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Biomedical subjects

L Krishnan

Publications and source records attributed to L Krishnan.

13 recordsLinked to original sources
PubMed1992

Management of advanced squamous cell carcinomas of the maxillary sinus.

From 1970 to 1988, 41 cases of advanced maxillary sinus cancers were treated at the University of Kansas Medical Center. Local control for the 37 evaluable patients was achieved in 21 (57%). Local control by radiation therapy alone was achieved in ten of 19 (53%) patients compared with eight of 14 (57%) treated with a combination of surgery and radiation therapy. A dose greater than 6500 cGy correlated with better local control in patients treated with radiation therapy alone. Neck node failure occurred in three of 35 (8%) patients when not electively treated. Neck metastasis either at presentation or at a later stage reduced survival. The overall absolute survival for the entire group at 5 years was 35%. A combination of preoperative radiation therapy and surgery is recommended for patients with advanced-stage maxillary sinus cancer. Radiation therapy is an equally good alternative for those who are not surgical candidates or refuse surgery.

Aged↗
PubMed1992

Breast cancer with extensive intraductal component: treatment with immediate interstitial boost irradiation.

Extensive intraductal component (EIC) has been reported to have a prominent role in local recurrence after treatment of early-stage breast cancer with lumpectomy and irradiation. Pathologic specimens from 250 breasts (245 patients) treated between June 1982 and June 1990 with lumpectomy, immediate (boost) interstitial iridium-192 to 15-20 Gy, and external-beam irradiation to the entire breast to 45-50 Gy were reviewed. EIC was present in 61 breasts. At a median follow-up period of 58 months (range, 14-110 months), there were 10 recurrences in the 250 treated breasts. Of these 10, three were in patients from the group with EIC. The 10-year actuarial recurrence rates in breasts with and without EIC were 9.1% and 5.2%, respectively. The difference between the two rates was not significant. If an immediate boost with interstitial iridium is used in therapy, the influence of EIC on local failure is insignificant.

Adult↗
PubMed1992

Computerised neonatal case records: a four year experience.

A computerized system for neonatal case records has been used for the last four years at Kasturba Hospital. The software was developed in-house. The data base can be used to generate discharge summaries, neonatal statistics and epidemiological information. For a single patient, entry of data and printing of the discharge summary takes four to five minutes. Consolidated demographic and epidemiological statistics or selective clinical data for clinical research is easily retrievable. The system is efficient, accurate and easy to operate.

Humans↗
PubMed1991

In vitro and in vivo immunosuppressive effects of supernatants from human choriocarcinoma cell lines.

Local immunosuppression mediated by placental suppressor factors may contribute to the absence of consistently demonstrable cellular immunity against the fetus. In this context, we have investigated the immunosuppressive capabilities of supernatants from human trophoblastic choriocarcinoma cell lines (HCS) by testing the effects of HCS on immune responses in vitro and in vivo in the human and murine systems. HCS suppresses mitogen-induced proliferation and mixed lymphocyte reactions in humans and in mice, as well as antigen-induced T cell proliferation in mice. HCS also suppresses the in vivo response of mice to allogeneic cells. Furthermore, HCS when injected intraperitoneally causes the induction of suppressor cells in mice which in turn prevent the mounting of an allogeneic response in other strains of mice. These results indicate that human choriocarcinoma cell lines secrete a suppressor factor(s) which induces suppression in vitro as well as in vivo through the generation of suppressor cells.

Choriocarcinoma↗
PubMed1991

A review of the role of radiation therapy in the treatment of patients with breast cancer.

Irradiation has been used to treat cancer of the breast since 1895. Over the period between 1895 to the present, the therapeutic use of irradiation has evolved from a cauterizing agent to a sophisticated use of theory and practice to cause tumor cell death while at the same time producing maximum normal tissue sparing. The use of radiation has made it possible for the surgeon to use conservative breast sparing surgery to obtain excellent cosmetic results, while at the same time producing a local control equal to that of mastectomy. For the patient, conservative surgery becomes a better option than mastectomy because it not only produces local control equal to that of mastectomy, but gives the wonderful added benefit of a more superior and pleasing cosmetic result.

Antineoplastic Agents↗
PubMed1990

Radiobiological advantages of an immediate interstitial boost dose in conservative treatment of breast cancer.

Minimum surgery with irradiation is emerging as one of the main modalities of therapy for operable early breast cancer. Between June 1982 and June 1986, 110 breasts with Tis, T1 to T3 lesions have been treated at our institution with lumpectomy and interstitial irradiation to the tumor bed with Iridium-192 perioperatively followed by external beam irradiation. There have been two local recurrences at or near the vicinity of the primary, at a median follow-up of 60 months. To analyze the parameters that might have contributed to the local control, we have examined the treatment volumes, prescribed dose to the tumor bed, dose at the core of the tumor bed, and dose to the surrounding normal tissue. Immediate interstitial implant has the radiobiological advantage of delivering continuous low dose irradiation, immediately upon removal of gross tumor to residual foci. Implantation of the afterloading catheters intraoperatively facilitates accurate dose delivery and avoidance of geographical misses. By precise treatment of any residual foci, immediately upon removal of the gross mass, perioperative interstitial irradiation improves local control and by facilitating less radical surgical excision, leads to better cosmetic results.

Brachytherapy↗
PubMed1990

Dosimetric analysis in brachytherapy of carcinoma of the cervix.

Brachytherapy plays an essential role in the definitive radiation treatment of cervical carcinoma. The dosimetry of intracavitary irradiation is complex in that the optimum doses that can be delivered are dictated not only by the volume and extent of tumor but also by the close vicinity of dose-limiting structures, such as the small and large intestines, rectum, and bladder. To facilitate understanding of the relationships between the various dosimetric parameters involved, a retrospective analysis of 50 randomly chosen intracavitary insertions with Cesium-137 in 41 patients performed at our institution between 1975 and 1985 was carried out. All 50 cases utilized Fletcher-Suit-Delcos applicators and only the insertions using three sources in the tandem and one in each of the ovoids were included in this analysis. Using the AP and lateral radiographs and the lymphatic trapezoid, the reference points were obtained and transferred digitally to the treatment planning computer, and computerized dosimetry performed. In addition to the specified reference points, points were added and modified to obtain more complete information. The doses at the specified points were normalized to the average dose at AT, a reference point 2 cm superior to external os and 2 cm lateral to the tandem, and expressed as a percentage. It was noted that the average dose at the closest bladder point was 103 +/- 41% of the dose at AT, the maximum rectal dose 77 +/- 29% of the dose at AT and the maximum small bowel dose 65 +/- 16% of that at AT. The analysis of percent contribution of various sources to different reference points revealed that the dose to point AT was equally contributed to by all sources; bladder and rectal doses were mainly contributed to by the lowermost uterine and ovoid sources. Our analysis may provide a model for optimizing brachytherapy in cervical carcinoma.

Brachytherapy↗
PubMed1990

Testicular neoplasms: seminoma.

From 1969 to 1984, 58 patients with a diagnosis of testicular seminoma were seen and treated at the University of Kansas Medical Center. The median age was 34 years (range of 20 to 62 years). The American Joint Committee on Cancer Staging System was followed: stage I (34 patients); stage II (6); stage III (8); and stage IV (10). Forty-two patients had typical seminoma, and 16 had anaplastic histology. Nine patients had elevated B subunit of human chorionic gonadotropin, and nine had a history of cryptorchidism. Fifty-six patients received radiation treatment, and seven received chemotherapy with or without radiation. The median follow-up was 7 years (range 3 to 16 years). The overall disease-free (absolute) survival according to stage was: stage I, 91% (100%); stage II, 66% (80%); stage III, 75% (85%); and stage IV, 50% (50%). There were no late complications. The survival for patients with anaplastic histology or with elevated B subunit of human chorionic gonadotropin was not significantly different from that of typical seminoma.

Adult↗
PubMed1976

Antibiotic treatment of parturient women colonized with group B streptococci.

A prospective study was conducted among third-trimester parturient women with cervical or urethral colonization with group B streptococci to determine the influence of antibiotic treatment on subsequent colonizations among their infants. Cultures were obtained from dry swabs inoculated directly onto selective blood agar media containing neomycin and naladixic acid. Seventy-four women were found to be colonized among 1,098 cultured (7%). A significant reduction in colonization was noted among mothers treated with ampicillin within three weeks of completion of therapy. This difference was no longer apparent at delivery. There was likewise no difference in the colonization rate of infants in the treatment and no-treatment groups. The data suggest that additional measures must be undertaken to prevent maternal recolonization.

Ampicillin↗