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Biomedical subjects

J E Ultmann

Publications and source records attributed to J E Ultmann.

At least 73 records · Page 4Linked to original sources
PubMed1977

Chromosomal aneuploidy in a patient with hypereosinophilic syndrome. Evidence for a malignant disease.

A patient with rapidly fatal hypereosinophilic syndrome and a bone marrow chromosomal abnormality, 49,XYY,t(3:5),+8,+mar, is described. Scanning and transmission electron microscopy of eosinophils failed to reveal any significant abnormalities. Previous cytogenetic data on patients with hypereosinophilic syndrome have been deficient in that few studies have been performed with banding technics. These technics may help in the classification of hypereosinophilic syndrome and predict which patients will have a rapidly fatal course.

Aneuploidy↗
PubMed1977

Chronic lymphocytic leukaemia and its relationship to other lymphoproliferative disorders.

Chronic lymphocytic leukaemia is a disorder with variable clinical presentation, but with constant and easily recognizable morphological features. The majority of cases are of B-cell lineage, the cells being characterized by IgM and IgD surface markers. In occasional cases monoclonal gammopathies with idiotypes identical to those of the SIg are produced. Some cases of CLL may be confused with Waldenström's macroglobulinaemia. The clinical and morphological features of certain other lymphoproliferative disorders have been summarized. Finally, a progression of B-cell differentiation along an immunoexpressive spectrum has been described and the relative position of CLL defined. A correlation of cell morphology and function is possible in most cases. The possibility that CLL may terminate in an acute blastic crisis or histiocytic lymphoma is raised. It is emphasized that LPD include a wide range of diseases, some being non-malignant, others of questionable malignancy, and still others being frankly malignant. Clinical, morphological and immunological data are required for diagnosis in some cases.

B-Lymphocytes↗
PubMed1977

Hemolytic anemias during pregnancy and the reproductive years.

Anemia is a common phenomenon in women during the reproductive years. In pregnancy, it is associated with an increased incidence of maternal-fetal morbidity and mortality. The approach to the investigation of anemic women suspected of having hemolytic anemia of either congenital or acquired etiology is the subject of this article. Various conditions in the pregnant women can have hematologic consequences for the newborn infant; these conditions include sensitization to fetal blood cells, infections, drug ingestion and the possession of genes for hereditary hemolytic disorders, which may be transmitted to the fetus. Because several forms of hemolytic anemias are hereditary or are caused by an altered gene, genetic consultation is important.

Anemia, Hemolytic↗
PubMed1977

Prognostic classification of Hodgkin disease in pathologic stage III, based on anatomic considerations.

Fifty-two patients with pathologic stage III Hodgkin disease were studied in an effort to determine whether location of involved abdominal nodes influenced survival. Treatment consisted of total nodal radiotherapy with or without subsequent combination chemotherapy. Th initial radiation field was the "extended mantle," which included supradiaphragmatic nodes, the splenic hilar area, and paraaortic nodes to the level of L2-L4. Subsequently, lower paraaortic and iliac regions were treated ("lower inverted Y"). Patients with disease limited to the spleen and/or splenic, celiac, or portal nodes ("anatomic substage" III1) had a more favorable 5-yr survival than did patients with involvement of paraaortic, iliac, or mesenteric nodes ("anatomic substage" III2): 93% versus 57%, respectively (p less than 0.05). The addition of combination chemotherapy to total nodal irradiation was associated with improved survival of patients in stage III2, but not of those in stage III1.

Hodgkin Disease↗
PubMed1976

Bone marrow involvement in non-Hodgkin's lymphoma: implications for staging and therapy.

We evaluated the incidence of bone marrow involvement in 121 patients with non-Hodgkin's lymphoma who were seen prior to the institution of definitive therapy. Involvement of the marrow was found to be dependent on both histologic type and the extent of extramedullary disease. It was observed most frequently in patients with poorly differentiated lymphocytic lymphoma (60%), but was not observed in 36 patients of all histologic types whose clinical evaluation and/or laparotomy revealed disease in stage I or II. Among 56 patients with poorly differentiated lymphocytic lymphoma in stage III or IV exclusive of marrow involvement, disease was observed in the marrow in 40 patients, or 71%. These observations, together with the results of previously reported therapeutic trials, suggest that staging laparotomy and total nodal radiotherapy alone may be of limited value in patients with poorly differentiated lymphocytic lymphoma when clinical evidence of stage III or IV disease is present.

Adolescent↗
PubMed1976

Results of involved field and extended field radiotherapy in patients with pathologic state I and II Hodgkin's disease.

A series of 44 previously untreated patients was found to have stage I or II Hodgkin's disease on the basis of a diagnostic workup which included laparotomy and splenectomy in 39 cases. The patients were randomized to either involved field or extended field radiotherapy. No difference was found in overall survival rates between the two groups. Regional recurrences were seen in four patients in the involved field group and in none of the extended field group. Regional recurrences were seen in four patients in the involved field group and in none of the extended field group. Radiotherapy to the extended field treatment port (generally an extended mantle) can be given with acceptable side effects. Staging laparotomy was of definite value, changing the classification and resulting therapy of two groups: (1) patients with clinical stage (CS) I or II, pathologic stage (PS) III involvement, who were treated with appropriately larger radiotherapy fields; and (2) patients with CS III, PS I or II, who were spared unnecessarily extensive radiotherapy.

Adolescent↗
PubMed1976

Avascular necrosis of the femoral head with combination therapy.

Four patients with malignant lymphoma who were treated with multiple courses of combination chemotherapy, consisting of cyclophosphamide, Oncovin, procarbazine, and prednisone (COPP), developed avascular necrosis of the femoral head(s). Disorders usually associated with the development of avascular necrosis were absent. The total prednisone dose received by each patient was small. Avascular necrosis of the femoral head should be considered in the differential diagnosis of bone pain in patients receiving multiple courses of combination chemotherapy.

Adult↗
PubMed1976

An approach to general oncology: principles and procedures.

The obstetrician-gynecologist is frequently the only physician to attend women during their reproductive years. Malignant disease outside the pelvic organs is a fairly frequent occurence in this age group. Certain findings in the patient's history and physical examination can suggest malignant disease. The routine laboratory examination can also provide indications of the presence of a neoplastic process. Once this process is suspected, histologic proof of malignancy must be obtained before further staging and therapy are considered. The extent of the disease is important for the planning of therapy, i.e., whether it is to be surgery, radiotherapy, chemotherapy or some combination of the three. Adjuvant chemotherapy is recognized as a form of treatment designed to eradicate micrometastases, prevent the occurrence of subsequent clinical metastatic disease and, as a result, improve survival.

Adult↗
PubMed1975

Cervical synovial sarcoma at the bifurcation of the carotid artery.

Cervical synovial sarcoma has been reported in only 15 cases; in none of these was there any association with a vascular structure. A patient with cervical synovial sarcoma encompassing the bifurcation of the left carotid artery underwent a left radical neck dissection, including excision of the left external carotid artery and the hypoglossal nerve. The tumor was dissected away from the common carotid and internal carotid arteries. Although the fibrous pseudocapsule of the tumor had not involved the fibrous adventitia of the carotid arteries. Radiation therapy with 6000 rads tumor dose was administered to a wide local field. There is no evidence of recurrence 1 year postoperatively. Histologic and ultrastructural findings were similar to those reported previously in a case of synovial sarcoma of an extremity.

Adult↗
PubMed1975

Staging laparotomy in non-Hodgkin's lymphoma.

In 57 patients with non-Hodgkin's lymphoma, a clinical, radiographic, scintigraphic and pathological correlative study showed the following results: (1) the inferior venacavagram, lymphangiogram and gallium-67 scan have a low sensitivity in detecting lymphoma: their accuracy is high when the findings are interpreted as abnormal (93%, 83% and 80% respectively), but low when they are interpreted as normal (47%, 67% and 58% respectively); (2) the clinical evaluation of spleen and liver is unreliable; (3) the incidence of lymphocytic lymphoma in the para-aortic-iliac nodes is high; (4) a pattern of involvement by contiguity and a predilection for the spleen were observed in lymphocytic lymphoma; (5) in lymphocytic lymphoma there is no liver involve without concomitant splenic involvement; (6) no definite pattern of spread could be seen in histiocytic lymphoma; (7) surgical staging changed the classification of the lymphoma in 56% of cases, 46% being reclassified to a more advanced stage; (8) surgical staging significantly improves the assessment of the stage of disease and therefore permits accurate treatment planning.

Adolescent↗
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↗