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Biomedical subjects

J D Schmidt

Publications and source records attributed to J D Schmidt.

At least 91 records · Page 5Linked to original sources
PubMed1979

Comparison of procarbazine, imidazole-carboxamide and cyclophosphamide in relapsing patients with advanced carcinoma of the prostate.

In this third cooperative chemotherapy trial of the National Prostatic Cancer Project 165 patients with histologically confirmed, relapsing clinical stage D prostatic cancer were randomized to receive either imidazole-carboxamide, procarbazine or cyclophosphamide. All patients had received and failed previous hormonal therapy. Patients whose disease progressed after 12 weeks on initial therapy were crossed over or randomized to receive an alternate drug. There were 129 patients available for comparison of treatments. The objective response rates (partial regression plus stable disease) were 26% for cyclophosphamide, 27% for imidazole-carboxamide and 14% for procarbazine. Subjective responses were noted in pain relief, improvement in performance status and weight gain. Procarbazine was associated with excessive toxicity, resulting in many patients (28%) discontinuing therapy within the first 3 weeks and closure of this particular arm of the study. The regimen of initial imidazole-carboxamide therapy with a later cross-over to cyclophosphamide when the disease continues to progress is associated with the longest increase in survival. Imidazole-carboxamide and cyclophosphamide appear to be active agents in advanced prostatic cancer and are worthy of continued use in this disease.

Aged↗
PubMed1979

The use of estramustine and prednimustine versus prednimustine alone in advanced metastatic prostatic cancer patients who have received prior irradiation.

Estramustine has been shown previously to be an effective drug in the treatment of metastatic prostatic cancer, demonstrating significant objective and subjective responses in long-term non-randomized trials and in other randomized trials. In this study prednimustine alone has shown a minimal over-all objective response rate of 12.9% of the cases, although with marked subjective improvement of pain relief and patient performance status. The combination of prednimustine with estramustine did not result in improvement of objective or subjective response parameters. The effects in terms of responses or in terms of toxicity for either agent were not additive when they were given in combination. Cross-over for those patients whose disease progressed on prednimustine therapy to estramustine had some benefit in over-all survival. Prednimustine alone or in combination with estramustine may be used safely and could improve markedly the quality of life for irradiated patients with advanced prostatic cancer who failed on hormonal treatment and have too poor a bone marrow reserve to be treated by other currently available myelosuppressive agents.

Chlorambucil↗
PubMed1979

In vitro adherence of radioactively labeled Escherichia coli in normal and cystitis-prone females.

Numerous investigators report data obtained using an in vitro quantitative assay for measuring bacterial adherence to epithelial cells. We found this assay to contain significant sources of error in the large variation in number of bacteria bound per cell and in the dependence on the investigator's visual counting of bacteria bound per cell. In the modified assay described here, we eliminated the need for visual counting of bacteria by incorporating the use of radioactively labeled Escherichia coli. This allowed quantitation of bacterial adherence to as many as 50,000 vaginal cells, whereas the visual counting system limits the determination to perhaps 50 cells. We feel that the use of radioactively labeled bacteria in place of the visual counting system increases the validity and sensitivity of this assay. Using the modified method, we found no statistically significant differences among values for adherence of E. coli type 04 to the vaginal cells of control and cystitis-prone women at either pH 6.4 or 4.0.

Adhesiveness↗
PubMed1978

Biopsy and clinical course after cryosurgery for prostatic cancer.

Open perineal cryosurgical prostatectomy has been reported previously in 154 consecutive prostatic cancer patients at our center. In 37 of these patients post-cryosurgery biopsies of the prostate were obtained. In the present report we compare this tissue to the preoperative biopsies. The data suggest that well differentiated cancers are associated with advantageous survival in cryosurgery patients. Lymphoid and eosinophilic cell infiltrates may represent post-cryosurgical local immune responses, with improved survival. Estrogen therapy seems to suppress this local immune response. One month or more after cryosurgery cancer in the biopsy correlates with palpable local recurrence but prior to 1 month it does not correlate. Cryosurgery by the open perineal approach has been an effective method to eliminate the primary lesion in localized and extensive prostatic cancer.

Biopsy↗
PubMed1978

Clinical significance of serum alkaline phosphatase isoenzyme levels in advanced prostatic carcinoma.

The alkaline phosphatase isoenzymes in 105 patients with stage D carcinoma of the prostate who entered the National Prostatic Cancer Study were analyzed and these values were correlated to clinical response. Only patients with at least 3 measurements of alkaline phosphatase were evaluated. In 91% of patients with metastatic bone disease, bone alkaline phosphatase was elevated. Those patients with higher pre-treatment levels of alkaline phosphatase generally showed a poorer response to therapy. The results of alkaline phosphatase isoenzyme estimation indicate that these biological markers may be used in the evaluation of patients with metastatic prostatic cancer to predict and monitor their response to chemotherapy. The evaluation of bone and liver alkaline phosphatase isoenzymes in earlier stages also may be valuable.

Alkaline Phosphatase↗
PubMed1978

Immunochemical detection of serum prostatic acid phosphatase. Methodology and clinical evaluation.

An immunochemical method for detection of prostatic acid prosphatase is described. Purified acid phosphatase was isolated from cancerous human prostate. A specific antiserum to the purified enzyme was produced in rabbits. The antiserum to postatic acid phosphatase did not react with acid phosphatase originating from other tissues. A counter immunolectrophoresis, utilizing the specific antibodies and a chemical staining technique, has been developed and clinically evaluated. Sera from patients with prostatic carcinoma (6/20 of stage B, 27/49 of stage C, and 98/125 of stage D) gave positive results. Sera from 19 patients with benign prostatic hypertrophy, from 89 patients with other tumors, from 12 patients with Gaucher's disease, from 107 healthy volunteers, and from 50 normal age-matched men all gave negative results. The sensitivity of this method was 0.4 IU of enzyme activity or 20 ng per ml of prostatic acid phosphatase protein. Further clinical evaluation of patients in the early stage of prostatic cancer and of patients undergoing chemotherapy is in progress.

Acid Phosphatase↗
PubMed1978

The use of estramustine and prednimustine versus prednimustine alone in advanced metastatic prostatic cancer patients who have received prior irradiation.

Estramustine has been shown previously to be an effective drug in the treatment of metastatic prostatic cancer, demonstrating significant objective and subjective responses in long-term non-randomized trials and in other randomized trials. In this study prednimustine alone has shown a minimal over-all objective response rate of 12.9 percent of the cases, although with marked subjective improvement of pain relief and patient performance status. The combination of prednimustine with estramustine did not result in improvement of objective or subjective response parameters. The effects in terms of responses or in terms of toxicity for either agent were not additive when they were given in combination. Cross-over for those patients whose disease progressed on prednimustine therapy to estramustine had some benefit in over-all survival. Prednimustine alone or in combination with estramustine may be used safely and could improve markedly the quality of life for irradiated patients with advanced prostatic cancer who failed on hormonal treatment and have too poor a bone marrow reserve to be treated by other currently available myelosuppressive agents.

Drug Therapy, Combination↗
PubMed1977

Emphysematous pyelonephritis.

Emphysematous pyelonephritis is an uncommon infection of the renal parenchyma found most often in diabetic patients. The fortieth case of emphysematous pyelonephritis is reported and a plan for management is proposed based on differentiating this condition from gas-forming infections of the perinephric space and the renal collecting system.

Air↗
PubMed1977

Primary adenocarcinoma of the bladder: a retrospective study of 20 patients.

A retrospective analysis is presented of 20 patients with primary adenocarcinoma of the bladder treated with non-radical procedures. The survival rate has averaged less than 1 year, regardless of the mode of therapy, with only 1 patient alive 2 years after segmental cystectomy. The male-to-female ratio of patients was only 2 to 1. All patients had deeply infiltrating tumor at the time of initial diagnosis. Chemotherapy in conjunction with irradiation therapy used in the treatment of 1 of the patients proved to be ineffective.

Adenocarcinoma↗
PubMed1977

A comparison between lymphangiography and pelvic node dissection in the staging of prostatic cancer.

On 40 consecutive patients with prostatic cancer who had pedal lymphangiography during the initial evaluation and, subsequently, underwent pelvic node dissection or biopsy, a surprisingly high number had falsely positive (59 per cent) or negative (36 per cent) x-ray findings. Initially the tumors were considered clinically to be stage B in 24 cases, stage C in 13 and stage D in 3. After lymph node dissection only 17 tumors were still considered to be stage B and 7 were stage C, while 16 tumors were actually stage D. This surgical staging is important for the further management of the patient as well as the prognosis, Pedal lymphangiogrpahy alone is unreliable for accurate assessment of the regional lymph node status in clinically localized prostatic cancer.

Adenocarcinoma↗
PubMed1976

Sarcoma of the prostate.

The experience at the University of Iowa Hospitals with 12 patients having sarcoma of the prostate is described. Although the total number of patients is small, two distinct groups can be identified. The infants, children, and young adults presenting with this malignancy had a very poor survival regardless of the therapy administered. However, the older men have generally done well, surviving several years following therapy for the relief of lower urinary tract obstruction. The longest surviving patient was treated by transurethral prostectomy followed by transperineal instillation of radioactive gold. A program of combination therapy utilizing surgery, external irradiation, and triple chemotherapy is suggested for use in children and young adults with prostatic sarcoma.

Adolescent↗
PubMed1976

Doxorubicin hydrochloride (adriamycin) in irradiated patients with advanced transitional cell carcinoma.

Twenty-five patients with advanced transitional cell carcinoma of the urinary tract were treated with doxorubicin hydrochloride (Adriamycin). Eight evaluable patients who received extensive external irradiation therapy and at least two doses of doxorubicin hydrochloride were studied to assess bone marrow toxicity and possible augmentation of radiation dermatitis. Myelosuppression was similar in both irradiated patients and those who received doxorubicin alone. None of the irradiated patients displayed skin augmentation reactions with doxorubicin. In the dose range used chemotherapy with doxorubicin did not appear to be particularly hazardous in irradiated patients.

Aged↗
PubMed1976

Chemotherapy of advanced prostatic cancer. Evaluation of response parameters.

A total of 125 patients with progressing advanced prostatic cancer were entered into a chemotherapy study comparing cyclophosphamide, 5-fluorouracil, and standard therapy. Parameters of response were studied in 110 patients who could be evaluated. Thirty-six patients (33 per cent) were considered to have an objective response, that is becoming stable (29 patients) or in partial regression (7 patients). Negative response parameters (predictors of a poor response to chemotherapy or standard theraphy leading to progress) included (1) bone marrow evidence of prostatic cancer, (2) abnormal liver scan, (3) prior radiation therapy (indirectly through increased toxicity to chemotherapy), and (4) lack of bilateral orchiectomy prior to randomization. Positive indicators (predictors of good responses) included (1) reduction of primary tumor mass, especially after administration of 5-fluorouracil or cyclophosphamide, and (2) hemoglobin values. There were more objective responders to cyclophosphamide than standard therapy whether the hemoglobin was initially normal or low. Indeterminate parameters of response included weight gain, presence of bony or soft tissue metastases, relief of pain, performance status, excretory urography, and biochemical determinations of liver and renal function.

Aged↗
PubMed1976

Clinical significance of serum acid phosphatase levels in advanced prostatic carcinoma.

This cooperative study was sponsored by the National Prostatic Cancer Project to determine the usefulness of serum acid phosphatase levels as a predictive indicator with regard to performance status, sites of metastases, response to treatment, and survival in patients with advanced prostatic carcinoma. The results indicate that survival was significantly shorter for those patients who had elevation of thier on-study (pretreatment) total serum acid phosphatase ler cent reduction of primary tumor mass, relief of pain, and acid phosphatase activity. No correlation could be demonstrated between serum acid phosphatase and performance status, site of metastases, and other criteria of response to therapy. It is concluded that this test as currently determined spectrophotometrically at this stage of disease and if employed alone is not sufficient to allow for total evaluation of the response of therapy. It is, however, helpful when used in correlation with the previously mentioned positive factors.

Acid Phosphatase↗
PubMed1976

Prostatic carcinoma. relationship between primary tumor, histologic grade, and response to chemotherapy.

This National Cooperative Study has randomly compared the usefulness of 5-fluorouracil (5-FU), cyclophosphamide (Cytoxan) and standard therapy in patients with advanced carcinoma of the prostate (Stage D). All patients studied were endocrine failures and were in progression. Favorable responses were seen with all three treatments regardless of histologic grade. Actual tumor regression occurred only in patients who received either 5-FU or cyclophosphamide. In patients with poorly differentiated or anaplastic tumors treated with cyclophosphamide, progression of disease was significantly less rapid than in patients treated with 5-FU or standard therapy. However, favorable responders could not always be identified in advance on the basis of histologic grade alone.

Carcinoma↗
PubMed1976

Comparison of flutamide (SCH-13521) and diethylstilbestrol in untreated advanced prostatic cancer.

A double-blind study comparing the efficacy of flutamide (SH-13521) and diethylstilbestrol in 15 patients with advanced, previously untreated adenocarcinoma in the prostate in herein presented. Patients receiving diethylstilbestrol, 1 mg. daily, remained stable without evidence of progression of their disease for an average of 25.6 weeks while those receiving either high-or low-dose flutamide showed no objective progression for an average of thirty weeks. There were no complete remissions, and no signficant side effects were seen with either of these agents. In this small series of hormonally untreated Stage D prostatic cancer patients, neither agent displayed significant superiority.

Aged↗
PubMed1976

Doxorubicin chemotherapy in advanced transitional cell carcinoma.

During the past year 25 patients with advanced transitional cell carcinoma were treated with intravenous doxorubicin hydrochloride (Adriamycin), 60 to 75 mg. per square meter of body surface area, every three weeks. Among the 19 evaluable patients, one partial objective remission lasting five months was observed. All 7 patients with bone pain had symptomatic relief and 12 patients had significant subjective improvement lasting an average of six-and-a-half months. Side effects were minimal and consisted of alopecia, mild leukopenia, and mild stomatitis; no significant cardiotoxicity was observed. Doxorubicin hydrochloride appears to have important antitumor activity in advanced urothelial tumors. Controlled clinical trials with this agent alone and in combined drug regimens are needed.

Aged↗