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Biomedical subjects

J Costa

Publications and source records attributed to J Costa.

At least 271 records · Page 15Linked to original sources
PubMed1982

Small-cell osteosarcoma.

Six cases of small-cell osteosarcoma, a tumor that resembles Ewing's sarcoma but produces osteoid matrix, are presented. The patients were young (6-31 years of age) and presented with symptoms of pain and/or swelling of 1-10 months duration. The lesions demonstrated a wide variation in radiographic appearance. Histologically, the tumors were composed of small, round cells that produced variable amounts of osteoid. In three cases chondroid was also present. Two of the six patients were treated with surgery alone and four received radiation and either single- or multiple-agent adjuvant chemotherapy. The two patients who received radiation and multiple-agent adjuvant chemotherapy have no evidence of disease at four and ten years after diagnosis. Recognition of this tumor as distinct from Ewing's sarcoma and from other forms of osteosarcoma is important to determine the incidence, clinical features, and optimal therapy for this tumor.

Adolescent↗
PubMed1982

Histopathological features of rapidly progressing breast carcinoma in Tunisia: a study of 94 cases.

The histological features of 94 cases of carcinoma of the breast seen in Tunisia were recorded and subsequently correlated with the clinical classification of the patients in terms of poussée évolutive (PEV) categories. Histological features analyzed in the breast tissues and skin included tumor type, nuclear grade, number of mitoses, involvement of the dermis, cutaneous inflammatory infiltrate and edema. Twenty-eight percent of the cases in which the skin was examined showed tumor emboli in the lymphatics of the dermis. The frequency of cutaneous permeation correlated with the PEV categories. The percentage of cases with nuclear grade 3 was higher for the group with rapid progression of the disease (PEV 1,2,3) than for the cases belonging to the PEV-0 category (90% versus 64.2%). The present study demonstrates that a large proportion of breast carcinoma patients in Tunisia suffer from "inflammatory carcinoma of the breast".

Breast Neoplasms↗
PubMed1982

Lymphomatoid Granulomatosis. Prospective clinical and therapeutic experience over 10 years.

Fifteen patients with lymphomatoid granulomatosis were studied prospectively over a 10-year period. Thirteen of the patients received the therapeutic protocol of cyclophosphamide (2 mg per kilogram of body weight per day) and prednisone (1 mg per kilogram on alternate days). Previous reports had indicated that mortality from lymphomatoid granulomatosis was as high as 90 per cent. Of the 13 patients who received the cyclophosphamide and prednisone protocol, seven had complete remissions lasting for 5.2 +/- 0.6 years (mean +/- S.E.M.) Six of the seven with disease in remission have received no therapy for 28.3 +/- 5.7 months. Malignant lymphomas developed in seven of the eight who died, and only two of the eight had therapy for an adequate period. Since virtually all patients who did not have complete remission went on to have malignant lymphoma, early recognition and prompt treatment during the lymphomatoid-granulomatosis phase of disease may not only lead to complete remissions but also percent the development of a lymphoid neoplasm.

Adolescent↗
PubMed1982

Idiopathic midline destructive disease (IMDD): a subgroup of patients with the "midline granuloma" syndrome.

"Midline granuloma syndrome" encompasses a number of specific clinicopathologic entities, such as "Wegener's granulomatosis, midline malignant reticulosis, lymphoma, nasal carcinoma and a broad spectrum of infectious diseases. In the course of studying a number of patients presenting with destructive lesions of the upper respiratory tract, 11 cases emerged as having unique clinicopathologic features. These are: 1) presence of locally destructive lesions which are always restricted to the upper respiratory tract. 2) Absence of systemic disease during a follow-up period of six months to 18 years (mean 7.3 years). On examination of repeated biopsy specimens the histopathologic picture consisted of acute and chronic inflammation with variable amounts of necrosis. Granulomata were seen in one case. Malignant or atypical cells were invariably absent. Frank vasculitis was not seen, although in five of the patients inflammatory cells in the wall of small vessels were conspicuous 4) Inability to demonstrate an infectious origin by culture or special stains. Radiation therapy has proven effective in patients with this entity, for which the term "Idiopathic Midline Destructive Disease" (IMDD) is proposed.

Adolescent↗
PubMed1982

The treatment of soft-tissue sarcomas of the extremities: prospective randomized evaluations of (1) limb-sparing surgery plus radiation therapy compared with amputation and (2) the role of adjuvant chemotherapy.

Between May 1975 and April 1981, 43 adult patients with high-grade soft tissue sarcomas of the extremities were prospectively randomized to receive either amputation at or above the joint proximal to the tumor, including all involved muscle groups, or to receive a limb-sparing resection plus adjuvant radiation therapy. The limb-sparing resection group received wide local excision followed by 5000 rads to the entire anatomic area at risk for local spread and 6000 to 7000 rads to the tumor bed. Both randomization groups received postoperative chemotherapy with doxorubicin (maximum cumulative dose 550 mg/m2), cyclophosphamide, and high-dose methotrexate. Twenty-seven patients randomized to receive limb-sparing resection and radiotherapy, and 16 received amputation (randomization was 2:1). There were four local recurrences in the limb-sparing group and none in the amputation group (p1 = 0.06 generalized Wilcoxon test). However, there were no differences in disease-free survival rates (71% and 78% at five years; p2 = 0.75) or overall survival rates (83% and 88% at five years; p2 = 0.99) between the limb-sparing group and the amputation treatment groups. Multivariate analysis indicated that the only correlate of local recurrence was the final margin of resection. Patients with positive margins of resection had a higher likelihood of local recurrence compared with those with negative margins (p1 less than 0.0001) even when postoperative radiotherapy was used. A simultaneous prospective randomized study of postoperative chemotherapy in 65 patients with high-grade soft-tissue sarcomas of the extremities revealed a marked advantage in patients receiving chemotherapy compared with those without chemotherapy in three-year continuous disease-free (92% vs. 60%; p1 = 0.0008) and overall survival (95% vs. 74%; p1 = 0.04). Thus limb-sparing surgery, radiation therapy, and adjuvant chemotherapy appear capable of successfully treating the great majority of adult patients with soft tissue sarcomas of the extremity.

Adolescent↗
PubMed1982

Reactivation of chronic hepatitis B virus infection by cancer chemotherapy.

Two patients referred for cancer chemotherapy were found to be chronic, asymptomatic hepatitis B surface antigen (HBsAg) carriers. They had normal serum aminotransferase levels, but their sera were positive for HGsAg and antibody to hepatitis B e antigen. Both patients developed acute, icteric hepatitis within 3 months of starting cycled chemotherapy. In both cases, the disease seemed to be caused by a recurrence of type B hepatitis; it was accompanied by a marked increase in HBsAg titer and the appearance of hepatitis B virus DNA and DNA polymerase in the serum. One patient had a second episode of acute hepatitis after a second course of chemotherapy, but both patients ultimately recovered and became seronegative for HBsAg. Thus, it seems that cancer chemotherapeutic agents can reactivate type B hepatitis in asymptomatic HBsAg carriers. This reactivation is most likely due to an increase in hepatitis B virus synthesis followed by a rebound in host immune responses to hepatitis B virus infection when therapy is stopped. Such a phenomenon could have important implications for the therapy of chronic hepatitis B virus infection.

Adult↗
PubMed1981

Risk of subsequent contralateral breast carcinoma in a population of patients with in-situ breast carcinoma.

One hundred ninety-one cases of unilateral noninvasive breast carcinoma were studied with regard to the development of subsequent cancers in the contralateral breast. The majority of patients were treated by mastectomy and have been followed for an average of nine years. Their overall survival did not differ significantly from that of age-specific population survival figures for U. S. women. Among all cases, 13 or 6.8% subsequently developed contralateral carcinoma; 3.1% of these contralateral tumors were invasive. The authors found only one histological type, namely lobular carcinoma in-situ for which the development of subsequent contralateral carcinomas was statistically significant. Seven of the 68 women with this type developed second breast cancers (10.3%; 4.4% of these were invasive). These data suggest that the occurrence of clinically apparent subsequent cancers developing in the opposite breast following the diagnosis of in-situ carcinoma is relatively small.

Adult↗
PubMed1981

Malignant melanoma: a search for occult lymph node metastases.

Lymph nodes regarded as "negative" following routine pathologic examination were reexamined in seven patients with malignant melanoma who later developed systemic metastases. A total of 185 lymph nodes were serially sectioned; five to seven levels of each lymph node were examined for the presence of occult metastases. In this manner previously undetected tumor was found within a solitary lymph node of one patient. It is concluded that attempts to detect occult melanoma metastases by routine serial sectioning of lymph nodes is not of practical applicability.

Adolescent↗
PubMed1981

The parathyroid glands in familial hypocalciuric hypercalcemia.

We analyzed, by light microscopy, specimens obtained at parathyroid surgery from 18 members of eight kindreds with familial hypocalciuric hypercalcemia. For comparison, similar analyses were performed with normal parathyroid glands (surgical or postmortem specimens) and with glands from patients with typical primary parathyroid hyperplasia. The average parathyroid parenchymal area in familial hypocalciuric hypercalcemia was 300 per cent of that in normal subjects (0.049 versus 0.15 sq. cm., p less than 0.0005) but significantly less than that in typical primary parathyroid hyperplasia. Thirteen of the 18 subjects with familial hypocalciuric hypercalcemia had one or more enlarged glands. Enlarged parenchymal areas were noted at all ages in familial hypocalciuric hypercalcemia, but there was a spectrum of histologic findings among the glands in each case, within most families, and between families. Mild parathyroid hyperplasia was a feature in most patients with familial hypocalciuric hypercalcemia who had undergone neck surgery. Simple quantitative analyses were useful in identifying parathyroid hyperplasia in the group with familial hypocalciuric hypercalcemia.

Adolescent↗
PubMed1981

Presence of human papilloma viral antigens in juvenile multiple laryngeal papilloma.

Juvenile laryngeal papillomas, solitary laryngeal papillomas of the adult, and cylindric cell papillomas of the nose and sinuses were examined for the presence of papillomavirus antigens by means of immunocytochemistry. By using an antiserum capable of recognizing a common group antigen that reacts with papillomavirus antigens of different species, it was found that half of the juvenile laryngeal papillomas studied contained cells staining for papillomavirus antigens. No positive cells were found in adult solitary papillomas or cylindric cell papillomas. These results strongly implicate a human papillomavirus as the causative agent of juvenile multiple laryngeal papillomas.

Antigens, Viral↗
PubMed1981

Results of reoperation for persistent and recurrent hyperparathyroidism.

Between August 1975 and January 1981, 106 patients thought to have persistent or recurrent hyperparathyroidism underwent a total of 108 parathyroid re-explorations at the National Institutes of Health. These 106 patients had a total of 175 previous operations for hyperparathyroidism (156 cervical and 19 mediastinal). Nephrolithiasis (54% of patients) and bone disease (24% o patients) were the predominant symptoms. Arteriographic examination and selective venous sampling provided highly accurate localizing results in 33% of the patients, and were of some help in 64%. The final diagnoses after reoperation and re-evaluation were: single-gland disease in 58 patients, primary nonfamilial hyperplasia in 19 patients, familial hyperplasia in three patients, multiple endocrine neoplasia (MEN) Type I in ten patients, MEN Type II in two, parathyroid carcinoma in four patients, secondary hyperplasia in three patients, and familial hypocalciuric hypercalcemia (FHH) in two patients. The diagnosis was in doubt in five patients. In the 95 patients with unequivocal hyperparathyroidism, not due to parathyroid carcinoma, surgery eliminated hypercalcemia in 91 (96%). Two patients died after operation, one of disseminated candidiasis, and one patient, with an immunodeficiency, of sepsis. Five patients developed temporary, and one permanent, recurrent nerve damage; 41% of the patients were hypocalcemic, at the time of discharge from the hospital.

Adenoma↗
PubMed1981

Synthesis of pro-collagen type II by a xenotransplanted human chondroblastic osteosarcoma.

The chondroblastic component of a human osteosarcoma was established as a transplantable tumor in nude athymic mice for the first time. The collagen biosynthetic production of the excised tumor was studied in organ culture. The majority of the collagen secreted in the culture media was pro-Type II as identified by diethylaminoethyl cellulose (DEAE cellulose) chromatography, gel electrophoresis, and cyanogen bromide cleavage. This system should be useful for producing large quantities of human pro-Type II collagen and for studying neoplastic cell switching of collagen synthesis.

Adult↗
PubMed1980

Advanced ovarian cancer: correlation of histologic grade with response to therapy and survival.

In order to determine the prognostic and therapeutic importance of histologic grade for patients with advanced ovarian cancer, the pathologic specimens from 82 patients with Stage III-IV disease (as defined by the International Federation of Gynecologists and Obstetricians (F.I.G.O.)) were reviewed and graded by two methods. A system based on cytologic detail using both the degree of anaplasia and the number of undifferentiated cells, (modified Broders' Grades 1--4) was found to be particularly useful because it identified four groups with different survival outcomes as well as an apparent differential response to chemotherapy. Specifically, the overall improvement of survival in patients with Stage III-IV disease observed in a prospective study of combination chemotherapy was related primarily to an increased survival of patients with Grade 2 and 3 lesions. Survival in Grade 1 patients was markedly better than for Grade 4 patients, but in neither case did survival appear to be influenced by the choice of chemotherapy. These observations suggest that prospective clinical trials assessing the efficacy of chemotherapy should employ cytologic grades as a separate stratification factor since chemotherapy for advanced disease may have to be tailored, in part, to the histologic grade.

Anaplasia↗
PubMed1980

N:NIH(S)-nu/nu mice with combined immunodeficiency: a new model for human tumor heterotransplantation.

A new "nude" mouse model was developed by successive crossings and backcrossings between athymic nu/nu mice, on an N:NIH(S) background, and female CBA/N mice that have an X-linked immune defect in B-lymphocyte function. The resulting doubly congenic N:NIH(S(II-nu/nu mice maintained the marked thymic hypoplasia and poor development of hair of the nu/nu mice. In contrast to nu/nu and CBA/N mice, in this new mouse model both T-cell zones of lymph nodes and the spleen were depleted of lymphocytes. Lymphocytic follicles were rare and diminutive; not germinal centers were noted. The nodal cortical and paracortical areas were represented principally by connective tissue, endothelial cells, and macrophages, including giant multinucleated cells. No medullary cords were recognized. The mice with combined immunodeficiency supported the growth of human tumor xenografts and were susceptible to murine viral hepatitis.

Animals↗