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Biomedical subjects

J E Marks

Publications and source records attributed to J E Marks.

At least 73 records · Page 4Linked to original sources
PubMed1980

Mixed infection in columnaris disease of fish.

In addition to Flexibacter columnaris, Corynebacterium sp was recovered from lesions associated with columnaris disease in catfish. Catfish exposed to pure cultures of the Corynebacterium sp developed circumscribed lesions, which regressed without further adverse effects. Disease signs were not demonstrable in catfish exposed to pure cultures of F columnaris; however, when catfish were exposed to mixed cultures of th Corynebacterium sp and F columnaris, signs of columnaris appeared and the fish died.

Animals↗
PubMed1980

Results of conservation surgery for cancers of the supraglottis and pyriform sinus.

A retrospective review of patients treated by surgery and/or radiation for carcinoma of the supraglottic larynx and the pyriform sinus was accomplished for the period 1964-1974. This patient population reflects the 10-year period following earlier experience with conservation surgery at this institution, and, thus, updates the current status of treatment for these cancers. Endpoints examined included survival, control, pattern of failure, the influence of nodal metastasis, and voice preservation. Of 160 patients treated for supraglottic laryngeal carcinoma, 119 received conservation surgery (subtotal supraglottic laryngectomy, SSL, or partial laryngopharyngectomy, PLP); 21 patients received total laryngectomy; and 20 others received palliative radiation. The 3-year actuarial survivals for these groups were 67%, 43% and 30%, respectively. Voice was preserved in 85% of the patients treated by conservation surgery, in 70% of those treated by radiation alone, and, of course, in none of the patients receiving total laryngectomy. There were 175 patients treated for carcinoma of the pyriform sinus; 85 received PLP; 57, total laryngopharyngectomy (TLP); and 33, palliative radiation. Acturial 3-year survival was 59% for the PLP-treated group, 36% for the TLP-treated group and 11% for the palliation group. Voice was preserved in 52% of the patients treated by conservation surgery, in 6% of those treated by radiation alone, and in none of those patients treated by total laryngectomy. Comparison of this data with that in other published reports indicates that, for selected patients, conservation surgery is as effective in controlling disease as is radical surgery. Furthermore, it is possible to preserve speaking ability in a significant number of patients having carcinoma of the supraglottic larynx or pyriform sinus.

Carcinoma, Squamous Cell↗
PubMed1980

Recruitment of patients to cooperative group clinical trials.

One of the prerequisites for a successful clinical trial is the accrual of a sufficient number of patients for study. Because the sample-size requirements for a randomized clinical trial can rarely be met by a single institution in a short period of time, cooperative groups have taken in a major role in conducting clinical trials. In this paper, the recruitment of patients at our institution to a lung cancer clinical trial is evaluated. A total of 653 lung cancer cases were reviewed. Of the 77 cases which were eligible for the trial, 41 were accessioned. The reasons why eligible patients were not accessioned to the trial are discussed.

Clinical Trials as Topic↗
PubMed1979

Prognostic significance of lesion size for glioblastoma multiforme.

From March 1974 to December 1976, 56 patients with glioblastoma multiforme had precraniotomy computed tomography (CT) scans from which the lesion size was determined by measuring the cross-sectional area. Thirty-two patients underwent surgery followed by irradiation, and 24 had surgery followed by irradiation and chemotherapy. There was no difference in survival between the 16 patients with small lesions and the 16 patients with large lesions in the surgery plus radiation alone group, nor in the 16 patients with small and 8 patients with large lesions in the surgery, radiation and chemotherapy group. Minimum follow-up was one year. Other possible prognostic factors including age, tumor grade, radiation dose, and performance status were comparable for each subgroup. Lesion size in glioblastoma multiforme appears unrelated to prognosis.

Adolescent↗
PubMed1979

An iridium-192 mold for use in treating carcinoma of the soft palate.

A Lucite sandwich mold containing Iridium-192 wire for use in the treatment of soft palate carcinoma is described. This mold is very simple to use, produces a homogeneous (+/- 10%) radiation field across the midplane of the tumor, and requires minimal machinist time.

Brachytherapy↗
PubMed1979

Voice preservation in treatment of carcinoma of the pyriform sinus.

A retrospective analysis of 175 patients having a histopathologic diagnosis of epidermoid carcinoma of the pyriform sinus presenting between January 1, 1964 and December 31, 1973 was undertaken to establish the effectiveness of conservation surgery in preserving voice. Patients were treated by three separate methods: 1. preoperative radiation therapy, partial laryngopharyngectomy and radical neck dissection (PLP and RND) (N = 85); 2. preoperative radiation therapy, total laryngopharyngectomy and radical neck dissection (TLP and RND), (N = 57); and 3. palliation, which consisted of palliative radiation therapy alone or combinations of radiation therapy and chemotherapy or palliative surgery (N = 33). Of the 85 patients treated with the expectation of cancer cure and voice preservation (PLP and RND), 44 or 52% actually had their voice preserved. Of course, in none of the patients treated by TLP and RND was voice preserved, but 2 of the 33 patients treated palliatively retained ability to speak. Overall, 46 of 175 patients (26%) with carcinoma of the pyriform sinus were afforded voice preservation. The ability to preserve voice is correlated with stage and an analysis of operative complications is presented.

Carcinoma, Squamous Cell↗
PubMed1979

Carcinoma of the supraglottic larynx.

Retrospective review of 160 patients with carcinoma of the supraglottic larynx was accomplished for the period 1964 to 1974. The majority were treated by low dose preoperative radiation and conservation surgery and the rest by preoperative radiation and total laryngectomy or radiation alone. Relapse-free and actuarial 5 year survival for all patients was 71% and 45%, respectively. Of primary and neck failures, 85% occurred within 2 years. Primary, nodal, and distant failures occurred in 11%, 21%, and 14% of all patients, respectively. Of 40 T and/or N failures, 33 (83%) occurred in the neck and three T and six N failures (23%) were surgically salvaged. Voice was preserved in 71% of the patients. Major complications were noted in 16% and minor complications in 26% of surgically managed patients; operative mortality was 4%. The presence of microscopic lymph node metastases best predicted those who would later develop T and/or N failure and distant metastases. Second primary tumors occurred in 26% and the leading cause of death was tumor.

Adult↗
PubMed1978

Carcinoma of the pyriform sinus. An analysis of treatment results and patterns of failure.

A retrospective review of 169 patients with carcinoma of the pyriform sinus was accomplished for a ten-year-period from 1964 to 1974. Of the 169, 80 (47%) were treated with low dose preoperative radiation and partial laryngopharyngectomy (PLP), 57 (34%) were treated with radiation and total laryngectomy-partial pharyngectomy (TLP), and 32 (19%) were treated with palliative radiation, surgery or chemotherapy. Act,arial five-year-survival was 31% for all cases, 59% for the PLP group, 21% for the TLP group and 4% for the palliation group. Eighty to 90% of the relapses occurred within two years. The primary and/or nodal failure rates were 23, 37 and 78%, respectively for the PLP, TLP and palliation groups while the distant metastasis rates were 15, 37 and 34% for the three groups. Sites of failure differed for the three groups with a relatively high rate of contralateral neck metastases (23%) in the TLP group and an overwhelming number of primary and ipsilateral failures (78%) in the palliation group. Retreatment of failures resulted in few salvages (15%) and a significant number of fatal complications (26%). The cause of death was tumor related in most cases.

Carcinoma, Squamous Cell↗
PubMed1977

Serial computed tomography of primary brain tumors following surgery, irradiation, and chemotherapy.

55 patients with primary brain tumors were studied by CT scans before, during, and after treatment to determine chronological changes in morphology. Pretreatment scans showed decreased density in most glioblastomas and low-grade astrocytomas and normal density in most unbiopsied tumors and optic nerve gliomas. All glioblastomas and 40% of the astrocytomas were enhanced by contrast material, suggesting that the latter tumor can be divided into two prognostic categories based on the presence or absence of enhancement. Lesion size regressed after treatment in 62% of patients, stabilized in 29%, and progressed in 9%. CT findings correlated with the clinical course in 93% of cases. 73% of tumors persisted, 20% disappeared, and 7% recurred after a mean follow-up of 10.1 months.

Astrocytoma↗
PubMed1976

The value of frequent treatment verification films in reducing localization error in the irradiation of complex fields.

Using treatment verification film to detect geometric miss or localization error (LE), a follow-up analysis of LE for patients treated with extended mantle fields was made for the period 1973-1974. There were 451 treatment verification films for 19 patients reviewed and 67 errors were detected for an error rate of 15%. This rate represented a continued decrease compared to the previous rate of 35% (330 errors for 902 films) during 1969-73. There was a continued reciprocal increase in number of films per patient per course of treatment which was thought, in part, to account for the improvement in technical precision. Reanalysis of localization error by site within the field showed a decrease in rate of error for the axillae from 1969-73 to 1973-1974 and a relative increase in rate of error for the upper abdominal nodes. The decrease in error rate for the axillae was ascribed to increased attention to leaving adequate margin between pulmonary shield and axilla and the increase in error rate for upper abdominal nodes was ascribed to inadequate margin between shield and spine. The relative increase in errors for the upper abdominal nodes correlated with the physicians who made the original decision about margin between spine and shield. Propagation of LE by site has been noted and can be prevented by monitoring treatment fields with verification film and correcting errors as they are noted.

Hodgkin Disease↗
PubMed1976

The effect of immobilisation on localisation error in the radiotherapy of head and neck cancer.

With the use of treatment verification films for the detection of localisation error (LE), a study was undertaken to determine the effect of change in position and immobilisation on LE in the radiotherapy of patients with head and neck cancer. For those patients not immobilised and treated in the lateral position, 28 errors were recorded in a review of 172 films, giving an error incidence of 16%. For patients immobilised by bite block and treated in the supine position, a total of four errors were recorded on review of 382 films, giving an error incidence of 1%. The reduction of LE from 16% to 1% by supine positioning and bite block immobilisation was significant with a P value of less than 0.001. The potential significance of LE in relation to CNS injury and tumour recurrence is discussed.

Aged↗
PubMed1975

Factors influencing local recurrence after abdominoperineal resection for cancer of the rectum and rectosigmoid.

One hundred and fifty-two patients who underwent abdominoperineal resection for cancer of the rectum and rectosigmoid are reviewed. Six physicians were selected to predict which of these patients would have a local recurrence. All information available at the end of the operation was duplicated and submitted to the observers. None of the physicians was able to predict local recurrence significantly better than random. There were 31 local recurrences, i.e. an incidence of 20-4 per cent. Low level of tumour in the rectum, local spread into perirectal fat or serosa, lymph node involvement and age below 60 years at time of operation were the only factors that were statistically related to local recurrence. The strategy for careful follow-up of patients at risk is outlined and a plea is made for a controlled trial of postoperative radiotherapy.

Age Factors↗
PubMed1974

Extended mantle radiotherapy in Hodgkin's disease and malignant lymphoma.

The extended mantle field eliminates the necessity for splicing at the level of the diaphragm and thereby eliminates the potential for radiation-induced transverse myelitis. Our experience to date with 95 patients with H.D. or M.L. is described. Modifications in technique, including changes in the geometry of the field, shielding, time, dose, fractionation, and simulation are described. End results, an analysis of failures, and complications encountered are presented. Morbidity was acceptable despite the increase in integral dose, particularly in young patients who were not debilitated by disease. The danger of radiation-induced esophagitis, dehydration, hemoconcentration, and pulmonary embolism is stressed.

Blood Cell Count↗