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Biomedical subjects

W F Whitmore

Publications and source records attributed to W F Whitmore.

At least 235 records · Page 13Linked to original sources
PubMed1981

Flow cytometry for followup examinations of conservatively treated low stage bladder tumors.

A series of 26 conservatively treated patients with low stage bladder tumors was examined later by outpatient cystoscopy, conventional cytology and flow cytometry. Based on those findings the patients were separated into 5 groups. In the 4 patients in group 1 all findings persistently were negative. The 4 patients in group 2 had initially normal cystoscopy with progressively more abnormal flow cytometry and intermittently positive cytology; they subsequently suffered tumors. The 10 patients in group 3 had positive cystoscopy and flow cytometry, and intermittently positive cytology. The 6 patients in group 4 had negative cystoscopy with intermittently positive cytology and persistently positive flow cytometry. In all 6 cases flow cytometry was more sensitive than conventional cytology in detecting early and, sometimes, cystoscopically occult neoplasms. In the 2 patients in group 5 cystoscopically visible papillomas and low grade papillary carcinomas were found with negative flow cytometry and negative or suspicious cytology. The papillary tumors in these 2 patients were believed to be composed principally of benign or atypical epithelium, with too few malignant cells to be detected by present flow cytometry techniques. Our preliminary results suggest that flow cytometry may be a valuable tool for followup of patients who have had conservatively treated low stage bladder tumors and are at risk for development of carcinoma. In addition, the techniques may be used to monitor changes in the proportion of benign and malignant cells and, thus, can be of help in following the course of newly forming papillomas, papillary carcinomas or carcinoma in situ in papillomas or flat epithelium.

Aged↗
PubMed1981

The influence of simultaneous resection of bladder tumors and prostate on the occurrence of prostatic urethral tumors.

The records of 137 patients who underwent simultaneous transurethral resection of bladder tumors and the prostate were compared to those of 150 patients who underwent transurethral resection of bladder tumors only. The data presented provide no evidence that simultaneous resection of bladder tumors with the prostate affects adversely the incidence of tumor occurrences in the prostatic urethra.

Aged↗
PubMed1981

The response of metastatic adenocarcinoma of the prostate to exogenous testosterone.

In a retrospective review the response of 67 patient with metastatic adenocarcinoma of the prostate to the administration of exogenous testosterone was analyzed. Among 52 patients in whom objective and/or subjective responses were evaluable 45 experienced unfavorable responses. There was prompt regression of most unfavorable responses with testosterone withdrawal. The duration of treatment required to evoke an unfavorable response was related to the clinical status of the patient. Twenty-five per cent of patients with symptomatic metastases who had received no prior treatment, 36 per cent in symptomatic remission after endocrine therapy and 94 per cent with symptomatic relapse after endocrine therapy experienced unfavorable responses within 30 days of treatment. No patient had objective evidence of tumor regression during testosterone therapy but 7 patients, 6 with remission and 1 untreated, experienced symptomatic benefit. We conclude that the response of patients with metastatic prostate cancer to exogenous testosterone is related to the mass and endocrine treatment status, and that exogenous testosterone can stimulate prostatic neoplasms that proliferate in the absence of normal endogenous testosterone levels.

Acid Phosphatase↗
PubMed1981

Regional lymph node metastasis from bladder cancer.

The prognosis for patients with bladder cancer metastatic to regional lymph nodes is dismal and only minimally altered by current treatment modalities. The 5-year survival rate after radical cystectomy for 134 bladder cancer patients with positive regional lymph nodes was only 7 per cent and 82 per cent of the patients died of bladder cancer. Stratification of patients into groups with varying extent of nodal disease showed a correlation between the level of nodal involvement and the interval to recurrence. While 38 per cent of the patients died of distant disease alone 25 per cent had only pelvic recurrence, indicating a possible therapeutic effect of a systmatic bilateral pelvic lymphadenectomy and implicating extrapelvic disease as a major determinant of patient survival.

Female↗
PubMed1981

Salvage cystectomy for bladder cancer after failure of definitive irradiation.

Selected patients in whom definitive external irradiation fails to control bladder cancer can potentially be salvaged by cystectomy. Before 1974, 189 patients at our cancer center underwent salvage cystectomy. The over-all 5-year survival rate was 37 per cent and the postoperative hospital mortality rate was 5 per cent. Infectious complications developed in a third of the patients and ureteroileal urine leak developed in 8 per cent but the incidence of other complications was not dissimilar to that after radical cystectomy without prior large dose irradiation.

Adult↗
PubMed1981

Cell surface antigens of human renal cancer defined by mouse monoclonal antibodies: identification of tissue-specific kidney glycoproteins.

Seventeen monoclonal antibodies derived from fusions with spleen cells of mice immunized with established culture lines of renal cancers identified nine cell-surface antigenic systems. Six of the systems (gp160, S25, gp120r, gp120nr, gp115, and V1) represent antigens not previously described. The other three systems are related to HLA-A, -B, and -C heavy chain and A and B blood group antigens. The most restricted of the newly described antigens are gp160, S25, and gp120r. These determinants are found only on cells of renal origin, both normal and malignant, and represent differentiation antigens of human kidney. In addition to the difference in the molecular weight of two of these antigens, gp160, S25, and gp120r can be distinguished on the basis of differential expression on a panel of cultured renal cancers and normal kidney epithelium and fetal kidney cells. Glycoproteins bearing gp120r share a determinant with renal gp120nr (as indicated by sequential precipitations with monoclonal antibodies that detect gp120r and gp120nr), but gp120nr is found on a broader range of cell types, including fibroblasts and cell lines derived from lung, bladder, and colon cancers. The two other new systems, gp115 and V1, have characteristics of broadly occurring differentiation antigens but can be distinguished from each other and from gp120nr by differences in molecular weight, heat stability (V1 is a heat-stable determinant), and differential expression on cell types of diverse origin.

ABO Blood-Group System↗
PubMed1981

Staging and surgery in testicular cancer.

Both staging and surgery in testicular cancer are thoroughly analysed. Extensive experiences from various authors are reported and compared. The essentials for staging are suggested and a new detailed stage grouping is proposed. The role of surgery in diagnosis, staging and therapy is examined. It is stressed that in non-seminomas, retroperitoneal lymph node dissection is not only a staging procedure, but it may be also a curative operation in several cases of patients with lymph node metastases and a prospective randomized clinical trial is advocated in order to clarify the usefulness of adjunctive chemotherapy in these cases. Surgery is also useful as adjuvant to chemotherapy in several patients with advanced non-seminomas and it is underlined that it should be undertaken early, after only 2 or 3 cycles of chemotherapy, in order to avoid the strong fibrosis that often occurs after long-term chemotherapy and which makes surgical dissection very difficult or even impossible. Lastly, even if extensive, surgery seems to be a safe procedure in these young patients.

Antineoplastic Agents↗
PubMed1981

VAB-6 combination chemotherapy in disseminated cancer of the testis.

Twenty-nine men with stage III or unresectable stage II malignant germ cell tumors and no previous chemotherapy received treatments with the VAB-6 protocol. The VAB-6 regimen is a 1-year program beginning with three successive inductions at 3-to-4-week intervals: day 1--cyclophosphamide, 600 mg/m of body surface area intravenously, bleomycin, 30 mg intravenously, dactinomycin, 1 mg/m2 intravenously, and vinblastine, 4 mg/m2 intravenously; days 1 through 3--bleomycin, 20 mg/m2 . d by continuous infusion; and day 4--cisplatin, 120 mg/m2 intravenously. Bleomycin is omitted from the third induction. One month after the third induction, any residual disease is resected. If the resected specimen contains malignant tissue, an additional two inductions are given before maintenance with vinblastine, 6 mg/m2 intravenously, and dactinomycin, 1 mg/m2 intravenously, every 3 weeks. Of 25 patients with evaluable records, 23 achieved complete remission, and 21 remain in complete remission (median follow-up, more than 16 months). Myelosuppression is the major toxicity. With VAB-6 response rate is high, and treatment is short and better tolerated than with previous VAB protocols.

Antineoplastic Agents↗
PubMed1981

Estrogen binding and estrogen receptor activity in the human prostate: a preliminary report.

Assay of estrogen receptor activity in prostates from patients who ranged in age from 22 to 78 years and had not received any previous hormonal therapy was carried out by incubation of cytosols with (3)H-estradiol in the presence and absence of excess, nonradioactive estradiol. Hyperplastic prostatic tissues were used in the study. The kinetics of each reaction were studied and analysis of the data revealed 3.4 to 35.7 femtomoles of receptor protein per mg of cytosol protein; the dissociation constants obtained from a Scatchard plot ranged from 1.1 × 10(-10) to 1.2 × 10(-8)M.The small number of patients prevents realistic quantitative assessment of the apparent estrogen binding activity demonstrated in these preliminary studies, but the qualitative identification of such activity provides possible grounds for further insight into the hormonal mechanisms in the pathophysiology of prostatic diseases and of their responses to endocrine therapy.

Adult↗
PubMed1981

Plasma lipid bound sialic acid in patients with prostate and bladder cancer.

Plasma lipid bound sialic acid (LSA) was measured in patients with prostate and bladder cancer to determine the usefulness of this biochemical marker in teh staging of malignant disease and in monitoring the efficacy of therapy. Patients with advanced stages of prostate cancer with bone metastases exhibited LSA levels significantly higher than normal subjects. Patients with bladder cancer showed elevations in LSA both in early noninvasive and in advanced stages of the disease. In both types of cancer, patients treated successfully and clinically free of disease did not have elevated LSA levels, whereas patients failing to respond to treatment had persistently high values.

Adult↗
PubMed1981

Segmental replacement of the ureter using tapered and nontapered ileum.

We attempted to reduce the absorptive surface area and maintain the natural antireflux mechanism of the distal ureter by using ileum as an interposed segment rather than a total ureteral substitute in six dogs. In each dog we compared the physiologic effects of a longitudinally tapered ileal segment versus a simple nontapered segment. Information from the intravenous pyelogram, renal function tests, and the pressure flow studies showed preservation of renal function and parenchyma, no secondary dilation of the upper tracts, continued peristaltic activity, no evidence of obstruction or stone formation secondary to mucus production, no early pyelographic abnormalities, and no differences in pressure flow characteristics between the tapered and nontapered segments. We believe that incorporating ileum into the urinary tract to bridge a ureteral defect is a safe and effective clinical alternative.

Animals↗
PubMed1981

The use of testicular lymphatics to bypass obstructed lymphatics in the dog.

The lymphatics of the hind limb were surgically obstructed in dogs by a procedure that included radical femoral lymphadenectomy. The testis was transposed to the thigh by a modified Torek procedure in an effort to bypass the created lymphatic obstruction. Functionally significant lymphatic-lymphatic anastomoses between the lower limb lymphatics and the testicular lymphatics were visually demonstrated either by direct inspection or by lymphangiography in 11 of 15 cases.

Animals↗
PubMed1980

Bladder cancer diagnosis by flow cytometry. Correlation between cell samples from biopsy and bladder irrigation fluid.

Results of flow cytometry (FCM) examinations of bladder irrigation specimens were compared with those of FCM examinations of cell suspensions from bladder biopsies of 44 urologic patients. The fluorescent dye, acridine orange (AO), was used to stain DNA and RNA differentially and abnormal urothelial cells were identified by their relative content of nucleic acids. Granulocytes and squamous cells could be distinguished from transitional cells in this procedure, and did not interfere with the analyses. Of 28 patients with papillary carcinoma, carcinoma in situ, and invasive carcinoma 27 were identified through FCM examination of irrigation cytology specimens; the one false-negative result was from a low-grade papillary carcinoma. Of 7 patients with papilloma, FCM examinations of irrigation specimens were positive in 4 and negative in 3. Results of FCM studies of biopsy specimens were in good but not complete agreement with those of irrigation specimens. In several cases, irrigation FCM disclosed tumor stemlines that were not identified in biopsy specimens. Discrepancies of this kind seemed most likely due to differences in sampling. Irrigation FCM seems to be a sensitive method for assessing multiple-site bladder tumors, and may be a useful technique for monitoring the course of conservatively managed bladder tumors.

Acridine Orange↗
PubMed1980

Interstitial radiation therapy for carcinoma of the prostate.

Pelvic lymph node dissection and iodine 125 implantation has been systematically utilized at Memorial Sloan-Kettering Cancer Center (MSKCC) since 1970 as one form of management of selected patients with stage B or stage C prostatic cancer. Experience with the technique is reviewed on the basis of previously published data and on the basis of a five-year follow-up of the first 100 patients. The operative procedure has been generally well tolerated, with a low morbidity, with a mortality rate of 0.67% (2/300), and with minimal adverse effects on urinary, rectal, and sexual functions. Thirty-six percent of the patients had regional lymph node metastasis, and such was associated with a 71% incidence of distant metastasis at five years. However, at five years 14% of patients with positive nodes remain free of evidence of neoplasm, and 38% of patients with negative lymph nodes have evidence of bone metastasis. At five years, 11% of patients have evidence of local recurrence only; 19%, distant metastasis only; and 32%, both local recurrence and distant metastasis. Five-year survival without stratification relative to lymph node involvement is 100% (16/16) for stage B1, 88% (23/26) for stage B2, 66% (6/10) for stage B3, 33% (2/6) for stage C1, 53% (17/32) for stage C2, and 1/1 for stage C3, but endocrine therapy has presumably contributed to such survival in those patients developing intractable local recurrence and/or symptomatic distant metastasis within the five-year follow-up.

Brachytherapy↗
PubMed1980

Mini-dose heparin therapy in pelvic lymphadenectomy and 125I implantation for localized prostatic cancer.

A retrospective comparison of patients undergoing pelvic lymphadenectomy and iodine-125 implantation for localized prostatic cancer was undertaken. A control group of 276 patients was compared with 105 patients in a mini-dose heparin group. No protective benefit in the prevention of thromboembolic events was demonstrated. Operative and postoperative complications are reviewed.

Brachytherapy↗