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At least 199 records · Page 11Linked to original sources
PubMed1999

Comparison of the effects of asparaginase administered subcutaneously versus intramuscularly for treatment of multicentric lymphoma in dogs receiving doxorubicin.

OBJECTIVE: To determine the effectiveness and safety of asparaginase administered s.c. versus i.m. for treatment of multicentric lymphoma in dogs receiving doxorubicin. DESIGN: Prospective study. ANIMALS: 49 dogs with multicentric lymphoma. PROCEDURE: Dogs were treated with doxorubicin every 3 weeks, for a total of 5 treatments, and were given 3 weekly treatments of asparaginase, s.c. or i.m. Using high-performance liquid chromatography, mean plasma asparagine, aspartic acid, glutamine, and glutamic acid concentrations were determined in dogs before and during treatment with asparaginase (10,000 U/m2 of body surface area, once a week for 3 weeks). Asparaginase was administered s.c. in 23 dogs and i.m. in 26 dogs. Variables evaluated included time to response to chemotherapy, remission and survival times, and clinical and serum biochemical indicators of toxicoses. RESULTS: Using the World Health Organization's staging system for lymphoma, 30 dogs were in clinical stage III and 19 were in clinical stage IV. One week after asparaginase treatment, plasma asparagine concentrations were low and plasma aspartic acid, glutamine, and glutamic acid concentrations were high. Differences in plasma amino acid concentrations were not found between s.c. and i.m. groups. For dogs in clinical stage IV, i.m. administration of asparaginase significantly decreased the number of days to complete remission, compared with s.c. administration (8 vs 17 days, respectively). For dogs in clinical stage III, i.m. administration favorably increased the duration of first remission (191 vs 103 days) and survival time (289 vs 209 days). Overall, dogs treated i.m. had a faster response to chemotherapy (9 vs 15 days), a longer remission (191 vs 109 days), and a longer survival time (286 vs 198 days), compared with all dogs treated s.c. Asparaginase toxicoses were not observed regardless of the route of administration. CLINICAL IMPLICATIONS: For dogs with multicentric lymphoma that are receiving doxorubicin, i.m. treatment with asparaginase is more effective than s.c. treatment.

Animals↗
PubMedDate not supplied

Ethical review of a multicentre study in Scotland: a weighty problem.

OBJECTIVE: To assess the current working practices of local research ethics committees (LRECs) in their review of a multicentre study approved by the new multicentre research ethics committee in Scotland. DESIGN: Observational data collected from correspondence with LRECs. SUBJECTS: All LRECs within the geographical area of the study in Scotland. INTERVENTIONS: None. OUTCOME MEASURES: Delay from application to calling an LREC meeting, to an initial LREC decision, to final LREC approval, and the number of A4 pages required. RESULTS: The median delay to review of an application at an LREC meeting was 28 days (range 14-97), the median delay from application to the time of LREC final approval was 39 days (range 21-109) and a total of 5,789 A4 pages (26.9 kg) were required to complete the application process. CONCLUSIONS: Despite recent standardisation of ethical review of multicentre research, elimination of unnecessary delay, cost and variation in LREC operating procedures is still necessary.

Ethics Committees↗
PubMed2000

Idiopathic multicentric osteolysis with nephropathy.

Idiopathic multicentric osteolysis is a rare syndrome that manifests with progressive loss of carpal and tarsal bones in childhood. Affected children have arthritic-like episodes, followed by progressive deformities, radiographic osteolytic changes, and variable degrees of disability. A rare form of this disease (type III, sporadic) is associated with serious nephropathy. We present the first reported case of type III idiopathic multicentric osteolysis in a Chinese woman. The patient, a 34-year-old woman with normal mental development and no family history of bone or kidney disease, presented with a 4-day history of nausea and vomiting. She had shortening and swelling of the hands, which had occurred in childhood and persisted at the time of admission. X-ray studies showed disappearance of the carpal bones, and multiple osseous erosions of the tarsal bones. Hypertension, severe azotemia, and metabolic acidosis were also noted. Advanced renal disease was documented after a series of investigations, including renal biopsy. She is now dialysis-dependent. This case illustrates the importance of early diagnosis and management of idiopathic multicentric osteolysis with nephropathy.

Adult↗
PubMed1992

Angiofollicular lymph node hyperplasia: a comparison of unicentric, multicentric, hyaline vascular, and plasma cell types of disease by morphometric and clinical analysis.

A morphometric and clinical analysis of 47 cases of angiofollicular lymph node hyperplasia (AFLH) demonstrated morphometric differences between plasma cell (28 cases) and hyaline vascular (19 cases) AFLH. Twenty-one AFLH cases were unicentric, and 26 cases were multicentric. Plasma cell types of AFLH, defined by standard morphologic and objective morphometric assessment, were associated with systemic clinical and laboratory abnormalities. Unicentric or hyaline vascular AFLH was amenable to surgical therapy, and multicentric or plasma cell AFLH without neuropathy was amenable to steroid treatment or chemotherapy with good prognoses. Multicentric or plasma cell AFLH with neuropathy was associated with resistance to steroids and chemotherapy and with a poor prognosis.

Blood Vessels↗
PubMed2003

Unilateral multicentric breast cancer.

Clinical characteristics of unilateral multicentric breast cancer (UMBC) were explored depending on aggressiveness, survival rate, disease-free period and local recurrence. The study included 296 women with breast cancer, surgically treated between 1990 and 2001. UMBC was histologically proved in 29 (9.8%) patients. Multicentricity was defined by following criteria: a) tumor with minimum one satellite node in the same or other quadrant of the breast; b) minimum one cut through the breast without tumor cells; c) histopathologically, discontinued tumors with intra-ductal invasion. The average age of patients was 63.4 (range 36-85). There were 9 (31.0%) women with one satellite node, 7 (24.1%) women with two satellite nodes, and 13 (44.8%) women with three or more satellite nodes. At the operation, axilla was positive in 20 (68.9%) women. Steroid receptors were highly positive in 12 (41.4%) patients. Primary and secondary tumors were of the same histological type in 26 (89.6%) patients. Local recurrence was found in only 3 (10.3%) patients. A five-year period without disease was achieved in 24 (82.7%) women. Kaplan-Meier analysis showed a significantly higher survival rate at lower tumor stages (I or II) unlike in advanced stages with predominantly N2 grade. The results of this study showed a slightly lower five-year disease-free period than in the case of patients with monocentric breast cancer (MOBC). The survival rate was significantly lower at all advanced stages, especially determined by N2 axilla. Therefore, the conclusion is that multicentricity doesn't increase the risk of poor prognosis, especially at lower tumor stages.

Adult↗
PubMed1990

[Multicentric reticulohistiocytosis (lipoid dermato-arthritis). A radiologic study of 3 cases].

The authors report their experience with 3 cases of multicentric reticulohistiocytosis observed over 6 years of outpatient radiological practice. The condition presents with the following radiological patterns: 1) clear-cut erosions of the articular surfaces, especially in the distal interphalangeal joints of the hands and in the metatarso-phalangeal joints of the feet, with symmetrical distribution (not necessarily); 2) osteolytic punched-out areas in the epiphyseal spongiosa, ranging in size from 1 mm to over 1 cm; 3) no osteoporosis, no osteo-proliferative or periosteal reactions, not even in the presence of large osteoarticular destructions; 4) frequent atlanto-epistropheal subluxation; 5) articular ankylosis at the sacroiliac joints only. The association of the above patterns and the relatively benign clinical course distinguish multicentric reticulohistiocytosis from rheumatoid arthritis, psoriasis arthritis, erosive osteoarthritis, and gout. A reliable diagnosis can be suggested on the basis of radiological findings alone, even before cutaneous or mucosal lesions appear--which are, at any rate, not sure to appear and typical of nails only. An unquestionable diagnosis can be made at histology of synovial and/or cutaneous nodules. Multicentric reticulohistiocytosis is considered an uncommon condition (nearly 100 cases in international literature to 1989); the authors believe it to be commoner though often misdiagnosed as a "variant of rheumatoid arthritis".

Adult↗
PubMedDate not supplied

Multicentricity of breast carcinoma: a case against partial mastectomy.

One hundred and seventy-three mastectomies for carcinoma of the breast during a two-year period were reviewed for multicentric foci in the pathologic specimen. There was a total of 38 cases of multicentric carcinoma, comprising 22%. Sixty-two percent of all carcinomas presented as clinical Stage A and B, of these, 21% were multicentric. It is our opinion that except for certain extenuating circumstances, the procedure of choice for carcinoma of the breast is either a modified or standard radical mastectomy.

Breast Neoplasms↗
PubMed1989

[Multicentric Castleman's disease].

We describe a case of histologically proven multicentric Castleman's disease in a 68 year old man. The clinical picture was dominated by severe hemolytic anemia. The outcome was fatal despite active treatment. We discuss the main pathological and clinical characteristics distinguishing multicentric Castleman's disease from the localized variant. The different age distribution, localized versus multicentric disease, different responses to treatment, and outcome, indicate that the two types of Castleman's disease represent different entities presenting common histological features in the lymphoid lesions.

Aged↗
PubMed1986

Multicentricity in breast cancer: a submacroscopic study.

One hundred human female breasts surgically removed by radical mastectomy for clinical cancer were analyzed under a dissecting microscope to search for other submacroscopic (less than 0.5 cm) foci collateral to and independent from the clinical one. These foci were found in 36 percent of cases, either in situ (17 percent), or infiltrating (12 percent), or both in situ and infiltrating (7 percent). This high percentage of multiple cancer confirms previous data, suggesting the wide intramammary distribution of breast cancer disease. Multicentricity appears to be significantly associated with the incidence of familial breast cancer (p less than 0.05) and advanced patient age in the range between 71 and 80 years (p less than 0.005). Axillary lymph node metastases are significantly associated with collateral foci of in situ cancer (p less than 0.025), but not with submacroscopic foci of infiltrating cancer and the general character of the mammary glandular parenchyma, tumor size or histologic type of the clinical neoplasm. The critical question is whether multicentricity makes a difference clinically and especially to women who do not have their entire breast removed. Radical mastectomy results in a severe cosmetic and functional problem for patients. According to many authors, the goal of the treatment should be the removal of breast cancer by conservative surgical techniques (lumpectomy, subcutaneous mastectomy, quadrantectomy), using adjuvant radiotherapy and/or chemotherapy. The use of radiotherapy as primary treatment of early breast cancer has been also suggested. There is disagreement about surgical management of breast cancer. In fact, some investigators emphasize that the natural biologic history of multicentric cancers has not been documented by any adequate follow-up series in women who do not have their entire breast removed. Thus far, no difference has been seen in disease-free or overall survival between groups of patients with early breast cancer treated by an alternative therapeutic procedure and patients treated by radical mastectomy. However, Veronesi et al. (1981) refer to 4 second primary tumors of the ipsilateral breast in the 352 cases of small cancers treated by quadrantectomy, axillary dissection, and adjuvant radiotherapy. Moreover, Hellman et al. (1980), using radiation therapy without mastectomy for the primary treatment of 176 patients with early breast cancer, found 1 case of new cancer in a separate quadrant. Further evaluation is necessary to establish the long-term results of the alternative treatments of breast cancer and for the understanding of the clinical significance of microscopic multifocal tumor in the mammary gland.

Adult↗
PubMedDate not supplied

[Cerebral and spinal cord glioma in the same individual multiple or multicentric?].

The problem of multiple primary gliomas is discussed starting from a personal report concerning with a case of coexisting cerebral and intramedullary gliomas. Pathological examination allows the Authors to differentiate the cerebral from the medullary tumor by means of the principles of the new WHO classification of brain tumors. In this way it is possible to support the hypothesis of multicentricity. In diagnosing multiple or multifocal tumors the clinical criteria are preferred to the pathological observations. It is felt that in this way a more correct diagnostic and therapeutic approach to the multicentric tumors may yield good results. The theoretical basis for multicentric growth conclude the work.

Brain Neoplasms↗
PubMed1982

[2 cases of multicentric glioma].

We reported two cases of multicentric glioma. The first case was 60-year-old female. In CT scan findings, separate mass lesions were observed in the right parieto-occipital area, left parietal lobe and left thalamic region. The second case was 53-year-old male. In CT scan findings, separate mass lesions were observed in the right fronto-parieto-temporal area and left frontal lobe. These two cases were considered to be metastatic brain tumor and radiation therapy and chemoimmunotherapy were performed. But in the postmortem examinations, both cases were evident to be not metastatic brain tumor but glioblastoma multiforme. And tumor cells were not found in commissural or other nerve pathways and cerebrospinal fluid system histologically. So our cases were considered as multicentric glioma. The pathogenesis of multicentric glioma are not understood till now. Therefore, it is interesting that the different histological findings were observed in the each tumor lesion of the first case.

Brain Neoplasms↗
PubMed1995

[Multicentricity and concomitant tumors in renal cell carcinoma: analysis by serial section of resected kidneys].

Nephron-sparing surgery was initially limited to the patients with localized renal cancer (RCC) present bilaterally or in a solitary kidney. Recently there is controversy in the indication for partial nephrectomy or enucleation to incidentally defined small RCC with normal opposite kidney. We examined the incidence of multicentricity in 43 kidneys removed for RCC with a diameter of less than 80 mm. The mean diameter of the predominant tumors was 45 mm (range 12 to 80 mm). The kidneys were serially sectioned at 5 mm intervals. Three of 43 kidneys (7%) had multiple RCC. The size of the concomitant tumors ranged from 2 to 15 mm. The multicentricity had no relation to pathological grade, stage, vascular invasion or infiltration pattern. In addition, the other 4 kidneys had 2 adenomas, 1 angiomyolipoma and 1 fibroma. Therefore we observed a 16% incidence of small renal nodules and a 7% multicentricity of RCC in the nephrectomized kidneys with normal opposite kidney.

Adenoma↗
PubMed1993

Presentation of multicentric Castleman's disease with sicca syndrome, cardiomyopathy, palmar and plantar rash.

Multicentric Castleman's disease (MCD), or multicentric angiofollicular lymph node hyperplasia, is an uncommon lymphoproliferative disorder which typically present with constitutional symptoms, multicentric lymphadenopathy, hepatosplenomegaly, effusions, and ascites. We describe a patient with several novel manifestations of MCD: sicca syndrome, lacrimal and salivary gland enlargement, cardiomyopathy, and palmar and plantar rash. Treatment of MCD with chlorambucil and prednisone was effective in the short term followup of this patient. MCD merits consideration in patients with lymphadenopathy and multisystem disease, including sicca syndrome, heart failure or rash.

Adult↗
PubMed1993

Multicentric gliomas: report of 2 cases.

Two cases of multicentric gliomas with long survival are reported. One patient underwent multiple surgical procedures while another had two separate surgical procedures at the same time. Presence of calcification of CT scan in one case raised suspicion for a preoperative diagnosis of oligodendroglioma. Lack of direct continuity or subarachnoid enhancement on CT scan and low histological grade of the tumours suggested their primary multicentric origin. The incidence of multicentric gliomas in our experience is 0.4% amongst 500 glial tumours over a period of eight years.

Adult↗
PubMed1993

Cytologic analysis of bronchoalveolar lavage fluid from 47 dogs with multicentric malignant lymphoma.

Bronchoalveolar lavage (BAL) was performed in 47 dogs with multicentric malignant lymphoma (ML). Cytologic results were evaluated, and ability to detect pulmonary involvement with ML, using BAL, was compared with ability to detect pulmonary involvement, using thoracic radiography and tracheal wash. Lung lobes were considered to be involved with ML on the basis of BAL fluid findings if morphologically abnormal lymphocytes were present in the fluid. Total nucleated cell count, relative lymphocyte count, and absolute lymphocyte count were greater (P < 0.001) in BAL fluid from dogs with multicentric ML than in BAL fluid from histologically normal dogs. Pulmonary involvement with ML was detected by BAL fluid cytologic examination in 89 of 135 lung lobes lavaged (66%). Lung lobes involved with ML were from 31 of the 47 dogs with multicentric ML (66%). Radiographic abnormalities supportive of pulmonary parenchymal involvement with ML were detected in 16 of the 47 dogs (34%). Of these 16 dogs, 15 (94%) had pulmonary involvement with ML on the basis of BAL fluid cytologic findings. Tracheal wash fluid contained abnormal lymphocytes in 4 of 41 dogs (10%). In all 4 dogs, BAL fluid also contained abnormal lymphocytes. Cytologic evaluation of BAL fluid was more sensitive in detecting pulmonary involvement with ML, compared with radiographic evaluation of the lungs or tracheal wash.

Animals↗
PubMed1996

Multicentric primary adenocarcinomas of the midgut: the first case report.

Multicentric adenocarcinomas of the midgut have not been described; even multiple adenocarcinomas limited to the small intestine are extremely uncommon, with only 14 cases reported in the literature. We report a case of multicentric synchronous involvement of the entire midgut with adenocarcinoma in a 52-yr-old Polish woman who had more than 30 lesions extending from duodenum to mid-transverse colon. There was no family history of cancer. Preoperative evaluation and intraoperative exploration were negative for primary malignancy of the lungs, breasts, ovaries, pancreas, and other parts of the gastrointestinal tract. Results of histopathological examination, immunohistochemical staining, and ras mutational analysis of the lesions uniformly support the diagnosis of multicentric poorly differentiated adenocarcinoma. The cause for this unusual presentation is unknown, although sporadic genetic alteration(s) of oncogene(s) might have been the precipitating event.

Adenocarcinoma↗
PubMed1997

[A case of multicentric intraosseous well differentiated osteosarcoma originating in the rib].

We have experienced a rare case of multicentric intraosseous well differentiated osteosarcoma originating in the left 7th and 9th rib. A 35-year-old man was admitted to our hospital with slowly growing mass of the left chest wall. From radiographic appearance the mass was suspected multicentric tumor of bone originating from the left 7th and 9th rib, and from needle biopsy the mass was suspected giant cell tumor of bone. Tumors were completely resected en bloc, and chest wall defect was covered with Marlex mesh. Pathological diagnosis was multicentric intraosseous well differentiated osteosarcoma originating in the left 7th and 9th rib. At 8 months after operation, the patient is doing well and there is no evidence of recurrence and lung metastasis.

Adult↗
PubMed1998

Hepatic resection for bilobar multicentric hepatocellular carcinoma: is it justified?

BACKGROUND: Hepatic resection for multiple hepatocellular carcinomas (HCCs) involving both lobes of the liver is rarely recommended because of high operative risks and low radicality. Thus the justification of hepatic resection for bilobar multicentric HCC remains undefined. METHODS: Two hundred eleven patients with HCC, who underwent curative hepatic resection, were studied retrospectively. The patients were divided into two groups. Group A consisted of 39 patients with bilobar (both sides of Cantlie's line) multicentric HCCs. Group B consisted of 172 patients with HCC with solitary or unilobar lesions. The backgrounds and resectional results of patients in groups A and B were compared. RESULTS: Patients in group A usually required multiple separate liver resections and a longer operative time. However, the operative blood loss, amount of blood transfused, and operative morbidity and mortality rates were not significantly different. Patients in group A showed higher incidences of associated satellite nodules, microscopic vascular invasion, and a lack of capsules. The 6-year disease-free and actuarial survival rates of patients in groups A and B were 30.5% and 41.8% (p = 0.17) and 42.9% and 51.4% (p = 0.12), respectively. For patients in group A the presence of satellite nodules in any resected tumor was the only independent unfavorable feature that influenced the actuarial survival rate after multivariate analysis. CONCLUSIONS: Liver resection is justified for bilobar multicentric HCCs in selected patients, if the tumors can be totally resected. Postoperative adjuvant therapies should be considered when satellite nodules are present in any resected tumor.

Adult↗