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Biomedical subjects
Publications and source records attributed to P Chan.
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A family including four members with decreased antithrombin III (ATIII) measured by a biological and an immunological method is described. Immunologically measured levels of other coagulation inhibitors were normal. In the antithrombin III deficient family members there was a history of thrombotic disease. Turnover of 125I-antithrombin III in a deficient individual showed the lower plasma levels probably to be due to a deficiency in the rate of synthesis rather than to an increased catabolic rate.
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Sixteen patients with intestinal and bladder injury secondary to external irradiation alone have been reviewed. Tolerance doses are shown to vary depending on the history of recent pelvic surgery, as compared to pelvic surgery in the past. A partial review of the literature and a discussion of the causative factors is presented.
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The median survival of patients with metastatic cancer can vary over a relatively large range. A staging system based on the natural history of metastatic cancer is necessary if one is to evaluate the results of treatment or predict survival.
Trichilemmoma is an uncommon cutaneous neoplasm that originates in the outer hair sheath. We are reporting two cases, one of lobular pattern, the other a massing of cells of the follicular infundibulum. In each case, the clinical appearance was nonspecific and the mistaken clinical diagnosis was basal-cell carcinoma.
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Pretreatment DNCB skin testing and absolute lymphocyte counts were studied in 85 consecutive head and neck cancer patients. All patients were treated primarily with radiation therapy alone or combined radiation plus surgery. The results of DNCB testing and absolute lymphocyte counts were not sufficiently predictive of outcome, (no evidence of disease after 2 years) to be useful in making treatment decisions on an individual patient. This applied to the good prognosis (T1, T2, N0-N3) and poor prognosis (T3, T4, N0-N3) groups.
Between 1950 and 1965, 365 patients were treated for transitional cancer of the bladder at our hospitals. A retrospective study was done, using clinical records and a histopathologic review to determine the long-term natural history of this population when treated conservatively. The natural history of 3 separate patient populations was discovered, based solely on the grading of the transurethrally resected fragments. Based on the grade on initial presentation these patients were divided into grades I, II and III. Of the patients 5 per cent in grade I, 16 per cent in grade II, 28 to 35 per cent in grade III not involving muscle and 83 per cent in grade III involving muscle died of bladder cancer. Ninety-seven patients (26 per cent) died of bladder cancer, 110 (31 per cent) died of other causes and 158 (43 per cent) have been alive more than 5 years (104 more than 10 years). Grade I tumors that progressed to a higher grade did so within 2 years of the initial diagnosis. Of the bladder cancer deaths 83 per cent occurred within 2 years of the initial diagnosis. Of 64 patients dying more than 5 years after presentation only 7 died of bladder cancer.
In women, dietary modification and life style affect the risk of breast cancer and may alter the hormonal status, while in experimental animals diet can alter the incidence of induced mammary tumors. In this study, a high fat diet increased the incidence of DMBA-induced tumors in rats while this increase in incidence was lowered and the effect of a high fat diet obliterated by an anti-prolactin during CB154. Premenopausal Japanese women had a higher estradiol level than their Caucasian counterpart. In Japanese but not Caucasian breast cancer patients, the estradiol decreased. When nurses were transferred from the Western to a vegetarian diet, the menstrual cycle was shortened, while their prolactin and testosterone decreased. Data indicate that dietary factors influence tumor incidence and hormone profile in rat mammary cancer and the hormonal status in women.
Two unusual anaerobic vibrio-like organisms were recovered from blood cultures of two patients. One isolate was identified as Desulfovibrio desulfuricans. It appeared to be the cause of a 24-h episode of fever, chills, and profuse perspiration. This is apparently the first documented report of human infection due to this organism. The second isolate was a Succinivibrio species. It has rarely been described as a cause of bacteremia. The clinical significance of the organism remains unclear.
The records of 158 patients irradiated for bone metastases were reviewed to evaluate the effectiveness of pain relief and to judge the effect of treatment on overall quality of life. Within 3 months 73% of the sites treated had pain relief, with 55%-65% having sustained relief up to 1 year or death. Of patients surviving more than 3 months, 63% maintained a satisfactory quality of life and were able to take care of most personal needs. The median survival of all patients was 1 year from initial treatment for bone metastasis. Radiation dose and the primary tumor site do not seem to be significant prognostic factors for initial pain relief or quality of life.
The authors reviewed 181 patients who received local radiation therapy for the prevention or control of extramedullary disease resulting from acute leukemia. 126 had acute lymphocytic leukemia and 55 had acute granulocytic leukemia. They were treated over a 18-year period of time with different forms of chemotherapy. Most had not received prophylactic CNS radiation therapy. Patients were evaluated for local control until death or hematologic relapse intervened. More than 80% of patients with clinical ALL meningeal leukemia had a successful response to doses over 1000 rads. This same response was not apparent in AML. More than 80% of clinical non-CNS extra medullary leukemia was controlled with doses of 600 rads or greater. Only one patient with extra-medullary relapse is still alive. The authors feel that lower preventative doses of radiation to the CNS are compatible with similar control rates, based on their own data and other suggestive data.
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