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Biomedical subjects

E Robinson

Publications and source records attributed to E Robinson.

At least 199 records · Page 11Linked to original sources
PubMed1989

[Treatment of stage I malignant melanoma].

In 259 patients with malignant melanoma of the skin referred here during 1973-1984, the median follow-up was 46 months. Of 182 with stage I disease, 97 (53.2%) were women and 85 men. Of these, 90.1% were Jews of European extraction and 8.2% were Jews of Asian-African extraction, while only 1.8% were non-Jews. 171 (94%) of the patients were treated by wide excision, with or without skin graft, as primary treatment, while 11 had limited local excision. In 16.4% the primary tumor was located on the upper limbs, in 34.6% the lower limbs, in 27.5% the trunk and in 19.2% the head and neck. 5-year survival was 70%. The 5-year actuarial survival was significantly influenced by: age (those under 50 had better survival, 79.5% vs 58.4%, p less than 0.05); by site of the primary lesion (88.5% for those of the upper limbs vs 59.4% for those of the lower limbs), p less than 0.01]; by depth of invasion as seen microscopically (81.2% for Clark I-II vs 52.8% for Clark IV-V, p less than 0.02); and by site of recurrence (43.4% if local vs 0 for distant, p less than 0.02).

Actuarial Analysis↗
PubMed1989

[Delay in the diagnosis of malignant melanoma].

We investigated delay in the diagnosis of malignant melanoma using the files of 180 patients diagnosed from January 1979 through October 1980, and interviewed 103 of the patients. 62% of the patients sought medical help more than 6 weeks after the appearance of symptoms, and the median delay was 6 months. There was no correlation between delay in diagnosis and sex or country of origin. Those in whom the primary tumor had bled were diagnosed earlier than those with other initial symptoms. Those with some knowledge of the signs of skin cancer did not seek medical care earlier than those without. The most frequent reasons for delay in diagnosis were that patients thought the lesions were insignificant or that they would heal without medical intervention. The first physician most patients consulted was their family physician or a dermatologist. Most family physicians (85%) immediately referred the patient to a dermatologist or plastic surgeon. 30% of the dermatologists did not refer the patient immediately for surgery, thus delaying diagnosis and treatment. Education of the public, and of physicians as well, is needed in the prevention and early detection of malignant melanoma.

Dermatology↗
PubMed1989

Clinical aspects of multiple primary neoplasms.

We review the medical literature for the clinical characteristics of patients developing multiple primary neoplasms (MPN). Also, preliminary results of our study at Memorial Sloan Kettering Cancer Center are reported. Although there have been very few specific reports on this topic, it was possible to find some data, suggesting a worse prognosis for patients with MPN. Several factors may be responsible for this, and further studies are in progress. Meanwhile, it is of great importance to decrease the incidence of cancer by prevention, such as reducing smoking and alcohol consumption. This may reduce the incidence of first primary neoplasms and MPN. Optimal treatment for the first primary neoplasm should be given, but the possible risk of MPN should be taken into consideration, and, if there are two alternatives for the treatment of the first tumor, the one that is less carcinogenic and that will allow appropriate therapy for a second primary neoplasm (MPN2) should be chosen. On follow-up of cancer patients, a low threshold of suspicion for a second primary neoplasm is recommended to detect them early for possible curative treatment. Because of the poor prognosis, more aggressive treatment regimens for MPN are warranted.

Breast Neoplasms↗
PubMed1989

Results of radiotherapy in stage I to II extranodal non-Hodgkin's lymphoma of the head and neck.

29 patients with previously untreated clinical stage I and II extranodal non-Hodgkin's lymphoma of the head and neck received involved or extended field radiotherapy at the Northern Israel Oncology Center during the years 1968 to 1979. Complete initial locoregional control was achieved in all patients; however, 18 patients (62%) relapsed. Two of the relapsing patients (11%) had "in field" failure, and one (6%) had "marginal" failure, with no evidence of disease elsewhere. 13 of the relapsing patients (72%) failed at distant sites, and two of these (11%) both locally and systemically. 13 of 15 patients (87%) with lymphoma of Waldeyer's ring relapsed, most commonly in the abdominal cavity. Only one of seven patients (14%) with lymphoma of the paranasal sinuses recurred. The five- and ten-year actuarial survival of all patients was 50% and 46%, respectively. While patients with lymphoma of the paranasal sinuses had a survival probability of 86% at ten years, patients with disease originating in Waldeyer's ring had an actuarial ten-year survival of 18% only. The prognosis of younger patients was better than the prognosis of patients older than 65. Although this series is too small and heterogeneous to derive definite treatment recommendations, it is suggested that radiotherapy to doses of 4000 to 6000 cGy can control most local disease. The overall results of radiation therapy alone have been unsatisfactory in our patients with lymphoma of Waldeyer's ring and the parotid gland due to failure outside the locally treated area, frequently in the abdominal cavity. Precise staging procedures are needed to detect sites of occult disease which require the use of systemic chemotherapy. It is felt that adequately staged, localized, small size non-Hodgkin's lymphoma of the paranasal sinuses can be treated by radiotherapy alone without loss of curability.

Actuarial Analysis↗
PubMed1988

Gallium 67 imaging in monitoring lymphoma response to treatment.

The value of gallium 67 (Ga) imaging in monitoring lymphoma response to treatment was assessed in 25 patients with Ga-avid tumors and compared to body computed tomography (CT), chest radiographs, and palpation of tumor infiltrated peripheral lymph nodes. Ga imaging was negative in 95% (20/21) of the patients who were clinically considered to be in remission and in whom treatment was stopped. The disease did not recur during a follow-up of 12 to 26 months in 15 patients. Six patients developed recurrence of the disease 3 to 12 months after treatment was stopped. In all six patients Ga imaging became positive again at the time of the appearance of active disease. In the group of patients in remission, CT was negative in 57% (11/19), chest x-rays in 55% (6/11) and peripheral lymph nodes were palpated in none of the patients (13/13). In four patients that did not achieve remission after treatment, Ga scans were positive. Ga imaging appears useful in monitoring lymphoma response to treatment. This is probably because Ga imaging monitors tumor cell viability, whereas body CT and chest radiographs show the tumor mass, which may consist of fibrotic or necrotic tissue.

Adolescent↗
PubMed1988

Auditory brainstem evoked potentials in leprosy.

An electrophysiological study of conduction in the auditory nerve and brainstem auditory pathways using the brainstem auditory evoked potential was undertaken in a group of 47 leprosy patients. There were no statistically significant differences between mean conduction times (interpeak latencies) in the leprosy and the control groups. Abnormal interpeak latencies were encountered in 3 leprosy patients, 1 of whom had a positive serological test for syphilis. In the remaining 2 patients, caudal pathway dysfunction (I-III interpeak latency abnormality) was indicated but specific auditory nerve involvement (an abnormally prolonged I-II interpeak latency) was not demonstrated. An explanation for these findings, other than the patients' disease, was not apparent.

Adolescent↗
PubMed1988

Clinical aspects of postirradiation sarcomas.

The number of cancer patients who live longer and are cured of their disease is increasing. Many of them have received radiotherapy as part of their treatment. Postirradiation sarcoma (PIS), while still uncommon, is a complication which is appearing more frequently as the number of long-term survivors increases. Studies of the clinical characteristics of PIS, such as stage of disease, grade, survival, and prognosis, are therefore of increasing importance, and may lead to different strategies for early detection and prevention. In a literature review of PIS, we identified 344 cases with sufficient data for analysis of these clinical characteristics. In these selected cases, we found that: (a) PIS was most often diagnosed at an advanced stage and high grade; (b) most of the tumors were located in areas where radical surgery could not be performed; (c) the response rate to chemotherapy was almost always poor; and (d) most patients with PIS died from locally advanced and/or metastatic disease within a few months after diagnosis. PIS is a serious, usually fatal, late complication of radiotherapy and it should be weighed in the decision to use this modality of therapy. In the follow-up of cancer patients, a low threshold of suspicion for PIS is recommended in order to detect it early for possible resection. Because of the poor prognosis, more aggressive and investigative chemotherapeutic regimens are warranted.

Adolescent↗
PubMed1988

Type C Niemann-Pick disease. Lysosomal accumulation and defective intracellular mobilization of low density lipoprotein cholesterol.

The intracellular accumulation of unesterified cholesterol was examined during 24 h of low density lipoprotein (LDL) uptake in normal and Niemann-Pick C fibroblasts by fluorescence microscopy with filipin staining and immunocytochemistry. Perinuclear fluorescence derived from filipin-sterol complexes was observed in both normal and mutant cells by 2 h. This perinuclear cholesterol staining reached its peak in normal cells at 6 h. Subsequent development of fluorescence during the remaining 18 h of LDL incubation was primarily limited to the plasma membrane region of normal cells. In contrast, mutant cells developed a much more intense perinuclear fluorescence throughout the entire 24 h of LDL uptake with little enhancement of cholesterol fluorescence staining in the plasma membranes. Direct mass measurements confirmed that internalized LDL cholesterol more readily replenishes the plasma membrane cholesterol of normal than of mutant fibroblasts. Perinuclear filipin-cholesterol fluorescence of both normal and mutant cells was colocalized with lysosomes by indirect immunocytochemical staining of lysosomal membrane protein. Abnormal sequestration of LDL cholesterol in mutant cells within a metabolically latent pool is supported by the finding that in vitro esterification of cellular cholesterol could be stimulated in mutant but not in normal cell homogenates by extensive disruption of the intracellular membranous structures of cells previously cultured with LDL. Deficient translocation of exogenously derived cholesterol from lysosomes to other intracellular membrane sites may be responsible for the delayed homeostatic responses associated with LDL uptake by mutant Niemann-Pick Type C fibroblasts.

Cell Membrane↗
PubMed1988

Carcinoma of the nasopharynx in Northern Israel: epidemiology and treatment results.

Between 1968 and 1984, 49 patients with carcinoma of the nasopharynx were treated at the Northern Israel Oncology Center. There were 6 stage I-II patients (12%) and 43 stage III-IV patients (88%). According to ethnic origin, there were 27 (55%) non-Ashkenazi Jews, 9 (18%) Ashkenazi Jews, and 13 (27%) Arabs. This distribution is different from the percentages of these ethnic groups in Northern Israel. All patients received combined cobalt 60 and 8-10 MeV electron beam radiotherapy to the primary tumor and the entire neck. Twelve stage III-IV patients received three courses of chemotherapy using bleomycin, methotrexate, and cisplatin (BMP) prior to definitive radiotherapy. The following 5-yr actuarial survival figures were achieved: all patients, 42%; stage I-II, 63%; stage III-IV, 37%; Arabs, 53%, non-Ashkenazi Jews, 47%; Ashkenazi Jews, 22%; BMP+radiotherapy, 54%; radiotherapy alone, 42%. It is concluded that there is an ethnic-related pattern of nasopharyngeal carcinoma in Northern Israel. Prognosis is better in non-Ashkenazi Jews and Arabs with early-stage lymphoepithelioma or anaplastic carcinoma, younger than 45 yr old, and receiving more than 5,500 cGy. Chemotherapy by BMP improves initial control rates with questionable benefit to long-term survival.

Adolescent↗
PubMed1988

Analysis of PC12 cell adhesion to muscle and non-muscle cells and components of the extracellular matrix.

The relative strength of PC12 cell adhesion to monolayers of myoblasts and fibroblasts as well as to purified components of the extracellular matrix has been determined. PC12 cell adhesion to myoblasts and fibroblasts was dependent on temperature, and the relative strength of adhesion to both increased over a 4-h period. The strength of adhesion to myoblasts was consistently found to be greater than that to fibroblasts. Whereas coating tissue culture plastic with purified collagen and laminin increased its ability to support PC12 cell adhesion, coating with plasma fibronectin or gelatin reduced cell adhesion. Trypsin treatment of PC12 cells was without effect on their adhesion to collagen and laminin and only partially reduced the strength of adhesion to myoblasts. In contrast trypsinized cells showed a greatly reduced ability to adhere to fibroblast monolayers. Pretreatment of PC12 cells with NGF had no obvious effect on the ability of the cells to adhere to any of the above substrata.

Adrenal Gland Neoplasms↗
PubMed1988

Repair of radiation induced damage--dependence on oxygen and energy status.

Repair of radiation-induced sublethal damage by Chinese hamster V-79 cells is studied under conditions of different pO2 (15 ppm to 21%) and cellular energy status. Cellular ATP content and energy charge are drastically reduced when cells are deprived of both oxygen and nutrient. Both indices are within normal range when cells are provided with nutrients or trace levels of oxygen (300 ppm). When deprived of nutrient, hypoxic (15 ppm O2) cells do not repair SLD, while cells in 300 ppm O2 do. Thus, cellular SLD repair appears to be dependent on cellular energy status which in turn is sensitive to oxygen concentration. Relatedly, nutrient deprived hypoxic cells are sensitized to radiation with storage under 23 degrees C, a phenomenon which may stem from a decrease of endogenous glutathione content.

Animals↗
PubMed1988

High-dose dexamethasone and high-dose metoclopramide versus high-dose dexamethasone and sulpiride in the management of cisplatin-induced emesis.

Twenty-eight courses of combination chemotherapy including cisplatin at the dose of 50 mg/m2 were analyzed in this antiemetic randomized double-blind study. The combination of high-dose dexamethasone and high-dose metoclopramide (regimen A) was compared with the combination of high-dose dexamethasone and sulpiride (regimen B). Regimen A was found to be more effective than regimen B when the mean score for intensity of vomiting was presented in only two categories. Four patients (14.3%) treated with regimen A suffered neither from nausea nor from vomiting. No serious side effects were observed.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1988

Cisplatin ototoxicity in guinea pigs with special reference to toxic effects in the stria vascularis.

The toxic effects of cisplatin (cis-diamminedichloroplatinum [II]) on the organ of Corti are well established. Few and conflicting data on this drug's effects on the stria vascularis exist. The present study presents animal experiments on the toxic effects of cisplatin in the stria vascularis and in the organ of Corti. Cisplatin-induced toxicity in albino and pigmented guinea pigs was evaluated morphologically and functionally, using light and transmission electron microscopy as well as auditory brainstem-evoked potentials on the organ of Corti and the stria vascularis. The results showed variability in hearing thresholds, ranging from no change to hearing loss of 30 dB, and prominent damage in the organ of Corti and in the stria vascularis. The toxic effects to both the organ of Corti and the stria vascularis should be considered when cisplatin is used in chemotherapy.

Animals↗