Biomedical subjects
Publications and source records attributed to F Camacho.
16 cases of adenoma of the nipple are reviewed. Such a number of cases would indicate this tumor is probably a more common disorder than previously recognized. Histogenetic theories and nosologic position are discussed.
We describe three cases of Connective tissue nevi in disseminated tumors, similar to those referred by de Graciansky and Leclercq . Although clinically similar, their different dermopathological pictures stand out, as does the fact that one showed osteopoikilid . We review the clinical and dermopathological features, nosology, associations, differential diagnosis and therapeutic procedures.
The authors describe the uncommon coexistence of linear verrucous naevus and pigmented naevus, an association which has not been reported previously. The completely benign nature of the disorder is pointed out.
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Thirty-six patients with advanced squamous cancer of the head and neck received chemotherapy with hydroxyurea, 2 g/m2 orally two of three weeks, plus methotrexate, bleomycin, and cisplatin (MBD) on a previously established schedule. Nineteen patients had objective responses, including six complete remissions. Eight of 13 patients with regional disease without prior radiation responded, as did 1 of 3 with distant metastases without prior radiation, and 10 of 20 with recurrent disease after radiotherapy. The median duration of response in those with recurrent or metastatic tumor was 6 months, and median survival was 6.5 months. These results are no better than those previously achieved without the addition of hydroxyurea. Toxicity, however, was milder than had previously been observed with MBD, suggesting that higher doses or more intensive schedules of hydroxyurea could be safely administered together with the other three drugs.
Evidence of increasing risk of nephrotoxicity was sought in the records of 95 patients who had received 300-826 mg/m2 cumulative doses of cis-platinum in single doses of 50-75 mg/m2 every 3-4 weeks, with hydration and diuresis using mannitol and furosemide. The incidence of serum creatinine elevation to greater than 1.5 mg/dl was 4.2% per patient and 0.75% per dose, no higher than the incidence observed at lower cumulative doses. Among 54 of these patients observed for at least 3 months after cessation of cis-platinum chemotherapy, only one had later deterioration of renal function to a serum creatinine of 1.9; both kidneys had been irradiated to 1900 rad in this patient. It was concluded that cumulative, delayed or severe nephrotoxicity are not significant problems related to prolonged cis-platinum administration at moderate doses when hydration and diuretics are routinely used.
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Five cases of Woolly hair, three generalised, and two localised are reported. On the first two, we carried out trichogrammes which were studied with polarized light, and on all five, SEM (Scanning Electron Microscopy). The data obtained coincided with previous descriptions (Pseudomonilethrix images, Pili torti, Trichorrhexis nodosa, reduced hair diameter, oval section following transversal cut, and a wavy-line disposition), although we emphasize the smaller number of layers of cuticle cells following the transversal cut, and the presence of Trichonodosis, not previously refered.
Twenty-four patients with advanced squamous cancer of the head and neck without distant metastases were given combination chemotherapy including methotrexate, bleomycin and diamminedichloroplatinum before planned local treatment with irradiation or surgery. Of 22 evaluable patients, 17 had objective partial or complete remission to initial chemotherapy. However, only ten patients ever had complete clearing at any time of all tumor on clinical evaluation. Median survival was ten months, and only two patients remained alive 14 and 29 months, respectively, from entry. Toxicity was minimal with the three-drug treatment, but the addition of mitomycin-C at the start of chemotherapy substantially increased toxicity without improving efficacy. Subsequent surgery and radiotherapy were accomplished without unusual difficulty.
Thirty patients with advanced non-small cell bronchogenic carcinoma were treated with cis-platin, 75 mg/M2 weekly for three weeks, then every three weeks. Eighteen were ambulatory, 22 had distant metastases, 14 had prior irradiation, and none had prior chemotherapy. Ten patients (33%) had objective remissions lasting a median of three months. Responders lived a median of five months, compared to three months for nonresponders. Transient mild azotemia was noted in twelve patients. Cis-platin has definite but modest activity in non-small cell bronchogenic carcinoma.
Thirty-four patients with advanced squamous cancer of the head and neck were treated with an outpatient regimen combining mitomycin-C, cis-diamminedichloroplatinum (II), methotrexate and bleomycin. Five had complete remissions and 15 partial remissions, for an overall response rate of 59%. Responses were noted on 11 of 13 patients (85%) with disease above the clavicles without prior irradiation. Median duration of partial remission was four months. Response rate was independent of age, performance status, presence of distant metastases and primary site. Hematologic toxicity was substantially more severe with this program than had been observed in a prior study using the same regimen without mitomycin-C. Since neither complete nor partial response rates, nor response durations improved with the addition of mitomycin, we conclude that it adds little to the efficacy of the other three agents.
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The fortieth observation in the world literature and the four in Spain of Zinsser-Cole-Engman. Syndrome is presented, and for this reason we have reviewed the clinical, hematological, genetical and diagnostic features of this disease.
Eighteen evaluable patients with squamous cancer of the uterine cervix recurrent after radiation therapy or with distant metastases were treated with dianhydrogalactitol (150 mg/m2) and cisplatin (DDP) (50 mg/m2), both given iv every 3 weeks. Only 39% of the patients responded, a result no better than that previously reported for DDP alone and only one-half as good as that previously reported by our group for a combination of this drug with mitomycin, vincristine, and bleomycin. Responses lasted a median of only 5 months. Hematologic toxicity was life-threatening in 22% of the patients and was severe in all but 11% of the remaining patients. We conclude that the addition of substantial and toxic doses of dianhydrogalactitol to DDP failed to substantially enhance the rate, quality, or duration of response compared to DDP alone.
A case is presented of a 7-yr-old boy with left hemithyroid agenesis associated with cervical thymic cyst. No left parathyroid glands were found. The diagnosis was established after surgical excision and histologic examination. Clinical and embryological implications of this condition are briefly discussed. No similar case has been found in the literature.
Techniques of advancing flaps to cover traumatic ulcers on legs are described briefly and illustrated in detail. In particular, the advantages of the direct, uncrossed variety are explained and shown.
We describe here six members of a family with Giedion's syndrome: sparse, fine, slow-growing hair, pear-shaped nose, cone-shaped epiphyses of the middle phalanges and variable growth retardation. There are other signs: elongated philtrum, thin upper lip, big and low set ears, medially broad eyebrows but narrow at the tip, clinobrachydactyly and marked dental caries, are as well observed in those patients. Differential diagnosis with other dysplasias is pointed out and both histological and trichological data are being valued.
A case of leiomyosarcoma of the penis in a farmer aged 70 is described. The patient was treated by excision/biopsy, and six months later three little tumors recurred on the glans and prepuce. A wide local excision and direct suture was carried out. No troubles happened in the next eight months. The ultrastructural study confirmed the histogenesis showing: polymorphic cells, as well as clear and dark ones, reduction of intracytoplasmic myofilaments, anisocytosis and poikilokaryosis and wide infoldings of the nuclear membrane; very vascularized areas with confluent vesicles on the endothelial cells; and intersticial haemorrhages. This tumor is included among the superficial leiomyosarcomas of "low malignancy" of McKenzie Pratt et Ross, for which simple excision that avoid mutilations is suitable. Differential histologic diagnosis includes epithelioid sarcoma of Enzinger. Leiomyosarcoma of the penis is a very rare malinant tumor. Only 15 cases have been described in the literature. A further case is reported and the previous cases are reviewed.