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Biomedical subjects

J Rosenman

Publications and source records attributed to J Rosenman.

47 records · Page 3Linked to original sources
PubMed1986

Local recurrences in patients with breast cancer at the North Carolina Memorial Hospital (1970-1982).

A study of predictive factors for locoregional recurrences after curative surgery for breast cancer was undertaken. Specifically, the authors wished to determine whether such recurrences correlated with either hormonal receptor status or a delay between the initial biopsy and the definitive surgery. A retrospective chart review was done on all women with breast cancer who had surgery for cure between 1970 and 1982. Factors analyzed included, among others, size of the tumor, clinical and pathologic status of the axilla, estrogen and progesterone receptors status, and delay between biopsy and definitive surgery. There were 404 patients studied. Pathologic axillary nodal status was the most important predictor of locoregional recurrence, with failures in 36 of 188 (19%) node-positive but only 9 of 216 (4%) node-negative patients (P = 0.0001). In node-positive patients, tumor size was a predictor of local recurrence, with failure in only 4 of 51 (8%) of tumors less than 2 cm, but in 14 of 44 (32%) of tumors greater than 6 cm (P = 0.004). Progesterone receptor (PR) status correlated with locoregional recurrence, but estrogen receptor status did not. In node-positive women, there were 4 of 14 PR-negative but 0 of 15 PR-positive local failures (P = 0.017); this result has not been previously reported. The presence of palpable axillary disease was also found to be a predictor of local recurrence. Finally, no increase in locoregional recurrence could be attributed to the delay between biopsy and definitive surgery. Two new predictors for locoregional recurrence in breast cancer, not previously emphasized, are PR and clinical axillary status. Should these findings be substantiated, patients at high risk for locoregional recurrence could then be more readily identified.

Actuarial Analysis↗
PubMed1986

Prostaglandin inhibitor and radiotherapy in advanced head and neck cancers.

Radiotherapy is the usual mode of treatment for unresectable head and neck cancer. To improve cure rates, extend survival, and reduce morbidity, we use accelerated hyperfractionation radiotherapy and an adjuvant drug to inhibit prostaglandin synthesis. In this study, 19 patients received 300 rad/day of radiotherapy in two equally divided doses to a total dose averaging 6,200 rad. Either indomethacin, 25 mg, or placebo was given four times a day in a double-blind fashion during therapy. Radiation mucositis was graded as 0 to 4+; pain, nutritional status, and tumor status were monitored daily and recorded biweekly. Evaluation of the data showed delayed mucositis in the experimental group for grades 1 to 3, with a significant difference at grade 3 compared with controls. The significance of a long-term comparison of cure rates would be doubtful considering the heterogeneity of the primary sites and regional disease in this group coupled with the small size of our study.

Clinical Trials as Topic↗
PubMed1984

The metastasis-free interval following curative treatment for breast cancer.

Although much research has been done to isolate factors that have good prognostic value for cure in breast cancer, comparatively little attention has been paid to the large variation in the metastasis-free interval (MFI) in those who are not cured. In this paper we studied 247 patients who were given curative treatment for breast cancer, all of whom developed metastatic disease. The MFI varied from 2 months to 22 years and was found to depend on nodal status, initial T-stage, and possibly, location of the tumor within the breast; it did not depend on age of the patient or histologic appearance of the tumor. In addition, the time from first relapse to death did not correlate with the MFI. With one exception (brain) the initial site of distant metastasis was the same in late relapsers as in early relapsers.

Adult↗
PubMed1984

Carotid arterial bifurcation advancement.

Acute postoperative thrombosis and late restenosis are well known complications of carotid endarterectomy. Vein or synthetic patches are imperfect solutions leading to occasional infections, false aneurysms and possible rupture. A new technique is described that patches the internal carotid artery with the external carotid artery after complete endarterectomy of both vessels. Twenty-five of these procedures were performed upon 22 symptomatic patients with no early or late morbidity or mortality. Theoretic advantages include wide patching of the internal carotid artery above the endarterectomy end point where narrowing is most dangerous, full endarterectomy of the external carotid artery and double tacking of the endarterectomy end points to deter circumferential intimal flaps.

Carotid Arteries↗
PubMed1982

The prenatal ultrasonic diagnosis of urethral obstruction and diverticulum of the urinary bladder.

In a 28 year old gravida 2 para 1 an ultrasonogram at 35 weeks of gestation revealed a huge cystic abdominal tumor in fetus. Postpartum ultrasound, excretory urography and micturating cystourethrography showed a trabeculated bladder with a large diverticulum and hydronephrosis due to a posterior urethral valve. The prenatal diagnosis of this anomaly and immediate surgical intervention prevented additional severe damage in the newborn.

Adult↗
PubMed1982

Improved quality of life of patients with small-cell carcinoma of the lung by elective irradiation of the brain.

About 30% of all patients with small cell undifferentiated carcinoma of the lung will ultimately develop metastases in the brain. It is now well established that elective whole brain irradiation can prevent such metastases, although it does not increase survival time. However, we have found that such treatment does increase the quality of life for these patients. Those with limited disease can survive with a Karnofsky scale of more than 60 for a mean time of 10 months compared with 6 months for an equivalent group treated only when these brain metastases occur. We have also found that treating patients therapeutically does not insure success as 6/16 eventually relapsed in the brain. We conclude that elective brain irradiation in patients with small cell undifferentiated carcinoma of the lung who present with a limited disease is of value because the quality of life is improved significantly.

Brain Neoplasms↗
PubMedDate not supplied

Initial experience with mesocaval H grafts: comparison with other portosystemic shunts.

Two policies concerning portosystemic shunt for bleeding esophageal varices were compared. In 18 patients, splenorenal or portocaval shunts were performed according to anatomic and hematologic considerations. In 13 patients, only mesocaval H grafts were performed. In the latter group, more patients had poor liver reserve and required urgent surgery. Accordingly, early and late mortality and morbidity were higher in these patients. the technical ease of performance of the mesocaval H graft did not cancel out increased risk in poorer candidates for surgery.

Adult↗