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Biomedical subjects

R Lafreniere

Publications and source records attributed to R Lafreniere.

45 records · Page 3Linked to original sources
PubMed1985

Primary squamous carcinoma of the rectum. Report of a case and review of the literature.

Squamous cell carcinoma of the colorectum is a rare pathologic curiosity. Since the first report by Schmidtman in 1919, only 69 cases have been reported in the English medical literature. The mean age at presentation is 52 years, and the disease presents itself equally in men and women. The rectum accounts for slightly less than one half of all cases. Survival appears to correlate with nodal status and findings of visceral metastases at presentation. Most tumors can be identified easily by physical examination and/or barium enema. Therapy is limited largely to surgical resection, although attempts at irradiation and chemotherapy have been made. At this time, the etiology of this disease process is unknown, but a likely explanation revolves around replacement of damaged epithelium by cells which undergo anaplasia due to repeated trauma. In addition to this review of the literature, the authors wish to add one additional report of a patient treated successfully by a multimodality approach.

Adult↗
PubMed1985

The Penrose drain: a safe, atraumatic colostomy bridge.

Because of the problems associated with the large, bulky bridges presently used for construction of loop ostomies, particularly complications of leaks and skin excoriation, we have studied the use of the Penrose drain as an alternative. This method has been time-tested on 45 patients and has been found to be safe, reliable, and inexpensive and has gained popularity among patients and ostomy nurses. The bulky colostomy bridge should no longer be accepted as a standard of care.

Colostomy↗
PubMed1985

A single layer open anastomosis for all intestinal structures.

Dissatisfaction with time-consuming double layer anastomoses in intestinal surgery and with occasionally questionable stapled anastomoses prompted a review of available techniques for hand sewn suture lines. Single layer anastomoses have been used extensively and their integrity and safety have often been questioned. In 1951, Gambee described a method of single layer anastomosis which, in practice, is a double layer technique. His results at 10 years were comparable to those obtained with other techniques. We have sought a modification to decrease anastomotic complications and improve ease of suture insertion. Along with a description of technique, a review of 170 anastomoses performed from July 1982 to June 1984 is presented without a single clinically apparent leak.

Humans↗
PubMed1985

Adoptive immunotherapy of murine hepatic metastases with lymphokine activated killer (LAK) cells and recombinant interleukin 2 (RIL 2) can mediate the regression of both immunogenic and nonimmunogenic sarcomas and an adenocarcinoma.

The incubation of normal murine splenocytes in recombinant interleukin 2 (RIL 2) gives rise to lymphokine-activated killer (LAK) cells that are specifically cytotoxic to fresh noncultured, autologous, syngeneic, and allogeneic primary and metastatic tumor cells, but are not toxic to normal cells. We have recently shown that the systemic injection of RIL 2 given alone or in conjunction with LAK cells can reduce the number of established pulmonary and hepatic micrometastases from a weakly immunogenic sarcoma in mice. In this report we have analyzed the response of hepatic metastases (HM) induced from both a nonimmunogenic sarcoma (MCA-102) and an adenocarcinoma (MCA-38). Treatment of mice bearing HM from the MCA-102 and MCA-38 tumors revealed that low doses of RIL 2 (5000 to 25,000 U t.i.d.) had little if any anti-tumor effect when given alone (mean percent reduction over control for the MCA-102 tumor: 14%, for the MCA-38 tumor: 10%, p, not significant). Doses of 100,000 U of RIL 2 affected a 38 and 53% reduction in the number of metastases over control for the MCA-102 and MCA-38 tumors, respectively (p less than 0.05). However, when LAK cells were added to the same doses of RIL 2, the corresponding mean percent reduction over control was 90% (p less than 0.005) and 61% (p less than 0.05) for MCA-102 and MCA-38, respectively, at RIL 2 doses of 5000 to 25,000 t.i.d. At doses of 100,000 U of RIL 2 administered with LAK cells, the corresponding percent reductions were 98 and 99%, respectively (p less than 0.005). Therapy with LAK cells plus RIL 2 can also prolong the survival of these mice. In addition, the intraportal administration of LAK cells is more effective than the i.v. administration of these cells. Thus, treatment of established HM from a nonimmunogenic sarcoma and an adenocarcinoma can be successfully mediated by the systemic infusion of LAK cells with RIL 2. These findings provide a rationale for clinical trials of infusion of LAK cells with RIL 2 in the therapy of HM in humans.

Animals↗
PubMed1985

Successful immunotherapy of murine experimental hepatic metastases with lymphokine-activated killer cells and recombinant interleukin 2.

Lymphokine-activated killer (LAK) cells are generated in vitro by the incubation of normal murine splenocytes in interleukin 2. We have shown previously that the systemic injection of LAK cells in conjunction with recombinant interleukin 2 can reduce the number of established pulmonary metastases in mice. In an attempt to study this approach in the treatment of hepatic metastases, we developed a technique for the induction of hepatic metastases in mice based on the intrasplenic injection of tumor cells and have tested the effects of LAK cells and recombinant interleukin 2 produced in Escherichia coli (RIL-2) therapy on these metastases. Treatment with LAK cells alone in 14 consecutive experiments rarely produced significant reduction in metastases over control (mean percentage reduction, 12%). Therapy with RIL-2 alone produced a dose-dependent reduction in the number of liver metastases. In 20 consecutive experiments when RIL-2 was administered i.p. three times a day at doses varying from 1,000 to 5,000, 10,000 to 15,000, and 25,000 units, a statistically significant (P less than 0.05) reduction in liver metastases was seen in 2 of 12, 2 of 4, and 8 of 12 determinations, respectively (percentage reduction, 0 to 97; mean, 42%). At doses greater than 25,000 units, the reduction in metastases was highly reproducible (percentage reduction, 66 to 95; mean, 83%) and was statistically significant in 14 of 14 determinations. When LAK cells were given i.v. in addition to RIL-2 administration in 16 consecutive experiments, the percentage reduction in liver metastases was markedly increased over that seen with RIL-2 alone (mean percentage reduction, 77% at doses of 5,000 to 25,000 units of RIL-2 and mean reduction, 97% for doses greater than 25,000 units of RIL-2). At doses of 5,000, 10,000, 25,000, and greater than 25,000 units of RIL-2 plus LAK cells, significant reduction of liver metastases (P less than 0.05) was achieved in 3 of 7, 2 of 2, 8 of 8, and 6 of 6 determinations, respectively. When animals were given fresh splenocytes or splenocytes cultured in complete medium without RIL-2 instead of LAK cells, no reduction in liver metastases was seen except for that attributable to the administration of RIL-2 alone. Sublethal total body irradiation of the mice prior to therapy abrogated the therapeutic effects of RIL-2, but the effects of treatment with LAK cells plus RIL-2 were maintained. Thus, treatment with RIL-2 alone or in combination with LAK cells is effective in reducing the number of established hepatic micrometastases in a murine model.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗
PubMed1984

Gestational macromastia.

Gestational macromastia is a rare entity. Causes are many and include excess hormonal production, hormonal imbalance, and decreased hormonal catabolism. Documentation of elevated serum prolactin levels and tissue hormonal receptor levels brings new light to this pathologic condition. Pharmacologic measures are not recommended because of lack of effectiveness and possible teratogenic side effects. Primary therapy should consist of local measures, such as breast support, bed rest, and analgesics. If this fails and progression is inevitable, we recommend total mastectomy with provision made for reconstruction and nipple banking. Skin flaps must be thin, and all breast tissue must be removed, otherwise the pathologic condition will continue during the ensuing months of the pregnancy and will recur with each successive pregnancy. Abortion is feasible, but this leaves the patient in need of a reduction or total mastectomy at a later date, and thus is not recommended as a primary line of therapy. If the patient progresses to delivery without complication, a reduction mammoplasty can be considered but only if no future pregnancies are planned.

Adolescent↗