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Biomedical subjects

B C Ghosh

Publications and source records attributed to B C Ghosh.

At least 19 recordsLinked to original sources
PubMed1992

Prognostic implications of evaluation for lymph node involvement by T-cell antigen receptor gene rearrangement in mycosis fungoides.

We investigated the correlation between the detection of clonal rearrangement of the T-cell antigen receptor gene (TCRR) in lymph node tissue with histopathologic lymph node classification in 33 patients with mycosis fungoides with and without the Sezary Syndrome. We analyzed DNA extracted from lymph nodes that were histologically uninvolved (LN1-2), dermatopathic nodes with clusters of atypical cells (LN3), and nodes effaced with lymphoma (LN4) and found TCRR in none of five LN1-2 nodes, 8 of 17 LN3 nodes, and 10 of 11 LN4 nodes. Further, the detection of TCRR correlated with presence of palpable adenopathy (P2 less than .0001) and was associated with a worse survival (P2 = .0024). Within the subgroup of patients with LN3 nodes, there was a trend (P2 = .14) toward inferior survival if nodes were involved by TCRR, irrespective of extent of skin disease. We conclude that detection of TCRR in nodes from mycosis fungoides patients is an objective and reliable means of assessing tumor infiltration of lymph node and is associated with an inferior survival.

Blotting, Southern↗
PubMed1992

Late relapse and mortality in stage I large bowel cancer.

The outcome was determined for patients with Stage I cancers of the large bowel (colon, rectum, and anus) who were treated from 1982-1989. In 119 consecutive patients, the 5-year survival was approximately 70% (72% by the absolute direct method; 67% by the actuarial life table method). Although the overall 5-year survival was similar to numerous other published reports, it was disturbing to observe that 41% of the living patients had relapsed. Furthermore, although 88/119 (67%) were alive at last report, 2-7 years after treatment, only 23 (19%) were believed to be free of cancer. We conclude that follow-up for more than 5 years and the assessment of disease-free survival are required to evaluate the outcome from Stage I large bowel cancer.

Actuarial Analysis↗
PubMed1992

Effects of a single oral dose of desipramine on postoperative morphine analgesia.

Drugs that block norepinephrine reuptake offer promise as opioid potentiators, because norepinephrine mediates opioid analgesia but not side effects such as sedation or nausea. In a two-by-two factorial design, we randomized 62 inpatients with pain following major surgery to receive either desipramine, 50 mg by mouth, or placebo at 6 a.m. on the first day after surgery. At their first request of pain medication after 8 a.m., they were given intravenous morphine, either 0.033 mg/kg or 0.10 mg/kg. Pain relief and side effects were assessed for 4 hr; peak relief on the visual analog scale (VAS) was the primary outcome variable. Pain relief, side effect scores, and time to remedication were significantly greater with the higher dose than with the lower dose of morphine, verifying assay sensitivity, but desipramine pretreatment did not significantly enhance morphine analgesia. The mean increase in peak VAS relief score after desipramine pretreatment, relative to placebo, was 6%; the 95% confidence interval for this estimate ranged from a 21% reduction to a 34% increase in pain relief. These results differ from a previous report that 1 week of pretreatment with desipramine, 75 mg per day, potentiated postoperative morphine analgesia. We conclude that if desipramine potentiation of opioid analgesia occurs in humans, its demonstration may require higher doses or chronic treatment.

Administration, Oral↗
PubMed1992

Phase II study of pentostatin and intermittent high-dose recombinant interferon alfa-2a in advanced mycosis fungoides/Sézary syndrome.

PURPOSE: This phase II study was undertaken to assess the efficacy and toxicity of alternating administration of pentostatin (deoxycoformycin [DCF]) and interferon alfa-2a (IFN) in patients with advanced or refractory mycosis fungoides (MF) or the Sézary syndrome (SS). PATIENTS AND METHODS: Forty-one patients underwent therapy with alternating cycles of DCF 4 mg/m2 intravenously (IV) days 1 through 3 and IFN 10 million U/m2 intramuscularly (IM) day 22, and 50 million U/m2 intramuscularly (IM) days 23 through 26. Twenty-nine patients had not responded to prior chemotherapy or total-skin electron-beam irradiation (TSEB), six had not responded to topical therapies, and six had no previous treatment. RESULTS: Two patients achieved a complete response (CR) and 15 achieved a partial response (PR), for an overall response rate of 41% (95% confidence interval, 26% to 58%). No responses were observed in the seven patients with visceral involvement. The median progression-free survival of patients who responded was 13.1 months. IFN-related constitutional symptoms were reported in 39% of patients; severe toxicities included cardiomyopathy in one patient, acute and chronic pulmonary dysfunction in four, and reversible mental status changes in two. Seven patients developed herpes zoster during therapy and six had staphylococcal bacteremia. CONCLUSION: These results suggest that the combination of DCF and IFN is an active regimen in MF patients without visceral involvement.

Adult↗
PubMed1992

Kaposi's sarcoma of the gallbladder.

A 30-year-old man with symptomatic acquired immunodeficiency syndrome presented with abdominal pain and disseminated intravascular coagulation. Radiographic studies revealed thickening of the gallbladder wall. Following stabilization of the coagulation disorder, the patient underwent a cholecystectomy, and the gallbladder was found to contain Kaposi's sarcoma (KS). There have been no previously published reports of KS found in the gallbladder of a living patient in the absence of cutaneous manifestations of KS. The current case illustrates that KS is a multi-focal systemic disease which may have extracutaneous primary manifestations.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Correlation of in vitro drug-sensitivity testing results with response to chemotherapy and survival in extensive-stage small cell lung cancer: a prospective clinical trial.

We devised a novel clinical protocol for extensive-stage small cell lung cancer (SCLC), selecting chemotherapy whenever possible on the basis of in vitro drug-sensitivity testing (DST) of individual patients' tumor specimens. Most of the specimens were obtained from metastatic sites during routine staging procedures. Increase of tumor cell number by culture in selective media usually was required before DST could be performed. We used the Weisenthal dye exclusion assay to place the seven drugs in rank order and to select the in vitro best regimen (IVBR), a three-drug combination of proved efficacy in SCLC. After initial staging and specimen acquisition, patients received etoposide and cisplatin (primary therapy) and were restaged after 12 weeks. Patients with partial or no responses and those relapsing after a complete response to primary therapy were switched to the IVBR if DST data were available. If DST data were unavailable, an empiric combination, vincristine-doxorubicin-cyclophosphamide, was administered as secondary therapy. Tumor-containing specimens were collected from 60 of the 80 patients (75%). One or more cell lines were established from 28 patients, and DST data were available from 26 patients (33% of total). Several parameters of in vitro drug sensitivity were significantly associated [two-sided P (P2) less than .05] with clinical response to primary therapy and also with response to the IVBR and were marginally associated with length of survival (.07 less than or equal to P2 less than or equal to .08). Sixteen patients (23%) received their IVBR as secondary therapy, and four of these (25%) attained a complete response, compared with three of 43 (7%) who received an empiric regimen (P2 = .16). We concluded that (a) selection of individualized chemotherapy is labor intensive but feasible in extensive-stage SCLC; (b) DST data are associated with clinical response to primary therapy and to secondary therapy with an IVBR; and (c) further observations will be required if we are to determine whether there is a modest therapeutic benefit to administering the IVBR as a secondary therapy.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1990

Long-term epidural pain relief using a totally implantable access system.

The majority of cancer patients at the terminal stage experience pain as a major symptom, and less than 60% of patients receive adequate pain relief. To relieve this symptom we have placed epidural catheters and attached them to an implantable access system. On this method the patients required 0.4-3.5 mg of morphine per hour with occasional boluses. Catheter life span ranged from 15 to 157 days with an average of 57 days.

Analgesia, Epidural↗
PubMed1990

Perineal leiomyosarcoma.

Perineal leiomyosarcomas are rare aggressive tumors for which the therapy remains to be defined. These tumors may be extensively infiltrating and therapy may require radical surgery. The problems encountered in treating these tumors are similar to those for retroperitoneal sarcomas. Namely, delay in diagnosis, lack of distinct anatomic boundaries, and close proximity to and encroachment on multiple organs prevents resection with adequate surgical margins. We discuss the current literature and present our management of perineal leiomyosarcomas.

Combined Modality Therapy↗
PubMed1990

Kaposi's sarcoma with emphasis on gastrointestinal manifestations.

Kaposi's Sarcoma is a rare disease. Gastrointestinal involvement of Kaposi's is very unusual. With the increasing incidences of Acquired Immune Deficiency Syndrome (AIDS) it has become more common in both civilian and military practice. The practicing physician should be aware of gastrointestinal symptoms of Kaposi's Sarcoma and their treatment.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Glucagonoma presenting as morbid obesity.

A case is described that represents the only reported patient with glucagonoma syndrome and morbid obesity. The diagnosis of glucagonoma should be considered in any patient with the classic criteria despite weight gain. The criteria for diagnosis of glucagonoma are 1) the presence of a glucagon-secreting tumor, 2) hyperglucagonemia, and 3) the clinical manifestations of either necrolytic migratory erythema, glucose intolerance, or hypoaminoacidemia.

Adenoma, Islet Cell↗
PubMed1988

Late recurrence of malignant melanoma.

A patient presented with metastatic disease nearly 12 years after initial excision of a "benign" nevus. Review of the original slides confirmed malignant melanoma. Another patient was found to have a metastatic deposit of melanoma in the breast 23 years after an apparently adequate excision of a melanoma on the back. The natural history of this tumor shows its unpredictable nature. A thorough history and lifelong follow-up are essential in patients with malignant melanoma.

Breast Neoplasms↗
PubMed1985

Adjuvant treatment of colorectal cancer. Current status and concepts.

Colorectal cancer is the second leading cause of cancer mortality in the United States, causing approximately 50,000 deaths per year. The overall prognosis and results of treatment have not changed impressively over the last three decades. Half of all the patients who undergo curative surgery finally succumb to locoregional or metastatic recurrence of their disease. Recent clinical research has been aimed at adjuvant therapeutic measures to improve survival after curative surgical resection. For rectal cancer, combined postoperative chemotherapy and radiation therapy have been shown to reduce the overall relapse rate and improve disease-free survival. Further studies of adjuvant treatment for rectal cancer are needed to evaluate the optimal radiation schedule and limit the side-effects of the treatment. Adjuvant treatment of colon cancer must still be regarded as unsettled. Since liver metastases are the most common unfavorable outcome of colon cancer, ongoing trials using liver-directed treatment (perfusion, irradiation) should be followed with interest. The lack of proven efficacy and the side-effects of these treatments strongly favor the inclusion of an observation-only control group in trials for adjuvant treatment of colon cancer. Unfortunately, there is as yet no proven significant benefit from immunotherapy as an adjuvant therapy for colorectal cancer, but further basic and clinical studies will be of great interest in this field.

Anticoagulants↗
PubMed1979

Ultrastructural localization of lactic dehydrogenase in mouse mammary carcinoma cells.

Electron microscopic study of lactic dehydrogenase (LDH) was carried out in C3H mouse mammary carcinoma cells. Scattered cytoplasmic LDH granules were noted as well as around mitochondria and nuclear membrane. Control studies with normal breast tissues failed to show any activity. This observation suggests that LDH plays an important role in C3H mammary carcinoma and may be of use as an additional marker.

Animals↗
PubMed1979

Role of angiography in the diagnosis of pancreatic neoplasms.

The vascular architecture of the pancreas has been described, but few reports indicate preoperative accuracy. During the last 3 years, selective superior mesenteric and celiac angiography was performed in 471 patients. In 35 of these patients, additional selective angiography of the superior pancreaticoduodenal and inferior pancreaticoduodenal arteries was performed to reveal the detailed vascular pattern of the pancreas and its surrounding structures. Exploratory surgery was performed in all patients except the four control subjects. The angiographic findings reflected a poorly vascularized infiltrating lesion with invasion of the blood vessels and serpiginous encasements. Peripancreatic extension of the tumor indicated nonresectability. In early pancreatitis, the pancreas showed increased vascularity and occasional stretched vessels. In more advanced pancreatitis, the arteries were prominent and irregular with increased parenchymal accumulation of contrast medium in the capillary phase. In pseudocysts of the pancreas, the only finding was stretching of the vessels around the lesion. A well circumscribed lesion with increased contrast medium in the capillary and venous phases diagnostic of pancreatic adenoma. Pancreatic angiography is an important diagnostic tool in evaluating and staging pancreatic neoplasms.

Acute Disease↗
PubMed1979

Plasmacytoma of the stomach.

A case of gastric plasmacytoma is presented. A detailed study including a selective angiogram described this unusual gastric neoplasm. Pathological examination by both light and electron microscopy confirmed the diagnosis of primary gastric plasmacytoma. The diagnosis and treatment of primary gastric plasmacytoma is discussed and pertinent literature is reviewed.

Aged↗