bluuebunny/crossref_metadata_2025 huggingface dataset:
Haemostatic and antialgic effects of the 25 mv photon beam concentrated dose in the treatment of carcinoma of the cervix
Authors: Patrício M. B. , Tavares M. A. , Guimarães M. F. , Belo M. C. , Vilhena M.
Published: February 2007

The authors present the results of a preliminary study on the use of a concentrated dose of 13 Gy in 48 hours in the treatment of cancer of the cervix, especially for haemostatic and antialgic purposes and mostly as a first part of a split course of radiotherapy. In 13 patients with early stages of the disease, the method was used as an emergency treatment with good response in 84.6% of the cases without serious complications. In 43 patients with advanced disease, the concentrated dose was generally repeated for palliation and relieved symptoms in about 72% of the cases but with complications in 16.3%. The authors recommend this method only when absolutely necessary to stop severe haemorrhage and suggest that patients with good response to the first flash course should continue treatment with conventional fractionation, bearing in mind the tolerance of the normal tissues.
Merkle cell carcinoma report of a case and possible role for adjuvant radiotherapy
Authors: Brown Pamela E. , Pinkston John A. , Blackmon John A. , McMahon John M.
Published: February 2007

A case of neuroendocrine (Merkle cell) carcinoma of the skin is described. This uncommon tumor occurred in a 76‐year‐old female and presented as a small exophytic nodule on the right anterior chest wall. Following primary excision, it was thought to be a basal cell carcinoma. The diagnosis of Merkle cell carcinoma was established only after the tumor had recurred locally and involved ipsilateral axillary lymph nodes. Although local control was achieved with surgery and radiotherapy, the patient died of probable hepatic metastases 18 months after presentation. The Merkle cell tumor is an undifferentiated small cell carcinoma originating in the skin and has distinct ultrastructural characteristics that help to differentiate it from other small cell tumors. The clinicopathologic characteristics of these potentially aggressive neoplasms are reviewed, and treatment is briefly discussed.
Randomized trial of the addition of cis‐platin (DDP) and/or BCG to cyclophosphamide (CTX) chemotherapy for ovarian carcinoma
Authors: Wilbur David W. , Rentschler Robert E. , Wagner Robert J. , Keeney Elden D. , King Alan , Hilliard Dennis A.
Published: February 2007

A prospective randomized trial has compared cyclophosphamide (CTX) with CTX plus cis‐diamminodichloroplatinum (DDP) as the initital chemotherapy for advanced ovarian carcinoma. A secondary randomization compared the addition of BCG treatment to either chemotherapy. The addition of DDP had no measurable impact on survival, but a small survival trend favoring BCG‐treated patients was noted (P < 0.08). Toxicity from BCG treatment was insignificant, but the addition of DDP increased both early nausea and vomiting and later hematologic toxicity. There were three long‐term complete remission patients, and these all came from the group of six patients with pretreatment residual disease < 2 cm. A univariate analysis of pretreatment prognostic factors indicated significantly better prognosis (P < 0.02) for patients with no palpable tumor, platelet count < 400,000/mm3, residual tumor < 2 cm, resting pulse < 91/min. and LDH < 250 U/L. The authors conclude that for patients with large (> 2 cm) residual disease, there is no compelling evidence that initial combination therapy is superior to aggressive single alkylating agent treatment.
Surgical treatment of bilateral synchronous wilms' tumors
Authors: Hanash K. A. , Sackey K. , Sabbah R. S. , Akhtar M. , Aur R. J. A. , Ali A. M.
Published: February 2007

Definite progress has been made in the treatment of bilateral Wilms' tumors with marked improvement in the prognosis. This is confirmed in our series of 6 consecutive patients with synchronous tumors. The recent trend toward more conservative surgery, double or triple drug chemotherapy, and avoidance of high‐dose radiation therapy has yielded good results.
Indolent lymphadenopathic Kaposi's sarcoma
Authors: Schwartz Robert A. , Brenden Lloyd D. , Breeden James H. , Lambert W. Clark
Published: February 2007

Kaposi's sarcoma is usually an indolent skin neoplasm. Diffuse lymph node and visceral involvement have been described in young African patients and in patients who are immunosuppressed; in such patients the disease is usually rapidly progressive. We describe the case of a 64‐year‐old man of Italian ancestry with diffuse lymph node involvement by Kaposi's sarcoma in the absence of any skin lesions. The patient had no evidence of immunosuppression. The course has been indolent, with no disease progression over 2 years of follow‐up on no therapy.
Effect of splenectomy on treatment of lewis lung carcinoma by an immunomodulatory polysaccharide and a cytotoxic agent
Authors: Michowitz Moshe , Kopel Shoshana , Hoenig Shoshana , Leibovici Judith
Published: February 2007

The effect of the spleen on the efficiency of chemotherapy (cyclophosphamide) and immunotherapy (the polysaccharide levan) of C57BL mice bearing the Lewis lung carcinoma was studied. The development of Lewis lung carcinoma caused a gradual splenomegaly in the C57BL mice. Splenectomy did not, however, affect tumor growth in the nontreated host. Levan induced a pronounced splenomegaly. Splenectomy reduced markedly the antitumoral effect of the polysaccharide. These results indicate that spleen elements participate in the inhibitory activity of levan. By contrast, splenectomy had no effect on the efficiency of treatment of cyclophosphamide.
Massive hemolysis in clostridium perfringens infections
Authors: Becker Richard C. , Giuliani Michael , Savage Richard A. , Weick James K.
Published: February 2007

Over a 14‐month period at the Cleveland Clinic Foundation, 424 strains of Clostridium were isolated; of these, 52 strains were Clostridium perfringens isolated from 41 patients. Eight strains of C. perfringens were isolated from the blood of six patients; five of these patients had neoplastic disease and three developed massive intravascular hemolysis with rapidly developing shock and death. Clinical details are given on three patients with fatal Clostridium perfringens sepsis, and the nature of presentation and pathophysiologic mechanisms are discussed.
Renal cell carcinoma and vasculitis: Report of two cases
Authors: Hoag Gordon N.
Published: February 2007

A 63‐year‐old caucasian male with systemic leukocytoclastic vasculitis involving the skin, lungs, and gastrointestinal tract was found to have a renal cell carcinoma at autopsy. A 77‐year‐old‐woman with a history of hypertension was felt to have temporal arteritis that was confirmed by biopsy. The autopsy revealed a renal cell carcinoma in association with widespread giant cell arteritis. The possible association of renal cell carcinoma with vasculitis and an assessment of the possible clinical usefulness are presented and cases of vasculitis with renal neoplasms are briefly reviewed.
Changing incidence of adenocarcinoma of the lung: A brief review
Authors: Reyes Cesar V. , Chua David , Aranha Gerald V.
Published: February 2007

The autopsy of lung cancer at Hines Veterans Administration Hospital was reviewed for a 27‐year period, between 1957 and 1983. There has been a changing histologic pattern with a recent increase in adenocarcinoma and a relative decrease of the other cell types. This observation, based on a virtually all‐male patient population, is partly attributed to better and improved diagnostic procedures.
Exclusion of small bowel from pelvis for postoperative radiotherapy for rectal cancer
Authors: Bakare Sanjivani C. , Shafir Michail , McElhinney A. James
Published: February 2007

The pelvis is the preferential site of disease when recurrence occurs after curative resection of rectal cancer. Postoperative adjuvant radiotherapy decreases local recurrence rates for Dukes stages B and C; however, after abdominoperineal or anterior resections, the small bowel descends into the lower pelvis, and, due to its low tolerance to radiation, optimal doses cannot be safely delivered unless the small bowel can be excluded from the pelvis. This can be achieved by cystopexy and/or by creating a pelvic sling with a knitted polypropylene mesh. Three cases are presented in which radiotherapy was satisfactorily delivered with these techniques.
Nodular liver lesions associated with chronic home hyperalimentation after massive enterectomy for ileal carcinoma
Authors: Kemeny M. Margaret
Published: February 2007

A case of an ileal carcinoma involving the entire midgut treated with a massive enterectomy of the small bowel distal to the ligament of Treitz, the right colon, and part of the transverse colon is discussed. After 1 year on home hyperalimentation, hepatic nodules were seen on CT scans; metastases could not be proven. At 3 years a hepatic wedge resection was performed, multiple areas of necrosis and fibrosis were found, but no carcinoma. This case is presented as an example of an alternative in treatment for this type of carcinoma and to illustrate the problems of differential diagnosis of liver defects on the CT scan in patients on longterm hyperalimentation.
Carcinoma of the prostate clinically and radiologically simulating malignant lymphoma
Authors: Liel Yair , Biderman Aia , Biran Chaim , Katz Miriam , Sacks Martin
Published: February 2007

A 65‐year‐old man presented with supraclavicular, mediastinal, and retroperitoneal lymphadenopathy clinically thought to be due to malignant lymphoma. Biopsy of a supraclavicular lymph node revealed metastatic adenocarcinoma positive for prostatic‐specific antigen. This site of the primary tumor was confirmed by needle biopsy of the prostate gland. The tumor regressed dramatically following treatment with estramustine phosphate.
Hydroxyurea plus pelvic radiation versus placebo plus pelvic radiation in surgically staged stage IIIB cervical cancer
Authors: Piver M. Steven , Vongtama Vitune , Emrich Lawrence J.
Published: February 2007

Forty‐five evaluable patients with stage IIIB carcinoma of the uterine cervix were entered into a prospective, double‐biind, randomized study to evaluate the possible radiation‐potentiating properties of hydroxyurea. All patients were documented to be without para‐aortic lymph node metastasis by pretherapy staging para‐aortic lymphadenectomy. The original plan of therapy was for continuous therapy (200 rads/day) of 6,000 rads of pelvic radiation for 6 weeks plus intrauterine radium. However, 16 patients received 6,000 rads in 8 weeks by split‐course therapy (2‐week rest after 3,000 rads) plus radium. Twenty‐nine patients received the planned continuous therapy. The median dose of pelvic radiation for patients who received continuous therapy or split‐course radiation was 6,000 rads. Leukopenia (WBC < 2,500/mm3) was significantly increased in the patients given hydroxyurea as compared to those given placebo (P < .001). There was no statistically significant difference relative to anemia, thrombocytopenia, radiation skin reaction, diarrhea, or radiation‐induced complications requiring surgical correction. The estimated 5‐year progression‐free survival rate for the combined, continuous, and split‐course radiation therapy hydroxyurea patients was 60 %, and its was 52 % for the corresponding placebo patients (P = .49). However, the estimated 5‐year progression free survival rate for the correctly treated patients (continuous therapy) was 91% for the hydroxyurea group and 60% for the placebo group (P < .06).
Metastatic disease in patients with newly diagnosed malignant melanoma
Authors: Zartman Gary M. , Thomas Mathew R. , Robinson William A.
Published: February 2007

In patients with stage I Clark's level III and IV malignant melanoma (MM), recurrence rates of 30‐60% can be expected after resection of the primary lesion. If metastatic disease could be detected early and treated in such patients, survival might be prolonged. Ninety patients (37 males and 53 females) with newly diagnosed, resected stage I cutaneous MM, levels III and IV, were evaluated for metastatic disease at diagnosis using a physical examination; CBC; SMA 18; chest films; brain computed tomography (CT) scan; and radioisotope liver, spleen, and bone scans. Fortyfour patients had level III and 46 had level IV melanomas ranging in thickness from 0.65 to 4.5 mm. None of these 90 patients was found to have metastatic disease. Such tests are not useful and can be replaced by a history and physical examination with substantially improved cost effectiveness.
Seeding and perineal implantation of prostatic cancer in the track of the biopsy needle: Three case reports and a review of the literature
Authors: Haddad Farid S. , Somsin Amporn A.
Published: February 2007

Several months (an average of 12.86 months) after perineal needling of the cancerous prostate for the purpose of obtaining tissue for biopsy, a tumor nodule becomes clinically evident in the subcutaneous tissue of the perineum, at the site of the needling in 0.34% of the cases. This nodule presents the same histological picture as the biopsy of the prostatic tumor. This is a review of 15 such cases (12 collected from the literature and an additional three unpublished cases, two of which are personal observations). At the time of needling, no metastases could be clinically detected in any of the patients; the serum acid phosphatase was normal in 73% of them. The average age of the patients was 65‐66 years. The perineal nodule was tender in 40% of the cases; its average size was 2.5 cm. Excision of the nodule was the most frequently employed form of management. At the time of reporting, 60% of the patients were living and well, for an average of 18.56 months after excision. In order to prevent perineal implantation, especially in patients who are at risk, it is suggested that a fine needle be employed to obtain prostatic tissue for biopsy, and that every possible therapeutic effort be made.
Metastatic renal cell carcinoma simulating glumus jugulare tumor
Authors: Boileau Michel A. , Grotta James C. , Borit Adam , Linden Christiaan Van Der , Nath Avindra , Ostrow Peter , Kopaniky Dennis
Published: February 2007

A 59‐year‐old man presented with jugular foramen syndrome caused by a mass with roentgenographic and histologic features highly suggestive of a glomus jugulare tumor. However, electron microscopic examination of the surgical specimen revealed features diagnostic of a previously unsuspected renal cell carcinoma. Because primary tumors of the glomus jugulare and metastatic renal cell carcinoma may present with the same clinical and roentgenographic findings and look similar histologically, careful electron microscopic examination of the tumor and urologic screening should be performed in suspected cases of glomus jugulare tumors.
Effects of serum immunosuppressive factors on antitumor cytotoxicity of interleukin 2‐induced lymphocytes
Authors: Sugiyama Yasuyuki , Sakata Kazuki , Saji Shigetoyo , Takao Hiroshi , Hamuro Junji
Published: February 2007

The cytotoxic ability of interleukin 2 (IL2)‐induced T cells and the effect on their cytotoxicity of serum suppressive factors obtained from cancer patients were examined. Peripheral blood mononuclear cells (PBL) of healthy adults were IL2‐cultured for 72 h either together with a gastric carcinoma cell line MKN‐28 or with phytohemagglutinin, then IL2‐cultured for another 11 days. Cytotoxicity of the MKN‐28 precultured lymphocytes against MKN‐28 was particularly increased. Presence during preculture or during cytotoxicity assay of sera from gastric cancer patients having the same histological type as MKN‐28 suppressed the cytotoxicity. However, the serum suppressive effect on cytotoxicity of the IL2‐cultured lymphocytes was far milder than that on PBL cytotoxicity.
Systemic rhabdomyosarcoma presenting as leukemia: Case report with ultrastructural study and reviews
Authors: Huntrakoon Manop , Callaway L. Alan , Vergara G. G.
Published: February 2007

A 20‐year‐old white male was initially suspected clinically and pathologically of having an acute lymphoblastic leukemic process because of fatigue, severe anemia, thrombocytopenia, a leuko‐erythroblastic peripheral blood picture, and a diffusely infiltrated bone marrow. Subsequent review of the bone marrow material indicated cytologic features consistent with either an embryonal, undifferentiated small cell mesenchymal malignancy or reticulo‐endothelial malignancy. Ultimately, the electron microscopic (EM) study of the tumor proved to be diagnostic of rhabdomysoarcoma. An extensive search for a primary site of rhabdomyosarcoma did not show any lesion, although the genitourinary region was clinically suspected. The clinical course was a rapidly downhill one with extensive bone and CNS involvement. The patient died 5 months later. An autopsy permit was not obtained. This case emphasizes the occasional tendency of rhabdomyosarcoma to masquerade as a hematopoietic malignancy at the time of presentation and the usefulness of EM study in confirming a diagnosis.
Spontaneous penetration of dura mater and bone by glioblastoma multiforme
Authors: Shuangshoti Samruay , Kasantikul Vira , Suwanwela Nitaya
Published: February 2007

Three patients are reported whose cranial dura mater and bones were penetrated by intracranial glioblastomas in the absence of previous craniotomy or radiotherapy. The gliomatous nature of the tumors was confirmed by localization of cytoplasmic glial fibrillary acidic protein (GFAP) of the neoplastic cells. Review of the literature disclosed only 15 glioblastomas, including the three cases, spontaneously penetrating the cranial dura mater and bones. These patients ranged in age from 3.5 to 70 years with an average age of 40 years. The male/female ratio was 5/8. Five glioblastomas were in the temporal lobes, three were in the frontal lobes, three were in the frontotemporal regions, two were in the occipital lobes, one was in the frontoparietal region, and one was in the temporoparietooccipital region. Six glioblastomas also had spontaneous distant metastases. In the absence of previous craniotomy and radiotherapy, rapid growth of the glioblastomas may promote such spontaneous penetration into the cranial dura mater and bones.
Primary adenocarcinoma of the esophagus
Authors: Steiger Zwi , Wilson Robert F. , Leichman Lawrence , Busuito Michael J. , Rosenberg J. C.
Published: February 2007

Of 163 patients with carcinomas of the esophagus seen between 1975 and 1982, 11 (6.7%) had a primary adenocarcinoma. Although the high ratio of men to women (10:1) was similar to that seen in patients with squamous cell carcinoma of the esophagus, the mean age of those with adenocarcinoma was younger (57 years). In contrast to squamous cell carcinomas, which predominately involve blacks, esophageal adenocarcinomas in these patients involved only Caucasians. The great majority of lesions were found in the lower third of the esophagus. Only 3 (27%) of the patients with adenocarcinomas gave a history of a large daily alcohol consumption and only 2 (18%) had a Barrett's esophagus. Although various combinations of surgery, chemotherapy, and radiotherapy could control the primary tumor rather well, the final results were poor. All patients have now expired; median survival time was 16 months.
Proximal gastrectomy as the surgical procedure of choice for upper gastric carcinoma
Authors: Kaibara Nobuaki , Nishimura Okitsugu , Nishidoi Hideaki , Kimura Osamu , Koga Shigemasa
Published: February 2007

To assess the efficacy of proximal gastrectomy in the treatment of upper gastric carcinoma, we analyzed clinical data from patients with lesions confined to the upper third of the stomach (group 1) and from patients with lesions which, while primarily located in the upper portion of the stomach, showed spread to the body of the stomach (group 2). Patients in group 2 showed more metastatic lymph node involvement, particularly of the infrapyloric lymph nodes, which were not included in lymphadenectomy accompanying proximal gastrectomy. None of the group 1 patients demonstrated metastasis to the infrapyloric lymph nodes. The postoperative 5‐year survival rate in curatively operated group 1 patients was not significantly different between those treated by proximal gastrectomy and those subjected to total gastrectomy. We conclude that proximal gastrectomy is indicated in patients with upper gastric carcinoma when it is confined to the upper third of the stomach.
Nature of the spleen cell populations capable of releasing tumor enhancing factor
Authors: Eiján Ana María , Jasnis María Adela , Kohan Silvia S. , Oisgold‐Dagá Sara
Published: February 2007

Supernatants obtained from short‐cultured spleen cells (SCS) from BALB/c mice bearing a syngeneic mammary transplanted tumor—S13—showed enhancing activity on tumor growth when inoculated into the foot pad of normal syngeneic mice 24 hr before injection of S13 tumor cells. The present work was designed to characterize the spleen cell population responsible for the releasing of the enhancing factor (EF) as long as the tumor grows (small tumor bearing mice—STEM—and large tumor bearing mice—LTBM). Pretreatment of spleen cells with anti‐Thy 1.2 serum + C' and nylon‐wool columns were utilized to separate cell populations and to characterize the cellular source of the enhancing activity in the spleens of STBM and LTBM. In this tumor system, evidence is presented for distinct enhancing cell populations operating in the spleens of STBM and LTBM. In early stages of tumor development, the EF was found to be associated with T and non‐T cells, whereas in advanced stages of tumor growth, this activity was found to be associated with only T cells.
Squamous cell carcinoma of the renal pelvis with sarcomalike stroma: A light and electron microscopic study with immunohistochemical analysis
Authors: Goldstein Jed , Mozes Marta , Lismer Leonid , Levin Israel
Published: February 2007

Primary neoplasms of the renal pelvis are rare. Most are malignant, and most of these are transitional cell carcinomas. We report the unusual occurrence of a squamous cell carcinoma with sarcomatoid stroma arising from the renal pelvic mucosa in a patient with renal lithiasis. Immunohistochemical stains for keratin intermediate filaments failed to demonstrate their presence in the spindle cell portion of the tumor. Transmission electron microscopic study did not reveal structures of an epithelial nature in these same cells. Our findings support the contention that the spindle cells of the stroma are not squamous in nature, but represent either a reactive or a neoplastic transformation of these underlying stromal elements.
Tumor‐induced osteomalacia: Long‐term follow‐up of two patients cured by removal of their tumors
Authors: Sparagana Mario
Published: February 2007

Two patients with mesenchymal tumors had osteomalacia associated with marked hypophosphatemia and renal phosphate wasting. Their serum calcium and parathyroid hormone levels were normal. The first patient also had aminoaciduria and glucosuria in addition to phosphaturia. Both patients were treated with very large doses of vitamin D2 and phosphate without improvement in the osteomalacia or normalization of the serum phosphate. Complete removal of a low‐grade fibrosarcoma in the second patient and removal of an ossifying fibroma in the first patient resulted in a cure in both patients despite no further therapy with vitamin D or phosphate. The excessive aminoaciduria and glucosuria of the first patient also remitted. During a 14‐year follow‐up period, there has been no evidence of tumor recurrence, hypophosphatemia, or osteomalacia in either patient. The levels of 1,25‐dihydroxycholecalciferol remain within the normal range in both patients.
In vitro production of human antibodies specifically reactive with human gastric cancer cells of established lines and autologous tissues
Authors: Takayama Tadatoshi , Sakabe Takashi , Fujii Masashi , Yamada El , Uno Masatsune , Ono Yasushi
Published: February 2007

Human lymphocytes derived from regional lymph nodes adjacent to the primary gastric cancer were transformed with Epstein‐Barr virus (EBV) to establish lymphoblastoid cell lines secreting human antibodies reactive with cell surface antigens expressed on the gastric cancer cells. The EBV transformation technique was applied to lymph node lymphocytes obtained from 4 gastric cancer patients. As a result of mass screening with the radioactive cell binding assay for the production of anti‐gastric cancer related antibodies, one culture (TGc‐106) among 1,400 microcultures was identified to secrete human antibody specifically reactive with an established human gastric cancer cell line as target (MKN‐45). Furthermore, it was demonstrated with the autologous assay system by the histoimmuno‐fluorescence method that cell surface antigens of autologous gastric cancer cells could be clearly defined with human antibody from one culture (TEb‐079) out of 470 microcultures established from a gastric cancer patient (GCP‐26); there was no reactivity against the surrounding normal cells constructing the gastric wall. The immunoglobulin class of the human antibodies produced both in TGc‐106 and TEb‐079 was determined from immunodiffusion tests to be IgM.
Effects of sodium cholate on experimental carcinogenesis and cell proliferation in an excluded colonic segment
Authors: Tempero Margaret A. , Zetterman Rowen K.
Published: February 2007

Bile salts appear to be important promoters of colon carcinogenesis. This study was designed to assess the importance of the fecal stream in cholic acid‐induced colon tumor promotion. Male Sprague‐Dawley rats underwent transverse colostomy after induction with dimethylhydrazine (DMH) and the excluded distal colon was irrigated with saline or sodium cholate (23 μM) 5 times per week until sacrifice. Controls initially injected with saline were similarly treated. All surviving animals were sacrificed at 28 weeks after the last DMH injection. Five animals from each group were randomly chosen to assess tritiated thymidine labeling and distribution by autoradiography in normal appearing colon mucosa of irrigated bowel. Cholate irrigation failed to increase tumor yield or modify the proportion of adenomas and adenocarcinomas in this model. Paradoxically, fewer tumors per affected rat were noted with sodium cholate irrigation. Cholate irrigation also failed to affect crypt cellularity, thymidine labeling indices, and labeling distribution in DMH‐treated rats and controls. An effect of DMH was seen, however, with an increase in thymidine labeling index and increased labeling in the top half of the crypt in all DMH‐treated groups. This study suggests that tumor promotion with primary bile salts is not a direct affect and may result from further bile salt metabolism within the fecal stream. DMH‐induced changes in cell proliferation were reproduced with this model. Use of an excluded colon segment to assess the effect of suspected tumor promoters on carcinogenesis or colon mucosal cell proliferation is feasible and may be a useful model for future studies.
Survival following self‐administered chemotherapy for liver metastases
Authors: O'dwyer Patrick J. , Minton John P.
Published: February 2007

Fifty‐three patients with unresectable liver metastases from colorectal cancer either self‐administered or had a family member administer 5‐fluorouracil (5‐FU) (12 mg/kg/day for 5 days in alternate weeks) through intraoperatively placed hepatic artery and/or portal vein catheters. Twenty percent had failed previous systemic chemotherapy. Seventeen who were symptomatic received additional radiotherapy. Metastasis was confined to the liver in 38, while 15 also had extrahepatic metastases. Median survival for those with hepatic metastases only was 21 months from diagnosis and 16 months from catheter insertion. There are three long‐term survivors in this group, alive 58, 69, and 86 months, respectively, from diagnosis. Median survival for those with hepatic and extrahepatic metastases was 10 months from diagnosis and 6 months from catheter insertion. No patient in this group has survived long term. Catheter‐related complications occurred in 20% of the patients; none were fatal. Drug toxicities were minor. Self‐administered chemotherapy is a safe, effective, and simple method of achieving prolonged survival in patients with unresectable hepatic metastasis from colorectal cancer.
Nonosseous sarcomas in a military hospital
Authors: Shaver Timothy R. , Lee Yeu‐Tsu Margaret
Published: February 2007

This is a retrospective review of 67 patients with soft tissue or visceral sarcomas treated during 1973–1982. There were 40 males and 27 females. The mean age was 36 with a range of 1 to 77 years of age. The most common histologic subtypes were rhabdomyosarcoma (19%), malignant fibrohistiocytoma (13%), fibrosarcoma, leiomyosarcoma, dermatofibro‐sarcoma protuberans (12% each), and liposarcoma (10%). Among the 42 soft tissue sarcomas 33% occurred in the trunk, 35% and 21% in the lower and upper extremities, and 10% in the head and neck region. Among the 25 visceral sarcomas, 16% were in the thorax, 56% involved abdominal or retroperitoneal organs, and 28% were in the head and neck region. Overall, 33 of the 54 patients with early sarcomas were treated by surgical resection alone while 21 others had postoperative adjuvant radiotherapy and/or chemotherapy. Factors influencing survival are presented and patterns of metastasis discussed. Overall, 45% of the patients showed metastatic disease either at diagnosis (15%) or duirng the follow‐up period (30%). The lung was involved in two‐thirds of the cases and was the most common site of spread. In patients with rhabdomyosarcoma and malignant fibrohistiocytoma, regional lymph node metastasis was noted in 36% and 17%, respectively.
Malignancy and concomitant primary hyperparathyroidism
Authors: Strodel William E. , Thompson Norman W. , Eckhauser Frederic E. , Knol James A.
Published: February 2007

Hypercalcemia is associated with a few primary malignant neoplasms and with a variety of tumors that have spread by metastases. Hyperparathyroidism is a diagnosis that is usually not considered in these patients. At our institution, 18 patients with malignant tumors presented over a 6‐year period with hypercalcemia caused by hyperparathyroidism. There were five men and 13 women with a mean age of 48 years (range 24–87 years). Primary tumors in these patients included colon carcinoma (four cases), breast carcinoma (four cases), lymphoma (four cases), thyroid carcinoma (four cases), Paget's disease (one case), and lung carcinoma (one case). Metastases of the primary tumor occurred in seven patients, and in 11 patients the tumor was not metastatic or recurrent. Serum levels of calcium, phosphate, and chloride averaged 11.8 mg/dl, and 100 mEq/liter, respectively. C‐terminal parathyroid hormone (PTH) levels ranged from 300 to 1,900 pg/ml with an average of 1,150 pg/ml (normal 50–340 pg/ml). At operation, a single parathyroid adenoma was discovered in 15 patients, and four‐gland hyperplasia was noted in three patients. In all cases, serum levels of calcium returned to normal after operation. We conclude that patients with malignant tumors and concomitant hypercalcemia should be evaluated for the possibility of hyperparathyroidism. In cases of primary hyperparathyroidism, elevated C‐terminal PTH level should be diagnostic. If hyperparathyroidism is determined to be the cause of hypercalcemia, neck exploration and parathyroidectomy are indicated.
Epitheloid hemangiomatosis mistaken for carcinomatosis
Authors: Goldman Gideon , Ilie Bianca , Kashtan Hanoch
Published: February 2007

We present a unique case of intra and extra‐peritoneal epitheloid hemangioma which was mistaken for diffused carcinomatosis, representing a clinical‐pathological problem, and emphasizing the unpredictable behaviour of this tumour. We are dealing with epitheloid vascular tumours, and briefly touch on the differential diagnosis, the principle of biological, pathological and clinical behaviour. Knowledge of this entity would provide an accurate diagnosis and would hence improve dealing with the problem. The conclusion is that this group of Histiocytoid‐epitheloid vascular lesions have varying biological potential and this unusual functional state represents a large spectrum of cells, from normal to neoplastic endothelium.
The rabbit as an experimental animal for tracheal surgery
Authors: Peleg Haran , Rao Uma N. M. , Emrich Lawrence J.
Published: February 2007

The circumferential resection of the trachea with end‐to‐end anastomosis is a well‐established clinical procedure. Still, some problems remain to be solved, such as the choice of optimal suture material. Dogs are primarily used for experimental work in this field, but are difficult to obtain. This operation was performed on nine rabbits, eight of whom survived to the preplanned date of sacrifice. Two of the survivors were found to have severe stricture at the anastomosis. This study indicates that the rabbit is a suitable experimental animal for circu, ferential resection and anastomosis of the trachea.
Thermal resistance of human malignant melanoma modulated by prostaglandin E2
Authors: Kern David H. , Krag David N. , Kauffman Gordon L. , Morton Donald L. , Storm F. Kristian
Published: February 2007

The inhibition of DNA synthesis in a human malignant melanoma cell line as measured by tritiated thymidine (3H‐TdR) incorporation was both time and temperature dependent. Two components of cell damage were identified: a cytostatic, temporary component from which no was observed. Thermotolerance was induced in M14 cells by sublethal heat treatment at 41°C for 1 hr. However, induction of thermotolerance was blocked by indomethacin, a prostaglandin synthetase inhibitor. Exogenous PGE2 at concentrations up to 10 μg/ml also protected cells from heat damage. These data suggest that prostaglandin synthesis increases during heat stress and may play a role in protecting cells from thermal damage.
Stage I uterine adenosarcoma: A report of six cases
Authors: Baker Trudy R. , Piver M. Steven , Lele Shashikant B. , Tsukada Yoshiaki
Published: February 2007

Six cases of Stage I adenosarcoma of the uterus are reported. Although these neoplasms have generally been regarded as being of low malignant potential with little propensity for distant metastasis, our experience reveals some of them to be aggressive tumors with rapid clinical demise. Five (83%) patients demonstrated recurrence after initial surgery, three despite postoperative vaginal radium or external pelvic radiation. Four of the recurrences occurred in the pelvis and abdomen; the fifth was limited to the vagina. Three patients were dead of disease within three years of diagnosis, two of whom achieved clinical remission for at least one year to combination chemotherapy. One of the remaining three patients died from intercurrent disease without recurrence, and two are alive without disease after treatment for recurrence. Based on this limited experience, we believe these neoplasms should be regarded as potentially as malignant as their mixed Miillerian counterpart.
Tumor markers carcinoembryonic antigen, tissue polypeptide antigen, and carbohydrate antigen 19/9 in liver diseases
Authors: Putzki H. , Ledwoch J. , Student A. , Jablonski M. , Heymann H.
Published: February 2007

The tumor markers carcinoembryonic antigen (CEA), tissue polypeptide antigen (TPA), and carbohydrate antigen 19/9 (CA19/9) have been compared with regard to their sensitivity to liver diseases. All three markers have been found to be sensitive to liver diseases, but to a different degree: TPA rises the most; CEA the least. The sensitivities of TPA and CA19/9 are higher in a group of liver diseases than, for comparison, in a group of colorectal carcinomas.
Prostatic‐specif IC antigen: Clinical experience utilizing lmmunoperoxidase staining techniques in patients with metastatic prostate cancer
Authors: Baker William C. , Meyers Frederick J. , White Ralph W. Devere
Published: February 2007

A human prostatic‐specific antigen was first purified in 1979 by M. C. Wang et al. In the years to follow, investigators have been able to develop antisera to prostatic‐specific antigen. Using an immunoperoxidase technique to stain both fresh and archival specimens, tissue of prostatic origin can be identified. The stain in our experience has been both specific and sensitive as an indicator of extraprostatic spread of carcinoma. We describe five cases where this technique has been useful in clinical practice.
Cytodiagnosis of soft tissue tumors
Authors: Oland Jan , Rosen Ada , Reif Renata , Sayfan Joel , Orda Ruben
Published: February 2007

The only acceptable definitive diagnosis of a soft tissue mass is histologic or cytologic examination. In recent years, fine‐needle aspiration cytology is used in more and more centers for diagnosis of soft tissue masses. We studied 196 aspiration cytologies performed on soft tissue lesions. Out of these, in 48 cases a definitive surgical procedure or open biopsy for histology and further evaluation were performed. There were 25 sarcomas and 23 benign tumors. There was one false negative cytologic result in this group; no false positive cytologies were detected. It seems that cytodiagnosis of soft tissue masses performed by an experienced pathologist is the method of choice, permitting a good diagnostic evaluation, with almost none of the traumatic and oncologic disadvantages of the other methods of biopsy.
Bladder cancer: Pelvic lymphadenectomy revisited
Authors: Herr Harry W.
Published: February 2007

The value of pelvic lymphadenectomy in patients undergoing cystectomy for bladder cancer is controversial. While perhaps 1–2 percent of all patients may be cured after excision of positive nodes, the overall contribution of this procedure to survival is minimal. Pelvic lymphadenectomy is however becoming more valuable for staging and therapy in combination with more effective systemic chemotherapy and its role in the overall management of patients with invasive bladder cancer is presently being redefined.
Metastatic spread of floor of the mouth squamous cell carcinoma via pectoralis major myocutaneous flap
Authors: Badellino F. , Berrino P. , Campora E. , Canavese G. , Galli A. , Margarino G. , Scala M. , Santi P. L.
Published: February 2007

In a patient with recurrent head and neck squamous cell carcinoma, reconstruction of the floor of the mouth was carried out by transposition of a pectoralis major myocutaneous flap after composite resection. Twelve months after surgery, a chest wall metastasis corresponding to the site of the vascular pedicle was observed. It appears that the lymphatic and hematogenous tumor spread can occur along the vascular pathways of a transposed myocutaneous flap.
Anorectal region malignant melanoma
Authors: Kantarovsky A. , Kaufman Z. , Zager M. , Lew S. , Dinbar A.
Published: February 2007

A retrospective study of eight patients who had suffered from malignant melanoma in the anorectal region was carried out. The initial presentation, histological findings, treatment, and survival are described. Mean survival was 18 months; however, one patient survived 147 months after initial diagnosis. An inverse correlation was noted between depth of tumor penetration and the number of giant multinucleated cells. No correlation was found between survival and histological findings or therapy regimen.
Intestinal alkaline phosphatase isoenzyme in patients with primary liver cancer during treatment with N10 propargyl 5, 8‐dideazafolic acid (CB 3717)
Authors: Buamah P. K. , Skillen A. W. , Cassells‐Smith A. J. , James O. F. W. , Harris A. L.
Published: February 2007

Serum aspartate transaminase (AST), alkaline phosphatase (ALP), and gamma‐glutamyl transferase (γGT) activities and the serum ALP isoenzyme pattern have been measured in eleven patients undergoing treatment with CB3717. There were increases in the activity of all three enzymes. The ALP isoenzyme pattern showed an increased contribution of the intestinal isoenzyme to the serum ALP activity. This may be due to increased intestinal mucosal leakage or impaired uptake and breakdown of the intestinal isoenzyme by the liver.
Excision of the large congenital melanocytic nevus facilitated by the use of the tissue expander
Authors: Wiltz Hector , Kollmer W. Lance , Rauscher Gregory E. , Sharma Parmod K. , Cohen Philip J. , Schwartz Robert A.
Published: February 2007

Large congenital melanocytic nevi both present a cosmetic problem and may predispose to the development of a melanoma. We present a series of three patients in whom the tissue expander was employed to facilitate a large excision with primary closure and excellent cosmesis.
Pelvic exenteration for carcinoma of the cervix: Analysis of 252 cases
Authors: Cuevas Hector Rodriguez , Torres Alfonso , Garza Mario De La , Hernandez Dimas , Herrera Lemuel
Published: February 2007

We present the results of 252 pelvic exenterations for primary and recurrent carcinoma of the cervix at the Hospital General de Mexico, a tertiarycare institution for the indigent. Emphasis is placed on the morbidity and mortality of the procedure in relation to patient selection. In underdeveloped countries, where early detection of cervical cancer is a rare event, pelvic exenteration must continue in the armamentarium of physicians; it can be associated with gains in the quality of life, with long‐term survival, with effective rehabilitation, and possibly with cures.
Ectopic decidua and metastatic squamous carcinoma: Presentation in a single pelvic lymph node
Authors: Cobb Camilla J.
Published: February 2007

The presence of ectopic decidua in pelvic lymph nodes from patients with squamous carcinoma of the cervix makes evaluation for metastatic disease difficult due to the light microscopic similarity between decidua and sheets of squamous epithelial cells. A patient is presented in whom decidualized endometriosis was intimately asssociated with metastatic moderately differentiated squamous carcinoma in a single pelvic lymph node. This phenomenon afforded an excellent opportunity to study the unique morphologic features that distinguish these two entities. A prior report of this kind was not found. In the absence of obvious squamous differentiation (i.e., intercellular bridges, dyskeratosis, and keratin “pearl” formation), as is frequently the case with squamous carcinoma of the cervix, the light microscopic features that are most useful in distinguishing squamous carcinoma from decidua include the presence of well‐defined nests of cohesive cells, nuclear hyperchromasia, and cellular pleomorphism.
Significant prolongation of segmental pancreatic allograft survival in two species
Authors: Du Toit Don F. , Heydenrych Jacobus J.
Published: February 2007

A study was conducted to assess the suppression of segmental pancreatic allograft rejection by cyclosporine (CSA) alone in baboons and dogs, and subtotal marrow irradiation (TL1) alone and TL1 in combination with CSA in baboons. Total pancreatectomy in the dog and primate provided a reliable diabetic model, induced an absolute deficiency of insulin and was uniformly lethal if not treated. Continuous administration of CSA in baboons resulted in modest allograft survival. As in baboons, dogs receiving CSA 25 mg/kg/d rendered moderate graft prolongation but a dose of 40 mg/kg/d resulted in significant graft survival (> 100 days) in 5 of 8 allograft recipients. Irradiation alone resulted in minimal baboon pancreatic allograft survival of 20 baboons receiving TL1 1,000 rad and CSA, 3 had graft survival > of 100 days. Of 15 baboons receiving TL1 800 rad and CSA, 6 had graft survival of > 100 days. In conclusion, CSA administration in dogs and TL1 in combination with CSA in baboons resulted in highly significant segmental pancreatic allograft survival.
Carcinoma of possible thymic origin presenting as a thyroid mass: A new subgroup of squamous cell carcinoma of the thyroid
Authors: Kakudo Kennichi , Mori Ichiro , Tamaoki Norikazu , Watanabe Keiichi
Published: February 2007

Intrathyroidal thymoma is a rare tumor that occurs in the thyroid gland and has been reported as a low‐grade malignant tumor. The present report describes a 59‐year‐old male patient with this tumor, who was treated with subtotal thyroidectomy followed by radiation and chemotherapy. The tumor was located in the lower pole of the left lobe and the isthmus of the thyroid, and it had invaded the thyroid parenchyma, thyroid capsule, adjacent connective tissue, and neck muscles. Continuity between the cervical thymus and the tumor was noted. Subsequently, the patient developed widespread metastases in the liver, lungs, bones, and lymph nodes without local recurrence. Histologic examination disclosed a solid growth of epithelial cells with squamous cell differentiation and keratinization. The tumor cells had an ill‐defined cell border and large nuclei with large nucleoli. Moderate mitoses and slight necrosis of the tumor were seen. Immunohistochernical examination showed that the tumor cells were stained positively for keratin but not for calcitonin or thyroglobulin. There were infiltrations of lymphocytes in the tumor and fibrous stroma, and most of them proved to be T cells.
Multimodality treatment of non‐small cell lung cancer: Response to cisplatin, VP‐16, and 5‐FU chemotherapy and to surgery and radiation therapy
Authors: Sridhar K. S. , Thurer R. , Kim Y. , Fountzilas G. , Davila E. , Donnelly E. , Charyulu K. K. N. , Saldana M. J. , Thompson T. , Benedetto P. , Raskin N. , Beattie E. J.
Published: February 2007

Twenty‐one patients with unresectable non‐small cell lung cancer (NSCLC), 11 with stage III M0, five with malignant pleural effusion, and five with a single resectable metastasis were treated with multimodality therapy. All received two to three cycles of preoperative chemotherapy with a new sequential combination of cisplatin (50 mg/m2 IV×1) followed by 5‐FU infusion (40 mg/m2/hr×72) and etoposide (80 mg/m2/day×3). Thirteen of 21 (62%) had a partial response, and three (14%) had a minor response to chemotherapy. Of the 19 who underwent surgical exploration, 17 were confirmed to have NSCLC. Ten patients with NSCLC and one with choriocarcinoma were rendered disease free by resection of the primary tumor and lymph nodes. Six received intra‐and/or perioperative interstitial therapy with 125I and/or 192Ir. Another patient was treated with 32P. Postoperative external radiotherapy was administered in 15 patients, and adjuvant chemotherapy was administered in ten. This multimodality therapy was well tolerated, safe, and highly effective, resulting in excellent palliation even in patients with pleural effusion and metastasis. The most promising results were in unresectable stage III M0 with a partial response rate of 82% following neoadjuvant chemotherapy and a complete response rate of 73% after surgery. In this group, median survival has not yet been reached and will exceed 12 months.
Staging laparotomy in Hodgkin's disease: A community hospital experience
Authors: Jones A. R. , Ruether J. D. , Ruether B. A.
Published: February 2007

Between 1977 and 1984, 50 patients with Hodgkin's disease underwent a staging laparotomy performed by nine surgeons in a community hospital. Adequate procedures were performed in 80% of cases compared to staging laparotomies done between 1969 and 1976 when only 40% were properly performed. Abdominal lymphangiogram had a false‐negative rate of 0 but a false positive rate of 70%. Clinical stage III disease was significantly downstaged at laparotomy (65% of cases). Postoperative complication rate was 4% and there were no operative deaths. A subset of patients not requiring laparotomy have been identified. Because the quality of staging laparotomy and lymphangiography was variable, we encourage all centres treating patients with Hodgkin's disease to review their own experience with these techniques before making individual patient treatment decisions.