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Biomedical subjects

J Kurtz

Publications and source records attributed to J Kurtz.

At least 55 records · Page 3Linked to original sources
PubMed1993

Ductal carcinoma in situ (intraductal carcinoma) of the breast treated with breast-conserving surgery and definitive irradiation. Correlation of pathologic parameters with outcome of treatment.

BACKGROUND: To evaluate the pathologic characteristics of the primary tumor relative to local control, survival, and freedom from distant metastases, an analysis was performed of 172 patients with ductal carcinoma in situ (intraductal carcinoma) of the breast treated with breast-conserving surgery and definitive breast irradiation. METHODS: The clinical records and pathology slides were reviewed from 172 women with ductal carcinoma in situ treated with breast-conserving surgery and definitive breast irradiation at multiple institutions in Europe and the United States. Central pathology review was performed by one pathologist without knowledge of the clinical outcome. The clinical outcome was measured in terms of local control, overall survival, cause-specific survival, and freedom from distant metastases. The median follow-up time was 84 months (range, 17-177 months). RESULTS: The pathologic parameters evaluated were histologic subtype, nuclear grade, amount of necrosis, and final pathology margin. The only pathologic parameter that correlated with the rate of local recurrence was the presence versus the absence of the combination of the histologic subtype of comedo carcinoma plus nuclear grade 3 (8-year actuarial rate of local recurrence of 20% versus 5%, respectively; P = 0.009 on univariate analysis; P = 0.017 on multivariate analysis). None of the pathologic parameters evaluated correlated with overall survival (all P > or = 0.16), cause-specific survival (all P > or = 0.13), or freedom from distant metastases (all P > or = 0.13). CONCLUSIONS: These results have demonstrated that there are important differences in the rate of local recurrence based on the pathologic characteristics of the primary tumor for women with ductal carcinoma in situ treated with breast-conserving surgery and definitive irradiation. However, the differences in local recurrence have not been associated with differences in survival or freedom from distant metastases. Careful follow-up for patients at increased risk for local recurrence is warranted because of the potential ability to salvage patients with local recurrence.

Adult↗
PubMed1993

Thyroid function before and after four-week light treatment in winter depressives and controls.

Thyroid function in patients in a current major depressive episode during the course of recurrent major mood disorder with seasonal pattern according to DSM-IIIR was compared to that of controls before and after 4 weeks' light treatment, and to that of controls at baseline and after 4 weeks' of arising early without exposure to bright light. No consistent abnormalities in thyroxine, free thyroxine index, triiodothyronine, reverse triiodothyronine, thyrotropin, thyrotropin response to TRH infusion, or thyroid autoantibodies were seen in depressives at baseline. No differences in these parameters were seen at baseline between depressives and controls. No intergroup differences were seen with treatment, although reverse T3 decreased significantly during the protocol in all groups. These data do not support the hypothesis that the thyroid axis plays a role in the pathogenesis of winter depressive symptoms or their response to light treatment.

Autoantibodies↗
PubMed1993

Conditioning the leukemic patient before allogeneic BMT: value of intensifying immunosuppression in the context of different levels of T lymphocyte depletion of the graft.

We have studied the value of additional immune suppression in BMT conditioning regimens in 45 patients with leukemia and 4 with myelodysplastic syndrome allografted between 1984 and 1991. A dose of 6 Gy total lymphoid irradiation (TLI) was delivered to 12 of 24 and 15 of 25 patients conditioned with 10 Gy and 12 Gy total body irradiation (TBI), respectively. Thirteen patients also received methylprednisolone (MP) before BMT to enhance immunosuppression. Differences in immunosuppression between the TBI with or without TLI or MP regimens and the influence of different levels of graft T cell depletion were measured in terms of transplant rejection, and complete versus mixed chimerism. The treatment-related complications were evaluated in terms of GVHD and incidence of pneumonitis. The overall transplant rejection rate was 6% (3 of 49). Complete chimerism was not significantly modified by increasing the TBI dose or by additional TLI (p > 0.10) but was more often seen in patients receiving MP given as pre-transplant immunosuppressor booster (p = 0.01). The incidence of GVHD was only influenced by the level of T cell depletion (p = 0.003). All 49 patients received a TBI lung dose in the range 9.5-10 Gy. A crude pneumonitis range of 19% (9 of 47 evaluable patients) was found. Neither the addition of TLI, MP nor the T cell depletion influenced the lung toxicity rate (p > 0.10) but pneumonitis was more frequent in patients with GVHD (p = 0.005).

Adolescent↗
PubMed1991

Ten-year results of breast-conserving surgery and definitive irradiation for intraductal carcinoma (ductal carcinoma in situ) of the breast.

An analysis of 259 women with 261 treated breasts from nine institutions in Europe and the United States was performed to determine the 10-year results of the treatment of intraductal carcinoma of the breast with definitive irradiation. All patients had undergone complete gross excision of the primary intraductal carcinoma, and definitive breast irradiation was delivered in all cases. The median follow-up time was 78 months (range, 11 to 197 months). The 10-year actuarial overall survival rate was 94%, and the 10-year actuarial cause-specific survival rate (including deaths only from carcinoma of the breast) was 97%. The 10-year actuarial rate of freedom from distant metastases was 96%. There were 28 failures in the breast, and the 10-year actuarial rate of local failure was 16%. The pathologic type of local recurrences showed invasive ductal carcinoma in 14 of 28 recurrences (50%) and noninvasive ductal carcinoma in 14 of 28 recurrences (50%). The median time to local failure was 50 months (range, 17 to 129 months). Twenty-four of 28 patients with local failure were salvaged with additional treatment, generally mastectomy, and 4 of 28 patients with local failure subsequently had distant metastases. Median follow-up time after salvage treatment of breast recurrence was 29 months (range, 3 to 90 months). Two patients without local failure subsequently had distant metastases, one of which occurred after a node-positive, contralateral breast carcinoma. These results demonstrate high rates of overall survival, cause-specific survival, and freedom from distant metastases for the treatment of patients with intraductal carcinoma of the breast. The local recurrences within the treated breast were generally salvaged with additional treatment, although with limited follow-up. Because of the long natural history of intraductal carcinoma of the breast, prolonged and careful follow-up of patients after breast-conservation and definitive irradiation is required.

Actuarial Analysis↗
PubMed1989

Factors contributing to erythrocyte lithium-sodium countertransport activity in lithium-treated bipolar patients.

Clinical and biochemical factors related to the activity of the erythrocyte lithium-sodium countertransport (LSC) system were investigated during lithium prophylaxis in 27 patients (13 male, 14 female) with bipolar affective illness. No relationship was found between erythrocyte LSC and such factors as age, gender, duration of lithium prophylaxis, quality of prophylactic lithium response, and family history of affective illness. There was a significant negative correlation between the activity of LSC and the magnitude of the erythrocyte lithium ratio both in whole group and in female patients. In seven patients with concomitant hypertension, the relationship between high activity of LSC and hypertension was not demonstrated. The levels of total cholesterol, HDL cholesterol, triglycerides, and potassium related neither to LSC activity nor to hypertension. Erythrocyte LSC in patients with lower TSH levels were significantly reduced compared to patients with higher TSH. The values of TSH were negatively correlated with T4 but not with T3. Concentrations of T3 were positively correlated with plasma total cholesterol levels. These results are discussed in the view of recent findings on erythrocyte LSC.

Adult↗
PubMed1986

Specific integral dose: a reconsideration of the integral dose concept.

The integral dose represents the total energy deposited by ionizing radiation within a body. Its distribution within normal tissues can be quite variable, depending upon beam energy and radiation technique. A close look at the concept of integral dose in its various forms should be helpful in quantifying the radiation burden borne by healthy tissues outside of the target volume. The integral dose, integral target dose and relative integral target dose will be reviewed, and the concept of specific integral dose will be introduced, using as examples the external irradiation of the urinary bladder employing various energies and techniques, as well as the intracavitary therapy of gynecological cancer using an afterloading apparatus.

Brachytherapy↗
PubMed1984

Heart rate and sleep time: their relationship with growth and adiposity in male infants.

In a clinical trial based on the direct relationship between heart rate activity and energy expenditure during awake and asleep states, 21 healthy 18-month-old infants had their heart rate monitored over a period of 24 h and correlated with their nutritional intake, growth parameters, and measurements of adiposity (fat cell size and skinfold thickness). Infants with higher 24-h and asleep heart rates had smaller fat cells (r = -0.50) and skinfold thickness (abdominal r = -0.70, suprailiac r = -0.80, triceps r = -0.67). Infants with higher relative weight had higher heart rates during awake periods (r = 0.60). Infants sleeping for longer periods had higher weight gain velocity from birth (r = 0.51) and higher relative weight (r = 0.54). This study demonstrates the heart rate activity and duration of sleep are related to growth and adipose tissue deposition during infancy.

Adipose Tissue↗
PubMed1980

[Present problems of addiction (author's transl)].

First the threatening increase of dependence on alcohol, medicines and illegal drugs is illustrated by reference to some statistics. After consideration of the causes of the increase of diseases of addiction, countermeasures are discussed. Possibilities for the practising doctor and possibilities for clinical treatment including juridical certification are put forward. In the treatment of misuse as a pre-form of addiction, the concept of an addiction group is presented in detail. This group is intended to enable the patient to find a definite place within his development of addiction by a combination of rational information and emotional learning.

Alcoholism↗
PubMed1980

Fast neutron teletherapy for advanced carcinomas of the oral cavity and soft palate.

A retrospective study was performed to determine the efficacy of using fast neutron radiation for treating advanced squamous cell carcinomas of the oral cavity and soft palate. The majority of patients were judged to have less than a 10% 5-year survival with conventional medical treatment. Fifteen patients with oral cavity tumors were treated for cure with neutrons alone and six were treated with a combination of neutrons and photons as part of a mixed beam fractionation scheme. In the neutron-only group, the complete regression rate was 33% in the mixed beam group, the rate was 50%. Five patients who had squamous cell carcinomas of the soft palate were treated for cure, one with neutrons alone and four with a mixed beam regimen. The complete regression rate was 100%. The two-year NED results are comparable with literature results for more selected groups of patients with oral cavity and soft palate tumors treated by conventional photon therapy. The acute treatment morbidity was perhaps somewhat greater in the subgroup of patients treated with neutrons alone, and this subgroup later developed a more pronounced subcutaneous fibrosis. Morbidity associated with the mixed beam treatment regimen was comparable to that associated with conventional radiotherapy.

Carcinoma, Squamous Cell↗
PubMed1978

Astrovirus gastroenteritis age distribution of antibody.

Astrovirus antibody was detected by immunofluorescence using infected primary human embryo kidney cultures as antigen. Of 87 Oxford children aged 0--10 years, only 7% in the 6 to 12-month-old group had antibody. The percentage of children having evidence of past infection rose progressively in the 1--4 age range and 75% of the 5 to 10-year-old group possessed astrovirus antibody. Fifty-four (77%) of a group of 70 young adults likewise had antibody.

Age Factors↗