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Biomedical subjects

M Luna

Publications and source records attributed to M Luna.

At least 109 records · Page 6Linked to original sources
PubMed1978

Nonbacterial thrombotic endocarditis in cancer patients: comparison of characteristics of patients with and without concomitant disseminated intravascular coagulation.

Thirty-one cases with malignant neoplasm and nonbacterial thrombotic endocarditis (NBTE) were studied. A threefold increase in the incidence of NBTE over the five-year period ending in 1976 was noticed. Seventy-one percent of patients with NBTE had concomitant disseminated intravascular coagulation (DIC). Adenocarcinomas of the lung or ovary were the most common tumors (48%), followed by hematologic malignancies (25%). Five patients had acute leukemia, two of whom had received bone marrow transplantation. Sudden changes in the status of cardiovascular and central nervous systems were the most common manifestations of NBTE and its complications. The possible predisposing factors included disseminated malignant neoplasms and infection with gram-negative bacilli. Identification of high-risk patients and early administration of preventive measures including anticoagulation might decrease the morbidity and mortality related to NBTE.

Adenocarcinoma↗
PubMed1978

An unusual case of metastatic carcinoma to the eyelid.

A 46-year-old woman developed a painless nodular lesion of her right lower eyelid four years after having a right radical mastectomy for breast carcinoma. The lesion slowly increased in size over one year to involve full thickness eyelid tissue that included the margin and inferior punctum and was associated with localized loss of cilia. The clinical appearance of the lesion and its course of development suggested a primary eyelid neoplasm. Incisional biopsy revealed metastatic mammary carcinoma.

Breast Neoplasms↗
PubMed1978

The prognostic and therapeutic value of frozen section determinations in the surgical treatment of squamous carcinoma of the head and neck.

The records of 216 patients with squamous cell carcinoma of the oral cavity, oropharynx, and hypopharynx treated by surgery alone were reviewed. Frozen section control at the time of the surgical procedure was used to evaluate the margins of the excision. Findings at frozen section were correlated with local control and survival. The inability of the surgeon to obtain clear margins by frozen section for whatever reason resulted in a very high incidence of local recurrence and death. The fact that the patient's tumor could be removed with free margins at the time of surgery did not guarantee long-term success, although the frozen section technic did prove to be reliable and an effective tool for evaluating the patient's prognosis and the efficacy of the surgical procedure.

Carcinoma, Squamous Cell↗
PubMed1978

Escherichia coli bacteremia in patients with malignant diseases.

Of 142 episodes of Escherichia coli bacteremia that were reviewed, appropriate antibiotics were administered during 98 episodes diagnosed premortem and 74 episodes (71%) responded. The highest cure rates were observed when the portals of entry were the urinary tract and soft tissues. Administration of adrenal corticosteroids did not affect the outcome of these patients. The patients' neutrophil counts at the onset and during infection were important factors in predicting survival. Septic shock occurred in 13% of all episodes, and only 11% of these patients responded. Of those patients who died, 63% died within the first 24 hours. Aminoglycosides, cephalosporins, and semisynthetic penicillins used alone or in combination offered optimal coverage.

Adolescent↗
PubMed1977

Pulmonary alveolar proteinosis: its association with hematologic malignancy and lymphoma.

Pulmonary alveolar proteinosis (PAP) developed in 5 patients with hematologic malignancy or lymphoma. Possible pathogenetic mechanisms which might predispose the patient to this association include the unavailability of competent alveolar phagocytes secondary to profound leukopenia, or inhibition of alveolar phagocytosis by elevated globulins. The spectrum of pulmonary abnormalities produced by PAP includes classical butterfly perihilar alveolar consolidation, lobar consolidation, parenchymal nodules, and hilar adenopathy. Four of the 5 cases had complicating infections, making the exact radiological correlation with PAP difficult.

Adolescent↗
PubMed1976

Fungemia due to Torulopsis glabrata in the compromised host.

Ten episodes of Torulopsis glabrata fungemia occurring in nine patients with terminal illnesses are described. Eight patients had underlying malignancies and one patient had a plastic anemia. Two episodes of fungemia were considered transient since they were clearly related to the administration of intravenous hyperalimentation (IVH). Most patients were adult women and had solid tumors of the genitourinary tract. Contributory factors were: antibiotic therapy (100%), immunosuppressive drugs (75%), abdominal surgery (63%), IVH (50%), neutropenia (38%), and diabetes mellitus (13%). The clinical course was indistinguishable from a severe bacterial infection. However, endotoxic shock was not observed. The infection was rapidly fatal in four patients. In the remaining five patients, the infection was altered favorably by the discontinuation of infected intravenous hyperalimentation catheters. However, tissue invasion by T. glabrata was found in two of these patients who died shortly thereafter from tumor progression. At autopsy, T. glabrata was identified in tissue sections of the lungs, kidneys, and mucosas of the gastrointestinal and genitourinary tracts. In all cases there was tissue necrosis with a minor inflammatory response consisting of mononuclear cells. To our knowledge, this is the single largest series of T. glabrata fungemia ever reported.

Adult↗
PubMed1976

Metastases from testicular carcinoma. Study of 78 autopsied cases.

The necropsy records of 78 patients with histologically proved germ cell tumors of the testis, who died as a direct result of their malignant disease, were reviewed to determine the usual modes of spread, distribution of metastasis, the histologic characteristics of the metastatic foci as compared with the morphology of the primary tumor and the specific cause of death. The sites of metastases in order of decreasing frequency for all cases were lung, retroperitoneal lymph nodes, liver, mediastinal lymph nodes, brain, kidney, gastrointestinal tract, bones, adrenals, peritoneum and spleen. The absence of metastases solely in the anterior mediastinum without involvement of other mediastinal nodes (middle/posterior) strongly supports the premise for a primary extragonadal origin whenever the anterior mediastinum alone is involved with malignant disease having the histologic appearance of a primary germ cell tumor. The histologic features of the metastatic lesions were usually similar in nature to those of the primary tumor except for seminoma in which the metastatic lesions proved to be of a different histologic pattern in almost one third of the patients dying from the disease. It should be axiomatic that whenever a patient with seminoma fails to respond appropriately to radiotherapy that his treatment be immediately discontinued and that appropriate biopsies be obtained to substantiate the histologic pattern present.

Adolescent↗
PubMed1976

Laboratory and clinical evaluation of tobramycin, a new aminoglycoside antibiotic.

The in vitro susceptibility to tobramycin of 1,466 bacterial isolates, including several genera and strains of common pathogenic gram-negative bacilli and Staphylococcus aureus, was determined by conventional serial dilution methods. Tobramycin exhibited marked in vitro antibacterial activity; almost all of the isolates tested were inhibited by less than or equal to 2.5 mug of the drug/ml. The antibiotic was used in the treatment of several types of infection in 29 patients with normal renal function. Observations were made on the therapeutic and secondary effects of the drug and on possible toxicity to the eighth cranial nerve. Clinical therapeutic results were satisfactory, The hearing of one patient was impaired, but the relation of this effect to tobramycin therapy is uncertain. Serum levels of the antibiotic were measured in 10 patients to investigate whether the drug accumulated during repeated administration. Mean serum levels of tobramycin 1 hr after intramuscular injection of 1.0 mg/kg were between 2.5 and 3.0 mug/ml on days 1, 3, and 6 of therapy. No accumulation of the antibiotic was observed after repeated administration.

Animals↗
PubMed1975

Successful control of systemic Aspergillus niger infections in two patients with acute leukemia.

The diagnosis and successful control of systemic Aspergillus niger infection in 2 adult patients with acute leukemia is reported. During induction therapy, the first patient developed pulmonary infiltrates, skin lesions and abnormal liver function tests. Aspergillus niger was found on skin and liver biopsy. This patient was successfully treated with Amphotericin B and granulocyte transfusions and he remains in remission. The second patient developed a pneumonitis and adynamic ileus with positive sputum and stool cultures for Aspergillus niger. The infection only responded to Amphotericin B and granulocyte transfusions and the leukemia to cytoreductive chemotherapy. The patient later relapsed and died after a febrile illness. Fungi morpholocially consistent with Aspergillus were found in the liver at autopsy. Infection with A. niger is rare even in this patient population; however fungal infections have become an increasing problem. The need for a high index of suspicion, especially when an infection is unresponsive to antibacterial antibiotics, the various diagnostic tools, and the need for aggressive therapy are stressed. Amphotericin B is the chemotherapy of choice but may be insufficient in a severely neutropenic host where the simultaneous use of granulocyte transfusions might be lifesaving.

Acute Disease↗
PubMed1975

Combination 6-mercaptopurine-adriamycin in refractory adult acute leukemia.

Remission induction therapy with 6MP and adriamycin in combination was administered to 19 adult leukemic patients refractory to previous therapy. Eight patients also received vincristine and prednisone. Thirteen patients had acute myelogenous leukemia, 3 undifferentiated leukemia, and 3 blastic transformation of chronic myelogenous leukemia. Four patients achieved remission but in only 2 were the remissions complete. Eleven patients failed to respond. Ten of the 19 patients developed unexpected severe liver toxicity manifested by a clinical picture of cholestasis (in the majority) or ascending cholangitis (in 2 patients). In the postmortem examination of 8 patients there was cholestasis and mild to severe hepatocellular damage in all.

Acute Disease↗
PubMed1975

Combined therapeutic approach to malignant lacrimal gland tumors.

The medical records of 13 patients with primary malignant lesions of the lacrimal gland revealed adenoid cystic carcinoma as the most common malignant tumor. The histologic cell type, neural invasion, and bony destruction were correlated with localized control and ultimate survival. Surgical removal of the lacrimal gland was adequate treatment for low-grade mucoepidermoid carcinoma confined to the gland itself. Combining a radical surgical removal of the area in planned sequence with high voltage radiation therapy offered the only reasonable hope for localized control in the more aggressive cell types or in tumors with neural invasion or bony involvement. A 40%-localized control and survival rate was achieved in the adenoid cystic carcinoma group of patients. Radiation therapy administered for cancer that obviously recurs after surgical resection was generally unsuccessful.

Adenocarcinoma↗