Biomedical subjects

P Sugarbaker

Publications and source records attributed to P Sugarbaker.

23 records · Page 2Linked to original sources

PubMed1980

The use of preoperative plasma CEA levels for the Stratification of patients after curative resection of colorectal cancers.

One hundred forty-five patients with colorectal cancer were analyzed in order to correlate the preoperative plasma carcinoembryonic antigen (CEA) levels with the sites and times of disease recurrence. The median follow-up periods of these patients was 50 months (range 36-72 months). Twenty-one patients were found to have metastases at the time of their operation. None of the seven patients whose primary tumors were classified as Dukes/Kirklin A have had tumor recurrence. Seventeen per cent of the patients with Dukes/Kirklin B tumors have had tumor recurrences, and 63% of the patients with Dukes/Kirklin C colorectal primary tumors have had tumor recurrence. No correlation was found between preoperative CEA values and subsequent risk of tumor recurrence or times to recurrence among the patients with Dukes/Kirklin B colorectal primary cancers. In Dukes/Kirklin C patients, however, elevated preoperative CEA values predicted a higher risk of tumor recurrence. Ninety per cent of the patients (19/21) with preoperative CEA levels greater than 5.0 ng/ml have had relapses, with a median time of 17 months before disease recurrence. Only 39% (9/23) of the patients with Dukes/Kirklin C lesions and CEA levels less than 5 ng/ml have had relapses and there is insufficient follow-up data as yet to determine the median survival time. If those patients whose Dukes/Kirklin C primary tumors were poorly differentiated on histologic examination are excluded, the contrast between patients having CEA levels greater than 5.0 ng/ml and those having CEA levels less than 5 ng/ml is even more marked. Sixteen of the 18 remaining patients whose CEA levels were greater than 5.0 ng/ml prior to curative resection have had relapses as compared with only three of 15 patients whose preoperative CEA values were less than 5. We conclude, therefore, that CEA is an important factor in stratifying patients after curative resection of their Dukes/Kirklin C colorectal tumors.

Carcinoembryonic Antigen↗

PubMed1980

Use of liposoluble contrast material to separate left renal and splenic parenchyma on computed tomography.

A lobulated or accessory spleen lying against the upper pole of the left kidney may simulate renal tumor on computed tomograms. Water soluble contrast material is usually of little help in the differential diagnosis, since it increases the attenuation of both the kidney and the spleen. Intravenous liposoluble contrast material preferentially increases the attenuation of the liver and spleen and thus permits clear separation of the enhanced lobulated or accessory spleen from the unopacified renal parenchyma.

Adult↗

PubMed1980

Clinical trials with a new intravenous liposoluble contrast material for computed tomography of the liver and spleen.

Ten patients with disseminated cancer were given intravenous injections of 0.2 ml/kg (40 mg l/kg) of the experimental contrast material EOE 13. Ct scans of the liver and spleen were taken prior to and 30 minutes after contrast infusion. Visualization of the liver was significantly improved in 5, moderately improved in 3, and not appreciably improved in 2. The spleen showed an obvious increase in density in all cases. No significant toxicity was encountered: untoward side effects consisted of fever, headaches, foul metallic taste, and weakness for a short period. Four patients had no side effects, and 2 experienced only abnormal taste sensation. Further experimental and clinical work is needed before the advantages and safety of this contrast material can be documented.

Autopsy↗

PubMed1979

Vasodilator correction of hypotension in the postoperative period.

This case is unusual in that hypotension, as opposed to hypertension, was a consequence of increased sympathetic tone in the postoperative period, but it illustrates the well known fact that patients in compensated congestive heart failure do poorly when faced with an elevated myocardial oxygen need from either increased rate or afterload. Vasodilator therapy was effective in immediately reducing afterload and systolic regurgitant fraction, thereby increasing oxygen supply and lowering myocardial oxygen consumption.

Adult↗

PubMedDate not supplied

Peritoneal carcinomatosis from gastrointestinal malignancy: natural history and new prospects for management.

Peritoneal carcinomatosis represents regional spread of gastrointestinal, gynecological and other malignancies with or without evidence of systemic metastases. The authors reviewed the natural history and the different types of peritoneal carcinomatosis. A new treatment approach that combines cytoreductive surgery and intraperitoneal chemotherapy is described. The principles of this surgery and the pharmacology principles of intraperitoneal drug administration are explained. The major attraction of intraperitoneal therapy is that following intracavitary drug administration, the peritoneal cavity is exposed to higher concentrations than the rest of the body. A total of 100 patients with peritoneal carcinomatosis followed from one to ten years were treated by this approach. Patients were divided into four prognostic groups according to the histologic findings, extent of diseases, distant metastases and the completeness of cytoreductive surgery. This new cytoreductive approach is particularly effective for patients with low-grade malignancies confined to the abdominal cavity and who had a complete cytoreductive surgery.

Absorption↗