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Biomedical subjects

P Littman

Publications and source records attributed to P Littman.

50 records · Page 3Linked to original sources
PubMed1977

Radionecrosis of the brain presenting as a mass lesion: a case report.

A case of radionecrosis of the brain in a patient previously treated for squamous cell carcinoma of the scalp is presented. Cerebral angiography revealed a mass effect primarily in the right frontal area. Computed tomography showed extensive hemispheric oedema. A frontal lobectomy was performed, and the recovery was excellent. The lower limit for brain tolerance for irradiation is about 5000 rads given in five weeks. This dose should not be exceeded when extracranial lesions are treated. Although computed tomography cannot diagnose brain necrosis, specifically, it should, along with the clinical history, be very helpful.

Brain↗
PubMed1976

Glassy cell carcinoma of the cervix.

A clinicopathologic analysis of 13 cases of glassy cell carcinoma of the uterine cervix is presented. The glassy cell carcinoma is considered to be a poorly differentiated mixed adenosquamous carcinoma. Its histologic appearance is distinctive, being characterized by cells with a moderate amount of cytoplasm having a ground glass or finely granular appearance, a distinct cell wall that stains with eosin and PAS, and enlarged nuclei with prominent nucleoli. In the present study this tumor was associated with extrapelvic spread in 6/13 cases at diagnosis. Results were poor with either surgery and/or radiotherapy. Only four of 13 patients survived 5 years. The glassy cell carcinoma appears to be a distinct clinicopathologic entity which warrants a place in the classification of carcinoma of the cervix.

Adenocarcinoma↗
PubMed1976

Pulmonary function in survivors of Wilm's tumor. Patterns of impairment.

Whole-lung irradiation in Wilms' Tumor patients has been given prophylactically and for treatment of metastasis. Thirty-three children with Wilm's tumor who have survived for 4 to 20 years from the time of diagnosis were avaiable for study. Whole-lung irradiation was given in doses from 1163 to 1370 rads (orthovoltage). Eighteen patients (Group N) received no irradiation to the lungs. The remaining 15 patients were divided according to whether pulmonary irradiation was given for metastatic disease (Group M--10 patients) or for prophylactic treatment (Group P--five patients). All but five patients in Group N received at least one course of actinomycin D. A routine set of pulmonary function tests was done to assess possible abnormalities of lung volume and the mechanics of breathing. Group N was normal. The findings in Group M suggested moderately reduced lung volumes and may have also reflected obstruction of the large airways and/or a limited expiratory effort. Group P had essentially normal lung volumes but also appeared to have obstruction of the larger airways. Abnormalities were generally not severe; only two patients, in Group M, were symptomatic. Excess irradiation, presence of metastatsis, additional lung irradiation, and pneumonitis may have contributed to morbidity.

Child↗
PubMed1976

Gallium-67 scans in children with solid tumors.

Twenty pediatric patients with malignant disease were studied by whole body gallium scans. Seven had Hodgkin's disease, five had soft tissue sarcomas, three had neuroblastomas, two had Wilm's tumors, and one each had a hepatoblastoma, embryonal cell carcinoma, and sacrococcygeal teratoma. Of 50 sites studied, there was a true positive result in 17%, and in 58% there were false negative results. The method served best in patients with Hodgkin's disease, where the true positive rate was 64%. In no instance did the gallium scan affect the clinical management of a patient.

Adolescent↗
PubMed1975

Cardiac pacemakers. Does radiation therapy affect performance?

Representative deman cardiac pacemakers were tested with several common radiation therapy devices and ancillary equipment. The experimental set-up essentially duplicated the dosimetric and electroconductive environment of the radiation therapy patient bearing a pacemaker. Observations of pulse width and interval confirmed that pacemaker output was generally not appreciably affected by the simulated treatments. Occasionally, changes were caused by ancillary equipment and start-up of treatment. We conclude that although interference hazards are sometimes seen, radiation therapy is not contraindicated in patients wearing pacemakers.

Humans↗
PubMed1975

Reticulum cell sarcoma of the brain. A review of the literature and a study of 19 cases.

Reticulum cell sarcoma of the brain is a rare neoplasm. However, patients who have been recipients of transplants have had a much higher than expected incidence of this tumor; reticulum cell sarcomas of the brain may be seen more often in the future. Most of the information available in the literature deals with the pathology and clinical course of the disease. Although several authors have commented on the radioresponsiveness of the tumor, little detail as to the exact treatment methods has been provided. Furthermore, it has been assumed that the prognosis of this tumor, after some form of surgery and postoperative radiotherapy, may be fairly good. This paper presents 19 patients who have had surgery followed by postoperative radiotherapy. Although a few patients have had good relief of symptoms for 3 to 4 years, only 1 patient is alive and free of disease over 5 years. This patient is the sixth reported long-term survival in the literature. Suggestions for the management of this disease are provided. If possible, limited surgery to remove circumscribed tumors should be done, but extensive resection should be avoided. Postoperative irradiation should include the whole brain to at least 4500 rads at 1000 rads per week, with a boost to residual tumor, if present, of 500 to 1000 rads in two to five treatments.

Adult↗
PubMed1975

Treatment of para-aortic nodes in carcinoma of the cervix.

Thirty-six cases of carcinoma of the cervix with positive pelvic or para-aortic nodesdiagnosed by lymph node scan, lymphangiogram, and/or biopsy have received radiation therapy to the para-aortic nodal area at the Hospital of the University of Pennsylvania. Megavoltage radiation delivering a tumor dose of approximately 5000 rads in 5 weekshas been used. Of 26 patients avaiable for foloowup for 2 years, 11 were alive; of 8 followed for 5 years, 4 were alive. The severe complication rate was 19.5%, with a 5.5% mortality. Conclusions an- implications for further therapy are discussed.

Aorta↗
PubMed1975

Rethinking the necessity of treating all fields at each radiotherapy session.

Examples of multifield and wedged treatment plans are evaluated in terms of the fractionation protocol. Isoeffect distributions derived from time-dose fractionation values are examined, emphasizing alternate treatment schedules of the same plan. The necessity of treating all fields at each session is found to be a function of the detailed nature of the individual treatment plan.

Bone Neoplasms↗
PubMed1975

Chlordiazepoxide metabolism in mice following hepatic irradiation.

Biotransformation of chlordiazepoxide was studied in mice following a single 1000-rad dose of hepatic irradiation. Meabolic N-demethylation of chlordiazepoxide in irradiated mice was impaired when tested 3 days after irradiation. No such effect was observed in mice tested 3 weeks or 6 weeks after irradiation. Thus, hepatic irradiation appeared to produce short-lived, reversible impairment of drug-metabolizing function. The effect was small and of uncertain biological significance.

Animals↗
PubMedDate not supplied

Tracheoinnominate artery fistula as a complication of radiation therapy.

Tracheoinnominate artery fistulization is a well-known complication of tracheostomy and of tracheal resection. The first known occurrence of this problem in a patient in whom no transtracheal procedure had ever been performed is reported, and high-dose radiation therapy delivered three years before for a mediastinal malignancy is suggested as the cause. No evidence of tumor was found in or adjacent to the tracheovascular communication. The tracheoinnominate artery fistula must be considered a potential complication of radiation therapy as well as of surgery.

Brachiocephalic Trunk↗