Biomedical subjects

E Robinson

Publications and source records attributed to E Robinson.

At least 19 recordsLinked to original sources

PubMed1992

[Familial breast cancer in Arabs].

500 surviving Arab cancer patients in follow-up were interviewed with regard to other cases of cancer in their families. Among 73 who had breast cancer, in 15 (20.3%) there was another case of breast cancer among first-degree relatives. The incidence of both primary and familial breast cancer was higher among Christian than among Moslem women. We conclude that Arab women with breast cancer in their families are at high risk for developing breast cancer themselves.

Breast Neoplasms↗

PubMed1992

[Primary breast cancer: conservation therapy].

A series of 200 patients with primary breast cancer, treated with breast conservation between 1981 and 1988, was analyzed retrospectively. The mean age was 54 +/- 14 years and mean follow-up 36 months. 58 patients (29%) were in pathological Stage I, 85 (42.5%) in II A, 34 (17%) in II B, and 7 (3.5%) in III. 16 (8%) were in clinical Stages I-II; 40 (20%) had multifocal tumors and 40 intraductal components. 45% of the lesions were excised with good margins, 13.5% with close margins (0.5 cm), 9% with microscopic residual, 4% with macroscopic residual and in 57 (28.5%) margins could not be determined. Level II axillary lymph node dissection was performed in 193 (96.5%). Adjuvant therapy (combined chemotherapy and/or hormones) was given to 105 (52.5%). Radiotherapy usually consisted of 50 GY tangential photon irradiation to the whole breast in 25 fractions. Electron or photon boost to the tumor bed was given to 112 (59%). Most patients received 20 GY, and most node-positive patients 50 GY to the lymphatic drainage. 69% tolerated combined radiotherapy-chemotherapy well and radiotherapy did not have to be interrupted. A year after completion of radiotherapy the cosmetic result was rated as good in 166/173 (96%) and fair in 7 (4%); there were no poor ratings. 11 (5.5%) developed breast recurrence and 5 (2.5%) supraclavicular or axillary lymph node metastases. 1 (0.5%) developed local recurrence and supraclavicular lymph node metastases simultaneously. 50 (10%) developed distant metastases, of whom 2 developed loco-regional recurrences simultaneously.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1992

Diversity in fine specificity and T cell receptor usage of the human CD4+ cytotoxic T cell response specific for the immunodominant myelin basic protein peptide 87-106.

Multiple sclerosis (MS), a human demyelinating disease, is thought to be caused by an autoimmunologic process, and myelin basic protein (MBP) is considered a likely autoantigen. Studies of T cell lines (TCL) responding to different parts of the MBP molecule have indicated that amino acids 87 through 106 contain an immunodominant epitope of MBP. We have demonstrated previously that amino acids 89 through 99 represent the core of this 87-106 peptide epitope. Importantly, this epitope is not only encephalitogenic in SJL/J mice and Lewis rats but also has been shown to be recognized by human cytotoxic TCL in the context of four HLA-DR molecules that are associated with MS in different geographic areas. If the immune response to MBP peptide 87-106 was homogeneous with respect to epitope specificity and TCR usage, specific immunotherapies targeting the interaction of peptide, MHC, and TCR might be possible. In this study, the fine specificity of 29 CD4+ cytotoxic, long term, and limiting dilution TCL that had been generated against whole MBP and were derived from four MS patients and two healthy relatives was dissected using truncated and alanine-substituted peptides for the 87-106 peptide. In addition, the TCR alpha and beta chain usage of 15 CD4+ TCL was determined. Using truncated peptides, the presence of several nested immunogenic epitopes within amino acids 87 to 106 was demonstrated. TCL with identical restriction elements and similar responses to truncated peptides could be differentiated further using alanine-substituted peptides. Finally, heterogeneity of TCR usage was shown not only for those lines that differed in their peptide specificity but also for some that showed identical responses and were restricted by the same HLA-DR antigen. In conclusion, the CD4+ cytotoxic T cell response to the immunodominant MBP peptide 87-106 demonstrates a high degree of heterogeneity at the level of fine specificity and TCR usage. These findings indicate that specific immunotherapies aimed at TCR in MS will probably be more complicated than previously anticipated.

Adult↗

PubMed1992

A comparison of the clinical characteristics of second primary and single primary sarcoma: a population based study.

The clinical characteristics of 240 patients with sarcoma as a second metachronous primary neoplasm (SPN) were compared with those of 8,815 patients with sarcoma as a single tumor. The data were obtained from patients registered during the period 1973-1986 in the Surveillance, Epidemiology and End Results (SEER) Program in the United States. Seventy-four of the 240 SPN patients had postirradiation sarcoma (PIS) while the other 153 patients developed the sarcoma as a second tumor in an area which was not exposed to prior radiotherapy (non-PIS). The stage of disease at diagnosis was more advanced in patients with PIS than in those with single sarcomas but the difference did not reach statistical significance. Overall, in comparable clinical stage localized and regional disease there was no statistically significant difference in survival between PIS and non-PIS sarcoma patients after adjusting for age. The survival of patients with localized or regionally advanced sarcoma as a second tumor was significantly worse than of those with single sarcomas with the same stage. There was no difference in survival between first or second sarcomas with metastatic disease.

Adolescent↗

PubMed1992

Salvage therapy for non-Hodgkin's lymphoma with a combination of dexamethasone, etoposide, ifosfamide, and cisplatin.

A total of 30 consecutive patients with refractory or relapsing non-Hodgkin's lymphoma (NHL) were treated with a combination of dexamethasone, etoposide (VP-16), ifosfamide, and cisplatin (DVIP). In all, 9 subjects (30%) showed a partial response and 10 (33%) achieved a complete response (CR) lasting from 2.5 to 24+ months. Aggressive histology, no prior therapy with VP-16, a CR to previous chemotherapy, and a treatment-free interval of greater than 6 months prior to the present study were associated with the high CR rate. DVIP caused pronounced myelosuppression (median granulocyte nadir and median platelet nadir, 380/mm3 and 73.000/mm3, respectively), but no drug-related death occurred. We conclude that DVIP is an effective salvage combination, especially in aggressive NHL, that produces acceptable toxicity.

Adult↗

PubMed1992

Clinical, demographic, and follow-up characteristics of patients with two primary metachronous tumors, one of them being in the colon.

The clinical characteristics of 152 patients diagnosed with two primary metachronous tumors--one or both of them in the colon--were studied. Nineteen patients had both primary tumors in the colon (Group I), 59 had the first primary tumor in the colon and the second tumor elsewhere (Group II), and 74 had the second primary tumor in the colon and the first primary tumor elsewhere (Group III). The group in which the second primary tumor was in the colon included significantly more female patients than did the other two groups, with a younger median age at diagnosis of first tumor. The median time interval between the two primary tumors was 44, 57, and 62 months in Groups I, II, and III, respectively. The number of clinic visits during the year before diagnosis of the second primary was similar in all groups, but only 60 percent of the patients kept their follow-up appointment. In most instances, the diagnosis was made after the patients' symptoms, although only a small percentage of the second primary tumors (15-30 percent) were diagnosed during routine follow-up. The second primary tumor occurred in the field of radiotherapy of the first primary tumor in 27 of 35 patients who received radiotherapy. To increase the number of patients diagnosed in an earlier stage of disease, they should be urged to keep their follow-up appointment, and physicians following patients with single tumors should be aware of the increased likelihood of a second tumor. To increase the cure rate of those tumors, efforts toward early diagnosis are warranted. This includes physical examination and mammography to detect breast cancer in women, annual occult blood tests and rectal examination, and sigmoidoscopy or colonoscopy at three-year intervals to detect colon cancer early.

Aged↗

PubMed1992

Denture base resins: comparison study of color stability.

Several denture base resins have been recently introduced that provide easier or faster processing. Although these materials have adequate strength properties, the color stability is also of interest. This study evaluated the color stability of five denture base acrylic resins and one denture base repair resin. The samples were subjected to conditions of accelerated aging to test color stability. Five samples of each material were processed and aged for 100 and 300 hours. The color stability was quantitatively measured using the Minolta Chroma Meter II. Color measurements were made before weathering and at 100 and 300 hours the color difference delta E was calculated for all samples. At 300 hours the color change of the materials was significantly different at p less than 0.01. It was found that: (1) the color of Lucitone Hy-pro and Acron was least affected by conditions of accelerated aging; (2) Triad, Accelar 20, and Perm demonstrated noticeable color changes; and (3) Compak-20 had an appreciable color change and was the least color-stable of the materials tested.

Acrylic Resins↗

PubMed1992

The value of postoperative irradiation in renal cell cancer.

This is a retrospective analysis of 147 evaluable patients, with histologically proven renal cell carcinoma, who were referred to our center between 1977 through 1988. All patients with disease limited to the kidney underwent nephrectomy. Post-operative megavoltage irradiation, with a median dose of 46 Gy, was given to 56 patients, using parallel opposing portals, or multiple field technique. Five and 10 year actuarial survivals in irradiated patients (Rt+) were 50 and 44%, respectively, and in non-irradiated patients (Rt-) 40 and 32%, respectively. The disease recurred locally in a total of 19 patients; 16 had tumor bed recurrence and three had scar recurrence. Local recurrence by stage was as follows: T2 N0M0: RT+ 0/17, RT- 2/28; T3 N0M0: RT+ 4/37 (10%), RT- 11/30 (37%) (p less than 0.05); T4 N0M0: RT+ 1/2, RT- 1/5. Two of the local recurrences in irradiated patients developed in a surgical scar which was not included in the treatment volume. Significant toxicity developed in three patients (5%). It is concluded that post-operative irradiation can reduce local recurrence rate in T3 N0M0 renal cell carcinoma. It is recommended that the surgical scar should always be included in the treatment volume and irradiated to a full dose.

Actuarial Analysis↗

PubMed1992

The development and evaluation of Basic Epidemiology: Student's Text.

This paper describes the development and evaluation of a World Health Organization book Basic Epidemiology: Student's Text. This book was a response to a need identified by members of the WHO Global Environmental Epidemiology network. A draft was commented on by members of the Network and then at an editorial meeting. Two thousand copies of a pre-publication version were prepared and this version was formally evaluated by 13 teachers of introductory courses of epidemiology and less formally by members of the Epidemiology Network. A high response was received to the evaluation questionnaires; 45% of the students rated the test overall as 'very useful' and another 54% as 'useful'; many useful comments were received and were incorporated into the final version which will be published by WHO in 1993.

Attitude of Health Personnel↗

PubMed1992

Lymphoma: predictive value of Ga-67 scintigraphy after treatment.

The negative predictive value (PV-) and positive predictive value (PV+) of gallium-67 scintigraphy and computed tomography (CT) were compared after treatment in 43 patients with Hodgkin disease and in 56 patients with non-Hodgkin lymphoma. The usefulness of these studies in predicting survival was also evaluated. In patients with Hodgkin disease, the PV- of Ga-67 scintigraphy was 0.84 and of CT was 0.88. The PV+ was 0.80 for Ga-67 studies and only 0.29 for CT. In patients with non-Hodgkin lymphoma, the PV- of Ga-67 scintigraphy was 0.84 and of CT was 0.80. The PV+ was 0.73 and 0.35, respectively. For both groups, the differences in disease-free survival between patients with negative and positive Ga-67 studies were significant (P less than .05 in Hodgkin disease and P less than .001 in non-Hodgkin lymphoma), but the differences were not significant for CT. These data show that, after treatment of patients with lymphoma, Ga-67 scintigraphy is a good predictor of clinical outcome and can be used beneficially in patient treatment.

Adolescent↗

PubMed1992

Clinical characteristics of patients with epidermoid carcinoma of the upper aerodigestive tract who develop second malignant tumors.

A total of 1294 patients with primary head and neck (H&N) cancer of a single site was diagnosed during the years 1970 to 1979 at the Memorial Sloan-Kettering Cancer Center, 163 subsequently developed a second malignant tumor (SMT). In 50% of the cases, the second tumor was in the H&N, and in 30% in the lung and esophagus; 41 patients developed a third tumor. Again, in 50% of these cases, the tumor was in the H&N and in 17% in the lung and esophagus. The stage of disease of all the second primary tumors was more advanced at diagnosis, mainly as a result of the large number of patients with lung and esophagus cancer. Patients who had a second tumor in the H&N were diagnosed in an earlier stage of disease than patients with a single H&N tumor. The survival of patients with localized second H&N cancer was worse than for those with a primary, localized single tumor.

Alcohol Drinking↗

PubMed1992

Toneline bite mark photography.

In bite mark analyses, the initial photograph is critical for the collection and presentation of evidence. A high-contrast film technique previously used primarily in the graphic arts field has been refined and applied to forensic odontology. The process, called toneline, reduces the interpretational bias of the investigator and yields a transparent overlay with a photographic outline of the bite mark which can be directly compared with models of the suspect's teeth.

Bites, Human↗

PubMed1991

A novel 21-kDa protein as a serum marker for benign and malignant urogenital tumors: preliminary communication.

A novel 21-kDa protein (p21) was isolated from auto-immune complexes, found in sera of 14 patients with malignant urogenital tumors and isolated on Protein A-Sepharose. Isolated complexes were analyzed in 15% polyacrylamide-SDS minigels. After staining with Coomassie blue R, the bands were scanned with a clinical densitometer. The level of p21 in sera of cancer patients was 3 times higher than that found in normal individuals. An attempt was made to correlate consecutive levels of p21 in the sera of these cancer patients with the clinical course. In 4 cases a significant decrease (57-75%) in the level of p21 was observed in parallel with response to treatment. In 9 of 10 cases where no response or tumor progression was observed, the relative abundance of p21 increased or remained unchanged. Thus, the level of p21 was indicative of progression or regression of the disease in 13 out of 14 patients. Similar high levels of p21 in sera were also found in 22 patients with benign hyperplasia of prostate. The p21 protein was not immunoreactive with known anti-ras antibodies such as Y13-259, 142-24E05 and anti-rap1. Partial amino acid analysis of this protein showed no complete homology to any known protein, but a partial homology to known bacterial proteins involved in DNA replication or transcription was observed. Monitoring of the novel p21 levels before and after treatment may be useful in follow-up of cancer patients, providing evidence of response to treatment.

Adult↗

PubMed1991

The association of breast cancer and colorectal cancer in men. An analysis of surveillance, epidemiology, and end results program data.

There is a known increased risk for the co-occurrence of both breast cancer and colorectal cancer in the same women, presumably as a result of either shared reproductive hormonal or environmental risk factors. Using data from the Surveillance, Epidemiology, and End Results Program of the National Cancer Institute, the authors investigated whether there is a similar relationship between breast cancer, colorectal cancer, and prostate cancer in men. The observed-expected ratio was not significantly elevated for either colorectal cancer after breast cancer or for breast cancer after colorectal cancer in men. There was an increased incidence of prostate cancer after colorectal cancer, but this relationship was not present in the opposite direction and is believed to result from detection bias. There was an increased incidence of breast and colorectal cancer in women. These results suggest that the observed breast and colorectal cancer relationship in women may be a result of shared reproductive hormonal factors.

Breast Neoplasms↗

PubMed1991

A comparison of the clinical characteristics of first and second primary head and neck cancers. A population-based study.

The clinical characteristics of 183 patients with second primary neoplasms in the head and neck region were compared with those of 20,598 patients with one primary tumor in the same region registered during the period 1973 to 1984 in the Surveillance, Epidemiology and End-Results Program. Second primary head and neck tumors were more likely to be diagnosed in a localized stage (47%) than if diagnosed as a single primary tumor (43%), but this difference was not significant. The tumor grade distribution was comparable in both groups. Using Cox proportional hazards modeling with age, sex, race, and stage as covariates, the median survival of patients with first and second head and neck cancer was identical (50 months). The survival of patients with localized second head and neck cancer was shorter than that of patients with single localized tumors (55 versus 102 months, P less than 0.026). Survival for regional tumors was similar (18 versus 21 months, not significant). The 84 second head and neck cancers in which the first head and neck cancer received radiation therapy (RT) had a median survival of 20 months; the 98 cases without prior RT had a median survival of 35 months. The high incidence of localized second cancers was probably due to the more intense surveillance. The worse survival in this group may be a result of prior RT or biologic characteristics of the tumor.

Carcinoma, Squamous Cell↗

PubMed1991

Clinical and flow cytometry characteristics of malignant pleural effusions in patients after intracavitary administration of methylprednisolone acetate.

Ten patients with recurrent pleural effusions due to advanced cancer were treated by intracavitary methylprednisolone acetate (Depo-Medrol [DM], Upjohn, Kalamazoo, MI). They received one to six courses of DM (median, three courses per patient) with doses ranging from 80 to 160 mg per course. Effusion cells were cryopreserved before and during DM installation for subsequent determination of ploidy by flow cytometry. Pleural effusion in all three patients with advanced breast cancer resolved and did not reaccumulate throughout follow-up for 11+, 10+, and 8+ months. Pleural effusion in a patient with metastatic gastric cancer and in two of four patients with adenocarcinoma of unknown origin partially resolved. Altogether six of ten patients (60%) subjectively and objectively benefited from this therapy. All patients tolerated the treatment well with no local or systemic side effects. Flow cytometry showed a reduction in ploidy of effusion cells in all three patients with breast cancer, from a peak mean channel of 6C to nearly 2C after therapy. Transient reduction of ploidy was seen also in the effusion of a patient with unknown primary tumor associated with clinical improvement. The clinical and laboratory data reported offers initial evidence that DM when instilled into the pleural cavity after incomplete thoracentesis may act as effective palliative therapy either alone or in combination with other anticancer agents.

Adult↗

PubMed1991

In vivo measurements of the fraction of dose of bleomycin labeled with cobalt 57 delivered to human tumors.

Concentrations of bleomycin labeled with cobalt 57 (Co-bleo) over time were measured in vivo in 17 patients with 32 sites of lymphoma and 18 patients with lung tumors after administration of the same dose of bleomycin. There were marked variations in individual tumor drug concentrations even among tumors with the same histologic type, indicating that the tumor concentration of this drug in individuals cannot be predicted from the administered dose. Also, tumor concentration could not be predicted from the area under the concentration over time curve (AUC) of Co-bleo in the blood; there was no correlation (r = 0.53) between the AUC and the concentration in the tumor at any point in time between 30 minutes and 8 hours after injection. There was no significant difference in the percent of the injected dose per milliliter (%ID/ml) which was delivered to the tumor when low and high amounts of bleomycin were administered to the same patient. Also, a good correlation (r = 0.88) between the %ID/ml over time was found when injection of low and high doses of bleomycin were compared. The results indicate that using quantitative single photon emission computed tomography (SPECT) and a labeled tracer dose it is possible to predict what fraction of the dose of a chemotherapeutic drug will concentrate in an individual patient's tumor in vivo. They also show that, for bleomycin, escalation of dose will result in a proportional increase of tumor concentration. This increase depends on individual properties of tumors which can be measured quantitatively in vivo by SPECT and are expressed as percent of %ID/ml of tumor tissue.

Adolescent↗

PubMed1991

[Primary malignant lymphoma of the testis].

Among 715 patients with non-Hodgkin's lymphoma referred to this oncology center between 1973-1989, there were 7 (0.9%) with primary lymphoma of the testis. The mean age was 55 (range 23-78). The presenting symptom in all the 7 was testicular mass or swelling. 6 of them underwent inguinal orchiectomy and 1 had a testicular biopsy. The pathological subtype of the lymphoma in all 7 was the diffuse large cell type. The disease stage was IE in 3, IIE in 3 and IVE in 1. Only 1 had bilateral testicular involvement. 6 were treated primarily with various combinations of chemotherapy and 1 by radiotherapy. 3 developed recurrent disease (2 treated primarily with chemotherapy and 1 by radiotherapy) and died 14, 19 and 27 months, respectively, after diagnosis. 3 are alive with no evidence of recurrent lymphoma. Follow-up in an additional patient has been too short for evaluation. Primary testicular lymphoma is a relatively rare form of extranodal lymphoma. It has a tendency to early systemic progression and is potentially curable by aggressive combination chemotherapy.

Adult↗