Biomedical subjects

E E Sterns

Publications and source records attributed to E E Sterns.

At least 37 records · Page 2Linked to original sources

PubMed1991

Thermography as a predictor of prognosis in cancer of the breast.

Although thermography is generally considered to lack sufficient sensitivity to be a useful in diagnosis of cancer of the breast, the association of a thermal abnormality with some breast cancers cannot be discounted. Breast cancers demonstrating such a thermographic abnormality have been reported to be associated with decreased survival when compared with patients with no such change. In a study of 214 patients confirmed to have breast cancer without distant metastases, 121 were found to have a thermographic abnormality. Patients whose tumors were thermographically abnormal had significantly larger primary lesions and a higher proportion of metastatic axillary lymph nodes. However, both the 5-year survival and the 5-year disease-free survival were not significantly different from patients who had no thermographic abnormality.

Breast Neoplasms↗

PubMed1991

Bilateral cancer of the breast: a review of clinical, histologic, and immunohistologic characteristics.

The clinical, histologic, and immunohistologic characteristics of 19 synchronous and 47 metachronous bilateral breast cancers was compared. Patients with metachronous tumors were 5 years younger and more likely to have a family history of breast cancer than those patients with synchronous cancers. The nondominant synchronous cancer was usually discovered mammographically accounting for small, node-negative tumors, and high prevalence of in situ lesions. The same was true of the second metachronous tumor when discovered mammographically. Patients with metachronous cancers who were not in a follow-up program had second cancers with characteristics similar to incidentally diagnosed unilateral cancer. The mean interval between metachronous cancers was 101 months. Significantly more first metachronous tumors were invasive lobular cancers. Histologic type of the first and second tumor was the same in only 68% of synchronous and 61% of metachronous cancers. Combined histologic evidence and differentiation was concordant in only 13% and 22% of tumors, respectively. Immunoperoxidase studies were performed with two human milk fat globule antibodies. Each antibody reacted similarly in the first and second tumor in less than 50% of tumors and concordance was less than 25% when both antibody reactions were assessed. Differences in histologic evidence, differentiation, and immunohistologic reaction suggest that both synchronous and metachronous cancers are morphologically and functionally dissimilar.

Adult↗

PubMed1989

Prognostic significance of pregnancy in stage I melanoma.

The clinical course of 66 patients with stage I melanoma, diagnosed during pregnancy, treated in the Division of Surgical Oncology at UCLA, was retrospectively reviewed. These patients were compared with 619 nonpregnant female patients with melanoma. There was no significant difference between the pregnant population and control population with respect to location of the primary tumor, age at diagnosis, Clark's level, mean depth of invasion (pregnant females, 1.24 mm vs control, 1.28 mm), and histologic type. The 5-year survival for the women diagnosed with melanoma during pregnancy and for the entire population was 86% and 87%, respectively. These results demonstrate that women diagnosed with melanoma during pregnancy fare no worse than their nonpregnant counterparts. Criteria other than the theoretical effect of pregnancy on the tumor should be used to counsel patients diagnosed with melanoma during pregnancy.

Adolescent↗

PubMed1989

Monoclonal antibodies in the diagnosis and treatment of carcinoma of the breast.

In relative terms, biologic research with Mab has reached early middle age. Information on the behavior of Mab in disease of the breast is interesting--indeed, tantalizing--in many areas, but practical applications for diagnosis and treatment are not yet available. The evidence implies that it will be forthcoming.

Antibodies, Monoclonal↗

PubMed1985

Effects of tamoxifen on testosterone metabolism in postmenopausal women with breast cancer.

Testosterone is a known estrogen precursor especially in postmenopausal women. Tamoxifen, an anti-estrogen, is used in the treatment of women with breast cancer in whom metastatic disease has been demonstrated. The action of Tamoxifen is thought to be to occupy the intracellular estrogen receptor sites in target tissues and thus block the action of the biologically active estrogen, estradiol. Effects of Tamoxifen on the production and metabolism of hormones have been postulated. We studied the kinetics of testosterone metabolism by the constant infusion of 3H-testosterone in six postmenopausal women with breast cancer prior to and during Tamoxifen therapy. The Tamoxifen did not produce any significant change in the metabolic clearance rate, the plasma concentration or the calculated blood production rate of testosterone. The only significant alteration in the conversion ratio of testosterone to metabolites was the reduction (p less than 0.02) in conversion to 5 alpha-dihydrotestosterone. A significant reduction in the plasma concentrations (p less than 0.05) of dehydroepiandrosterone and of luteinizing hormone (p less than 0.02) was found. Other steroid and peptide hormones did not show any significant changes. We conclude that Tamoxifen therapy has very little effect on the kinetics of testosterone metabolism in postmenopausal women with metastatic breast cancer.

Aged↗

PubMed1985

Delayed intestinal perforation after nonpenetrating abdominal trauma.

The incidence of hollow-organ injury has increased steadily since the use of seat-belts was introduced. It has become apparent that the clinical manifestations of intestinal injury may be delayed considerably. Delayed perforations can pose a diagnostic challenge to the attending surgeon. The authors report four patients who suffered delayed intestinal perforation 6 or more days after sustaining nonpenetrating abdominal trauma in motor vehicle accidents while wearing passive seat-belt restraints. All patients had low severity of injury (scores ranging from 4 to 13) but had persistent vague abdominal pain before perforation occurred. Three of the four patients suffered spinal trauma as their major initial injury. Such patients appear to be at higher risk for delayed perforation and should be monitored carefully.

Abdominal Injuries↗

PubMed1982

Thermography in breast diagnosis.

The role of two types of thermography in the diagnosis of breast disease was studied in 502 women seen over a two-year period. Thirteen cancers were diagnosed in eleven women. The most significant finding was the large number of equivocal or abnormal thermograms in women with normal breasts of benign disease, while in patients with proven cancer, the thermogram was abnormal in less than half. Clinical diagnosis of breast cancer was not enhanced by either or both types of thermogram. Despite specific criteria, thermographic interpretation was inconsistent except in the thermograms reported as "normal." On the basis of the findings, the authors could not recommend that an abnormal thermogram be used as an indication for mammography, since this would result in an inordinate number of these studies, particularly in young women. The findings suggest that thermography is not a sufficiently precise modality for use in routine breast diagnosis.

Adult↗

PubMed1982

Effects of aminoglutethimide on delta 5-androstenediol metabolism in postmenopausal women with breast cancer.

delta-5-Androstene-3 beta, 17 beta-diol has potential estrogenic activity because it is known to bind to receptors and translocate to the nucleus of certain estrogen target tissues. Its role in the biology of breast cancer is unclear. Aminoglutethimide plus hydrocortisone ("medical adrenalectomy") has been used to treat postmenopausal women with metastatic breast cancer. We studied delta 5-androstene-3 beta, 17 beta-diol metabolism in postmenopausal women with breast cancer before and during aminoglutethimide-plus-hydrocortisone therapy, utilizing the constant infusion technique. The metabolic clearance rate for five subjects was 799 +/- 89 liters/24 hr (470 +/- 47 liters/24 hr/sq m) before and 751 +/- 93 liters/24 hr (444 +/- 57 liters/24 hr/sq m) during therapy. Plasma delta 5-androstene-3 beta, 17 beta-diol and delta 5-androstene-3 beta, 17 beta-diol free index decreased despite absence of change in the metabolic clearance rate. Increased dehydroepiandrosterone/delta 5-androstene-3 beta, 17 beta-diol conversion ratios in individual patients suggested an increase in 17 beta-hydroxysteroid dehydrogenase activity during therapy. There were no alterations in the formation of the estrogen precursors testosterone and delta 4-androstene-3,17-dione.

Adenocarcinoma↗

PubMed1982

Is aminoglutethimide an alternative to adrenalectomy for metastatic carcinoma of the breast?

Aminoglutethimide inhibits steroid synthesis by the adrenal gland and the peripheral conversion of androgens to estrogens. As such it has been recommended in the place of adrenalectomy for the treatment of advanced breast cancer. Aminoglutethimide with hydrocortisone was given to 19 women with metastatic cancer of the breast whose disease was progressive, who would otherwise have undergone adrenalectomy and whose potential for response was good. Four patients could not tolerate the drug and seven failed to respond. Eight women had an objective response, complete in two and partial in four. In two patients the disease stabilized. The period of treatment ranged from 11 to 26 months but three patients are still on treatment after 26 months. The authors conclude that aminoglutethimide has a place in the management of women with advanced breast cancer who satisfy the criteria for hormone manipulation.

Adrenalectomy↗

PubMed1981

Estradiol receptor levels in human breast carcinomas.

The presence or absence of a specific estradiol-binding protein receptor in the cytoplasm of primary and secondary tumour cells has been used by physicians as an important guide in deciding whether to use hormonal therapy for patients with metastatic breast cancer. This report gives the levels of estradiol receptors in the cytosol of 228 primary and secondary breast tumours, measured by a sensitive multiple-point assay in which dextran-coated charcoal separated bound form unbound estrogen. The data were analysed with a Scatchard plot. Of the 175 primary and 53 secondary tumours 53% and 32% respectively gave positive results. The mean receptor level in the primary tumours was significantly higher among older patients and increased with age. With metastatic lesions positive results were more common in lymph node samples tha in skin nodule samples.

Adult↗

PubMed1981

Plasma concentrations of C-19 steroids, estrogens, FSH, LH and prolactin in post-menopausal women with an without breast cancer.

The plasma levels of 5 alpha-dihydrotestosterone, testosterone, delta 5-androstene-3 beta-17 beta-diol, delta 4-androstenedione, dehydroepiandrosterone, estrone, estradiol, dehydroepiandrosterone sulfate, follicle stimulating hormone, luteinizing hormone and prolactin were measured in normal post-menopausal women and in post-menopausal women with proven breast cancer. The mean prolactin level was significantly higher (p less than 0.01) and the mean 5 alpha-dihydrotestosterone level lower (p less than 0.05) for the women the breast cancer. There were no significant differences for any of the other hormones. As well, there were no significant differences for the extent of binding of testosterone and delta 5-androstene-3 beta, 17 beta-diol to plasma proteins between the two groups of subjects.

Aged↗

PubMed1981

Incidental appendectomy?--Yes.

A consecutive group of 100 patients over the age of 40 years, who were operated upon for histologically proven acute appendicitis, were reviewed. Although there were no deaths, 36 had complications, of which 30 were related to wound infection. Thirty-one patients were found at operation to have perforation. Of these 100 patients, 13 could have had their appendices removed previously at the time of an elective laparotomy. The morbidity of incidental appendectomy was reviewed in 200 randomly selected patients, also over the age of 40 years, who underwent either elective hysterectomy or cholecystectomy. Half had an incidental appendectomy and the other half did not. The indication for appendectomy was the preference of the surgeon. There was no important difference in operative or postoperative problems in the two groups of patients. The authors conclude that incidental appendectomy is a worthwhile and safe procedure unless there are specific contraindications.

Acute Disease↗

PubMed1975

The difference in the clearance of interstitial albumin by the lymphatics from the stomach and the small and large intestine.

The capacity of the lymphatics to clear interstitial albumin was compared between the stomach, small intestine, and colon. The lymphatic and vascular transport in the stomach and colon was similar, clearing approximately 9 per cent of interstitially injected radioiodinated serum albumin by the thoracic duct lymph and 2 to 3 per cent by the blood in a five hour period. More than a third of the injected material remained at the site of injection. The small intestine was cleared of 37 per cent of the albumin by the lymph and more than 6 per cent by the blood, leaving less than 9 per cent at the injection site in the same period of time. Evidence that the small intestine was more effective and rapid in clearing interstitial albumin than either the stomach or colon was statistically significant.

Albumins↗

PubMed1974