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Biomedical subjects

I Penn

Publications and source records attributed to I Penn.

At least 145 records · Page 8Linked to original sources
PubMed1978

Malignant neoplasms following cardiac transplantation.

Between Jan 6, 1968, and April 11, 1977, 124 patients underwent cardiac transplantation at Stanford University Medical Center, with a mean and median period of follow-up of 18.3 and 9.7 months, respectively. Malignant neoplasms developed in seven patients--three lymphoproliferative neoplasms, two skin cancers, one acute leukemia, and one colon carcinoma. Visceral tumors were often fatal and caused 11% of deaths after three months following transplantation. The incidence and spectrum of malignant neoplasms in this population are similar to those observed in recipients of renal homografts.

Adolescent↗
PubMed1978

Upper extremity complications of axillofemoral grafts.

Four patients sustained five upper extremity complications after axillobifemoral grafting including brachial plexus injuries, axillary artery thrombosis, and arterial steal. To avoid these problems, the following precautions are recommended: (1) proper positioning of the patient to prevent hyperabduction of the shoulder; (2) adequate exposure of the axillary artery during dissection and gentle handling of the nerve trunks; (3) meticulous technic during construction of the proximal anastomosis and avoidance of undue tension on the graft; and (4) careful preoperative assessment of the axillary-subclavian artery as a potential donor vessel.

Aged↗
PubMed1977

Transplantation in patients with primary renal malignancies.

Seventy-three patients with primary renal neoplasms underwent kidney transplantation. Three distinct groups were identified. Thirty-four patients (group 1), who underwent antineoplastic therapy 1 year or less before transplantation, developed metastases or recurrences in 53% of the cases. In contrast, none of 15 patients in group 2 had this problem. All of these patients had a waiting period of at least 15 months between nephrectomy and transplantation. These findings emphasize the value of a lengthy waiting period between treatment of the neoplasm and performance of transplantation with its associated immunosuppressive therapy. Group 3 also had a favorable outcome. All had incidentally discovered renal malignancies, in 18 patients during the work-up of chronic renal failure or after bilateral nephrectomy in preparation for renal transplantation, and in 6 several months after transplantation when the recipient's own kidneys were removed or autopsy examination was performed. None of these 24 patients developed recurrences or metastases.

Adenocarcinoma↗
PubMed1977

Malignancies associated with renal transplantation.

An increased incidence of cancer occurs in renal homograft recipients. Malignancies may be inadvertently transplanted with the kidney from donors with cancer, or may arise de novo at some time after transplantation. The latter tumors occur on an average of thirty-four months after the operation. The most common tumors are carcinomas of the skin and lip, lymphomas (mostly reticulum cell sarcomas), and carcinomas of the cervix of the uterus. The lymphomas have a marked predilection for the central nervous system. Besides conventional cancer therapy, reduction or cessation of immunosuppression may be warranted. The development of malignancies is not a contraindication to renal transplantation since the over-all death rate from cancer in kidney homograft recipients is low.

Adolescent↗
PubMed1976

Second malignant neoplasms associated with immunosuppressive medications.

Previous studies have shown that immunosuppressive therapy permits the growth and spread of inadvertently transplanted malignant cells in man, and, in addition, is associated with a 5 to 6% incidence of de novo cancers in organ homograft recipients who were apparently free of cancer before and at the time of transplantation. In the present report two further groups of patients were studied. There was a 4% incidence of new tumors in 101 organ homograft recipient- who had had pre-existing cancers. The immunosuppressive effects of cancer chemotherapeutic agents may have been responsible for the development of 166 new malignancies in 160 patients who received treatment for 161 neoplasms. This does not contraindicate the use of chemotherapy in patients with advanced or widespread neoplasms, as the occasional development of new malignancies is far outweighed by the many months or years of control of the original tumors.

Humans↗
PubMed1976

Squamous cell carcinoma of the skin and lip in renal homograft recipients.

Forty-four squamous cell carcinomas (SCC) of the skin and lip were observed in 9 of 464 renal homograft recipients. Clinically and histologically the SCC's fell into two groups. Two patients with widespread warts, suggestive of epidermodysplasia verruciformis, showed multiple SCC's predominantly on the upper extremities which were associated with minimal solar elastosis of the adjacent dermis. The other seven patients did not have widespread warts; their SCC's occurred predominantly on the head and neck and were associated with prominent solar elastosis of the adjacent dermis. The degree of solar elastosis was particularly striking in view of the young age of this group (mean age: 37 years). Inflammatory cellular response to the transplant SCC's was significantly diminished in comparison with a group of control SCC's from non-immunosuppressed patients. In both transplant groups sunlight appears to be an important etiologic factor; in the first group viruses may also be important.

Adult↗
PubMed1975

Immunosuppression and cancer. Importance in head and neck surgery.

The immune system is an important factor in the host's defenses against cancer. Immunosuppressive therapy associated with organ transplantation is accompanied by a substantially increased incidence of malignant neoplasms, many of which involve the head and neck. Treatment of carcinoma of the larynx by excision and laryngeal transplantation is not justified because of the complications, including malignant neoplasm, that are associated with immunosuppressive therapy. Cancer chemotherapeutic agents have immunosuppressive side-effects, and patients have manifested new malignant neoplasms while their original tumors were controlled by the antineoplastic drugs. These findings have important implications for the management of patients with malignant neoplasms, since other forms of cancer treatment, such as radical surgical procedures and radiotherapy, may also impair the host's resistance to cancer. Therefore, we should reappraise our methods of cancer therapy and examine their effects on the host's resistance to his neoplasm.

Adult↗
PubMed1975

Gynecologic malignancies in immunosuppressed organ homograft recipients.

Immunosuppressed organ homograft recipients have a 5 to 6% incidence of de novo malignancies at some time after transplantation. Gynecologic cancers were encountered in 21 of 224 patients (9%) with these tumors. The predominant lesion was carcinoma of the cervix (18 cases), of which 16 were intraepithelial and 2 were invasive. Gynecologic malignancies have also been encountered in non-transplant patients who were treated with immunosuppressive agents or cancer chemotherapy. All such individuals require gynecologic examination before commencement of treatment and at regular intervals thereafter so that malignancies may be diagnosed at an early stage and treated effectively. Most neoplasms respond well to conventional cancer therapy, but high-grade malignancies may necessitate reduction or cessation of immunosuppressive therapy as well.

Adolescent↗