[Early endoscopy for upper gastrointestinal bleeding in patients with esophageal varices (author's transl)].
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Biomedical subjects
Publications and source records attributed to A Morales.
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A case of intimal laceration of the renal artery by blunt trauma is presented. Although complete and prolonged functional loss was documented, total recovery was eventually observed. Postulates regarding pathogenesis are provided. The usefulness of arteriography for therapeutic and prognostic reasons is emphasized.
Patients with recurrent superficial bladder tumors have been treated by vesical and intradermal administration of Bacillus Calmette-Guerin. The pattern of recurrence in 9 patients has been altered favorably. Although the findings are still preliminary they appear to hold promise of a new therapeutic approach to the treatment of a group of neoplasms for which effective therapy is still lacking.
Of 18 patients with renal adenocarcinoma 10 with metastatic disease received Bacillus Calmette-Guerin immunotherapy. Objective responses were recorded in 4 patients. When the intradermal route and relatively small amounts of vaccine were used the complications were minimal and self-limiting. Bacillus Calmette-Guerin immunotherapy appears to be more effective than other modalities in the treatment of renal adenocarcinoma. However, definitive conclusions cannot be drawn since there is no control group. A prospective clinical trial is now in progress at this institution.
We evaluated 18 patients with adenocarcinoma of the kidney immunologically in a linear fashion. Delayed cutaneous hypersensitivity was significantly altered in patients with metastatic disease. In vitro studies have shown a progressive decline in the absolute number of circulating lymphocytes and the T cell subpopulations that parallels the advance of the maligant process. Evaluation of lymphocyte function by the response to mitogens appears to be of little significance in a sequential study.
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A total of 154 patients with carcinoma of the prostate received estrogen therapy with diethylstillbestrol (DES), chlorotrianisene or ethinyl estradiol. During a mean follow-up period of 26 months the incidence of complications -- thromboembolic episodes, fluid retention and gynecomastia -- was recorded. Although the incidence of cardiovascular complications was significantly higher in the DES group, the differences in mortality between the groups were not significant. The differences in incidence of fluid retention and gynecomastia also lacked significance. All three compounds produced adrenal cortical hyperplasia as indicated by the increased serum cortisol values.
A group of patients with metastatic renal adenocarcinoma was treated with cyclophosphamide. No antitumor effect was noted and, probably, enhancement of neoplastic growth was produced in some cases. Compared with other available therapies, a shorter survival rate was noted.
An unusual long-term survival of a patient with metastatic renal cancer is reported. Asthma developed after lung lesions were detected. After development of his allergy, new lesions have failed to appear and growth of old ones has slowed. The possibility that allergy can be a factor in the control of neoplasia is discussed.
Specimens obtained after scraping the bladder mucosa were found to be of excellent quality because of the large cell harvest and the minimal inflammatory exudate. In addition, tumor recurrence could be predicted in a significant number of cases with this technique.
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Metastatic renal adenocarcinoma has been highly resistant to most therapeutic approaches. However, hormonal treatment has been reported to induce significant subjective or objective improvement. Two groups of patients receiving either androgens or progestogens were evaluated. The number of responses was disappointing. Furthermore, neither of the 2 regimens appeared to increase the mean surival between detection of metastases and fatal outcome.
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Patients with prostatic cancer, receiving oestrogen therapy were found to have elevated serum cortisol levels and lymphopenia. Oestrogens are known to have a profound effect on the immune system; the possibility that this effect is mediated through the adrenal cortex is discussed. The significance of these findings, however, remains to be determined.
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