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C E Platz

Publications and source records attributed to C E Platz.

At least 37 records · Page 2Linked to original sources
PubMed1990

The diagnostic utility of immunophenotyping and immunogenotyping in the pathologic evaluation of lymphoid proliferations.

One hundred eighty-two specimens of suspected lymphoma and lymphocytic leukemia were examined by morphology, immunophenotype, and immunogenotype (genotype) in order to answer the following questions: How often and in what situations does immunophenotyping help resolve a diagnostic problem that is not resolved by morphology? How frequently does genotyping help resolve a diagnostic problem that is not resolved by morphology and immunophenotyping? Of 182 cases for which fresh tissue was available, sixty-five cases were considered morphological diagnostic problems: There were 32 cases of neoplasia versus non-neoplastic proliferation, 16 cases of neoplasia with undifferentiated or ambiguous morphology, and 17 cases of lymphoma or lymphocytic leukemia with an uncertain subtype. Immunophenotyping helped to resolve 33 of these 65 cases. Of the remaining 32 cases genotyping helped to resolve the diagnosis in 16. These results suggest that immunophenotyping may diagnose approximately 50% of those cases which present a morphological problem, and that genotyping is also helpful in a limited but significant number of problem cases.

Diagnosis, Differential↗
PubMed1990

Immunophenotypic and genotypic characterization of primary non-Hodgkin's lymphoma of the gastrointestinal tract.

Antigen receptor gene rearrangement studies have been applied to gastrointestinal (GI) lymphoid proliferations in only a limited number of cases, and their use and contribution to the diagnosis and characterization of GI lymphomas is unknown. We retrospectively studied 17 cases of primary GI lymphoma using fresh/frozen tissue with a combination of immunophenotypic and genotypic techniques. The vast majority of the neoplasms were B-cell lymphomas (88%) with rare T-cell tumors. The most common B-cell immunophenotype was IgM-kappa (40%), while five of the B-cell lymphomas (33%) lacked surface light chain immunoglobulin. Immunophenotypic evidence of histiocytic differentiation was not identified. Clonality was confirmed in 59% (10/17) of the neoplasms by immunophenotyping and 88% (15/17) by antigen receptor gene rearrangement studies. All of the 15 B-cell lymphomas (100%) demonstrated clonally rearranged immunoglobulin gene rearrangement. The two lymphomas with T-cell immunophenotypes did not demonstrate T-cell receptor beta-chain gene rearrangement. Antigen receptor gene rearrangement data can be useful and may even be necessary in certain cases for the proper classification and/or diagnosis of GI lymphoid proliferations.

Adult↗
PubMed1990

In vivo evaluation of monopolar versus bipolar electrosurgical polypectomy snares.

The energy required and tissue damage in bipolar and monopolar polypectomy snares were compared in a canine model. The bipolar snare required an average of 34 joules of energy, whereas the monopolar snare required 228 joules to cut the same diameter of gastric mucosa tended into a polypoid structure (p = 0.0005). The reduced energy delivered to the tissue from the bipolar procedure resulted in only 32% average depth of damage to the underlying gastric wall, whereas the monopolar procedure caused an average 69% (p = 0.001). Surgically created polyps required 247 joules and 69 joules for corresponding monopolar and bipolar polypectomy (p = 0.001). The decreased energy required and the correspondingly reduced damage caused to the underlying bowel wall by the bipolar snare should reduce the incidence of perforation and post-polypectomy syndrome. The bipolar snare completes a local circuit about the snare, eliminating the return electrode and, consequently, the possibility of any return electrode burns. The bipolar snare thus provides an added safety margin during polypectomy.

Animals↗
PubMed1989

A comparison of urologic application of bipolar versus monopolar five French electrosurgical probes.

Urologic endoscopic procedures often involve electrosurgery. Recently bipolar probes have become commercially available. This study compares monopolar and bipolar electrosurgical probes in relation to power losses in urologic endoscopic instruments with the infusion of sterile water and saline, and the power transmitted by probes to tissue correlated to tissue destruction in each fluid. The power losses through each instrument in both solutions were minimal. The bipolar electrode functioned at a much lower power output than did the monopolar electrode. The bipolar probe was also more effective in saline than sterile water. The depth, width and volume of tissue damage for both electrodes were found to vary with generator power output. The data shows the burns had similar diameters for both probes but the bipolar probe caused significantly less burn depth than the monopolar probe. These initial studies indicate that bipolar electrodes can function in normal saline with less depth damage compared to the monopolar probe.

Animals↗
PubMed1989

Osteomyelitis of the foot in diabetic patients: evaluation with plain film, 99mTc-MDP bone scintigraphy, and MR imaging.

Diagnosis of osteomyelitis of the foot in diabetic patients may be difficult because of the coexistence of chronic cellulitis, vascular insufficiency, and peripheral neuropathy. This study compared the diagnostic accuracies of plain films, bone scans, and MR imaging studies in diabetic patients with suspicion of osteomyelitis of the foot. Twenty-nine plain radiographs, 20 bone scans, and 30 MR studies were obtained in 24 patients. Twenty-nine bones from 14 patients were pathologically proved either positive (25 bones) or negative (four bones) for osteomyelitis. Another 15 bones (10 patients) studied with MR had no pathologic proof, but the bones healed with only local wound care and/or a short course of oral antibiotics. These patients had trauma, cellulitis, or unhealed ulcers. The sensitivity and specificity of plain films were both 75%. Bone scans had a very low specificity (100% false-positive rate). A negative bone scan should strongly exclude the probability of osteomyelitis. Unlike the findings in previous reports, MR had much higher sensitivity and specificity than bone scans in detecting osteomyelitis in diabetic patients. When the 10 patients without pathologic proof (those who presumably had neuroarthropathy, vascular insufficiency, and/or cellulitis) were included, the sensitivity and specificity of all three techniques decreased. Our experience with this small group of patients suggests that MR is a useful imaging technique for diagnosing osteomyelitis of the foot in diabetic patients.

Adult↗
PubMed1986

Hepatic imaging in stage IV-S neuroblastoma.

Stage IV-S neuroblastoma describes a group of infants with tumor spread limited to liver, skin, or bone marrow. Such patients, who constitute about 25% of affected infants with neuroblastoma, may expect spontaneous tumor remission. We report 18 infants with Stage IV-S neuroblastoma, 83% of whom had liver involvement. Imaging investigations included Technetium 99m sulfur colloid scan, ultrasound, and CT. Two patterns of liver metastasis were noted: ill-defined nodules or diffuse tumor throughout the liver. Distinction of normal and abnormal liver with diffuse type metastasis could be quite difficult, particularly with liver scans. We conclude that patients with Stage IV-S neuroblastoma have ultrasound or CT examination as an initial workup, with nuclear medicine scans reserved for followup studies.

Adrenal Gland Neoplasms↗
PubMed1986

Malignant melanoma of the vulva: a clinical-pathologic review of 16 cases.

A study of 16 malignant melanomas of the vulva was undertaken to identify the histologic variants found on the vulva and to evaluate the use of microstaging as a predictor of behavior. Ten of 16 cases were melanoma of mucous membrane (MMM) type of acral lentiginous melanoma. This percentage (63%) is notably higher than in previous reports. Three cases were nodular melanoma (NM). All lesions of MMM and NM type occurred on mucous membranes. Three cases were superficial spreading melanoma and all occurred on skin. Neurotropism was observed in 5 of the 10 MMM. Neurotropic melanoma has been reported only once previously in the vulva. Depth of the melanomas was greater than 1.0 mm in 13 of the 16 cases. This correlated with Clark and Chung levels of 3 or higher in the same 13 cases. A poor outcome with an overall 5 year survival of 20% of cases with invasive disease was found. The poor outcome and large number of thick lesions would suggest a correlation, but the distribution is skewed and number of cases too small for statistical documentation.

Adult↗
PubMed1985

Mucin production in defining mixed carcinoma of the uterine cervix: a clinicopathologic study.

Eighty-seven Stage 1 cervical carcinomas treated by radical hysterectomy between 1970 and 1979 were reviewed for histologic type, outcome, and factors predicting behavior. Initially, the cases were histologically classified by the Wentz and Reagan system and graded according to the Broders method. Stains for intracellular mucin were then examined in 69 cases and 39% were shown to contain intracellular mucin. Using intracellular mucin as an indicator of mixed carcinoma, this study showed a distribution of 35% keratinizing, 16% nonkeratinizing, 3% small cell, 16% adeno-, 3% undifferentiated, and 26% mixed carcinoma. The mixed carcinomas were derived from the traditional keratinizing, nonkeratinizing and small cell categories. Mixed carcinoma was the only histologic type that predicted lymph node metastasis (p = 0.009). The presence of lymph node metastasis predicted death due to disease or recurrence (p = 0.014) as did pure adenocarcinoma histology (p = 0.025). Overall 5 year survival was 92%. Survival at 5 years for adenocarcinoma was 85%, but one additional death occurred at 12 years and a first recurrence occurred at 7 years. An additional patient with a collision tumor (adenocarcinoma and squamous carcinoma) died at 8 years. Mixed carcinoma is relatively common and appears to be associated with a higher incidence of lymph node metastasis. Adenocarcinoma appears to have a poorer prognosis and a tendency for late recurrence in distant sites.

Adenocarcinoma↗
PubMed1985

Specimen xeroradiography after needle localization and biopsy of noncalcified, nonpalpable breast lesions.

Xeroradiography was used to detect and aid in needle localization of 63 nonpalpable breast lesions over an 8-year period. In 28 patients (44%), no microcalcifications were present in the lesion biopsied. Xeroradiographs of these noncalcified lesions after their submersion in water carried a clean and close resemblance to their in vivo appearance and aided the pathologist in localizing the abnormality within the biopsy specimen. This simple method improved the accuracy of the needle-guided biopsy while allowing excision of minimal breast tissue. A total of 17 (27%) lesions revealed malignancy. At the time of mastectomy, all carcinomas were at an early stage with no nodal involvement. No recurrence has been detected to date with a mean follow-up period of 24 months. This procedure requires close cooperation between the surgeon, radiologist, and pathologist.

Adult↗
PubMed1984

Radiotherapy plus razoxane for advanced limited extent carcinoma of the lung.

Forty-four patients with limited extent American Joint Committee on Cancer Stage II-III non-small cell carcinoma of the lung were randomly assigned to potentially curative radiation therapy plus one of two schedules of razoxane. The weekly schedule was 1 gram per square meter body surface area (BSA) every 8 hours for two doses per week, and the daily schedule was a fixed dose of 250 mg per day. The 50% Kaplan-Meier survival estimate for both groups combined was 9 months. There was no survival difference between the two dose-schedules. Toxicity was formidable with an 82% incidence of esophagitis, and a 20% incidence of grade III-IV esophagitis. Fifty-nine percent of patients developed hematologic toxicity. This was greater with the weekly dose-schedule (P = 0.01). Forty-one percent of patients developed radiographic or symptomatic pneumonitis. One patient developed a fatal myelitis. This program is no more effective than irradiation alone, and has substantial morbidity.

Adenocarcinoma↗
PubMed1984

The frozen section in lymphadenectomy for carcinoma of the prostate.

From January 1969 through August 1982 we performed 257 pelvic lymph node dissections for staging of carcinoma of the prostate. One or more lymph nodes were submitted for frozen section in 100 cases (39 per cent): 43 (43 per cent) had positive nodes on frozen and permanent sections, while frozen section was negative in 57 (57 per cent). Of the latter 57 cases (16 per cent) had positive nodes on paraffin sectioning of all tissue submitted. Thus, in our series there was a 16 per cent chance of overlooking metastatic disease at the time of pelvic lymph node dissection even with the aid of intraoperative frozen sections.

False Negative Reactions↗
PubMed1984

Enzyme activities in normal, dysplastic, and cancerous human breast tissues.

The activities of six different enzymes were compared in 29 normal, 34 dysplastic, and 80 cancerous (both primary and metastatic) human breast tissues; in MCF-7 cells; and in primary rat mammary tumors. Benign lesions generally showed enzyme activities similar to those of normal breast tissues. Malignant tumors had significantly increased activities of lactate dehydrogenase (LDH), malate dehydrogenase (MDH), fructose-bisphosphate aldolase, hexokinase (HK), pyruvate kinase (PK), and creatine kinase. Enzyme activity in the malignant tumor was always higher than that in apparently normal or fibrocystic tissue from the same patient. Enzyme activities did not correlate with the levels of estrogen and progesterone receptors. LDH, MDH, and HK were elevated to a similar extent in all the tissues examined. Conversely, PK was elevated to a much greater extent in cancerous tissues, particularly in MCF-7 cells. The elevated activities of these enzymes may have diagnostic potential, especially when tumor tissue and apparently normal tissue from the same patient are compared.

Adenofibroma↗
PubMed1983

Cryosurgery in prostatic cancer: elimination of local lesion.

From 1969 through 1976, we performed cryosurgery in 229 cases of prostatic cancer. Most of these patients had bulky, locally extensive primary tumors, and one-half had disseminated disease. Through the open perineal approach, which gives exposure for an adequate freeze, cryosurgery has been well tolerated. The primary surgical goal has been to reduce or eliminate the local lesion to minimize subsequent cancer-related lower urinary tract problems and to cure those patients with truly localized disease. In every case cryosurgery produced dramatic shrinkage of the local lesion. After four to eight weeks a local recurrence was suspected in 13 per cent, and 41 per cent eventually had some evidence of a recurrent cancer nodule or persistent cancer in the bladder neck. In a series of statistical analyses we have related these recurrences to other clinical factors. Cryosurgery has been a safe, effective way to reduce or eliminate the primary prostatic cancer, even in patients with large local lesions.

Aged↗
PubMed1983

Isozyme patterns of normal, benign, and malignant human breast tissues.

Isozyme patterns of 23 different enzymes were compared in normal, benign, and malignant breast tissues; in MCF-7 cells; and in organoids of normal human breast tissue. Benign lesions generally showed isozyme patterns similar to those of normal tissues. Lactate dehydrogenase isozyme 5 was significantly increased in malignant tumors; MCF-7 cells had only lactate dehydrogenase (L-lactate:NAD oxidoreductase; EC 1.1.1.27). The mitochondrial form of malate dehydrogenase was also significantly increased in human malignant tumors; this was especially evident when comparing tumor and apparently uninvolved breast tissue from the same patient. The K4 isozyme of pyruvate kinase was the major form in most malignant breast tumors, but in only 41% of normal tissues, 30% of fibrocystic disease specimens, and 46% of fibroadenomas. A more anodal band of pyruvate kinase, probably a K3M or K3Kpm hybrid, predominated in most normal and benign tissues, but in only 63% of primary and 56% of secondary tumors. All specimens had predominantly creatine kinase BB, aldolase A4, and hexokinase I. Traces of aldolase A3C and of hexokinase II were observed in some tumors. None of the tumors had the Regan variant of alkaline phosphatase. The isozymes of lactate and malate dehydrogenases and of pyruvate kinase appear to be the most promising as putative tumor markers.

Breast↗
PubMed1982

Predicting therapeutic outcome in patients with diffuse histiocytic lymphoma treated with cyclophosphamide, adriamycin, vincristine and prednisone (CHOP).

Seventy-five patients with diffuse histiocytic lymphoma (DHL) ranging in age from 33 to 94 years were treated with cyclophosphamide, Adriamycin, vincristine and prednisone (CHOP). Thirty-eight patients (51%) achieved complete remission, but nine of these patients relapsed after remission lasting one to 23 months (median time to relapse, four months). We used multivariate analysis to identify those characteristics that significantly affected treatment outcome. The chances for complete remission were adversely affected by DHL appearing after histologic conversion from another lymphoma (P = 0.006), the presence of systemic symptoms (P = 0.24), and not having the large noncleaved (LNC) histologic subtype (P = 0.40). The chance for relapse from complete remission was increased only by the presence of systemic symptoms (P = 0.042). Overall survival was adversely affected by the presence of bone marrow involvement (P = 0.002), having other than LNC histologic subtype (P = .010), and the presence of systemic symptoms (P = 0.043). It appears that patients whose DHL appears de novo and who also are symptom status A (70% long-term disease-free survival) or have the LNC histologic subtype (67% long-term disease-free survival) have an excellent outlook when treated with CHOP at the doses used in this study. However, patients with B symptoms (16% long-term disease-free survival), histologic conversion to DHL (8% long-term disease-free survival), previous chemotherapy (8% long-term disease-free survival), and bone marrow involvement (8% long-term disease-free survival) respond poorly and for these patients other treatments need to be identified. In addition, patients with B symptoms who achieve complete remission with CHOP are at high risk to relapse (59% relapse rate) and should be considered for "intensification" therapy after complete remission is documented.

Adult↗
PubMed1982

Cryosurgery in prostatic cancer: survival.

From 1969 through 1976 we performed cryosurgery in 229 cases of prostatic cancer. This article presents survival in cryosurgery and other treatment groups. In every stage, despite a preponderance of large primary tumors and poor-risk patients, cryosurgery matched total prostatectomy and compared favorably to other modalities, including radiation therapy, at our center and elsewhere. According to previous authors, and in view of the present data, eradication of the local lesion is associated with better survival even in advanced cases. Cryosurgery provides a safe, effective method.

Aged↗