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Biomedical subjects

N Dubin

Publications and source records attributed to N Dubin.

54 records · Page 3Linked to original sources
PubMed1984

Characterization and survival of patients with serous cystadenocarcinoma of the ovaries.

Factors affecting survival of 241 patients with ovarian serous carcinoma diagnosed and/or treated at New York University Medical Center from 1960 through 1980 are analyzed. Characteristics independently correlated with a favorable prognosis include low tumor stage and grade, presenting sign of a mass, and omentectomy. Patients under 50 years of age have a lower mortality rate (corrected for stage and grade) than older women. The presenting complaints of patients with a poor survival include nausea and/or vomiting, anorexia, and abdominal swelling. For patients with stage I disease neither bilaterality (stage Ib versus Ia) nor transcapsular extension of tumor adversely affected prognosis. However, patients with stage I disease with ascites appear to have a survival experience similar to patients with stage III disease.

Adult↗
PubMed1984

Evaluation of a sequential 5-FU and hydroxyurea combination in advanced bowel cancer.

Twenty-nine patients (two with small bowel cancer and 27 with colorectal cancer) were treated with a sequential 5-FU-hydroxyurea combination following the suggestion of schedule-dependent synergism in experimental systems. No enhanced toxicity was observed, but the response rate was only 4%. Seven additional patients manifested greater than or equal to 50% declines in CEA, but caution must be used in interpreting such changes as antitumor activity.

Adult↗
PubMed1984

Response of mycosis fungoides to topical chemotherapy with mechlorethamine.

Seventy-six patients with mycosis fungoides (MF) were given topical mechlorethamine hydrochloride therapy. Allergic contact hypersensitivity reactions to the drug developed in 51 patients (67.1%). Sixty-four patients of the original 76 continued therapy, with 43 (67.2%) achieving a complete remission and 12 (18.8%) achieving a partial remission. Stage I disease responded significantly better than did subsequent, more severe disease stages. The median times to complete remission were 5.6 months, 32.3 months, and 22.3 months for stage I, II, and III disease, respectively. The conditions of patients with contact sensitivity did not respond better than those of patients without contact sensitivity. Patients with substage A disease did not respond better patients with substage B disease. These findings are encouraging and indicate that the use of topically applied mechlorethamine for early-stage MF should be continued, despite the development of contact dermatitis to the drug.

Administration, Topical↗
PubMed1984

Prediction of lymph node metastases from the histologic features of primary cutaneous malignant melanomas.

Elective regional lymph-node dissection was performed on 98 patients with clinical Stage I cutaneous malignant melanoma and 26 of them were found to have microscopic evidence of metastases. The histology of the primary lesions was reviewed in order to find possible prognostic parameters that would allow prediction of nodal involvement. There was an increased risk of occult lymph node metastases with increasing thickness of the primary lesions. While this trend was not found to be statistically significant, no occult lymph node metastases were found for lesions less than 1.0 mm in thickness. Significant features included mitotic figures, "prognostic index," and plasma cells within the infiltrate. A multiple logistic regression analysis identified three groups of patients with low, medium, and high risk of occult metastases, based on thickness, location, and plasma cells. The correlation between plasma cells and the incidence of metastases in lymph nodes might represent an immunologic phenomenon.

Cell Count↗
PubMed1984

Epidemiology of minimal breast cancer among women screened in New York City.

A case-control study based on a screened population in New York City examined epidemiologic risk factor differences between minimal breast cancer (in situ and small invasive carcinomas) and all other breast carcinomas, referred to as clinical breast cancer. Histopathologic re-review of the original slides identified 113 minimal and 792 clinical breast cancers among 1,290 eligible cases; 2,173 randomly selected screenees served as controls. Among those who developed cancer, black women were twice as likely to develop minimal, as compared to clinical, breast cancer. Women who were less than 20 years of age at first live birth had more than double the probability of being diagnosed with minimal breast cancer, whereas women with first live birth at age 30 years or greater and nulliparous women were at 1.5 times the risk of clinical breast cancer. The relative proportion of minimal breast cancer increased with increasing number of children breast fed, being twofold among women who nursed 2 children or more. Unlike clinical breast cancer, minimal breast cancer was not associated with either family history of breast cancer or obesity. Meaningful histologic differences were not apparent between the case subgroups. Except possibly for obesity, these results could not be explained by any plausible diagnostic bias.

Adult↗
PubMed1984

Epidemiology of breast cancer in a screened population.

Breast cancer risk factors were examined in a screened population expected to exhibit selection bias. Data were obtained for 1,383 breast cancer cases and 2,543 randomly selected controls screened at the Guttman Breast Diagnostic Institute between 1968 and 1979. Relative risk (RR) estimates were found to be elevated for the usual factors: greater age, greater weight, early menarche, late first live birth or nulliparity, late menopause, and family history of breast cancer. Adjustment for screening variables (number of screenings, breast symptomatology, and year of first screening) removed substantial bias in RR estimates. The unadjusted analysis tended to reduce the magnitude of RR for family history and weight among screenees in general and for age among women screened only once. Although the unadjusted analysis showed no effects for either previous breast biopsy or religion, adjustment for screening variables indicated that among rescreened women, previous biopsy, Jewish and Catholic religion were associated with increased risk; among women screened once only, these characteristics were associated with decreased risk of breast cancer.

Adult↗
PubMed1983

Multivariate risk score for recurrence of cutaneous basal cell carcinomas.

Multiple logistic analysis relating prognostic factors to risk of recurrence was performed for 1,417 basal cell carcinomas treated from 1955 to 1969 at New York University. The overall five-year recurrence rates by therapy were as follows: curettage-electrodesiccation, 26.0% (197/758); x-ray therapy, 9.7% (40/412); and surgical excision, 9.3% (23/247). Results for each treatment subgroup indicated that increasing lesion diameter and location of the lesion on various sites of the head, especially the nose, were associated with an increased risk of recurrence, whereas lesion location on the neck, trunk, limbs, or genitalia was associated with a decreased risk of recurrence. Additional significant factors correlated with increased risk were as follows: among patients treated with x-irradiation, male sex, and, among those treated by curettage-electrodesiccation, prior therapy and increasing patient age.

Adult↗
PubMed1982

Risk factors for Kaposi's sarcoma in homosexual men.

An investigation of 20 homosexual men with histologically confirmed Kaposi's sarcoma and 40 controls revealed significant associations between Kaposi's sarcoma and use of a number of drugs (amyl nitrite, ethyl chloride, cocaine, phencyclidine, methaqualone, and amphetamine), history of mononucleosis, and sexual activity in the year before onset of the disease. Patients with Kaposi's sarcoma also reported substantially higher rates of sexually transmitted infections than did controls. Multivariate analysis indicated independent significant associations for amyl nitrite and sexual activity and showed use of phencyclidine, methaqualone, and ethyl chloride to be non-significant. Evaluated at the median exposure for patients, the analysis yielded risk-ratio estimates of 12.3 for amyl nitrite (95% confidence limits 4.2, 35.8) and 2.0 for sexual activity (95% confidence limits 1.3, 3.1).

Adult↗
PubMed1982

Primary melanoma thickness correlated with regional lymph node metastases.

We studied 119 patients with stage I primary cutaneous malignant melanoma, who were undergoing regional lymph node dissection, to determine the relationship of lymph node metastases to thickness of the primary lesion. The lymph nodes in the dissection specimen were each evaluated by serial sections. None of the patients with lesions less than 1.0 mm thick had nodal micrometastases. When lesions exceeded 1.0 mm in thickness, there was no appreciable increase in the incidence of nodal metastases until a thickness greater than 4.0 mm was reached, in which cases the incidence of metastases was 50%. Predictive variables were determined by multiple logistic regression analysis. Only lesions that were at least 4.0 mm thick and were not located on the upper extremities were significant predictors of lymph node metastases; within this category there was a 64% incidence of lymph node metastases.

Biopsy↗
PubMed1982

Pathologic predictors of recurrence in stage 1 (TINOMO) breast cancer.

A group of 122 consecutively treated pathologic Stage 1 (TINOMO) patients with cancer of the breast were studied to define histopathologic predictors of recurrence. Lymphatic invasion was the most significant predictor of recurrence; recurrence was present in 32% (8/25) of patients who had lymphatic invasion and in 10.3% (10/97) of patients who did not (P = 0.006). Histologic type was also predictive of recurrent disease. Eighteen per cent (18/101) of patients with invasive ductal or lobular carcinoma developed recurrent disease, while none of the group of 21 patients with medullary carcinoma, tubular carcinoma, colloid carcinoma, Paget's disease, and intraductal carcinoma with minimal invasion suffered a recurrence (P = 0.036). Vascular invasion, grade of malignancy, cellularity, presence or absence of circumscription, cellular infiltrate, fibroblastic response, neural invasion, and necrosis were not significant predictors of recurrence. Multiple logistic regression analysis of patients with invasive ductal or lobular carcinoma confirmed the results for individual factors, that only patients with lymphatic invasion were at higher risk of recurrence.

Breast Neoplasms↗
PubMed1981

Regional lymph node dissection for malignant melanoma of the extremities.

Seven hundred thirty-nine patients with malignant melanoma of the extremities were treated with a uniform surgical approach that included wide and deep excision of the primary site and regional node dissection therapeutically and electively for invasive lesions (Clark's levels III, IV, and V). Of the 490 patients who underwent lymph node dissections, follow-up was available for 457 (93%). Life-table comparison of 362 patients with histologically negative nodes to 95 with histologically proved lymph node metastases yielded statistically significant differences in survival (P less than 0.001). Five-year cumulative survival rates were 91% in the group without and 48% in the group with nodal metastases. Among histologically positive patients, differences in life-table survival curves for the 60 clinically negative patients compared to the 35 clinically positive patients were also statistically significant (P = 0.004); 5-year cumulative survival rates were 57% for the former group and 33% for the latter. Although there appears to be an advantage to regional lymph node dissection for micrometastases as opposed to gross nodal involvement, for the majority of patients metastatic melanoma in these nodes is the major indicator of systemic disease.

Actuarial Analysis↗
PubMed1980

Myocardial prostaglandin E release by nitroglycerin and modification by indomethacin.

In open chest dogs, studies were made of the effects of intravenous trinitroglycerin (10 micrograms/kg per min) on circumflex arterial coronary blood flow, coronary vascular resistance, systemic arterial pressure and myocardial prostaglandin E production before and after indomethacin (n = 9) or indomethacin vehicle (n = 5). During a 30 minute trinitroglycerin infusion, coronary sinus prostaglandin E concentration increased significantly (approximately +41 percent, p less than 0.01) without significant changes in left atrial prostaglandin E concentration. After indomethacin (5 mg/kg), but not indomethacin vehicle alone, a second trinitroglycerin infusion (10 micrograms/kg per min) produced a significantly smaller decrease in coronary vascular resistance (p less than 0.05) and systemic blood pressure (p less than 0.01) and no increase in coronary sinus prostaglandin E (p less than 0.001) by comparison with control values. The heart rate response to trinitroglycerin was significantly greater (p less than 0.05) after than before indomethacin. This study suggests that the mechanism of action of trinitroglycerin may be at least partially mediated through the prostaglandin system.

Animals↗
PubMed1979

The association of parity and marital status with the development of ovarian carcinoma: clinical implications.

Three hundred twenty-seven patients with ovarian carcinoma were compared with matched controls to determine the association of parity and marital status with the development of ovarian cancer. Nulliparous women were found to have 2.31 times the risk of developing ovarian cancer as parous women. Unmarried women had 3 times the risk of developing ovarian cancer, but marital status was not established as a variable independent of parity. Almost 8% of patients with ovarian carcinoma had had hysterectomies when they were over 40 years of age. This study indicates that parity is an important consideration when determining whether a patient is at high risk for the development of ovarian carcinoma. Other epidemiologic variables are discussed in an effort to facilitate the judicious selection of patients for elective oophorectomy at the time of hysterectomy.

Adult↗
PubMed1978

Prevalence of nevocytic nevi on lateral and medial aspects of arms.

The numbers of clinically diagnosed, elevated nevocytic nevi (at least 2 mm in diameter) within 50 sq cm areas on the lateral and medial aspects of the arms of 1,000 subjects (age range 2 to 87 years) were compared. A total of 349 nevi was found on the lateral aspects and only 116 on the medial aspects of arms. Nevi were found on the lateral aspects of the arms in 23.4% (234) of the subjects and on the medial aspects in but 10.9% (109) of the subjects. These differences are highly significant in both men and women. Nevi were found in 30.2% (281) of the 930 whites but in only 9.1% (5) of the 55 blacks included in the study. Also, blacks did not show greater prevalence of nevi on the lateral as compared to the medial aspects of their arms. One explanation for the greater prevalence of nevi on the lateral over that on the medial aspects of the arms is that sunlight plays a role in the induction of acquired nevocytic nevi.

Adolescent↗
PubMed1978

Scalpel excision of basal cell carcinomas.

A total of 468 coded, histologically proved basal cell carcinomas were excised from 446 patients in the Skin and Cancer Unit of New York University Medical Center from 1955 to 1967. The five-year cumulative recurrence rate was 6.8%. The highest recurrence rates, in areas in which sufficient data were available, were for the periocular regions, the scalp, and the nose and paranasal areas. Following re-treatment of recurrences, 464 of the 468 lesions (99.1%) were cured at the time of the most recent examination. After the second postoperative year, at least 70% of results were recorded as cosmetically good or excellent at the time of last follow-up. The most common complication was hypertrophic scars. There was a tendency for increasing incidence of such scars with increasing diameters of the lesions.

Adolescent↗
PubMedDate not supplied

Effect of different mammographic radiation exposures on predicted benefits of screening for breast cancer.

The benefits and risks of screening for breast cancer, including both mammographic and clinical examinations, are analysed by means of a probabilistic model. The model, applied to previously unpublished data provided by the HIP (Health Insurance Plan of Greater New York) breast cancer screening project, permits more precise stratification by age than previous analyses and allows for incorporation of oncogenic risks due to mammography. It is assumed that, from the tenth year of screening onward, radiation induces 6 cases of breast cancer per year per million women screened per rad delivered to the breast tissue per exam. The predicted pattern of breast cancer cases and deaths is commensurate with that actually observed in the first nine years of the HIP study. In extrapolation to lifetime experience, the model predicts an ultimate decrease in the probability of dying of breast cancer only for women over age fifty at initial screening and an increase in life expectancy for the entire screened group, at an exposure level of three rads per exam. Had radiation dosage been one rad or less per exam, which is within the range now possible with modern equipment and procedures, the radiation risk would not offset even a modest benefit such as is predicted for the younger women, either in number of deaths or years of life expectancy.

Adult↗