The term spindle cell lesion, or tumor, is a purely descriptive one and if applied without further qualification is meaningless as a guide to therapy and prognosis. The three lesions presented in this report--sarcomatoid carcinomas, nodular fasciitis, and fibrosarcoma--serve to illustrate this point. One, the sarcomatoid carcinoma, is an epithelial malignancy in which the majority of the sarcoma-like spindle cells are believed to be variants of the epithelial cells. Nodular fasciitis, a self-limited and benign soft tissue lesion, is composed principally of myofibroblasts. Primarily an extramucosal lesion, it presents a pseudosarcomatous microscopic appearance. Fibrosarcomas represent the other end of the spindle cell lesion spectrum in that they are soft tissue malignancies of fibroblastic origin. Clinical, pathologic, and biologic implications of these lesions when they arise in the mucosae of the upper aerodigestive tracts of the head and neck are presented.

Carcinoma↗

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Reduction in the incidence of early rejection in cadaveric renal allograft recipients treated with ATGAM induction and sequential mycophenolate mofetil.

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Adolescent↗

PubMedDate not supplied

Warthin's tumor: a functional immunologic study of the lymphoid cell component.

The origin and nature of the lymphoid cell component of Warthin's tumor are controversial. The present report describes the application of immunologic functional testing to the study of Warthin's tumor lymphocytes. Numbers of B and T cells are comparable to those of other lymph nodes. A vigorous stimulatory response to phytohemagglutinin reflects the predominance of functional T cells. These findings, in conjunction with morphologic observations, support the concept that the lymphoid component of Warthin's tumor is derived from a pre-existing lymph node.

Adenolymphoma↗

PubMedDate not supplied

Safety, tolerability, antiemetic efficacy, and pharmacokinetics of oral dolasetron mesylate in pediatric cancer patients receiving moderately to highly emetogenic chemotherapy.

PURPOSE: The safety, antiemetic efficacy, and pharmacokinetics of single oral doses of dolasetron, a new highly selective 5-HT3 receptor antagonist, were evaluated in children with cancer undergoing treatment with moderately to highly emetogenic chemotherapy. PATIENTS AND METHODS: A total of 32 children, ages 3 to 18 years, were enrolled in a nonrandomized, multicenter, open-label, dose-escalation study. Three oral dose levels (0.6, 1.2, or 1.8 mg/kg) were studied. Safety, efficacy, and pharmacokinetic parameters were assessed over 24 hours at each dosage level. RESULTS: The most effective dose was 1.8 mg/kg; 60% of the patients achieved a complete or major response (< or =2 emetic episodes in 24 hours). A complete response was achieved in 3 of 9 patients (33%) who received 0.6 mg/kg, 4 of 13 (31%) patients who received 1.2 mg/kg, and 5 of 10 (50%) patients who received 1.8 mg/kg of dolasetron. Overall, dolasetron was well tolerated. Adverse events were mild and similar to those reported in adults. Peak plasma concentrations (Cmax) of dolasetron's active reduced metabolite, MDL 74,156, were dose proportional and occurred, on the average, within 1 hour of oral administration. The half-life (t1/2) in plasma was approximately 6 hours for all dose levels, and the mean clearance (CLapp) was unrelated to dose. CONCLUSIONS: Oral dolasetron is safe and effective in reducing chemotherapy-induced nausea and vomiting, particularly at the 1.8-mg/kg dose level. These results support further evaluation of oral dolasetron in larger randomized clinical trials in the pediatric cancer population.

Administration, Oral↗

PubMedDate not supplied

Hodgkin's disease: contemporary classification and correlates.

The current histologic classification of Hodgkin's disease into lymphocyte predominance, nodular sclerosis, mixed cellularity, and lymphocyte depletion forms is practical, reproducible by pathologists, and correlates with extent and course of disease. Such a classification, however, is only a step toward complete understanding of this often enigmatic disease.

Adult↗

PubMedDate not supplied

Comparative evaluation of a new inhalation anesthetic, BAX-3224, and halothane in Macaca speciosa.

Two groups of 8 monkeys were anesthetized with either BAX-3224, a new fluorinated methyl-propyl ether, or with halothane, 3 hours daily for a total of 30 hours. Vomiting incidence was 12.5 percent with BAX-3224 during both induction and recovery, compared with 3.7 percent for halothane during induction and 7 percent for halothane during recovery. Induction time did not change during the course of study with either agent. Respiration was spontaneous and cardiopulmonary function was stable. Electroretinographic (ERG) responses were consistent, flicker-light responses similar, but visual evoked responses (VER) were not present during BAX-3224 anesthesia. A 33 percent incidence of electroencephalographic (EEG) silence occurred with BAX-3224, which was consistent with absence of VER. Hematologic and serum chemistry values were similar for both agents. Serum fluoride ion concentrations, measured before exposure and 4 times during the 10-day study, did not change after administration of either agent. This finding was significant for BAX-3224, a fluorinated ether. No cardiac arrhythmias were observed during BAX-3224 anesthesia, compared with a 17 percent incidence during halothane induction. Recovery time was 32 minutes following BAX-3224 and 14 minutes after halothane. BAX-3224 produced anesthesia similar to that of halothane, did not induce changes incompatible with recovery from anesthesia, and showed great potential as a new volatile liquid anesthetic agent with excellent biologic stability.

Anesthesia, Inhalation↗

PubMedDate not supplied

Non-Hodgkin's lymphomas: contemporary classification and correlates.

Recent advances in immunology have resulted in an entirely new approach to the classification of the non-Hodgkin's lymphomas based on immune function. Previous classifications, still in use today, are based on morphology and although prognostically useful, are imprecise and include diverse disease entities. The present report reviews the evolution of these classifications and emphasizes the prognostic, therapeutic, and conceptual advantages of the functional (immunologic) approach to the study of lymphomas.

B-Lymphocytes↗