bluuebunny/crossref_metadata_2025 huggingface dataset:
Breast cancer survival among orientals and whites living in the United States
Authors: Natarajan Nachimuthu , Nemoto David , Nemoto Takuma , Mettlin Curtis
Published: February 2007

Data from the 1982 breast cancer survey of the American College of Surgeons were used to study the survival differences between Oriental and white women. Oriental women were significantly younger than white women. Oriental women were reported with a slightly higher percent of localized breast tumors (59.2% vs. 53.8%) and a slightly higher percent with negative nodes (60.3% vs. 56.2%) compared with whites. Oriental women in the United States have a higher 5‐year survival rate compared to whites. Multivariate analyses taking into account differences in age, stage of disease, and histology did not alter the finding of a significant difference in survival experiences.
Implantofix vascular access system: An experience with 19 patients
Authors: Alpeter David M. , Welling Richard E. , Alexander Saba K. , Mahalingam Kris , Arbaugh James
Published: February 2007

The use of implantable vascular access devices has increased rapidly in recent years. We have placed the new Implantofix Implantable Drug Delivery System 7500 in 19 patients. The patients reported only minor discomfort. The majority of the nurses found the Implantofix port easier to access than other ports, and some reported less swelling and soreness at the port site. Some of the physicians had difficulty visualizing the radiopaque catheter on X‐ray; Burron is currently developing a more radiopaque system.The Implantofix system offers several important benefits. Its compact size assures minimal discomfort for the patient. A new peel‐away sheath offers a choice of insertion methods. The system is particularly economical because it can be implanted in an ambulatory care facility or an outpatient surgery room equipped with fluoroscopic capabilities.
Effects of rat platelet extracts and human platelet‐derived growth factor on megakaryocytopoiesis in vitro
Authors: Uyar Ruhi , Cooper George W. , Hou Xiao Ping
Published: February 2007

An improved plasma clot culture system was developed for the culture of rat megakaryocyte colonies in vitro. Greater stimulation of megakaryocyte colony growth was provided when both serum and plasma were added to the culture medium than when plasma was added alone. Freeze‐thawed extracts prepared from 900 × 106 platelets/ml saline and also 9 ng/ml of human platelet‐derived growth factor (PDGF) caused maximum increases over the controls of 71% and 42%, respectively, in the numbers of megakaryocyte colonies. The increase in the numbers of megakaryocyte colonies induced by platelet extracts and by PDGF implied that substance(s) released by platelets might play an important role in the control of megakaryocytopoiesis.
Tumor tissue is more sensitive to mitomycin C, carboquone, and aclacinomycin A than is adjacent normal tissue in vitro
Authors: Maehara Yoshihiko , Kusumoto Hiroki , Kusumoto Tetsuya , Anai Hideaki , Sugimachi Keizo
Published: February 2007

In tissues obtained from patients undergoing gastrectomy or colectomy, sensitivity to mitomycin C (MMC), carboquone (CQ), and aclacinomycin A (ACR) was examined in 20 tumors (15 gastric, 5 colorectal) and in the adjacent normal mucosal tissues, using the in vitro succinate dehydrogenase inhibition test. The succinate dehydrogenase (SD) activity decreased to a greater extent in the tumor tissues than in adjacent normal tissues, at rates of 80% for MMC, 80% for CQ, and 90% for ACR. There were no correlations between SD activities of tumor and adjacent normal tissue, r = 0.157 for MMC, r = 0.435 for CQ, and r = 0.375 for ACR. Normal tissues were sensitive to MMC in 25 % of cases sensitive to MMC in the tumor tissues, 46% for CQ, and 38% for ACR. These results show that the antitumor effects of MMC, CQ, and ACR are relatively specific for tumor tissues and that the assay of chemosensitivity of normal tissues is meaningful for predicting the toxic effects of antitumor drugs on these tissues.
Aggressive chemotherapy in endodermal sinus tumor
Authors: Athanikar Nita , Saikia Japan K. , Ramkrishnan Gopal , Nair Chandrika N. , Nadkarni Kanchan S. , Advani Suresh H.
Published: February 2007

Twenty‐eight patients with pure or predominantly endodermal sinus tumor were studied for their clinical behavior, relation with serum α‐fetoprotein (AFP), and response to intensive postoperative combination chemother apy. Eight percent of the patients were younger than 20 years of age. One patient was a pseudohermaphrodite. Serum AFP was estimated in 17 patients and was elevated in all. Seven patients were treated with adjuvant chemotherapy following surgery with a cisplatin‐containing combination. Five patients (71%) are alive and continue to remain free of disease, with a median survival of 28 months after treatment and an overall median survival of 34 months. Two patients treated with adjuvant chemotherapy experienced early recurrence of the disease, which was detected with a rise in serum AFP before the clinical manifestation of recurrence.
Controlled clinical trial of adjuvant immunotherapy with BCG and neuraminidase‐treated autologous tumour cells in large bowel cancer
Authors: Gray B. N. , Walker C. , Andrewartha L. , Freeman S. , Bennett R. C.
Published: February 2007

A controlled, randomised clinical trial of immunotherapy was performed in 301 patients with stage B or C colorectal cancer. The immunotherapy treatment consisted of 18 vaccinations over a 2 year period following surgery with a combination of BCG given by scarification plus subcutaneous injection of Vibrio cholera neuraminidase (VCN)‐modified autologous tumour cells. Five year follow‐up has now been completed in all patients. The immunotherapy did not alter either the disease‐free interval or the overall survival of patients in comparison with a control group of patients not receiving immunotherapy.
Leiomyosarcomas of the extremities
Authors: Neugut Alfred L. , Sordillo Peter P.
Published: February 2007

Leiomyosarcomas are uncommon malignant neoplasms that rarely arise in the extremities. We report on the clinical characteristics of 17 cases seen at the Memorial Sloan‐Kettering Cancer Center over a 32 year period. Most neoplasms occurred in the lower extremities, and most of the tumors recurred after surgery alone, with several late recurrences. The overall prognosis was grim, with a median survival of 24 months. More aggressive multidisciplinary approaches to this disease are warranted.
Intraoperative antegrade irrigation in complicated left‐sided colonic cancer
Authors: Meijer S. , Hoitsma H. F. W. , Van Loenhout R. M.
Published: February 2007

Emergency one‐stage surgery for acute, complicated, left‐sided colonic cancer can be performed because of intraoperative antegrade irrigation of the large intestine. This procedure was performed in 17 patients: 15 patients with an obstructive, left‐sided cancer and two patients with a perforated carcinoma. The age distribution ranged between 57 and 92 years. There were two postoperative septic complications: a small wound abscess and a partial abdominal wall dehiscence. One patient died because of massive upper gastrointestinal bleeding. This method permits the creation of a primary anastomosis in the left colon, obviating the necessity of a coeco‐ or colostomy, preternatural anus, or an extensive right‐sided hemicolectomy. Several surgical interventions are avoided, resulting in a decrease of mortality, morbidity, duration of hospital stay, and costs. Moreover, intraoperative irrigation could be an attractive alternative for the usual preoperative mechanical bowel preparation, which is especially burdensome in elderly patients.
Pulmonary embolism and cancer: Predisposition to venous thrombosis and embolism as a paraneoplastic syndrome
Authors: Sons Hans U.
Published: February 2007

In patients with a malignant primary disease the risk of thromboembolic complication is demonstrably increased. This is undoubtedly attributable to a whole range of factors (multifactorial etiology) which are highlighted in the present synoptic study. In addition to local influences from the tumor, a particular role appears to be played by an increased aggregation of thrombocytes, various tumor cell products, polyglobulism, hypercalcemia, increased release of thrombocinase, microthrombotic embolization, and a decrease in antithrombin III.
Percutaneous superfine‐needle aspiration biopsy of intrathoracic lesions guided by simulator
Authors: Liu Cuanc‐Sen , Wu Yi‐Long , Zeng Cang‐Guang , Yang Ming‐Tian , Cai Yong‐Hui , Rong Tie‐Hua , Huang Zhi‐Fan , Liang Xiao‐Man
Published: February 2007

The result of percutaneous superfine‐needle aspiration biopsy in 100 patients with intrathoracic lesions guided by simulator is reported. The success rate of aspiration biopsy was 94%, and no major complication was observed. The method of localization by simulator had advantages such as accuracy in localization, no limitation of mass size and site, and a high rate of puncture success. Cell smears obtained by superfine needle were similar to those obtained by fine‐ or large‐bore needles, but fewer complications were encountered. This is a useful technique that can provide early cytological diagnosis, especially for the peripheral type of pulmonary mass.
Palliative and curative surgical therapy of malignant stenoses of the esophagus and cardia
Authors: Sons H. U. , Streicher H. J.
Published: February 2007

Between January 1967 and July 1986, 171 patients with malignant stenosis of the esophagus and cardia were subjected to curative or palliative surgical treatment. Specifically, there were 84 primary esophageal carcinomas, 5 cases of malignant esophageal stenosis caused by an extraesophageal malignant tumor (inter alia bronchial carcinoma), and 82 primary carcinomas of the cardia. The average age of the patients as a whole was 63.7 years, and the sex ratio (male:female) was 4.0:1. In 18 esophageal carcinoma patients and 21 patients with carcinoma of the cardia curative resection was possible, but in 132 patients merely palliative surgery was performed, most frequently esophageal intubation and gastrostomy. The specific operations with a curative objective performed upon the esophageal carcinoma patients were abdominothoracic esophageal resection with upward displacement of the stomach (n = 16) or interposition of a colonic segment (n = 2), whereas in the patients with carcinoma of the cardia, proximal resection was performed in 13 cases, either subtotally or as a cardiofundectomy, and total gastrectomy in 8 cases. For the subsequent reconstruction of the passage the interposition of a jejunal segment was most frequently used. The clinical mortality for the curative resections was 33% for the 18 esophageal carcinoma patients and 9.5% for the 20 patients with carcinoma of the cardia. The long‐term survival rates are depressing: of the patients who underwent curative resection 47.6% were still alive after one year, 28.6% after 2 years and 14.3% after 5 years. Of the patients treated only palliatively on account of an already advanced stage of the tumor, 91.5% died within the first year; only 4.9% of patients from this group were still alive after 2 years.
Radical nerve‐sparing prostatectomy: The first 30 patients treated with epidural anesthesia
Authors: Drago Joseph R. , Nesbitt John A. , Badalament Robert A.
Published: February 2007

From August 1985 to January 1987, 30 patients were treated with radical nerve‐sparing prostatectomy with epidural anesthesia. Transrectal ultrasound evaluation was available for the vast majority of these patients. Utilizing the anatomic techniques of early dorsal vein ligation, hypogastric artery control, and epidural anesthesia, blood loss was kept to a minimum, with 22 patients requiring no transfusions in this series. In addition, with the use of ultrasound, PSA (prostatic‐specific antigen) determination, and pelvic CAT scan, 22 of the 30 patients (75%) had organconfined disease. Twenty patients were potent preoperative and 14 are potent postoperative, for a potency rate of 70%.
Use of a totally implantable drug delivery system in a university‐affiliated community hospital
Authors: Smith‐Behn James , Ghani Abdul
Published: February 2007

We reviewed our experience at the Western Reserve Care System with totally implantable drug delivery systems (IDDS) in cancer patients with vascular access problems. Fifty‐one ports were placed in 50 patients. Forty‐nine of the IDDS were placed under local anesthesia. One patient developed a hemothorax during placement. Two catheters were removed because of infection. Two catheters found to be occluded responded to flushing with streptokinase. All catheters remained functional up to the time of treatment completion or of the patient's death. The low morbidity and high success rates of IDDS should encourage placement early in the course of chemotherapy.
Limitations of flow cytometric DNA analysis for the diagnosis of bladder cancer
Authors: Boileau Michel A. , Swartz Douglas , Schmidt Karmen L. , Schmidt Waldemar A.
Published: February 2007

Flow cytometric analysis was done on exfoliated urothelial cells from 11 control patients and 31 patients with transitional cell carcinoma: 9 grade I, 11 grade II, and 11 grade III. The determination of aneuploidy by DNA analysis did not provide identification of low‐grade tumor cells. Other flow cytometric parameters of cellular change such as cell size, nuclear size, nuclear/cytoplasmic ratio, or cell refractivity may provide better identification of low‐grade lesions.
Nutritional effects of postgastrectomy reconstruction: A clinical evaluation
Authors: Zelnick Ronald , Auguste Louis‐Joseph , Wise Leslie
Published: February 2007

To evaluate the nutritional benefits of a jejunal pouch vs. esophagojejunostomy following total gastrectomy, we reviewed 24 consecutive cases of total gastrectomy: 14 males and 10 females, 39 to 85 years of age (mean 66.6 y.) undergoing 9 jejunal pouches (JP) and 15 Roux‐en‐Y esophagojejunostomy (EJ). Indications for surgery included 15 adenocarcinomas, 3 lymphomas, 1 leiomyoma, and 5 hemorrhagic gastritis. The operative mortality was 12.5%. One JP patient was lost to follow‐up. The mean survival for EJ was 13.3 months and for JP 36 months. Total gastrectomy resulted in persistent weight loss and hypoalbuminemia, and the creation of a jejunal pouch did not seem to improve significantly the nutritional status following total gastrectomy.
Optimal debulking following chemotherapy of advanced‐stage epithelial ovarian carcinoma
Authors: Piura Benjamin , Glezerman Marek
Published: February 2007

We reviewed the records of 110 consecutive patients with advanced‐stage epithelial ovarian carcinoma treated at the Soroka Medical Center, Beer‐Sheva, Israel, from 1961‐1987. Twenty patients (18.1%) had optimal debulking at initial laparotomy, 30 patients (27.2%) had nonoptimal debulking at initial laparotomy, 20 patients (18.1%) had an “inoperable” disease at initial laparotomy, and 40 patients (36.3%) had such poorly written records that no information about the degree of resectability at initial laparotomy could be obtained. Four patients, in whom the residual tumor left at initial laparotomy had responded to chemotherapy, had a second laparotomy. In all four patients optimal debulking surgery at second laparotomy was easy to perform and was successful. The value of a second laparotomy after a few cycles of chemotherapy in order to optimally debulk the residual tumor left at initial laparotomy is discussed. It is concluded that a second attempt of debulking surgery after chemotherapy has a respectable place in the management of patients with advanced‐state epithelial ovarian carcinoma, but further research is needed.
Factitious microcalcifications in breast biopsy material: Laboratory‐induced error by use of tattoo powder for specimen mammography
Authors: Lager Donna J. , O'Connor John C. , Robinson Robert A. , Brown Robert C. , Urdaneta Luis F.
Published: February 2007

A xeromammogram led to the surgical excision of a calcified breast lesion on a 66‐year‐old female. Before specimen mammography was performed, the excised tissue was oriented with tattoo pigment. The specimen mammogram then revealed multiple calcifications caused by unsuspected radio‐opaque material in the tattoo pigment, and the original calcifications were obscured. This case demonstrates the hazards involved utilizing tattoo powders for orienting xeromammographically discovered specimens.
Inflammatory pseudotumor of the liver
Authors: Standiford S. B. , Sobel H. , Dasmahapatra K. S.
Published: February 2007

Inflammatory pseudotumors (plasma cell granulomas) are localized lesions consisting of a fibrous stroma, chronic inflammatory infiltrate with a predominance of plasma cells, and an absence of anaplasia, which can mimic malignant disease by their gross appearance. Reported in many sites, they are most frequently described in the lung. Twelve cases involving the liver and biliary tract have previously been reported. Here, a 77‐year‐old man who presented with fever and malaise was found to have a lesion in the left lobe of the liver, which, on exploration, was found to be an inflammatory pseudotumor. This patient, and each of those previously reported, has recovered uneventfully. Because of the benign course of this lesion, hepatectomy should be considered only in those instances in which the mass effect of the lesion is producing symptoms or in those cases in which a firm histologic diagnosis cannot be made preoperatively or by frozen section intraoperatively.
Efficacy of intravesical mitomycin C in the treatment of superficial transitional cell carcinoma of the urinary bladder
Authors: Pavlotsky Abraham , Eidelman Abraham , Barak Frida , Alon Haim , Horn Yoav
Published: February 2007

We treated 47 patients with recurrent transitional cell carcinoma of the bladder with intravesical chemotherapy. Twenty milligrams of mitomycin C per treatment was introduced 7 days after transurethral resection (TUR) or diagnostic cystoscopy, and was repeated at 2‐week intervals for five times followed again by cystoscopy. Two more similar courses were administered for a total of 36 weeks. Clinical data revealed no toxicity‐related symptoms. Cystoscopic follow‐up showed a gradual decline in the presence of tumor to a complete response rate of 87.1% at 36 weeks. Thirteen patients who were previously treatment failures with other drugs responded to mitomycin C.
Treatment of breast cancer in women older than 70 years
Authors: Svastics Egon , Sulyok Zoltan , Besznyak Istvan
Published: February 2007

Do age, associated diseases, general state, or the stage of tumor determine the operability of breast cancer in the elderly? Risk factors are studied on the basis of data on 465 patients over 70 years of age who had breast cancer surgery between 1977 and 1986. Operative mortality of patients is analyzed, and according to the results, the outcome of the surgery is mainly influenced by patients' performance status (Karnofsky/Zubrod index) and stage of disease and not by the associated diseases or patient age.
Survival and complications after radical surgery for carcinoma of the rectum
Authors: Cunsolo A. , Bragaglia R. B. , Petrucci C. , Poggioli G. , Gozzetti G.
Published: February 2007

The results of 164 abdominoperineal resections and 87 anterior resections carried out between 1972 and 1985 for cancer of the rectum were reviewed, assessed, and compared. The problems with anterior resection included a 1.1% hospital mortality and a 5.4% anastomotic failure rate in the 73 manual sutures and 28.5% in the 14 mechanical sutures; recurrence rate was 15.4% and the global 5‐year‐survival was 62%. There was no mortality in the Miles series; the recurrence rate was 4.8% and the 5‐year‐survival rate was 53.5%. Urogenital complications after Miles were found in 86.9%: urinary alone 10.8%, sexual alone 19.5%, both 56.5%.
Lung metastases after curative or noncurative irradiation of microscopic primary melanomas
Authors: Nathanson S. David , Westrick Patricia , Anaya Patricia , Hetzel Fred W. , Lee Min
Published: February 2007

Melanomas growing in the feet of syngeneic C57BL/6 mice were treated with a single dose of X‐irradiation. After doses of 0, 3.75, 7.5, 10, 20, or 30 Gy the tumor‐bearing limb was amputated at tumor sizes 1, 2, 3, 4, or 5 mm. After doses of 40, 50, 62.5, or 72.5 Gy, progressive tumor growth did not occur, and amputation of tumor‐bearing limbs was done when controls were 1, 2, 3, 4, or 5 mm in size. Eighteen days after amputation the mice were killed, and pulmonary metastases were documented at autopsy. None of the mice developed pulmonary metastases after curative irradiation of the primary foot tumor. After subcurative irradiation there was a significant increase (P < .003) in pulmonary metastases. The size of the primary melanoma is important in the prediction of these metastases. In this model melanomas can be cured by an adequate dose of irradiation, but in those not cured the incidence of lung metastases is increased. The impact of this biologic phenomenon on survival is unclear.
Hospital costs, cancer patients, and surgical diagnostic related groups
Authors: Muñoz Eric , Chalfin Donald , Sterman Harris , Goldstein Jonathan , Margolis Irving , Wise Leslie
Published: February 2007

This study of 4,359 Medicare patients in 107 noncancer stratified surgical Diagnostic Related Groups (DRGs) tested the hypothesis that patients with a diagnosis of a malignancy (i.e., cancer) in these DRGs would have higher resource utilization than patients without a diagnosis of a malignancy (i.e., noncancer) in these same surgical DRGs. The 1,008 cancer patients had 3.2 times the financial loss ($1,617 per patient vs. $510 per patient) compared to the 3,35 1 noncancer patients (P < .05). Patients with cancer had a greater percentage of outliers, more diagnosis (P < .0001) and procedures (P < .0001) per patient, and a higher mortality (P < .01) than patients without cancer. These findings raise the question of the equity of DRG payment for patients with cancer in many surgical DRGs. Financial disincentives to treat certain groups of Medicare cancer patients at our hospital may affect both their access and quality of care in the future.
Intermediate results and functional evaluation of limb‐salvage surgery for osteosarcoma: An intergroup study in Japan
Authors: Tomita Katsuro , Tsuchiya Hiroyukl
Published: February 2007

This is a 2‐7‐year follow‐up report by 21 institutes in Japan concerning limb‐salvage surgery for osteosarcoma. Between 1980 and 1985, 248 patients with osteosarcoma were treated, and 105 patients had limb‐salvage surgery. The percentage of cases treated by limb‐salvage surgery increased with each year. The cumulative survival rate was 71% at 5 years in the limb‐salvage group, and in the amputation group it was 46%; this indicates that cases for limb‐salvage surgery were carefully evaluated for this procedure. In limb‐salvage patients, tumor resection was classified according to the surgical margin as intralesional excision, marginal excision, wide‐with‐marginal resection, wide resection, and radical resection. Wide resection was performed in most cases as the method of choice. Local recurrence was seen in 13 cases (12%). The overall functional evaluations by Enneking's system showed that the number of results rated excellent or good was relatively high in the early follow‐up period, but this decreased later on, and cases rated fair or poor increased as the years passed. This was mainly due to postsurgical complications (44 cases). We identify a few problems in the functional evaluation system used now and suggest a reform of the system, so that physical and mental factors would evaluated separately.
Levels of tissue polypeptide antigen in serum and the progression of gastric cancer
Authors: Hamazoe Ryuichi , Koga Shigemasa , Maeta Michio , Shimizu Norio , Inoue Yasuhiro , Ishiguro Minoru , Murakami Atsunobu
Published: February 2007

Correlations between levels of tissue polypeptide antigen (TPA) in serum and histologic stage or progression of cancer were studied in 94 patients with gastric cancer. Levels of TPA in serum from patients with cancerous invasion into the vein of the stomach wall (v‐invasion) were elevated in parallel to the progression of cancer by stage, and were significantly higher in each positive case than in each negative case of lymph node metastasis or of cancerous invasion into lymph vessels of the stomach wall (P < 0.05 and P < 0.01, respectively). There were no differences in levels of TPA in serum from patients without v‐invasion when these cancers were classified by stage, progression, or histologic type. It appears that elevation of levels of TPA in serum is associated with vinvasion, and that a determination of the level of TPA in serum is useful for the prediction of hematogenic metastasis in cases of gastric cancer.
Complications of hypogastric artery cisplatin infusions
Authors: Menashe David S. , Jacobs Stephen C.
Published: February 2007

In an attempt to increase the therapeutic index of Cisplatin (CDDP), 29 continuous 48 hour intra‐arterial (IA) infusions of 100–150 mg/m2 CDDP were given to 26 patients with bulky stage T3–T4 bladder cancer. Hypogastric artery catheters were placed distal (n = 42) or proximal (n = 7) to the origin of the superior gluteal artery. Atherosclerosis (n = 5) or aneurysm (n = 2) prevented successful IA catheter placement. Catheter maintenance resulted in no bleeding or thromboembolic episodes. Urethral catheters caused two urinary tract infections. Systemic toxicity was mild with on 4/29 infusions resulting in WBC< 3,000, 3/29 infusions resulting in creatinine elevation, and 1/29 in peripheral neuropathy. Local effects of the IA CDDP included gluteal pain and ecchymosis (n = 1) and moderately disabling lower extremity neuropathies (n = 3). Systemic side effects of CDDP can be diminished by use of IA route of administration and slow continuous infusion.
Ruptured hepatocellular carcinoma evokes risk of implanted metastases
Authors: Sonoda Takashi , Kanematsu Takashi , Takenaka Kenji , Sugimachi Keizo
Published: February 2007

In three patients with hepatocellular carcinoma (HCC), implanted metastases occurred in the peritoneal or pleural cavity after rupture of the tumors; in one patient this was caused by trauma, and in two others this complication became obvious during resection of the tumor. Hepatic resection was successful, and the postoperative status was satisfactory. Implanted metastases were present in the peritoneal or pleural cavity of these three patients 6 years, 10 months, and 6 months after surgery, respectively. We wish to emphasize that a ruptured HCC may lead to implanted metastases.
Influence of the routes of continuous intrahepatic infusion of 5‐fluorouracil on its pharmacokinetics
Authors: Didolkar Mukund S. , Jackson Andre J. , Covell David G. , Walker Alonzo P. , Eddington Natalie D.
Published: February 2007

Continuous infusion chemotherapy via hepatic artery using newly available mechanical devices is frequently used to treat hepatic metastases to achieve a high concentration of 5‐fluorouracil (5‐FUra) in the hepatic circulation while minimizing systemic exposure. We compared four routes of intrahepatic administration to find out the best one in the canine model. To ascertain this data, 5‐FUra (30 mg/kg) was given as a continuous infusion over a 3 hr period into either a systemic vein (femoral), portal vein, hepatic artery, or hepatic artery distal to its ligation after hepatic dearterialization. A total of eight dogs were studied. During 5‐FUra infusion, concomitant blood samples were taken from the inferior vena cava and hepatic vein at 1, 2, 3, 5, 10, 15, 30, 60, 120, and 180 min. 5‐FUra levels were determined in plasma by high‐performance liquid chromatography. Blood flow in the portal vein and hepatic artery was measured by an electromagnetic flowmeter. The data described by a multicompartmental model, including the measured flows, had separate hepatic arterial and portal compartments with elimination from each described by linear kinetics. Mean area under the curve values in μ/ml × min and the ratios of the systemic/hepatic vein areas following 5‐FUra infusion via systemic, portal vein, hepatic artery, or hepatic artery after dearterialization routes were: 975/539 (R = 1.80), 939/748 (R = 1.35), 211/454 (R = 0.46), and 562/1,424 (R = 0.39). The results indicated that the administration of 5‐FUra via the hepatic arterial route distal to its ligation results in the highest hepatic vein drug levels with the smallest systemic/hepatic vein exposure ratio, followed by intra‐arterial route, while systemic and portal vein routes were not nearly as advantageous as the intra‐arterial routes.
Use of contralateral rectus femoris flap: An alternative for covering exposed femoral vessels of the thigh
Authors: Madariaga Juan , Duboys Elliot B. , Stern Jack T.
Published: February 2007

Myocutaneous coverage of large defects in the thigh following resection of tumors is necessary to ensure adequate protection of the underlying femoral vessels. The usual muscles employed as flaps to achieve this protection are ipsilateral sartorius, rectus femoris, tensor fasciae latae, gracilis, rectus abdominis, or vastus lateralis. However, for situations in which these muscles are not available, the surgeon needs an alternative flap. This report details the successful use of the contralateral rectus femoris muscle to cover exposed femoral vessels in the upper and middle thirds of the thigh. Findings of anatomical dissections confirm that, by freeing the muscle at its origin, its reach can be extended about 6 cm. Postoperatively, no functional deficits resulted from the flap and no damage to the skin graft occurred with radiation therapy. Use of the contralateral rectus femoris flap should therefore be considered when a reliable alternative to conventional flaps must be employed.
Lung cancer in chromate workers: High‐risk group for multiple lung cancer
Authors: Uyama Tadashi , Monden Yasumasa , Tsuyuguchi Masaru , Harada Kunihiko , Kimura Suguru , Taniki Toshikatsu
Published: February 2007

We diagnosed eight (8.9%) lung cancer patients in 90 workers exposed to chromate compounds. The duration of exposure ranged from 8 to 31 years, with a mean value of 18 ± 8 years. The histological classification was squamous‐cell carcinoma in seven patients and adenocarcinoma in one patient. The site of origin of the primary tumors was located peripherally in two (25%) and centrally in six (75%). All but one of these patients underwent surgery. In three (37.5%) of these patients, lung cancer foci were detected during the postoperative follow‐up by sputum cytology and bronchoscopy. Two of these three patients had multicentric cancer foci: double primary early squamous‐cell carcinoma in one and early squamous‐cell carcinoma + small‐cell lung cancer in the other. In a high‐risk group such as chromate workers, we should emphasize early detection of lung cancer by serial sputum cytology, chest x‐rays, and bronchoscopy. Lung cancer patients with chromate exposure should be treated with due regard to the possibility of synchronous or metachronous cancer.
Extremity soft tissue sarcomas: Analysis of prognostic variables in 300 cases and evaluation of tumor necrosis as a factor in stratifying higher‐grade sarcomas
Authors: Lack Ernest E. , Steinberg Seth M. , White Donald E. , Kinsella Timothy , Glatstein Eli , Chang Alfred E. , Rosenberg Steven A.
Published: February 2007

From July 1975 to February 1985, 300 patients with extremity soft tissue sarcomas (STS) were entered into treatment protocols at the National Cancer Institute. Using the Cox proportional hazards model, the STS were analyzed for independent prognostic variables that had significant association with disease‐free and overall survival. The effects of adjuvant treatment were also included in the analysis. Percent tumor necrosis was the basis for separating intermediate and high‐grade STS (< 15% necrosis = grade 2; > 15% necrosis = grade 3). The most important prognostic variable was histologic grade, which was highly associated with relative risk of metastasis and fatal outcome (P< .0001). Histologic type of STS was not a significant prognostic variable in predicting metastases. Patients with tumors located on the proximal or middle part of the extremity had a fivefold increased risk of death (P= .02) compared with patients who had STS located more distally. Mitotic activity (P= .0005) and vascular invasion (P= .0034) were also associated with malignant behavior, but histologic grade was the most significant predictor of outcome. Histologic grade of malignancy was based upon a combination of tumor typing and visual estimation of extent of tumor necrosis; using these two features, one can reliably separate low‐grade (i.e., grade 1) from high‐grade STS and also stratify the more aggressive (i.e., grade 2 and 3) tumors. Over the 9.5‐year period of study, the tumor‐related mortality was as follows: grade 1 (1/38), 3%; grade 2 (19/142), 13%; and grade 3 (45/120), 38%.
Morphologic and morphometric studies on tumor necrosis produced by radiotherapy, and hyperthermia singly and in combination
Authors: Patrício M. Brites , Vilhena MáRio , Soares Jorge
Published: February 2007

The purpose of the present study was to evaluate the therapeutic effects of hyperthermia associated with radiotherapy on neoplasia. Two transplanted experimental tumors (undifferentiated carcinoma of mouse breast and sarcoma 37) were used. A protocol was followed that included, for both models, four groups of animals: 1) control group; 2) radiotherapy group; 3) hyperthermia group; 4) radiotherapy associated with hyperthermia group. The animals were sacrificed after therapy according to a different schedule for each type of tumor. The morphology of the neoplasia in every group of treated tumors was compared with that of the control group. For quantitative evaluation of the necrosis, we studied the ratio of the tumor necrotic areas (N) to a tumor standard area (T). From the results obtained, the following conclusions were made: 1) Necrosis produced by combined treatment was significantly greater than that obtained by using one only; 2) necrosis appeared early after treatment and remained relatively unchanged; 3) The damaging effect of the hyperthermia occurred earlier than that produced by radiotherapy when these methods were used separately, thus suggesting distinct mechanisms of tumor necrosis.
Accuracy of the subrenal capsule xenograft assay in predicting the clinical growth and chemosensitivity of human squamous head and neck carcinomas
Authors: Parnes Steven M. , Sagerman Paul , Bennett James A. , Deconti Ronald C.
Published: February 2007

Thirty‐seven of 54 human squamous head and neck carcinomas were successfully grown as first transplant generation xenografts under the kidney capsule of conventional mice immunosuppressed by daily treatment with 60 mg/kg of cyclosporine. Of the 18 different tumors evaluated for chemosensitivity, 39% responded to cis‐platinum, 19% to 5‐fluoro‐uracil, 33% to methotrexate, and 40% to Cis‐Pt/5Fu. In comparing the assay results in nine patients who received the same chemotherapeutic drugs, two of three patients responded to their drug with xenograft shrinkage noted, whereas four of six patients who did not respond had tumor growth in the mouse. It is hoped that this model will become useful for new drug testing and, in certain cases, for selection of chemotherapy for patients with refractory tumors.
Hydroxyurea plus pelvic irradiation versus placebo plus pelvic irradiation in nonsurgically staged stage IIIB cervical cancer
Authors: Piver M. Steven , Khalil Moneer , Emrich Lawrence J.
Published: February 2007

Twenty‐five patients with FIGO stage IIIB carcinoma of the cervix were entered into a prospective, double‐blinded randomized study to evaluate the possible radiation potentiating properties (i.e., improved survival) of the S phase cell cycle specific inhibitor of DNA synthesis hydroxyurea (H). In contrast to our previous randomized trial of patients with FIGO stage IIIB carcinoma of the uterine cervix who were documented to be without paraaortic lymph node metastasis by pretherapy staging paraaortic lymphadenectomy [Piver et al.: J Surg Oncol 35:129–134, 1987], these patients either refused surgical staging or, because of medical conditions, could not undergo pretherapy paraaortic lymphadenectomy. Patients were to receive 6,000 cGy/6 weeks to the pelvis by megavoltage radiation therapy followed by 2,500 cGy to point A by intracavitary and vaginal radium/cesium. The median pelvic cGy for the Hu patients was 5,967 cGy and for the placebo patients 6,013 cGy. Leukopenia (WBC < 2,500/mm3) significantly increased in patients given hydroxyurea as compared with those given placebo (P < 0.0001). There was no statistically significant difference relative to anemia, thrombocytopenia, radiation skin reactions, diarrhea, or radiation induced complications requiring surgical correction. The estimated 5 year disease‐free interval was 54% for the hydroxyurea patients (median not reached) and 18% for the placebo patients with a median of 11 months. Because of these results, those of our previous reports, and those of the Gynecologic Oncology Group, we believe that hydroxyruea plus pelvic radiation should be the standard against which new potential radiation sensitizers are tested.
Evaluation of cytokeratin markers to differentiate between benign and malignant prostatic tissue
Authors: Guinan Patrick , Shaw Michael , Targonski Paul , Ray Veronica , Rubenstein Marvin
Published: February 2007

Cytokeratins are intermediate filaments found within basal and secretory epithelial cells. Antisera raised against cytokeratins are available but frequently differ in specificity. Many are incompletely characterized for their reactivity against epithelial components. Cytokeratin (Cyto) P is a polyclonal antisera specific for 56 and 64 kd cytokeratins. Cyto M is a pool of monoclonals reacting against 40, 46, 50, 52, 58, and 65‐67 kd cytokeratins. Initially, utilizing immunohistologic techniques, we evaluated these two antisera for their ability to distinguish between prostatic tissues of benign (benign prostatic hypertrophy [BPH]) or malignant (carcinoma of the prostate [CAP]) origin in the 34 cases evaluated. Specimens were analyzed for both Cyto P and Cyto M reactivity, as well as for the degree of reactivity. Lastly, in an effort to determine the morphologic relationship of atypical hyperplasia (AH) with either BPH or CAP, nine additional prostate specimens were analyzed. Cyto P was reactive in 8 of 8 (100%) BPH specimens and in 2 of 26 (8%) CAP specimens. Mean Cyto P degree of reactivity in the positive specimens was greater in BPH than in CAP (2.6 vs. 1.0). Cyto M reactivity was present in 8 of 8 (100%) BPH specimens and in 23 of 25 (92%) CAP specimens. Mean Cyto M degree of reactivity in the positive specimens was greater in CAP than in BPH (3.6 vs. 2.8). Cyto P was reactive in 3 of 9 (33%) AH specimens, with a mean degree of reactivity of 2.7. Cyto M was reactive in 9 of 9 (100%) AH specimens, with a mean degree of reactivity of 3.9. Cyto P reacted with only the basal cells, whereas Cyto M reacted with basal as well as secretory cells. These differences appeared to be the result of the differential reactivity of basal cells, which are present in BPH but absent in CAP. In summary, Cyto P and Cyto M are potentially useful markers in differentiating BPH from CAP, and it appears that AH is immunohistopathologically related to both.
Selective internal radiation (SIR) therapy for treatment of liver metastases: Measurement of response rate
Authors: Gray B. N. , Burton M. A. , Kelleher D. K. , Anderson J. , Klemp P.
Published: February 2007

Ten patients with liver metastases from primary tumors in the colorectum were treated with selective internal radiation (SIR) therapy. This involved the embolisation of yttrium‐90‐containing microspheres into the hepatic artery at the time of laparotomy. The microspheres were concentrated in the microvasculature of the tumour nodules by the concurrent administration of angiotensin II. The radiation dose being delivered to liver parenchyma was measured at the time of operation by use of an intraoperative radiation detection probe. All nine patients in whom the preoperative carcinoembryonic antigen (CEA) level was elevated experienced a decrease in CEA levels posttreatment. Intraoperative dosimetry confirmed the poor correlation between total radioactivity used and radiation dose received by normal liver parenchyma.
Improvement of the rapid immunoperoxidase staining method for intraoperative pathological diagnosis of pancreatic cancer using microwave irradiation
Authors: Ichihara Tohru , Nakao Akimasa , Suzuki Yuichi , Sakamoto Junichi , Nonami Toshiaki , Harada Akio , Nagura Hiroshi , Takagi Hiroshi
Published: February 2007

The rapid immunostaining of gastrointestinal cancer‐associated antigens, CA19–9, CEA, DUPAN2, and CA50, for intraoperative pathological diagnosis of pancreatic cancer can be completed in only 13 min by applying microwave irradiation, which was used to accelerate the incubation of the primary antibody. Only 3 s irradiation at 500 W for fresh‐frozen sections produced specific antigen staining of greater intensity than that obtained with longer incubation, and tissue preservation was satisfactory with minimal non‐specific background staining. This rapid immunoperoxidase staining method on the cryostat section of pancreatic biopsy specimens can provide important information for determining an appropriate operative method for pancreatic cancer patients.
Bone and liver imaging in regionally advanced melanoma
Authors: Salwen Walter A. , Krementz Edward T. , Campeau Richard J.
Published: February 2007

The clinical records of 94 patients with regionally advanced melanoma (nodal disease or regional satellites) were reviewed to determine the value of preoperative bone and liver imaging. Of 68 bone scans obtained, none were suggestive of metastases. Of 97 liver imaging studies (computed tomography, scintiscan, or sonography) in 88 patients, only two were found to have demonstrable metastases. Liver enzyme elevation was present in both of these patients. Bone and liver imaging in the absence of signs or symptoms of dissemination by history, physical examination, chest x‐ray, and enzyme determination for regionally advanced melanoma appears to be of little value unless the patient is involved in a protocol study.
MC‐38 adenocarcinoma tumor infiltrating lymphocytes: Correlation of cytotoxicity with time of tumor harvest after tumor inoculation
Authors: Lafreniere Rene , Borkenhagen Knut , Bryant Laurette D.
Published: February 2007

Tumor infiltrating lymphocytes (TILs) are capable of mediating significant tumor regressions in vitro and in vivo in animal systems. In humans, however, many TIL cell lines are not cytotoxic in vitro, and clinical trials thus far have been less than encouraging. We attempted to correlate TIL cytotoxicity with time of tumor harvest and TIL cell surface antigenic expression. TILs harvested from early MC‐38 adenocarcinoma tumors (days 9 and 20 post‐tumor implantation), demonstrated significantly higher cytotoxicity against a variety of tumor targets compared to older TILs (days 31 and 37), The younger TILs had a higher expression of the Lyt‐1 (Helper T cells), asialo GM1 (NK and T cells), and 49H.8 (NK cells) antigens. Comparison with the MCA‐102 sarcoma, a tumor that does not lead to cytotoxic TILs, revealed a low expression of the Lyt‐1 antigen on their cell surface. We conclude that TILs cytotoxicitv is time‐dependent and may be dependent on the presence of Lyt‐1+ cells in the overall TIL population of cells.
Functional estrogen receptors as biochemical marker for the detection of hormone‐dependent breast cancer
Authors: Vij U. , Murugesan K. , Kapur B. M. L. , Sarin R. , Dhawan I. K. , Farooq A.
Published: February 2007

The translocatable receptors categorized as functional receptors were quantitated in a cross‐incubation study of breast cancer nuclei with receptor‐rich uterine cytosol. Data demonstrated that tumors that contained cytosolic estrogen receptor (ER) but had translocation defect might not be hormone dependent, whereas tumors with low ER but intact nuclear trans‐location step will respond to antiestrogen therapy. Cytosolic ER was estimated in 114 primary breast cancer tissues and ten metastatic axillary lymph nodes; 58% of postmenopausal and 54% of premenopausal breast cancer tissues were ER+ with a cutoff value of 10 fmoles and 3 fmoles/mg protein, respectively. Of tumors in the premenopausal and postmenopausal state, 62% and 57%, respectively, were positive for nuclear ER, with a cutoff value of 10 fmoles/100 μg DNA. This study suggested that evaluation of functional ER level would reduce the number of false‐negative and false‐positive tumors.
Autologous transfusions for cancer patients undergoing elective ablative surgery
Authors: Lichtiger Benjamin , Huh Yang O. , Armintor Margie , Fischer Harald E.
Published: February 2007

Patients who have cancer are exposed to the adverse consequences of blood transfusions, such as transmissible diseases. This study presents an examination of a program of autologous blood deposit for cancer patients undergoing elective surgical procedures. Over a 3‐year period, 235 patients deposited 388 units of autologous blood: 6 for head and neck tumor surgery, 8 for neurosurgical tumors, 8 for gastrointestinal and colorectal tumor surgery, 14 for adrenal tumor surgery, 16 for gynecologic tumor surgery, 23 for soft tissue and bone tumor surgery, 25 for mastectomies and reconstructive breast surgery, 42 for genitourinary tumor surgery, and 93 for bone marrow aspirations for autologous transplants. One hundred eighty‐two patients (77.4%) used 278 units (71.6%) of their autologous blood units during the operations, 50/182 required additional homologous blood, and 53 did not require transfusions with autologous blood. Our study shows that a majority of these patients (132/182) underwent surgery using only autologous transfusions. Therefore, we believe that predeposited autologous blood is a viable alternative to homologous blood for cancer patients undergoing surgery.
Mortality and morbidity of primary pharyngogastric anastomosis following circumferential excision for hypopharyngeal malignancies
Authors: Mehta Samir A. , Sarkar Sudeep , Mehta Ashok R. , Mehta Mona S.
Published: February 2007

Seventy‐five patients underwent gastric transposition for replacement of the pharyngoesophagus. These patients had primary or recurrent malignant tumors of the hypopharynx, postcricoid region, and cervical esophagus. The operative procedure consisted of a transhiatal esophagectomy and gastric pull‐up to establish gastrointestinal continuity, with a unilateral or bilateral neck dissection where indicated. Seven patients died, a mortality rate of 9.33%. The average hospital stay of uncomplicated cases was 18 days and for complicated cases was 40 days. Immediate restoration of oral intake was achieved in 70.6% of patients. We conclude that gastric transposition after circumferential laryngopharyngeal excision is a procedure with low mortality and acceptable morbidity leading to early relief of dysphagia.
Comparison of clinical and surgical‐pathologic staging in patients with endometrial carcinoma
Authors: Ayhan Ali , Yarali Hakan , Urman Bülent , Yüce Kunter , Günalp Serdar , Ayhan Ayşe , Havlioǧlu Samim
Published: February 2007

In that accurate staging is essential to proper management of patients with endometrium cancer, preoperative clinical staging was compared with surgical‐pathological staging in 160 patients with endometrium cancer. One hundred fifty‐two patients had clinical stage I, and eight had clinical stage II disease. Overall, the clinical stage was changed in 26.9% of patients. The incidence of inaccurate staging was 25% for clinical stage I and 62.5% for clinical stage II disease. Endocervical curettage was found to have a 12.5% false‐positive rate and an 8.6% false‐negative rate. The extent of malignant disease for endometrium cancer (clinical stages I‐II) cannot be adequately and accurately assessed with clinical staging because there is a high rate of discordance between clinical and surgical‐pathologic staging.