PubMed Health⌕ Search

Biomedical subjects

C M Pinsky

Publications and source records attributed to C M Pinsky.

At least 55 records · Page 3Linked to original sources
PubMed1978

Intralesional injection of the methanol extraction residue of Bacillus Calmette-Guerin (MER) into cutaneous metastases of malignant melanoma.

Twenty-two patients with cutaneous metastases of malignant melanoma were treated with intralesional injections of the methanol extraction residue of bacillus Calmette-Guerin (MER). The local reaction consisted of erythema and pustule formation followed by ulceration and tumor necrosis. Side effects included fever, chills, headache and malaise in the majority of patients; nausea, vomiting, cyanosis and hypotension occurred infrequently. Hypersensitivity reactions were not observed. Temporary abnormalities in liver function were seen in 11 of 19 patients tested. Reversible lymphopenia and thrombocytopenia developed in 7 of 17 and 7 of 18 patients, respectively. Immune function, as measured by skin tests for delayed hypersensitivity and the in vitro response of isolated lymphocytes to mitogens and microbial antigens, was not influenced by treatment with MER. Transient increases were observed in total hemolytic complement, complement components and the reduction of nitroblue-tetrazolium by neutrophils. Eight of eighteen evaluable patients showed a complete disappearance of all injected lesions. We conclude that intratumoral injection of MER is effective treatment for cutaneous metastases of malignant melanoma, with a complete response rate comparable to that observed after intralesional injection of BCG.

Adult↗
PubMed1978

Adjuvant trial of levamisole in patients with squamous cancer of the head and neck: a preliminary report.

A preliminary report is made of a randomized double-blind study comparing levamisole with placebo as surgical adjuvant treatment of patients with squamous cancer of the head and neck. The study groups were comparable according to the prognostic factors of type (primary or recurrent), site (oral cavity, pharynx, larynx), and stage of disease and were also similar in pretreatment immune function and in radiation exposure. Of 65 evaluable patients, 31 were treated with levamisole and 34 received placebo. Although there was no difference in the distribution of the time to recurrence of the overall treatment group, there was a difference of borderline significance in favor of levamisole in the primary disease patients (P less than 0.006). Further analysis of subgroups in the primary disease category showed decreased recurrence rates in patients receiving levamisole who had cancer of the oral cavity P less than 0.01 or who had stage II disease, P less than 0.02. Considering site and stage simultaneously, the only significant difference was in stage II patients with oral cancer. The above results, though encouraging, must be viewed with caution due to small sample sizes and relatively short follow-up of most patients.

Antigens, Bacterial↗
PubMed1978

Immunocompetence of patients with transitional cell carcinoma as measured by dinitrochlorobenzene skin tests and in vitro lymphocyte function.

Patients with transitional cell carcinoma of the bladder have a highly significant stepwise decrease in responsiveness to challenge with DNCB with advancing stage of disease. Seventy-five percent of those patients with superficial tumors are skin-test positive versus only 35% for those having tumors that are locally advanced and/or metastatic. MLC response and ability to stimulate in this culture as well as PHA and Con A response of blood leukocytes have been studied in relation to stage of disease and therapy. Recent irradiation appears to inhibit significantly MLC responsiveness, and PHA and Con A blastogenesis. Although responsiveness for this group of patients is decreased from normal, a further decrease occurs in responsiveness to Con A with advancing stage of disease. Blood leukocytes from some patients with urinary bladder carcinoma appear to have a decreased ability to function as stimulator cells in one-way MLC. This ability to stimulate returns to normal levels with tumor removal.

Carcinoma, Transitional Cell↗
PubMed1978

Effects of transfer factor in patients with advanced cancer.

Eighteen patients with advanced cancer were given subcutaneous injections of pooled dialyzable transfer factor (TFd) from normal donors for periods of from 9 days to 6.5 months. Minor tumor regression was observed in only two patients, an effect of no therapeutic significance. However, treatment with TFd was associated with at least a temporary increase in delayed hypersensitivity reactions in 12 of 17 patients tested, including four patients who became responsive to 2,4-dinitrochlorobenzene. In general, in vitro tests of immune function were not changed after treatment with TFd except for levels of C1q, and/or C3, which were increased in 6 of 10 patients tested. We conclude that TFd may augment delayed hypersensitivity in patients with advanced cancer, and that its effects are, at least in part, immunologically nonsepcific.

Adolescent↗
PubMed1978

Randomized trial of levamisole in patients with squamous cancer of the head and neck: a preliminary report.

This is a preliminary report of a randomized double-blind study comparing levamisole with placebo as surgical adjuvant treatment of patients with squamous cancer of the head and neck. The study groups were comparable according to the prognostic factors of type (primary or recurrent), site (oral cavity, pharynx, or larynx), and stage of disease and were also similar in pretreatment immune function and in radiation exposure. Of 65 evaluable patients, 31 received levamisole and 34 received placebo. Although there was no difference in the distribution of the time to recurrence of the overall treatment group, there was a difference of borderline significance in favor of levamisole in the primary disease patients (P less than 0.06). Further analysis of subgroups in the primary disease category showed decreased recurrence rates in patients receiving levamisole who had cancer of the oral cavity (P less than 0.01) or who had stage II disease (P less than 0.02). Considering site and stage simultaneously, the only significant difference was in stage II patients with oral cancer. The above results, although encouraging, must be viewed with caution due to small sample sizes and the relatively short followup of most patients.

Carcinoma, Squamous Cell↗
PubMed1978

A preliminary evaluation of tissue polypeptide antigen in serum or urine (or both) of patients with cancer or benign neoplasms.

We evaluated assays of Tissue Polypeptide Antigen in serum and urine, as an index to the presence of cancer. In the assay, serum, which is first absorbed with human albumin-labeled sheep erythrocytes, or untreated urine (diluted with an equal volume of TPA-free serum) is incubated with antibody specific to Tissue Polypeptide Antigen and then reacted with sheep erythrocytes labeled with Tissue Polypeptide Antigen. We found an increased concentration of Tissue Polypeptide Antigen in the serum of 378 of 513 (74%) and in the urine of 49 of 77 (64%) patients with cancer, as compared with 40/112 (36%) and 7/29 (24%), respectively, for individuals with benign neoplasms. Normal individuals were defined as those with less than 0.09 unit of the antigen per milliliter of specimen. Concentrations exceeding this were found in 2/67 (3%) sera and 6/56 (11%) urines from supposedly normal persons. Tissue Polypeptide Antigen was found in above-normal concentrations in patients with cancer, regardless of neoplasm type and extension, with a higher proportion of abnormal values in patients with distal metastases.

Antigens, Neoplasm↗
PubMed1978

Levamisole as an immunoadjuvant: phase I study and application in breast cancer.

A phase I study of levamisole in patients with cancer was undertaken to determine its therapeutic dose range, side effects, limiting toxicity, and influence on immune function. Simultaneously, a group of patients receiving adjuvant combination chemotherapy for carcinoma of the breast were entered in a randomized study to observe whether levamisole was capable of overcoming the immunodepressive effects of cytotoxic drugs. In the phase I trial the doses used ranged from 65 to 410 mg/m2. The maximum tolerated dose was 358 mg/m2. Side effects were generally low in intensity and related to the gastrointestinal and central nervous systems; the limiting toxic effect was intractable nausea. Significant changes in immune test values were noted in both acute and chronic trials. Alterations in immunoglobulin levels, complemented values, and numbers and types of lymphocytes and mitogenic responses to concanavalin A as well as specific mitogens were observed. In the randomized trial there was no difference between the chemoimmunotherapy and chemotherapy-alone groups.

Adjuvants, Immunologic↗
PubMed1977

Immunologic evaluation and prognosis in patients with head and neck cancer.

Patients with mucosal squamous cell carcinoma of the head and neck generally have suppressed T cell function, and this suppression tends to be more pronounced with progression of disease. The prognostic relationships of multiple tests of immune function were analyzed in 183 clinically staged patients. Correlation of immune parameters with prognosis was evident only with the DNCB response, which correlated with recurrence in stages I and II disease (but not in stages III and IV). There was no correlation of any of the in vitro tests of immunofunction with recurrence in any stage. There were no correlations between any of the immune parameters and age or sex nor between DNCB reactivity and any of the in vitro responses.

Carcinoma, Squamous Cell↗
PubMed1977

The clinical utility of plasma and urinary carcinoembryonic antigen in patients with genitourinary disease.

Carcinoembryonic antigen was measured in the urine and plasma of 108 patients with several types and various stages of genitourinary cancer. The value of the carcinoembryonic antigen assay as an early indicator of neoplastic disease was evaluated and a correlation was made between the extent of disease and the concentration of urinary and plasma carcinoembryonic antigen. Patients were classified according to stage of tumor involvement as follows: no evidence of disease, non-malignant disease, non-invasive disease, no known metastasis, regional metastasis and disseminated metastasis. The urinary carcinoembryonic antigen levels more closely paralleled the extent of disease than did the plasma carcinoembryonic antigen levels in patients with bladder cancer. Neither urinary nor plasma carcinoembryonic antigen levels were useful in assessing the extent of disease in patients with prostatic or testicular cancer. Studies related to microbiological interference in the carcinoembryonic antigen assay indicated that bacterial counts up to 10(5) organisms per ml. did not interfere. Cytological studies indicated that the presence of white blood cells, atypical cells and malignant cells could result in elevated urinary carcinoembryonic antigen levels.

Carcinoembryonic Antigen↗
PubMed1977

Depressed in vitro lymphocyte responses to PHA in patients with Hodgkin disease in continuous long remissions.

Twenty consecutive patients with Hodgkin disease in continuous complete remission and off treatment for at least 5 yr (range 5-25 yr, median 9 yr) were studied with a battery of immunologic parameters. Skin test reactivity to four common antigens, sensitization to 2,4-dinitrochlorobenzene, absolute lymphocyte count, relative percentage of T cells (as measured by spontaneous rosette formation with sheep erythrocytes) and B cells (as measured by immunofluorescence with polyvalent antiserum), and absolute number of T and B cells were normal when compared with controls. However, the mean value of lymphocyte response in vitro to the mitogen phytohemagglutinin for the study population was significantly decreased (p less than 0.001) when compared with the controls. This abnormality in response to mitogen could not be correlated with age, sex, stage, symptoms, histologic subclassification, or previous treatment. The data suggest the existence of a persisting cell-mediated immune defect in the circulating lymphocytes in patients with long-standing Hodgkin disease that might otherwise be considered "cured."

Antigens↗
PubMed1976

Treatment of Bowen's disease with topical dinitrochlorobenzene and 5-fluorouracil.

"Bowen's disease" is a clinical and histologic diagnosis describing the lesions (single or multiple) of cutaneous in situ squamous cell carcinoma. The case of a 54-year-old man with 60 such intra-epidermal carcinomas, and a history of arsenic ingestion, is presented. The patient was sensitized to dinitrochlorobenzene (DNCB), and his lesions were treated with a topical DNCB preparation. All lesions disappeared completely (demonstrated by biopsy of several sites) except for a large (12 X 7 cm) tumor on the flank which partially resolved. Total regression of this lesion was achieved by adding topical 5-fluorouracil (5-FU) therapy. This case demonstrates that the inflammatory reaction induced by DNCB (as evidenced by erythema and by a dense inflammatory cell infiltrate in biopsied areas of treated lesions) can lead to regression of extensive in situ epidermoid carcinoma, and that combined therapy with DNCB and 5-FU can be more effective than DNCB alone. Both agents in appropriate concentrations led to selective destruction of neoplastic tissue with no effect on adjacent normal skin. No systemic toxicity was observed.

Arsenicals↗
PubMed1976

Immune evaluation with skin testing. A study of testicular, prostatic, and bladder neoplasms.

Fifty patients with testicular carcinoma, 45 with prostatic neoplasm, 84 with bladder carcinoma, and 13 with benign bladder papilloma were evaluated for skin reactivity to DNCB and other intradermal antigens. Correlation between pathologic staging and skin-test reactivity was sought. Reaction to DNCB among patients with testis tumors was more significantly depressed by chemotherapy than by the extent of retroperitoneal or distant metastatic disease indicating that skin testing as a means of following the course of disease or of predicting survival may be limited by alterations caused by chemotherapy. DNCB reactivity did not correlate with the prognosis for the different stages of disease, but follow-up studies of individual patient survival are needed for substantiation. Depression of DNCB reactivity exists among patients with prostatic carcinoma whether the disease is localized or widely metastatic. Only lengthy follow-up will determine if there is any correlation of reactivity with survival in individual patients. DNCB reactivity among patients with bladder tumors shows progressive reduction with increasing stage disease and lends support to the evidence suggesting immune deficiency in patients with bladder neoplasm.

Adolescent↗
PubMed1976

Comparison of multiple in vivo and in vitro parameters in untreated patients with Hodgkin's disease.

Multiple in vivo and in vitro immune parameters were used to examine 52 untreated patients with Hodgkin's disease in all stages. A significant number (p less than 0.01) of patients in all stages demonstrated abnormalities in DNCB sensitization, peripheral blood lymphocyte response to phytohemagglutination, absolute lymphocyte count, absolute number of T cells (as measured by spontaneous rosette formation with sheep erythrocytes), and absolute number of B cells (as measured by immunofluorescence with polyvalent antiserum). The number of T and B cells fell progressively with each stage, but the proportion of T to B cells remained constant. Cutaneous anergy was found in STAGES III and IV. Depressed circulating immunoglobulins were found in a few patients in all stages. Neither the total lymphocyte number nor the number of T and B cells correlated with the measures of lymphocyte function (skin test reactivity, DNCB sensitization, mitogen response, or immunoglobulin levels). This study suggests that selective abnormalities in the immune system exist even in early Hodgkin's disease, involving the absolute number of circulating T and B lymphocytes and T-lymphocyte function. The study fails, however, to define a consistent pattern of immune defects as characteristic of Hodgkin's Disease.

B-Lymphocytes↗