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Biomedical subjects

W F Taylor

Publications and source records attributed to W F Taylor.

At least 91 records · Page 5Linked to original sources
PubMed1983

Carcinoma of the vulva: analysis of treatment and survival.

The treatment of 224 patients with invasive squamous cell carcinoma of the vulva over a 20-year interval at the Mayo Clinic resulted in an overall survival rate of 75%, compared with 89% for age-matched controls. For patients with stage I disease, 5-year survival was 90%; for those with stages II, III, and IV, it was 81, 68, and 20%, respectively. A precipitous decline in survival rates was noted when metastases to regional nodes were encountered, when lesion size was more than 3 cm, and when histologic dedifferentiation exceeded grade 2. Incorrect clinical staging efforts were observed in 25% of the cases, so the necessity for surgical staging was apparent.

Breast Neoplasms↗
PubMed1982

Carcinoma of the vulva: analysis of treatment failures.

Continuous follow-up of 224 patients treated for primary invasive squamous cell carcinoma of the vulva in a 20-year period (1955 to 1975) at the Mayo Clinic resulted in the detection of recurrent (or persistent) neoplasia in 59 (26%). Rates of treatment failure increased with advancing stage of disease-from 14% for Stage I to 71% for Stage IV. The rate of local vulvar recurrence was 18%, which was about three times greater than the recurrence rates for the groin, pelvis, and distant sites. However, the 1- and 5-year survival rates of 73% and 50%, respectively, after vulvar recurrence were in sharp contrast to the corresponding rates of 34% and 10% for regional or distant recurrence. When 35 patients with central vulvar extension of disease were evaluated, groups at excessive risk for treatment failure (lesions 4 cm or larger inguinal node involvement, or both) were identified and modifications in conventional therapy applicable to these groups were considered.

Aged↗
PubMed1982

Relationships between pancreaticobiliary ductal anatomy and pancreatic ductal and parenchymal histology.

To determine whether ductal or parenchymal histologic abnormalities were related to the type of openings of the pancreatic duct and common bile duct into the duodenum, 390 unfixed human postmortem en bloc pancreaticoduodenal specimens were examined anatomically, radiographically, and histologically. In 353 specimens, ductal openings were classifiable: 25% had a well-defined ampulla, 18% a long common channel, 31% a short common channel, 7% an interposed septum, and 19% had separate openings for the pancreatic and bile ducts. Ductal histologic abnormalities were present in 25% of the specimens and most (77%) were found in the pancreatic head. When ductal openings were grouped according to the presence or lack of a prominent common channel, ductal epithelial abnormalities were more common in the absence of a prominent common channel (30% vs. 19%, p less than 0.04). Papillary epithelial hyperplasia was associated only with the absence of a prominent common channel (P = 0.02). Histologic abnormalities were more common in the elderly (P less than 0.005) but were not associated with cause of death or the presence of the minor pancreatic duct. Lack of a common channel is associated with abnormal ductal epithelium. This anatomic arrangement may be a factor in pancreatic carcinogenesis.

Age Factors↗
PubMed1982

Synovial sarcoma.

One hundred and eighty-five patients, whose ages ranged from two to seventy years (mean, thirty years), have been treated at the Mayo Clinic for synovial sarcoma. Sixty-nine per cent of the tumors occurred in the lower extremity: 25 per cent, in the upper extremity; and 6 per cent, in the trunk. Histological characteristics included a predominant bimorphic pattern in 33 per cent of the tumors, a monomorphic pattern in 31 per cent, and a mixed pattern in 36 per cent. For all patients, the five-year survival rate was 38 per cent and the ten-year rate was 23 per cent, with a median survival time of thiry-nine months. However, for those patients treated since 1960, the five-year survival rate was 55 per cent and the ten-year rate was 38 per cent. Female patients had a significantly better survival time than did male patients. Younger patients had a better survival rate, and the prognosis was better for those patients whose tumor were either less than five centimeters in diameter or located in the lower extremity. Survival rates were best for those patients who had wide local excision, but this type of surgery was performed for the lesions that had a more favorable prognosis. A regression study indicated that the size of the tumor was the single most important prognostic variable for survival. Second in importance was the extent of disease on initial presentation, followed by the chronological time of treatment, the age of the patient, and the anatomical site of the tumor.

Adolescent↗
PubMed1982

Bilateral tubal pregnancy with vaginal delivery.

A 26-year-old woman was admitted with a diagnosis of septic incomplete abortion. Subsequently she was discovered to have bilateral tubal ectopic pregnancies. The right tube was not badly damaged. Its contents were removed by linear salpingotomy and the tube was repaired. Fifteen months later the patient delivered a live infant.

Abortion, Incomplete↗
PubMed1981

Efforts at early diagnosis of pancreatic cancer: the Mayo Clinic Experience.

By contract with the National Cancer Institute, the authors have prospectively evaluated the diagnostic accuracy of serologic, secretory, endoscopic, and imaging procedures. Ultrasonography, computed tomography, endoscopic retrograde pancreatography, angiography, and pancreatic exocrine function tests have similar sensitivity, specificity, and predictive value in the diagnoses of pancreatic disorders. A newly developed ultrasonic endoscope has been evaluated for human use and preliminary findings suggest that it is safe. This endoscope generates a high resolution of real time images of extraluminal gastrointestinal organs, including the pancreas. This technique may be useful in detecting small premetastatic and resectable cancers of the pancreas.

Cholangiopancreatography, Endoscopic Retrograde↗
PubMed1981

Some results of screening for early lung cancer.

Screening for lung cancer is somewhat controversial in that very few evaluations of the screening process have been made, and even fewer have involved the use of concomitant, unscreened controls. This report of the Mayo Lung Project provides evaluation of a randomly selected 4500 clinic patients, offered screening for lung cancer at four-month intervals for six years. Another 4500 randomly selected controls not offered screening were merely observed. Good screening is defined, the Mayo project is evaluated, and puzzling results are presented and discussed. From the screened group, 98 new cases of lung cancer have been detected, 67 by study screening and 31 by spontaneous reporting of symptoms (15) or by x-ray examinations (16) done in other than study circumstances. From the controls, 64 new lung cancer cases have been detected, 43 by symptoms and 1 by other methods. Lung cancer mortality is 39 for study patients and 41 for controls. There is thus no evidence at this time that early case finding hs decreased mortality from lung cancer.

Adenocarcinoma↗
PubMed1981

Renal adenocarcinoma in young adults: survival and variables affecting prognosis.

Survival rates and various prognostic factors were studied in 89 patients between 20 and 40 years old who underwent nephrectomy for renal adenocarcinoma between 1950 and 1978. Although rare, renal carcinoma in young adults seems to follow a course similar to the disease seen in older patients. Among 18 suspected prognostic factors 2 are strongly and independently associated with survival. These are the pathologic stage of the tumor and preoperative weight loss. Several other prognostic variables show a statistically significant association with survival. These include the presence of preoperative fever, duration of symptoms, tumor cell type, microhematuria on admission to the hospital, tumor grade and sex. However, advanced statistical techniques demonstrate that the association of these variables with survival can be accounted for mostly by their close correlation with the stage of the tumor. Certain variables show no prognostic significance. These included the diameter of the tumor, age of the patient, presence or absence of gross hematuria, flank pain, palpable mass, arterial hypertension, sedimentation rate and side or site of the tumor.

Adenocarcinoma↗
PubMed1981

Hemodynamic effects of Medical Anti-Shock Trousers (MAST garment).

Despite widespread use of the Medical Anti-Shock Trousers (MAST) little is known about the exact mechanism by which they increase arterial pressure. It is assumed that an autotransfusion occurs. To examine this question, blood pressure, heart rate, forearm blood flow, cardiac output, and stroke volume were measured in ten healthy adults, supine and during 60 degree headup tilt with MAST garment pressures of 409 and 100 mm Hg. Supine, the garment produced no net 'autotransfusion,' but raised blood pressure (27%) by increasing peripheral resistance (48%) with decreased stroke volume and cardiac output (18%). During headup tilt without the MAST device, venous pooling in the legs decreased stroke volume (52%), cardiac output (30%), and increased total peripheral resistance (40%). Application of the garment during tilt shifted this blood centrally, producing increased stroke volume (52%), cardiac output (30%), and increased total peripheral resistance (40%). Application of the garment during tilt shifted this blood centrally, producing increased stroke volume (14%). In supine normovolemic subjects, the garment raised pressure almost exclusively by increased systemic afterload. Forearm vascular resistance did not change and the increased pressure augmented flow to the arm, i.e., to noncompressed tissue. With increased venous pooling during tilt, the MAST garment acted as a 'G-suit' and caused a central shift of blood volume. These findings could explain: 1) why fluid replacement is not always adequate to maintain pressure when deflating the trousers; 2) why the trousers should not be used if one wishes to avoid increasing afterload (e.g., certain patients with acute myocardial infarction). We conclude that the MAST garment acts as a local, effective, nonpharmacologic vasoconstrictor and should be used when such an effect is clinically appropriate.

Adolescent↗
PubMed1981

High-dose methotrexate with a safe rescue program.

23 patients with osteogenic sarcoma were observed during 142 6-hour high-dose infusions of methotrexate (MTX, 3,000--8,200 mg/m2). Calcium leukovorin was given by intravenous injection at 3-hour intervals beginning 2 h after the completion of each MTX infusion with extension of the intervals to 6 h following the first day of rescue. All patients also received continuous intravenous infusions of alkalinized fluids for the entire duration of leukovorin rescue. No larger doses of leukovorin were given to any patient. Three of the 142 MTX infusions resulted in mild cytotoxic side effects. Plasma MTX clearance ranged from 90 to 600 ml/min among the 62 infusions where plasma clearance could be accurately calculated. The 3 patients with mild toxicity had low drug clearance, but others with similar low MTX clearance experienced no apparent toxic effects beyond the expected transient nausea.

Adolescent↗
PubMed1981

U.S. centralized cancer patient data system for uniform communication among cancer centers.

The evolution of the Centralized Cancer Patient Data System, a cooperative venture of the 21 comprehensive cancer centers in the United States, and its structure at the end of 3 years of data collection are described. Functions of the data system are detailed in terms of input and output. It is concluded that the short-run objective of establishing a data system to provide high-quality patient data that ae 21 comprehensive cancer centers in the United States, and its structure at the end of 3 years of data collection are described. Functions of the data system are detailed in terms of input and output. It is concluded that the short-run objective of establishing a data system to provide high-quality patient data that ae 21 comprehensive cancer centers in the United States, and its structure at the end of 3 years of data collection are described. Functions of the data system are detailed in terms of input and output. It is concluded that the short-run objective of establishing a data system to provide high-quality patient data that are comparable among cancer centers has been largely accomplished. Moreover, the very process of setting up the national data system has benefited the participating centers by upgrading their individual cancer registries. For the future, the goal is to realize the research potential of this new cooperative data collection mechanism, as well as the accumulating data themselves. Progress toward the long-term goal is just beginning.

Cancer Care Facilities↗
PubMed1981

Management of osteogenic sarcoma: a perspective based on the Mayo Clinic experience.

We reviewed pertinent aspects of the Mayo Clinic experience with osteogenic sarcoma to place into perspective some of the recent advances in the management of patients with this tumor. Various histopathologic subtypes have been recognized and can be differentiated from the conventional or classic osteogenic sarcoma. Our experience indicated that, when appropriate, crossbone amputation provided adequate and effective surgical treatment. A controlled study in which pulmonary micrometastases were evaluated failed to demonstrate that prophylactic pulmonary irradiation after amputation conferred any therapeutic advantage. The use of combination chemotherapy or transfer factor did not improve disease-free survival when the results were compared with our recent experience with surgical treatment alone. Progressive improvement in disease-free and total survival was observed between 1963 and 1974, although we have been unable to relate this to the effects of adjuvant chemotherapy. Aggressive surgical excision of pulmonary metastatic lesions had a positive effect on total survival. These observations led us to conclude that carefully controlled studies are still needed to define more clearly the role of adjuvant chemotherapy in nonmetastatic osteogenic sarcoma. Although such a study is in progress at the Mayo Clinic, it is too early for any evaluation of the results.

Antineoplastic Agents↗
PubMed1981

Intestinal control of human postprandial gastric function: the role of components of jejunoileal chyme in regulating gastric secretion and gastric emptying.

Intestinal control of gastric secretion and emptying were studied in healthy humans by using intubation-marker-perfusion techniques. An occluding balloon was used to separate the jejunoileal test segment from the more proximal gut. Mixed-nutrient, semielemental meals (300 and 600 calories) were administered while varying the jejunal perfusate: normal saline, jejunal chyme or its protein (casein hydrolysate), lipid (oleic acid), or carbohydrate (maltose) components. The meal in contact with the stomach and duodenum increased gastric secretion above fasting levels. This was partially inhibited by whole chyme in contact with the jejunum, the lipid and carbohydrate components of chyme mediating this inhibition. Jejunoileal chyme inhibited gastric emptying, with all three nutrient components acting as inhibitors. Effects on gastric secretion and emptying were dose-dependent, being greater after the larger meal and most prominent in the early postprandial period; these effects on gastric emptying were more prominent than those on gastric secretion. These results suggest that the intestinal phase of gastric function is directed mainly toward regulation of the reservoir function of the stomach: to adapt the gastric delivery of nutrients and fluid to the capability for efficient digestion and absorption.

Adult↗
PubMed1981

Survival of patients surgically treated for stage I lung cancer.

When the TNM staging system of the American Joint Committee (AJC) for Cancer Staging and End-Results Reporting was applied to 3,912 patients seen during a 6 year period at the Mayo Clinic, 624 (16%) fulfilled the criteria for postsurgical pathological Stage I non-small cell bronchogenic carcinoma. Of these 624 patients, 129 were excluded from further survival analysis for various reasons. The remaining 495 consisted of two groups: 350 patients who were enrolled within 30 days into a prospective postoperative 4 monthly follow-up program and 145 patients who were enrolled later or were followed less frequently. Because no significant difference was noted in survival rates between these groups, data were pooled. Of the combined group of 495 patients, 84% survived lung cancer for 2 years and 69% of 5 years (actuarial estimation). The survival of patients classified T1 N0 M0 (91% alive at 2 years and 80% at 5 years) is so good that it seems unlikely that adjuvant therapy in this group could demonstrate improved survival. In addition to TNM classification, age at operation, sex, and extent of operation were important determinants of survival.

Adult↗
PubMed1981

Hemodynamic changes during whole body surface cooling and lower body negative pressure.

Six young healthy male subjects were studied to evaluate the use of whole body surface cooling (WBSC) as an antiorthostatic intervention. Previous studies in our laboratory have demonstrated the perfusion of an Apollo cooling garment with 16 degrees C water produced a significant increase in stroke volume and decrease in heart rate at rest and during lower body negative pressure (LBNP). However, optimal perfusion temperatures have not been determined. The present study examined the effects of WBSC using perfusion of water at a temperature of 10 degrees C. This perfusion temperature produced a greater decrease in mean skin temperature (Tsk) than water at 16 degrees C, -4 degrees C drop compared to -2 degrees C respectively. The hemodynamic effects were also more prominent with 10 degrees C water as shown by the increase in stroke volume of 11% at rest and of 35% during LBNP at -50 torr compared to control measurements at ambient temperature. Heart rates were lowered significantly (8 beats/min) and systolic arterial blood pressure was higher (8 torr). Cooling with 10 degrees C water produced a slight increase in muscle tone, reflected by a small but significant increase (+84 ml/min) in oxygen uptake. These data suggest that WBSC is an effective nonpharmacologic means of controlling preload and deserves further investigation as an antiorthostatic intervention.

Adult↗