bluuebunny/crossref_metadata_2025_split huggingface dataset:
Current status of endocrine treatment of carcinoma of the breast
Authors: Buzdar Aman U. 
Published: February 2007

AbstractSequential administration of endocrine therapies can result in objective remission in a significant fraction of patients with metastatic breast cancer. Combined hormonal therapies and combined hormonochemothera‐pies have not resulted in better results than the sequential administration of these same therapies. Tamoxifen (an antiestrogen) given as an initial therapy results in local control of the disease in a significant fraction of patients with locally advanced breast cancer who are not candidates for cytotoxic therapy. Tamoxifen as an adjuvant therapy for operable breast cancer prolongs disease‐free survival and reduces mortality in patients >50 yr of age with higher estrogen receptor concentrationsThe role of tamoxifen as adjuvant therapy for patients <50 yr of age remains unclear. Also, adjuvant tamoxifen in combination with cytotoxic drugs has not produced superior results, and the duration of adjuvant tamoxifen therapy remains to be determined. Experimental data suggest prolonged administration of tamoxifen may be needed to control microme‐tastases.
Hormonally active gynecologic tumors
Authors: Morgan Linda S. 
Published: February 2007

AbstractHormonally active gynecologic tumors include gestational trophoblastic disease (GTD) and some of the primary ovarian tumors. The presenting symptoms in patients with these tumors are frequently related to their endocrine activity. The main hormone produced by gestational tropho‐blastic disease is human chorionic gonadotropin (HCG) and the main symptoms are those associated with a normal pregnancy, except they are frequently exaggerated. The endocrinally active ovarian tumors are mainly those of the sex—cord stromal group and these may produce any of the sex steroids (estrogens, androgens, or progestins). Some germ cell tumors of the ovary are hormonally active because they contain syncytio‐trophoblastic cells which produce HCG. There are two specialized types of mature teratomas that are discussed: struma ovarii, which produce thyroid hormones, and carcinoids, which produce serotonin.
Thymoma
Authors: Couture Mark M. , Mountain Clifton F. 
Published: February 2007

AbstractA review of the evaluation, treatment, and end results for 52 patients with thymoma treated at The University of Texas M.D. Anderson Cancer Center (1950‐1984) is presented. The objective of the study was to examine the influence of a number of clinical characteristics on survival, including histologic and staging classifications, associated diseases, symptom status, and treatment. Forty‐nine patients (94%) underwent surgical exploration; 13 were stage I, 12 were stage 11, and 24 were stage 111. Complete resection was accomplished in all of the stage I and I1 groups and in 6 of the stage I11 patients. An asymptomatic history, surgical stage I disease, lymphocytic thymoma cell type, and complete resection favorably influenced prognosis. The cumulative 5‐year survival rate for all patients was 40%. No patient with stage I thymoma had recurrent disease, however, there were 9 recurrences (50%) in the completely resected stage II/III patients, six of whom remained disease‐free following treatment with radiotherapy, chemotherapy, or a combined approach.
Current status of parathyroid autotransplantation
Authors: Brunt L. Michael , Sicard Gregorio A. 
Published: February 2007

AbstractAutotransplantation of the parathyroid glands is a clinically useful modality for the management of patients with certain forms of hyperparathyroidism. In conjunction with total parathyroidectomy, this procedure has been used to treat patients with primary and secondary hyperparathyroidism who have generalized parathyroid hyperplasia. Parathyroid autotrans plantation is also an important adjunct to the management of patients undergoing radical thyroid or laryngeal surgery to prevent permanent hypoparathyroidism from devascularization of all in situ parathyroid tissue. The technique of parathyroid cryopreservation has been well established and provides surgeons with greater flexibility in the approach to patients undergoing reoperative parathyroid surgery in whom there is uncertainty about the functional status of the remaining parathyroid tissue. Parathy‐ roid allotransplantation has been successfully performed in immunosuppressed patients but is rarely indicated. Parathyroid autografts can be placed heterotopically in a forearm muscle or in the sternocleidomastoid, but the former site is preferred in patients with hyperplastic or adenomatous tissue. This technique results in a low incidence of permanent hypoparathyroidism after radical parathyroidectomy, and recurrent hypercalcemia can be easily managed by local excision of a portion of the grafted tissue.
Update on pancreatic islet cell transplantation
Authors: Jung Pa Jong , Merrell Ronald C. 
Published: February 2007

AbstractThe biological validation of islet grafts would free total pancreas resection from the onus of severe diabetes mellitus. Islet cell transplants can reverse diabetes mellitus and prevent complications in animal models. Immune rejection has foiled attempts at human transplantation despite moderate success with whole pancreas grafts. Aggressive rejection of islet grafts has been extensively studied in animal models and seems no different in substance from standard cell‐mediated rejection but vastly different in tenacity. Rejection cannot be prevented by immunosuppression strategies effective for transplantation of heart, kidney, or liver. New strategies to circumvent islet rejection include encapsulation of the islets to obfuscate immune recognition, pretreatment of the islets in vitro to reduce immunogenicity, donor manipulation to provide specific tolerance, and combination strategies. In the development of these strategies, much has been learned or confirmed about the nature of immune rejection, and another round of human trials can be anticipated.
APUD Update
Authors: Douglas Harrison W. , Hocking Michael P. 
Published: February 2007

AbstractApudomas are a diffuse group of tumors that have interested surgeons for a long time. With recent developments in their radiological localization and pharmacological control, they are now treated in a truly multidisciplinary approach. In this chapter, recent developments in the radiological, surgical, and medical approaches to these tumors are reviewed. Emphasis is placed on how non‐surgical developments have affected the surgical treatment of specific apudomas. Resulting changes in surgical philosophy are also reviewed.
Nitrous oxide: A cause of cancer or chemotherapeutic adjuvant?
Authors: Koblin Donald D. 
Published: February 2007

AbstractThe administration of nitrous oxide rapidly inactivates the vitamin B12‐dependent enzyme methionine synthase. This inactivation disrupts the normal interrelationships between vitamin B12 and folic acid, and results in altered levels of folic acid derivatives and certain amino acids and their metabolites. Attempts have been made to use the antifolate properties of nitrous oxide to treat patients with leukemia. Although transient improvements may be observed in patients with leukemia who are given nitrous oxide, prolonged administration of nitrous oxide is highly toxic and causes marked hematological and neurological abnormalities. Animal and in vitro studies suggest that the action of nitrous oxide may be tumor selective, and that nitrous oxide may interact with and enhance the therapeutic effect of other antitumor agents. However, there is a delicate balance between the possible beneficial and harmful effects of nitrous oxide, and the conditions for which nitrous oxide may prove useful as a chemotherapeutic adjuvant remain to be definedConcern has also been raised that nitrous oxide may have carcinogenic potential, especially in operating room and dental personnel who are chronically exposed to trace concentrations of this gas. However, there is no convincing evidence to date that nitrous oxide causes cancer in either animals or humans.
Pain management of the oncologic patient
Authors: Arter Olga E. , Racz Gabor B. 
Published: February 2007

AbstractAfter the first 5 years of life, cancer is one of the three most common causes of death. Most investigations of cancer pain have shown that 50–70% of patients suffer needlessly. Pain may be due to the tumor or a co‐existant benign pain syndromeMethods of pain management include: 1) neurolytic blockade: stellate ganglion block, celiac plexus block, lumbar sympathetic block, epidural phenol, subarachnoid neurolysis; and 2) non‐pharmacologic methods: radiofrequency thermocoagulation lumbar sympathectomy, transcutaneous nerve stimulation (TENS), dorsal column stimulation (DCS)In summary, we utilize every possible combination of therapeutic modalities for cancer pain management. With so many safe procedures available, we encourage the primary physician to refer patients early in their disease process. Neurolytic procedures should be performed prior to initiation of high dose narcotic therapy, radiation, chemotherapy, and surgery when possible.
Intraspinal narcotics for treatment of cancer pain
Authors: Lubenow Timothy R. , Ivankovich Anthony D. 
Published: February 2007

AbstractInadequate pain relief remains a problem for many patients with cancer. Narcotic administration by the epidural or subarachnoid route is a relatively recent innovation and is indicated when pain is poorly controlled with high doses of systemic narcotics, or when patients experience limiting narcotic side effects. When given by the epidural or intrathecal route, narcotics have a longer duration of action and a lower dose is effective. These techniques involve personnel trained in catheter insertion and maintenance. Epidural and intrathecal administration of narcotics is an alternative when oral narcotics are ineffectiveIn this report the term “intraspinal” refers to epidural and/or subarachnoid placement of catheters and drugs.
Ambulatory anesthesia
Authors: Philip Beverly K. 
Published: February 2007

AbstractAmbulatory surgical procedures are a large and increasing fraction of all surgery in the United States. A specialized health care team must be assembled to care for these patients and meet their special needs. Ambulatory surgery patients should be selected according to medical and psychosocial criteria. Patient preparation includes a history and physical examination, limited laboratory tests, empty stomach, and appropriate monitoring. Premedication should be supportive, and verbal as well as medicinal; drugs include ataractics and analgesics. All forms of general or regional anesthesia may be used. Recovery goals must be well defined, aiming for “home readiness.” Ambulatory anesthesia care is concluded with postdischarge follow‐up, for quality assurance and risk management.
Incidence of regional lymph node metastasis in operable osteogenic sarcoma
Authors: Caceres Eduardo , Zaharia Mayer , Calderon Ruth 
Published: February 2007

AbstractRecords of 182 consecutive patients with the diagnosis of operable osteogenic sarcoma, treated between 1954 through 1980 by the Breast, Bone and Mixed Tumors Department of the Instituto Nacional de Enfermedades Neoplasicas (Lima, Peru), were reviewed to study the incidence of regional lymph node metastases in this disease.All the patients included in this study had radical surgery, which means the complete resection of the bone where the tumor is located, including the proximal joint, which permitted excision of the regional lymph nodes.Nineteen patients (10.4%) had evidence of sarcoma metastatic to draining lymph nodes. A comprehensive analysis of the literature shows that the incidence of metastasis to the lymph nodes in this study, is higher than those cited in a review of the literature, probably due to the policy in the management of osteogenic sarcoma in our institution, during the period of study.
Transabdominal radical nephrectomy in ninety‐one consecutive patients with Wilsm' tumor
Authors: Pow‐Sang Julio E. , Benavente Victor , Pow‐Sang Julio M. , Aguero Victor 
Published: February 2007

AbstractNinety‐one children that were subjected to transabdominal radical nephrectomy are reviewed. The patients' ages ranged from 20 days to 10 years. Forty cases had a right side tumor and 44 a left side tumor; bilateral tumor incidenc e was 7.70% (7 cases). The tumor weight incidence was 75% for ⩾500 g and 37.5% for ⩾1,000 g. Incidence of local extension of the disease was 21.98%. Intraoperative complications were 12 ruptures of the kidney capsule, 1 laceration of the cecum, 1 opening of the pleura, 1 section of the superior mesenteric artery, and 1 section of the right common iliac artery. The mortality rate in unilateral surgery, because of intraoperaive massive hemorrhage, was 3/83 (3.61%). One patient with bilateral tumor died because of accute renal insufficiency and sepsis. One patient with caval thrombus which extended up to the right atrium died because of intraoperative massive pulmonary embolism.
Bilateral ilioinguinal lymph node dissection in the management of cancer of the penis
Authors: Pow‐Sang Julio E. , Benavente Victor , Pow‐Sang Julio M. , Pow‐Sang Mariela 
Published: February 2007

AbstractTwenty‐nine patients with squamous cell carcinoma of the penis underwent bilateral ilioinguinal groin dissection 6 weeks after removal of the primary penile lesion. Eighty percent of the patients were alive and without evidence of disease at 5 years when the dissected lymph nodes were negative. When positive nodes were found, 62.5% of the patients were alive and without evidence of disease at 5 years: two of these patients had one iliac deep node positive each. The mortality rate at 5 years because of progression of disease was 6.6% when the dissected lymph nodes were negative, as compared to 37.5% when the dissected lymph nodes were positive.
Surgical treatment of non‐small cell lung cancer by stage
Authors: Martini Nael 
Published: February 2007

AbstractResection is the treatment of choice for stage I and II non‐small cell lung carcinoma. The 5‐year survival following resection is 72% in stage I carcinoma and 49% in stage II carcinoma. Resection alone or combined with radiation and/or chemotherapy is also indicated in some patients with stage IIIa disease. The 5 year survival with resection is 56% in tumors invading chest wall (T3NO), 30% in superior sulcus tumors, 30% in patients with N2MO disease, and 36% in patients with tumors in proximity to carina. Surgery is of very limited value in patients with tumors invading the mediastinum and in patients with stage IIIb or stage IV disease. Details of case selection in each treatment category are presented.
Diagnosis and treatment of pleural mesothelioma
Authors: Rusch Valerie W. 
Published: February 2007

AbstractPleural mesotheliomas are uncommon tumors. They can be broadly classified as localized and diffuse. The localized form is a non‐epithelial neoplasm that occurs as commonly in women as in men and is not related to asbestos exposure. It is usually asymptomatic, and is occasionally associated with paraneoplastic syndromes. Localized mesotheliomas arise more frequently from the visceral than from the parietal or mediastinal pleura. The long‐term outcome of these tumors is determined mainly by their clinical presentation, and by whether or not they can be completely resected.Diffuse pleural mesotheliomas are invariably malignant. They are clearly related to asbestos exposure, and are far more common in men than in women. Histologically, they are completely or partially epithelial tumors. Diffuse mesotheliomas present with dyspnea, chest pain, and weight loss and are not associated with paraneoplastic syndromes. Distinguishing malignant mesothelioma from metastatic adenocarcinoma can be difficult and usually requires a large tissue biopsy on which immuno histochemistry and electron microscopy can be performed. The management of diffuse malignant mesothelioma remains controversial. Treatment appears to prolong survival which ranges from 6 to 12 months with supportive care alone. Surgical resection, either with extrapleural pneumonectomy or by pleurectomy/decortications remains the mainstay of treatment because of the relative ineffectiveness of radiation and chemotherapy. Surgical resection alone, however, is inadequate, so most current treatment regimens combine operation with radiation and/or chemotherapy. Even with aggressive multimodality treatment, the median survival currently ranges from 18 to 24 months. A better understanding of prognostic factors, a better staging system, and innovative treatment strategies are desperately needed in this disease.
Prognostic indicators in patients with pulmonary metastases
Authors: Putnam Joe B. , Roth Jack A. 
Published: February 2007

AbstractPulmonary metastases from different primary neoplasms have different biological characteristics which may correlate with patient survival. Objective criteria to reliably select or exclude patients who would benefit from resection of these metastases are not available; however, various prognostic indicators have been studied for their correlation with postresection survival. Prognostic indicators differ among various tumor histologies. Prognostic indicators identified preoperatively which may influence post‐resection survival include age, sex, histology and location of the primary tumor, tumor doubling time, disease free interval, the number of nodules on preoperative roentgenographic studies, and the number of metastases resected. Following surgery, resectability, and the number of metastases resected may predict expected survival for patients meeting certain criteria. No single criterion should be used to exclude patients from surgery as resection will provide numerous patients with significant postresection survival.
Neck dessection: Concepts, Controversies, and Technique
Authors: Byers Robert M. 
Published: February 2007

AbstractThe various types of neck dissections are described. The indications for each type of neck dissection are discussed for patients with necks staged No, N +, for the patient with an unknown primary and for the patient whose neck dissection is in conjunction with radiation. The technical aspects of modified neck dissections are addressed but not in great detail. The indications for the use of postoperative radiation are emphasized. The nodal groups at risk for metastases from various primary sites are identified and a terminology for neck dissection is suggested.
Advances in radiation therapy for head and neck cancer
Authors: Toonkel Leonard M. 
Published: February 2007

AbstractRadiation therapy either as a single modality or as part of multimodality plans remains an integral part of curative treatment for cancers of the head and neck. This paper traces the modernization of radiation therapy regarding tumors of the head and neck using examples of sites of malignancy where radiation therapy is the sole modality or where radiation therapy can be combined with surgery and chemotherapy for optimal results. As local‐regional control rates have improved with the use of combined radiation therapy and surgery and aggressive hyperfractionation schemes for advanced primary tumors, distant metastases and second primary neoplasms are now accounting for a larger proportion of treatment failures. Until such time as more effective systemic therapy and cancer control mechanisms are developed to address these problems, radiation therapy will continue to play a major role in the overall management of patients with cancers of the head and neck.
Current advances in reconstruction of the mandible in head and neck cancer surgery
Authors: Marx Robert E. 
Published: February 2007

AbstractToday's reconstruction of head and neck cancer related deformities is based on an in‐depth knowledge of soft and hard tissue repair coupled with the technical ability to transplant and reorient soft and hard tissues into a functional and cosmetic improvement for each patient. The recent advances of (1) the science of bone regeneration, (2) myocutaneous flaps, (3) hyperbaric oxygen, and (4) allogeneic bone cribs have resulted in reconstructions which are now predictable outcomes with few complications and minimal morbidity. This writing will discuss the contribution and mechanism of each of these four advances and how their application can be used to consistently reconstruct even large deformities with both hard and soft tissue loss, as well as in tissues which have been severely radiated.
Incidence of carcinoma of the thyroid in nodular goiter
Authors: Cole Warren H. , Watne Alvin L. 
Published: February 2007

AbstractSince the incidence of cancer in nontoxic nodular goiter as reported by us in 1944 appeared high (17.1%), we made another study during the next four years and discovered an incidence almost identical (17.2%). Our figures on incidence of cancer in nontoxic nodular goiter appeared so high because we were the first authors to break down the goiters into the three different types and to discover that the incidence was high in only one type of goiter and not in the others. The incidence of cancer was only 4.6% in toxic nodular and toxic diffuse goiter added togetherFor decades, we have known that goiter is a geographic disease. It is possible that carcinoma of the thyroid is slightly geographical. At least it appears that there is a slightly geographical relationship in regard to the 16 patients we have observed in our clinic with cancer during 1944–1949; of these 16 patients, 11 had advanced malignant disease. We cannot have accurate figures on results regarding treatment of our cases until long‐term follow‐up is concluded.
Medullary carcinoma of the thyroid: Current diagnosis and management
Authors: Lairmore Terry C. , Wells Samuel A. 
Published: February 2007

AbstractMedullary thyroid carcinoma (MTC) accounts for 5–10% of thyroid malignancies and occurs in either a sporadic or a familial form. The familial form is inherited in an autosomal dominant pattern, and expressed clinically as multiple endocrine neoplasia (MEN), types IIa and IIb, or as familial MTC alone. This neoplasm is derived from the parafollicular or C‐cells, and has the ability to secrete a variety of polypeptide hormones including calcitonin, which serves as a tumor marker for the presence of MTC. The development of a calcitonin radioimmunoassay and the screening of patients at risk for the familial forms of MTC allows the diagnosis of the neoplasm in an occult stage when total thyroidectomy results in virtually 100% cure. We will present our experience with the diagnosis, treatment, and postoperative follow‐up of our patients with this interesting neoplasm.
Neck dissection for thyroid cancer
Authors: Ballantyne Alando J. 
Published: February 2007

AbstractDecisions concerning the extent of surgical treatment for thyroid cancer remain controversial. Limited surgical procedures, designed to remove only the cancer that is clinically evident, can be successful since the primary determinants in survival are age, sex, and histologic type rather than number of positive nodes or other factors. A retrospective review of 339 patients who had surgical procedures for cancer of the thyroid at MDA hospital from 1975 to mid‐1989 did not show a conclusive advantage for any type of neck dissection. The operations were tailor‐made to include all evident clinical cancer. Secondary procedures such as surgery, radioactive iodine, or radiation therapy were successful in treating recurrences, which occurred in all surgical groups, whether limited or radical.