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Biomedical subjects

R C Watson

Publications and source records attributed to R C Watson.

At least 73 records · Page 4Linked to original sources
PubMed1978

The value of diagnostic aids in detecting pancreas cancer.

By contract with the National Cancer Institute, the accuracy of diagnostic techniques was assessed in 184 patients suspected of having pancreas cancer. Of 138 patients who were operated upon, 89 were found to have pancreas duct cancer, 30 had cancer of a different site of origin in the head of the pancreas region and in 19 there was no evidence of cancer at operation. All of the 46 patients who were not operated upon, 13 proven to have cancer and 33 patients discharged as free of cancer, were followed in our clinic. The majority of our patients presented with signs and symptoms of biliary obstruction. Computerized transaxial tomography (CTT) gave a "correct" diagnosis in 31 of 33 patients (94%) with proven cancer, there were 2 patients with a false negative report and a false positive diagnosis occurred in 8 of 20 patients (40%) without cancer. Celiac angiography (CA) gave a correct diagnosis in 78 of 94 patients (83%) with cancer, a false negative in 17%, and a false positive in 32%. 76Selenomethionine pancreas scan correctly diagnosed 27 of 36 patients (75%) with cancer, gave a false negative in 25% and a false positive in 31%. Ultrasonography gave a correct diagnosis in 18 of 27 patients with cancer (67%), a false negative in 33% and a false positive in 28%. Endoscopic retrograde cholangiopancreatography diagnosed correctly 8 of 11 cases (73%) of cancer, there were false negative diagnoses in 3 cases (27%) and false positives in 3 of 14 patients (21%). Duodenal aspiration techniques gave a very low percentage of correct diagnoses. Chronic pancreatitis most commonly gave rise to a false positive diagnosis. Serum alkaline phosphatase was elevated in 82% of patients, gave 18% false negatives and 33% false positives. Carcinoembryonic antigen (CEA) was elevated (greater than 2.5 ng/ml) in most of the pancreas cancer patients but also in patients with other cancers and with non-cancerous diseases. In our hands, CTT, CA, alkaline phosphatase, 75Se-methionine and ultrasonography, in descending order, have given the highest percentage of correct diagnoses but false positive and false negative diagnoses prevented any single test from being conclusive.

Biopsy, Needle↗
PubMed1977

Adriamycin in advanced urinary tract cancer: experience in 42 patients and review of the literature.

Forty-two patients with measureable, advanced, genito-urinary cancer received Adriamycin. Significant clinical responses (CR/PR) occurred in only five (14%) of 35 adequately treated patients. Four additional patients achieved a minimal response anf four others showed stabilization of their disease for 4 to 9 months. Review of the literature suggests an overall response rate of 20%. Patients with a urinary diversion lived significantly longer (P 0.006) than patients who did not have this procedure (42.5 months vs 21.5 months). The need to define various patient characteristics in future chemotherapeutic trials in bladder cancer is discussed.

Adenocarcinoma↗
PubMed1977

Radiation treatment planning.

Radiation treatment planning has developed into a substantial and effective component of the entire radiation treatment approach. Over the last 2 decades, with the development of high energy electron and x-ray sources, and also with the availability of new radionuclides and techniques for internally applied radiation, all of which permit a high degree of concentration of radiation, treatment planning has been developed to make best use of these modalities. The use of automatic computation has proved necessary in order to handle the large amounts of radiation data involved in treatment dose calculation. Tumor and anatomical localization has been carried out with increasing precision. Several cases are described which illustrate planning and in particular the use of computerized transverse tomography. The use of moving shadow-shields is also described. For internally applied radiation, the features of iodine-125 are illustrated.

Adult↗
PubMed1977

Tumor vascularity as a prognostic factor for hepatic tumors.

The prognostic and therapeutic significance of tumor vascularity was studied in 36 patients with hepatoma or metastatic colon cancer in the liver. All patients had nonresectable tumor and were treated by hepatic artery ligation and hepatic arterial infusion chemotherapy. Chemotherapy consisted of methotrexate, actinomycin-D, 5-fluorouracil and cyclophosphamide. Hepatic tumors were categorized into Grades I to III in the order of increasing vascularity as determined by preoperative hepatic angiography. Tumor vascularity of 15 patients with hepatoma was Grade III in 11 (73%) and Grade II in 4 (27%). No patient with hepatoma had a Grade I tumor. The median survival of patients was 10 and 6 months for Grade III and II hepatomas, respectively, after hepatic artery ligation, and 18 and 8.5 months for Grade III and II, respectively, from the time of diagnosis of hepatoma. Tumor vascularity of 21 patients with metastatic colon cancer was as follows: Grade III in 3 (14%); Grade II in 10 (48%); and Grade I in 8 (38%). The median survival was 11, 10.5 and 4 months for Grades III, II and I, respectively, after hepatic artery ligation, and 17, 14.5 and 7.2 months for Grades III, II and I, respectively, from the time of diagnosis of hepatic metastases of colon cancer. The results indicate that the more vascular the hepatic tumor on angiogram, the better the prognosis following hepatic artery ligation and infusional chemotherapy.

Antineoplastic Agents↗
PubMed1977

Intrapericardial installation of radioactive chromic phosphate in malignant effusion.

Treatment of 28 patients with malignant pericardial effusion was accomplished primarily by intrapericardial instillation of radioactive chromic phosphate. At time of diagnosis of pericardial disease, 14 patients had major manifestations of tamponade; the rest had little or no clinical evidence of effusion. Only eight of the 28 patients had further problems with effusion after the initial pericardiocentesis and 32P instillation. Additional aspirations were done on those patients 2 weeks to 5 months later. The average survival was 9 months; seven patients lived more than 1 year.

Adult↗
PubMed1977

The neuropathology of malignant external otitis.

A case report of malignant external otitis is presented with particular emphasis on the neuropathological sequelae. The most striking finding was a mycotic aneurysm of the basilar artery with resultant thrombosis and brain stem infarction. Diffuse pachymeningitis was also present. The severity of the changes described in this case further point out the need for early recognition and adequate treatment of this potentially fatal disease complex.

Aneurysm, Infected↗
PubMed1976

Cis-dichlorodiammineplatinum(II) in advanced bladder cancer.

Cis-dichlorodiammineplatinum(II) (DDP) was given at a dose of 1.25 or 1.6 mg/kg to 24 patients with advanced measurable, urinary tract cancer. Eight patients (35%) achieved a partial remission and four additional patients had a minor response. There were 14 patients with epidermoid (transitional cell) bladder cancer who had had no prior chemotherapy and all eight partial responders were in this group. DDP appears to be one of the more active antineoplastic agents in bladder cancer.

Aged↗
PubMed1975

The changing management of childhood Hodgkin's disease.

Between 1929 and September 1974, 211 children under 15 years of age with biopsy-proven Hodgkin's disease were treated at Memorial Sloan-Kettering Cancer Center. For analysis these patients were placed into three historical groups which displayed the most marked changes in diagnostic workup and therapy. They are as follows: Pre-1959-80 patients with "clinical" staging, local field radiation therapy, palliative chemotherapy; 1960-1969-86 patients with lymphangiographic staging, extended field radiation therapy, palliative chemotherapy; 1970-September 1974-45 patients with "contemporary" staging, including laparotomy, involved field radiation therapy, and/or multiple drug chemotherapy. Twenty-seven children with Stage IV disease at diagnosis or those with recurrent disease received this multiple drug regimen. This consisted of Adriamycin, followed by combined prednisone, procarbazine, and vincristine, then cyclophosphamide. Drug cycles were repeated every 3-4 months for a period of about 24 months. Twenty-five achieved remission, 20 complete and 5 partial. The median duration of complete remission was 18 plus months. This multidisciplinary management of Hodgkin's disease has shown early, encouraging results. Longer followup is needed to determine that this improvement in survival will persist into adulthood.

Adolescent↗
PubMed1974

Major hepatic resection using vascular isolation and hypothermic perfusion.

The technique and results of 29 major hepatic resections using the method of complete vascular isolation and hypothermic perfusion of the liver are reported. The method enables the surgeon to perform otherwise difficult or impossible resections through chilled bloodless hepatic parenchyma. Major intrahepatic vascular structures can thus be recognized and controlled readily under clear vision. Direct neoplastic involvement of, or tumor thrombi in the portal vein, hepatic vein or vena cava, can be successfully dealt with by appropriate surgical measures. The operative mortality was 10.3% for this series which included many tumors previously deemed unresectable. The technical detail and intraoperative physiologic monitoring crucial to success in the use of the method are described. It is hoped that with the widened scope of resectability afforded by this technique, and the use of adjuvant chemotherapy, the currently experienced low cure rates for hepatic cancer can be improved.

Cyclophosphamide↗