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Biomedical subjects

F C Sparks

Publications and source records attributed to F C Sparks.

At least 19 recordsLinked to original sources
PubMed1990

Percutaneous drainage of a diverticular abscess can make colostomy unnecessary in selected cases.

Diverticular abscess is a common acute abdominal problem in patients over 50 years of age and may require single or multiple operations. Percutaneous drainage of the abscess may permit a single operation in selected patients, making a colostomy unnecessary. This approach is probably underutilized and should become the procedure of choice in selected patients with no other medical problems such as immunosuppression. We report two patients, including one with a fecal fistula, in whom percutaneous drainage converted a situation in which two operations, one with a colostomy, would have been required, to a single operation without a colostomy. This approach saves about $7,000 per patient. The avoidance of colostomy and the cost savings make this approach attractive in selected patients with diverticular abscesses.

Abscess↗
PubMed1986

Adjuvant chemo-immunotherapy in stage II carcinoma of the breast.

From July of 1974 to June of 1978, 131 patients with Stage II carcinoma of the breast were randomly assigned to one of three treatment arms in order to assess the efficacy of adding immunotherapy to adjuvant chemotherapy. All patients had metastases in the axillary lymph nodes, but no clinical evidence of systemic disease. Prognostic factors were relatively equally distributed among the three treatment arms. All patients received adjuvant chemotherapy consisting of cytoxan, methotrexate, and 5-fluorouracil (CMF). In addition, patients received adjuvant immunotherapy consisting of Bacille Calmette Guerin (BCG) or BCG plus a tumor cell vaccine. This vaccine was a mixture of allogeneic breast cancer cell lines grown in tissue culture. Fourteen patients receiving tumor cell vaccine developed hepatitis B, leading to the abandonment of this arm of the study. Side effects of chemotherapy were tolerable. No statistically significant difference could be demonstrated in recurrence rate or survival. However, the two groups receiving adjuvant chemo-immunotherapy had a slightly shorter time to recurrence and lower overall survival. The use of chemo-immunotherapy as administered in this study did not improve the clinical course of patients with Stage II breast cancer and was associated with significant morbidity.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1979

Adjuvant chemotherapy for breast carcinoma: psychosocial implications.

Fifty women receiving adjuvant chemotherapy after surgery for Stage II breast carcinoma were interviewed in an effort to describe the psychosocial effect of the treatment. Perceptions of emotional distress and behavioral disruption were rated in five areas, yielding a rating of overall level of disruption and distress. Results showed that all women experienced adverse changes while receiving adjuvant treatments. Of the 50 women, 88% described a decrease in activities related to the effects of adjuvant chemotherapy; 54% reported an increased financial burden; and 41% claimed that their family and/or sexual life had been adversely affected. Despite these adverse changes, 74% of these patients "would definitely" recommend the treatment to friends in a similar situation. Results from this preliminary study may provide useful information to potential participants in adjuvant trials and to the physicians who conduct such trials.

Activities of Daily Living↗
PubMed1979

Intratumor bacillus Calmette-Guerin therapy for chest wall recurrence of carcinoma of the breast.

Intratumor bacillus Calmette-Guerin administration is effective for treating chest wall recurrence from carcinoma of the breast in selected patients. Our results suggest that bacillus Calmette-Guerin therapy can be used alone, with systemic chemotherapy, hormonal therapy or in previously irradiated tissue. It represents local treatment for local disease that is well tolerated. Intratumor bacillus Calmette-Guerin treatment is a useful clinical method for the treatment of local chest wall disease.

Adult↗
PubMed1979

Treatment for melanoma of the lower extremity with intralesional injection of bacille Calmette Guérin and hyperthermic perfusion.

Twenty-seven patients with locally recurrent melanoma of the lower extremity were treated during a six year period. Recurrences were noted with primary lesions, at Clark's level II, III, IV or V, greater than 1.7 millimeters in depth of invasion and included intransit metastases, satellitosis, subcutaneous metastases and combinations of the three. Median time to recurrence was 12 to 14 months whether or not lymphadenectomy had been performed or lymph node metastases were present. Local recurrence was treated initially with intratumor bacille Calmette Guérin; 20 of 27 patients had complete or transient disease control and 14 patients were alive at 1.5 to 55.0 months. More responders reacted to dinitrochlorobenzene and purified protein derivative skin tests, although these parameters did not predict response to therapy. If intratumor bacille Calmette Guérin therapy did not control local disease or if the disease progressed toward the upper third of the thigh, patients underwent hyperthermic perfusion with L-phenylalanine mustard. Nine patients underwent ten therapeutic perfusions with objective response in seven of nine, with five being alive at two to 65 months. Intratumor bacille Calmette Guérin therapy and subsequent hyperthermic perfusion in bacille Calmette Guérin failures are rational treatment alternatives for locally recurrent melanomas of the extremity.

Adult↗
PubMed1978

Breast cancer presenting as renal colic.

A unique case of breast cancer presenting as renal colic due to ureteral obstruction is presented. Although antemortem diagnosis has been uncommon, ureteral metastases frequently are found in autopsy studies. Improvements in the management of patients with disseminated breast cancer may lead to more frequent recognition of this problem. Therapy should be directed against the tumor in general, and not specifically against the ureteral lesion unless renal function is jeopardized. Hormonal manipulation is the treatment of choice in patients with estrogen receptor-positive tumors. Ureteral catheterization or urinary diversion should be attempted only in combination with systemic injury.

Breast Neoplasms↗
PubMed1978

The effect of intramural injection of immunotherapeutic agents on bladder histology and systemic humoral response.

Bacillus Calmette-Guerín (BCG), Corynebacterium parvum, and various mycobacterium fragments were injected intramurally into mouse bladders and the resulting systemic humoral stimulation and local histologic reactions were evaluated. C. parvum and methanol extracted residue of BCG elicited significant immunostimulation without producing irreversible bladder damage. The severe histologic disruption caused by BCG could be reduced by the antituberculus drug isoniazed without abrogating the humoral stimulation. Intramural bladder injection of BCG produced greater humoral stimulation than subcutaneous administration.

Animals↗
PubMed1977

Effect of dose, route, and schedule of BCG on antibody titer and survival of murine skin grafts across a weak histocompatibility barrier.

Skin was transplanted from male to female C57BL/6JRC mice. Bacillus Calmette-Guérin (BCG) was administered once subcutaneously, intramuscularly, or intraperitoneally either 14 days prior to grafting or on the day of grafting in a dose of 5 X 10(5), 5 X 10(6), or 5 X 10(7) microorganisms. Serum antibody to BCG was assayed using complement fixation. There was a linear inverse relation between skin graft rejection and dose of BCG (p less than .01) such that the lowest dose of BCG was the most effective. The IM and SQ routes were more effective than the IP route. Schedule did not have significant effect on skin graft survival. Time to appearance of antibody correlated directly with dose. The prolonged survival of skin grafts combined with early appearance of antibody to BCG suggested that high doses of BCG could result in antigenic competition.

Animals↗
PubMed1977

Effect of isonicotinic acid hydrazide on the intratumor injection of BCG.

Rats with established subcutaneous tumors were treated by repeated intratumor injections of BCG over a 5-week period. Isonicotinic acid hydrazide (INH) was given to some rats to determine if this drug decreased the effect of BCG on local tumor growth. INH alone had no effect on either survival or tumor volume. Rats treated with either BCG or BCG and INH had prolonged survivals and smaller tumor volumes than did controls rats. In these experiments, INH did not decrease the effect of BCG on local tumor growth. However, the intratumor injection of BCG in rats receiving INH systematically was associated with better survival and smaller tumor volumes compared to the intratumor injection of BCG alone.

Adenocarcinoma↗
PubMed1977

Primary melanoma of skin of the breast region.

Primary melanoma of skin of the breast region accounted for less than 5% of all malignant melanomas. During a two-year period, 12 patients were seen with these unique lesions. It appears that wide excision and prophylactic lymphadenectomy, including radical mastectomy, gave the best long-term local and regional control. Dissection of the internal mammary nodes did not seem to be beneficial. Pertinent literatures emphasizing several important pathological factors which correlate with higher incidence of metastases to the regional lymph nodes are reviewed. A rational therapeutic approach, synthesizing above information and incorporating postoperative adjuvant immunotherapy, is suggested.

Adult↗
PubMed1977

Systemic therapy for metastatic breast cancer.

The data reviewed in this conference suggest that initial therapeutic decisions for patients with metastic breast cancer be based on the presence or absence of an estrogen receptor in the tumor. Patients with estrogen receptor in their original primary breast cancer or in a subsequent metastitic lesion are candidates for hormonal manipulation, whereas patients lacking estrogen receptor in their tumor are treated for their metastic disease with nonhormonal chemotherapy. Nonhormonal therapy usually consists of a combination of cytotoxic drugs including cyclophosphamide, methotrexate, and 5-fluorouracil (CMF). Other programs of combination chemotherapy are under active study, especially programs that include nonspecific immune stimulation with Corynebacterium parvum or bacillus Calmette-Guérin (BCG). Inasmuch as patients with Stage II primary breast cancer frequently have "micrometastatic" disease, combination chemotherapy is also under study as an adjuvant to surgery. Preliminary results strongly support the use of such therapy.

BCG Vaccine↗
PubMed1977

Monitoring immunotherapy with Bacillus Calmette-Guérin by antibody titer.

Antibody titer to Bacillus Calmette-Guérin (BCG) was determined by complement fixation in 111 normal volunteers and 83 melanoma patients. In 43 of these melanoma patients, sequential determination of antibody titer was made and correlated with clinical course. Low titers of antibody to BCG were found frequently in normal volunteers and in melanoma patients prior to BCG immunotherapy. The typical response to BCG immunotherapy was a rapid rise of antibody titer to high levels. Six of 19 patients with recurrence had disappearance of antibody preceding clinical recurrence by up to 5 months. In 13 of 40 patients receiving BCG, serum antibody was a better indicator of the patient's response than measurement of delayed cutaneous hypersensitivity to purified protein derivative. These results suggest that measurement of the antibody response to BCG may be useful in developing an optimum mode of BCG immunotherapy as well as predicting clinical recurrence in patients with melanoma.

Antibodies, Bacterial↗
PubMed1977

Effect of pelvic and retroperitoneal surgery on the urethral pressure profile and perineal floor electromyogram in dogs.

Study of the urethral pressure profile and perineal floor electromyogram in 12 dogs subjected to colonic resection, abdominal vascular stripping, and pudenal nerve transection suggest that specific defects in urethral continence function may follow pelvic and retroperitoneal surgical dissection. These alterations, attributable to damage of the pudendal nerves and the sympathetic fibers in the posterior peritoneum, must be accurately evaluated before treatment of postoperative urodynamic problems.

Animals↗