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Biomedical subjects

F D Kitchin

Publications and source records attributed to F D Kitchin.

At least 19 recordsLinked to original sources
PubMed1986

Unilateral vs. bilateral retinoblastoma. Correlations between age at diagnosis and stage of ocular disease.

Retrospective analysis of 358 cases of retinoblastoma for correlation between age and intraocular stage at the time of diagnosis revealed: in both early and advanced stages of intraocular disease, bilateral retinoblastoma presents at an earlier age than does unilateral retinoblastoma; support for the Knudson "two-hit" hypothesis of retinoblastoma genetics, the existence of a positive family history for retinoblastoma does not guarantee an earlier age at diagnosis compared to sporadic disease; and for any age at diagnosis, unilateral or bilateral disease, Group V is the most common intraocular stage found.

Age Factors↗
PubMed1984

Second nonocular tumors in retinoblastoma survivors. Are they radiation-induced?

A review of 693 patients with bilateral retinoblastoma and 18 patients with unilateral/germinal retinoblastoma was carried out to find the incidence, time, course and pattern of second nonocular tumors in retinoblastoma survivors. Of 688 patients who survived therapeutic radiation for retinoblastoma, 89 developed second tumors: 62 in the field of radiation and 27 out of the field. Of 23 patients who received no radiation, five developed second tumors: one in the field and four out of the field. The most common tumor found was a sarcoma both in and out of the field of radiation. The incidence of second tumors increases with time, although the mean latent period is 10.4 years. At 10 years, the incidence of second tumors is 20%, at 20 years, it is 50% and at 30 years, 90%. The incidence of tumors in patients treated without radiation and where tumors developed outside the field was 10% at 10 years, 30% at 20 years and 68% at 32 years. There was no relationship between incidence of tumors and dose of therapeutic radiation when analyzed with life tables. A second course of radiation therapy did not increase the incidence of second nonocular tumors.

Brain Neoplasms↗
PubMed1984

Cytogenetic analysis of retinoblastoma: evidence for multifocal origin and in vivo gene amplification.

Retinoblastoma (Rb) is an uncommon childhood tumor of the neural retina with a significant genetic component in its etiology. A small proportion of patients have a deletion in chromosome 13 encompassing band 13q14, an observation which permitted the assignment of the RB1 locus to this region. About 20% of Rb tumors exhibit microscopic deletions of band 13q14 or monosomy 13. Trisomy 1q and i(6p) have also been reported in a high percentage of tumors. We analyzed the chromosome complements from direct preparations of 10 Rb tumors derived from seven patients. Modal chromosome numbers ranged from 45 to 48, and occasional duplications of the genomes were noted. In general, the tumors were chromosomally stable, although karyotypic evolution and random chromosome loss were encountered. Consistent abnormalities included trisomy 1q, i(6p), 6q-, and del(13)(q12----14). One patient with bilateral Rb had three tumor clones (two in one eye and one in the other) with chromosome abnormalities unrelated in origin. A second patient with unilateral Rb had two tumor clones with chromosome abnormalities again unrelated in origin. These two patients provide some of the first cytogenetic evidence for the multifocal origin of primary Rb. In the untreated tumor of a third patient, a homogeneously staining region (HSR) was detected in 1p32, indicating gene amplication in vivo; previously, an HSR at this site has been reported in the established Rb cell line Y79.

Adolescent↗
PubMed1984

Bleomycin-induced chromosome breakage in G2 lymphocytes of retinoblastoma patients.

Retinoblastoma (Rb) cells may be more sensitive to X-irradiation than normal cells when assayed for clonogenic survival, suggesting that such sensitivity can be used as a trait for detecting RB1 gene carriers. We studied induction of chromosome damage in lymphocytes from patients with Rb by the radiomimetic antineoplastic antibiotic, bleomycin (BL). Lymphocytes were treated in G2 for 4 h at four concentrations of the drug (0.0, 0.3, 0.9, and 2.7 micrograms/ml), and chromosome damage was evaluated. No difference in levels of spontaneous or induced damage was detected among hereditary Rb, non-hereditary Rb, and normal lymphocytes. The role of X-ray treatment in the induction of second tumors in Rb patients is discussed.

Bleomycin↗
PubMed1983

Retinoblastoma treated in infants in the first six months of life.

One hundred fifty-eight children with retinoblastoma received diagnoses and were treated during the first six months of life and then were observed for a mean of 7.4 years. The mean age at diagnosis was 3.6 months. Four patients received diagnoses at birth, one of metastatic disease. Ninety-four patients (60%) had leukokoria, reflecting the fact that 108 (68%) were initially seen with group V tumors (Reese-Ellsworth staging) despite their young age. One hundred seven (68%) were initially seen with bilateral retinoblastoma and 51 (32%) were seen with unilateral disease; in ten of the latter group, tumors later developed in the fellow eye. The eyes of 90 patients with bilateral involvement were asymmetric at first visit (that is, their eyes were involved at different stages of disease). Of 52 eyes receiving bilateral irradiation, 26 (50%) required further treatment, 23 (70%) of these for a resistant tumor and ten (30%) for new tumors. Despite the early age at diagnosis and treatment, 13 (25%) of treated eyes ultimately required enucleation. Metastatic retinoblastoma developed in ten patients and they died. Second, nonocular tumors developed in 13 patients. Early age at diagnosis does not ensure that the disease is caught at an early stage.

Eye Neoplasms↗
PubMed1982

The management of unilateral retinoblastoma without primary enucleation.

Sixty-six patients were treated "conservatively" for unilateral retinoblastoma. Forty-eight of 57 (84%) were treated primarily with unilateral radiation, one patient was treated with a cobalt plaque, and eight patients were treated with either cryopexy or xenon arc photocoagulation. With a median follow-up of 73 months, there have been no deaths. Five of 39 eyes that were in groups I to III have been salvaged. Virtually all eyes in groups IV and V (12 of 14) came to enucleation. The age at diagnosis for patients with a positive family history was early (2.5 months), and the patients had a greater number of individual tumors in one eye (2.4), compared with those without a positive family history (27 months, 1.2 tumors per eye). When unilateral retinoblastoma is detected at an early age, the most common sign is strabismus, not leukokoria.

Child, Preschool↗
PubMed1982

Retreatment of retinoblastoma with external beam irradiation.

A retrospective review of cases on file at the Ophthalmic Oncology Center of New York Hospital-Cornell Medical Center, New York, was undertaken to examine the effectiveness of a second course of radiotherapy on retinoblastoma. One hundred four patients were found to have been treated with at least two courses of external beam irradiation to one eye. All but one of the cases were bilateral, the other eye with more advanced disease having been previously enucleated. At the time the decision was made to repeat radiotherapy, 15 eyes could be classified group I, II, or III. Twelve (80%) of these eyes survived. Of the 89 eyes that showed more advanced growth (group IV or V), only two (2.2%) survived. In all, 14 of the 104 eyes wer saved--nine with useful (macula) vision, five without. Second nonocular tumors developed in 18 patients (22.8% of those who survived retinoblastoma itself). There appears to be no increased risk of second tumors from the second course of irradiation.

Child, Preschool↗
PubMed1982

Simultaneous ocular and orbital involvement from metastatic bronchogenic carcinoma.

A 64-year-old man presented with a nonrhegmatogenous retinal detachment, proptosis, and ptosis. Clinical examination, fluorescein angiography, B-scan ultrasonography and computed tomographic (CT) scan confirmed the presence of concomitant intraocular tumor and orbital mass. The CT scan of the chest and a lung biopsy specimen revealed the presence of an unsuspected asymptomatic bronchogenic carcinoma that rapidly developed widespread metastases. Metastasis to the eye from bronchogenic carcinoma may occur simultaneously with orbital metastasis, and this may be associated with rapid progression and growth.

Carcinoma, Bronchogenic↗
PubMed1981

Treatment of bilateral groups I through III retinoblastoma with bilateral radiation.

Thirty-seven patients with bilateral retinoblastoma, groups I, II, and III, were treated with simultaneous bilateral radiation. The median age at diagnosis was 4 months. Twenty-two of these patients were examined because of known history of retinoblastoma. Eight of these 22 patients had no evidence of retinoblastoma on at least one examination before the detection of retinoblastoma, and two had bilateral disease present at birth. Of 74 eyes treated, 39 required additional treatment and 11 ultimately were enucleated. Three patients died of metastatic disease. Seven patients subsequently had second nonocular tumors develop that were both in and out of the field of radiation.

Child↗
PubMed1981

Simultaneous bilateral radiation for advanced bilateral retinoblastoma.

A retrospective review of 1,424 cases of retinoblastoma disclosed 34 patients with advanced bilateral retinoblastoma whose sole initial treatment was simultaneous bilateral radiation. All patients had a combination of bilateral group IV or V retinoblastoma. Mean age at diagnosis was 13.1 months. Five-year survival of patients was 88% (28/32). In two (7%) of 28 surviving patients, a second nonocular tumor developed: one inside and one outside the field of radiation. Of the 64 eyes treated, 44 ultimately were enucleated. Of ten eyes requiring a second course of radiation, nine were enucleated. In only one eye was enucleation due to radiation complications. Eleven patients required additional treatment with light coagulation, cryopexy, or cobalt plaques.

Adolescent↗
PubMed1980

Osteogenic sarcoma of the humerus after cobalt plaque treatment for retinoblastoma.

A 13-year-old boy developed an osteogenic sarcoma of the right humerus ten years after treatment for bilateral retinoblastoma. The bilateral retinoblastoma has been managed with enucleation of one eye and successful treatment of the solitary tumor in the other eye with a single application of a local 10-mm round cobalt plaque. Patients with bilateral retinoblastoma have a significant (15 to 20%) chance of developing a second, nonocular, neoplasm. These neoplasms have occurred from one to 42 years after the treatment for retinoblastoma. The most common of these tumors is an osteogenic sarcoma; it may occur after external beam irradiation, local cobalt plaque, or no irradiation. The tumors may be in the skull or at distant sites whether or not these patients receive radiation.

Adolescent↗
PubMed1980

Lactate dehydrogenase in tears.

Lactate dehydrogenase levels in tears were measured in normal subjects and in patients with retinoblastoma. When specimens were collected without trauma in normal subjects, there were usually no detectable levels of lactate dehydrogenase. When the eyelids were rubbed (probably liberating epithelial cells) lactate dehydrogenase levels were detectable and were five to ten times those of normal aqueous humor. When lactate dehydrogenase isoenzymes in such specimens were analyzed, the level of lactate dehydrogenase 5 was always higher than that of lactate dehydrogenase 1 (similar to normal aqueous humor). While occasional patients with retinoblastoma do have elevated levels of lactate dehydrogenase in tears, it is uncertain if this is due to epithelial destruction or retinoblastoma itself. Lactate dehydrogenase in tears does not appear to be a useful test for the diagnosis of retinoblastoma given present techniques for collection and analysis.

Child↗
PubMed1979

Lactate dehydrogenase levels and isozyme patterns. Measurements in the aqueous humor and serum of retinoblastoma patients.

Lactate dehydrogenase (LDH) activity was determined in 24 cases of histologically proved retinoblastoma. The mean level was 1,825 IU/L, with a range of 10 to 15,920 IU/L. Twenty-two patients had elevated aqueous humor LDH levels. In two, the aqueous humor level was within the normal range. Student's t testing showed a highly significant difference between cataract and retinoblastoma aqueous humor. The retinoblastoma aqueous humor to blood ratio ranged from 0.045 to 58,529--not a good index of retinoblastoma. Isozyme patterns of retinoblastoma aqueous humor were statistically similar to those of normal cataract aqueous humor. The serum LDH level of cataract patients was not statistically different from that of retinoblastoma patients. The LDH 5/LDH 1 ratio of retinoblastoma aqueous humor ranged from 0.042 to 27.05--not a good index of retinoblastoma, as 28 of 34 aqueous samples of cataract patients had LDH 5 greater than LDH 1. Ten of 13 retinoblastoma patients had aqueous humor LDH 5 greater than LDH 1. The best index of the presence or absence of retinoblastoma is the total aqueous humor LDH level.

Aqueous Humor↗
PubMed1979

The treatment of orbital rhabdomyosarcoma with irradiation and chemotherapy.

Fifty-eight patients with orbital rhabdomyosarcoma were treated with irradiation alone (25) or irradiation and chemotherapy (33) with follow-ups of 6 months to 14 years (mean 5.2 yr). At present, 74% are alive and 26% have died. Local control of the tumor was accomplished in 91% of cases. When local sinuses were invaded the survival rate was 55%. Chemotherapy appears to be of greatest value when disease is limited to the orbit. Irradiation or irradiation and chemotherapy should now be the treatment of choice for orbital rhabdomyosarcoma.

Adolescent↗
PubMed1979

The occurrence of new retinoblastomas after treatment.

New separate tumors have developed in 11% of eyes containing retinoblastoma treated primarily with external beam radiation. The tumors were primarily found in the inferior retinal periphery and averaged 1.5 disc diameters in size. All of the tumors were controlled, with photocoagulation and cryopexy being the most frequently used treatments.

Child, Preschool↗
PubMed1977

Lactate dehydrogenase levels and isoenzyme patterns in the serum and aqueous humor of adult cataract patients.

Serum and aqueous humor lactate dehydrogenase (LDH) levels were assayed in 46 patients with senile cataracts at the time of cataract extraction. The mean aqueous level was 37 IU/liter and the mean serum level 152 IU/liter. In each case, the serum LDH level was higher than the corresponding aqueous LDH. The LDH isoenzyme levels were also determined; LDH 4 and LDH 5 were elevated in cataract aqueous samples, while the serum isoenzymes were normal. The LDH studies of normal and diseased globes must be rigorously standardized to avoid artificially high or low levels.

Adult↗