Biomedical subjects
J R Simpson
Publications and source records attributed to J R Simpson.
Disseminated lupus erythematosus profundus.
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"Collagen disease" due to carbamazepine (Tegretol).
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Carcinoma of the tonsillar fossa: a nonrandomized comparison of irradiation alone or combined with surgery: long-term results.
The results of therapy are reported in 296 patients with histologically proven epidermoid carcinoma of the tonsillar fossa; 127 were treated with irradiation alone (5,500 to 7,000 cGy), 133 with preoperative radiotherapy (2,000 to 3,000 cGy) or were initially planned for preoperative irradiation but treated with radiotherapy alone, and 36 with postoperative irradiation (5,000 to 6,000 cGy). The operation in all but 4 patients consisted of an en bloc radical tonsillectomy with ipsilateral lymph node dissection. Actuarial 5-year no evidence of disease (NED) was as follows: survival rates for patients with T1 tumors, 76%; T2, 54%; T3, 45%; and T4, 20%. Patients with no cervical lymphadenopathy or with a small metastatic lymph node (N1) had better relapse-free survival (60% to 70% at 5 years) than those with large or fixed lymph nodes (30% to 40%). Primary tumor recurrence rate in the T1-T2 groups was about 20% in patients treated with irradiation and surgery and 30% for those treated with irradiation alone (difference not statistically significant), 30% in patients with stage T3 lesions in all treatment groups, and 33% in patients with T4 disease treated with surgery and postoperative irradiation compared to 52% with irradiation alone (p = 0.03). The overall recurrence rate in the neck was about 20% for the N0 patients, 25% for N1, and 30% for those with N2 and N3 cervical lymph nodes in the 4 treatment groups. The incidence of contralateral neck recurrences was about 8% with the various treatment modalities.(ABSTRACT TRUNCATED AT 250 WORDS)
Adenoid cystic salivary gland carcinoma: a clinicopathologic correlation.
Between 1960 and 1980, 71 cases of adenoid cystic carcinoma (ACC) were reviewed according to treatment modality and clinical course. Histologic review of pathologic slides was performed to classify the tumors into their predominant histologic pattern (tubular, cribriform, solid). The predominant histologic patterns of the tumors were equally divided between tubular and cribriform. Very few were classified as a solid pattern. In the patients receiving the same type of therapy (surgery and irradiation), the cribriform and tubular variants of ACC demonstrated no difference in the rate of distant metastases and overall survival. The cribriform variant demonstrated a significantly worse prognosis in terms of local recurrence rate. The patients who had a solid histologic pattern of ACC appeared to have an overall worse prognosis in terms of distant metastases and long-term survival. The long-term survival of patients with ACC may be related to the development of distant metastases despite local control.
Success of elective irradiation of occult lymphatic metastases from cancers of the larynx and pyriform sinus.
We determined the success of elective neck irradiation for 104 patients with carcinomas of the larynx and pyriform sinus whose only surgery was resection of the primary cancer. Tumor regrew in the neck of 22 patients (21%) and was twice as likely to recur in the neck when there was simultaneous regrowth of tumor in the laryngeal remnant or pharynx. The observed rate of neck recurrence did not vary appreciably from the expected rate as determined by the incidence of occult lymphatic metastases in dissected neck specimens. The rate of neck recurrence was less after high doses (greater than 45 Gy) than low doses (less than or equal to 45 Gy) of irradiation, suggesting a benefit from higher doses of elective neck irradiation.
Hair, serum, and urine chromium concentrations in former employees of the leather tanning industry.
In this study, we measured concentrations of Cr in hair, serum, and urine of men who were previously employed in the leather tanning industry. Concentrations of Cr in hair and serum were significantly lower than corresponding values obtained during their employment and were comparable to levels obtained for controls in a previous study. These results suggest that Cr III accumulated from employment in the leather tanning industry does not result in long-term elevation of Cr concentrations in the body.
Preoperative irradiation and surgery for carcinoma of the base of the tongue.
From 1960 through 1978, 101 patients with histologically proven epidermoid carcinoma of the base of the tongue were treated with preoperative irradiation and surgery at Washington University School of Medicine. Local and regional control at 3 years was achieved in 65% of the patients, and at 5 years in 57%. Sixteen percent of patients who suffered local or regional failure were salvaged by further surgery. Distant metastases developed in approximately 18% of patients and second malignancies developed in 20%. It appears that the combination of preoperative irradiation plus surgery provides substantial local control rates and survival for patients with base of tongue cancer in both early and moderately advanced stages.
Wastes, health and the engineer.
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