bluuebunny/crossref_metadata_2025 huggingface dataset:
Relation between the incorporation of 5‐fluorouracil into liver carcinoma and normal tissue RNA at hepatic arterial administration in the rat is altered by overnight starvation
Authors: Roos Gunnel , Stenram Unne
Published: February 2007

The cytotoxicity of 5‐FUra has been related to its incorporation into RNA. In a model of secondary liver cancer in the rat, the incorporation of 5‐FUra into the acid‐soluble fraction, RNA and DNA of several normal tissues and an adenocarcinoma of the colon transplanted to the liver was determined. A therapeutic labelled dose of the drug was infused via the hepatic artery for 2 hr and the rats killed 1 hr later. Half of the rats were starved overnight before treatment. The incorporation of 5‐FUra into liver and intestinal RNA increased at starvation. It was unchanged in kidney and bone marrow.The incorporation into tumor RNA decreased insignificantly. The incorporation into tumor RNA was significantly higher than in hepatic, intestinal, and renal RNA at ad libitum feeding. This difference disappeared at overnight starvation. © 1993 Wiley‐Liss, Inc.
Carcinoembryonic antigen (CEA) in stage IV gastric cancer as a risk factor for liver metastasis: A univariate and multivariate analysis
Authors: Ikeda Yoichi , Mori Masaki , Adachi Yosuke , Matsushima Tetsuya , Sugimachi Keizo , Saku Motonori
Published: February 2007

Serum carcinoembryonic antigen (CEA) levels were determined in 68 patients with Stage IV gastric cancers, the objective being to examine the clinicopathological relationship between the metastatic patterns of gastric cancer and the serum CEA level. Of the 68 patients, 31 were diagnosed as cases of liver metastases and 37 as cases of peritoneal dissemination. Serum CEA levels were elevated in 21 of 31 patients (67.8%) with liver metastases and in 7 of 37 patients (18.9%) with peritoneal dissemination (P < 0.01). A univariate analysis showed that liver metastasis correlated with a young age (P < 0.01), the lower portion of stomach (P < 0.05), Borrmann types 1 and 2 (P < 0.01), differentiated type (P < 0.01), and nonserosal involvement (P < 0.05) more than did peritoneal dissemination. A multivariate analysis showed that in addition to Borrmann type 1 and 2, elevated CEA levels (>2.5 ng/ml) is an independent risk factor involved in liver metastasis. Thus careful follow‐up and postoperative adjuvant therapy are required for patients with elevated CEA levels, even with “curative” resection. © 1993 Wiley‐Liss, Inc.
Prognostic value of the number of metastatic lymph nodes in gastric cancer with radical surgery
Authors: Isozaki Hiroshi , Okajima Kunio , Kawashima Yasuo , Yamada Sinichi , Nakata Eiji , Nishimura Junko , Ichinona Tadashi
Published: February 2007

To evaluate the effectiveness of extended lymph node dissection in gastric cancer, the relationship between the number of lymph nodes with metastasis and the long‐term outcome was studied retrospectively in 761 patients who underwent curative resection with extensive lymph node dissection. The cumulative 5‐year survival rate was 85.8% in patients without lymph node metastasis, 60.2% in those with 1–4 lymph nodes, 35.6% with 5–10 nodes, and 12.3% with 11 or more nodes involved. Concerning N2 or N3 patients in whom metastatic lymph nodes would have remained without extensive dissection, the 5‐year survival rate was 70.5% in those with 1–4 lymph nodes involved and 44.0% with 5 or more lymph nodes involved when no serosal invasion was observed. It was 38.5% with 1–4 lymph nodes and 5% with 5 or more lymph nodes involved when serosal invasion was observed. These results suggest that extensive lymph node dissection is effective in gastric cancer patients without serosal invasion and, when only a few lymph nodes are involved, also in those with serosal invasion. However, it is not considered to be effective in patients with serosal invasion and metastasis to many lymph nodes. Combination therapies are thought to be required in such patients. © 1993 Wiley‐Liss, Inc.
Flow cytometric DNA analysis of interleukin‐2 responsive renal cell carcinoma
Authors: Gomella Leonard G. , Ehya Hormoz , Steinberg Seth M. , Rupp Michael , Merino Maria , Robertson Cary , Linehan W. Marston
Published: February 2007

Adoptive immunotherapy using interleukin‐2 (IL‐2) based therapy can result in marked tumor regression in some patients with metastatic renal cell carcinoma. DNA flow cytometry has not been previously studied as a predictor of outcome of this therapy. Archival paraffin embedded tumors were studied in 23 IL‐2 treated patients with metastatic renal cell carcinoma. Eleven patients were complete responders (CR) and 12 were nonresponders (NR). In the CR group, 4/11 (40%) were diploid and 7/11 (60%) were aneuploid. In the NR group, 9/12 (75%) were diploid and 3/12 (25%) were aneuploid. Although there was a trend that patients with an aneuploid DNA pattern were more likely to undergo a complete response, ploidy pattern alone was not significantly predictive of response (p2 = 0.10, Fischer's exact test). When combining ploidy pattern with other variables that were predictive for complete response, such as good performance status and a higher pretreatment weight, prediction of complete response was not improved by including ploidy. This preliminary report suggests that DNA ploidy does not appear to provide any additional information concerning responsiveness to IL‐2 based immunotherapy beyond that obtained by performance status and pretreatment weight in this patient population. © 1993 Wiley‐Liss, Inc.
Changes in histopathological features of gastric carcinoma over a 26‐year period (1965–1990)
Authors: Inoue Manami , Tajima Kazuo , Kitoh Tsuyoshi , Sakamoto Junichi , Yamamura Yoshitaka , Sato Tsuneko , Suzuki Ryoji , Koshikawa Takashi , Nakamura Shigeo , Suchi Taizan
Published: February 2007

Epidemiological study has shown that the incidence rate of gastric carcinoma in Japan has declined recently. To explore the factors that have influenced this decrease, the changing pattern in clinico‐pathological features of gastric carcinoma was studied from the epidemiological point of view. The 5,015 cases of gastric carcinoma treated with gastrectomy at Aichi Cancer Center Hospital from 1965–1990 were divided into two histopathological types: the well‐differentiated and other types. Proportional distribution was compared over the three different periods (1965–1973, 1974–1982, 1983–1990) according to the clinico‐pathological features of the gastric carcinoma, i.e., sex, age, lesional location, etc. The recent relative decline of gastric carcinoma is due mainly to the decline of carcinoma of the well‐differentiated type. This decline has been highly correlated to the decline in carcinoma of the antrum, which has been the most common in Japan. This changing pattern of clinicopathological features of Japanese gastric carcinoma might be affected by the change of exposure patterns to epidemiological factors, i.e., a Westernizing diet. © 1993 Wiley‐Liss, Inc.
Blood transfusion practices after resection of intrathoracic neoplasms
Authors: Gwin John L. , Keller Steven M.
Published: February 2007

A heightened awareness of the risks of blood transfusion and the previously reported common administration of blood products (31–55%) following thoracic surgery prompted us to evaluate our recent transfusion practices. Of 355 patients who underwent a thoracotomy or median sternotomy from July 1987 through September 1991, 91 (25.6%) were transfused a mean 3.1 units of blood within the first 30 postoperative days. Transfused and nontransfused patients were compared with respect to age, body surface area, preoperative hemoglobin, estimated operative blood loss, and estimated postoperative hemoglobin. Univariate analyses of variance indicate significant (P < 0.01) differences between the two groups of patients for preoperative hemoglobin, blood loss, and estimated postoperative hemoglobin. Transfusion frequencies by year of operation are: 1987, 36%; 1988, 31%; 1989, 33%; 1990, 23%; 1991, 15%. We conclude that our transfusion requirements are lower than reported rates and that clinical parameters may help predict the need for subsequent transfusion.
Testicular circulatory isolation in man: Comparison of radionuclide angiography with doppler evaluation
Authors: Farr Susan A. , Littlefield James L. , Fletcher James W. , Camacho David W. , Johnson Frank E.
Published: February 2007

Testicular circulatory isolation (TCI) holds promise as a method to avoid drug‐induced infertility in male patients about to receive cancer chemotherapy. Complete exclusion of blood flow to the testicle is essential to the success of this technique. We have compared the hand‐held Doppler probe and radionuclide angiography (technetium‐99m pertechnetate) as monitors of testicular blood flow in 10 patients subjected to unilateral TCI. When Doppler evaluation indicated that testicular circulation had been interrupted, the radionuclide angiogram uniformly confirmed and quantified this conclusion. These results validate the hand‐held Doppler as an appropriate tool for assessing testicular blood flow in patients undergoing TCI. © 1993 Wiley‐Liss, Inc.
Multiple breast papillomas in adolescence
Authors: Batchelor John S. , Farah Gassan , Fisher Cyril
Published: February 2007

The condition of multiple breast duct papillomas although relatively common in adult women is not a well recognized clinical entity in adolescent females. The risk of adolescents with this condition developing carcinoma is presently unknown, although in adulthood it is regarded by some authorities as a precancerous condition. We report a case of a 14‐year‐old girl with such a lesion who remains well with no breast abnormalities 2 years after surgery. The clinicopathological features of the condition and the relevant literature are discussed. © 1993 Wiley‐Liss, Inc.
Diagnosis and surgical treatment of small papillary carcinomas of the thyroid gland
Authors: Miki Hitoshi , Oshimo Kazushi , Inoue Hiroyuki , Kawano Muneo , Tanaka Katsuhiro , Komaki Kansei , Uyama Tadashi , Monden Yasumasa
Published: February 2007

The preoperative and pathological findings of 38 cases of small papillary carcinoma of the thyroid gland measuring ⩽10 mm in diameter and 74 cases of large papillary carcinoma measuring more than 10 mm were compared. In the small carcinoma cases, the sensitivity of palpation, ultrasonography, and fine‐needle aspiration biopsy (FNAB) was higher than that of computed tomography and soft tissue roentgenography of the neck. Therefore, palpation, US, and FNAB should be instituted as reliable diagnostic methods, but other examinations seem unsuitable as methods for preoperative qualitative diagnosis. No definite correlation was found between the intraglandular dissemination and the size of the carcinoma, and the frequency of metastasis was relatively high even in the small carcinoma cases. If the patient elects to undergo surgery, subtotal thyroidectomy with lymph node dissection should be performed for small thyroid carcinomas as well as large carcinomas. © 1993 Wiley‐Liss, Inc.
Western blot analysis of glycoproteins bearing lewisa and sialyl‐lewisa antigens in human colorectal mucosa
Authors: Takabayashi Tsukasa , Watanabe Masahiko , Sakurai Yoichi , Sugano Kokichi , Kodaira Susumu , Kitajima Masaki
Published: February 2007

Glycoproteins (GPs) bearing Lewisa and sialyl‐Lewisa antigens (Lea, sialyl‐Lea) derived from human colorectal carcinomas and their surrounding non‐neoplastic mucosa (normal mucosa) were analyzed using Western blotting. GPs bearing Lea were detected mainly as segmental bands of Mr 310, 220, 160, and 80 kDa in 80% of the normal mucosa, but these GPs were detected predominantly as broad bands ranging from high to low molecular weight (MW) in 71% of the carcinoma tissues. GPs bearing sialyl‐Lea were detected only in 23% of the normal mucosa and limited on huge MW bands, i.e., more than 400 kDa, whereas these GPs were detected predominantly as broad bands in 49% of the carcinoma tissues. In the cases with lymph node metastasis, the MW of GPs bearing sialyl‐Lea varied over a wide range and were detected as broad bands, compared with the cases without metastasis. In conclusion, the MW of GPs bearing Lea and sialyl‐Lea in normal colorectal mucosa was different from that in colorectal carcinomas. That is, the MWs of GPs bearing Lea varied more in carcinoma tissues, and the GPs bearing sialyl‐Lea from carcinoma tissues had lower MWs than those from normal mucosa. It was, furthermore, suggested that the increased expression of lower MW GPs bearing sialyl‐Lea are associated with an increased metastatic potential of the tumor cells.© 1993 Wiley‐Liss, Inc.
Monoclonal antibodies and their role in modulation of the immune response
Authors: Arlen Myron , Tsang Kwong Y.
Published: February 2007

Clinical studies in patients having been vaccinated with immunogenic glycoproteins suggest that a monoclonal antibody response is important in helping to induce cell mediated tumor destruction. Such a monoclonal response was noted to characterize the reaction to several different immunogenic antigens administered in an adjuvant setting. The resulting cell mediated reaction appeared to be associated with concomittant antibody dependent cell mediated cytotoxicity (ADCC) and an anti‐idiotype monoclonal response. Both 31.1 and 33.28 protein derived colon carcinoma monoclonal antibodies have been found to be capable of turning on natural killer (NK) cell activity as part of ADCC. In vivo studies with specific antigens to induce an anti‐tumor response have suggested that the mechanism of tumor cell destruction is complex and associated with T‐cell activation, anti‐idiotype production, and complement binding on the tumor membrane. © 1993 Wiley‐Liss, Inc.
Predictors of survival following surgical resection of thymoma
Authors: McCart J. Andrea , Gaspar Laurie , Inculet Richard , Casson Alan G.
Published: February 2007

The aim of this study was to determine the predictors of long‐term survival following surgical resection of thymoma. Forty‐one patients with a histologically proven diagnosis of thymoma were evaluated and treated over a 30‐year period (1961 to 1991) at our institution. Seven patients (Masaoka stage III or IV) were unresectable and were treated by radiotherapy and/or chemotherapy, with an overall 5 year survival of 50%. Thirty‐four patients underwent primary surgical excision of the thymoma, most often through a median sternotomy, with 5‐ and 10‐year survivals of 90%. Complete excision of the thymoma was achieved in 31 patients with a median survival of 54 months vs. 17 months if incomplete. Independent prognostic factors influencing survival were stage, histology, and patients judged to have a benign thymoma at surgery. Although the thymoma was associated with myasthenia gravis (8 patients) and second primary cancers (8 patients), neither factor was associated with overall survival. We conclude that the most significant predictors of long‐term survival of thymoma include complete excision, Masaoka stage I disease, and lymphocytic histology. Multivariate analysis suggested that postoperative chemoradio‐therapy may impact on survival. © 1993 Wiley‐Liss, Inc.
Study of c‐erbB‐2 protein and epidermal growth factor receptor expression and DNA ploidy pattern in colorectal carcinoma
Authors: Nakae Shiro , Shimada Etuji , Urakawa Tomoaki
Published: February 2007

Correlation of c‐erbB‐2 protein (n = 44), epidermal growth factor receptor (EGFR) (n = 41) expression, and DNA ploidy pattern (n = 42) with clinical outcomes of human colorectal cancers was studied. Using monoclonal antibodies against c‐erbB‐2 protein and EGFR, an immunohis‐tochemical study of the expression of c‐erbB‐2 protein and EGFR in frozen tissue sections from the lesion was performed. There was no significant correlation between the expression of c‐erbB‐2 protein and clinicopatho‐logical findings such as, tumor size, histological type, depth of invasion, lymph node metastasis, lymphatic vessel invasion, or venous invasion. However, the incidence of c‐erbB‐2 protein expression in Dukes D was significantly higher (9/10, 90%) than that in Dukes A to C (16/34, 47.1%). Similar tendency was also observed in the expression of EGFR. Aneuploid case was observed in 12 of observed 25 (48%) cases without lymph node metastasis, while it was observed in 16 of 17 cases (94.1%) with lymph node metastasis and there was significant association between DNA ploidy pattern and lymph node metastasis (P< 0.01) and most of the cases (17/20, 85%) were aneuploidy in Dukes C and D. The results above suggest that the expression of c‐erbB‐2 protein or EGFR was associated with distant metastasis, while on the other hand DNA ploidy pattern was correlated with lymph node metastasis. © 1993 Wiley‐Liss, Inc.
The size of regional lymph nodes does not correlate with the presence or absence of metastasis in lymph nodes in rectal cancer
Authors: Kotanagi Hitoshi , Fukuoka Takemi , Shibata Yutaka , Yoshioka Toshiaki , Aizawa Osamu , Saito Yuri , Tur Gennady E. , Koyama Kenji
Published: February 2007

We evaluated the relationship between the size of regional lymph nodes and the presence of metastasis in them in rectal cancer. Of 1,064 lymph nodes in 46 specimens, 133 (13%) were found to have metastases. A half of the positive nodes and most of the negative ones were less than 5 mm in diameter. Therefore, we must find lymph nodes smaller than 5 mm in diameter for assessment of lymph node metastasis. Although positive nodes were larger than negative ones, there was no significant difference. However, when comparing the size of lymph nodes in relation to their location, the epi‐ and pararectal lymph nodes larger than 10 mm in diameter were highly suggestive of metastases, but the size of the lymph node was not a reliable indicator of lymph node metastases in other situations. © 1993 Wiley‐Liss, Inc.
Secretion of vasointestinal peptide by a primary liver tumor with rhabdoid features
Authors: Weyman Christine , Dolson Lynn , Kedar Amos
Published: February 2007

A 5‐year‐old child presented with an unresectable liver neoplasm, the histology of which resembled a malignant rhabdoid tumor. Clinical course was unrelenting despite therapy, and the child died four months later. During the course of her illness, she developed watery diarrhea and was found to have a high serum level of vasointestinal peptide (VIP). This is the first report of a childhood tumor with rhabdoid features to secrete VIP. © 1993 Wiley‐Liss, Inc.
The regional treatment of liver metastases from breast cancer
Authors: Schneebaum Schlomo , Walker Michael J. , Young Donn , Farrar William B. , Minton John P.
Published: February 2007

To determine the effect of aggressive regional therapy for liver metastasis from breast cancer, we retrospectively reviewed data on 74 patients identified with liver metastases. Forty had only liver metastases. In this group of 40 patients, 18 were treated with regional therapy only, i.e., surgical resection and/or regional chemotherapy via hepatic artery or portal vein catheters whereas 22 patients had systemic chemotherapy. The two groups were comparable. The regional chemotherapy regimen was 5‐FU, Adriamycin, methotrexate, and cytoxan. Median survival (27 months) for those patients treated with regional therapy (N = 18) was significantly longer than for those (N = 22) treated with systemic therapy (5 months) (P = 0.001). Only 45% of the regional treatment group failed in the liver. Our data, although retrospective and selective, suggest that certain subgroups of breast cancer patients with metastatic liver disease may benefit from aggressive regional therapy. © Wiley‐Liss, Inc.
Integrated approach to the management of patients with advanced germ cell tumors of the testis
Authors: Ravi R. , Rao R. Ranga , Shanta V.
Published: February 2007

Between 1985 and 1991, 63 patients with disseminated germ cell tumors of the testis were treated with initial cisplatin based combination chemotherapy. Complete response was seen in 38% of patients. Adjunctive surgical resection of residual disease was carried out in 26 patients (41%), including the use of intraoperative radiation therapy in two patients with seminoma. Furthermore, two other patients with seminoma and residual mass underwentretroperitoneal irradiation. Salvage chemotherapy was administered to five patients with progressive disease, and only one of these could be salvaged with adjunctive surgery. A disease‐free state was achieved in 75% of patients at a mean follow‐up period of 30 months. © Wiley‐Liss, Inc.
The effect of sulindac on colon polyps: Circumvention of a transformed phenotype—A hypothesis
Authors: Waddell William R.
Published: February 2007

Sulindac suppresses the growth of colon polyps in Gardner syndrome and familial adenomatous polyposis. The mechanism of action is not known. The problems are to ascertain the significance of high prostaglandin concentrations in transformed cells, colon polyps and cancers and to explain how sulindac restores normal growth patterns. A few clinical observations and an abundance of experimental data can be integrated to produce a reasonable model based on current biochemical and physiologic concepts. A fundamental defect in the formation of colon polyps is mutation of the APC (adenomatous polyposis coli) gene that leads to inadequate suppression of proliferation. There is high PGE2 content in colon polyps and cancers, presumably the result of stimulation by protein kinase C (PKC). In small quantities it stimulates cyclic AMP production but with persistent high concentrations it desensitizes and down‐regulates specific PG receptors and inactivates adenylate cyclase, cAMP synthesis, and the cAMP‐dependent mechanism for control of proliferation. The PKC pathway is thereby unopposed. It is hypothesized that restriction of PG synthesis by sulindac is accompanied by resensitization of PG receptors, and reactivation of the cAMP‐dependent pathway for control of cell growth. It is further postulated that restoration of cAMP synthesis and protein kinase A activity converts a functionally inadequate mutant APC suppressor gene to one sufficient to inhibit colon polyp formation. © Wiley‐Liss, Inc.
Rapidly growing thyroid carcinoma during pregnancy
Authors: Kobayashi Kaoru , Tanaka Yoshiyuki , Ishiguro Shingo , Mori Tohru
Published: February 2007

We experienced two cases of papillary carcinoma of the thyroid during pregnancy. The thyroid carcinomas grew rapidly in early pregnancy. We speculate that human chorionic gonadotropin plays an important role in the rapid growth of thyroid carcinoma during pregnancy. © Wiley‐Liss, Inc.
Melanotic neuroectodermal tumor of infancy: Report of a case with ganglionic differentiation
Authors: Shah Rajesh V. , Jambhekar Nirmala A. , Rana Durgesh N. , Raje Noopur S. , Albuqurque Kevin V. , Mistry Rajesh C. , Desai Prafulla B. , Advani Suresh H.
Published: February 2007

Melanotic neuroectodermal tumor of infancy (MNTI) is a rare but well‐documented lesion of neuroectodermal derivation. Maturation of the neural elements has been reported only occasionally. We report a case of MNTI of the maxilla showing maturation of neural elements to ganglionic cells. © Wiley‐Liss, Inc.
Granulosa cell tumor of the ovary: A study of 18 cases
Authors: Piura Benjamin , Nemet Dan , Yanai‐Inbar Ilana , Cohen Yoram , Glezerman Marek
Published: February 2007

In a study of 18 patients diagnosed with ovarian granulosa cell tumor between 1961 and 1992, clinical and pathologic findings were evaluated. Of the 18 patients, 15 (83.3%) were diagnosed in Stage I and three (16.7%) in Stage III or IV. Six patients (33.3%) underwent conservative surgery and in 12 (66.7%) total abdominal hysterectomy and bilateral salpingo‐oophorectomy was performed. At follow‐up three patients (16.6%) had died of disease, three, 16 and 288 months, respectively, after initial surgery. The actuarial 5‐year survival rate for Stage I was 100%, while that for Stages III and IV combined was 33.3% (P < 0.05). It is concluded that for patients with Stage IA, unilateral oophorectomy seems to be adequate treatment and for those with more than Stage IA, surgery should include total abdominal hysterectomy and bilateral salpingo‐oophorectomy. Postoperative adjuvant chemotherapy is advocated for patients in whom spread of tumor beyond the ovaries has occurred. © Wiley‐Liss, Inc.
Analysis of multiple primary cancers in a single institution
Authors: Santos Mary C. , Gardner Bernard , Feldman Joseph
Published: February 2007

Records of 120 patients with two and 16 with three primary cancers were evaluated. There were 49 males and 71 females among the double primaries with ages ranging from 27–102 years (average 68 years at the time of fist cancer). Of 35 breast cancer patients 16 new primaries developed in the opposite breast and other sites including four colon, three lung, and three endometrium. Of 20 colon cancer patients second primaries occurred in 11 sites most commonly colon (four) and lung (three). The frequency of second primaries may be skewed by the fact that patients with lethal cancers did not live long enough to develop them. This is borne out by the fact that 74 of the 120 patients were alive at the time of the study, implying a highly favorable group of patients. The interval between primaries was longer in females than males (P < 0.05) and this difference disappeared when breast and endometrial cancer were eliminated. When age was evaluate as a factor younger patients appeared to have a longer interval between primaries (P = 0.24) and this became significant for breast patients under age 55 years (91 months vs. 36 months) (P < 0.05). The stage of the second breast primary bore no relationship to the interval between primaries. © Wiley‐Liss, Inc.
Expression of proliferating cell nuclear antigen in Wilms' tumors and other pediatric renal tumors: The correlation between histologic classification and proliferative activity
Authors: Nagoshi Makoto , Tsuneyoshi Masazumi
Published: February 2007

In order to estimate the proliferative activities in each prognosis predicting histologic type immunohistochemical studies for proliferating cell nuclear antigen (PCNA) have been performed on 27 pediatric renal tumors using formalin‐fixed paraffin‐embedded specimens. Image analyses determined the percentage of positive areas for PCNA, which were then represented in the PCNA score. The PCNA scores of nephroblastomas without anaplasia roughly correlated with the S phase fractions obtained by flow cytometry. The PCNA scores for each tumor were as follows; the renal specimens for the control study (n = 10, a mean ±SSD of 8.04 ± 3.59%); the nephroblastomas without anaplasia (n = 15, 27.70 ± 7.59%); the nephroblastomas with anaplasia (n = 3, 36.89 ± 1.17%); the sarcomatous renal tumors (n = 5, 27.75 ± 5.02); the renal cell carcinomas (n = 2, 28.31 ± 0.86%), a congenital mesoblastic nephroma and a juxtaglomerular cell tumor (10.05 and 10.80%, respectively). The PCNA scores of the pediatric renal tumors correlated with neither the outcome of the patients nor the histologic groups in predicting the prognosis for such pediatric renal tumors. © Wiley‐Liss, Inc.
Transient mutism following posterior fossa surgery in children
Authors: Al‐Jarallah Ahmed , Cook Jay David , Gascon Generoso , Kanaan Imaduddin , Sigueira Edir
Published: February 2007

We report 3 patients, ages 5, 9 and 13 years, with mutism following posterior fossa surgery (PFS). All presented with headache of 10–180 days duration, excellent premorbid learning performance and paucity of neurologic signs. Radiographic studies demonstrated large posterior fossa tumor occupying the fourth ventricle, and hydrocephalus, leading to gross total resection of the tumor. Within 24–48 hr, all patients were mute. None had problems with swallowing and coughing. AH were able to nod “yes or no,” follow commands, point to body parts, and make their wants known by gestures. Jaw, gag, snout and palmomental reflexes were normal. CT scan and MRI Brain showed no cerebral hemispheric lesions. All children regained speech although dysarthric, within 5–12 weeks. Twenty‐two previously reported cases are similar to ours. We conclude that this post‐surgical mutism syndrome is unique and must be differentiated from aphemia, Broca's aphasia, hysterical mutism and elective mutism. The cerebellum, in a way not yet understood, does play a role in speech production. © Wiley‐Liss, Inc.
Adrenal adenocarcinoma: A review of 53 cases
Authors: Zografos George C. , Driscoll Deborah L. , Karakousis Constantine P. , Huben Robert P.
Published: February 2007

Problem: Fifty‐three patients (30 men, 23 women) with histologically proven adrenal carcinoma were reviewed. Nineteen (36%) had endocrine manifestations from functioning tumors. Arteriography was positive in 95% (19/20), CT scan in 94% (17/18), and ultrasound in 92% (12/13). Seventy‐six percent of the patients, at the time of diagnosis, were stage III and IV. Most common metastatic sites were the liver, lymph nodes, bone, and lungs. Local recurrence developed in 39% of cases (15/38).

Method: Forty‐one patients underwent an operation. Complete surgical removal of all gross tumor was achieved in 24 patients.

Result: The overall median survival time was 8 months, and the estimated 5‐year survival rate 19%. There were significant differences in survival between the various stages (P= 0.01) and between the group of patients who underwent complete excision of the tumor and those with incomplete resection (P= 0.002).

Conclusions: Complete surgical excision offers the best prospect for long‐term survival in localized adrenal carcinoma. © Wiley‐Liss, Inc.
Reconstruction of chest wall defects following extirpative surgery
Authors: Savant Dhairyasheel N. , Patel Snehal C. , Bokil Kamlesh P. , Bhathena Hosi M. , Kavarana Naozer M. , Vyas Jeetendra J.
Published: February 2007

Reconstructive procedures following chest wall resection pose a special surgical challenge. With modern surgical technique, a wide range of reconstructive options are at the surgeon's disposal and, hence it is imperative that the appropriate procedure be selected in a given patient. A total of 64 patients underwent resection of malignant chest wall tumors at the Tata Memorial Hospital. The technique of preference at our institution for reconstruction of full‐thickness chest wall defects uses a combination of autogenous fascia lata and Marlexmesh. We present our experience with chest wall reconstruction following extirpative surgery in these patients. © Wiley‐Liss, Inc.
Central venous brachial catheter (P.A.S. port TM) and catheter scanning system (cath‐finder TM)
Authors: Carré M. Carmen , Vega José Manuel López , Carles Joan , Lizón José , Villar Anselmo , Lera Santiago Alonso , Alastrue Antonio , Rull Miguel , van der Hossladt C. , Aguiló Javier , Díaz‐Rubio Eduardo , Rosell Rafael
Published: February 2007

To assess the effectiveness and safety of an implanted portal with a central venous brachial implanted catheter, P.A.S. Port TM(P–P), and the accuracy of its Cath Finder TM tracking system (C–F), (Pharmacia Deltec) vs. radiology, a phase II multicentric study was designed.

The catheter was implanted in 53 oncologic patients treated with chemotherapy and the performance of the catheter was evaluated for 3 months. No problems arose during the implantation in 77% of the cases and in all cases radiologic location of the catheter tip coincided with the C–F. We can conclude that P–P is easy to implant and to maintain in the arm and that it is well tolerated by the patients. C–F is an accurate and reliable system for locating the catheter tip. The use of both systems is an attractive alternative to the standard ones. © Wiley‐Liss, Inc.
Growth pattern and prognosis of gastric cancer invading the subserosa
Authors: Maehara Yoshihiko , Oshiro Tatsuo , Adachi Yosuke , Ohno Shinji , Akazawa Kohei , Sugimachi Keizo
Published: February 2007

Gastric cancer invading the subserosa with infiltrative growth was classified as part of the serosal invasion group and named prognostic serosal invasion positive [ps(+)] histologically.

We analyzed clinicopathological features and prognosis of 166 Japanese patients with gastric cancer invading the subserosa, according to the growth pattern. All patients were treated in the Department of Surgery II, Kyushu University. Patients with infiltrative growth (ssγ) were younger and their tumors were frequently undifferentiated compared to findings in those with noninfiltrative growth: expansive (ssα) and intermediate growth (ssß). There was no difference in any other clinicopathological characteristic between those with infiltrative and noninfiltrative growth tumors. The 10‐year survival rate was 66.7% for the infiltrative type and 54.2% for the noninfiltrative type, with no statistically significant difference. Lymph node metastasis, curative resection, and extended lymph node dissection, but not growth pattern, proved to be independent prognostic factors, as determined by multivariate analysis.

Our findings suggest that it is not the growth pattern which affects the prognosis of ss cancers. Extensive lymph node dissection should be done when lymph node metastasis is present. © Wiley‐Liss, Inc.
Prognostic significance of in vitro thymidine uptake in patients with colorectal carcinoma
Authors: Tanigawa Nobuhiko , Masuda Yasuhiko , Muraoka Ryusuke , Tanaka Takeo
Published: February 2007

In 127 patients with colorectal carcinoma, we measured thymidine uptake by tumor cells cultured in a semisolid medium and compared the influence of various parameters on survival by univariate and multivariate analysis.

Fifty‐four of the 127 carcinomas (42.5%) incorporated >1,000 cpm of tritiated thymidine per culture dish and were designated as the high‐uptake group, while the other tumors (57.5%, 73/127) were designated as the low‐uptake group. There was no significant correlation between high or low thymidine uptake and most of the clinicopathological characteristics of the patients. Patients in the high‐uptake had a poor prognosis and a 7‐year survival rate of 32.6%, which was significantly different from the rate of 69.3% in the low‐uptake group (P< 0.0005). Multivariate analysis showed that thymidine uptake was one of the variables strongly associated with survival in our study population.

Thus, it is concluded that thymidine uptake by tumor cells has a high capacity of predicting prognosis, independent of its relationship to other variables. Furthermore, it seems to us that thymidine uptake can help in selecting those patients with colorectal carcinoma who are most likely to benefit from perioperative adjuvant therapy. © Wiley‐Liss, Inc.
Adoptive cellular therapy of human breast and colorectal tumor targets using ex vivo activated memory T lymphocytes with potentiation by cis‐diamminedichloroplatinum(II)
Authors: Gold Jay E. , Bleiweiss Ira J. , Goldfarb Alisan B. , Bauer Joel J. , Gelernt Irwin M. , Schwartz Myron E. , Reiner Mark A. , Miller Charles M. , Weiss Marshall F. , Brower Steven T. , Masters Ted R. , Osband Michael E.
Published: February 2007

Autolymphocyte therapy (ALT) is adoptive cellular therapy of cancer using ex vivo activation of autologous peripheral blood lymphocytes (PBL). Memory T cells are the principal effector population in ALT, with in vivo activity in patients with metastatic renal cell carcinoma (RCC) and melanoma, and ex vivo cytotoxicity against autologous tumor targets. However, the noncytolytic lymphocyte portion of ex vivo‐activated memory T cells (ALT cells) may also contribute as antitumor effectors. Pre‐treatment of murine and human tumor cells ex vivo with chemotherapeutic agents can enhance their susceptibility to antitumor lymphocytes ex vivo and in vivo. To determine whether cis‐diamminedichloroplatinum(II) (DDP) could enhance ex vivo antitumor effects of ALT cells by immuno‐modulation, human breast and colorectal carcinoma target cells were derived from both primary and metastatic surgical specimens and incubated in complete medium (CM) with DDP or in CM alone (control group). Viability of each group was confirmed by trypan blue—dye exclusion test. ALT cells were prepared from autologous PBL at surgery. Primary and metastatic tumor cells from each group were used as targets for ALT cells and levels of interferon‐γ (IFN‐γ) release were measured as a determination of antitumor effect and recognition. Primary tumor target cells incubated in DDP showed enhanced antitumor effects and recognition by autologous ALT cells, as measured by the IFN‐γ assay compared to non‐DDP‐treated controls. Metastatic autologous tumor target cells demonstrated less IFN‐γ release than did the primary targets, although this was enhanced by pre‐treating metastatic tumor targets with DDP. ALT cells demonstrated minimal IFN‐γ release when incubated with allogeneic tumor targets. These data suggest that autotumor recognition of metastatic tumor targets is comparable to that of primary lesions following ex vivo pretreatment of metastatic cells with nonlethal doses of certain chemotherapeutic agents. DDP may somehow alter the physical properties of target cells, rendering them susceptible to immune‐mediated attack and the combination of ALT and DDP may lead to increased therapeutic efficacy in patients with metastatic breast and colon cancer. © Wiley‐Liss, Inc.
Multidisciplinary treatment of biliary tract cancers
Authors: Kraybill William G. , Lee Henry , Picus Joel , Ramachandran Ganeshan , Lopez Marvin J. , Kucik Nancy , Myerson Robert J.
Published: February 2007

Ninety‐six patients referred for radiation therapy to Washington University affiliated institutions with tumors of the extrahepatic biliary tree form the basis of this report. Patients were examined with regard to demographic factors, tumor primary site, presenting symptoms, methods of diagnosis, and methods of management. The median survival of all 96 patients in this series was 11 months. There was no significant difference between patients with gallbladder cancer and patients with cancer of the biliary ductal system. There was a statistically significant improvement in survival in those patients undergoing resection as management or as a component of the management of their tumors (P= 0.02). Patients receiving >4,000 cGy of radiation therapy had an improved survival compared to those patients receiving ≤4,000 cGy of radiation therapy (P= 0.003). While surgical resection improved survival for those patients undergoing removal of all gross tumor, this effect was noted especially in patients with gallbladder cancer. © Wiley‐Liss, Inc.
Digital rectal examination, serum prostate specific antigen, and prostatic ultrasound: How effective is this diagnostic triad?
Authors: Haid Max , Rabin David , King Karen M. , Feinstein Charles M. , Janson Kenneth L. , Levine Stanley R. , Mutchnik David L. , Lambiase Elyse A. , Bradley Richard
Published: February 2007

Ninety‐nine of 105 consecutive men who underwent transrectal prostatic ultrasound (TRUS) at Highland Park Hospital had the results correlated with digital rectal examination (DRE), serum prostate specific antigen (PSA), and biopsy results. Ninety‐six cases had evaluable ultrasound studies. Thirty‐two of the 99 who underwent biopsy had primary carcinoma of the prostate. Prostate volume, predicted PSA, a ratio of observed/predicted PSA, and Gleason score were examined. There was no correlation between age and prostate volume, volume and the presence of carcinoma, or PSA and Gleason score. Thirty‐one point six percent of the abnormal DREs, 36.6% of the abnormal TRUSs, and 40.6% of the elevated PSAs occurred in men with prostatic carcinoma (PCa). If PSA was normal (less than or equal to 4.0 ng/ml) and either DRE or TRUS was abnormal, then the risk of carcinoma was 2.9%. If PSA was elevated, regardless of the other two tests, the risk of finding PCa was at least 38%. If all three tests were abnormal, the risk of carcinoma was 38% in our series and 68% in a meta‐analysis. Many men with PSA values between 4 and 10 ng/ml have benign biopsies. However, close future follow‐up with consideration of repeat biopsy should be strongly considered. © 1994 Wiley‐Liss, Inc.
P53 alteration correlates with negative ER, negative PGR, and high histologic grade in breast cancer
Authors: Sasa Mitsunori , Kondo Kazuya , Komaki Kansei , Morimoto Tadaoki , Monden Yasumasa
Published: February 2007

Seventy tumors of invasive ductal carcinoma of the breast were examined for p53 alteration by the RT‐PCR‐SSCP method. Sixty‐five samples (92.9%) were investigated in the regions of codons 101–200 and 201–300. In total, 16 samples (24.6%) showed p53 gene alteration. We found that p53 gene alteration showed a correlation with (1) a negative ER status, (2) a negative PgR status, and (3) a high histologic grade (especially numerous mitotic figures) of the tumor. However, we found no correlation between p53 gene alteration and the lymph node status or clinical stage. Thus, p53 gene alteration in breast cancer may occur in highly malignant breast cancer other than advanced clinical stage cancer or node‐positive cancer. © 1994 Wiley‐Liss, Inc.
Serum CA 125 concentrations in patients with benign ovarian tumours
Authors: Buamah Paul K. , Skillen Andrew W.
Published: February 2007

Serum CA 125 concentrations have been measured in 115 patients with histologically confirmed nonmalignant pelvic disease, that is, serous cystadenoma (n = 56), mucinous cystadenoma (n = 14), fibroma (n = 33), thecoma (n = 8), and Brenner tumour (n = 4). Increased CA 125 concentrations (> 35 KU/L) were found in 14 patients, with a range of 46–891 KU/L, a mean of 205 KU/L, and a median of 97 KU/L. The highest values were found in patients with ascites. Serial measurements in one patient showed a fall in the 2 days immediately after surgery, over the next 3 days showing a two‐ to three‐fold increase, followed by a slow return to normal over the next 7 weeks. Elevated CA 125 levels may not indicate ovarian malignancy and do not differentiate between benign and malignant pelvic masses. © 1994 Wiley‐Liss, Inc.
Comparative endoscopic study of primary gastric lymphoma vs. gastric carcinoma
Authors: Swaroop V. Santhi , Mohandas K. M. , Swaroop V. Durga , Soman C. S. , Krishnamurthi S. , Nagral Aabha , Jagannath P. , Desouza L. J.
Published: February 2007

The endoscopic records of 56 patients with primary gastric lymphoma and 120 patients with gastric adenocarcinoma (matched for age and sex) were compared with respect to site, extent, and type of tumor by endoscopy and biopsy results. Diagnosis of lymphoma was suspected on the basis of gross endoscopic appearance in 30 patients with 96% sensitivity. The endoscopic findings that achieved statistical significance in favor of lymphoma were extensive disease involving whole stomach, proximal stomach involvement, extension of tumor into duodenum, and the presence of volcano crater‐like ulcers on polypoid lesions. Endoscopic biopsies were positive for lymphoma in 92% patients. Immunoperoxidase staining for leucocyte common antigen was positive in all the 24 patients with lymphoma where it was performed. We conclude that lymphoid origin of the stomach tumor may be suspected in one‐half of the cases of primary gastric lymphoma by gross endoscopic findings. Multiple endoscopic biopsies are safe and highly sensitive and specific in the diagnosis of primary gastric lymphoma. © 1994 Wiley‐Liss, Inc.
Regional chemotherapy in the canine liver
Authors: Zografos George C. , Kanter Peter , Sharma Satya D. , Driscoll Deborah L. , Blumenson Leslie E. , Karakousis Constantine P.
Published: February 2007

Using a fluorometric assay, mean drug levels of Adriamycin were significantly higher in the normal canine liver following bolus injection of this drug via the hepatic artery or portal vein as compared to hepatic tissue levels following systemic intravenous administration (P < 0.001). However, the variations in tissue levels observed after hepatic artery (± 16.8 mcg/gm tissue) or portal vein (± 21.1 mcg/gm) infusion were significantly wider than those observed after systemic (± 1.3 mcg/gm) administration (P = 0.03). Using C14‐labeled drugs, regional infusion of Adriamycin through the hepatic artery or portal vein resulted in significantly higher mean drug levels in the liver than after systemic intravenous administration, but the difference was more pronounced with bolus infusion of the drug than 1‐hour infusion. 5‐FU bolus or 1‐hour infusion in the hepatic artery resulted in significantly higher mean drug levels in the liver compared to peripheral intravenous administration, but this was not so with the 3‐hour infusion.

The above experiments confirm previous studies that regional chemotherapy results in higher drug levels in the regional tissues compared to systemic administration. They also: (1) demonstrate the spotty drug distribution in the regional tissues after regional administration, a potentially correctable problem, and (2) suggest that the advantage of intra‐arterial infusion may be more pronounced within a certain range of infusion times. © 1994 Wiley‐Liss, Inc.
Esophageal carcinoma simultaneously associated with gastric carcinoma: Analysis of clinicopathologic features and treatments
Authors: Kato Hoichi , Tachimori Yuji , Watanabe Hiroshi , Mizobouchi Shunji , Igaki Hiroyasu , Yamaguchi Hajime , Ochiai Atsushi
Published: February 2007

Among 1,420 patients with throacic esophageal carcinoma, 85 (6.1%) had synchronous gastric carcinoma. Seventy‐two patients (84.7%) underwent esophagectomy. Their operative mortality and prognosis were similar to those without gastric carcinoma. Among them, 25 patients, of whom the majority had advanced gastric carcinoma, underwent transthoracic esophagectomy with total gastrectomy (group A); eight died of esophageal cancer and four of gastric cancer. Forty‐six patients, of whom the majority had gastric carcinoma in an early stage, underwent esophagectomy and esophagogastric anastomosis following partial gastrectomy or local treatment for gastric carcinoma (group B). None of the group B patients had recurrent gastric carcinoma. The operative burden was larger in group A. The 5‐year survival rate for groups A and B were 38.8% and 23.0%, respectively. Esophagectomy and esophagogastric anastomosis after limited treatment for gastric carcinoma is an adequate treatment for the majority. However, esophagectomy and total gastrectomy are recommended for patients with advanced gastric carcinoma. © 1994 Wiley‐Liss, Inc.
Effect of the combination of hyperthermia and irradiation on human colon cancer cells
Authors: Tur Gennady E. , Sato Yasuhiko , Fukuoka Takemi , Andoh Hideaki , Kotanagi Hitoshi , Koyama Kenji
Published: February 2007

The combination of hyperthermia and radiation is considered to have a synergistic effect on mammalian cells, which depends on temperature and duration of time of the hyperthermia and on the sequence in which the modalities are given. The response of cultured colon cancer cells to hyperthermia and ionizing radiation was evaluated using the flow cytometry method by measuring DNA damage. The enhanced DNA damage after combined treatment with hyperthermia and irradiation was recognized after both sequences: heat followed by radiation as well as radiation followed by heat. The results demonstrated that the sequence of radiation plus heat produced more DNA damage on colon cancer cells than did the reverse order. The clinical application of these results is discussed. © 1994 Wiley‐Liss, Inc.
Munchausen's syndrome and cancer
Authors: Bruns Alan D. , Fishkin Paul A. , Johnson Eric A. , Lee Yeu‐Tsu Margaret
Published: February 2007

Munchausen's syndrome is a chronic factitious disorder characterized by frequent hospitalizations, self‐inflicted injuries, and dramatic medical histories. People with this condition assume the role of a sick patient and submit to unnecessary invasive, painful, and even dangerous medical procedures. In review of the literature, there have been four reports of patients feigning oncological disease. We admitted a 27‐year‐old woman who had undergone operative insertion of a Port‐A‐Cath and multiagent chemotherapy for “advanced ovarian cancer.” Physicians should be aware of Munchausen's syndrome in order to avoid costly medical procedures and unnecessary operations and to stop the patient's vicious circle of pathological lying and self‐inflicted injury. © 1994 Wiley‐Liss, Inc.