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Biomedical subjects

M M Hreshchyshyn

Publications and source records attributed to M M Hreshchyshyn.

At least 19 recordsLinked to original sources
PubMed1995

Diagnosis of breast carcinoma with radiolabeled monoclonal antibodies (MoAbs) to carcinoembryonic antigen (CEA) and human milk fat globulin (HMFG).

The current study attempted to assess the potential proficiency of radioimmunodetection (RAID) of primary, residual, multicentric, and recurrent breast carcinoma using two radiolabeled murine monoclonal antibodies (MoAbs), anti-human milk fat globulin (HMFG1) labeled with iodine (123I) and anti-carcinoembryonic antigen (CEA) labeled with technetium (99Tc). Thirteen patients with suspicious clinical and/or mammographic primary or recurrent breast carcinoma were studied in a phase I-II prospective, consecutive, nonrandomized, noncontrolled study. Five patients received intravenous infusion with 0.5-2.0 mg anti-CEA MoAb type CYT 380 labeled with 99Tc [13-22 millicurie (mCI)] and 8 patients received intravenous infusion with 0.25-1.0 mg anti-HMFG1 MoAb (Unipath, U.K.) labeled with 123I (4-17 mCI). Both MoAbs used in this study demonstrated ability to bind specifically to breast cancer lesions, resulting in successful RAID in 10 of 12 of studied patients (5 of 5 patients in the anti-CEA-99Tc and 5 of 7 in the anti-HMFG-123I group--accuracy 83.3%). One patient was excluded due to protocol violation. Seven patients had true-positive scans when correlated with surgery (sensitivity 87.5%). The MoAb scans accurately diagnosed lesions in 3 of the 4 primary invasive breast carcinomas confirmed histologically. Presence of residual carcinoma following wide excision was established in 1 of 2 patients and presence of soft tissue metastases in 3 patients. Three patients had true-negative scan (specificity 75%): 2 patients presented with suspicious mammographic recurrence postlumpectomy and 1 patient had questionable soft tissue recurrence. One patient with primary breast carcinoma had a false-negative scan and another had a false-positive scan in the presence of fibrosis following lumpectomy and radiation therapy. No adverse reactions were noted in the patients studied. RAID findings were confirmed by immunohistochemistry in 6 of 9 cases studied. Our data suggest that radiolabeled MoAbs used in this study are potentially useful diagnostic agents for evaluation of primary or recurrent breast carcinoma, particularly in the areas where conventional methodology is limited.

Adult↗
PubMed1993

Treatment of advanced ovarian carcinoma in the elderly.

This study retrospectively analyzes the treatment of advanced ovarian cancer (Stages III and IV) in elderly patients (> or = 65) compared to that in younger patients (< 65). The purpose of this study was to identify possible treatment bias toward the elderly and to statistically analyze the nature of these differences. Seventy patients were evaluated of which 29 were identified as elderly and 41 as young. All patients were treated with platinum-based chemotherapy. Chi 2, log rank, Kaplan-Meier, and Cox model analyses were performed for multiple variables including age, grade of tumor, adequacy of surgery, and dose intensity. The elderly significantly differed from the young in the following analyses: median length of hospitalization, 20 days vs 11 days (P < 0.001); optimum surgery, 79.3% vs 97.5% (P = 0.02); initial chemotherapeutic dose reduction, 15.4% vs 0% (P = 0.02); median survival compared to age, 19.2 months vs 36.7 months (P < 0.03). When survival analysis was performed comparing 17 elderly patients and 40 younger patients who had optimum surgery and optimum initial chemotherapy, the median survival remained essentially unchanged, 22.0 months vs 36.7 months. There were differences in treatment intensity between young and old, however, the indications generally were valid and when analyzed by the Kaplan-Meier and Cox model, these differences became insignificant. It was concluded that when elderly patients can undergo aggressive surgical and chemotherapeutic management, survival remained significantly decreased for aged compared to younger patients. Physician bias was not a major factor accounting for the poorer survival observed in elderly patients. Age was the most significant variable related to survival and could not be accounted for by differences in adequacy of surgery or dose intensity.

Adult↗
PubMed1992

Prevention and treatment of osteoporosis. One of the most frequent disorders in American women: a review.

This review summarizes basic pathophysiology, epidemiology, classification and theories on the etiology of osteoporoses. Diagnostic, preventative and therapeutic aspects are discussed including the use of hormones and hormone analogues (estrogen, progestins, calcitonins, anabolic steroids), calcium, fluoride, bisphosphonates, vitamins D and their metabolites and the recently proposed "coherence therapy". Reference is made to new compounds under study including imidazoquinazolinones, methylxanthines and benzothiophenes.

Calcitonin↗
PubMed1991

The interferon system in carcinoma of the cervix. Effect of radiation and chemotherapy.

Thirteen patients with advanced carcinoma of the cervix were studied for parameters of the interferon system compared with 40 age-matched and sex-matched controls. All patients had measurable serum interferon levels; controls did not. All patients had non-antibody-type interferon-inhibitory activity, and controls had none. Interferon-synthesizing potential was higher in controls than in patients. After successful radiation and chemotherapy, these parameters normalized in the patients. No change was seen in one patient who did not respond to therapy.

Adenocarcinoma↗
PubMed1990

Pelvic radiation in stage I endometrial adenocarcinoma with high-risk attributes.

From 1977 to 1987, 45 patients with FIGO stage I endometrial adenocarcinoma with high-risk attributes and disease confined to the pelvis were prospectively treated with postoperative pelvic radiation. By study design, all patients underwent staging laparotomy with pelvic and paraaortic lymphadenectomy. All patients had either grade 1 or 2 adenocarcinoma and greater than 50% myometrial invasion or grade 3 adenocarcinoma with less than or greater than 50% myometrial invasion. The estimated 5-year survival for all 45 patients was 77% and the 5-year disease-free interval was 82%. Regional control was achieved in 89% of all patients, with 4% recurring at distant sites. When patients were stratified according to surgical-pathologic findings, 33 patients with disease confined to the uterus or uterus and pelvic nodes (surgical stage I) had estimated 5-year survival and disease-free interval of 88%. Of these 33 patients, 10 with grade 1 or 2 adenocarcinoma and deep myometrial invasion had 5-year disease-free intervals of 100%, while 23 patients with grade 3 adenocarcinoma with less than or greater than 50% myometrial invasion had disease-free intervals of 79 and 91%, respectively. From these results, it was concluded that patients with high-risk attributes demonstrated to have disease confined to the uterus or uterus and pelvic nodes can achieve excellent survival following surgical staging and postoperative pelvic radiation.

Adenocarcinoma↗
PubMed1989

Effect of physical activity on lumbar spine and femoral neck bone densities.

The lumbar spine and femoral neck densities of 123 and 141 normal adult women (50 +/- 10 years), respectively, measured by dual photon absorptiometry, were correlated with the number of hours of walking per day associated with their regular daily activities. This measure of exercise, obtained by detailed questionnaire and interview, was analyzed because it is regular, seasonally stable, and quantifiable. Both lumbar spine and femoral neck densities were significantly correlated with walking, with 0.8% and 1.9% increases in average bone density per hour of daily walking, respectively. This increase in density is substantial, considering that the age-related rate of bone loss in the same population is 0.7% and 0.5% per year of lumbar spine and femoral neck, respectively. This means that, on the average, a woman walking one additional hour per day has a femoral neck bone density comparable to that of a women 4 years younger who does not pursue this additional activity. This physical activity-associated enhancement of bone density may be critical at old age when osteoporosis is clinically manifested.

Adult↗
PubMed1989

Normal and abnormal features of the lumbar spine observed in dual photon absorptiometry scans.

Dual photon absorptiometry (DPA) is an extensively used technique for measuring the density of the lumbar spine. The presence of vertebral and extra-vertebral pathologies can lead to increased scatter of data and artifactual bias when constructing diagnostic reference value curves. The bone density of patients with such abnormalities cannot be compared with those of normals because it will appear artificially high. Furthermore, little effort has been made to identify and evaluate spinal abnormalities using the pictograms produced in this method. We have analyzed 60 DPA scans for morphologic changes, using x-rays for comparison, and have found practically complete concurrence between these two radiologic methods on features, though only the former is capable of accurately quantifying bone density. Examples of DPA presentation of anatomical morphology are shown to aid the user in interpreting DPA findings.

Adult↗
PubMed1988

Associations of parity, breast-feeding, and birth control pills with lumbar spine and femoral neck bone densities.

The relationships between parity, breast-feeding, and the use of birth control pills and the bone densities of the lumbar spine and the femoral neck, measured by dual-photon densitometry, were studied in normal women. Femoral neck density was found to decrease by 1.1% per live-birth, whereas lumbar spine density showed no significant association with parity. Breast-feeding was found to increase lumbar spine density by 1.5% per breast-fed child, whereas femoral neck density was not significantly correlated. No significant relationships between the use of birth control pills and the bone densities were found.

Adult↗
PubMed1988

Erythrocyte filterability in normal and high-risk pregnancy.

Erythrocyte filterability was studied longitudinally in normal pregnancy and in certain categories of high-risk pregnancy. Study subjects included ten normal controls, 12 insulin-dependent diabetics, eight gestational diabetics, and five essential hypertensives. Our results indicate that erythrocyte filterability remains relatively stable over the course of normal gestation. We noted no differences between controls and essential hypertensives or gestational diabetics, although a favorable effect of insulin therapy was suggested in gestational diabetics. Erythrocyte filterability and mean arterial blood pressure were not related. Insulin-dependent diabetics demonstrated a significantly elevated and widely varying erythrocyte filterability, and individual patient trends correlated well with outcome. Fibrinogen levels in diabetics rose precipitously and were significantly higher than normal throughout gestation. Fibrinogen levels paralleled changes in erythrocyte filterability, with the two parameters positively correlated. Mean glucose control had no influence on filterability. We conclude that in the diabetic pregnancy, varying erythrocyte filterability is related to altered fibrinogen metabolism and may contribute to perinatal morbidity.

Diabetes Mellitus, Type 1↗
PubMed1988

Effects of natural menopause, hysterectomy, and oophorectomy on lumbar spine and femoral neck bone densities.

Lumbar spine and femoral neck bone densities of women, aged 35-65, were measured by dual photon bone densitometry. After exclusion of women with spinal and other abnormalities, this study included 233 subjects: 60 menstruant, 91 who underwent natural menopause (56 more than 2 years post-menopause), 45 bilaterally oophorectomized, and 37 hysterectomized without bilateral oophorectomy. No significant differences were found between the age-normalized average bone densities of the menstruant, early postmenopausal, and late postmenopausal women; nor was there a difference between the rates of their bone loss. The bone densities of the hysterectomized women were significantly lower than those of the normals. The bone densities of the oophorectomized women were significantly lower than those of the hysterectomized patients. The rates of bone loss, however, were comparable in all groups studied. The use of estrogen without progestin was associated with significantly higher lumbar spine densities in the oophorectomized women, but showed no significant effect in any of the other groups.

Adult↗
PubMed1986

Partial and total skinning vulvectomy in treatment of carcinoma in situ of the vulva.

From July 1974 to December 1984, 24 skinning vulvectomies (17 partial and seven total) were performed in 24 patients with carcinoma in situ of the vulva. The objective for partial skinning vulvectomy was preservation of the cosmetic and functional integrity of the vulva in younger and sexually active patients in whom a steady increase in the incidence of vulvar intraepithelial neoplasia has been observed in the last decade. Two groups selected for partial skinning vulvectomy with skin graft were patients with multicentric vulvar intraepithelial neoplasia with colposcopic evidence of normal skin, and patients with localized but a wide surface area of vulvar intraepithelial neoplasia such that poor cosmetic results would be unavoidable should excision be approximated with primary skin closure. Only patients with involvement of the entire vulva were subjected to total skinning vulvectomy with total skin graft replacement. Recurrence and/or persistence were observed in two patients, both treated with total skinning vulvectomy. At present, all 24 patients remain free of detectable neoplasia on follow-up of six months to 11 years and all have very good cosmetic and functional results.

Adolescent↗
PubMed1985

CO2 laser therapy for cervical intraepithelial neoplasia.

One hundred and fifty-six patients with cervical intraepithelial neoplasia (CIN) were treated with CO2 laser and followed for 2 1/2 to 6 years. There were 19 recurrences, of which 14 occurred in patients treated with a power density of less than 1000 W/cm2 to a depth of 6 mm. All of the recurrences were subjected to a second laser treatment. Overall failure rate was 4.5%. The incidence of acute bleeding during, and late bleeding 6 to 14 days following treatment, were 8 and 4%, respectively. Late bleeding occurred in patients who were treated with 800 to 1000 W/cm2 power density and to a 3 to 10 mm depth of destruction. Complications were directly and failures were inversely proportional to the power density and depth of destruction. Following therapy, the transformation zone was adequately seen in the majority of the patients.

Adolescent↗
PubMed1985

Marker chromosomes of the long arm of chromosome 1 in endometrial carcinoma.

Cytogenetic studies were performed on endometrial specimens of four patients with hyperplasia, six with adenocarcinoma, and one with a mixed mesodermal tumor. Except for one cell, all 65 cells from the hyperplastic specimens had a normal female karyotype. However, a total of 92 cells from the five adenocarcinoma specimens had chromosome abnormalities, though all 20 cells from a specimen of a well differentiated adenocarcinoma showed a normal karyotype. The chromosome number and morphology of the aneuploid cells had minimal changes. The modal number of chromosomes was pseudodiploid in one case and hyperdiploid in four cases. Three kinds of structural abnormalities involving chromosomes #1 were identified to be of clonal origin: del(1p21) in two cases, tdic(1;16)(p21;q24) in one case, and i(1q) markers in two cases. Because the carcinoma cells had two chromosomes #1 of normal morphology, the presence of the marker chromosome led to partial trisomy or tetrasomy of the long arm of chromosome #1. This involvement may be assumed to represent a karyotypic change characteristic of some adenocarcinomas of the endometrium. Complex karyotypes with many rearranged chromosomes were observed in cells from the mixed mesodermal tumor. The karyotypic differences between endometrial carcinoma and the mixed medodermal tumor suggest that the genesis (and its mechanism) of the former may differ from that of the latter.

Adenocarcinoma↗
PubMed1984

A clinical and pathologic study of 30 cases of malignant mixed mullerian epithelial and mesenchymal ovarian tumors: a Gynecologic Oncology Group study.

Between November 1971 and June 1980, thirty patients with primary malignant mixed mullerian tumors of the ovary were entered into a Gynecologic Oncology Group registry and treatment protocol. The mean age of the patients is 60.4 years. Six were Stage II, twenty-three were Stage III, and one patient had Stage IV disease. Among the 30 cases, 15 were designated carcinosarcomas (CS) and 15 were mixed mesodermal sarcomas (MMS). Twenty-three of the thirty study patients died from 1 to 16 months following their initial surgery. Two of the seven living patients have persistent cancer at 11 and 54 months. Four patients were alive and well at 6, 11, 22, and 32 months at the close of the study. Of the 12 patients receiving vincristine, dactinomycin, and cyclophosphamide (VAC) with (8 cases) or without (4 cases) radiation therapy (RT), there were two clinical complete responses; both died with disease at 6 and 16 months. One of the six patients receiving adriamycin had a complete response (CR). She is alive with disease at 11 months. There was no apparent difference in the survival or stage distribution among the cases with CS and MMS. Survival was somewhat better for the patients with earlier stage disease or smaller residual tumor burden.

Adenocarcinoma↗