Biomedical subjects

A Kunschner

Publications and source records attributed to A Kunschner.

6 recordsLinked to original sources

PubMed2003

Concurrent sequencing of full-dose CMF chemotherapy and radiation therapy in early breast cancer has no effect on treatment delivery.

With the increasing use of breast-conserving therapy plus systemic chemotherapy for the treatment of early breast cancer, the optimal sequencing of radiation therapy and chemotherapy remains controversial. Sequencing of therapy may influence not only treatment delivery, but control rates, complications and cosmesis. The aim of this study was to evaluate whether concurrent sequencing of standard doses of CMF (cyclophosphamide, methotrexate and 5-fluorouracil) and adjuvant radiation therapy for early breast cancer impacted on optimum treatment delivery. As both an intravenous (i.v.) 3-week regimen and classic (standard) CMF were utilised in this study, both types of CMF were compared. The effect of sequencing on complications and treatment delays were also assessed. 116 patients treated with CMF chemotherapy and adjuvant tangent breast radiation were studied. 73 patients were treated prospectively with concurrent therapy and were retrospectively compared with a matched group of 40 patients treated with sequential or sandwich therapy. All patients had stage 1 or 2 cancers. There were no planned dose reductions introduced for either treatment modality. Concurrent sequencing had no impact on the ability to deliver optimum radiation or chemotherapy doses. There was no significant difference in acute Radiation Therapy Oncology Group (RTOG) skin reactions or complications between the two groups. Although small, there was a significant delay (1.32 days (0-15 versus 0.36 (0-7)) in the concurrent group (P=0.03) in the delivery of radiation therapy. Sequencing had no significant effect on haematological parameters. 'Standard' CMF had a more profound effect on treatment delivery than i.v. CMF (Radiation delay 2.2 days versus 0.26, P=0.002, % chemotherapy delivered 93% versus 99% P=0.000004). At a mean follow-up of 2.6 years, there was no difference in the cosmetic scores between the two groups. Both local and distant control rates were excellent. This study has shown that standard radiation therapy can be delivered safely concurrently with CMF chemotherapy. Whether this approach may lead to better control rates in the future needs further study.

Adult↗

PubMed1993

Primitive neuroectodermal tumor arising in an ovarian mature cystic teratoma: immunohistochemical and electron microscopic studies.

The occurrence of a malignant neuroectodermal tumor in a mature cystic teratoma is extremely rare. Five cases of ovarian primitive neuroectodermal tumors (PNET) or neuroepitheliomas have been reported. In two, the tumor was adjacent to foci of a mature teratomatous element. We present the immunohistochemical profile and electron microscopic study of an ovarian mature cystic teratoma with PNET or malignant neuroepithelioma. The transition between the mature neural elements and the malignant PNET presents a model for monodermic neuroepithelial differentiation and explains the histogenesis of this unusual tumor.

Adult↗

PubMed1989

Differences between white and Chinese populations in human leukocyte antigen sharing and gestational trophoblastic tumors.

The prevalence of gestational trophoblastic tumors varies widely among different populations: it is lowest in whites (3 to 6/100,000) and highest in Chinese (68 to 202/100,000). This observation suggests that the origin of the disease is different in the two populations. To test this hypothesis, we examined couples in whom the woman developed a gestational trophoblastic tumor in a white population (Pittsburgh) and a Chinese population (Taiwan) for sharing of human leukocyte A, B, DR, and DQ antigens, which we consider markers for sharing of major histocompatibility complex-linked recessive genes affecting both embryogenesis and carcinogenesis. No human leukocyte antigen sharing occurred between partners in Pittsburgh, but there was significant human leukocyte antigen sharing in Taiwan. The latter couples shared human leukocyte antigen B (p less than 0.04) and human leukocyte antigen DQ (p less than 0.007) and shared three or more human leukocyte A, B, DR, and DQ antigens (p less than 0.02) significantly more frequently than did normal couples. However, there was no increased sharing of any specific human leukocyte antigen allele. These findings support the hypothesis that gestational trophoblastic tumors occur on a sporadic basis in whites and on a genetic basis in Chinese.

Asian People↗

PubMed1989

Mammographic localization and biopsy: the experience of a gynecologic oncology group.

From 1976 through 1986, two hundred eighty or 9% of all breast biopsies performed by a private gynecologic oncology group were for mammographically suspicious but occult breast lesions. Sixteen percent were found to be malignant. There has been improvement in mammographic techniques, and localization procedures have evolved to the current use of hooked-wire needles, which allow for the excision of smaller amounts of tissue and use of outpatient surgery facilities. Recently, the cancers encountered have been more often carcinoma in situ rather than invasive lesions. With the current increase in mammographic screening, there needs to be a continuing evolution in diagnostic modalities.

Adult↗

PubMed1981

Intramuscular angiomatosis of pelvic wall complicating pregnancy. Clinical, histological, and ultrastructural observations.

This is the first report of intramuscular angiomatosis involving the right bulbocavernous muscle in a pregnant woman, who underwent a cesarean section because of the risk of dystocia. The tumor was formed by well- and poorly differentiated vessels infiltrating the skeletal muscle fibers, which showed various degrees of degeneration. On electron microscopy, the neoplastic vessels were formed by large endothelial cells rich in organelles, limiting a luminal space and surrounded by a multilayered basal lamina. Pericytes were usually present around the endothelial layers. The neoplastic vascular structures seemed to grow by a process of gemmation. Our observations confirm the notion that this kind of benign neoplasm may pursue a rapidly growing course and presents a disturbing histological appearance which requires proper interpretation and precise diagnosis.

Adult↗

PubMed1978

Early vulvar carcinoma.

Fifty-eight cases of early vulvar neoplasia were reviewed from the Tumor Registry at Magee-Womens Hospital, between 1947 and 1976. Twenty-three cases were carcinoma in situ; 16 were microinvasive, and 19 were occult carcinoma. All of the cases were treated surgically. The modality of surgical treatment varied from local excision to radical vulvectomy with inguinal lymph node dissection. Regardless of the surgical therapy, none of the patients died of the vulvar malignancy. It is recommended, as part of routine gynecologic surveillance, that more critical attention be given to examination for early epithelial neoplastic lesions of the vulva. This can be accomplished by simple inspection and the use of special diagnostic aids. Biopsy specimens should be reviewed histologically for depth of invasion and the treatment individualized to the patient with considerations for conservatism, especially in younger women.

Adult↗