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Biomedical subjects

Z Fuks

Publications and source records attributed to Z Fuks.

At least 271 records · Page 15Linked to original sources
PubMed1979

Electron-beam therapy for mycosis fungoides: the Stanford University experience.

The use of high-dose electron-beam therapy for mycosis fungoides at Stanford University is reviewed. Since 1966, 140 patients have been treated in this fashion. Their clinical characteristics including initial extent of disease are reviewed. The results of routine staging studies are examined. Eighty-four percent of the patients achieved an initial complete remission; this was inversely related to the initial extent of skin involvement. The overall survival rate was 46% at 10 years with the major prognostic factor being the initial extent of skin involvement. Other factors which had an influence on the patient's progrnosis included the presence of palpable adenopathy, the patient's age, the achieving of an initial complete remission, the initial dose of electron-beam therapy, and the treatment with adjuvant topical mechlorethamine. The development of a rationale for the treatment of patients with all stages of mycosis fungoides based upon these clincal observations is discussed.

Adult↗
PubMed1979

In vitro proliferation of macrophage depleted human peripheral blood lymphocytes.

The incorporation of thymidine by normal human peripheral blood lymphocytes was tested in vitro following various culture conditions. A significant increase of thymidine uptake was observed in cultures depleted of plastic adherent, nylon wook adherent, or phagocytic cells. This proliferative activity occurred in the presence of various sera but was not due to a blastogenic response to a foreign protein, since it was also observed when autologous plasma was the only source of protein in the culture medium. The similarities and differences between this 'spontaneous' proliferative phenomenon and other blastogenic responses which are regulated by macrophages are discussed.

Adolescent↗
PubMed1979

Radiation therapy in the management of cutaneous T-cell lymphomas.

The lesions of mycosis fungoides (MF), a neoplasm of T lymphocytes, are extremely radiosensitive. The history of ionizing radiation in the treatment of MF is discussed in this paper. Low-energy X-rays have long been successful in the treatment of individual lesions and in the effective palliation of patients with this disease. The major breakthrough in the treatment of MF with ionizing radiation came with the development of the ability to treat the total skin by means of electrons which penetrate to depths of only 1--2 cm, thereby treating the epidermis and dermis while sparing more deeply situated tissues. The complications and results of this therapy are reviewed. The aggressive use of electron-beam therapy has resulted in many long-term remissions. It is important to use high initial doses of radiation and to treat patients when they are still in the early stages of disease. The potential use of other modalities of radiation, including total-lymphoid radiation with megavoltage photons, low-dose fractionated total-body radiation, and sequential hemibody radiation, are reviewed.

Humans↗
PubMed1978

Transplantation of allogeneic bone marrow without graft-versus-host disease using total lymphoid irradiation.

Bone marrow (BM) and skin allografts from C57BL/Ka (H-2b/b) mice were transplanted to BALB/c (H-2d/d) recipients treated with total lymphoid irradiation (TLI), whole-body irradiation (WBI), or fractionated thymic irradiation TLI prolonged skin allograft survival about five times as long as that in untreated controls, and allowed for permanent engraftment of BM cells in approximately equal to 90% of recipients. None of the BM recipients showed clinical signs of graft-versus-host disease (GVHD) (diarrhea, weight loss, hunched back, etc.). On the other hand, recipients given WBI and allogeneic BM cells developed severe clinical GVHD. The majority of the latter recipients died within 12 days after BM transplantation, and 95% died within 61 days. Although TLI protected BALB/c mice against GVHD induced by BM cells, all recipients given TLI and allogeneic spleen cells developed lethal GVHD. Thymic irradiation alone marginally prolonged skin allograft survival, and did not allow for allogeneic BM engraftment. These results suggest that TLI may be a useful regimen in clinical BM transplantation, since this form of radiotherapy is used extensively in humans and has few severe side effects.

Animals↗
PubMed1977

Induction of specific tissue transplantation tolerance using fractionated total lymphoid irradiation in adult mice: long-term survival of allogeneic bone marrow and skin grafts.

BALB/c mice were treated with fractionated high dose (3,400 rads) total lymphoid irradiation (TLI), and given semiallogeneic (BALB/c x C57BL/Ka) or allogeneic (C57BL/Ka) bone marrow and/or skin allografts. TLI alone prolonged the mean survival time (m.s.t.) of C57BL/Ka skin grafts to 49.1 days (control, 10.7 days). Shielding of the thymus during TLI produced only a slight increase in graft survival (m.s.t., 19 days). TLI combined with splenectomy was no more effective than TLI alone. Infusion of 10(7) semiallogeneic or allogeneic bone marrow cells after TLI produced stable chimeras in 7/8 and 8/15 recipients, respectively. Chimeras were specifically tolerant to donor tissues, since C57BL/Ka skin grafts were accepted for more than 250 days, but third-party (C3H/He) skin grafts were rejected rapidly. In addition, chimeric lymphocytes responded to C3H/He and C3H. Q but not to C57BL/Ka cells in the one-way mixed leukocyte reactions. BALB/c C57BL/Ka chimeras showed no clinical evidence of graft vs. host disease. These findings may have application of clinical organ transplantation, since (a) the recipient treatment (TLI) has already been shown to be safe in humans, (b) donors and recipients can be completely allogeneic, and (c) bone marrow and skin graft survival was permanent (greater than 250 days).

Animals↗
PubMed1977

The coexistence of nodular and diffuse patterns in nodular non-Hodgkin's lymphomas: significance and clinicopathologic correlation.

One hundred and twenty-six cases of nodular lymphoma have been classified cytologically by the criteria of Rappaport, and have been divided into three architectural groups, based on the degree of nodularity. Eighty-five percent of the patients have been followed for at least 5 years after initial therapy. Analysis of actuarial survival curves reveals that patients in the poorly differentiated lymphocytic and mixed histiocytic-lymphocytic categories with the three architectural patterns ("nodular only," "nodular with focal diffuse," and "nodular with diffuse") have similar long-term and disease-free survivals. Nevertheless, any degree of nodularity imparts a more favorable prognosis than diffuse lymphoma of coreresponding cell type. In the small number of patients with a nodular lye than in the other two histiocytic type, associated with diffuse areas, the prognosis is less favorable than in the other two histologic groups. Thus, a nodular lymphoma of so-called histiocytic type with diffuse areas may behave more like a diffuse than nodular lymphoma, and warrants appropriate therapy.

Female↗
PubMed1977

E-rosette inhibiting substance in Hodgkin's disease spleen extracts.

Patients with Hodgkin's disease often manifest impairment of cell-mediated immune responses in both in vivo and in vitro tests, as well as a markedly decreased percentage of E rosette-forming (T) lymphocytes in the peripheral blood. This report describes the inhibition of E-rosette formation by normal peripheral blood lymphocytes after incubation with extracts prepared from the spleens of patients with Hodgkin's disease. Such extracts also depressed E-rosette formation by the peripheral blood lymphocytes of patients with Hodgkin's disease after those cells had been restored to normal function by prior incubation in foetal calf serum. Similarly prepared extracts from the spleens of normal donors had no immunodepressive effect. The E-rosette inhibitory substance in the Hodgkin's disease spleen extracts was found to be a complex containing beta-lipoprotein, C-reactive protein, and C1q.

C-Reactive Protein↗
PubMed1977

The role of total skin irradiation with electrons in the management of mycosis fungoides.

The study presents a group of 176 patients with biopsy proven mycosis fungoides treated with total skin irradiation with electrons. The treatment resulted in a complete disappearance of all cutaneous lesions in 117/176 (66 percent) of the patients. The rate of complete remission was dose-dependent and was inversely dependent on the extent of the disease. Nineteen patients have been continuously free of any evidence of mycosis fungoides 4-14 years following a single course of treatment and may be considered as cured. Most of the patients presenting with significant peripheral lymphadenopathy (Stage II) eventually relapsed with cutaneous lesions and 37 percent of these patients developed extra-cutaneous dissemination. The prognosis of patients with extracutaneous involvement was poor and no patients in this series survived for more than three years after the histological diagnosis of extractaneous dissemination. The role of total skin irradiation with electrons in the management of each stage of the disease, given either alone or in combination with other treatment modalities, is discussed.

Electrons↗
PubMed1976

Interaction between serum factors and T lymphocytes in Hodgkin's disease. Use as a diagnostic test.

We studied the mechanism of defective binding of sheep erythrocytes to the surface of peripheral blood T lymphocytes (E-rosette-formation) in Hodgkin's disease. The decreased percentage of E-rosette-forming cells (range, 21 to 77 per cent) in 25 patients with Hodgkin's disease was reversed and returned to normal range (52 to 78 per cent) by prior incubation of the T lymphocytes in tissue-culture medium with 20 per cent fetal-calf serum for 18 to 24 hours. The percentage of E-rosette-forming cells was suppressed by additional incubation with serum from patients with Hodgkin's disease (range, 20 to 61 per cent) but not with serum from patients with other neoplasms or from normal subjects (range, 52 to 74 per cent). Only target T lymphocytes from patients with Hodgkin's disease were suppressed by Hodgkin-disease serum. The findings suggest that there is a specific interaction between serum factors and the surface of peripheral blood T lymphocytes in Hodgkin's disease.

Female↗
PubMed1976

Long-term survival of skin allografts in mice treated with fractionated total lymphoid irradiation.

Treatment of recipient Balb/c mice with fractionated, high-dose total lymphoid irradiation, a procedure commonly used in the therapy of human malignant lymphomas, resulted in fivefold prolongation of the survival of C57BL/Ka skin allografts despite major histocompatibility differences between the strains (H-2d and H-2b, respectively). Infusion of 10(7) (C57BL/Ka x Balb/c)F1 bone marrow cells after total lymphoid irradiation further prolonged C57BL/Ka skin graft survival to more than 120 days. Total lymphoid irradiation may eventually prove useful in clinical organ transplantation.

Animals↗
PubMed1976

Long-term effects on external radiation on the pituitary and thyroid glands.

Chronic damage following external irradiation of the normal pituitary and thyroid glands, delivered incidentally during radiotherapy of neoplasms of the head and neck may be more common than has been appreciated in the past. A case of a child who developed pituitary dwarfism 5 1/2 years after radiation therapy has been delivered for an embryonal rhabdomyosarcoma of the naso-pharynx is described. A review of similar cases from the literature is presented. Likewise, external irradiation of the normal thyroid gland produces a spectrum of radiation-induced syndromes. Clinical damage to the pituitary and thyroid glands is usually manifested months to years after treatment and is preceded by a long subclinical phase. A careful exclusion of these glands from radiation treatment fields is recommended whenever possible. An early detection of endocrine function abnormalities in patients receiving radiation to these glands is desirable, since appropriate treatment may prevent the deleterious effects of external irradiation of the pituitary and thyroid glands.

Adult↗
PubMed1976

Abdominal irradiation in non-Hodgkin's lymphomas.

The incidence of subdiaphragmatic relapses in a group of 170 patients with non-Hodgkin's lymphomas treated with radiation to lymph-node bearing areas above and below the diaphragm is described. In patients treated with the standard inverted "Y" abdominal radiation portals, subdiaphragmatic relapses occurred in 29% of 132 patients. This high local failure rate may be attributed to the exclusion of many of the mesenteric lymph nodes and most of the liver and intestines from the irradiated fields. A safe and apparently effective radiation technique which treats the whole abdomen, used at Stanford in 38 patients since 1973, is described. Full thickness lead blocks protect the right hepatic lobe during the initial 1500-rad whole abdominal treatment (through anterior-posterior opposed fields). Horizontal decubitus (cross-table) lateral fields are then used to bring the para-aortic and mesenteric lymph node radiation doses to 3000 rads, followed by an additional 1400 rads through wide anterior-posterior ports, for a total central abdominal dose of 4400 rads. Dosimetric considerations, anatomic descriptions of subdiaphragmatic lymphatic drainage, complications of treatment, and the initial results of whole abdominal radiation therapy are also presented.

Abdomen↗
PubMed1976

Non-Hodgkin's lymphomas of stage III extent. Is total lymphoid irradiation appropriate treatment?

Many investigators have regarded Stage III lymphomas as a generalized form of disease and have accordingly recommended systemic treatment programs. Between 1961 and 1973, 68 patients with clinical or pathologic Stage III non-Hodgkin's lymphomas were seen in the Division of Radiation Therapy at Stanford University Medical Center and were treated by high dose (3500 rads or more) total lymphoid radiation therapy only. Of the 17 patients who had a diffuse histologic pattern, the actuarial survival at 5 years was 39%, but only three patients have remained free of disease. In contrast, for the 51 patients who had a nodular histologic pattern, the actuarial survivals at 5 and 10 years were 75% and 65%, respectively. Corresponding relapse-free survivals for patients with nodular lymphomas were 43% and 33%, respectively. Of 28 patients who relapsed with nodular lymphomas, 18 (64%) had relapses confined to lymph nodes; six of these were extensions to previously unirradiated epitrochlear-brachial nodes. Seven of the 18 patients were treated only with further conventional external radiation therapy at the time of their relapses and remain free of disease for additional periods of 2 to 5 years. Hence, 30 of 51 (59%) patients with nodular lymphomas have thus far been controlled by high dose total lymphoid irradiation only. Over 90% of relapses among patients with nodular lymphomas were seen within the first 5 years. The data suggest that high dose conventional radiation therapy to incorporate not only the routine total lymphoid fields but also the epitrochlear, mesenteric, and Waldeyer's ring region has curative potential even in Stage III non-Hodgkin's lymphomas, especially in the nodular group.

Adolescent↗