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Biomedical subjects

C Perez

Publications and source records attributed to C Perez.

At least 181 records · Page 10Linked to original sources
PubMed1982

Prognostic indicators in stage III and localized stage IV breast cancer.

One hundred eighty-three patients with Stage III and nonmetastatic Stage IV breast cancer, seen between 1960-1975 at the Division of Radiation Oncology, Mallinckrodt Institute of Radiology, were retrospectively analyzed to determine the prognostic significance of the following clinical features: (1) "grave signs" (skin ulceration, skin fixation, chest wall fixation, and edema); (2) size of primary tumor; (3) nodal stage; and (4) inflammatory changes. Since therapy among 147 patients with noninflammatory cancer comprised of either irradiation alone (54 patients) or surgery plus irradiation (93 patients), all the above factors were analyzed also with respect to the method of treatment. In 147 patients with noninflammatory carcinoma, the local failure rate, regional failure rate, distant failure rate and five-year disease free survival were all unaffected by the presence or absence of "grave signs," whether treated by irradiation alone or surgery plus irradiation. The size of the primary tumor, in patients treated with irradiation alone, influenced the rate of local failure (44% for tumors 0-8 cm and 76% for tumors greater than or equal to 8 cm) and five-year disease-free survival (30 versus 4%, respectively). Such a statistically significant difference in local failure rate or disease-free survival was not noted when treated with combined modality. N stage also influenced the prognosis in patients treated with irradiation alone since the regional failure rate increased from 9% for N0, N1 to 58% for N2, N3 patients. This was reflected in a decreased disease-free survival (4 versus 30%) for patients with advanced nodal disease who were treated with irradiation alone. No such difference was noted when the nodal disease was treated with a combination of surgery and irradiation. The 36 patients with inflammatory carcinoma had essentially the same incidence of local, regional and distant failure as the 147 patients with noninflammatory carcinoma but the appearance of distant metastases occurred significantly earlier in patients with inflammatory carcinoma than in those with noninflammatory carcinoma. This earlier appearance of distant metastases was reflected in the significantly lower disease-free survival for the patients with inflammatory carcinoma (6 versus 28%). The data from this analysis suggests that consideration should be given to removing the presence of grave signs from the current AJC staging system and substituting in its place the size of the primary tumor (less than 8 cm versus greater than or equal to 8 cm). Further analysis on a large number of patients is needed to substantitate this recommendation.

Breast Neoplasms↗
PubMed1982

Association of spermine and 4S RNA during axonal transport in regenerating optic nerves of goldfish.

Experiments were designed to determine whether polyamines are bound to 4S RNA and then transported axonally along regenerating optic axons of goldfish. In one set of experiments, inhibition of retinal RNA synthesis by intraocular injections of 10 microgram of cordycepin, blocked the axonal transport of both [3H]RNA and [14C]spermidine by about 65%, 6 and 14 days after injection. Intraocular injections of vinblastine, (0.1, 0.5 or 1.0 microgram) an agent which interrupts axonal transport of proteins, had no effect on retinal RNA synthesis nor on the amount of [14C]spermidine incorporated into the TCA-insoluble fraction of retinal extracts. However, the axonal transport of both [3H]RNA and [14C]polyamines was affected in a dose-dependent fashion; the inhibition of both was approximately 80% at the higher dose. Further evidence for an association between axonally transported 4S RNA and polyamines came from experiments in which regenerating optic axons were cut and allowed to degenerate 6 days after injection of [3H]spermidine into the eye. The loss of optic axons from the tectum 7 days after cutting the nerve resulted in an 86% loss of TCA insoluble polyamines, indicating a largely intra-axonal locus. A similar loss of 4S RNA was found in identical experiments following injections of [3H]uridine into the eye. Finally, experiments were performed in which [3H]spermidine was injected into both eyes of 12 fish whose optic nerves had been regenerating for 18 days. Six days later, fish were sacrificed and RNA was extracted from tectal homogenates by hot phenol and ethanol precipitation. The major stable RNA species were separated by SDS-polyacrylamide disc gel electrophoresis and radioactivity was determined by extraction of 2.0 mm gel slices. Results showed co-migration of 3H with 4S RNA optical density peaks, and not with 28S and 18S ribosomal RNA peaks, suggesting that some polyamine-associated radioactivity is bound to axonally transported 4S RNA. When the nature of that radioactivity was determined on an amino acid analyzer, it was found to be present primarily as spermine and not as the injected compound spermidine. The data are consistent with the hypothesis that some spermine is bound to 4S RNA and then axonally transported along regenerating axons of the goldfish optic nerve.

Animals↗
PubMed1982

[Hepatitis caused by Campylobacter coli (author's transl)].

Campylobacter coli is known to cause ulcerous enterocolitis, but hepatitis has not yet been reported. A 50-year-old woman without history of liver disease was admitted with diarrhoea, fever, poor general condition, subicterus and enlarged liver. Campylobacter coli was grown in haemoculture, and a specific antibiotic treatment resulted in complete cure. The results of haemoculture, the necrosis and polymorphonuclear infiltrates found in liver biopsies, the return to normal of biochemical tests and liver size under antibiotic therapy and the absence of any other cause of acute or chronic liver disease are strong arguments in favour of the hepatitis being caused by Campylobacter coli in this patient.

Campylobacter Infections↗
PubMed1982

Stage III and localized stage IV breast cancer: irradiation alone vs irradiation plus surgery.

One hundred forty-seven patients with non-inflammatory, Stage III and IV cancer were treated with irradiation alone (54 patients) or with a combination of irradiation and mastectomy (93 patients). In the T3 category, the local failure rate was 45% (5/11) for the irradiation alone patients vs 12% (3/25 for the irradiation plus surgery patients; in the T4 category these figures were 65% (28/43) vs 13% (9/68), respectively. Corresponding local failure rates by size of primary tumor were 50% (2/4) vs 15% (5/29 for tumors 0-5 cm, 43% (9/21) vs 14% (6/45) for 5-8 cm tumors, and 75% (22/29) vs 5% (1/20 for tumors greater than or equal to 8 cm. The rates of regional failure for the two treatment methods were compared according to N stage; they were 9% (2/23) for irradiation alone vs 11% (8/76) for irradiation plus surgery in the N0-1 category, and 58% (18/31) vs 18% (3/17), respectively, for the N2-3 category. A dose response analysis for patients with tumors greater than 5 cm treated with irradiation alone did not show a decrease in local failure rate with increasing total tumor dose over a range of 4000 to 7000 rad, suggesting that doses in this range are too low for these large tumors. Since a significant late complication rate has been reported with doses higher than this, patients with non-inflammatory, but large (greater than 5 cm) tumors, should be treated with a combination of surgery and irradiation whenever possible to achieve maximum local-regional control with a minimum probability of complications. In 36 patients with inflammatory carcinoma, the rates of local and regional failure were 52% (15/29) and 38% (11/29), respectively, for patients treated with irradiation alone, and 14% (1/7) and 29% (2/7), respectively, for patients receiving irradiation plus surgery. Since none of these differences were statistically significant, one cannot conclude that surgery should necessarily play a role in the treatment of inflammatory carcinoma.

Breast Neoplasms↗
PubMed1981

Pubertas praecox in craniopharyngioma. Case report.

A case of craniopharyngioma associated with true precocious puberty is reported in a child operated on when she was 2 years and 8 months of age. Precocity was noted 10 months after operation and was fully documented 1 year later. A pneumoencephalogram showed a recurrence of tumor in the hypothalamic area. Hormonal therapy was instituted to stop sexual maturation. Reoperation was undertaken only when her visual symptoms reappeared. She received a postoperative course of radiotherapy. On last examination, she was neurologically well, and computerized tomography did not show further growth of the residual tumor. The diagnosis of precocious puberty and its etiology in this patient are discussed.

Child, Preschool↗
PubMed1981

Survival after metastasis in osteosarcoma.

We analyzed survival patterns of 106 patients with metastatic osteosarcoma treated at the M. D. Anderson Hospital from 1954 to 1975. All were 20 years of age or less, had a confirmed diagnosis of medullary osteosarcoma (excluding mandibular and radiogenic osteosarcoma), and had developed evidence of metastasis at diagnosis or during treatment. Clinical characteristics evaluated statistically as possible prognostic factors in postmetastatic survival were: age at diagnosis, sex, race, site or primary, site of first metastasis, year of diagnosis, and time from diagnosis to metastasis. Two factors, year of diagnosis and time to metastasis, showed statistically significant association with postmetastastic survival. Those patients treated in 1971 or later (62) had significantly longer postmetastatic survival times than those (44) treated in 1970 or earlier (P = 0.002). Also, 14 patients who developed metastasis 1 year or more after diagnosis had significantly longer postmetastatic survival times than the 19 with metastasis at diagnosis (P = 0.002) or the 73 who developed metastasis during the 1st year after diagnosis (P = 0.005). Analysis also indicated a statistically significant interaction effect between the two factors (P = 0.093) that suggested the time to metastasis had a greater influence on postmetastatic survival time in those diagnosed in 1971 or later than in those diagnosed earlier.

Adolescent↗
PubMed1980

Combined modality treatment of localized small-cell lung carcinoma. A randomized prospective study of the Southeastern Cancer Study Group.

Seventy patients with small-cell lung carcinoma limited to the thorax +/- ipsilateral supraclavicular lymph nodes were randomized to either of two study arms: 33 patients received radiation therapy (RT) alone consisting of 4500 rads in 5-6 weeks to primary tumor and regional lymph nodes, and 3500 rads in 2 1/2 weeks to brain as prophylaxis; 37 patients received, in addition to the RT above, chemotherapy (CT) with cyclophosphamide (500 mg/m2), Adriamycin (50 mg/m2), and DTIC (250 mg/m2) every 3 weeks given in two cycles before RT and seven cycles post-RT. Patients receiving RT alone who showed recurrence were crossed over to receive CT as above. Of 23 patients receiving RT alone who were evaluable 17 or 74% were responders; seven of these responses were complete (30%). On the RT and CT arm, of 24 evaluable cases, the response rate was 75%, of which 12 (50%) were complete. The median duration of disease-free survival of patients receiving RT + CT was 27 weeks, which ws superior to that of patients receiving RT alone (9.9 weeks, p = 0.019). The median survival of responders was essentially the same on both treatment arms; RT + CT, 47.7 weeks vs. RT alone, 50 weeks (p = N.S.).

Adult↗
PubMed1979

Evaluation of overall toxicity of high-dosage methotrexate regimens.

The occurrence of overall toxicity was analyzed for 43 patients with osteosarcoma who received 349 high-dosage courses of methotrexate (HD-MTX) with citrovorum factor (Leukovorin) "rescue" (CF). The dosages of HD-MTX ranged from 50 to 350 mg/kg. Overall toxicity was assessed on the basis of five manifestations of toxicity: stomatitis, dermatitis, myelosuppression, liver dysfunction, and kidney function abnormalities. The great majority (91.4%) of the infusions were well tolerated, but 8.6% were associated with moderate or severe toxicity. Stomatitis and serum glutamic-oxaloacetic transaminase (SGOT) changes were the most frequent postinfusion findings. Three patients died from causes related to MTX toxicity. Dose, age, sex, and number of prior infusions were investigated by logistic regression analysis for prognostic effect on frequency of moderate to severe overall toxicity. Age and number of prior infusions had significant (P less than 0.06) effects on overall toxicity. Patients older than 15 years with greater than 10 prior infusions constituted the "high risk" group with a risk of moderate to severe toxicity 6.3 times that of the younger patients with fewer than 10 infusions.

Adolescent↗
PubMed1979

Detection of Haemophilia A carriers by replicate factor VIII activity and factor VIII antigenicity determinations.

Factor VIII (fVIII) activity and antigenicity were determined on replicate fresh blood samples drawn on three separate occasions in 48 normal females and 37 obligatory haemophilia A carriers, in an attempt to improve the detection rate. fVIII activity was assayed by a one-stage method and fVIII antigenicity by the Laurell's technique employing an anti-fVIII antiserum prepared in rabbits. The mean results for the individual subjects were analysed after establishing a discriminant function. The probability of being a carrier was determined on the basis of laboratory data and family history. The probability data were translated into more simple terms applicable for genetic counselling by defining three categories: Definite carriers, doubtful carriers and definite normals. Of the obligatory carriers, 83.8% were classified definite carriers, 13.5% doubtful carriers and 2.7% as definite normals. Of the normal females, 4.2% were classified as definite carriers, 18.7% doubtful carriers and 77.1% as definite normals. Adjustment of the results according to age was found unnecessary. The precision of the determinations of fVIII antigenicity and fVIII activity in individual subjects was calculated for different numbers of replicate tests performed in the same individual. It was found that if only one test is performed, a substantial error might occur. Three replicate tests considerably diminish this error, although it is still in the range of +/- 16--29%. For suspected carriers who fall in the doubtful category it is suggested that six or even more tests are performed.

Adolescent↗
PubMed1979

Age-related pharmacokinetics of high-dose methotrexate in patients with osteosarcoma.

Plasma methotrexate (MTX) concentrations were determined in 52 patients after 409 infusions of high-dose (HD) (50-250 mg/kg) MTX with citrovorum factor (CF) rescue. In addition, detailed pharmacokinetic studies were conducted in nine of these patients. Plasma drug levels were compared at 6, 24, 48, and 72 hours from the start of MTX infusions in four different age groups (less than or equal to 10, 11-14, 15-17, and greater than or equal to 18 years of age). At the same drug dose, the younger patients had lower plasma MTX levels than the older patients at 6 and 24 hours. This difference increased in significance with increasing MTX dose. However, MTX plasma levels became similar at 48 and 72 hours, regardless of age. The half-life for the first phase of biphasic MTX clearance in children was shorter than that in adults. In addition, the urinary excretion of MTX was faster in younger children at all doses. The younger patients had a greater apparent volume of distribution of MTX after HD infusion. These results indicate that the age-dependent pharmacokinetics can be attributed to greater distribution and elimination of MTX in the younger patients. The potential difference in the metabolism of MTX between children and adults is currently under investigation. Our observations suggest that age exerts a dominant effect on the pharmacokinetics of HD-MTX.

Adolescent↗