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Biomedical subjects

C Merrin

Publications and source records attributed to C Merrin.

At least 19 recordsLinked to original sources
PubMed1979

Management of multiple lung metastases.

During the past seven years, 78 patients with multiple lung metastases under went lung resection. Most of the patients with bilateral lung metastases had lung resection through a median sternotomy rather than by bilateral thoracotomies. "Local excision" of the lung lesions was the most frequently used technique in order to preserve as much lung tissue as possible. Sixty-three of the 78 patients received adjuvant therapies following lung resection. Operative mortality was 3.8%. The over-all median survival was 18.3 months. Analysis of the data showed shorter tumor doubling time to be an indicator of poor prognosis, whereas other factors such as disease-free intervals and unilateral vs bilateral metastases did not affect the postoperative survival.

Adolescent↗
PubMed1978

Detection of bone metastases in urogenital malignancies utilizing 99mTc-labeled phosphate compounds.

A retrospective study of 99 patients with proved urogenital malignancies was done to determine the value of bone scanning versus roentgenographic skeletal survey in assessing the degree of metastatic involvement. Findings on bone scans were positive in 59 patients, and in 7 of these patients results of roentgenographic skeletal survey were negative; 11 additional patients had only minimal roentgenographic abnormalities in contrast to more extensive involvement demonstrated by bone scanning.

Adolescent↗
PubMed1978

Multimodal treatment of advanced testicular tumor with radical reductive surgery and multisequential chemotherapy with cis platinum, bleomycin, vinblastine, vincristine and actinomycin D.

Advanced testicular tumors in 34 patients were treated by combination chemotherapy with bleomycin, vinblastine, vincristine, cis platinum and actinomycin D. The therapy was divided into 3 phases: 1) induction, 2) consolidation and 3) maintenance. Induction lasted 4 weeks and consisted of 420 mg. bleomycin, 0.2 mg./kg. vinblastine, 4 mg./kg. cis platinum, and 20 mg. prednisone daily. Consolidation lasted 6 weeks and consisted of 5 mg. actinomycin D, 6 mg. vincristine and 6 mg./kg. cis platinum. Maintenance therapy was achieved with 2.5 mg. actinomycin D every 6 weeks and 1 mg./kg. cis platinum every 3 weeks. A tumor reductive operation was done before induction of chemotherapy in 13 patients and after induction of chemotherapy in 12 patients. Nine patients were treated with chemotherapy alone. Three patients with brain metastases received concomitant radiotherapy to the brain (3,000 rads). A previous operation and chemotherapy had failed in 11 patients and previous radiotherapy had failed in 1 patient. All patients treated had at least 1 objective response (34 of 34 or 100 per cent). Partial clinical remission was achieved in 7 of 34 patients (21 per cent). A complete clinical remission was observed in 27 of 34 patients (79 per cent) and of this group 6 had a relapse. At present, 22 of 34 patients are free of disease from 4 to 24 months, with an average of 13 months (65 per cent). The toxicity consisted of nausea, vomiting, mucositis, alopecia, mild leukopenia and tinnitus. This approach seems to be effective in producing long clinical remissions in the majority of patients with advanced disease.

Adolescent↗
PubMed1978

Adjuvant chemotherapy for bladder cancer with doxorubicin hydrochloride and cyclophosphamide: preliminary report.

We describe 25 patients with bladder cancer who received adjuvant chemotherapy with doxorubicin hydrochloride and cyclophosphamide after radical cystectomy. Two patients had stage A disease, 3 had stage B, 3 had stage C and 17 had stage D. The 2 patients with stage A tumors have been free of disease for 12 and 15 months, respectively, and the 3 patients with stage B tumors have been free of disease for an average of 25 months. Of the 3 patients with stage C tumors 2 have been free of disease for an average of 34.5 months. Of the 17 patients with stage D tumors 10 have been free of disease for an average of 1 year (59 per cent). These preliminary results seem to indicate the value of adjuvant chemotherapy with doxorubicin hydrochloride and cyclophosphamide in cases of bladder cancer.

Cyclophosphamide↗
PubMed1978

Treatment of advanced bladder cancer with cis-diamminedichloroplatinum (II NSC 119875): a pilot study.

A pilot study was done using 19 patients with bladder cancer to test the efficacy of cis-diamminedichloroplatinum as a single agent to treat transitional cell carcinoma. Fourteen patients had stage D lesions, 3 patients had stage C and 2 patients had stage B tumors. The patients received 1 mg./kg. cis-diamminedichloroplatinum mixed with 2,000 cc dextrose 5 per cent in one-third normal saline solution, 37.5 gm. mannitol and 40 mEq. potassium chloride. The mixture was given in a slow infusion lasting 6 to 8 hours every week for the first 6 weeks and every 3 weeks thereafter. In the patients with stage D disease 1 complete clinical remission, 7 partial clinical remissions, 1 minimal objective response and 1 subjective response were observed. Four patients did not respond to the treatment. In the 3 stage C patients no response to the drug was observed. In the stage B patients 1 partial remission and 1 minimal objective response were seen. A total objective response (complete remission and partial remission) was seen in 9 of the 19 patients (47 per cent). The duration of the responses varied from 2 to 10 months, with an average of 4.8 months. These promising results seem to indicate the high degree of effectiveness of cis-diamminedichloroplatinum against transitional cell carcinoma of the bladder.

Carcinoma, Transitional Cell↗
PubMed1978

Treatment of advanced carcinoma of the prostate (stage D) with infusion of cis-diamminedichloroplatinum (II NSC 119875): a pilot study.

A study was done on 21 patients who had advanced carcinoma of the prostate (stage D) treated with 1 mg./kg. cis-diamminedichloroplatinum per week for 6 weeks. The infusions were then spaced every 3 weeks thereafter. One patient had never been treated previously and 20 patients were failures of previous therapy with estrogens and/or radiotherapy and/or chemotherapy. A partial objective clinical remission was seen in 9 of the 21 patients (43 per cent). This response lasted from 3 to 14 months, with an average of 5.8 months. The responses were evidenced by a 50 per cent or more decrease of lesions in the liver (2 patients), recalcification of a bone lytic lesion (1 patient), disappearance of positive lymph nodes in the neck (2 patients), disappearance of pleural effusion (1 patient), disappearance of lymphatic block of lower extremities (2 patients) and disappearance of lung metastases and ureteral obstruction (1 patient). Six patients (28.5 per cent) had a complete disappearance of the bone pain and became ambulatory and asymptomatic, 2 patients (9.5 per cent) with bony metastases remained asymptomatic and apparently stable and 4 patients did not respond to treatment and showed progression. Cis-diamminedichloroplatinum seems to be the most effective drug available to date for the treatment of advanced carcinoma of the prostate.

Aged↗
PubMed1978

Isoenzymes of human prostate acid phosphatase.

The isoenzymes of human prostatic acid phosphatase have been studied by an isoelectric focusing technique. Purified acid phosphatase from malignant prostates contained eight isoenzymes with pI 4.4--5.3. The sera from patients with prostate cancer were shown to have similar acid phosphatase isoenzyme patterns at pI 4.0--5.5; as the serum enzyme activities increased, the pI of isoenzymes shifted to more acidic pH. These isoenzyme patterns of sera from patients with prostate cancer were different from those of patients with Gaucher's disease or from acid phosphatase of human erythrocytes, both of which exhibited only one enzyme band around pI 5.0 and 6.0, respectively. Treatment of serum sample of prostate cancer with neuraminidase did not result in a single enzyme band but alter the pI of isoenzymes, which shifted to a higher pH region. The significance of acid phosphatase activities and its isoenzyme patterns in prostate cancer merits further investigation.

Acid Phosphatase↗
PubMed1977

The surgical management of multiple lung metastases.

From 1970 to June, 1976, 56 patients who had multiple metastatic tumors of the lung were treated by lung resection. Most of the bilateral lung lesions were removed through a median sternotomy so as to avoid staged bilateral thoracotomy. The surgical mortality was 1.8%. A total of 26 patients are alive at 7 to 69 months (estimated median survival, 20.7 months). Patients with tumor doubling time of less than 40 days had lower survival results (median, 9.5 months), compared to patients with tumor doubling time of more than 40 days (median not yet reached). The type of primary tumor, tumor-free interval, number of lesions removed, and presence of unilateral as opposed to bilateral lung metastases did not seem to affect the therapeutic results.

Adolescent↗
PubMed1977

Treatment of recurrent and widespread testicular tumor by radical reductive surgery and multiple sequential chemotherapy.

There were 37 patients with stages II and III testicular tumors treated by a combination of multisequential chemotherapy and radical reductive surgery. Two protocols were used: 30 patients received bleomycin, vinblastine, platinum, doxorubicin hydrochloride, cyclophosphamide and actinomycin D (protocol A), and 7 patients received bleomycin, vinblastine, vincristine, platinum and actinomycin D (protocol B). A complete clinical remission was achieved in 19 of the 37 patients (51.3 per cent), for an average survival of 12.9 months to date. A partial clinical remission was obtained in 7 patients (18.9 per cent), for an average survival of 14.2 months. Eleven of the patients (29.7 per cent) escaped from therapeutic control. The collective response (complete and partial clinical remissions) represented 70.2 per cent of the patients (26 of 37), with an average survival of 14.8 months. A new approach for the simultaneous excision of metastases in the abdomen and the chest is described and the rational basis for the combination treatment of these tumors is discussed.

Adolescent↗
PubMed1977

The clinical value of lymphangiography: are the nodes surrounding the obturator nerve visualized?

Twenty-five patients subjected to pelvic node dissection for urologic malignancies underwent bilateral pedal lymphangiography preoperatively. Postoperatively, 50 samples of the nodes selectively removed from the regions surrounding the obturator nerve were radiographed. All 50 samples revealed the presence of radiopaque dye. The lymph nodes surrounding the obturator nerve represent the first point of lymphatic metastases in carcinoma of the prostate and the bladder. Their visualization by lymphangiography emphasizes the importance of such a diagnostic study for the correct clinical staging of these diseases. The lymphatic anatomy of the pelvis is reviewed and compared to the radiological findings in lymphangiography.

Evaluation Studies as Topic↗
PubMed1977

Seminoma.

Explore the source record for details and available documents.

Adult↗
PubMed1977

Eight years of experience with preoperative angiographic and lymphographic staging of bladder cancer.

Our experience with the preoperative staging of bladder cancer by bilateral selective hypogastric arteriography has been accumulated since 1968. More than 150 patients have been studied by selective angiography before radical cystectomy. Our latest series of 52 patients (1972 to 1976) compares to our previous experience demonstrating angiographic staging accuracy to detect bladder invasion and occult metastases at a rate exceeding that of clinical staging alone. Arteriographic staging of D lesions, when supplemented with lymphography, approaches 100 per cent accuracy. Falsely negative lymphograms currently are extremely uncommon (1.9 per cent). In several illustrated instances angiographic staging was proved to be even more accurate than the pathologic staging of a limited cystectomy specimen. The over-all angiographic and lymphangiographic staging accuracy in our most recent series of cystectomy patients was 78.8 per cent. The techniques and reliability of the data are discussed in detail, including the factors that interfere with the exact arteriographic staging of bladder cancer. However, these factors are more troublesome in early stage lesions. These studies demonstrate the role and value as well as areas of limitation of preoperative arteriography and lymphography in the evaluation of invasive bladder cancer.

Aged↗
PubMed1976

Combination radical surgery and multiple sequential chemotherapy for the treatment of advanced carcinoma of the testis (stage III).

Nineteen patients with advanced testicular carcinomas (Stage III) were treated by a combination of multisequential chemotherapy with vinblastine, bleomycin, platinum, adriamycin, cytoxan, actinomycin D, and reductive surgery. Of the sixteen patients who were operated on 10 patients are alive and free of disease from 5 to 15 months. Two patients are alive with residual disease and four patients died. (Three were free of malignant tumor and one had residual malignant disease.) Three patients are still receiving preoperative chemotherapy. Pathology reported benign tumors in 8 out of 16 patients operated on. All these patients were previously treated with multiple chemotherapy. Several facts emerge from this study: (1) the great effectiveness of the combination of multisequential chemotherapy and reductive surgery to produce complete clinical remission in advanced testicular carcinomas (63.6%, 13 out of 19 patients); (2) the possibility of benign transformation of these tumors (50%, 8 out of 16); (3) the importance of the second-look surgery in testicular tumors.

Adolescent↗
PubMed1976

Brain metastasis from prostatic carcinoma.

Between 1959 and 1971 there were 91 patients with clinically diagnosed prostatic carcinoma who were autopsied at Roswell Park Memorial Institute. In four of these 91 (4.4%) intracerebral metastasis were found at autopsy, but only in one of these four was the diagnosis arrived at pre-mortem. This report describes the diagnosis and management of intracerebral metastasis from prostate carcinoma. It appears, on the basis of our initial experience, that the clinical diagnosis of this entity deserves more frequent consideration.

Adenocarcinoma↗
PubMed1976

Hemangiopericytoma of the Urinary Bladder: a case report and review of the literature.

A case of hemangiopericytoma arising in the urinary bladder is presented. Initial symptoms included hematuria and frequency of urination. Hemangiopericytoma is a vascular tumor of pericyte origin which occurs primarily in several organs and can be benign or malignant. Reports in the literature of genitourinary system involvement are reviewed. It is concluded that genitourinary tumors of this type should be considered malignant and treated aggressively.

Adenocarcinoma↗
PubMed1976

Sisomicin in urinary tract infection: Tolerance and efficacy study.

Twenty-one patients with gram-negative urinary tract infections were treated with sisomicin, a new aminoglycoside antibiotic. Bacteriologic cure was achieved in 62 per cent of patients, and improvement in another 33 per cent. Mild transient elevation of serum creatinine occurred in 3 patients. No other toxicity was observed. Further clinical trials with more frequent dose administration and in combination with other antibiotics is suggested.

Adult↗
PubMed1976

Nonhormonal chemotherapy for disseminated renal cell carcinoma.

Twenty-five patients with disseminated renal cell carcinoma have been followed for eleven months. These patients have been treated with CCNU, bleomycin, methotrexate, and platinum in various combinations. The results have been discussed in light of other studies using chemotherapeutic agents against this disease process.

Adenocarcinoma↗