bluuebunny/crossref_metadata_2025 huggingface dataset:
Oncogene expression and oral cancer
Authors: Pillai Radhakrishna , Reddiar Kannan Sankara , Balaram Prabha
Published: February 2007

Cancer of the oral cavity remains a major problem in the United States as well as in many other countries, some of which record as much as 30% of all their cancers to be in the oral region. Despite numerous advances in the fields of epidemiology and etiology, little is known of the molecular basis of oral cancer. Advances in the field of oncogenes have produced a tool to study the different stages of carcinogenesis, including transition from premalignant to malignant stages. These strategies have direct relevance to oral cancer where the premalignant stage is well defined. Preliminary studies into the expression and function of oncogenes suggest abnormalities including individual and multiple amplification of three or more types of these genes. This review briefly describes the concept of oncogenes, and their possible role in the development of neoplasia and specifically on studies in oral cancer.
Colorectal ornithine decarboxylase activity in human mucosa and tumors: Elevation of enzymatic activity in distal mucosa
Authors: Nishioka Kenji , Grossie V. Bruce , Chang Tai‐Hwa , Ajani Jaffer A. , Ota David M.
Published: February 2007

To examine the value of ornithine decarboxylase (ODC) assay as a biological marker of potential malignancy in large bowel, we harvested 43 colorectal carcinoma, 7 adenoma, 6 polyps, and 77 normal‐appearing mucosa at surgery from patients with colorectal carcinoma. In addition, 13 normal rectal mucosa were obtained at biopsy from patients with benign diseases or diseases unrelated to colorectal carcinoma as normal control. ODC activity was significantly higher in polyps and adenocarcinomas than in normal‐appearing mucosa from patients with colorectal carcinoma. ODC activity in normal‐appearing mucosa varied throughout the large intestine, with significantly higher activities in the distal segment of the large bowel. The higher ODC activity detected in the sigmoid colon and rectum correlates with the higher incidence of tumor development in this region of the large bowel. This observation needs to be taken into consideration when ODC activities of the colorectal mucosa are measured as biological markers of potential malignancies.
Estrogen and estrogen receptors in thyroid carcinomas
Authors: Mizukami Yuji , Michigishi Takatoshi , Nonomura Akitaka , Hashimoto Takuma , Noguchi Masakuni , Matsubara Fujitsugu
Published: February 2007

Thyroid tissues, composed of normal thyroid (10 cases), Graves' thyroid (4), and papillary carcinoma (10), were measured for the presence of receptors for estrogen (ER) using an enzyme‐immunoassay method. The mean value of ER in papillary carcinoma tissues (4.0 ± 3.6 fmol/mg protein) was higher than that in normal thyroid tissues (0.8 ± 0.4 fmol/mg protein) or that in Graves' thyroids (2.6 ± 0.9 fmol/mg protein). In 10 papillary carcinomas, 3 were from male patients and 7 were from females. The mean value of ER in the tumors from male patients (7.2 ± 5.1 fmol/mg protein) was higher than that from female patients (2.6 ± 1.7 fmol/mg protein).

Another set of 100 thyroid tissues from normal (20 cases), Graves' disease (10), follicular adenoma (8), and papillary carcinoma (62) was also examined for the presence of estradiol(E2) using an immunohistochemical method on formalin‐fixed paraffin‐embedded sections. E2‐positive tissues were found in 4 (40%) of 10 Graves' thyroids, 4 (50%) of 8 adenomas, and 47 (76%) of 62 papillary carcinomas. In 62 papillary carcinomas, E2‐positive tissues were found in 37 (73%) of 51 female patients and 10 (91%) of 11 male patients. In relation to relapse of the carcinomas, E2‐positive carcinomas were found in 10 (71%) of 14 patients with relapse of the disease and in 14 (54%) of 26 patients with no relapse (the difference was not significant). The findings indicate that thyroid carcinomas may be estrogen‐dependent, but no definite conclusions could be drawn between the biological behavior of the tumors and the E2‐positivity.
Gastrointestinal lipoma and malignancies
Authors: Siegal Annette , Witz Michael
Published: February 2007

Twenty gastrointestinal lipomata in 18 patients are reviewed: 15 located in the colon, 3 in the distal ileum, one in the duodenum, and one in the stomach. They were found most frequently in European‐born, elderly women and presented with variable abdominal symptomatology. Four lipomata were removed during endoscopy, the remainder at laparotomy, partial colectomy being performed in 10 cases. All, except 2 subserosal types, were located in the submucosa, and their average size was 2.7 cm diameter. Microscopically, none showed true encapsulation, and all were composed of mature fat cells without cellular atypia. In spite of nonspecific changes at endoscopy, one‐half of the cases showed, on microscopic examination, atrophy of the overlying glands and a prominent eosinophilic and/or lymphoplasmocytic infiltration of the lamina propria. Two large subserosal lipomata were associated with Crohn's disease. In addition, in 39% of cases, malignant tumours, either single or double, were present in the gastrointestinal tract or elsewhere. Gastrointestinal “lipomata” are located in the sites of normal fatty infiltration in the elderly; these growths could be a local aging or reactive process of the intestinal wall rather than true neoplasms without any potential malignancy. However, coexistent malignancies should be carefully searched for in elderly patients with colonic lipoma.
The spleen in the spleen syndrome: The association of splenoma with hematopoietic and neoplastic disease—compendium of cases since 1864
Authors: Steinberg J. J. , Suhrland Mark , Valensi Quentin
Published: February 2007

Splenomas have been described as benign congenital growths. We report six cases of splenomas, all in males. Three had hairy cell leukemia, one had Hodgkin's disease, and one had myeloid metaplasia. Average splenic weight was 1629 gm, and all had multiple splenomas (average diameter 1.89 cm). Splenomas bulged above the cut splenic surface, were pseudo‐encapsulated, and showed involvement of the underlying disease. A re‐evaluation of 105 prior cases are adult (86%; age: 49), with 56% associated with neoplastic disease or hematologic abnormalities. Average spleen weight was 626 gm, and 22% contained multiple splenomas. We conclude that splenomas are most likely an acquired proliferative process strongly associated with neoplastic disease or hematologic abnormalities. Splenomas can also be congenital growths (hamartoma; 26% of the series), which are of little importance.
Parotid manifestations of HIV infection
Authors: Zeitlen Scott , Shaha Ashok
Published: February 2007

A lump in the parotid region is generally a salivary tumor unless proved otherwise. Recently with an epidemic of acquired immune deficiency syndrome (AIDS) and AIDS‐related complex (ARC), a large number of pathologies are noticed in the parotid region. These conditions generally involve the intraparotid and periparotid lymph nodes. Hyperplastic lymphadenopathy and the benign lymphoepithelial lesions are the most common variants. Our knowledge regarding these new conditions is just evolving. There remains a therapeutic dilemma starting from observation only to local excision and superficial or total parotidectomy. These lesions must be kept in mind when we evaluate a patient with risk factors for human immunodeficiency virus (HIV) infection.
Melanoma tumor vaccine: Five‐year follow‐up
Authors: McGee J. Michael C. , Lytle Glenn H. , Malnar Karen F. , Price Joseph A. , Humphrey Loren J.
Published: February 2007

For many years, various melanoma vaccines have been employed. This is a unique melanoma vaccine in that it is a subcellular tumor homogenate and no adjuvants have been added. This vaccine has been given to 129 stage I and 61 stage II melanoma patients. All were followed at least 5 years and had 87.5% and 63.9% 5‐year survival rates, respectively. Sixty‐four stage I males and 65 stage I females had 84% and 90% 5‐year survival rates, respectively. We saw no difference between those with or without lymph node dissection.

Thirty‐six stage II males and 25 stage II females had 66.7% and 60% 5‐year survival rates, respectively. Of stage II patients, 23 had only one positive node, 22 had two to four positive nodes, and 9 had five or more positive nodes with 69%, 63%, and 55% 5‐year survival rates, respectively. Large published series were used as historical controls [6,27,28], and significant differences were noted when compared to our stage II patients (P = 0.001)—those with two to four positive nodes (P = 0.03), and those with five or more positive nodes (P = 0.04). We conclude that there is a significant increase in survival for these stage II patients, at high risk of recurrence, receiving a tumor homogenate vaccine. This vaccine warrants further analysis, development, and use in a phase III randomized clinical trial.
Primary breast lymphoma
Authors: Misra Anoop , Kapur Brij Mohan Lal , Rath Gaur Kishore
Published: February 2007

Primary breast lymphoma (PBL) is a rare tumor of the breast. Three cases of PBL are being described. All three cases achieved remission following biopsy, chemotherapy, and/or radiotherapy. The literature is extensively reviewed with emphasis on true incidence of PBL and survival rates.
Complications of infection and immunologic status after surgery for patients with esophageal cancer
Authors: Saito Takao , Shimoda Katsuhiro , Shigemitsu Yuji , Kinoshita Tadahiko , Kuwahara Akihiko , Miyahara Masaki , Kobayashi Michio
Published: February 2007

Correlations between defective cell‐mediated immunity (CMI) and infections following surgery for esophageal cancer were evaluated. Peripheral lymphocytes, T cells, B cells, PHA transformation, and PPD skin test were measured in 81 patients with esophageal cancer, 58 with gastric cancer, and 50 healthy controls. The depression of CMI was predominant to a similar extent in patients with esophageal cancer and in those with gastric cancer. The average level of PHA transformation immediately before surgery was significantly lower in the esophageal cancer patients with fatal septic complications than in those without such problems. Although preoperative radiation therapy markedly depressed the levels of the four parameters, this association was also noted in 28 patients not given radiation. It thus appears that PHA transformation may be valuable in the prediction of fatal septic complications after major surgery in patients with esophageal cancer.
Adenocarcinoma of the pancreas: A multimodality approach—A single surgeon's experience (1979—1988)
Authors: Schuricht Alan L. , Barbot Donna J. , Mohiuddin Mohammed , Rosato Francis E.
Published: February 2007

A retrospective review of a single surgeon's experience with adenocarcinoma of the pancreas was performed. One hundred‐one patients were treated over a 10‐year period from 1979 to 1988. Seven patients underwent potentially curative resections and 28 patients presented with metastatic (stage IV) disease. Sixty‐four patients had locally advanced and unresectable primary lesions. A total of 51 patients received I‐125 seed implantation. There was no statistically significant difference in morbidity (33% vs. 30%) or mortality (6% vs. 8%) between patients receiving I‐125 implantation and those undergoing palliative surgical procedures without implantation. Operative mortality was highest in patients presenting with stage IV lesions (11%).

In those patients with locally advanced and unresectable carcinomas, there was a nonsignificant increase in survival (12.8 mo vs. 10.7 mo) in those receiving intraoperative I‐125 implants when compared to those who did not when both groups received postoperative adjuvant chemotherapy and external beam radiotherapy.

Based on these encouraging results, it is concluded that I‐125 implantation can be performed safely and shows a trend toward improving long‐term survivorship in patients with locally advanced pancreatic carcinoma when used in conjunction with chemotherapy and external beam radiation.
The effect of head and neck cancer treatment on whole salivary flow
Authors: Marunick Mark T. , Seyedsadr Mahmoud , Ahmad Kurshid , Klein Barbara
Published: February 2007

The effects of multimodality therapy for head and neck cancer on whole salivary flow were evaluated. Eighteen subjects with head and neck cancer were studied. Resting and stimulated whole salivary flow rates were recorded, pretreatment, after individual modality therapy, and post‐treatment. Twenty‐four subjects with no history of head and neck cancer matched for age, and sex distribution, served as controls. Primary site, stage, major salivary glands resected, radiation fields, and dose to major salivary glands are reported. The average salivary flow rates for 18 subjects following treatment was reduced 83% for resting and 86% for stimulated saliva from pretreatment levels. The null hypothesis that the overall resting and stimulated whole salivary flow rates are unaffected by treatment (surgery and radiation) of the head and neck cancer was rejected (P values at 0.05 level of significance). Stage and location of primary, total dose delivered to and volume of gland exposure are important factors when predicting xerostomia following multimodality therapy.
Establishment of a human chorionic gonadotropin‐producing human gastric carcinoma in nude mice
Authors: Takahashi Yutaka , Ueno Masashi , Mai Masayoshi
Published: February 2007

A human chorionic gonadotropin (HCG)‐producing gastric carcinoma was transplanted into BALB/c nu/nu nude mice. The original tumor tissue had been obtained by gastrectomy from a 55‐year‐old patient with gastric carcinoma. The tumor was transplanted serially in nude mice, and its doubling time was stable to approximately 12 days. A positive correlation was observed between serum HCG level and tumor weight. The serum HCG level of the mice and the histology of the tumor, papillary adenocarcinoma with partial poorly differentiated adenocarcinoma, did not change on serial transfers. HCG was positively stained by an immunochemical technique only in the site of the poorly differentiated adenocarcinoma, while staining was negative in the site of the papillary adenocarcinoma, which constituted most of the tumor. These results indicate that this tumor in nude mice will be useful not only as a therapeutic experimental system but also for studying the potential malignancy of HCG‐producing cancer cells.
Extended single transverse neck incision for composite resections: Does it work?
Authors: Myssiorek David , Becker Gary D.
Published: February 2007

Since Crile's original description of neck dissection in 1906 (Crile GW: JAMA 47:1780–1786, 1906), a variety of neck incisions has been described, suggesting that none is sufficiently versatile to satisfy the criteria necessary for the ideal neck flap. Single transverse neck incisions (STNI) for complete neck dissections have been performed since the 1950s but are not as commonly used as trifurcate incisions. A criticism of the STNI is that the perceived difficulty exposing the surgical field may compromise removal of disease and impair normal surgical technique, resulting in a higher incidence of recurrent neck disease and postoperative complications. One hundred nine patients with squamous cell carcinoma of the head and neck were operated using the STNI. There was no incidence of skin necrosis or carotid artery hemorrhage. Fourteen percent developed fistulae and 12% developed wound dehiscences. Recurrence in the operated neck was not identified. Cosmesis was considered good in all patients. We conclude that STNI does not result in an increased incidence of postoperative complications or recurrent neck disease compared with standard trifurcate incisions.
Clinical features of the differentiated and undifferentiated types of advanced gastric carcinoma: Univariate and multivariate analyses
Authors: Moriguchi Sunao , Kamakura Tatsurou , Odaka Tomohiro , Nose Yoshiaki , Maehara Yoshihiko , Korenaga Daisuke , Sugimachi Keizo
Published: February 2007

This study was done to define clinical features for the different pathological types of advanced gastric carcinoma. One thousand one hundred three patients were identified and classified into two groups: 479 patients (43.4%) had a differentiated adenocarcinoma and 624 patients (56.6%) had an undifferentiated adenocarcinoma. Patients with the undifferentiated type were more likely to have large invasive tumors and a higher incidence of peritoneal dissemination. Conversely, the patients with the differentiated type were more likely to have a liver metastasis. Multivariate analysis, using Cox' proportional hazard model adjusted for sex, age, and other factors, suggested that tumor size was one of the seven most independent prognostic factors in patients with the undifferentiated type (relative risk = 1.01), but this parameter lost prognostic value in patients with the differentiated type. With regard to correlation between survival time and tumor size, the larger the tumor (over 10 cm), the shorter the survival time of patients with the undifferentiated type, as compared to findings in patients with the differentiated type (P< 0.01). Thus, differences in clinical characteristics, including characteristics in the individual patients, extent of tumor, distant metastasis, prognostic factors, and prognosis correlate with the histopathological type of gastric carcinoma.
Axillary dissection in breast cancer: When, why, how much, and for how long? Another operation soon to be extinct?
Authors: Deckers Peter J.
Published: February 2007

The prognostic significance of tumor size and location of the primary tumor in the breast as well as the pathologic status of the axillary lymph nodes in patients with invasive primary breast cancer have been thoroughly studied. A direct adverse relationship between increasing tumor size and prognosis is well established. Likewise, even though 50% of invasive tumors are located in the upper outer quadrant of the breast, it is unusual to find statistically significant differences in survival based on quadrant location alone. Although the American College of Surgeons' (ACS) National Survey in 1978 [1] and even earlier data from Fisher et al. [2] both indicate that women with medial tumors and negative nodes do somewhat worse than patients with lateral tumors and negative nodes, this difference is, at most, 5%. Moreover, the prognosis for patients with positive nodes was not statistically different based on tumor location. However, the likelihood of axillary lymph node involvement is influenced by location of the primary tumor in the breast. In the ACS survey, 43% of patients with tumors in the lateral half of the breast had positive axillary nodes, compared with 35% for patients with medial‐half tumors. Fisher has observed that 52% of patients with lateral‐half tumors had positive nodes, compared with 29% of patients with medial‐half tumors. This tendency occurs independent of tumor size.
Imaging‐guided and nonimaging‐guided fine needle aspiration of liver lesions: Experience with 406 patients
Authors: Edoute Yeouda , Tibon‐Fisher Orly , Ben‐Haim Shlomo A. , Malberger Ehud
Published: February 2007

The aim of the present study was to determine the diagnostic accuracy of different modes of fine needle aspiration (FNA) of liver lesions. A total of 492 FNAs wereperformed on 406 patients in order to confirm or to rule out focal or multifocal neoplastic disease: 29% under ultrasound (US) guidance, 3% with computed tomographic (CT) guidance, 67% preoperatively, and 1% intraoperatively without imaging guidance. Based on histologic, cytologic, and clinical findings, final diagnoses were reached in 387 patients, of whom 264 had malignant liver disease and 123 had benign liver disease. Of 321 aspirations performed in patients with malignant liver disease, the cytologic findings suggested malignancy in 225 (70.1%) suspected malignancy in 25 (7.8%), and did not reveal malignancy in 71 aspirations (22.1%). Among the 123 patients with benign liver disease, the cytologic findings were reported as benign in all but two patients, who had false‐positive cytologic findings. The overall sensitivity, specificity, positive, and negative predictive values for cytologic findings were 85.6, 98.4, 99.1, and 76.1%, respectively. The overall diagnostic accuracy was 89.7%. In one patient, fatal intraperitoneal bleeding due to chronic intravascular coagulation complicated the FNA procedure. We conclude that imaging‐guided FNA as well as nonguided FNA for cytologic diagnosis of liver lesions are highly accurate and only rarely may be associated with a fatal complication.
Carcinoma of the cystic duct
Authors: Yamaguchi Koji , Nishihara Kazuyoshi , Tsuneyoshi Masazumi
Published: February 2007

Carcinoma of the cystic duct is a rare neoplasm, and we herein report four cases of carcinoma of the cystic duct. The patients consisted of a 69 year old and 71 year old woman and a 61 year old and 93 year old man. They complained of either abdominal pain or abdominal mass. All the tumors were microscopically well‐differentiated adenocarcinoma, mostly limited to the wall, that showed no lymph node or distant metastasis. Three patients who had undergone resection were doing well 20 days, 67 months, and 125 months after the operation, respectively. These findings may suggest that not only the early development of symptoms caused by obstruction of the narrow lumen of the cystic duct, but also slow growth and late metastasis produce a favorable clinical course in patients with carcinoma of the cystic duct.
Second cancer in patients treated for testicular seminoma
Authors: Stein Moshe , Loberant Norman , Laviov Michaela , Rennert Gaddy , Lachter Jesse , Kuten Abraham
Published: February 2007

The exact risk of developing a second primary cancer following radiotherapy for testicular seminoma is not known. At the Northern Israel Oncology Center, between the years 1968‐1988, 75 patients with early stage (I,IIA) testicular seminoma were treated by orchiectomy followed by radiation therapy. The overall 10‐ and 20‐year survival probability was 95% and 90%, respectively. Eight patients (11%) developed nine second cancers, with a cumulative rate of one case per 1,000 years of follow‐up. The second primary cancers were: two bronchogenic carcinomas, one contralateral seminoma, one thymoma, one papillary carcinoma of the thyroid, one carcinoma of the stomach, one transitional cell carcinoma of the urinary bladder, one carcinoma of the colon, and one malignant melanoma. Three of these tumors developed within the irradiated field. Five of these eight patients are alive with no evidence of recurrent cancer. We conclude that patients treated for seminoma have an increased risk of developing a second cancer. There is a need for greater awareness of this possibility. The overall prognosis remains favorable.
A long term follow‐up of pectoralis osteomyocutaneous flaps
Authors: Shaha Ashok
Published: February 2007

Reconstruction of the arch of the mandible has always been a difficult problem. The problem of reconstruction is compounded by bony defect and also the loss of soft tissue after resection of tumors of the floor of the mouth. A variety of different methods have been utilized for immediate and delayed reconstruction of the arch of the mandible with limited success. There are various post‐operative complications and problems related to infection, soft tissue loss, and recurrence of the tumor. A free microvascular reconstruction is considered the best and the state of the art. However, it requires specialized training and expertise in microvascular surgery. Other methods have been successful, such as the pectoralis myocutaneous flap, pectoralis osteomyocutaneous flap. We have utilized the pectoralis osteomyocutaneous flap in six instances. Two of these patients have been followed for a long time, ranging from 7‐8 years and we have noticed certain changes in the soft tissue and the rib. We are reporting here the long term results of the two patients who are alive from 7‐8 years. The major finding in these patients was rib resorption and deteriorating cosmetic appearance and development of “Andy Gump” deformity.
Female urethral diverticula with clear cell adenocarcinoma
Authors: Wheeler John S. , Flanigan Robert C. , Hong Hi Young , Walloch Jami L.
Published: February 2007

Clear cell adenocarcinoma in a urethral diverticulum in the female is a very rare and unusual tumor. We recently treated two patients with this tumor. Their presentation, histologic evaluation, and management are reviewed in light of the limited experience in the literature.
Experience with desmoid tumor in a community teaching hospital
Authors: Welling Richard E. , Hermann Mark E. , Kasper Gregory C.
Published: February 2007

Desmoid tumors are rare fibroblastic proliferations that occur primarily in the abdomen and extremities. They have an estimated incidence in the United States of two to four per million inhabitants per year. A recent case of desmoid tumor prompted us to review past medical records for previous cases with the same diagnosis. Since 1985, our institution has treated five patients with a total of eight desmoid tumors. Four patients (80%) were female with ages ranging from 24 to 32 years. The other patient was a 22‐year‐old male with a history of Gardner's syndrome and recurrent desmoid tumors. The majority of our patients were females in the fertile age group, substantiating the hormonal effects believed to play a role in the development of these lesions. In addition, it became obvious that more investigations must be done in appropriate treatment of desmoid tumors and the documentation of these tumors in registries would be of significant benefit.
Accuracy of the bronchoscopic DNA content analysis of non‐small‐cell lung carcinoma
Authors: Haneda Hitoshi , Miyamoto Hiroshi , Isobe Hiroshi , Abe Shosaku , Akita Hirotoshi , Ishikuro Akihiko , Kawakami Yoshikazu , Okayasu Kenji , Endo Takashi , Inoue Kazuaki
Published: February 2007

To assess the accuracy of the bronchoscopic DNA content analysis, samples of non‐small‐cell lung carcinomas (NSCLC) were investigated by means of flow cytometry. Samples were dissociated using the detergent Triton X‐100. In 58 NSCLC cases, 39 (67%) had DNA aneuploid tumors. We compared the DNA indices of bronchoscopic brushing samples with 21 corresponding surgical samples. In 16 (76%) cases, DNA ploidy of both bronchoscopic and surgical samples were in concordance. In 3 (14%) cases, both bronchoscopic and surgical sample showed DNA aneuploidy, but the number of the DNA aneuploid stem cell lines was different. The cause of these differences was ascribed to the intratumor DNA heterogeneity. In 2 (10%) cases, the bronchoscopic sample showed DNA diploidy, but the surgical sample showed DNA aneuploidy. In these cases, tumor cells obtained by bronchoscopic brushing were so few that the small DNA aneuploid peak was undetectable in the DNA histogram. But the tumor DNA ploidy was evaluated correctly in 90% of 21 cases using bronchoscopic samples. Consequently, despite some drawbacks, the DNA ploidy diagnosis using bronchoscopic samples in this relatively small study, was almost as reliable as surgical samples.
Primary pleural mesotheliomas in south India: A 25‐year study
Authors: Kini Usha , Shariff Shameem , Thomas John A.
Published: February 2007

In this report from South India, 15 patients with primary pleural mesothelioma have been diagnosed in the 25‐year period 1, April 1966 through 31, March 1991, representing 0.02% of 76,239 biopsies received. The patients were mainly male with a mean age of 46.5 years. All except two had lived in urban Bangalore. None had been exposed to asbestos. The presentation clinically was peculiar, being continuous pricking pain, breathlessness, and cough with sputum. Physical and roentgenogram examination showed massive pleural effusion with irregular pleural thickening. Thoracotomy findings showed a distinct sessile nodularity with many slit‐like spaces. Histologically, 14 were epithelial type mesotheliomas and 1 was a sarcomatous type. While the epithelial type neoplasms showed patchy squamoid differentiation, all showed mucin production. The CEA was always observed in areas of moderate differentiation. Spread occurred centrifugally to local structures on the same side as the lesion.
Use of an instrument‐holding clip for deeply recessed anastomoses of the rectum and esophagus
Authors: Didolkar Mukund S. , Cawley C. Michael
Published: February 2007

Posterior layer closure of deeply located anastomoses including those performed in the course of low anterior rectal resection, total gastrectomy, and esophagogastrectomy, are often difficult. Usually five to six seromuscular or through‐and‐through posterior wall sutures are inserted sequentially and the loop or cut end of bowel is advanced over these parallel sutures. The sutures are then tied down. Entanglement of these sutures in a deep surgical field with limited access can lead to tears in the bowel wall. In addition, uneven and nonsequential tying of these sutures may compromise the anastomosis itself. We have described here how manual anastomosis in deep, hard to reach surgical fields can be better accomplished with the use of an instrument‐holding clip. Use of the described instrument‐holding clip, to clearly delineate and anchor each suture in sequence, eliminates these problems. An easily available device, it can save operative time, facilitate a more even anastomosis, and decrease the chance of bowel wall tearing, thus enhancing the security of the anastomosis. © 1992 Wiley‐Liss, Inc.
Metachronous second primary malignant fibrous histiocytoma in two skeletal muscles
Authors: Nathanson S. David , Zarbo Richard J. , Sarantou Terry
Published: February 2007

The first recorded case of a metachronous second primary malignant fibrous histiocytoma (MFH) of soft tissue is presented. The patient, who has been followed every two months since the treatment of his buttock sarcoma by neoadjuvant therapy, is free of disease 24 months later. The clinical presentations, different histologies, and DNA contents of these two MFHs are consistent with metachronous primary sarcomas. The literature on second primary neoplasms is discussed. © 1992 Wiley‐Liss, Inc.
Immediate mandibular stabilization following resection of advanced oral cavity carcinoma using the Joe hall morris external fixation device
Authors: Midis Gregory P. , Feuer Adine , Bergman Stewart A. , Elias E. George , Lefor Alan T. , Didolkar Mukund S.
Published: February 2007

Internal mandibular fixation after resection of advanced oral cavity carcinoma with mandibulectomy has a significant complication rate. We placed the Joe Hall Morris (JHM) external mandibular appliance in 29 patients undergoing mandibulectomy for advanced oral cavity carcinoma. Fourteen patients received postoperative radiation therapy (RT). Three of 29 patients (10%) had complications associated with the JHM appliance: one patient had a broken connecting bar, a second had loosening of a single pin, and a third had loss of fixation requiring complete replacement of the appliance. Complications not associated with the appliance occurred in 8 patients (28%) including mandibular exposure (1), orocutaneous fistula (2), partial flap dehiscence (4), and flap necrosis (1). Oral continence was maintained in 26 patients, and occlusion was normal in 27. The appliance was removed in 12 weeks to 6 months in all patients. The JHM appliance allows for a reliable and rapid immediate fixation of the mandible with acceptable functional and aesthetic results, and no delay or interference with postoperative radiotherapy. Since the life expectancy of these patients is short, most do not require subsequent permanent fixation after removal of the appliance. © 1992 Wiley‐Liss, Inc.
The influence of hepatic artery ligation and of vasopressin on liver tumour blood flow in rats
Authors: Naredi Peter , Lindér Per , Holmberg Stig B. , Söderberg Rigmor , Carlsson Göran , Gustavsson Bengt , Jacobsson Lars , Hafström Larsolof
Published: February 2007

The blood flow in an experimental adenocarcinoma in the rat liver was determined with the 133Xe‐washout technique before and after hepatic artery ligation (HAL). There was an initial reduction of the washout of 50%. This was further reduced after 1 day by 50%, which was maintained for 7 days. Seven days after HAL or sham procedures the 133Xe‐washout was of similar magnitude in the liver tumours, although after the sham procedure the tumours were larger (3.4 g vs. 1.5 g). The estimated tumour blood flow was then approximately 0.04 ml × min−1 × g−1. The influence on normal liver parenchyma of HAL was a reduction at 30 minutes, which was maintained for 7 days. Postacton®—a synthetic vasopressin—did not influence the 133Xe‐washout in normal liver parenchyma in non‐tumour, as well as in tumour‐bearing animals. There was no influence of Postacton® on the 133Xe‐washout in the liver tumours. Thirty minutes after HAL Postacton® gave a reduction of blood flow in normal liver parenchyma of tumour‐bearing animals, which is thus only from the portal vein. In tumours Postacton® did not significantly reduce the tumour blood flow immediately after HAL. © 1992 Wiley‐Liss, Inc.
Modified presternal esophagogastroplasty in the treatment of esophageal cancer
Authors: Anikin Vladimir A.
Published: February 2007

Six male patients with locally advanced esophageal cancer underwent surgical treatment including modified presternal esophagogastroplasty. The main reason for this kind of esophagogastroplasty was anticipated risk of transplant gangrene or anastomotic leak. Esophagoplasty technique provides a possibility for prolonged enteral nutrition and facilitates the further reconstruction in case of partial transplant gangrene. There was no hospital mortality. All patients, despite postoperative complications, began their oral food intake with good tolerance of the regular diet. © 1992 Wiley‐Liss, Inc.
Postoperative adjuvant chemotherapy for operable esophageal cancer: A pilot clinical study
Authors: Sharma Sanjay , D'Cruz Anil K. , Kannan Rajan , Vyas Jatendra J.
Published: February 2007

Thirty‐eight patients with node positive squamous cell carcinoma of the esophagus were entered into a pilot clinical study using postoperative adjuvant chemotherapy (cisplatinum 100 mg/m2 and methotrexate 150 mg/m2 × 4 cycles) with an intent of improving cure rates and overall survival. Patient compliance was excellent and toxicity minimal. At 24 months of follow‐up 22 patients (58%) were disease free, while 14 patients (37%) have relapsed and 2 were lost to follow‐up. A highly significant correlation was noted between the number of nodes involved, the grade of the tumour, and the response to chemotherapy. Patients with poorly differentiated tumours and those with more than 4 nodes involved were more likely to develop recurrent disease (P < 0.01 and P < 0.005). We conclude that postoperative chemotherapy following resection for carcinoma of the esophagus is well tolerated with minimal side effects. It may also have an impact on improving disease free and overall survival. © 1992 Wiley‐Liss, Inc.
Reasons for non‐entry in randomized clinical trials for breast cancer: A single institutional study
Authors: Kotwall Cyrus A. , Mahoney Leo J. , Myers Robert E. , Decoste Linda
Published: February 2007

Reasons for patient non‐entry in randomized clinical trials (RCTs) assessing oncologic treatment modalities are not well documented in the literature. We have prospectively recorded reasons for RCT non‐entry in breast cancer patients at St. Michael's Hospital, Toronto. From September 1984 to November 1989, 592 consecutive patients were evaluated through the clinical trials office. One hundred six out of the 592 patients were placed into a RCT (17.9%). Protocol ineligibilities accounted for 273 non‐entries (46.1%) and protocol eligible but not entered patients accounted for 213 (36.0%) non‐entries. The most common reason for protocol ineligibility was advanced age (94 patients). The most common reason for protocol eligible but not entered patients was patient refusal (148 patients). A total of 272 patients in both non‐entered groups were identified as having reasons for non‐entry that were potentially correctable. In summary, protocol ineligibilities account for the majority of non‐entered patients, but patient refusal accounted for the single largest group of potentially correctable non‐entries. More dissemination about the merit of RCTs in the lay press and amongst primary care physicians must take place if we are to expediently and efficiently answer important oncologic questions. © 1992 Wiley‐Liss, Inc.
Cross‐femoral venous bypass in combination with tumor resection
Authors: Radford Diane M. , Walker Howard S. J.
Published: February 2007

The cross‐femoral venous bypass procedure (also known as the Palma/Dale procedure) was introduced for unilateral iliac or common femoral vein occlusions resulting in chronic deep venous insufficiency. We have utilized the procedure successfully in a patient who required extensive pelvic tumor resection involving sacrifice of pelvic venous collateral channels and unilateral ligation of external, internal, and common iliac veins. The case report and review of the literature are presented. © 1992 Wiley‐Liss, Inc.
Primary malignant tumors of the small intestine: Analysis of 40 Japanese patients
Authors: Kusumoto Hiroki , Takahashi Ikuo , Yoshida Motofumi , Maehara Yoshihiko , Watanabe Akihiro , Oshiro Tatsuo , Sugimachi Keizo
Published: February 2007

Forty Japanese patients with primary malignant tumors of the small intestine were reviewed. Adenocarcinoma was the most common tumor type comprising 19 patients (47%), followed by malignant lymphoma, 11 (30%), leiomyosarcoma, 8 (20%) and carcinoid tumor, 1 (3%). Adenocarcinomas and leiomyosarcomas were primarily located in the duodenum or jejunum, whereas lymphomas were more common in the jejunum or ileum. Abdominal pain (65%) and nausea or vomiting (35%) were the most common symptoms with these tumors. Barium contrast studies were able to detect 83% of these tumors. Our results also suggest that computed tomography and ultrasonography are not reliable for diagnosing jejunal tumors while superior mesenteric angiography is effective for diagnosing ileal tumors. The duodenal and ileal tumors tended to metastasize to lymph nodes while jejunal ones tended to penetrate the serosa or to disseminate into the peritoneal cavity. The percentage of tumors potentially cured by surgery and the 5 year survival rates of the leiomyosarcomas (75% and 57%, respectively) were higher than those of adenocarcinomas (42% and 10%, respectively) and lymphomas (42% and 32%, respectively). © 1992 Wiley‐Liss, Inc.
Adjuvant immunotherapy in melanoma: A new approach
Authors: Elias E. George , Tomazic Vesna J. , Buda Barbara S.
Published: February 2007

Patients with metastatic cutaneous melanoma to two or more regional lymph nodes have an extremely poor prognosis despite radical lymphadenectomy. In an attempt to improve the survival and to determine the safety of a new method of tumor specific adjuvant immunotherapy in such a high risk group of patients, nine patients were studied. Three to four weeks after regional lymphadenectomy, each of them received a single intradermal injection of Bacillus Calmette‐Guérin. Three weeks later, they were immunized by allogenic melanoma cells obtained from live donors with distant metastases. Each patient received three vaccinations, each from a different donor (except in one), to avoid development of HLA response, but maintaining exposure to melanoma antigens. No cultured melanoma cells were used. Each vaccine consisted of mitomycin‐C treated tumor cells mixed with purified protein derivative (PPD) of tuberculin given intradermally once per month for 3 months. The patients were then observed with no further treatment. Utilizing the leukocyte migration inhibition test, there was some in vitro evidence of tumor specific cell mediated response which seemed to disappear 1–2 months postimmunization. At 5 years, five of the nine patients (55%) were alive free of disease. No autoimmune diseases were detected in any of the immunized patients. A major hindering factor for such an approach was the limited availability of the allogenic melanoma cells. © 1992 Wiley‐Liss, Inc.
Determination of the resection line in early esophageal cancer using intraoperative endoscopic examination with lugol staining
Authors: Kuwano Hiroyuki , Kitamura Kaoru , Baba Kinya , Morita Masaru , Matsuda Hiroyuki , Mori Masaki , Sugimachi Keizo
Published: February 2007

Determination of the resection line using intraoperative endoscopic examination with Lugol staining was performed when preoperative examinations such as an esophagogram could not be effectively carried out and the carcinoma was not palpable from the outer surface of the esophageal wall. During the past two years, we performed this technique on eight patients. The carcinoma was restricted within the epithelium in one, the mucosal layer in five, and the submucosal layer in two. Although intraepithelial carcinoma contiguous to the main lesion was seen in six and cancer multiplicity was evident in two, all of the resected stumps were free of any cancer tissue. There have been no cases of recurrence and a limited operation, such as distal esophagectomy, was able to be performed in six. Therefore, intraoperative endoscopic examination is useful for early esophageal cancer. © 1992 Wiley‐Liss, Inc.
Comparison of flow cytometric dna content in primary gastric carcinoma and metastases
Authors: Umehara Yasuhiko , Kimura Taizou , Yoshida Masayuki , Oba Noriyuki , Harada Yukio
Published: February 2007

Nuclear DNA contents were comparatively determined by flow cytometry in primary and metastatic lesions from 112 cases with stomach cancer. Aneuploidy frequency and mean DNA index were higher in lymph node metastatic lesions than in primary lesions, both resected synchronously. In these lymph node metastatic lesions, DNA ploidy patterns did not change in 79% (89/112 cases), and did change in 21% (23/112 cases). Concordance of the DNA index between primary lesions and synchronous liver metastatic lesions was seen in 63% (5/8 cases), but the concordance rate was only 25% (4/16 cases) for primary lesions and metachronous liver metastatic lesions and 0% (0/8) for primary lesions and lung metastases. DNA ploidy changes in metastatic lesions were marked in distal metastatic lesions, or more marked in metachronous metastases than in synchronous ones. The results of the present study suggested the possibility of detecting changes in biological characteristics of metastatic lesions by flow cytometric DNA analysis. © 1992 Wiley‐Liss, inc.
Thyroid and thymic malignancy following childhood irradiation
Authors: Jensen Mark O. , Antonenko David
Published: February 2007

Synchronous thyroid and thymic malignancy following childhood thymic irradiation has only been reported in two known cases previously, with a third case identified here. A rationale is presented for following these radiated patients as they age with thyroglobulin and thyroid‐stimulating hormone (TSH) levels as a measure of risk of the development of nodular thyroid disease and, if such occurs, for an aggressive surgical approach. There exists a growing population at risk atributable to the success of radiation treatment of Hodgkin's and pediatric head and neck tumors. The question is raised regarding the theoretical benefits of thyroid suppressive therapy in this group at risk. With the instructive case presented, radical surgery for either thymic or thyroid carcinoma and careful monitoring for decades‐late local recurrences of thymoma are suggested. © 1992 Wiley‐Liss, Inc.
Retroperitoneal surgery in patients with nonseminomatous testicular cancer and minimal residual tumor
Authors: Qvist Hanne , Fosså Sophie Dorothea , Ous Sigurd , Lien Hans H. , Stenwig Anna E. , Giercksky Karl‐Erik
Published: February 2007

In the period 1980–1991, 78 patients with advanced nonseminomatous testicular cancer underwent retroperitoneal lymphadenectomy for post‐chemotherapy residual masses <2 cm. To decrease the frequency of “dry ejaculation” in these patients with no or limited residual disease, the extent of dissection was reduced during the period, with bilateral dissections (49 cases, 1980–1986) being initially replaced by unilateral procedures (19 cases, 1983–1990) and subsequently by nerve‐sparing techniques (10 cases, 1990–1991). As expected, a higher total number of lymph nodes was found in the retroperitoneal specimens after bilateral (44 (13–100)) than after unilateral (21 (7–35)) and nerve‐sparing (18 (7–60)) procedures. The number of lymph nodes with pathological changes was low, with 3 (1–16) after bilateral, 2 (1–9) after unilateral, and 2 (1–4) after nerve‐sparing operations. Histological examination revealed only necrosis/fibrosis in 65% of the patients, elements of mature teratoma in 28%, and remnants of viable malignant tumor in 6%. There were no major postoperative complications. “Dry ejaculation” was reported by 84% of the patients with bilateral operations, but was generally avoided after the unilateral (16%) and nerve‐sparing (nil) procedures. After a mean follow‐up of 83 (5–138) months, 6 patients have developed a recurrence, only one of them primarily in the retroperitoneal space. It is concluded that in patients with minimal residual retroperitoneal tumor, postchemotherapy lymphadenectomy using a unilateral or nerve‐sparing technique seems to offer an effective therapeutic alternative with acceptable postoperative morbidity and preserved ejaculation. © 1992 Wiley‐Liss, Inc.
Malignant melanoma of the vulva: A clinicopathologic study of 18 cases
Authors: Piura Benjamin , Egan Mark , Lopes Alberto , Monaghan John M.
Published: February 2007

In a study of 18 patients diagnosed with vulvar malignant melanoma between 1975 and 1991, the effect of clinical and pathologic variables on the survival was evaluated. The overall 5‐year survival rate was 28.6%. In 14 cases the tumor was retrospectively microstaged with use of Breslow depth and Chung levels. International Federation of Gynecology and Obstetrics (FIGO) stage and Breslow depth did not correlate well with survival. Positivity of groin lymph nodes at initial surgery was associated with an insignificant worsening in survival. An inverse correlation, although statistically not significant, was demonstrated between advancing Chung levels and survival. It is concluded that since the data with respect to microstaging of vulvar malignant melanoma is, as yet, still limited, great caution should be used in electing less aggressive surgery than radical vulvectomy and bilateral groin lymphadenectomy for patients with early‐microstage localized disease. © 1992 Wiley‐Liss, Inc.
A comparison of the clinical characteristics of second primary and single primary sarcoma: A population based study
Authors: Robinson Eliezer , Bar‐Deroma Raquel , Rennert Gadi , Neugut Alfred I.
Published: February 2007

The clinical characteristics of 240 patients with sarcoma as a second metachronous primary neoplasm (SPN) were compared with those of 8,815 patients with sarcoma as a single tumor. The data were obtained from patients registered during the period 1973–1986 in the Surveillance, Epidemiology and End Results (SEER) Program in the United States. Seventy‐four of the 240 SPN patients had postirradiation sarcoma (PIS) while the other 153 patients developed the sarcoma as a second tumor in an area which was not exposed to prior radiotherapy (non‐PIS). The stage of disease at diagnosis was more advanced in patients with PIS than in those with single sarcomas but the difference did not reach statistical significance. Overall, in comparable clinical stage localized and regional disease there was no statistically significant difference in survival between PIS and non‐PIS sarcoma patients after adjusting for age. The survival of patients with localized or regionally advanced sarcoma as a second tumor was significantly worse than of those with single sarcomas with the same stage. There was no difference in survival between first or second sarcomas with metastatic disease. © 1992 Wiley‐Liss, Inc.