 1 bilateral primary lung cancer). This procedure provides a wide operative field and is an effective method of thoracotomy for patients with bilateral lung tumors. In future, this method should be more actively performed for patients in whom it is indicated. © 1992 Wiley‐Liss, Inc.
Endobronchial brachytherapy: A preliminary experience
Authors: Susnerwala Shabbir S. , Sharma Sanjay , Deshpande Deepak D. , Dinshaw Ketayun A. , Viswanathan Palayamkottai S.
Published: February 2007

Fourteen patients with malignant airway obstruction were treated with a placement of a flexible nylon catheter for low dose rate manual afterloading Iridium 192 endobronchial brachytherapy using a flexible fibreoptic bronchoscope. Eight patients had obstructive pneumonitis at initial presentation, while 6 cases were recurrences after previous external irradiation. Six evaluable patients of the former group had complete or partial reinflation of lung and were followed by external radiotherapy. Of the latter group, 3 were evaluable and had moderate to good palliation of their symptoms. No complication was observed. The technique is simple and safe with good patient compliance. Further evaluation is indicated to assess its role in the locoregional management of lung cancer. © 1992 Wiiey‐Liss, Inc.
Papillary carcinoma of the thyroid after postpartum thyroiditis
Authors: Van Hoeven Karen H. , Goldstein Marsha , Friedman Elliott
Published: February 2007

Postpartum thyroiditis is a benign, often self‐limited cause of thyroid dysfunction. This report describes the first case of papillary carcinoma arising in a woman with postpartum thyroid disease. Both clinicians and pathologists must keep a high index of suspicion in postpartum patients with persistent thyroid abnormalities, even when a previous biopsy may have disclosed benign disease.
Substituting ornithine for arginine in total parenteral nutrition eliminates enhanced tumor growth
Authors: Grossie V. Bruce , Nishioka Kenji , Ajani Jaffer A. , Ota David M.
Published: February 2007

Total parenteral nutrition (TPN) may enhance the growth of some tumors: this enhanced growth is associated with an increase in the erythrocyte polyamine levels. The effect of arginine in TPN on tumor growth was compared with ornithine using rats with a transplantable Ward colon tumor. The relationship of circulating arginine, ornithine, glutamine, and polyamines with tumor growth was investigated. For rats fed chow ad libitum, increasing tumor weights were associated with a linear decrease in the plasma arginine levels which was consistently lower than that of age‐matched non‐tumor bearing (NTB) rats; ornithine and lysine levels were not affected. Subsequent experiments suggest that plasma glutamine levels were also lower in tumor bearing rats. Pair‐fed NTB rats had reduced arginine but not glutamine levels in plasma. TPN regimens with arginine or with ornithine substituted for arginine at two levels (equimolar [Orm‐Em] or isonitrogenous [Orn‐IN]) were given to colon tumor bearing rats for 8 days. The final tumor weight of rats which received the arginine‐containing regimen (19.8 ± 5.7 g, n = 4) (P < 0.05) was significantly greater than the tumor weight of rats fed chow ad libitum (12.1 ± 3.3 g, n = 6). The final tumor weights of Orn‐EM (11.2 ± 2.6 g, n = 4) or Orn‐IN (11.6 ± 0.8 g, n = 6) were similar to the chow‐fed controls. The plasma arginine levels were elevated, compared with the control, when arginine was present in the regimen. The plasma arginine levels of rats which received Orn‐EM or Orn‐IN were lower than the controls. The plasma ornithine levels were not affected by arginine in the regimen but were elevated with increasing levels of ornithine in TPN. Plasma glutamine levels were decreased when arginine was present in the regimen but were elevated when ornithine was substituted for arginine. Erythrocyte putrescine was increased when either arginine or ornithine was included in the TPN regimens. These results demonstrate that while arginine in a parenteral regimen stimulates tumor growth, substituting ornithine for arginine in TPN does not enhance the growth of a transplantable colon tumor. © 1992 Wiley‐Liss, Inc.
A trial of adjuvant chemoimmunotherapy with mitomycin c and ok‐432 for stage III gastric carcinoma
Authors: Arinaga Shinya , Karimine Nobuya , Takamuku Kiyoshi , Nanbara Shigeru , Inque Hiroshi , Abe Ryoji , Watanabe Daisuke , Matsuoka Hideo , Ueo Hiroaki , Akiyoshi Tsuyoshi
Published: February 2007

We previously found that the ability to generate cytotoxic cells induced by in vitro activation of peripheral blood mononuclear cells (PBM) with OK‐432, a bacterial immunopotentiator, was markedly increased following intravenous administration of a single dose of mitomycin C (MMC) in cancer patients. On the basis of this clinical finding, we designed a treatment regimen that consisted of MMC 12 mg/m2 intravenously on day 1 and OK‐432 5 Klinische Einheit (KE) intradermally on days 6, 8, and 11, when the generation of OK‐432 activated killer cells had been shown to be significantly augmented. Then, it was followed by long‐term tegafur. Fifteen patients with stage III gastric carcinoma who had undergone curative resection were treated with the above regimen. The survival of these patients was significantly better than that of 26 comparable stage III patients concurrently treated with MMC 12 mg/m2 alone, followed by long‐term tegafur (P < 0.01). The results indicate that OK‐432 combined with MMC may be effective against stage III gastric carcinoma, when these agents are used probably in an appropriate combination. © 1992 Wiley‐Liss, Inc.
Enucleation of a secondary esophageal mural tumor
Authors: Bakshandeh Norman , Beattie Edward J. , Harvey James C.
Published: February 2007

Metastatic tumors to the esophagus have been described as having the imaging characteristics of benign mural tumors such as leiomyomata, but application of enucleation in treating such tumors has not been described. Our report describes long esophageal myotomy and enucleation of tumor for palliation of dysphagia due to a mural tumor originating from a lung primary. © 1992 Wiley‐Liss, Inc.
Regional DNA content heterogeneity in colonic adenocarcinoma: Prognostic significance in patients with liver metastases
Authors: Graham Roger A. , Teague Kim , McLemore Donia , Cleary Karen , El‐Naggar Adel
Published: February 2007

We retrospectively examined by flow cytometry the DNA ploidy pattern in tissue blocks from 25 primary colon adenocarcinomas and their lymph node and liver metastases. Intratumoral heterogeneity was present in 22% of primary tumors and 21% of metastatic liver deposits. Intertumoral heterogeneity, measured between the primary tumor and its lymph node and liver metastases, was 0% and 20%, respectively. Of 24 patients who underwent successful resection of their liver metastases, 8 neoplasms had uniformly diploid DNA content, while 16 tumors had aneuploid DNA pattern in either the primary tumor, the metastases, or both. Five‐year survival was better in the diploid group (38% vs. 7%, P = 0.10 by log rank analysis). Three of eight patients in the diploid group remain free of disease, while all 16 patients with aneuploid cell populations have died of recurrent disease. © 1992 Wiley‐Liss, Inc.
Primary oesophageal carcinoma in teens
Authors: Kumar Arvind , Shukla Nutan K. , Mishra Mahesh C. , Shahi Uday P. , Kapur Brij M. L.
Published: February 2007

Seven teenaged patients with primary oesophageal carcinoma, treated at our hospital in the last 6 years are presented and their management discussed. Five patients had localised disease. Three of them underwent total oesophagectomy, one was given radical radiotherapy, and one was lost to follow‐up. Two patients had metastatic disease at presentation. The primary oesophageal carcinoma in this age group may not be so rare as reported in the literature and must be considered in the differential diagnosis of dysphagia. Like their older counterparts, the outcome depends on the stage of the disease and is not influenced by age per se. © 1992 Wiley‐Liss, Inc.
Prognostic profile for patients with pheochromocytoma derived from clinical and pathological factors and DNA ploidy pattern
Authors: Nativ Ofer , Grant Clive S. , Sheps Sheldon G. , O'Fallon Judith R. , Farrow George M. , Van Heerden Jonathan A. , Lieber Michael M.
Published: February 2007

Eighty‐eight patients with pheochromocytoma and paraganglioma treated over a 28 year period (1960–1987) were studied. Based on clinical course, they were divided into three prognostic groups: benign (n = 57); multiple (n = 12); and metastatic (n = 19). Using clinical data, histopathologic findings, and tumor nuclear DNA content a prognostic profile for each group was constructed. The following variables were studied: age, familial pheochromocytoma, associated endocrine or neoplastic disorders, number and location of the lesion at diagnosis, size of the tumor, and the nuclear DNA ploidy pattern. Of these prognostic factors the most significant to predict a future malignant clinical course were large size and local tumor extension at time of surgery. Family history of pheochromocytoma, associated endocrine disorders, and young age at presentation predicted multiplicity. Old age, absence of familial pheochromocytoma or related endocrine disorders and DNA diploid tumors seem to be favorable findings. Using these variables in combination may be helpful for early identification of patients with malignant, multiple, or benign pheochromocytoma and paraganglioma. © 1992 Wiley‐Liss, Inc.
Primary brain lymphoma after X‐ray irradiation to the scalp for tinea capitis in childhood
Authors: Stein Moshe , Haim N. , Kuten Abraham , Doron Yafa , Ben Arieh Yehudi T. , Cohen Yoram
Published: February 2007

A 39‐year‐old male developed primary brain lymphoma 33 years after receiving scalp irradiation for tinea capitis. This is the first reported association between cranial irradiation during childhood and subsequent development of primary brain lymphoma. © 1992 Wiley‐Liss, Inc.
Investigation of colon cancers for human papillomavirus genomic sequences by polymerase chain reaction
Authors: Shah Keerti V. , Daniel Richard W. , Simons Jonathan W. , Vogelstein Bert
Published: February 2007

Two previous studies have reported the presence of human papillomavirus (HPV) genomic sequences in colorectal cancers. We examined DNAs from 50 colorectal tumors for HPV sequences by polymerase chain reaction (PCR), using HPV consensus L1 primers for amplification. The PCR products were screened with a generic HPV probe consisting of amplimers of HPV‐16 and HPV‐18. All tumor DNAs were negative for HPV sequences. These results call into the question the reported association of colorectal cancers with HPVs. © 1992 Wiley‐Liss, Inc.
Axillary node dissection for early breast cancer: Some is good, but all is better
Authors: Moffat Frederick L. , Senofsky Gregory M. , Davis Kevin , Clark Kimberley C. , Robinson David S. , Ketcham Alfred S.
Published: February 2007

Optimal management of the axillary lymphatics in breast cancer patients remains a contentious subject. Axillary recurrence, while infrequent, may have very significant clinical consequences in the affected patient. Axillary sampling, partial and total axillary lymphadenectomy, radiotherapy, and surgery plus radiotherapy are discussed with attention to efficacy in prevention of axillary recurrence, accuracy of nodal staging, and morbidity. The incidence of axillary recurrence decreases and accuracy of staging increases with the number of lymph nodes resected. There is little difference in incidence of morbidity between partial and total axillary lymphadenectomy. Radiotherapy is not as effective as lymphadenectomy for regional disease control and, when administered following a surgical staging procedure, increases the risk of lymphedema of the ipsilateral upper extremity and, in patients undergoing breast‐conserving surgery, the ipsilateral breast. We believe that total axillary lymphadenectomy provides optimal regional disease control and axillary staging with morbidity comparable to that of partial lymphadenectomy. © 1992 Wiley‐Liss, Inc.
Heterogeneity in gastric carcinoma with special reference to DNA content and mitotic activity: Histopathologic differentiation
Authors: Saito Atsushi , Korenaga Daisuke , Haraguchi Masaru , Maehara Yoshihiko , Sugimachi Keizo
Published: February 2007

DNA ploidy and mitotic activity were microspectrophotometrically investigated in 46 patients with gastric carcinoma. Measurements of DNA content and mitotic index (M.I.) were examined in the mucosal, submucosal, muscularis propria, and serosal layers of tumors, respectively. The frequency of cells with values exceeding hexaploid chromosome (6c) and mitotic counting analysis revealed a significant higher value in serosa, compared with findings in the mucosa. This tendency was not evident in cases of a differentiated type adenocarcinoma but was noted in those with the undifferentiated type. There were 37 tumors (80.0%) with the same DNA distribution patterns in every layer of the stomach (homogeneous DNA ploidy). Heterogeneity of DNA ploidy was observed in nine tumors (20.0%). Carcinoma with a heterogeneous DNA ploidy manifested a significantly higher incidence of metastasis to the lymph nodes than did those with homogeneous type. Characteristically, there was venous permeation preponderance in the differentiated type and peritoneal dissemination preponderance in the undifferentiated type. This evidence of DNA heterogeneity in gastric carcinoma tissues suggests a possible correlation with the metastatic behavior. © 1992 Wiley‐Liss, Inc.
Flow cytometric DNA analysis of hepatic tumours on ultrasound‐guided fine‐needle aspirates
Authors: Russo Antonio , Bazan Viviana , Plaja Sergio , Cajozzo Massimo , Bazan Pietro
Published: February 2007

A study was performed on a nonconsecutive series of 51 patients in order to assess the feasibility, reliability, and usefulness of flow cytometric (FCM) DNA analysis of samples obtained from benign and malignant hepatic tumours by means of ultrasound‐guided fine‐needle aspiration (UG‐FNA). Cytological and often histological confirmation of the nature of the lesion was obtained in all cases from an expert pathologist. For FCM DNA analysis in 32 cases, it was also possible to use samples obtained at surgery from the actual tumours. There were no post UG‐FNA complications, either early or late. It was possible to perform FCM DNA analysis on 6/7 (85.7%) of the benign tumour aspirates and all 44 (100%) coming from the malignant tumours. All the benign tumours showed a DNA‐diploid pattern, while the DNA content was aneuploid in 91% of the malignant tumours. Apart from one case, the results of the FCM DNA analysis of the samples removed at surgery were the same as those obtained from the aspirates (97%). FCM DNA analysis on UG‐FNA samples from hepatic tumours is a fairly simple, reproducible, well‐tolerated technique; it does not involve risks if performed by skilled operators and, since it can be easily repeated even on small tumours, it is a suitable method for monitoring hepatic metastases during chemotherapy. © 1992 Wiley‐Liss, Inc.
Posthemipelvectomy hernia
Authors: Kraybill William G. , Standiford Steven B. , Johnson Frank E.
Published: February 2007

We present four patients who developed posthemipelvectomy hernias. Identified etiologic factors include infection at the time of hemipelvectomy, radiation therapy, and excessive weight gain. Two patients were reconstructed using local tissues, and two required prosthetic materials. There were no hernia recurrences, although two patients died of recurrent cancer. © 1992 Wiley‐Liss, Inc.
Value of retroperitoneal lymph node dissection in advanced testicular seminoma
Authors: Kamat Murali R. , Kulkarni Jagdeesh N. , Tongaonkar Hemant B. , Ravi R.
Published: February 2007

Seven patients with advanced seminoma of the testis (stages II C and III) were treated with 3 induction cycles of VAB‐6 chemotherapy. Three patients had complete remission after chemotherapy and are alive disease free at 32, 38, and 40 months with no additional treatment. Four patients were subjected to retroperitoneal lymph node dissection for residual retro‐peritoneal masses measuring 2–4 cm after chemotherapy, which revealed fibrosis in 2 patients and metastatic seminoma in the other 2. Patients with metastatic residual masses were given postoperative radiation therapy to the retroperitoneum and are alive disease free at 33 and 34 months, while those with fibrosis are alive disease free at 30 and 52 months, respectively, with no additional treatment. © 1992 Wiley‐Liss, Inc.
A 94 year old male stage IV breast cancer patient showing complete remission under tamoxifen treatment after operation
Authors: Tateishi Masahiro , Toda Tomohiro , Minamisono Yoshikazu , Nagasaki Susumu , Sugimachi Keizo
Published: February 2007

A 94 year old man with an invasive ductal carcinoma of the breast (T4N2M1, stage IV), underwent a modified radical mastectomy to improve his quality of life. The estrogen receptor status of both the breast tumor and the metastatic axillar lymph nodes was high. Immunohis‐tochemical staining for epidermal growth factor, epidermal growth factor receptor, or c‐erbB‐2 protein was negative. The patient received only tamoxifen continuously for 3 months, and later apparently showed a complete remission. Therefore, in advanced male breast cancer with a high estrogen receptor status, operation in conjunction with hormone therapy may lead to a favorable result in some cases. © 1992 Wiley‐Liss, Inc.
Poorly differentiated solid type adenocarcinomas in the stomach: A clinicopathologic study of 71 cases
Authors: Ueyama Toshihiko , Tsuneyoshi Masazumi , Meyer John S
Published: February 2007

A review of 71 cases of solid carcinoma of the stomach selected from 2,738 cases of surgically resected poorly differentiated adenocarcinomas (PDAs) was undertaken. The average age of the patients, which included 47 men and 24 women, was 62 years. The clinicopathologic features of solid carcinomas were similar to those of the differentiated type adenocarcinomas. The solid carcinomas were divided into 42 of the solid alveolar type and 29 of the free‐cell type; 32 of the former (76%) had foci of overt differentiated areas, while most of the latter type lacked such foci and had some signet‐ring cells. Many tumors of both types had a prominent venous permeation and lymph node metastasis even in the early stage of invasion. The 5‐year survival rates were 37% in all cases, 44% in cases with carcinoma with a limited invasion of the submucosa or the muscularis propria, and 27% in carcinoma invading down to the subserosa. These survival rates were poor in comparison with the 110 cases of ordinary PDA (diffuse type of Lauren) selected as controls. These findings suggest that tumors of the solid alveolar type are transformed from the differentiated type of adenocarcinoma, while those of the free‐cell type are originally from PDAs. It is also suggested that solid carcinomas did show a high incidence of venous permeation and lymph node metastasis and that the prognosis for this type of carcinoma is poor. © 1992 Wiley‐Liss, Inc.
Cisplatin‐based (PVB+M) chemotherapy in good‐risk and poor‐risk nonseminomatous germ cell tumors
Authors: Saikia Tapan , Hegde Upendra , Advani Suresh , Ramakrishnan Gopal , Kulkarni Jagdeesh , Desai Prafulla B.
Published: February 2007

Twenty‐seven patients with metastatic nonseminomatous germ cell tumors were treated with Cisplatin, vinblastine, bleomycin, and low‐dose meth‐otrexate (PVB + M) combinations. Patients were divided into good‐risk and poor‐risk groups. All seven patients (100%) with good‐risk factors achieved complete response, and all are alive disease free at a median of 70 months. In the poor‐risk group, only 10 of 20 patients (50%) achieved complete response, and seven (35%) are alive disease free at a median of 58 months. Eight patients, 4 in each group, were required to undergo surgery for removal of postchemotherapy residual masses. The results confirm that Cisplatin‐based chemotherapy protocols are adequate to cure most patients with good‐risk factors, and newer approaches are needed for patients at poor risk. © 1992 Wiley‐Liss, Inc.
Skeletal metastasis from occult carcinoma
Authors: Shih Lih‐Yuann , Chen Tien‐Hsiung , Lo Wai‐Hee
Published: February 2007

We reviewed 177 patients with skeletal metastases, seen between 1984 and 1989, to define the characteristics of metastatic bone disease from an occult primary carcinoma. In 52 (30%) patients, the primary carcinomas could not be identified when the bone metastases were first diagnosed. This group was predominantly male, with intractable pain the most common symptom. The primary tumors were identified on antemortem evaluation in 28 (54%) patients after extensive examination. Among these, the primary tumor was in the lung in 9 patients, followed by liver (8), kidney (5), prostate (3), thyroid gland (2), and rectum (1). The identifiable occult malignancies possessed three common features: all were osteophilic tumors, all had a high incidence in the specific geographic area, and all were not amenable to early detection. The mean survival of these patients was 11 months. Current treatment modalities failed to affect the course of these patients, except for those with primary carcinomas of the kidney and prostate. This observation attests to our limitations in both the diagnosis and treatment of this problem. Efforts should be directed primarily toward excluding those common and/or treatable tumors only. © 1992 Wiley‐Liss, Inc.
Early gastric cancer: An analysis of 44 cases with emphasis on the prognostic significance of the macroscopic and microscopic growth patterns
Authors: Oliveira Pedro , Nobre‐Leitão C. , Chaves Paula
Published: February 2007

Forty‐four consecutive cases of “early gastric cancer” were studied according to the macroscopic classification proposed by the Japanese Gastroenterological and Endoscopy Society and further analyzed in terms of growth patterns. The tumours were then classified into the small mucosal type, the superficially spreading (Super) type and the penetrating growth (Pen) type. The Lauren type (intestinal vs. diffuse), presence of lymphatic and venous invasion, and lymph node metastasis were also assessed. Most elevated tumours showed a superficial growth pattern and were classified as Lauren's intestinal type, whereas depressed lesions were associated with submucosal invasion and were classified as diffuse. Microscopic patterns did not show any correlation with Lauren's classification. Mean duration of follow‐up was 67.8 months and the overall actuarial survival was 93%, 80%, and 72%, at 2, 5, and 10 years, respectively. Aside from venous invasion no correlation was found between survival and any of the morphological parameters analysed. © 1992 Wiley‐Liss, Inc.
Therapeutic gain of local and radical resection combined with postoperative radiation for murine fibrosarcomas
Authors: Todoroki Takeshi , Suit Herman D. , Karakousis Constantine P.
Published: February 2007

Resection of 8‐mm fibrosarcomas (FSaII) growing in the right leg of syngeneic C3H/Sed mice was performed under a dissecting (×8) microscope. Local and radical resection achieved 20% (5/25) and 48% (12/25) tumor control, respectively. TCD80s (average dose expected to control 80% of irradiated tumors) for radiation alone given as one fraction per day for 5 consecutive days were 73.1 and 118.0 Gy for the microscopic and 8‐mm tumors, respectively. Radiation therapy started at 4 or 7 days following local or radical resection enhanced both the local tumor control and the treatment‐related morbidity represented by leg shortening. From enhancement ratios (ERs) for tumor control (TCD80 for radiation alone/TCD80 for postoperative radiation) and for leg shortening (dose for 5‐mm leg shortening for radiation alone/postoperative radiation) values, therapeutic gain factors (TGFs) were derived as ER tumor/ER leg shortening. These were 1.3 and 1.4 for local and radical resection followed by radiation started on the 7th postoperative day, respectively. Corresponding figures for radiation started on the 4th postoperative day resulted in 1.2 for both resection procedures. © 1992 Wiley‐Liss, Inc.
The changing role of the surgeon in the management of cancer in the university setting and its impact on resident training
Authors: Sariego Joaquin , Byrd Michael , Matsumoto Teruo , Kerstein Morris
Published: February 2007

A retrospective review was performed of 22,168 cancer cases registered by the Tumor Registry between 1965 and 1990. Eighty‐six percent of these cases involved solid tumors; this number remained fairly constant throughout the study period. There was a significant trend toward more advanced disease at the time of presentation, most marked in the last 10 years; prior to 1980, 63.7% had localized or in situ cancer as opposed to only 49.4% since 1980 (P<0.001). This suggested that more advanced cases were being submitted for treatment. As expected, more disseminated disease at the time of presentation was coupled with an overall decrease in the number of cases in which surgery comprised part of the treatment: 43.6% prior to 1980 vs. 38.1% after 1980. This trend has reversed, however, in the last 5 years. Though the number of cases in which surgery was the only treatment modality remained constant prior to and after 1985 (26.8% and 27.1%, respectively), the number of cases in which surgery was part of a multimodality treatment plan significantly increased (39.9% prior to 1985; 45.3% after 1985). This was coupled with a significant decrease in the number of cases treated with nonsurgical modalities alone (60.1% prior to 1985; 54.7% after 1985). Therefore,not only has the surgeon been called upon to operate on more advanced disease for cure in the last 5 years, but he or she has also become increasingly involved in multimodality treatment. Since 40.4% of university departments of surgery (as of 1990) did not provide specific training in surgical oncology, it is suggested that these departments reevaluate the objectives of their educational programs in view of the changing, increasingly complex role of the surgeon in the multidisciplinary approach to the care of the cancer patient. © 1992 Wiley‐Liss, Inc.
Impaired neutrophil bactericidal activity correlates with the infection occurring after surgery for esophageal cancer
Authors: Saito Takao , Shigemitsu Yuji , Kinoshita Tadahiko , Katsuta Takeshi , Shimoda Katsuhiro , Miyahara Masaki , Kobayashi Michio
Published: February 2007

We examined whether or not preoperative impaired bactericidal activities of polymorphonuclear neutrophils (PMN) are associated with infections following surgery for esophageal cancer. Intracellular killing (KI), superoxide anion‐producing capacity (SOP), and myeloperoxidase (MPO) activity were measured in 22 patients with esophageal cancer, 27 with gastric cancer, and 13 age‐matched controls. The average level of KI was significantly depressed in patients with esophageal cancer or with gastric cancer, to a similar extent, compared to findings in controls, but SOP was not. In esophageal cancer patients, the SOP level was significantly higher in those with postoperative septic complications than in those without such problems, whereas the KI level was depressed to a similar extent in both. Therefore, a depression of KI with elevation of SOP of PMN may serve to predict complications of infection following surgery in patients with esophageal cancer. © 1992 Wiley‐Liss, Inc.
Breast masses in adolescent females
Authors: Siegal Annette , Kaufman Zvi , Siegal Gil
Published: February 2007

In a retrospective study of 38 adolescent females operated on for mammary masses, 42 fibroadenomata (FA), 2 fibrous scars around abscesses, and one papilloma were found. All were postmenarchal. Clinical and pathological features were reviewed and the patients reexamined or interviewed. FA were mostly asymptomatic and removed a few weeks after incidental discovery. They were often seen in Jewish girls of parents born in North Africa and the Middle East, and were more frequently located in the outer superior quadrant of the left breast. New FA appeared in almost half of the cases later on in the same breast, as well as in the other breast, or bilaterally. Necrosis occurred in three FA and was unrelated to the size of the tumor. There was no correlation between the size of FA, multiplicity, or necrosis, nor between increased stromal or epithelial atypia, cellularity, or mitotic activity. One explanation for the high rate of multiplicity might be related to this neoplasm occurring in an actively developing organ under hormonal control. There was no increased breast carcinoma apparent in the family history. Therefore, except in cases of fast‐growing tumors, a conservative approach is recommended because of the frequency of multiple FA as well as aesthetical postoperative complications. © 1992 Wiley‐Liss, Inc.
Noncurative resection for advanced gastric cancer
Authors: Maehara Yoshihiko , Kakeji Yoshihiro , Takahashi Ikuo , Okuyama Toshiro , Baba Hideo , Anai Hideaki , Sugimachi Keizo
Published: February 2007

Between 1965 and 1985, 489 patients with advanced gastric cancer who were treated with gastric resection and in whom tumor cells remained after the operation were defined as cases of a “noncurative resection.” The clinicopathological features and prognosis of these patients were examined and two groups were prepared: locally advanced cancer and cancer with a distant metastasis. In locally advanced cancer cases, tumor cells remained in the neighboring organs, lymph nodes, and/or resected margins; in those with distant metastasis, peritoneal dissemination and/or liver metastasis were present regardless of whether or not the metastasis was removed, with or without locally noncurative factors. Serosal invasion was prominent and high rates of lymph node metastasis and lymphatic inolvement were evident in both groups. The survival rate for patients with locally advanced gastric cancer was better than that of patients with distant metastasis (P < 0.01). Survival time in patients with locally advanced cancer can be lengthened by resecting all of the primary tumor and as much of the metastatic lesions as possible, even if the surgical management is “noncurative.” Aggressive postoperative chemotherapy for patients with distant metastasis from a gastric cancer is to be recommended. © 1992 Wiley‐Liss, Inc.
Chromosome aberrations of human small cell lung cancer induced by a new 111in‐bleomycin complex
Authors: Hou De‐Yan , Maruyama Yosh , Drago Joseph R.
Published: February 2007

A new 111Indium labeled bleomycin complex (111In‐BLMC) was prepared and found to be effective for tumor imaging and therapy both in mouse glioma and human small cell lung cancer (SCLC) cells. Chromosome aberrations were studied in human SCLC cells to explore its mechanisms of killing cancer cells. SCLC cells (N417) were exposed to 111In‐BLMC, BLM, or 111InCl3 (for control) for 1 hour, treated with colcemid, and chromosomal changes were analyzed. A dramatic increase in chromatic gaps, breaks, chromosome breaks, double minutes, rings, triradii, quadriradii, and chromosome stickiness were observed in the cells treated by 111In‐BLMC compared to BLM or 111InCl3. These results indicated that 111In‐BLMC has therapeutic potential for combination chemo‐radiotherapy of cancer (e.g., by Auger electrons and local energy deposition). © 1992 Wiley‐Liss, Inc.
Antitumor effect of triphenylethylene derivative (TAT‐59) against human breast carcinoma xenografts in nude mice
Authors: Koh Jun‐Ichi , Kubota Tetsuro , Asanuma Fumiki , Yamada Yoshinori , Kawamura Eiji , Hosoda Yoichiro , Hashimoto Mitsumasa , Yamamoto Osami , Sakai Shoji , Maeda Koutaro , Shiina Eiichi
Published: February 2007

The antitumor activity of a newly synthesized triphenylethylene derivative {(E)‐4‐[1‐4‐[2‐(dimethylamino)ethoxy‐phenyl]‐2‐(4‐isopropyl)phenyl‐1‐butenyl] phenyl monophosphate} (TAT‐59) was investigated against human breast carcinoma xenografts in nude mice with reference to the changes of hormone receptors. Five strains (MCF‐7, Br‐10, R‐27, ZR‐75–1, and T‐61) used for the experiments possessed cytosol estrogen receptor (ER), and their growth was estradiol dependent. Five mg of TAT‐59 and tamoxifen citrate (TAM) per kg were administered p.o. daily except Sunday. TAT‐59 showed a positive antitumor effect against MCF‐7 and R‐27, whereas TAM was effective on MCF‐7, and their adverse effects detected by mortality rate, body weight loss, and spleen weight loss were similar to each other. The reduction of ER and production of progesterone receptor (PgR) after the treatment with TAT‐59 were more potent than after TAM, suggesting that TAT‐59 exerts its antitumor effect through binding to ER. These findings suggest that TAT‐59 might merit use in clinical trials with breast cancers. © 1992 Wiley‐Liss, Inc.
Primary gastrointestinal lymphomas in Turkey: A retrospective analysis of clinical features and results of treatment
Authors: Dinçol Dilek , Içi Fikri , Erekul Selim , Günel Nazan , Karaoǧuz Handan , Demirkazik Ahmet
Published: February 2007

Thirty‐three patients with primary gastrointestinal lymphoma (GIL) followed at Ankara University Medical School have been evaluated. The most frequent locations of the disease are the small intestine (48.4%) and the stomach (39.3%). The intermediate and high grade lymphomas constitute 84.8% of the cases. The mean age of the patients with small intestinal lymphoma is 28.7 years and 47.1 years for those with gastric lymphoma. The patients treated with surgery and chemotherapy (S + CT) have a longer survival than those treated with chemotherapy (CT) alone. In conclusion: 1) Small intestinal lymphoma occurs more frequently than gastric lymphoma in our study. 2) The median age of the Turkish patients with primary GIL is approximately 10 years less than those in the Western countries. 3) The therapeutic results of S + CT are superior to those of CT in the early stages of the disease. © 1992 Wiley‐Liss, Inc.
Cervical exploration for primary hyperparathyroidism
Authors: Shaha Ashok R. , Jaffe Bernard M.
Published: February 2007

The classical presentation of primary hyperparathyroidism, “moans, bones, groans,” is no longer commonly seen since the diagnosis of hypercalcemia is now made much earlier with the routine use of the SMA 12. In the past 8 1/2 years, 85 patients underwent cervical exploration in our institution for primary hyperparathyroidism. There were 34 male and 51 female patients, ranging in age from 18–84 years. The specific symptoms included hypertension in 40 patients, generalized weakness in 25, renal stones in 14, psychiatric problems in 2, and bone changes on X‐ray in 4. Forty‐one patients were totally asymptomatic. The diagnosis was made mainly on the basis of history, serum calcium and phosphorous levels, parathormone assay, and 24‐hour urinary calcium studies. Preoperative localization studies were performed in 38 patients. Thallium technetium subtraction scans, when positive, were very helpful. The surgical approach involved stepwise exploration of both sides of the neck with identification of all four parathyroid glands. In patients with uniglandular pathology (87%), the adenoma was removed with biopsy of at least one normal gland. In multiglandular disease, the abnormal glands were removed. Frozen section was routinely performed to confirm the presence of parathyroid tissue and no attempt was made to pathologically distinguish adenoma from hyperplasia. Two patients had parathyroid carcinoma. In three patients, serum calcium levels did not fall, resulting in an operative success rate of 96%. One patient treated by subtotal parathyroidectomy developed permanent hypoparathyroidism and one other patient developed temporary hypocalcemia. Only a single patient developed vocal cord palsy. Early exploration in patients with primary hyperparathyroidism is indicated. The basic diagnostic workup is sufficient for initial exploration. It is important to distinguish uniglandular from multiglandular pathology after careful bilateral exploration and identification of all four parathyroid glands. © 1993 Wiley‐Liss, Inc.
Composite reconstruction of the esophagus
Authors: Omura Kenji , Misaki Takuro , Urayama Hiroshi , Ishida Fumio , Watanabe Yoh
Published: February 2007

Composite reconstruction of the esophagus using both the mobilized stomach and free jejunal graft is described. Tension at the anastomotic site can be minimized with interposition of a jejunal autograft between the pharyngeal stump and the mobilized stomach, even when the mobilized stomach is not long enough. Furthermore, problems derived from differing calibers of the pharyngeal stump and the mobilized stomach can be resolved by creating an end‐to‐side pharyngojejunal anastomosis. Our method is proposed as one procedure for reconstruction of the esophagus when the pull‐up organ is too short. © 1993 Wiley‐Liss, Inc.
Risk of internal mammary lymph node metastases and its prognostic value in breast cancer patients
Authors: Noguchi Masakuni , Ohta Nagayoshi , Thomas Michael , Kitagawa Hirohisa , Miyazaki Itsuo
Published: February 2007

The risk of an internal mammary lymph node (IMN) metastasis and its prognostic value for patients with invasive breast cancer were assessed by evaluating 142 patients who had either a mastectomy with lymph node dissection or a biopsy of the IMN. By univariate analysis, overall survival significantly correlated with the patient's age, clinical axillary node status, tumor size, and DNA ploidy, as well as histologically confirmed axillary and IMN metastases. By multivariate analysis, however, only the presence of axillary and IMN metastases appeared to be an important independent factor affecting survival. However, the incidence of IMN metastases was associated significantly with age, clinical tumor and axillary node status, tumor size, axillary lymph node metastases, and DNA ploidy. Accordingly, the patient's age, tumor size, DNA ploidy, and axillary lymph node metastases proved to be effective variable for discrimination. Consequently, in predicting the presence of IMN metastases, a diagnostic accuracy of 82%, a sensitivity of 84%, and a specificity of 82% can be achieved by a discriminant function. We conclude that the discriminant function with these four variables is effective in assessing the risk of IMN metastases. © 1993 Wiley‐Liss, Inc.
Surgical treatment of esophageal carcinoma in patients eighty years of age and older
Authors: Kuwano Hiroyuki , Morita Masaru , Baba Kinya , Kitamura Kaoru , Toh Yasushi , Matsuda Hiroyuki , Sugimachi Keizo
Published: February 2007

Before 1979, no patient 80 years of age or older had been operated on at our institution for esophageal cancer, while in the middle period (1980–1984), three patients were operated on, and postoperative pulmonary complications and operative death occurred in 66.7 and 33.3%, respectively. However, in the recent period (1985–1990), there was no postoperative morbidity or mortality in the five cases over age 80. On the other hand, there were 12 patients over age 80 who did not undergo operation, of whom all died of cancer. In the eight operated patients over age 80, two cases are still alive 17 and 34 months after operation. According to the above findings, when the patient's general condition is evaluated to be sufficient to tolerate the operation and the cancer is judged to be resectable, esophageal resection is thought to be indicative in all patients over eighty. © 1993 Wiley‐Liss, Inc.
Colorectal carcinoma: Analysis of management in two medical eras
Authors: Nazarian Homayoun K. , Giuliano Armando E. , Hiatt Jonathan R.
Published: February 2007

Trends in presentation, diagnosis, management, and outcome were analyzed for 503 patients with colorectal cancer seen at the UCLA Medical Center between 1960 and 1970 (Group A; n = 210) and 1980 and 1985 (Group B; n = 293). Patients in the latter group exhibited a shift in site to the right side of the colon (18% in Group A vs. 31% in Group B; P < .01), an increase in the number of primary resections without colostomy (38% vs. 61%; P < .01), a lower overall complication rate (28% vs. 18%; P = .01), and a decline in 30‐day mortality (6.2% vs. 2%; P = .01). Although little difference was seen in detection of asymptomatic tumors, earlier lesions were treated in the latter group, accounting for substantially reduced rate of recurrence (69% in Group A vs. 44% in Group B; P < .01). Future management should include an emphasis on earlier detection in order to continue the trend toward enhanced survival. © 1993 Wiley‐Liss, Inc.
Carcinoma of the penis: The Indian experience
Authors: Kamat Murali R. , Kulkarni Jagdeesh N. , Tongaonkar Hemant B.
Published: February 2007

A total of 150 evaluable patients with carcinoma of the penis were treated at the Tata Memorial Hospital between 1984 and 1987. The majority of patients were in the 4th to 7th decades. All patients presented with a growth on the penis, the biopsy of which revealed squamous carcinoma. The primary lesions were T1 in 34, T2 in 73, T3 in 41, and T4 in 2 patients, respectively. The inguinal nodes were not palpable (N0) in 77 patients, palpable but histologically not metastatic in 39 patients, and metastatic in 34 patients. The treatment of the primary lesion was surgery in 142 patients and radiation therapy in 8 patients. Patients with nonpalpable nodes were kept under surveillance and those with pathologically metastatic nodes were subjected to bilateral ilioinguinal lymphadenectomy. The size related 5 year survivals were 83.3% for T1 60.4% for T2 and 39.5% for T3 lesions. The 5 year survivals for patients with grade I lesions were 90.3%, for grade II 58.6%, and for grade III 16.7%. The 5 year survival rate for patients for N0 nodes was 75.4% while the 3 year survival rates for patients with N1 and N2 nodes were 40% and 38.8%, respectively. The factors signifying poor survival were perinodal extension and iliac node metastases. There were 8 penile stump recurrences, of which 6 could be salvaged. Metachronous inguinal node metastases developed in 16 patients among whom surgical lymphadenectomy was possible in 12 while 4 had unresectable metastases. © 1993 Wiley‐Liss, Inc.
A suitable model for experimental liver metastasis of human colon cancer xenografts using mice with severe combined immunodeficiency
Authors: Furukawa Toshiharu , Kubota Tetsuro , Watanabe Masahiko , Nishibori Hideki , Kuo Tsong‐Hong , Saikawa Yoshiro , Kase Sugurcj , Tanino Hirokazu , Teramoto Tatsuo , Ishibiki Kyuya , Kitajima Masaki
Published: February 2007

Studies on liver metastasis of human colon cancer are limited because of a lack of suitable animal models. In this study, the usefulness of mice with severe combined immunodeficiency (SCID), which congenitally lack functional T and B lymphocytes, was evaluated in comparison with currently available nude mice. Three human colon cancer xenografts transplantable into nude mice were disaggregated enzymatically to obtain tumor cell suspensions, and implanted intrasplenically into SCID and nude mice. The incidence of splenic tumorigenesis and of liver metastases were significantly greater in SCID mice for all xenografts, in comparison with nude mice. In total, 33 of 36 SCID mice and 17 of 43 nude mice developed liver metastases. On the basis of this result, we conclude that SCID mice would be a more suitable model than nude mice for studying liver metastasis of human colon cancer. © 1993 Wiley‐Liss, Inc.
Colorimetric chemosensitivity testing using sulforhodamine B
Authors: Kubota Tetsuro , Takahara Tetsuya , Nagata Midori , Furukawa Toshiharu , Kase Suguru , Tanino Hirokazu , Ishibiki Kyuya , Kitajima Masaki
Published: February 2007

A colorimetric chemosensitivity test was investigated using sulforhodamine B (SRB), which stains protein synthesized by cells, as an end‐point marker. Four cultured cell lines, 9 human tumor xenografts serially transplanted into nude mice, and 14 fresh surgical specimens were subjected to this assay. The optimal conditions for the assay were 3–5 × 104 cells per well in a 96‐microplate, an SRB concentration of 4%, and an incubation time of more than 10 minutes. When mitomycin C, doxorubicin, cisplatin, and 5‐fluorouracil were assessed by the SRB assay, the concentration‐effect curves revealed a sharp slope between plateaux at low and high concentrations, suggesting that this assay has an excellent sensitivity which can assess the effect of drugs as “all or none.” Although this high sensitivity resulted in good reproducibility of the assay for cultured cell lines, the predictive rate of the SRB assay for the chemosensitivity of human tumor xenografts in vivo was limited to 63.9%. As a result, this SRB assay is thought to be useful for evaluating the chemosensitivity of cultured cells as all or none, since it can assess directly cellular protein synthesis, which is one of the most important parameters of cell renewal, with excellent sensitivity. © 1993 Wiley‐Liss, Inc.
Major amputation for malignant melanoma: An epidemiological study
Authors: Ebskov Lars Bo
Published: February 2007

The annual number of amputations in Denmark as a consequence of malignant melanoma on the limbs has been constant during the period 1978–1987. In contrast, the number of malignant melanoma localized to the extremities increases. For lower limb amputation the mean age is 58 y for males and for females, 72 y. The sex ratio, male to female is 1:2.2. Of the 13 male amputees 7 (54%) had died after 18 mo, of the 28 female amputees 20 (74%) had died after 19 mo. An analysis (Kaplan‐Meier) shows a 5‐y survival rate of about 28%. The mortality is found to be related to sex and level of amputation. Six cases of upper extremity amputation are presented. A review of the literature in order to compare the demographic factors and to outline the indications for amputation reveals a number of differences, most significantly the higher mean age at time of amputation (about 65 y) in Denmark than the figures earlier published (about 45 y). The consensus seems to be that amputation is rarely indicated except as a form of palliation. © 1993 Wiley‐Liss, Inc.