Multiple primary tumors in a 72-year-old woman.
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Biomedical subjects
Publications and source records attributed to B Sundar.
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Thirty-three patients with advanced prostate cancer were prospectively randomized to receive either Bacillus Calmette-Guerin (BCG) adjuvant immunotherapy plus conventional therapy or conventional therapy alone. Conventional therapy consisted of estrogens or observation. There was a statistically significantly (p less than 0.05) longer survival in the 16 BCG-treated patients (42 weeks) than in the 17 control patients (29 weeks).
The effects of stage and therapy of prostate cancer on the immune response were evaluated in 193 patients with an histologic diagnosis of prostatic malignancy. There was little or no effect, as measured by these generally non-specific tests, on the immune response. The host-tumor immune interaction is difficult to evaluate in prostate cancer. The complexities of measuring prostate tumor immunity are discussed and the literature is reviewed.
Nine patients underwent urinary tract refunctionalization after prior supravesical diversion. Emphasis is placed on careful preoperative evaluation of these patients, including studies of renal and bladder function. In 8 patients continuity could be restored without interposition of bowel segment, while in the ninth case, this was necessary because of short ureteral lengths bilaterally. This was the only technical failure in this series requiring restoration of the diverted state. There was a dramatic improvement noted in the quality of life and mental status in the 8 patients in whom the procedure was successful.
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The diagnostic value of the CEA test was evaluated in 2,029 blood and urine samples from 308 patients with urologic cancer, 13 with nonurologic cancer, 20 urologic patients with nonmalignant disease, and in 30 controls. The blood CEA test was positive in 50% of the patients with active urologic cancer and in 35% of those with inactive cancer. The urine CEA test was elevated only in patients with active bladder cancer, but most of these had concurrently infected urines. At the present time, the CEA test does not reflect the accuracy necessary for an acceptable diagnostic test for the detection of urologic cancer.
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Five cases of congenital H-type tracheo-oesophageal fistula are presented. The clinical features common to all were choking and coughing precipitated by feeds, recurrent chest infections, and episodes of abdominal distension. The usefulness of repeated oesophagograms in diagnosing the condition is emphasized. Operation in all cases was by the cervical approach. The single postoperative death was related to pre-existent severe chest infection, and no postoperative complications were encountered in the other patients.
We describe a technique for making computed tomography (CT) angiographic studies more practical and workable. True CT angiography can be performed with arterial contrast injection combined with helical CT technique. Detailed angiographic images can be obtained; reconstructed images are aided by the helical technique, and other special studies can also be performed.