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Biomedical subjects

E G Elias

Publications and source records attributed to E G Elias.

At least 19 recordsLinked to original sources
PubMed1994

Survival differences between black and white women with breast cancer.

Several reports have indicated that black women with breast cancer have a poorer prognosis than white women. To investigate this phenomenon and to identify some of the underlying reasons, 172 patients with infiltrating ductal carcinoma of the breast, who were managed similarly, were studied. Survival analysis comparing the two populations with breast cancer revealed that white women had significantly longer overall survival (OS), P = 0.015 by Wilcoxon and 0.019 by log-rank, and borderline significantly longer disease-free survival (DFS), P = 0.04 by Wilcoxon and 0.07 by log-rank. While there was no significant difference in OS and DFS between the two groups with negative nodes, significantly poorer DFS and OS was noted in black patients with one to three positive lymph nodes compared to white patients, P = 0.008. The white patients had a higher incidence of hormone receptor-positive tumors, especially progesterone receptor (P = 0.0016). However, survival analysis failed to show any difference between the black and the white populations based on hormonal receptors. Such findings suggested that further investigation of other factor(s) is warranted.

Adult↗
PubMed1994

Breast cancer prevention trial.

The incidence of breast cancer continues to rise and now affects one in eight women, despite major early-detection efforts. The Breast Cancer Prevention Trial (BCPT), under the auspices of the National Surgical Adjuvant Breast and Bowel Project (NSABBP), will evaluate the effect of tamoxifen in reducing the incidence of invasive breast cancer, breast cancer mortality, cardiovascular mortality, and bone fractures. A total of 16,000 healthy women 35 years of age or older will be randomized to receive tamoxifen or a placebo over a five-year period. As of March 1993, 42% of the needed study participants had been enrolled in the trial. The University of Maryland is participating in the BCPT, and Maryland physicians can refer potential study participants to 12 locations throughout Maryland.

Adult↗
PubMed1992

Immediate mandibular stabilization following resection of advanced oral cavity carcinoma using the Joe Hall Morris external fixation device.

Internal mandibular fixation after resection of advanced oral cavity carcinoma with mandibulectomy has a significant complication rate. We placed the Joe Hall Morris (JHM) external mandibular appliance in 29 patients undergoing mandibulectomy for advanced oral cavity carcinoma. Fourteen patients received postoperative radiation therapy (RT). Three of 29 patients (10%) had complications associated with the JHM appliance: one patient had a broken connecting bar, a second had loosening of a single pin, and a third had loss of fixation requiring complete replacement of the appliance. Complications not associated with the appliance occurred in 8 patients (28%) including mandibular exposure (1), orocutaneous fistula (2), partial flap dehiscence (4), and flap necrosis (1). Oral continence was maintained in 26 patients, and occlusion was normal in 27. The appliance was removed in 12 weeks to 6 months in all patients. The JHM appliance allows for a reliable and rapid immediate fixation of the mandible with acceptable functional and aesthetic results, and no delay or interference with postoperative radiotherapy. Since the life expectancy of these patients is short, most do not require subsequent permanent fixation after removal of the appliance.

Adult↗
PubMed1992

Adjuvant immunotherapy in melanoma: a new approach.

Patients with metastatic cutaneous melanoma to two or more regional lymph nodes have an extremely poor prognosis despite radical lymphadenectomy. In an attempt to improve the survival and to determine the safety of a new method of tumor specific adjuvant immunotherapy in such a high risk group of patients, nine patients were studied. Three to four weeks after regional lymphadenectomy, each of them received a single intradermal injection of Bacillus Calmette-Guérin. Three weeks later, they were immunized by allogenic melanoma cells obtained from live donors with distant metastases. Each patient received three vaccinations, each from a different donor (except in one), to avoid development of HLA response, but maintaining exposure to melanoma antigens. No cultured melanoma cells were used. Each vaccine consisted of mitomycin-C treated tumor cells mixed with purified protein derivative (PPD) of tuberculin given intradermally once per month for 3 months. The patients were then observed with no further treatment. Utilizing the leukocyte migration inhibition test, there was some in vitro evidence of tumor specific cell mediated response which seemed to disappear 1-2 months postimmunization. At 5 years, five of the nine patients (55%) were alive free of disease. No autoimmune diseases were detected in any of the immunized patients. A major hindering factor for such an approach was the limited availability of the allogenic melanoma cells.

Adult↗
PubMed1992

Complications of operative and endoscopic gastrostomies.

In a retrospective study of fifty cases of gastrostomy insertion performed operatively (OG) or using a percutaneous endoscopic approach (PEG), complication rates were 74 percent (nineteen adults) and 76 percent (seventeen children) in the OG group, and 86 percent (fourteen adults) in the PEG group. While most complications were minor, major ones were usually related to the underlying disease and the general condition of the patient.

Adult↗
PubMed1992

Cancer prevention.

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Drug Therapy↗
PubMed1991

An immunological aspect of melanoma and its potential application in adjuvant therapy.

In an attempt to understand some of the natural immunological characteristics of cutaneous melanoma so that we can plan justifiable immunotherapeutic approaches, 23 patients were studied. The autologous leukocyte migration inhibition assay was utilized to assess in vitro their tumor-specific cellular immunity. This assay was specifically used because when presensitized lymphocytes are exposed to the same antigen, they release lymphokines which inhibit the natural migration of the leukocytes. All the patients were staged pathologically according to the TNM system. Twelve of them had regional metastasis, i.e., stage III, and underwent regional lymphadenectomy. The other 11 had distant metastases, i.e., stage IV disease, and all their gross tumors were resected. These 23 patients were the source of tumor material and peripheral blood. Fresh autologous leukocytes were obtained for the assays, from each patient, on the day of surgery and prior to the administration of the preoperative medications. These were tested in vitro, on the same day, with freshly prepared autologous tumor extracts as the source of autologous tumor antigens. The results revealed that the preoperative leukocytes of patients with stage III melanoma expressed hypersensitivity to their tumors, with significant inhibition of their leukocyte migration, compared to those with distant metastases who expressed no such sensitivity, P = 0.012. Such hypersensitized lymphocytes may be capable of producing more efficient lymphokine activated killer (LAK) cells for an effective adjuvant adoptive immunotherapy.

Adjuvants, Immunologic↗
PubMed1991

Long-term results of a combined modality approach in treating inflammatory carcinoma of the breast.

Twenty-eight patients with inflammatory carcinoma of the breast were managed initially by induction chemotherapy consisting of 3 courses of a combination of cyclophosphamide, doxorubicin hydrochloride, and 5-fluorouracil. Twenty-two showed a partial response, and 21 underwent mastectomies. Histopathologic examination of the surgical specimens revealed no residual tumor in 2 breasts, but all 21 patients had residual metastases in their axillary lymph nodes. Postoperatively, they received the same chemotherapy. The other six patients who failed to respond to induction chemotherapy received radical radiation therapy followed by a combination chemotherapy regimen that consisted of cyclophosphamide, methotrexate, 5-fluorouracil, vincristine, and prednisone. Any patient in whom chemotherapy failed during the follow-up period was treated by radiation therapy and/or a combination of mitomycin-C and vinblastine as necessary. At the time of diagnosis, 17 patients who had no evidence of distant metastasis, i.e., stage III B disease, had disease-free survival ranging from 5 to more than 84 months, with a median of 30 months, and an overall survival of 7 to more than 120 months with a median of 32 months. The 5-year survival rate was 18%. The other 11 patients who had distant metastases, i.e., stage IV disease, had an overall survival ranging from 4 to 14 months. The results of this approach of initial systemic chemotherapy followed by local-regional cytoreductive therapy, then systemic therapy, might suggest some survival benefits in patients with stage III disease.

Adult↗
PubMed1991

Gastric tumors.

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Biomarkers, Tumor↗
PubMed1991

Metastatic basal cell carcinoma.

Metastatic basal cell carcinomas of the skin are rare tumors. Early excision of the primary lesion remains the best method of treatment, although unresectable tumors can be controlled by radiation therapy. Patients with regional lymph node metastases can be managed by radical lymph node dissection, while those with systemic metastases can be palliated by a combination of chemotherapy, radiation therapy, and surgery.

Aged↗
PubMed1990

Resolution of inferior vena cava syndrome after embolization of a hepatic adenoma.

A 77-year-old man presented with severe pruritus and massive lower body edema. Computerized axial tomography of the abdomen showed a large hepatic mass compressing the inferior vena cava, and a liver biopsy specimen showed hepatic adenoma. Embolization of vessels feeding the hepatic tumor resulted in complete resolution of pruritus and ascites, and clinical remission has persisted for 1 year following partial obliteration of tumor vasculature. Angiographic ablation of tumor blood supply represents a nonoperative means for inducing clinical remission in patients with symptomatic hepatic adenoma who are at high surgical risk.

Adenoma↗