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Biomedical subjects

M A Simon

Publications and source records attributed to M A Simon.

At least 145 records · Page 8Linked to original sources

Cardiac metastases from soft-tissue sarcomas.

Cardiac metastases were present in 30 of 120 (25%) consecutive autopsies of patients with soft-tissue sarcoma (STS). Fifty percent of the patients had metastases to the myocardium, while 33% had pericardial metastases and 17% had both. Congestive heart failure was present in ten patients and was commonly caused by diffuse myocardial or restrictive pericardial metastases. Other signs and symptoms of cardiac involvement by STS included chest pain (three patients), arrhythmias (two), conduction block (two), simulation of an atrial myxoma (one), and sudden death (one). Echocardiography was used infrequently, but was diagnostic in 80% of cases in which it was used. We conclude that metastatic STS commonly involves the heart and produces cardiac symptoms.

Adolescent↗

Limb-salvage treatment versus amputation for osteosarcoma of the distal end of the femur.

A retrospective multi-institutional study of 227 patients with osteosarcoma of the distal end of the femur was done to compare rates of local recurrence, metastasis, and survival. Three cohorts of patients who had had either a limb-sparing procedure, an above-the-knee amputation, or disarticulation of the hip were compared. The results revealed prevalences of eight of seventy-three, nine of 115, and zero of thirty-nine as to local recurrence; forty-three of seventy-three, sixty-five of 115, and twenty-one of thirty-nine as to metastasis; and thirty-three of seventy-three, forty-eight of 115, and eighteen of thirty-nine as to death. Of the seventeen patients who had a local recurrence, sixteen died. In the limb-salvage group, eighteen patients required amputation, because of local recurrence in eight and other local complications in ten. The Kaplan-Meier estimates of the percentage of patients who survived and the percentage of patients without recurrent disease showed no difference among the three surgical groups (Mantel-Cox test statistic: p = 0.8) after a median length of follow-up of five and one-half years. Various covariant adjusted estimates yielded similar results. For the entire group of patients, the rate of continuously disease-free survival was 42 per cent, and the over-all rate of survival was 55 per cent at five years. It appears that, compared with above-the-knee amputation or disarticulation of the hip, the use of a limb-salvage procedure for osteosarcoma of the distal end of the femur did not shorten the disease-free interval or compromise long-term survival.

Adolescent↗

Immunohistochemical study of mononuclear phagocyte antigens in giant cell tumor of bone.

The cytogenesis of giant cell tumor of bone (GCT) was assessed by immunohistochemical methods. Three GCT were analyzed by a sensitive immunoalkaline phosphatase technique with a panel of monoclonal antibodies, including eight reacting with separate antigens previously found to be present on mononuclear phagocytes (MPs) and one specific for the endothelial marker, coagulation Factor 8. Among the MP-associated antigens evaluated were leukocyte common antigen (LCA), HLA-DR, C3b receptor, and C3bi receptor. Also incorporated in the panel were antibodies to MP-associated antigens with well-characterized tissue distribution but of currently unknown function. Constituent cells of the tumors varied in their reactions with the antibodies of the panel. Although mononuclear cells in tumor stroma were labeled with all of the antibodies against the MP markers, giant cells reacted strongly only with antibodies to LCA and the MP-associated antigen recognized by the antibody EBM11. Giant cells were weakly and focally labeled with antibodies (KB90 and UCHM1) against two additional MP-associated determinants and were unreactive with the remaining antibodies in the panel. Spindled stromal cells, which appeared to produce collagen, were not labeled with any of the antibodies in the panel. Only endothelial cells reacted with antibody to Factor 8. The results of this study suggest that giant cells of GCT are derived from stromal cells of mononuclear phagocyte lineage, and that the stromal precurser cells lose some, but not all, MP-associated antigens as they mature into giant cells.

Adolescent↗

Endoscopic retrograde cholangiopancreatography in Echinococcus (hydatid) cysts of the liver.

Endoscopic retrograde cholangiopancreatography (ERCP) was carried out on 19 patients with hydatid cyst of the liver, either before or after operation. Cholangiographic findings included biliary tract obstruction in 8 cases, intrinsic compression in 4 cases, laminated membranes or daughter cysts in the biliary tree in 3 cases, perforation into the biliary tract in 2 cases, stricture in the biliary ductal system in 1 case, and biliary fistula in the remaining case. Biliary tract obstruction was secondary to chemical cholangitis by formalin in 2 patients. ERCP is a useful procedure in patients with suspected intrabiliary rupture or when symptoms occur after surgical removal of the cyst.

Adolescent↗

The nucleotide sequence and the tissue-specific expression of Drosophila c-src.

We have examined the coding capability and expression of the Drosophila homolog of the vertebrate proto-oncogene c-src. Sequence analysis of a cDNA clone representing the Drosophila c-src locus suggests that the gene encodes a 62 kd protein that is remarkably similar to the protein product of chicken c-src. The Drosophila c-src locus is transcribed into three mRNAs that are each regulated independently during development. Drosophila c-src RNA is abundant in embryos and pupae but rare in larvae and adults. In situ hybridization reveals that after the first 8 hr of development, c-src RNA accumulates almost exclusively in neural tissues such as the brain, ventral nerve chord, and eye-antennal discs, and in differentiating smooth muscle. We conclude that c-src may not be a mitotic signal but instead may play a role in the development of neural tissue and smooth muscle.

Amino Acid Sequence↗

Psychological outcome of extremity sarcoma survivors undergoing amputation or limb salvage.

When compared to amputation, limb salvage procedures for extremity sarcomas have been advocated because of potential functional benefits and presumed psychological-outcome advantages. The purpose of this study was to compare psychological outcomes between survivors who underwent either amputation or limb salvage procedures for extremity sarcomas. Fifteen amputees and 20 patients with salvaged limbs (mean age, 37.9 years; range, 15 to 71 years) were evaluated 1 to 5 years after surgery for extremity sarcomas. Demographic and medical information was obtained and cognitive functioning, affect, mood, body image, physical functioning, global psychological adjustment to illness and surgery, and lifetime prevalence of psychiatric disorders before and after surgery were assessed. Two patients were excluded because of the presence of an incapacitating organic mental syndrome. The remaining patients, 14 amputees and 19 patients with salvaged limbs, had a variety of soft-tissue and bone sarcomas. No significant differences were found between the groups in age, sex, marital status, surgically involved extremity, chemotherapy status, and social class at the time of surgery and interviews. There were no significant differences between the groups in scores of cognitive capacity, symptoms, mood, body image changes, global physical functioning, global adjustment to illness and surgery, and lifetime prevalence of psychiatric disorders before or after surgery. Most patients revealed only mild psychological symptoms and 55% demonstrated good to excellent adjustment to their surgeries and diseases. There were no significant differences in measures of psychological outcome for patients with extremity sarcomas who underwent limb salvage procedures compared to those who underwent amputation. A psychological-outcome advantage of limb-salvage surgery compared to amputation has yet to be demonstrated.

Adaptation, Psychological↗

Pregnancy and aggressive or malignant primary bone tumors.

The authors performed a retrospective study of 33 patients to assess the effect of pregnancy on the behavior of primary bone malignancies, and to develop a strategy for pregnant women with such malignancies focusing on decisions concerning the fetus. This study indicates that pregnancy has no effect on the clinical behavior of bone sarcomas, and, therefore, there is no reason to perform an abortion because of their simultaneous occurrence. However, optimal treatment of the tumor may cause irreparable harm to the fetus. Three main medical factors need to be considered when the future of the fetus is being decided: (1) the trimester at the time of diagnosis; (2) the anatomic site of the tumor; and (3) the type and grade of the tumor, as it relates to the expected treatment of the tumor.

Adult↗

Clinical utility of the erythrocyte sedimentation rate in preoperative evaluation of solitary skeletal lesions.

We investigated the utility of the erythrocyte sedimentation rate in planning the diagnostic and surgical strategy for patients who were found by conventional radiography to have a solitary skeletal lesion. A series of 101 patients was separated into two groups according to their ultimate diagnoses. Group I included patients with skeletal metastases of unknown origin, unusual bone infections, and marrow cell tumors. Group II included benign and malignant primary bone tumors. Using the Westergren method to determine the erythrocyte sedimentation rate prior to biopsy, we found that only one of 65 Group II patients had a rate above 30 mm/h whereas 22 of 36 Group I patients had rates greater than 60 mm/h. By using Receiver Operating Characteristic analysis, we estimated the trade-offs between sensitivity and specificity that can be achieved with various threshold sedimentation rates. In particular, we found that a critical erythrocyte sedimentation rate of 30 mm/h allows separation of Group II patients from Group I patients with 96.9% sensitivity and 82.6% specificity. Our results indicate that the erythrocyte sedimentation rate can be used effectively in conjunction with conventional radiography in the planning of an appropriate further diagnostic strategy.

Adolescent↗

The clinical value of bone and gallium scintigraphy for soft-tissue sarcomas of the extremities.

In a prospective study of forty-five patients, we evaluated the usefulness of bone and gallium scintigraphy prior to definitive surgery for a soft-tissue sarcoma in an extremity. Bone scintigraphy provides a baseline for staging and often reveals periosteal invasion that is not detected by routine radiographs. Blood-pool scintigraphy with bone tracers is very sensitive for a diagnosis of malignant disease. Gallium scintigraphy appeared to be a reliable preoperative indicator of malignant disease of soft tissue (sensitivity, 85 per cent; specificity, 92 per cent) and was useful for detecting the infrequent occult, non-pulmonary metastasis. Combined gallium and bone scintigraphy with blood-pool imaging provided a reliable prediction of the presence or absence of a malignant lesion in patients with a soft-tissue mass in an extremity. We recommend that bone and gallium scintigraphy be routinely used in the initial clinical staging of soft-tissue sarcomas.

Adolescent↗

Three loci related to the src oncogene and tyrosine-specific protein kinase activity in Drosophila.

Rous sarcoma virus (RSV) is an acutely oncogenic avian retrovirus which induces sarcomas in animals and transforms fibroblasts in cell culture. Genetic analysis indicates that the viral src gene (v-src) mediates neoplastic transformation. The product of v-src is a 60,000 molecular weight (MW) phosphoprotein (pp60v-src) possessing the enzymatic activity of a tyrosine-specific protein kinase. The viral src gene is derived from a cellular gene (c-src) which also encodes a 60,000 MW phosphoprotein (pp60c-src) with tyrosine-specific protein kinase activity. Both birds and mammals are known to possess c-src. Shilo and Weinberg have reported that the genome of the fruit fly, Drosophila melanogaster, contains nucleotide sequences that are homologous to v-src. We report here the molecular cloning and chromosomal mapping of three loci from the Drosophila genome that contain such sequences. We also show that Drosophila contain both phosphotyrosine and a tyrosine-specific protein kinase activity immunoprecipitated by antisera directed against pp60v-src. It should now be possible to identify the precise locus that encodes a src-specific protein kinase in Drosophila, and to explore the role of c-src in the growth and development of D. melanogaster.

Animals↗