Search PubMed⌕ Search

Biomedical subjects

L Herrera

Publications and source records attributed to L Herrera.

At least 163 records · Page 9Linked to original sources
PubMed1987

Biologic modulation of 5-fluorouracil with high-dose leucovorin and combination chemotherapy of 5-fluorouracil and cisplatin in metastatic colorectal adenocarcinoma.

The data from an ongoing 3-arm prospective study of 72 patients with advanced colorectal carcinoma is presented. The 3 regimens are as follows: Regime 1 (every 4 weeks)--5-fluorouracil (FUra) (450 mg/m2 iv bolus daily for 5 days, then 200 mg/m2 iv bolus every other day for 6 doses); regime 2 (every week for 4 weeks, then every other week)--methotrexate (MTX) (50 mg/m2 in a 4-hour infusion) followed by FUra (600 mg/m2 iv bolus); regime 3 (weekly for 6 weeks followed by a 2-week rest period)--D,L-leucovorin (D,L-CF) (500 mg/m2 in a 2-hour infusion) with FUra (600 mg/m2 iv bolus) 1 hour after the D,L-CF infusion began. All monitoring lesions except lung were documented by tissue biopsy. Thirteen of 18 patients in the FUra + D,L-CF arm were evaluable for response. Six of the 13 patients (46%) have had a partial response. The duration of the 6 responses has been 11, 8, 7, 4, 3 and 3 months. In patients with liver metastases as the monitoring lesion, a dramatic improvement in liver function tests has been seen during the first 2 courses (12 weeks) of treatment, but this was not sustained. The toxicity of FUra + D,L-CF was predominantly gastrointestinal; unlike with FUra alone, myelosuppression was not predominant.

Adenocarcinoma↗
PubMed1987

Incidence of urinary tract infections in patients requiring long-term catheterization after abdominoperineal resection for rectal carcinoma: does Betadine in the Foley drainage bag make a difference?

Twenty-three patients who underwent abdominoperineal resection for rectal adenocarcinoma were entered into a prospective study to determine the efficacy of periodic instillation of Betadine into the urinary drainage system as a prophylactic measure for catheter-associated urinary tract infections. We decided to use a control group of 33 consecutive patients done in the period just preceding the starting of this prospective study. In both groups the mean duration of the Foley catheter drainage was similar. Eight of eight female patients in the treatment group and six of seven patients in the control group developed a urinary tract infection. However, only five of 15 male patients (33%) in the treatment group whereas 16 of 26 males in the control group (61%) developed a urinary tract infection. Thus, the addition of Betadine in the drainage system of urinary indwelling catheters was associated with a 50% decrease in the incidence of urinary tract infections in males.

Abdomen↗
PubMed1987

The prognostic value of preoperative alkaline phosphatase for resection of solitary liver metastasis from colorectal carcinoma.

A retrospective review was undertaken to determine the influence of preoperative alkaline phosphatase levels on the prognosis of patients who had undergone resection of liver metastasis from colorectal adenocarcinoma at Roswell Park Memorial Institute. From March 1967 to March 1985, 26 patients underwent laparotomy who were thought to have solitary liver metastasis. Twenty of these patients were divided into two groups: group A consisted of seven patients who survived at least 24 months without any evidence of disease and were free of disease at the time of this report. Group B consisted of 13 patients who recurred or died from metastases following liver resection. The preoperative levels of alkaline phosphatase clearly showed that an elevated level before surgery was associated with a poor prognosis in the majority of cases. In group A only one of seven patients had an elevated level where seven of 13 patients in group B had elevated preoperative alkaline phosphatase levels. In conclusion, preoperative alkaline phosphatase levels may be helpful in determining the prognosis of patients considered for curative resection of solitary liver metastasis from colorectal carcinoma.

Adenocarcinoma↗
PubMed1986

Epidermoid carcinoma of the anal canal.

The charts of 67 patients treated for epidermoid carcinoma of the surgical anal canal were reviewed. The clinical presentation, type of surgical procedure performed, lymph node status of the pararectal and inguinal nodes, time of recurrence, site of recurrence, and median survival from the date of primary surgery and from the date of recurrence were determined. There were 55 patients (82%) who had a minimum of 5 years' follow-up since initial treatment. Optimal surgical treatment requires an abdominoperineal resection with wide dissection of the ischiorectal fossa and perineum in all patients, as well as an en bloc excision of the posterior vaginal wall in women. Although excision of the posterior vaginal wall improves the disease-free interval, median survival is not altered, compared with the group without vaginectomy. The predominant sites of local recurrence in men are the pelvis and perineum, and in women, the pelvis and posterior vaginal wall. The status of the pararectal lymph nodes from the operative specimen can give accurate information about the relative risk of recurrence. The presence of inguinal lymph node metastases represents a poor prognosis because of a close association with systemic metastases.

Adult↗
PubMed1986

Anastomotic recurrence of adenocarcinoma of the colon.

The cases of 158 patients with locally recurrent colorectal carcinoma were retrospectively studied. Eighteen patients (11.4%) had a recurrent lesion at the site of anastomosis. Sixteen patients who underwent a primary curative resection had a median disease-free interval of 13 months, while two patients with a palliative resection had a disease-free interval of two months. All recurrences occurred within 27 months of the primary surgery. Abdominal pain was the most frequent presenting symptom, followed by melena and a change in bowel habits. Eighty-nine percent of the recurrences occurred in the context of metachronous or synchronous metastases equally distributed between local-regional and distant diseases. Thirteen patients underwent resection of recurrent disease, of which eight resections were curative. The median survival following curative resection was 23 months, with 14 months for palliative resection and five months for no resection.

Adenocarcinoma↗
PubMed1986

Gardner syndrome in a man with an interstitial deletion of 5q.

Chromosome analysis of blood cells from a 42-year-old white male with mental retardation, colon carcinoma, horseshoe kidney, absence of left lobe of the liver, agenesis of the gallbladder, and possible Gardner syndrome revealed a constitutional marker chromosome due to del(5)(q13q15) or del(5)(q15q22). A polymorphic chromosome #22 with enlarged satellites was inherited from the father, who is phenotypically normal, and was probably unrelated to the congenital malformations. This is the first report of a Gardner syndrome patient with an interstitial deletion of 5q.

Chromosome Banding↗
PubMed1986

The morbidity of perineal wounds following abdominoperineal resection for rectal carcinoma.

The clinical charts of 44 patients who underwent an abdominoperineal resection for adenocarcinoma of the rectum at Roswell Park Memorial Institute were retrospectively reviewed. The morbidity of an open perineal wound versus the closed perineal wound were evaluated. All of the patients received a Nichol's bowel preparation and following the abdominal portion of the dissection reperitonealization of the pelvic floor was performed. The overall morbidity for the open perineal wounds was 21% compared to a morbidity of 63% for the perineal wounds that were closed primarily. The mean length of hospitalization from the time of abdominoperineal resection was 21 days for the open perineal group and 22 days for the closed perineal group. The inclusion of wound sinus tracts in our morbidity assessment may explain the higher complication rate of the closed wound group than previously reported in the literature. This retrospective review emphasizes that the morbidity of the open perineal wound following abdominoperineal resection has been overemphasized. One is trading a potentially increased incidence of septic wound complications in the closed perineum for a protracted wound closure in the open perineum.

Abdomen↗
PubMed1986

Aminocaproic acid (AMICAR) in advanced colorectal carcinoma.

We treated 20 patients with measurable histologically confirmed colorectal adenocarcinoma with aminocaproic acid (AMICAR). There were 11 males and 9 females with a median age of 63 years. All 20 patients had received prior chemotherapy. The majority of monitoring lesions were distributed between lung and liver. We evaluated 12 patients in this series for response. Three patients had stable disease and nine patients had progressive disease. All patients were evaluable for toxic effects, the most common being nausea and vomiting. AMICAR given orally at 210 mg/kg of actual body weight/day is not an effective single agent in the treatment of metastatic colorectal carcinoma. In view of previously published animal data the role of AMICAR in the adjuvant setting for colorectal carcinoma still needs to be determined.

Adenocarcinoma↗
PubMed1986

Osseous metastases from colorectal carcinoma.

In a 10 year (1970 to 1980) retrospective study of 66 patients with primary colorectal adenocarcinoma and osseous metastases, there were 47 patients who had bone and other distant metastases whereas 19 patients had osseous metastases only. The median disease-free interval was 21 months. The overall median survival time from diagnosis of osseous metastases was 7 months. Bone scanning is probably more sensitive for diagnosing bone metastases that radiography. Radiotherapy seems to be the most effective treatment for symptomatic osseous metastases.

Adult↗
PubMed1986

Glycerolipid metabolism in lung from ventilated and unventilated rabbits.

The incorporation of [14C]-glycerol 3-phosphate and [3H]-palmitate into phosphatidic acid, phosphatidylcholine, phosphatidylethanolamine and triacylglycerols by lung microsomes from ventilated and unventilated rabbits was measured. Unventilated lung microsomes showed an impairment of the "de novo" synthesis of phosphatidic acid and, therefore, a general decrease of glycerolipids synthesized from glycerol 3-phosphate. The incorporation of [3H]-palmitate into phosphatidic acid was considerably lower than the incorporation of [14C]-glycerol 3-phosphate by lung microsomes from both ventilated and unventilated rabbits, and the 3H/14C molar ratio did not change during incubation time. These observations suggest the preferential utilization of endogenous fatty acids by acyltransferases involved in the formation of phosphatidic acid. The activities of the enzymes implicated in the synthesis of phosphatidylcholine from lysophosphatidylcholine remained unchanged in lung from both ventilated and unventilated rabbits.

Animals↗
PubMed1986

Abdominal exploration for suspected recurrent carcinoma of the colon and rectum based upon elevated carcinoembryonic antigen alone or in combination with other diagnostic methods.

Thirty-six patients underwent abdominal exploration due to elevated carcinoembryonic antigen (CEA) levels after a curative resection for carcinoma of the colon and rectum. Three groups were evaluated. In group 1, CEA elevation alone was the indication for the exploration in 13 asymptomatic patients. In group 2, 13 other asymptomatic patients underwent exploration because of elevated CEA levels in combination with other findings. In group 3, ten patients were symptomatic with an elevated CEA level at the time of exploration. Five patients from groups 1 and 2 underwent a curative resection for recurrent tumor (14 per cent). Three of these patients are still alive more than five years after exploration. Nine patients had negative findings at exploration for tumor recurrence (25 per cent false-positive results). Six of these patients are alive while three have died of metastatic disease. Twenty-two of the 36 patients (61 per cent) had unresectable disease at the time of exploration. Four of these patients underwent some form of surgical palliative procedure. Considering the five patients who underwent a curative resection with the latter four patients, this results in 25 per cent of the patients benefitting from surgical exploration.

Adult↗
PubMed1986

Enhanced levels of insulin-like growth factor messenger RNA in human colon carcinomas and liposarcomas.

The insulin-like growth factors I and II (IGF-I and -II) are proteins which stimulate cell proliferation and are important in normal human growth and development. They are coded for by separate genes and bind to specific cell surface receptors, eliciting a mitogenic response. IGFs are secreted by several cell lines derived from adult tumors. We have examined a number of human adult tumors for IGF messenger RNA (mRNA) expression and found IGF-II mRNA levels were consistently elevated in two types, colon carcinoma and liposarcoma. Adult colonic mucosa contains low levels of IGF-I and -II mRNA while several colon tumors, particularly of rectal and rectosigmoid origin, contained significantly elevated levels of IGF-II message. Over 90% of liposarcomas examined contained greatly elevated levels of IGF-II mRNA while control tissue (adipose) contained very low or undetectable IGF mRNA levels. Many of these tumors also contained elevated IGF-I mRNA levels. Northern analysis of these RNAs revealed differences in the abundance and sizes of IGF transcripts compared to other normal and malignant tissues known to express IGF.

Carcinoma↗
PubMed1985

Phase II study of combination bleomycin, vincristine and high-dose methotrexate (BOM) with leucovorin rescue in advanced squamous cell carcinoma of the anal canal.

Fifteen patients with advanced squamous cell carcinoma of the anal canal were treated with a combination of bleomycin, vincristine, and high-dose methotrexate (BOM) with leucovorin rescue. Three out of twelve patients with measurable disease had objective responses of 1, 2, and 5 months. Five of the fifteen patients had severe or life-threatening complications as a result of this treatment regimen. The narrow therapeutic index of the BOM therapy makes it a less than ideal drug combination for the treatment of advanced squamous cell carcinoma of the anal canal.

Aged↗
PubMed1985

Isolated metachronous metastases to soft tissues of the buttock from a colonic adenocarcinoma.

The more common patterns of dissemination and recurrence of colonic cancer are known and well-documented. In contrast, extravisceral, distant soft tissue metastases are comparatively rare. Therefore, these metastases are not subject to meaningful generalizations, with the exception that they are often associated with widespread metastatic disease. This report describes the first case of carcinoma of the colon metastatic to the skeletal muscle of the contralateral buttock and the sciatic nerve without concurrent evidence of pelvic or distant metastases. Curative resection was not possible because of involvement of the proximal sciatic nerve.

Adenocarcinoma↗
PubMed1985

Surgical resection of pulmonary metastases from colorectal adenocarcinoma.

From 1962 to 1982, 27 patients with pulmonary metastases as the only site of recurrent colorectal carcinoma underwent pulmonary resection at Roswell Park Memorial Institute. Only five of these patients had symptomatic pulmonary lesions. No postoperative mortality occurred. The median survival after pulmonary resection was 27 months. Five patients are alive presently without recurrent colorectal cancer and two patients are alive with recurrent pulmonary metastases. Patients with solitary lesions had a better survival than patients with multiple lesions. The major sites of recurrence following thoracotomy were the lungs and liver.

Adenocarcinoma↗