Biomedical subjects
A Routh
Publications and source records attributed to A Routh.
Survival of carcinoma of the prostate patients less than 55 years old compared to older patient groups.
Both incidence and death rate from cancer of prostate are rising. Prostate cancer is the most common malignancy in man and second most common cause of death in men. Lung cancer is the leading cause of death in men. Carcinoma of prostate is generally a disease of older men. Carcinoma of prostate can also occur in the middle-aged men. This study was performed to find whether the middle-aged men survived longer than older men when both groups of patients were compared according to equivalent stage of the disease. In this series, survival is slightly better in younger age groups when patients of all stages are pooled together. Due to small number of patients in younger age groups, survival difference cannot be calculated for each stage of the disease.
Brain metastases from unknown primary site.
We report our experience with 32 patients presenting with brain metastasis from unknown origin. This constitutes 11.5 percent of 276 consecutive patients with brain metastasis seen over a period of eight years at the University of Mississippi Medical Center. Patients with solitary resectable lesion underwent surgery followed by irradiation. All patients with multiple metastasis were treated with whole brain radiation and dexarnethasone. The mean survival was 31.50 weeks for patients with single lesion and 19.11 weeks for multiple lesions. The investigations and treatment management of brain metastasis from unknown primary site are discussed.
Cost containment detrimentally affects patient care.
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Syndrome of inappropriate ADH secretion and diplopia: oat cell (small cell) rectal carcinoma metastatic to the central nervous system.
Extrapulmonary small cell carcinoma is being increasingly recognized as a distinct clinical entity. We report a patient with small cell carcinoma of the rectum metastatic to the brain, presenting with diplopia and inappropriate antidiuretic hormone syndrome.
Management of brain metastases: past, present, and future.
Brain metastasis is an important cause of morbidity and mortality in cancer patients. Because most of these patients die of systemic disease, the primary therapeutic goal is to improve the quality of life. Conventional therapy for brain metastases is usually whole-brain irradiation. Chemotherapy often results in regression of brain metastases in chemosensitive tumors. We review our institutional experience in the treatment of brain metastasis with both radiation and chemotherapy. In the future, improvement in the management of brain metastases will depend on improved chemotherapy, radiosensitizers, and radiotherapy techniques such as stereotactic radiosurgery.
Bats in the surgery: a practitioner's guide.
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The long-term side effects of radiation therapy for benign brain tumors in adults.
Radiation therapy plays an integral part in managing intracranial tumors. While the risk:benefit ratio is considered acceptable for treating malignant tumors, risks of long-term complications of radiotherapy need thorough assessment in adults treated for benign tumors. Many previously reported delayed complications of radiotherapy can be attributed to inappropriate treatment or to the sensitivity of a developing child's brain to radiation. Medical records, radiological studies, autopsy findings, and follow-up information were reviewed for 58 adult patients (31 men and 27 women) treated between 1958 and 1987 with radiotherapy for benign intracranial tumors. Patient ages at the time of irradiation ranged from 21 to 87 years (mean 47.7 years). The pathology included 46 pituitary adenomas, five meningiomas, four glomus jugulare tumors, two pineal area tumors, and one craniopharyngioma. Average radiation dosage was 4984 cGy (range 3100 to 7012 cGy), given in an average of 27.2 fractions (range 15 to 45 fractions), over a period averaging 46.6 days. The follow-up period ranged from 3 to 31 years (mean 8.1 years). Findings related to tumor recurrence or surgery were excluded. Twenty-two patients had complications considered to be delayed side effects of radiotherapy. Two patients had visual deterioration developing 3 and 6 years after treatment; six had pituitary dysfunction; and 17 had varying degrees of parenchymal changes of the brain, occurring mostly in the temporal lobes and relating to the frequent presentation of pituitary tumors (two of these also had pituitary dysfunction). One clival tumor with the radiographic appearance of a meningioma, developed 30 years post-irradiation for acromegaly. This study unveils considerable delayed sequelae of radiotherapy in a series of adult patients receiving what is considered "safe" treatment for benign brain tumors.
Patients with localized pancreatic adenocarcinoma in central Mississippi: a retrospective analysis of survival.
Factors influencing the survival of central Mississippi patients with adenocarcinoma of the pancreas were analyzed by a retrospective analysis of the two largest tumor registries in the state. The authors report that this Mississippi data agree with very recent reports describing significant benefit from chemoradiotherapy in localized disease, and suggests a less fatalistic attitude of the medical community towards localized pancreatic carcinoma is appropriate.
Carcinoma of the endometrium in a teenager.
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Carcinoma of the piriform sinus.
Carcinoma of the piriform sinus is one of the most aggressive tumors of the head and neck region. Almost 80% to 90% of the patients will be first seen in the advanced stages. No method of treatment is satisfactory. We present results of various methods of treatment, of which the combination of surgery and radiotherapy may be the best.
Superior vena cava obstruction from Merkel cell carcinoma.
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Quality of life after loco-regional recurrence and in advanced breast cancer.
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Malignant fibrous histiocytoma arising from chronic ulcer.
A patient had malignant fibrous histiocytoma that developed in a chronic ulcer. Squamous cell carcinoma can develop on long-standing ulcers, but malignant fibrous histiocytoma developing in an ulcer is extremely rare.
Radiation sensitivity of 9L gliosarcoma cells at different oxygen pressures.
Monolayer cultures of 9L gliosarcoma cells received radiation doses of 0-1750 ret at oxygen pressures ranging from 50 to 545 mmHg. Growth inhibition, which could be demonstrated in all radiated cell cultures, was most pronounced in those receiving the highest dose of radiation. There was no relationship between the radiation sensitivity of the cells and the oxygen pressure of the fluid media of the cell cultures at the time radiation was administered. Cells subjected to the lowest oxygen tensions (50-52 mmHg) did not grow whether they had received radiation or not. The technical difficulty of removing oxygen from tissue culture media is described. Possible points of significance in the findings of this study are discussed with regard to previous observations on the radiosensitivity of the 9L tumor model, current concepts in radiobiology, and implications for future studies of human tumors in cell culture.