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Biomedical subjects

S B Gusberg

Publications and source records attributed to S B Gusberg.

At least 37 records · Page 2Linked to original sources
PubMed1982

Chemosensitivity testing with CIS-platinum (2) diamminedichloride in squamous cell carcinoma of the cervix uteri.

The prophylactic Papanicolaou Test contributes in diagnosing dysplasias and carcinoma in situ of the uterine cervix with a realistic 100% cure. Surgery and radiotherapy improved considerably quantity and quality of life in stages 1 and 2 lesions. However, stages 3 and 4 have shown little improvement in results. Systemic treatment with chemotherapy offers hope for control. Most of the drugs are ineffective against squamous cell carcinoma of the cervix. Experimental and clinical trials with CIS-platinum (2) diamminedichloride (DDP) show effectiveness against cervical carcinoma. In an effort to individualize the treatment, a chemosensitivity testing (CST) is applied analogous to the radiosensitivity testing (RST). Basically, a control biopsy and posttest dose of DDP biopsies are studied to evaluate the response using objective morphological criteria. This safe, relatively simple, clinically applicable approach offers an objective dimension in selecting the patients and in monitoring the treatment. An important observation that gives this study an original authenticity is the fact that radiation and chemotherapy affects the cells in an identical way. This similar morphological reaction most probably means an analogous biological expression of cellular injury and necrosis of the neoplastic cells.

Carcinoma, Squamous Cell↗
PubMed1981

Improved chemotherapy for ovarian cancer with cis-diamminedichloroplatinum and adriamycin.

In a prospective controlled randomized trial, patients with advanced ovarian carcinoma (FIGO Stage III or IV) were treated with cis-diamminedichloroplatinum (II), (DDP), alone, DDP and Adriamycin (ADM), or Triethylenethiophosphoramide (ThioTEPA) and methotrexate (MTX). DDP alone produces objective responses in 31% of evaluable patients, ThioTEPA and MTX in 36%. The combination of DDP and ADM produces the best response rate, 80% (.01 less than P less than 0.25). The risk of progression or death is substantially reduced for the two DDP regimens combined when compared with ThioTEPA-MTX (P = .03). Multivariate analysis further suggests the superiority of the two DDP regimens because poorly differentiated tumors and large, greater than 2 cm, residual tumors failed to produce their usual adverse effect on prognosis when patients were treated with the two DDP regimens. Patients with poorly differentiated tumors or tumors of unknown grade treated with platinum or DDP-ADM experienced better survival than similar patients treated with ThioTEPA (P = .01).

Cisplatin↗
PubMed1981

Detection of endometrial cancer and its precursors.

Any approach to the control of endometrial cancer must include a consideration of the individual at high risk; this will include the obese, the infertile, those with failure of ovulation and dysfunctional bleeding; and those postmenopausal women who ae chronic estrogen users. The detection of adenomatous hyperplasia offers us the opportunity to recognize the developmental phase of the disease before invasion is established. The cytologic method of Papanicolaou, used in the conventional way, is inefficient for the detection of endometrial cancer. Cell studies taken by cannula from the endometrial cavity can be more accurate for the diagnosis of invasive cancer but fail in the hands of most pathologists to detect adenomatous hyperplasia. We have found the highest rate of accuracy in the aspiration curettage histologic method, both for endometrial cancer and adenomatous hyperplasia. It is quick, relatively painless in most, and an outpatient procedure that does not require anesthetic. It offers the pathologist a sample that is readily interpreted. Our public education effort must include the warning that a negative Pap smear does not rule out endometrial carcinoma.

Curettage↗
PubMed1980

Leukocyte migration enhancement as an indicator of immunologic enhancement. I. Pregnancy.

Leukocyte migration studies with amniotic fluid (AF) were performed in 47 pregnant women and 24 control patients. Previous reports about the enhancing effect of AF on leukocyte migration during pregnancy were confirmed (p less than 0.003). No enhancing effect was observed with first-trimester leukocytes. Maximal enhancement occurred during the second trimester (p less than 0.0001). It decreased during the third trimester (p less than 0.01) and lost significance in the postpartum period (p less than 0.072). Fifteen pregnant and control patients were investigated with autologous plasma. Leukocyte migration enhancement (LME) was significant with pregnancy plasma (PL) (p less than 0.03). Again LME was the largest during the second trimester (p less than 0.006). It is concluded that an immunologically active factor is present in AF and PL which in term induces the enhancing activity of a predetermined effector cell subgroup. This process is absent in conjunction with male leukocytes and is lacking in the majority of patients with toxemia of pregnancy.

Amniotic Fluid↗
PubMed1980

Leukocyte migration enhancement as an indicator of immunologic enhancement. III. Common denominators of pregnancy and malignancy.

Leukocyte migration enhancement (LME), a common denominator of pregnancy and malignancy, was investigated in order to determine the immunologic factors and processes involved in this in vitro assay. Reproducibility of results was confirmed by parallel investigations of single patients in an independent laboratory. Preliminary evidence also suggests that the phenomenon of LME is observable not only with the leukocyte migration assay, as performed in the present study, but also with the "indirect" migration inhibitory factor (MIF) assay. Highly significant correlation between results obtained with plasma (PL) and amniotic fluid (AF) was observed (p less than 0.00089). No significant correlation between LME and IgG concentrations as well as complement (C3) concentrations in AF and PL could be detected. C3 concentrations correlated significantly to gravity (p less than 0.007) and parity (p less than 0.003). No immune complexes were detected in either AF or PL samples. An unspecific protein effect as the cause of LME was ruled out in showing no significant correlation between LME and protein concentrations of AF and PL. A highly significant correlation between antigen concentration in PL and migration area was demonstrated (p less than 0.00001). It is suggested that leukocyte migration inhibition (LMI) represents a state of antigen excess, while LME represents antibody excess. Through selective removal of the IgG immunoglobulins LME could be converted into LMI, indicating an IgG subfraction as the responsible immunoglobulin in the phenomenon of LME.

Amniotic Fluid↗
PubMed1980

Leukocyte migration enhancement as an indicator of immunologic enhancement. II. Malignancy.

Leukocyte migration studies were performed on 19 cancer patients and 24 control subjects. Amniotic fluid (AF) as well as autologous plasma (PL) were investigated. No difference in the migration pattern between patients and control subjects was observed with AF, but cancer patients showed significant leukocyte migration enhancement (LME) with PL when compared to control subjects (p less than 0.04). Among 18 cancer patients with persistent disease only three did not show significant LME. All three represented specifically immunodepressed states. None of the untreated group of cancer patients failed to show LME with autologous PL. It is concluded that, as in pregnancy, an immunologic active factor is present in PL of cancer patients which induces a specific subpopulation of leukocytes and thereby LME. The possible mechanism of activation is briefly discussed. Through the detection of LME leukocyte migration may become of importance for the early detection of malignancy and monitoring of treatment success.

Adenocarcinoma↗
PubMed1979

A blocking factor in amniotic fluid causing leukocyte migration enhancement.

Amniotic fluid was found to cause significant leukocyte migration enhancement during the second and third trimester of pregnancy and in the early postpartum period when compared to the migration area obtained with an ovarian tumor homogenate antigen (p less than 0.01), choriocarcinoma spent medium (p less than 0.01), and placental pool homogenate (p less than 0.01). Only borderline significance (p less than 0.1) was obtained when migration enhancement with AF was compared between pregnant and nonpregnant female control patients, indicating minimal unspecific activity of AF. Migration enhancement with autologous amniotic fluid was slightly larger than with homologous amniotic fluid, but the difference did not reach significance (p less than 0.4). None of the control antigens caused migration enhancement; placental pool homogenate in concentrations above 4 mg. per cent caused migration inhibition but did not in lower concentrations. The enhancing effect of AF could be abolished by dilution but not by addition of excessive antibody to estrogen of HCG. It is suggested that a blocking factor is present in AF preventing recognition of fetoplacental antigen by the maternal immune system. Thus in vitro leukocyte migration enhancement may correlate to in vivo graft enhancement.

Amniotic Fluid↗
PubMed1979

Familial malignant melanoma of the female genitalia: a case report and review.

An additional case of familial occurrence of malignant melanoma is presented, involving mother and son. This is the fourth case of familial occurrence of malignant melanoma in the female genitalia and the first occurring in the vagina reported in the literature. We present a review of the literature concerning the hereditary property of malignant melanoma, including a list of all 92 families and 240 patients reported. The importance of a family history of malignant melanoma for the early diagnosis of this disease in relatives at risk is stressed.

Adult↗
PubMed1978

Treatment of advanced ovarian cancer with cis=dichlorodiammineplatinum(II): poor-risk patients with intensive prior therapy.

Nineteen patients with advanced ovarian adenocarcinoma were treated with cis-dichlorodiammineplatinum(II) (DDP), 50 mg/m2 as an iv bolus once every 3 weeks. Prior treatment had exhausted other chemotherapeutic options or damaged the bone marrow sufficiently to contra-indicate treatment with standard drugs. All patients had evaluable tumors and evidence of failure of prior therapy. DDP produced objective responses, relieved symptoms due to tumor, and improved the patients' quality of survival. There were no serious hematologic complications due to therapy except anemia.

Adenocarcinoma↗
PubMed1977

Estrogen metabolism in normal and neoplastic endometrium.

Studies on normal endometrium at different phases of the menstrual cycle have shown that progesterone and synthetic progestins reduce the levels of estradiol receptors in the tissue and increase the activity of estradiol-17beta-dehydrogenase, an enzyme that converts estradiol to estrone. These effects may account for the antiestrogenic characteristics of the progestins. Similar effects were obtained in some postmenopausal patients with endometrial adenocarcinoma treated for two to 10 days with oral medroxyprogesterone acetate. These results point to the potential usefulness of a short-term, in vivo biochemical test which, combined with histologic observations, may identify patients who are likely to respond to treatment with progestins.

Adenocarcinoma↗