PubMed Health⌕ Search

Biomedical subjects

L E Wold

Publications and source records attributed to L E Wold.

At least 73 records · Page 4Linked to original sources
PubMed1989

Primary malignant bone tumors of the hand.

Malignant bone tumors of the hand are rare and few centers have extensive experience in the care of patients with these lesions. Eighteen patients with 22 lesions were evaluated at our institution. There were nine chondrosarcomas, four hemangioendothelial sarcomas, two cases each of osteosarcoma and fibrosarcoma, and a single case of Ewing's tumor. The average age of the patients was 39 years. Ten lesions each were located in the metacarpals and phalanges, with two lesions in the carpus. There were nine local recurrences, which appeared at an average of 24.5 months (range, 3 to 74 months). Curettage procedures resulted in the highest rate of local recurrence (85%). Three patients died of metastatic disease. Surgical control of these lesions requires careful preoperative planning and wide surgical margins. Regular oncologic follow-up is necessary.

Adolescent↗
PubMed1989

Lymphokine-activated killer (LAK) cell activity in tumor-infiltrating lymphocytes from non-small cell lung cancer.

Tumor-infiltrating lymphocytes (TILs) are often seen in non-small cell lung cancers (NSCCs). Their functional role in the pathogenesis of lung cancer is unknown. The authors studied TILs in 27 patients with NSCC and determined the following: (1) the immunologic phenotype as defined by monoclonal antibodies against various surface markers, (2) activation state as indicated by interleukin-2 (IL-2) receptor expression and the kinetics of proliferation response to IL-2, and (3) the ability to develop lymphokine-activated killer (LAK) type cytotoxicity against both natural killer (NK)-resistant tumor cell targets (M14) and fresh autologous tumor cells. The authors' results show TILs from NSCCs to be a heterogeneous population composed of T-cells, B-cells, monocytes, and NK cells in frequencies similar to those found in peripheral blood lymphocytes (PBLs). TILs demonstrated increased IL-2 receptor expression and a more rapid proliferative response to IL-2 than PBLs, implying activation of TILs by the tumor milieu. Finally, TILs generated cytotoxicity against NK-sensitive (K562) and NK-resistant (M14) cell line targets consistently after in vitro treatment with IL-2 but were less consistent in their ability to lyse fresh autologous tumor cells and less effective than PBL LAK cells in lysing all targets. Comparison with LAK cells generated from normal volunteers suggests that decreased killing of autologous tumor cells only partially results from an inherent resistance to lysis by fresh NSCC targets. It appears, therefore, that tumor cells taken from NSCCs are not readily killed by the immune cells that infiltrate the tumor stroma and that this failure does not result from nonspecific immune deficiency in TILs.

Adult↗
PubMed1989

Dedifferentiated chondrosarcoma of bone.

Dedifferentiated chondrosarcoma is a highly malignant variant of chondrosarcoma. Approximately 11% of chondrosarcomas can be expected to dedifferentiate into more anaplastic lesions. Radiographic evidence of a benign-appearing cartilage lesion adjacent to a lytic, highly aggressive lesion suggests dedifferentiation. Despite radical surgical treatment, the prognosis is unfavorable, with a 5 year survival rate of 10%.

Aged↗
PubMed1989

Interlaboratory variability of immunohistochemical stains. Results of the cell markers survey of the College of American Pathologists.

Immunohistochemical techniques have become commonplace adjunctive aids in anatomic pathology. Although much has been written describing modifications of the basic techniques, sensitivity, and specificity of reagents, little has been published regarding the interlaboratory variability in immunostain results on a given test sample. The Cell Markers Survey of the College of American Pathologists was organized to address this question of interlaboratory variability and to disseminate information on the techniques and reagents currently available.

Biomarkers↗
PubMed1989

Lesions of the breast in children exclusive of typical fibroadenoma and gynecomastia. A clinicopathologic study of 113 cases.

This large series of cases demonstrates that the breast of the child or adolescent is the potential site for a number of interesting lesions exclusive of fibroadenoma and gynecomastia. Adenoma of the nipple, juvenile papillomatosis, and juvenile or cellular fibroadenoma should be correctly diagnosed to insure conservative surgical management and appropriate clinical follow-up. The results of the Juvenile Papillomatosis Registry suggest that this lesion is a morphological marker of potentially more serious breast disease in the future. Recognition of a cellular fibroepithelial neoplasm, especially in young black females, as a cellular fibroadenoma will hopefully eliminate the need for the diagnosis of "benign" cytosarcoma phyllodes. On occasion, the equivocal case may be labeled a "phyllodes tumor fo indeterminate biologic behavior." Those neoplasms with stromal atypia and mitotic activity, overgrowth of stroma with epithelial dissociation, and sarcomatous elements are appropriately designated as cytosarcoma phyllodes. In contrast to vascular tumors of the breast in adults, the majority of vascular lesions in the child's breast are bening and represent either a capillary or a histiocytoid hemangioma. Our experience and reports in the literature support the conclusion that most malignancies of the breast in children are metastatic. Rhabdomyosarcoma was the most common example in our study, but secondary involvement by acute leukemia or malignant lymphoma also occurs.

Adenofibroma↗
PubMed1988

Aneurysmal bone cyst: clinicopathologic features and treatment of ten cases involving the hand.

Ten cases of aneurysmal bone cyst in the hand were identified among 208 such lesions in our institutional files. The patients (six women and four men) had a mean age of 27.3 years. Two patients had open physes. Seven lesions were in the metacarpals. Radiographic examination showed that in all cases the lesion was both expansile and completely lucent. There were no recurrences in the three patients treated by complete excision and bone grafting. Curettage and bone grafting in seven cases was associated with four recurrences. Three of these four local recurrences were treated successfully with curettage procedures. Treatment of aneurysmal bone cysts of the small bones of the hand requires either thorough exteriorization, curettage, and bone grafting or excision and bone grafting.

Adolescent↗
PubMed1988

Identification of atrial natriuretic factor within ventricular tissue in hamsters and humans with congestive heart failure.

In normal mammals, atrial natriuretic factor (ANF) is present within atrial myocardial cells but is absent from ventricular myocardium. In primitive organisms ANF is present within both atria and ventricle, suggesting that the ventricle may participate both in the synthesis and release of the hormone. The current study was designed to test the hypothesis that ventricular ANF develops as a homeostatic response to intravascular volume overload. Studies were performed on cardiac tissue obtained from (i) normal and cardiomyopathic hamsters, (ii) autopsied humans with and without cardiac disease, and (iii) living humans with congestive heart failure (CHF) undergoing diagnostic right ventricular endomyocardial biopsy. The myocardium was examined for the presence of immunoreactive ANF using a two-stage immunohistochemical technique, with nonimmune rabbit sera used as a negative control. There was unequivocal evidence of focal subendocardial deposits of immunoreactive ANF present in both of the ventricles of all six cardiomyopathic hamsters, four of five autopsied human subjects with CHF, and five of seven biopsied humans. No immunoreactive ANF was observed within the ventricular myocardium of control hamsters or normal humans. Utilizing crude tissue homogenates and radioimmunoassay techniques, the quantity of ANF was determined in cardiac atria, ventricles, and noncardiac skeletal muscle. Heart failure is characterized by a reduction in atrial ANF and an increase in ventricular ANF. This study demonstrates immunoreactive ANF is present within the ventricular myocardium in cardiomyopathic hamsters and humans with CHF, and suggests that the ventricle may be capable of responding to chronic volume overload by producing ANF.

Animals↗
PubMed1988

Randomized trial of observation versus adjuvant therapy with cyclophosphamide, fluorouracil, prednisone with or without tamoxifen following mastectomy in postmenopausal women with node-positive breast cancer.

Following mastectomy for node-positive breast cancer, 261 postmenopausal women were randomized to observation or adjuvant treatment with cyclophosphamide, fluorouracil, prednisone (CFP) alone or combined with tamoxifen (T). Doses used were: C, 150 mg/m2 intravenously (IV) days 1 to 5; F, 300 mg/m2 IV days 1 to 5; P, 10 mg by mouth 3 times daily on days 1 to 7; and T, 10 mg by mouth 2 times daily. A total of ten courses of treatment, administered every 6 weeks, was planned and T was stopped 6 weeks after the last course of CFP. Two hundred thirty-four patients were fully eligible and evaluable. With a median observation time slightly in excess of 5 years, the proportion of recurrences on each arm were: CFP, 29 of 75 (39%); CFPT, 29 of 71 (41%); and observation, 50 of 88 (57%). Relapse-free survival distributions for both CFP and CFPT were superior to observation (both two-sided P = .01). Considering prognostic factors in covariate analysis revealed two-sided P = .0006 for CFP v observation and P = .0003 for CFPT v observation. No substantial difference was identified between CFP and CFPT. Survival data are not yet mature with 31% dead; and, although slight separations of the curves exist in favor of the treatment arms, no significant differences in survival have been seen. Both adjuvant therapy programs are well tolerated and there were no treatment-related deaths. Further maturation of the data is required to determine if the advantages in relapse-free survival will be translated into any overall survival benefit which must be considered the goal of primary interest.

Aged↗
PubMed1988

Primary leiomyosarcoma of bone.

Adequate treatment of primary leiomyosarcoma of bone requires surgical ablation with the goals being those for any malignant tumor of bone--eradication of the lesion and preservation of as much function as possible. Careful preoperative staging will determine whether amputation is necessary or whether successful limb-saving resection is possible.

Aged↗
PubMed1988

Absence of intratubular germ cell neoplasia in testicular yolk sac tumors in children. A histochemical and immunohistochemical study.

The majority of testicular germ cell tumors in adults are accompanied by neoplastic intratubular germ cells; these cells were uniformly absent in ten pure yolk sac tumors (endodermal sinus tumors) of the testicle in children studied morphologically and immunohistochemically. These differences may reflect divergent pathogenetic mechanisms that in turn may explain the tendency for different histologic types of testicular germ cell tumors to occur at different ages and the discordant biologic behavior between germ cell tumors of similar morphologic type in children and adults.

Child, Preschool↗
PubMed1988

Prostaglandin synthesis by osteoid osteoma and osteoblastoma.

Osteoid osteomas are characterized clinically by a pattern of nocturnal pain which is exquisitely sensitive to salicylates. Etiology for the pain has been ascribed by previous investigators to the presence of nonmyelinated nerve fibers or to the effect of prostaglandins. In an effort to corroborate the potential role of prostaglandins in mediating the pain associated with this tumor, we have determined the concentration of prostaglandins E2, F2 alpha, 6-keto-F1 alpha, and thromboxane B2 utilizing radioimmunoassay of extracts of homogenated tumor tissue. Results were compared with similar extracts of normal bone and a variety of other osseous tumors. The increased concentrations of prostaglandin E2 found in cases of osteoid osteoma and osteoblastoma confirm studies of explants of these tumors previously recorded in the literature.

Bone Neoplasms↗
PubMed1987

Elective whole-lung irradiation in osteosarcoma treatment: appearance of bilateral breast cancer in two long-term survivors.

The effect of "prophylactic" lung radiation in preventing pulmonary metastasis was studied in a subset of patients with osteosarcoma. Benefit was not noted. Thirteen of the irradiated patients in the treatment group were females; in 2 of the 13, bilateral breast cancer developed approximately 15 years later. Radiation administered to the breast of an adolescent female carries a considerable risk of causing breast cancer.

Adolescent↗
PubMed1987

Breast cancer in residents of Rochester, Minnesota: incidence and survival, 1935 to 1982.

The incidence and survival rates for breast cancer among residents of Rochester, Minnesota, from 1975 to 1982 were compared with rates from 1935 to 1974. The age-adjusted incidence rates of breast cancer, after exclusion of patients with carcinoma in situ, increased 14% between the periods 1965 to 1974 and 1975 to 1982 (from 87.2 to 99.5 per 100,000 person-years). Much of this increase was due to the greater number of patients with less advanced disease: the frequency of both regional lymph node involvement and distant metastatic disease at initial diagnosis decreased. In addition, the incidence of carcinoma in situ more than doubled between the periods 1935 to 1944 and 1975 to 1982. These increased proportions of less advanced disease coincide with increased public and physician awareness of the importance of early detection. No change was demonstrated in overall survival during the study period, perhaps because the follow-up for the final study period was shorter than that for the previous periods. When divided into subsets by staging characteristics, only patients with distant metastatic disease had statistically significant improvement in survival over time (P less than or equal to 0.01)--from a median survival of 21 months in the period 1955 to 1974 to 28 months in the period 1975 to 1982. This increased survival is probably related to advances in therapy (such as combination chemotherapy). In addition, earlier detection of distant metastatic disease in the later study periods might have produced the apparent improvement in survival in this subgroup.

Adult↗
PubMed1987

Osteoid osteoma of the hand and wrist.

The average age of 19 patients with osteoid osteoma of the hand or wrist was 23 years (range, 8 to 70 years). Nine lesions were in the proximal phalanx, four in the distal phalanx, one in a middle phalanx, and one in a metacarpal. Two lesions were in the capitate, one of the hamate, and one in the triquetrum. The average time from onset of symptoms to successful treatment was 16 months. Fifteen of the 19 patients had had treatment elsewhere; 14 had had unsuccessful operative procedures, usually related to incorrect diagnoses. Sixteen patients had a minimum follow-up of 5 months (range, 5 months to 31 years; mean, 11 years) after operation. Surgical failure occurred in four patients with phalangeal lesions (two proximal and two distal). Three of the four patients subsequently were cured by reoperation, and the other patient obtained further treatment elsewhere.

Adolescent↗
PubMed1987

Second malignancies in patients surviving osteosarcoma.

Sixty-nine patients were identified who had survived for at least 10 years after therapy for ordinary-type intramedullary osteosarcoma and for whom adequate follow-up data were available to determine whether second malignancies had developed. Eight patients (11.6%) had developed second malignant tumors, 5 of whom had died of their second malignancies. Although these figures are higher than those expected for cancer incidence and death rates, the differences are not statistically significant.

Adolescent↗