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Biomedical subjects

M B Garnick

Publications and source records attributed to M B Garnick.

At least 109 records · Page 6Linked to original sources
PubMed1982

Computerized tomography: how accurate for abdominal staging of testis tumors?

To assess the ability of computerized tomography to predict correctly the presence of retroperitoneal lymphadenopathy, a prospective study was performed on 30 patients with all stages of testis tumor. All patients underwent a computerized tomography scan within 1 week before retroperitoneal lymphadenectomy and the results then were correlated with gross and histologic findings. The computerized tomography scan suggested retroperitoneal lymphadenopathy in 14 patients, in 1 of whom no retroperitoneal lymphadenopathy was found at exploration (false positive, 7 per cent). The sensitivity (computerized tomography negative divided by true positive) was 90 per cent, for an over-all accuracy of 73 per cent. Most importantly, however, 7 of the 16 computerized tomography scans (44 per cent) interpreted as normal proved to be false negative. Of these 7 scans 5 were in patients with tumors classified as stage B2 or greater. We conclude that the computerized tomography scan, when positive, is highly likely to detect metastatic nodal involvement. However, the false negative rate, even in patients with tumor-filled lymph nodes 2 to 3 cm. in diameter, limits the reliability of a negative computerized tomography scan to exclude metastases. Technological improvements are needed to refine the technique and, thus, to reduce the false negative rate.

False Negative Reactions↗
PubMed1982

Pulmonary complications of chemotherapy regimens containing bleomycin.

Twenty patients with pulmonary complications associated with combination chemotherapy regimens containing bleomycin were studied to determine common patterns of pulmonary radiographic abnormalities. All patients were receiving bleomycin on one of two different regimens of combination chemotherapy. Ten patients with non-Hodgkin lymphoma received a relatively low dose (22-64 mg total) and 10 patients with testicular cancer received a higher dose (360 mg total). The high-dose group showed subclinical radiographic lung toxicity changes in eight (80%) patients during and after therapy. Chronic pulmonary abnormalities were seen in nine (90%) patients in the high-dose group but in only three (30%) patients in the low-dose group. These was no significant difference in the pattern and distribution of lung infiltrates in these two groups. Infiltrates involving mainly the costophrenic triangle were seen in 18 (90%) patients; in six (33%) of these the changes were confined to the costophrenic triangles bilaterally and nearly symmetrically. Five (25%) patients had infiltrates at the periphery of the lungs. Elevation of the diaphragm was seen in 16 (80%) patients. A pleural reaction without gross effusion was seen in nine (45%) patients, of whom five (55%) demonstrated thickening of the interlobar fissures. Chronic lung changes were mostly confined to the bases in the form of failure of reexpansion of the costophrenic triangle (55%), persistent elevation of the diaphragm (35%), and a reticular meshwork of fibrosis at the costophrenic triangles (25%). Minimal lung disease was manifest as ground glass appearance at the lung bases and as fine, linear or reticulonodular densities that involved the costophrenic triangles.

Adult↗
PubMed1982

Complications of retroperitoneal lymphadenectomy in the management of nonseminomatous tumors of the testis.

Retroperitoneal lymphadenectomy is the definitive operation for the accurate pathologic staging and treatment of Stage A, B1 and B2 nonseminomatous germ cell tumors of the testis. A review of 33 patients who underwent thoracoabdominal lymphadenectomy during a three year period yielded evidence of four minor complications and one major complication that resulted in the only operative death. The thoracoabdominal approach is preferred and allows one to palpate the ipsilateral thoracic cavity for unsuspected pulmonary metastasis to perform with greater ease bilateral dissection that includes a left suprahilar dissection, to use an extraperitoneal approach in patients without bulky abdominal disease--Stage B3 and C--and can be performed safely and with minimal morbidity and mortality by the well trained urologic surgeon.

Adolescent↗
PubMed1982

Ultrasonography as a diagnostic adjunct for the evaluation of masses in the scrotum.

One hundred and twenty-four patients underwent prospective preoperative examination of the scrotum with an advanced, commercial B-mode imaging system. There was reliable distinction between simple hydrocele and complex fluid collections. Particular attention was directed toward the problem of neoplastic disease mimicking, or masked by, clinical features of inflammatory disease. There were no false-negative results. Twenty-two patients were suspected of having a tumor of the testis upon ultrasonic examination; 19 were proved to have tumor. In only three patients were the diagnosis indeterminate. A high degree of correlation existed between the ultrasound and surgical and clinical confirmation. Ultrasound is a safe, simple, expeditious adjunct to improve the clinical diagnosis of masses within the scrotum.

Genital Diseases, Male↗
PubMed1981

Testicular cancer in a Russell-Silver dwarf.

A case of Russell-Silver dwarfism is described in which surgically corrected inguinal cryptorchidism was followed by advanced embryonal carcinoma. This case is noteworthy because 42 per cent of male Russell-Silver dwarfs have cryptorchidism, yet testicular malignancy in this syndrome has not been reported previously. Risk factors for the development of testicular cancer in this case include cryptorchidism, inguinal hernia and testicular atrophy. Optimal management of testicular abnormalities in the Russell-Silver dwarf is discussed.

Adult↗
PubMed1980

High dose methotrexate with leucovorin rescue. Rationale and spectrum of antitumor activity.

Methotrexate (MTX) in high doses (3 to 7.5 g/m2) with leucovorin rescue (HDMTX-LCV) can be delivered on a weekly basis in a setting of proper pharmacologic monitoring. Myelosuppression occurs in 28 per cent of the patients and in 8 per cent of the courses and usually results from delayed MTX excretion secondary to mild reversible nephrotoxicity. The incidence of tumor regression was 50 per cent in head and neck cancer; 59 per cent in non-Hodgkin's lymphoma; 40 per cent in small cell lung cancer; 24 to 50 per cent in breast cancer and 50 per cent in osteogenic carcinoma, for an over-all response rate of 39 per cent (70 of 178) in patients with disseminated cancer. HDMTX-LCV is not recommended for the conventional treatment of metastatic cancer because of the potential for toxicity and the fact that the response rates cited are probably not superior to those which can be achieved by conventional doses of MTX. However, the relative lack of myelosuppression and mucositis, when compared to conventional unrescued MTS, and the achievement of therapeutic concentrations of MTX in the central nervous system with the HDMTX-LCV program have led to its incorporation into clinical trials of combination chemotherapy.

Adult↗
PubMed1980

Prostatic adenocarcinoma, sarcoidosis and hypercalcemia: an unusual association.

A case is reported of hypercalcemia, prostatic adenocarcinoma and sarcoidosis. This represents the second reported occurrence of sarcoidosis and prostatic carcinoma, and illustrates the intriguing association between systemic sarcoidosis and malignancy. The reported experience demonstrating the association between sarcoidosis and malignant disease is reviewed.

Adenocarcinoma↗
PubMed1979

Metastatic carcinoma of the penis: complete remission after high dose methotrexate chemotherapy.

A case of extensive metastatic epidermoid carcinoma of the penis is reported. Disseminated disease developed after penectomy and lymphadenectomy and it continued to progress while the patient received radiation therapy. Chemotherapy with high dose methotrexate followed by citrovorum factor rescue was instituted. After completion of 10 weekly cycles of treatment there was biopsy-proved complete regression of all lesions, which lasted 9 months when the patient suddenly died of pneumonia completely unrelated to the tumor or chemotherapy treatment. This chemotherapeutic approach deserves additional trial in patients with advanced stages of penile carcinoma.

Carcinoma, Squamous Cell↗