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B Tilley

Publications and source records attributed to B Tilley.

29 records · Page 2Linked to original sources

Regional lymph node and pulmonary metastases after local hyperthermia of melanomas in C57BL/6 mice.

The effects of local tumor hyperthermia on regional lymph node metastases are inconclusive. We studied the effects of hyperthermia on the incidence of popliteal, femoral, and abdominal lymph node metastases in C57BL/6 mice with primary B16 melanomas (F10 variant) growing subcutaneously in the left foot. Tumors were heated to 42.3, 43.5, and 44.2 degrees C for 90 minutes either 7 days after inoculation of 5 X 10(4) viable cells (microscopic tumor = mic) or when the tumors were approximately 3 mm in diameter (macroscopic tumor = mac). Femoral lymph node metastases occurred in 0/21 control animals and in 8/22 (36%), 11/19 (58%), and 11/17 (65%) animals whose primary tumors were heated to 42.3, 43.5, and 44.2 degrees C, respectively. For all three treatments, the increase in metastases as compared to controls was statistically significant (p less than 0.004, Fisher's exact test). The incidence of abdominal lymph node metastasis was slightly higher in the treated groups than controls. Twenty of 21 (95%) control mice developed popliteal lymph node metastases and hyperthermia-induced increases could not be demonstrated. Fifteen of 21 control mice killed 3 weeks after amputation of tumor-containing leg had pulmonary metastases with an average of 6 +/- 4 (standard deviation) lesions per affected mouse. Pulmonary metastases occurred in 22/22 (100%), 17/19 (89%), and 13/17 (76%) of mice whose tumors were heated to 42.3, 43.5, and 44.2 degrees C, respectively. The numbers of metastases for affected mice were significantly increased compared to controls for tumors heated to 43.5 and 44.2 degrees C (28 +/- 43, 43 +/- 52, 119 +/- 121, p greater than 0.02, p less than 0.006, p less than 0.002, for two sample T-test). While 0/8 mic tumors were cured 5/9 mac tumors heated to 44.2 degrees C disappeared (p less than 0.03, Fisher's exact test) and there was a growth delay in the remaining mice. Mic tumors, heated to 43.5 degrees C, had an accelerated onset of growth while mac tumors heated to this temperature had a slight growth delay. Growth of both mic and mac primary tumors heated to 42.3 degrees C was similar to controls. These results show that therapeutic and subtherapeutic local hyperthermia increases metastases to regional lymph nodes and to lungs even when primary tumor growth rate is partially or totally controlled.

Animals↗

Phototherapy of bladder cancer: dose/effect relationships.

Hematoporphyrin derivative photodynamic therapy has very important clinical applicability in the diagnosis and treatment of transitional cell carcinoma of the bladder, but many aspects of the photodynamic process are yet to be elucidated. This paper investigates the role of dihematoporphyrin ether (DHE) concentration, the duration of light exposure, and the initial size of the tumors in the treatment of a transplantable murine transitional cell tumor system. The best results were noted in tumors less than six mm. in diameter when treated with 15 mg./kg. DHE and exposed to 100 to 180 minutes of visible light. Animals with small initial tumor size combined with higher DHE concentration and longer light exposure time were most likely to show tumor response.

Animals↗

Carcinomas of the colon and rectum. A comparison of staging classifications.

Five staging methods for colorectal cancer were compared to the Dukes method in order to assess which methods were most sensitive and specific. Three hundred fifty-two patients with resected carcinomas of the colon and rectum were followed from 6 to 11 years or until death. All patients were staged by intraoperative and pathological criteria. Survival curves were constructed for each stage. The pTNM system was most sensitive at predicting death. The Gastrointestinal Tumor Study Group (GITSG) system was the most specific at predicting survival. However, the Dukes system did no worse than either of these staging systems and predicted relatively few false-positive and false-negative cases. The sensitivity and correctness of the Dukes system was improved by adding information regarding percent of lymph node metastases, ulceration of the primary tumor, and adjacent organ invasion.

Adenocarcinoma↗

Failure of standard cardioplegic techniques to protect the conducting system.

To determine the site of persistent electrical activity during cardioplegic arrest, microelectrodes that were also capable of recording temperature were placed along the conducting system in dogs undergoing one hour of cardioplegic arrest. Electrical activity was highest in the atrioventricular (AV) junction area (AV node and proximal bundle of His), and the temperature in this area could not be lowered to the level of the temperature in the left ventricular apex by routine cardioplegic technique. Neither changing K+ concentration (16 to 20 mEq/L) nor adding procaine hydrochloride abolished the activity of the conducting system during cardioplegia, and only 2 of 15 dogs were in sinus rhythm 30 minutes after reperfusion. When the conducting system temperatures were lowered to less than 15 degrees C by right AV lavage with iced saline solution, electrical activity was abolished during arrest and all 4 of 4 animals were in sinus rhythm 30 minutes after reperfusion. This study localizes the site of persistent conducting system activity during cardioplegic arrest, confirms it can be abolished with local cooling, and establishes the relationship between conducting system activity during cardioplegia and the incidence of conduction block and junctional rhythm following reperfusion.

Animals↗

Presurgical serum immunoglobulin concentrations and the prognosis of operable breast cancer in women.

Serum concentrations of IgG, IgA, IgM, IgE, and allergen-specific IgE were measured in presurgical serum samples from 400 women admitted to a multidisciplinary study of primary breast cancer. The relationships between the serum immunoglobulins and patient survival were analyzed with the use of a Cox proportional hazards linear model. After adjustment for TNM stage, tumor histopathologic grade, and estrogen receptor (E2R) status, lower IgM concentrations were associated with longer survival. Lower IgE concentrations were also associated with longer survival, but only in patients whose tumors were E2R positive. IgG and IgA were not related to survival. Serum IgM and IgE concentrations, allergen-specific IgE scores, and the tumor E2R status were combined to construct a three-level risk classification that was more prognostic than any of the individual components. Cox model analysis demonstrated that this combination of immunologic and hormonal variables provided significant new information beyond that obtained from TNM staging and histopathologic grading of the tumors (P = .01). This new information may be useful to physicians in advising patients with primary, operable breast cancer about the relative risks and benefits of adjuvant therapy and in designing clinical trials of adjuvant therapy.

Breast Neoplasms↗

The porcine bioprosthetic valve. Twelve years later.

The porcine bioprosthetic heart valve has been commercially available since 1970 and has been the prosthetic heart valve of choice in our institution since 1971. Since that time 817 patients with 951 porcine valves have been discharged from the hospital and were available for long-term follow-up. Patient survival rates, with operative mortality excluded, were 80% +/- 1.7% (standard error) at 5 years and 68% +/- 2.7% at 10 years. Survival rates for patients with aortic valve prostheses were 78% +/- 2.8% at 5 years and 57% +/- 5.4% at 10 years; for patients with mitral valve prostheses, survival rates were 80% +/- 2.2% at 5 years and 69% +/- 3.2% at 10 years. Freedom from thromboembolism for aortic valves was 93% +/- 1.4% at 5 years and 88% +/- 2.6% at 10 years; for mitral valves the freedom from degeneration or primary tissue failure for aortic valves was 97% +/- 1.3% at 5 years and 71% +/- 7.6% at 10 years; for mitral valves these figures were 96% +/- 1.2% at 5 years and 71% +/- 4.1% at 10 years. Valves in patients 35 years of age and below had a significantly greater rate of degeneration (p less than 0.001). After 12 years' experience the porcine bioprosthetic valve has performed well with regard to patient survival and low rate of thromboembolism. For patients older than 35 years the freedom from primary tissue failure is 80% at 10 years.

Adolescent↗