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Biomedical subjects

J R Stroehlein

Publications and source records attributed to J R Stroehlein.

30 records · Page 2Linked to original sources
PubMed1981

Colorectal cancer in young adults.

The clinical and pathologic characteristics of colorectal cancer in patients younger than 30 years are compared with those in patients 30 to 39 years of age. Patients in the two age groups had similar symptoms, predominantly undifferentiated neoplasms, and poor prognoses. However, when the characteristics of these patients were compared with those described for a general patient population with colorectal cancer there was a gradual decrease in the incidence of mucin-producing tumors, poorly differentiated carcinomas, and primary lesions in the right colon, with increasing age at diagnosis. The highest incidences were found in patients less than 30 years old. The degree of tumor anaplasia and stage of tumor at diagnosis significantly influenced the duration of disease-free interval after curative resection of the primary and the duration of survival. Ninety-six percent of patients younger than 40 years had carcinomas extending beyond the colonic wall at diagnosis, adversely affecting long-term survival. The five-year survival of only 25% to 30% in these patients emphasizes the need for early diagnosis and aggressive treatment.

Adolescent↗
PubMed1980

Palliation of malignant ascites by the LeVeen peritoneo-venous shunt.

A LeVeen peritoneo-venous shunt was placed in each of 5 patients under local anesthesia to relieve symptomatic malignant ascites. All patients had marked ascites due to histologically documented intraabdominal carcinomatosis, extensive hepatic neoplasm, or a combination of malignant ascites and severe parenchymal liver disease. Cases included metastatic breast carcinoma, pancreatic carcinoma, melanoma, and primary cholangiocarcinoma. Prompt relief of respiratory distress and discomfort associated with tense ascites was achieved in all patients; however, survival was short (one week to seven months) due to advanced disease. The LeVeen shunt can provide effective palliation of malignant ascites in carefully selected symptomatic patients.

Abdominal Neoplasms↗
PubMed1979

Gastric carcinoma in young adults.

The clinical and pathologic characteristics of gastric carcinoma in patients younger than 30 are compared with those of patients 30 to 39 years of age. Patients in both age groups had similar symptoms, predominantly undifferentiated neoplasms, and poor prognoses. In both groups, there were significant delays in initiation of definitive treatment because of delays in diagnosis. In 80% of the patients, the malignancy extended beyond the stomach wall at diagnosis, adversely affecting their long-term survival. The 20% five year survival in both groups indicates the necessity of early diagnosis and aggressive treatment.

Adult↗
PubMed1977

Nonoperative retrieval of an impacted long intestinal tube.

A patient with recurrent intestinal obstruction and jejunocutaneous fistula was referred for treatment of the latter condition. Management with total parenteral nutrition was complicatied by bacteremia. Subsequently, a double-lumen tube was passed via an existing gastrostomy for purposes of aspirating above the level of the fistula and infusing appropriate nutrients and fluids distally. A period of marked clinical improvement was followed by increased fistula output and evidence of intestinal obstruction secondary to gaseous distention of a sealed latex terminal balloon which was retrieved only after percutaneous puncture. The unusual complication of prolonged intestinal intubation is discussed with special reference to this nonsurgical method of managing the impacted balloon and tube. Factors affecting balloon distention are discussed and the necessity of venting intestinal balloons reemphasized.

Female↗
PubMed1976

Hemoccult detection of fecal occult blood quantitated by radioassay.

Results from the quaiac slide or Hemoccult (HO) test for fecal occult blood were compared with quantitative determinations of gastrointestinal loss after intravenous administration of 51Cr-labeled red cells. Subjects were 80 consecutive patients, without dietary restriction, who were referred because of clinical suspicion of gastrointestinal blood loss or complex anemia. A total of 555 stool specimens analyzed for 51Cr loss were graded negative, trace, or positive by the HO method. Of 338 specimens containing 0-2 ml/day by isotope assay, 7.4% were positive to the HO qualitative test. Loss of at least 10 ml/day in 51Cr equivalent was necessary to assure that the majority of HO reactions would be positive. Of specimens containing more than 30 ml/day, 93% were positive. The ratio of 51Cr-labeled red cell equivalents to stool volume and the percentage of positive HO reactions increased together. When this ratio exceeded 10%, two thirds of the HO responses were positive.

Adolescent↗
PubMed1976

Hemoccult stool tests: false-negative results due to storage of specimens.

Stoll samples mixed with 0 to 38 mg of hemoglobin per gram of stool were tested for occult blood by the Hemoccult (HO) method when fresh and after storage for 1 to 14 days. The intensity of the HO reaction in fresh stool samples was directly related to the hemoglobin concentration, and approximately 8 mg/g was required for a positive reaction. After samples had been stored on HO cards for 4 days, the intensity of the HO reaction was decidedly less in all. Except at the highest concentrations studied, all became HO-negative or trace within 8 days. In contrast, samples of most concentrations that were stored in tightly capped containers prior to preparation of HO cards maintained a positive reaction intensity for 1 week. Nevertheless, the intensity of the HO reaction decreased significantly (P less than 0.01) with each method of storage. No false-positives were induced by storage during this portion of our study. Samples from 100 stool specimens sent to the clinical laboratory for determination of occult blood were also smeared on separate HO cards for testing immediately and after 4, 7, or 10 days of storage. Only one positive HO reaction was observed on an HO card prepared from a specimen initially classified as HO-negative. In contrast, up to 40% of the stored HO cards prepared from specimens initially classified as HO-positive were HO-negative when analyzed 4 days later.

False Negative Reactions↗
PubMedDate not supplied

Chemotherapy for colorectal cancer with a combination of PALA and 5-FU.

Fifty-one previously untreated patients with advanced, measurable colorectal cancer were randomized to receive single doses of PALA and 5-FU either weekly (24 patients) or daily for 5 days every 4 weeks (27 patients). In both schedules the daily dose of PALA was administered iv over 1 hour, while the dose of 5-FU was administered iv over 30 minutes, starting 3 hours after completion of the PALA dose. Doses of both drugs were changed simultaneously, based on toxic effects. Partial responses were seen in four of 24 evaluable patients receiving the weekly regimen and in three of 26 patients receiving the 5-day regimen. Skin rash, mucositis, and diarrhea were the dose-limiting toxic effects in both treatment regimens. These toxic effects were more common and severe at higher doses and on the weekly schedule. Myelosuppression was mild and moderate, the doses and schedules used in this study did not significantly increase the activity of 5-FU. Further evaluation of these doses and schedules for activity against colorectal cancer is not warranted.

Adult↗