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Biomedical subjects

M L Friedlander

Publications and source records attributed to M L Friedlander.

64 records · Page 4Linked to original sources

Ploidy as a prognostic factor in ovarian cancer.

The cellular DNA content of 50 ovarian common epithelial carcinomas was determined by flow cytometry, and tumours were classified as being either diploid or aneuploid. A significant association between tumour stage and ploidy was demonstrated, with all diploid tumours being of an early stage (p less than 0.001). Forty percent of early-stage tumours (FIGO stages I and II) and all late-stage tumours (FIGO stages III and IV) were aneuploid. This heterogeneity with respect to DNA content among tumours of a similar stage may allow the identification of neoplasms with a different natural history. The proportion of S-phase cells determined by flow cytometry is a measure of cellular proliferation and may also be of prognostic significance. Diploid tumours had a median S phase of 9.8% (2.4-14.1%), while aneuploid tumours had a significantly higher S phase of 19.6% (7-24.7%; p less than 0.05). In this study there was no relationship between histological grading of invasive carcinomas and ploidy, but in view of the relatively small numbers and limited follow-up, it was not possible to perform a multivariate analysis of all known prognostic factors in ovarian cancer. Our results suggest that ploidy reflects tumour behaviour, but prolonged follow-up and increased patient accrual is necessary to assess whether the flow cytometric analysis of DNA content will provide clinically important information in ovarian cancer.

Adenocarcinoma↗

Lorazepam as an adjunct to antiemetic therapy with haloperidol in patients receiving cytotoxic chemotherapy.

Twenty-seven consecutive patients were treated with 3 mg oral lorazepam and 2.5 mg intravenous haloperidol in an effort to improve patient tolerance of cytotoxic chemotherapy and decrease nausea and vomiting. Antiemetic efficacy and side-effects were assessed using a patient questionnaire. Vomiting either did not occur, or was considered to be of only moderate intensity in 22 patients (81%) and usually ceased within 24 hours of commencing chemotherapy. Similarly, nausea was either absent or of only moderate severity, lasting less than 48 hours in the majority of patients. Eight of 11 patients who had received similar previous cytotoxic treatment with antiemetic agents but not lorazepam considered that lorazepam and haloperidol had considerably improved their tolerance of chemotherapy. The side-effects of haloperidol and lorazepam were mild and well tolerated.

Anti-Anxiety Agents↗

Method for analysis of cellular DNA content of paraffin-embedded pathological material using flow cytometry.

A method has been developed that allows flow cytometry to be used for measuring the cellular DNA content of paraffin-embedded human tumors. Thick (i.e., 30 micron) sections were cut from tissue blocks using a microtome and dewaxed in xylene. The sections were then rehydrated by sequentially immersing them in 100, 95, 70, and 50% ethanol before finally washing in distilled water. Single cell suspensions were then prepared by incubation in 0.5% pepsin, pH 1.5, at 37 degrees C for 30 min. The cells were counted, washed, and stained with 1 microgram/ml 4',6'-diamidino-2-phenylindole for 30 min, and DNA content was measured using an ICP 22 flow cytometer. There was a good correlation between the DNA histograms produced using this method and those obtained using unfixed tissue from the same tumor stained with ethidium bromide plus mithramycin. This method allows the retrospective study of archival material where the clinical outcome is already known, and it should, therefore, be particularly useful for determining the prognostic significance of abnormal DNA content measured by flow cytometry.

DNA, Neoplasm↗

Demographic, cognitive and experiential predictors of presurgical anxiety.

A heterogeneous sample completed a demographic survey, a measure of internal-external locus of control (I-E), the Hospital Stress Rating Scale (HSRS), and a state anxiety measure on the eve of major surgery. Three sets of variables (demographic, cognitive, and experiential) together significantly accounted for one-quarter of the variance in state anxiety. However, only the cognitive set (I-E and the HSRS) was uniquely significant, supporting the view of presurgical anxiety as a patient's response to interpretation of a life-threatening event. Higher levels of anxiety were associated with more anticipated stressful experiences, stronger beliefs that powerful others and chance influence events, and weaker beliefs that events are caused by one's own efforts. Implications are presented for identifying patients at risk for presurgical anxiety and for designing interventions to enhance the patient's sense of control.

Adult↗

Counting the costs of cancer therapy.

The costs of cancer treatment were estimated for five groups of cancer patients: those with operable breast cancer receiving adjuvant chemotherapy and patients with advanced breast cancer, ovarian cancer, germ cell cancer and small cell lung cancer. Cancer treatment costs were substantial but chemotherapy cost was a relatively minor item. Methods of limiting treatment costs are identified as reducing hospital stay, encouraging outpatient administration of chemotherapy and limiting the number of supernumary investigations. The cost of different cancer treatment options should be considered when management decisions are made.

Breast Neoplasms↗