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Biomedical subjects

B Levin

Publications and source records attributed to B Levin.

At least 253 records · Page 14Linked to original sources
PubMed1986

Malignant tumors of the major salivary glands.

A total of 512 patients with major salivary gland tumors were treated at our institution between the years 1960 to 1975. The 147 cases of malignant salivary gland tumors were reviewed according to presenting characteristics and stage, histology, and outcome. Treatment for each type is summarized. The battery of diagnostic aids and prognostic indicators available to the physician are also reviewed. The newer and more controversial procedures of CT scanning, nuclear magnetic resonance scanning, and fine-needle aspiration are discussed in detail. In the past, salivary gland tumors have been classified by histology alone. Current trends employ the TNM staging system in planning treatment and predicting end results. We have found a far better survival rate in patients with various tumor types presenting with stage I or II disease, but point out that patients with high-grade tumors often present with advanced disease. All major salivary gland tumors should be approached according to the principles of cancer surgery. The minimum procedure is thus superficial or total parotidectomy with preservation of the facial nerve. In low-grade malignancies, the diagnostic procedure will have accomplished this definitive treatment. Salivary gland tumors are rare in the pediatric population. Such malignancies often defy radical treatment. Although cure rates in many categories of high-grade tumors are low, the only hope for survival is an initial aggressive surgical approach. Although radiation was used for recurrent disease only during the years of this study, it is currently being used as adjuvant therapy in almost all malignancies except low-grade mucoepidermoid. Recurrences are almost always fatal.

Adult↗
PubMed1985

Treatment of cadaveric renal transplant recipients with total lymphoid irradiation, antithymocyte globulin, and low-dose prednisone.

The ability of preoperative total lymphoid irradiation (TLI) to reduce the need for chronic immunosuppression after cadaveric renal transplantation was examined in 25 recipients who were given a brief course of antithymocyte globulin (ATG) postoperatively with daily low-dose prednisone (0.1-0.2 mg/kg) as the sole maintenance immunosuppressive drug. Patients were selected for the study on the basis of their low levels of cytotoxic antibodies. Grafts were not HLA-matched, and the mean interval between completion of TLI and transplantation was 9 days. During an observation period of up to 25 months, 2 grafts were lost because of rejection. There were two deaths due to disseminated viral infections and two to late cardiovascular complications. At the last observation point, the mean serum creatinine of the 19 patients with functioning grafts was 1.5 mg/dl, and the mean dose of prednisone was 10.2 mg/day. 10 of these patients did not have a rejection episode. Comparison of patients given TLI with a group given cyclosporin at the same institution showed similar graft survival but better graft function in the TLI group.

Adult↗
PubMed1985

Marker chromosomes in direct preparations of human large bowel tumors.

A survey of 257 marker chromosomes in 48 primary human large bowel adenocarcinomas showed that 44% were markers with recognized patterns. Chromosomes #1, #3, #5, #8, #9, #13, and #17 were involved most frequently. Markers related to chromosomes #7 and X were not seen in any recognizable form. The unidentified chromosomes were classified as markers with abnormal banding regions. In correlating tumor location and stage of invasion with markers, there were fewer markers in tumors from the right side. However, there was little difference in the number of markers seen in the left-sided tumors, irrespective of histopathologic stage, suggesting that function and microenvironmental conditions between various parts of the colon may be related to these differences. The most striking observation is that 21% of all tumors analyzed were without any obvious markers.

Adenocarcinoma↗
PubMed1985

Chromosomal banding patterns in human large bowel adenomas.

Chromosome studies were performed on direct preparations of 38 benign human large bowel adenomas by fluorescent banding techniques. Five adenomas had a normal diploid karyotype line. Six adenomas had numerical abnormalities, and seven polypoid lesions exhibited structural and numerical changes. In 20 adenomas without analyzable metaphases, it was presumed that the cells were dividing at a lower rate. Mosaics were observed in 25% of cases. The most common finding was trisomy of 7, 8, or 13.

Adenoma↗
PubMed1985

Ulcerative colitis and colonic cancer. Problems in assessing the diagnostic usefulness of mucosal dysplasia.

To assess the association of mucosal dysplasia and colonic cancer in patients with ulcerative colitis and to avoid bias in biopsy interpretation that may have affected results of previous studies, the authors examined coded histology slides from colectomy specimens of 22 patients who had ulcerative colitis and colonic cancer and 22 patients who had ulcerative colitis but no colonic cancer. As expected, it was found that dysplasia occurred contiguous to each cancer. However, at a distance from the cancer (i.e., in histology blocks not containing cancer), some dysplasia was found (low or high grade) in 16/22 cases (73 percent), and high grade dysplasia in 11/22 cases (50 percent). These results suggest that there may be somewhat weaker association than previously reported between colonic cancer and dysplasia at a distance from the colonic cancer. Further, these results suggest that, in studies of dysplasia, it is important to avoid bias in biopsy interpretation and to describe sampling methods.

Adolescent↗
PubMed1985

Results of a survey of complete denture procedures taught in American and Canadian dental schools: an update.

Dental educators carry a heavy burden of responsibility. Principles and procedures are usually deeply inculcated in students by their teachers, which has a wide-spread effect on the future of dentists and patients. Prosthodontic treatment of edentulous patients, like any other branch of art and science, is not static; but viable, moving, and improving. Constant reevaluation of current and future programs should be made by all teachers who are responsible for prosthodontic education.

Canada↗
PubMed1985

Therapy for metastatic colorectal cancer with hepatic artery infusion chemotherapy using a subcutaneous implanted pump.

Sixty-two patients with metastatic colorectal carcinoma involving the liver were treated by hepatic intra-arterial chemotherapy using an implantable infusion pump. The 53 patients with metastases confined to the liver had a median survival (MS) of 17 months and an objective response rate of 32%. Four patients (8%) demonstrated a complete response (CR), with normal abdominal computed tomography (CT) scan results and plasma carcinoembryonic antigen (CEA) levels, and 13 patients (25%) demonstrated a partial response (PR), with at least a 50% decrease in the liver lesions by CT scan and at least a 50% decrease in CEA levels. Thirty patients (57%) had stable disease (S), and six patients (11%) had no response (NR). Nine patients with extrahepatic tumor plus hepatic metastases had an MS of only 4.9 months. None of these patients had an objective response, and only four patients had S. Quality of response was clearly associated with longevity. Forty patients treated with floxuridine (FUDR) and mitomycin (M) (F + M) showed a 20% objective response rate, while the 13 patients treated with FUDR and dichloromethotrexate (DCMTX) (F + D) attained a 69% objective response rate. Although F + D treatment appears to be superior, there may have been selection biases that make such an observation only preliminary. Twenty-six (49%) of the 53 patients developed hepatitis during infusion chemotherapy, which resolved after temporary cessation of the chemotherapy. Of the 17 patients with CR or PR, 12 patients (71%) had hepatitis, whereas only 14 (39%) of the 36 patients with S or NR had hepatitis. Eleven patients had evidence of peptic ulceration by endoscopic examination during the infusion chemotherapy. All the ulcers healed after chemotherapy was discontinued.

Adenocarcinoma↗
PubMed1985

The Coronary Artery Surgery Study (CASS). A critical appraisal.

The applicability of the Coronary Artery Surgery Study (CASS) to clinical practice is seriously hampered by the following findings. (1) The CASS randomized study applies to only a small minority of patients with coronary artery disease. Attempts to extend the conclusions of CASS to the vast majority of patients with coronary artery disease are unjustified. (2) The high percentage of crossover of the medical group made it impossible for CASS to accomplish its primary goal of contrasting medical and surgical treatment. (3) Despite the fact that crossover of medically assigned patients created a bias against surgical treatment, the observed mortality in the surgical group was still 31% lower than that in the medical group. (4) The failure of CASS to find this difference to be statistically significant must take into account the fact that the statistical power of CASS was so low that a real difference was likely to be overlooked. (5) The conclusion that patients similar to those in the study may safely defer operation is unwarranted and violates the principles of prospective study design. In addition, CASS failed to address the possibility that deferring operation may compromise long-term survival.

Angina Pectoris↗
PubMed1985

Treatment of metastatic colorectal carcinoma with cisplatin and 5-FU.

Twenty patients with measurable metastatic colorectal carcinoma were treated every 3 weeks with cisplatin (100 mg/m2 iv) on Day 1 and 5-FU (1000 mg/m2/day by iv infusion over 24 hours) on Days 1-5. Seven patients were previously treated with chemotherapy. The mean performance status for all of the patients was 1.5 (Eastern Cooperative Oncology Group). None of the patients had an objective response to the chemotherapy; 11 patients had stable disease and nine had no response. This study demonstrates that the combination of cisplatin and 5-FU, administered at this dose and schedule, has minimal activity in patients with metastatic colorectal cancer.

Adenocarcinoma↗
PubMed1984

Retinoic-acid-binding protein in normal and neoplastic human esophagus.

The concentration of cellular retinoic acid binding proteins (CRABP) was determined in the cytosol of normal esophageal tissue and in esophageal carcinomas. Unlike the reported results for human breast, colon, melanoma, or oropharynx cancers, the CRABP levels in esophageal cancers were either undetectable or contained levels of CRABP which were significantly lower than that of adjacent histologically disease-free tissue (P less than 0.005). Moreover, there was no difference between the normal mucosa of cancer or noncancer patients with regards to the CRABP concentration. The absence of CRABP in the cancer tissue was not dependent on the degree of differentiation. These results indicate that the CRABP disappears when the normal mucosa becomes malignant. If such a change is also demonstrated in known premalignant conditions of the esophagus, CRABP could serve as a diagnostic biochemical marker for early detection of this cancer.

Adenocarcinoma↗
PubMed1984

Primary osteogenic sarcoma of the spine.

Primary osteogenic sarcoma of the spine is a rare tumor making up 0.85% to 2.0% of all osteogenic sarcomas. The majority (29/41) of previously reported cases have occurred in vertebrae affected by Paget disease or radiation exposure. Two cases of osteogenic sarcoma of the spine, one lumbar, the other thoracic, with no known predisposing factors are presented.

Adult↗
PubMed1984

Chromosomes in human large bowel tumors. A study of chromosome #1.

Chromosome studies on 49 patients with large bowel adenocarcinomas showed abnormalities of chromosome #1 in 19 cases (39%). One had monosomy, 13 showed trisomy, and 5 cases had structural abnormalities. Eighteen patients had tumors on the right side of the colon; of these, only 3 had an abnormal #1 (17%); 16 of 28 tumors (57%) located on the left side had abnormalities of #1. The regions of consistent duplication of 1q were q24----q44? The presence or absence of changes of chromosome #1 may be useful as a prognostic indicator in large bowel cancer.

Adenocarcinoma↗