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Biomedical subjects

B Fisher

Publications and source records attributed to B Fisher.

At least 19 recordsLinked to original sources
PubMed1979

Further observations on the inhibition of tumor growth by C. parvum with cyclophosphamide. VII. Effect of treatment prior to primary tumor removal on the growth of distant tumor.

The present investigations were directed toward determining whether primary tumor manipulation prior to its removal is advantageous for the control of metastases and survival. Studies were carried out to ascertain whether 1) there is justification for delaying surgical removal of a primary tumor to permit preoperative administration of cyclophosphamide (CY) and/or C. parvum (CP) and 2) there is an advantage to administering the immunotherapy directly into a primary tumor. After operation, in all investigations, systemic CP and CY was used. Despite the putative similarity of animals, tumors and treatment regimens there was marked variation in response of tumors to therapy. No benefit was derived from administering preoperative immunotherapy alone. When operation was delayed to employ systemic immuno-chemotherapy, a slight improvement in the control of distant tumor was noted. The employment of preoperative intratumor immunotherapy led to a greater prolongation of survival and more inhibition of distant tumor growth than did immediate primary tumor removal or the use of preoperative systemic immunotherapy. The results suggest that there may be an advantage to delaying removal of a primary tumor so that it may be employed in therapeutic strategies directed toward control of metastatic disease.

Animals↗
PubMed1979

1-phenylalanine mustard (L-PAM) in the management of premenopausal patients with primary breast cancer: lack of association of disease-free survival with depression of ovarian function. National Surgical Adjuvant Project for Breast and Bowel Cancers.

Breast cancer patients participating in a prospective randomized clinical trial who were less than or equal to 49 years of age, had positive axillary nodes, and who received prolonged 1-phenylalanine mustard (L-PAM) as an adjuvant to mastectomy continue (after 4 years) to demonstrate a significantly greater disease-free survival (p = .007) than do patients who received placebo. Benefit was achieved in patients who were less than or equal to 39 years as well as those who were 40-49 years of age. Those in the younger age group showed a greater improvement in disease-free survival at 4 years relative to their controls (32% vs. 69%; p = .01) than did those in the older age group (48% vs. 61%; p = .09). When patients were examined relative to their nodal status, a highly favorable effect was found to have been achieved with L-PAM in those with 1-3 positive nodes (54% vs. 86%; p = .006). Results indicate that both age groups were benefited. When considered over time, they demonstrate that a relatively greater effect was achieved in the younger women. While L-PAM failed to significantly alter the disease-free survival of those with greater than or equal to 4 positive nodes a slightly better effect was achieved in the group less than or equal to 39 years. Since adjuvant chemotherapy has been found to be more effective in premenopausal than postmenopausal women, it has been presumed that decreased ovarian function, as a result of the chemotherapy, is responsible for the findings. To support or repudiate that concept, information regarding serum levels of follicle stimulating hormone (FSH), luteinizing hormone (LH) and estradiol (E2), as well as menstrual function, has been obtained from women receiving L-PAM or L-PAM plus 5-FU therapy. In contrast to findings relative to disease-free survival, ovarian function and menses were most affected in patients 40-49 years of age. Amenorrhea occurred in 73% of patients in that age group and in only 22% of those less than or equal to 39 years (p less than .001). Similarly, a significant increase in LH and FSH and a decrease in E2, all indicative of ovarian suppression, was observed only in the older group of patients. Thus, it is concluded that while ovarian suppression may account for some of the adjuvant chemotherapeutic effect in premenopausal women, the dichotomy of findings in younger and older premenopausal women relative to therapeutic response and ovarian function indicates that other factors could be responsible.

Adult↗
PubMed1979

The significance of concordance in mammographic interpretations.

Twenty-eight women participating in a screening program had a breast cancer diagnosed subsequent to the report of a negative mammogram which was read by only one of a group of radiologists. Fourteen occurred prior to a scheduled routine screening visit (interval cancers) and 14 were detected during such an examination. The negative mammograms from the 28 cancer patients, together with those from 120 women without cancer (controls) were independently reviewed by each member of a panel of three radiologists. Forty-six percent of the cancer cases and 5.8% of the controls were interpreted as positive by two or more of the radiologists. These findings suggest that agreement among several independent reviewers enchances the value and accuracy of mamography by reducing the number of false negative interpretations.

Breast Neoplasms↗
PubMed1979

Benign prostatic hyperplasia in an XX man.

A sixty-nine-year-old white phenotypic male who was being investigated for a myeloproliferative disorder, was found to have an XX karyotype in all cells examined in bone marrow, lymphocytes, and skin fibroblast cultures. Despite essentially no testosterone in the plasma, he also suffered from severe prostatic hyperplasia, a finding not reported previously in patients with this genotype. While endocrine studies showed normal follicle-stimulating hormone, the luteinizing hormone level was twice the upper limit of normal and estrogens were in the normal female range. Except for complete absence of Leydig cells, testicular histology resembled that usually found in Klinefelter syndrome. The patient died of the combined effects of the myeloproliferative disease and urinary tract obstruction. The mechanism of occurrence of the sex chromosome anomaly as well as the cause and implication of the unusual finding of prostatic hyperplasia are discussed.

Aged↗
PubMed1979

Effect of Corynebacterium parvum in prevention and reversal of atrophy of the liver following portacaval shunt.

Since it has been demonstrated that the administration of Corynebacterium parvum is associated with increased hepatocyte proliferation in both normal and regenerating livers, it seemed appropriate to determine whether the use of this agent would affect the hepatic atrophy which occurs following end-to-side portacaval shunts. When administered at shunting, liver weight and liver deoxyribonucleic acid failed to decrease to the same extent as that occurring in untreated, shunted rats. An increase in liver deoxyribonucleic acid synthesis was observed following portacaval shunt only in treated rats. Corynebacterium parvum administration to portacaval shunt rats with livers demonstrating marked atrophy 15 to 18 days following shunting resulted in the reversal of such atrophy. There was an increase in liver weight and deoxyribonuclei acid to the extent that those values were equal to, or greater than, those of livers from nonshunted rats. By increasing the number of cells within liver, Corynebacterium parvum administration prevents or reverses the decrease in liver size, that is, atrophy, which occurs after portacaval shunts were performed.

Animals↗
PubMed1979

Effect of surgical removal on the growth and kinetics of residual tumor.

Findings from this study using a transplantable C3H mammary tumor failed to indicate interaction relative to growth parameters between two foci present in the same host. Whether they were growing alone or in the presence of a second focus, tumor growth rates were similar until the combined mass of multiple tumors approached that which was incompatible with survival. Only then was a difference in growth observed. Cytokinetic parameters, i.e., labeling index, primer-dependent DNA polymerase index or growth fraction, DNA synthesis time, tumor doubling time, and cell cycle time, were also similar whether tumors grew alone or in the presence of a second focus. Following removal of a tumor, changes were observed within 24 hr in the kinetics of the residual focus. There was an increase in labeling index (duration approximately equal to 10 days) and primer-dependent DNA polymerase index with a decrease in the tumor doubling time. Minimal change was noted in DNA synthesis time and cell cycle time. The kinetic changes observed were reflected in a measureable increase in tumor size approximately equal to a week following tumor removal. Absence of an alteration in DNA synthesis time and cell cycle time indicates that the increase in tumor growth was probably due to a conversion of noncycling cells in G0 phase into proliferation. Relationship of the findings to the use of adjuvant chemotherapy is considered.

Animals↗
PubMed1978

Detection and significance of occult axillary node metastases in patients with invasive breast cancer.

Blocks of axillary lymph nodes from 78 patients with invasive breast cancer, which after "routine" pathological examination were regarded as negative for metastases, were step-sectioned at 20 u intervals. Occult metastases were detected in 24% of the cases. A significant association between such metastases and a lack of or slight degree of an intraductal carcinomatous component of the dominant cancer was noted. There was no relationship between occult metastases and 15 other histopathological and 3 clinical features investigated, including an average 5 year survival rate. Similarly there was no correlation between any of the possible discriminants investigated in the 24% of patients who have died of their diseases or are living with recurrence regardless of the presence of occult metastases. Factors accounting for the lack of universal survival in patients with Stage I (and those with occult metastases that might be designated as stage 11/2) remain enigmatic. It is concluded that attempts to detect occult metastases by extending histopathological methods may be more academic than practical or therapeutically significant.

Axilla↗
PubMed1978

Variation of macrophage migration by a factor from regional lymph node cells of breast cancer patients.

Using a standard heterologous assay in which lymphokines alter guinea pig peritoneal macrophage migration, it was found that regional lymph node cells (RLNCs) from patients with primary breast cancer elaborate soluble factors which variably affect such migration. Variation of migration resulted when soluble factors employed were obtained from different nodes in the same patient as well as from nodes from different patients. Some nodes from a patient elaborated migration inhibition factors (MIF) and other migration enhancing factors (MEF). The findings are in keeping with others obtained by us relative to the variation in lymphocyte transformation and thymidine uptake by RLNCs and further emphasize that all RLNs in patients with breast cancer are not biologically similar. They lend support to our previous hypothesis that the reason why some RLNs contain metastases and others do not is more likely due to biological differences than because of anatomical happenstance, i.e., transport of tumor cells to some nodes and not to others.

Adenocarcinoma↗
PubMed1978

Preliminary observations on the use of Corynebacterium parvum in patients with primary intracranial tumors: effect on intracranial pressure.

It has been observed that patients with metastatic brain lesions developed neurologic symptoms when given Corynebacterium parvum. To obtain more information in patients with intracranial mass lesions, intracranial pressures (ICP) were measured or observed in six patients undergoing C. parvum therapy. All patients except two (one previously shunted, one recently operated) demonstrated a profound increase in ICP. It is presumed that either edema is formed within brain and tumor tissue (inasmuch as neurologic deterioration has not been observed in patients without an intracranial lesion) or transient increases in cerebral blood flow adversely alter an already compromised intracranial volume. Surgical decompression of tumor volume or use of Lasix may abort this response to C. parvum infusion.

Adolescent↗