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Biomedical subjects

J E Goodnight

Publications and source records attributed to J E Goodnight.

36 records · Page 2Linked to original sources
PubMed1986

Identification of unsuspected thyroid carcinoma using immunoperoxidase for thyroglobulin.

Two patients with poorly differentiated metastatic cancer were shown to have metastatic thyroid carcinoma. Each patient had poorly differentiated cancer and remaining thyroid tissue in the neck. The diagnosis was secured using the immunoperoxidase technique with an antibody against thyroglobulin. The proper evaluation of patients with carcinoma of unknown primary involves specific tissue identification using special techniques in pathology.

Adenocarcinoma↗
PubMed1986

Apocrine adenoma of the breast.

Apocrine adenoma of the breast is a very rare entity. Criteria for diagnosis include qualification as adenoma and differentiation from apocrine carcinoma.

Adenoma↗
PubMed1985

Limb-sparing surgery for extremity sarcomas after preoperative intraarterial doxorubicin and radiation therapy.

Complete local control of 25 extremity bone and soft tissue sarcomas was obtained by combined preoperative intraarterial doxorubicin and radiation therapy, followed by limb-sparing resection with reconstruction and adjuvant chemotherapy. At a 32 month median follow-up, there are no local tumor recurrences. Functional limbs were salvaged in 21 patients (84 percent). Fifteen patients (60 percent) were continuously disease-free and overall survival was 80 percent. After the extensive combined modality therapy, extremity complications, including delays in wound healing, occurred in 10 patients. Nevertheless, most complications were resolved with salvage of functional limbs. These results support an aggressive multimodality limb-sparing approach to high-grade extremity sarcomas.

Adult↗
PubMed1984

Failure of subcutaneous mastectomy to prevent the development of breast cancer.

Three patients treated with bilateral subcutaneous mastectomies and implants for fibrocystic disease or carcinoma in situ subsequently developed invasive breast carcinoma. These cases emphasize that subcutaneous mastectomy does not prevent the development of breast cancer. If the circumstances in an individual patient justify prophylactic mastectomy, then the appropriate procedure would seem to be total mastectomy, which would accomplish thorough removal of all breast tissue, the subareolar region, and the nipple. Subcutaneous mastectomy for the patient who is likely to harbor occult invasive disease seems particularly inappropriate. As a means to reduce the risk of breast cancer, the procedure is unproved and must be considered an experimental therapeutic approach.

Adenocarcinoma↗
PubMed1982

Thermochemotherapy for melanoma metastases in liver.

Metastatic melanoma in the liver has carried an extremely poor prognosis regardless of therapy. Because transient responses (1/6 disease regressions and 2/6 disease stabilizations for four months) in selected patients treated with intraarterial (IA) DTIC infusion were encouraging and because localized hyperthermia may be both tumoricidal and synergistic with chemotherapy, these modalities were combined for treatment of patients with advanced liver metastases. Of 10 patients treated with IA-DTIC plus heat, three (30%) had disease-regression and five (50%) had disease stabilization for 3-14 months (median 6.5 months) and survived 3.5-18 months (median 8.5 months). During treatment, 4/5 patients had pain relief and 7/10 retained or acquired normal activities. Myelosuppression was minimal and no hyperthermia toxicity occurred. A retrospective review of 10 patients with similar disease levels who were treated with conventional intravenous (IV)-DTIC indicated no responses, and no responses were seen in five patients treated with IV-DTIC plus heat. However, this latter group may have been selected patients due to the inability to place a percutaneous hepatic artery infusion catheter. This pilot study suggests that combination IA-DTIC and hyperthermia has a high response rate, is safe, and can provide quality survival for many patients.

Adult↗
PubMed1981

Hemobilia.

Hemobilia is a relatively rare manifestation of hepatobiliary disease that is usually characterized by recurrent colicky upper abdominal pain, gastrointestinal bleeding, and obstructive jaundice. In most instances, hemobilia presents as complication of liver injury, blunt abdominal trauma, or liver surgery. Other causes are percutaneous diagnostic procedures, hepatic artery aneurysms, inflammatory disease, biliary tract stones, and liver and bile duct neoplasms. The diagnosis of hemobilia is confirmed by endoscopy and selective angiography. Treatment of hemobilia is primarily surgical, with direct exploration of the liver, ligation of the bleeding point, and relief of bile duct obstruction. If liver damage is minimal, nonoperative management may be successful but requires careful observation and serial arteriography.

Hemobilia↗
PubMed1981

Bile duct carcinoma.

Bile duct carcinoma most often causes death by obstructing bile flow; relief of this obstruction extends survival. Options include passage of tubes through the tumor to maintain internal bile drainage, hepatic-enteric bypass, and percutaneous tube drainage. As experience with liver surgery has grown, the number of bile duct carcinomas that have been successfully resected has increased. Complete removal of the tumor produces more long-term survivors than other procedures, but most patients still succumb to their disease. Nevertheless, aggressive treatment to excise the lesion or bypass the biliary obstruction significantly improves quality and length of life for many patients.

Bile Duct Neoplasms↗
PubMed1979

Intratumor bacillus Calmette-Guerin therapy for chest wall recurrence of carcinoma of the breast.

Intratumor bacillus Calmette-Guerin administration is effective for treating chest wall recurrence from carcinoma of the breast in selected patients. Our results suggest that bacillus Calmette-Guerin therapy can be used alone, with systemic chemotherapy, hormonal therapy or in previously irradiated tissue. It represents local treatment for local disease that is well tolerated. Intratumor bacillus Calmette-Guerin treatment is a useful clinical method for the treatment of local chest wall disease.

Adult↗
PubMed1978

Clinical trials of immunotherapy: present status.

This brief review of the more promising clinical trials suggests that immunotherapy is indeed beneficial for selected cancer patients. Because of its limited potency, it should not be used as primary treatment for malignant disease except as local immunotherapy for certain accessible tumors. It is effective for eradication of primary neoplasms of the skin as well as cutaneous metastases of malignant melanoma and breast carcinoma. The most important role for immunotherapy is in combination with other modalities. It may help control occult micrometastases that cause recurrence and death following surgical procedures or irradiation. Results of adjuvant immunotherapy appear promising for malignant melanoma, for carcinoma of the lung, breast, and colon, and for soft-tissue sarcomas. In combination with chemotherapy, immunotherapy appears to prolong remission and survival in acute myelogenous leukemia and in disseminated tumors of the lung and breast. Clearly, immunotherapy is not a panacea for malignant disease, but it could become an important arm in a multimodality attack on cancer.

Breast Neoplasms↗
PubMed1978

Adjuvant immunotherapy.

Because systemic spread occurs early in the growth of many malignancies, control of occult micrometastases must be an integral part of cancer treatment. For this reason, surgery and radiation therapy alone may fail to achieve a cure despite eradication of the primary tumor. Chemotherapy is potent and systemic in its effects but kills tumor cells by first-order kinetics so the last cancer cell may not be eliminated. An agent is needed that can selectively attack and destroy small numbers of tumor cells on a systemic basis without a significant increase in toxicity. Experimental observations indicate that immunotherapy could fill this role. Immunotherapy has been tested as an adjuvant to surgery, radiation therapy, and chemotherapy, and is clearly beneficial for selected cancer patients. There are many unresolved questions regarding the underlying mechanisms as well as the practical application of adjuvant immunotherapy, but the initial investigations indicate that it could play a vital part in the treatment of cancer. There is evidence that stimulation of host resistance can result in control of systemic micrometastases.

Animals↗
PubMed1976

Serum-blocking factors versus specific cellular tolerance in long-term survival of rat heart allografts.

Long-term survival of Ag-B compatible rat heart allografts was obtained by short-term treatment of the recipients with antilymphocytic serum (ALS). Graft survival apparently was based on a specific change in the hosts rather than on persistent nonspecific effects of ALS. The hosts were not fully tolerant in that they were able to reject secondary skin allografts from the heart donor strain, although in a delayed fashion. The long-surviving heart allografts retained their immunogenicity as they were rejected when retransplanted to new hosts. The passive transfer of serum from long-term heart graft acceptors to new hosts receiving fresh allografts delayed rejection by several days. This effect was seen only with the serum from long-term acceptors suggesting that serum-blocking factors were involved in long-term survival of the heart allografts. However, the ability of adoptively transferred lymphoid cells to break tolerance to a heart allograft residing in a classically tolerant host was tested. In contrast to normal lymphoid cells, cells from the long-term acceptors were unable to break tolerance, suggesting that a specific cellular tolerance had been induced in this cell population. Moreover, a serum from the long-term acceptors failed to block the breakage of tolerance by normal lymphoid cells.

Animals↗
PubMedDate not supplied

Radioimmunotherapy for breast cancer: treatment of a patient with I-131 L6 chimeric monoclonal antibody.

We report the first treatment of metastatic breast cancer by systemic radioimmunotherapy. The serial therapy doses were chosen based on quantitative imaging data in a treatment planning approach. A terminally ill patient with aggressive, locally advanced breast cancer who had failed radiation treatment and chemotherapy was injected intravenously with radiolabeled I-131 chimeric L6, a human-mouse chimeric lgG1 monoclonal antibody to adenocarcinoma. Initially, an imaging 10 mCi dose of I-131 chimeric L6 (dose 1) deposited 8.8% of the injected dose in her chest wall tumor at 48 hours. Ten days later the patient was given a 150 mCi I-131 chimeric L6 dose (dose 2) followed three weeks later by a 100 mCi dose (dose 3). Tumor uptake and retention were comparable for doses 1 and 2, and decreased for dose 3. Following dose 3 the patient developed a manageable thrombocytopenia and transient Grade IV granulocytopenia. The tumor was observed to decrease in size with peak tumor regression occurring two weeks after dose 3. This partial response (PR) was achieved by radioimmunotherapy at a time when conventional therapy had been unable to impact the growth of the patient's massive and aggressive tumor.

Antibodies, Monoclonal↗
PubMedDate not supplied

Cis-dichlorodiammineplatinum(II) alone and combined with DTIC for treatment of disseminated malignant melanoma.

Twenty-one patients with disseminated malignant melanoma were treated with cis-dichlorodiammine-platinum(II) (cis-DDP): ten with cis-DDP alone at a dose of 20 mg/m2 iv x 4 days every 4 weeks and 11 with cis-DDP at a dose of 15 mg/m2 iv x 4 days combined with DTIC at a dose of 200 mg/m2 iv x 5 days every 4 weeks. Two of 21 patients (10%) showed a partial response to therapy. There were no complete responses and no apparent increases in length of survival for responders compared to nonresponders. One drug-related death occurred. Otherwise, drug toxicity was acceptable and appeared to be diminished by iv hydration and prolonged administration. In this study, cis-DDP was not effective for treatment of disseminated malignant melanoma.

Adolescent↗
PubMedDate not supplied

cis-Diamminedichloroplatinum(II) alone and in combination in the treatment of testicular and other malignancies.

A total of 124 patients with malignancy were treated with cis-diamminedichloroplatinum(II) (CDDP) alone (58 patients, 121 courses) or in combination with other drugs (66 patients, 176 courses). Toxic effects of single-agent therapy were primarily nausea and vomiting; mild renal hematopoietic, and auditory toxic effects occasionally occurred. Positive responses were seen in ovarian and testicular tumors. Rare responses were also seen in melanoma and bladder carcinoma. CDDP combined with vinblastine and bleomycin resulted in a 39% complete response rate in testicular germ cell tumors. All complete responders and ten patients treated in an adjuvant fashion remain alive and disease-free. Failures to achieve a complete response were associated with bulky extrapulmonary disease, pulmonary disease greater than 2.5 cm in diameter, and past failure to respond to vinblastine and bleomycin. CDDP combination regimens for acute leukemia and for melanoma were of little value. Combination chemotherapy for head and neck cancer showed activity, including a complete response in one of two patients with nasopharyngeal lymphoepithelioma.

Cisplatin↗