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Biomedical subjects

W F Whitmore

Publications and source records attributed to W F Whitmore.

At least 253 records · Page 14Linked to original sources
PubMed1980

Radiocolloid scintigraphic mapping of the lymphatic drainage of the prostate.

Radionuclide lymphoscintigraphy with the new microcolloid 99mtechnetium antimony sulfide is a diagnostic technique with potential application in patients with urologic malignancy. Scintigraphic images were obtained after simple interstitial injection into the prostate of 9 normal dogs and 2 patients with prostatic cancer and into the testis in 2 dogs. The images show the physiologic lymphatic drainage of the organs injected.

Adenocarcinoma↗
PubMed1980

Cryptorchidism and testicular cancer.

An analysis of 125 patients with a history or clinical evidence of cryptorchidism and testicular germinal tumor treated at our hospital from 1934 to 1975 is presented. Cryptorchidism was corrected ipsilaterally or contralaterally in 83 patients with intrascrotal testis cancer when they were from 4 to 42 years old, either spontaneously (21 patients), by orchiopexy (51 patients) or by hormonal therapy (11 patients). Forty-two cryptorchid patients (uncorrected cases) presented with either ipsilateral inguinal (24 patients), abdominal (14 patients) or contralateral intrascrotal tumors (4 patients). Tumor histologic types on orchiectomy were pure seminoma in 54 patients, embryonal carcinoma in 35, teratocarcinoma in 33 and pure choriocarcinoma in 3. The 5-year survival rates were 60 per cent for the corrected cases and 63 per cent for the uncorrected cases according to cryptorchid state, and they were 78 per cent in patients with pure seminoma and 48 per cent in patients with other germinomas according to histologic type. The majority (58 of 73) of 5-year survivors received regional lymphatic irradiation, in 39 patients with pure seminoma, and/or systemic chemotherapy, in 19 patients with germinal carcinomas, with or without regional lymphadenectomy.

Adolescent↗
PubMed1980

Complications of ureteroileal conduit with radical cystectomy: review of 336 cases.

Review of complications of the ileal conduit in patients undergoing radical cystectomy for bladder cancer showed a statistically significant increase in renal calculi, ureteral obstruction, acute and chronic pyelonephritis and deterioration of renal function by 60 months postoperatively. Ureteroileal fistulas occurred in 3.3 per cent, stomal stenosis in 5.1 per cent, intestinal fistulas in 5.4 per cent, severe intestinal obstruction in 6 per cent and abdominal wound infection or dehiscence in 20.2 per cent of the cases. The over-all operative mortality was 13.7 per cent, with 8 per cent of the deaths attributed to complications from the ileal conduit. Comparison of colonic conduits to ileal conduits as a means of urinary diversion with radical cystectomy for bladder cancer demonstrated no convincing evidence of its superiority.

Adult↗
PubMed1980

Flow cytometry in bladder cancer detection and evaluation using acridine orange metachromatic nucleic acid staining of irrigation cytology specimens.

A new technique for simultaneous multiparameter deoxyribonucleic acid, ribonucleic acid and nuclear size measurements by flow cytometry was applied to the examination of bladder irrigation cytology specimens from 107 urologic patients. The cell samples from patients with bladder carcinoma could be distinguished from normal by 2 features: 1) an increase in the proportion of bladder epithelial cells with more than diploid deoxyribonucleic acid and 2) aneuploid cell peaks. These criteria identified 12 of 13 cases of invasive carcinoma, 24 of 28 cases of carcinoma in situ and 11 of 13 cases of papillary carcinoma. An increased proportion of cells with more than diploid deoxyribonucleic acid or aneuploidy was found in 9 of 14 patients with papilloma and 6 of 19 patients with a history of bladder tumors but no evident disease at present--these were believed owing to increased epithelial proliferative rates or nuclear chromatin abnormalities not visible by light microscopy. None of the 20 patients who had never had bladder tumors was abnormal. While the results in this small clinical trial have been most encouraging an additional descriptor of nuclear chromatin structure is believed necessary to discriminate benign, reactive proliferative epithelium from neoplasm when the latter is near diploid or shedding few cells. Studies to develop such a parameter presently are under way.

Acridine Orange↗
PubMed1980

Experience with interstitial implantation of iodine 125 in the treatment of prostatic carcinoma.

Between February 1970 and April 1977 300 patients with localized prostatic carcinoma were treated with I-125 implantation and bilateral pelvic lymphadenectomy at Memorial Sloan-Kettering Cancer Center (MSKCC). 68% had clinical Stage B (T-1 and T-2) and 32% had Stage C (T-3) neoplasms. Pelvic lymph nodes were histologically positive in 38% of the patients. Five-year survival for all patients was 73%. Five-year survival for Stage B disease was 100% and Stage C 65%. Lymph node metastases implied a poor prognosis. While 92% of patients with negative nodes survived five years, only 46% of the patients with positive nodes did so. Supplemental external radiation to pelvic and periaortic region in 28 patients with positive nodes did not improve survival or disease free interval or reduce distal or local recurrence but rather increased the incidence of radiation morbidity. The complications and morbidity as a consequence of I-125 implantation are minimal. The ultimate role of I-125 implantation in the management of localized prostatic cancer is yet to be determined. The early experience with this technique, however, suggests that it may be as effective as alternative modalities for comparable stages in terms of patient survival and may prove superior in terms of the quality of survival.

Bone Neoplasms↗
PubMed1979

Cell surface antigens of human renal cancer defined by autologous typing.

Sera from 28 patients with renal cancer were tested for reactivity with surface antigens of cultured autologous renal cancer cells. Four serological assays were used to survey sera for autologous antibody. Immune adherence, protein A, and C3-mixed hemadsorption assays detected reactivity in a high percentage of patients (80-100%), whereas mixed hemadsorption assays were negative with sera from all but one patient. Reactive sera from six patients were analyzed by absorption tests with autologous, allogeneic, and restricted to autologous renal cancer cells; class 2 antigens, present on certain allogeneic renal and nonrenal cancer cells; and class 3 antigens, found on a wide variety of normal and malignant cell types. The sera of one patient detected class 1, 2, and 3 antigens, the sera of three patients detected class 2 antigens, and the sera of two patients detected class 3 antigens. This analysis of renal cancer, with the recognition of three classes of surface antigens recognized by autologous sera, resembles the results of autologous typing of three other human malignancies: malignant melanoma, acute leukemia, and astrocytoma. Evidence provided by autologous typing of these cancers indicates that class 1 and class 2 antigens are tumor-restricted and that under certain circumstances these antigens are immunogenic for the autologous host.

Adult↗
PubMed1979

A report of the workshops on the current status of the histologic grading of prostate cancer.

A national multidisciplinary study of four major systems for the histological grading of primary prostatic cancer was completed during 1978. In a series of workshops culminating in a final review, criteria of grading were critically assessed against the background of patient survival data. The overall consensus was that the Gleason system should tentatively be adopted as the pathologic reference point for classifying patients. This system can be used in conjunction with other systems. It seems definable, reproducible, reasonably simple, and has clinical relevance as judged by correlations with patient survival. Further study may demonstrate advantages from incorporation of the nuclear or cytologic characteristics of tumor cells into the Gleason system. New techniques of acid phosphatase determination, bone scans, and assessment of the regional lymph nodes should provide better staging criteria for correlation with primary tumor histology in the furture. These workshops presented a unique opportunity for representative clinicians and pathologists in the United States to express their viewpoints in a comprehensive fashion on this timely and important topic.

Anaplasia↗
PubMed1979

A critical analysis of response criteria in patients with prostatic cancer treated with cis-diamminedichloride platinum II.

Cis-diamminedichloride platinum II (DDP), 50--70 mg/m2 iv, q 3w was administered to 25 patients with Stage D adenocarcinoma of the prostate. Since the assessment of tumor regression in a disease-oriented phase II study demands a clear end-point of response, case selection was restricted to patients who had objectively measurable lesions, i.e., nodes, skin, lung, and liver metastasis. Partial remission occurred in 3 (12%) and stabilization of disease in 1 patient. Responders lived 53 weeks vs. 20 weeks for non-responders. In the dosage and schedule used in this protocol, DDP was not an active agent in the treatment of prostatic cancer. Various patient characteristics are examined and correlations made between remission rates and survival in this study vs. 4 other response schemata. A critical analysis of patient selection, "lead time" -- diagnosis to chemotherapy, and the definitions of the terms "measurable" lesions, "evaluable" parameters, "objective response", stabilization of disease and response criteria employed in the 4 schemata are also discussed.

Adenocarcinoma↗
PubMed1979

Experience with flutamide in previously untreated patients with advanced prostatic cancer.

Twenty-one patients with advanced prostatic adenocarcinoma previously untreated with conventional endocrine therapy were treated with an oral non-steroidal antiandrogen, flutamide. There were 19 favorable responders, 1 failure and 1 equivocal response. Flutamide seems to be a safe antiandrogen, which is effective in the management of previously untreated patients with advanced prostatic carcinoma.

Adenocarcinoma↗
PubMed1979

Solitary vaginal metastasis from unsuspected renal cell carcinoma.

Four cases of solitary vaginal metastasis from previously unsuspected renal cell carcinoma are presented. Vaginal bleeding, the presenting symptom in each patient, led to the finding of the metastatic vaginal lesion and to the urological evaluation, which revealed the occult primary renal cell carcinoma. With surgical treatment 2 of the 4 patients have remained well for more than 5 years.

Adenocarcinoma↗
PubMed1979

Complications of 125iodine implantation and pelvic lymphadenectomy in the treatment of prostatic cancer.

The operative, postoperative and late complications experienced by 300 consecutive patients who underwent 125iodine implantation and pelvic lymphadenectomy for localized prostatic cancer were analyzed. Of the patients reviewed 68 per cent had clinical stage B lesions, while 32 per cent had clinical stage C lesions. The incidence of intraoperative complications was 6 per cent. There were 2 postoperative deaths and 23 per cent of the patients had postoperative complications. Of 177 patients followed postoperatively for 6 months or more (mean 29.3 months) late morbidity was experienced by 49 (28 per cent). The incidence of impotence in 109 patients who were potent preoperatively and who were followed for a minimum of 15 months was 7 per cent.

Adult↗
PubMed1979

Cell-cycle distribution of urothelial tumour cells as measured by flow cytometry.

The fraction of cells in S + G2 + mitosis from 54 urothelial tumours was calculated by flow cytometry after acridine orange (AO) staining of cells obtained by bladder irrigation or biopsy. Fluorescence signals emitted by the AO-stained DNA and RNA of each cell were separated optically and measured for 5,000 cells per specimen. The patients were classified by the histology of their tumours and clinical data into 5 diagnostic categories: NED (no evidence of disease, but history of bladder tumour), 3; papilloma, 8; non-invasive papillary carcinoma, 8; carcinoma in situ, 17 and invasive carcinoma, 18. The fraction of cells with DNA values in S + G2 + M of the cell cycle varied between 7 and 57% of the total, with a wide range within each diagnostic category, but no statistically significant differences between the groups. The proportion of cells in S + G2 + M from an individual tumour was not correlated with histologic grade or clinical behaviour. The possibility that some tumour cells with DNA values above G1 level are quiescent cells arrested at S or G2 is discussed.

Cell Count↗