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Biomedical subjects

M S Soloway

Publications and source records attributed to M S Soloway.

At least 253 records · Page 14Linked to original sources
PubMed1981

Side effects associated with intravesical mitomycin.

The nature and severity of side effects accompanying intravesical chemotherapy with mitomycin C were studied in 29 patients. No patient experienced systemic toxicity. Local side effects developed in 7 patients (24 per cent), and consisted of moderate cystitis in 3 and drug-related palmar desquamation, with or without generalized rash, in 4. Based on skin tests 3 of these patients were believed to have a contact dermatitis. The fourth patient had a generalized rash, in addition to palmar desquamation, that appeared after subsequent instillations of mitomycin C and the drug had to be discontinued. Careful cleansing of the hands and perineum on the day of treatment can prevent most skin reactions.

Aged↗
PubMed1981

Leiomyosarcoma of the bladder and subsequent urethral recurrence.

A case of leiomyosarcoma of the bladder with subsequent urethral recurrence is presented. Although it is well documented that urethral recurrence, or more likely new occurrence, is not uncommon following transitional cell carcinoma of the bladder, we believe that this is the first reported instance of a sarcoma of the bladder and urethral recurrence. Therefore, management of sarcoma of the bladder might include distal urethrectomy at the time of cystoprostatectomy.

Humans↗
PubMed1981

The effect of mitomycin C on superficial bladder cancer.

A course of intravesical mitomycin C, consisting of 8 weekly doses of 30 or 40 mg., was evaluated in 16 patients with superficial bladder cancer (stages O and A). Cystoscopically documented tumor was destroyed completely in 11 patients (69 per cent), while 3 patients exhibited partial tumor regression. Two patients had only multifocal, grade 3 carcinoma in situ and both had a complete response with negative biopsies and cytology at the 12-week evaluation. Toxicity was minimal. Further data, including longer followup, are needed to define the potentially promising role of this agent in the over-all management of superficial bladder cancer.

Aged↗
PubMed1981

Comparison of estramustine phosphate and vincristine alone or in combination for patients with advanced, hormone refractory, previously irradiated carcinoma of the prostate.

There were 121 men with hormonally refractory metastatic cancer of the prostate who were randomized to receive estramustine phosphate or vincristine, or the combination of these 2 agents. All patients had received prior radiation therapy (greater than 2,000 rad). There were 90 patients who could be compared for response. The objective response rates (partial regression or stabilization of disease) for the 3 treatment groups were 26 per cent for estramustine phosphate, 24 per cent for estramustine phosphate plus vincristine and 15 per cent for vincristine. Subjective parameters varied little among the 3 regimens. The median duration of response for those responding to estramustine phosphate was similar (20 weeks) to that for vincristine (22 weeks) and greater than that for the combination (13 weeks). The probability of survival did not differ significantly for patients randomized to each of the 3 regimens. The addition of vincristine to estramustine phosphate did not enhance the response rate achieved by estramustine phosphate alone and vincristine alone produced the lowest response rate. Estramustine phosphate continues to be the most active agent in previously irradiated patients with hormonally refractory metastatic cancer of the prostate.

Drug Therapy, Combination↗
PubMed1981

A comparison of hydroxyurea, methyl-chloroethyl-cyclohexy-nitrosourea and cyclophosphamide in patients with advanced carcinoma of the prostate.

This is the fifth completed randomized clinical trial of the National Prostatic Cancer Project. There were 125 patients with histologically confirmed relapsing clinical stage D prostatic cancer randomized to receive hydroxyurea, methyl-chloroethyl-cyclohexy-nitrosourea or cyclophosphamide. All patients had received and failed previous hormonal therapy. Patients whose disease progressed after 12 weeks on the initial therapy were crossed over or randomized to receive an alternate drug. There were 98 patients available for comparison of treatments. Objective responses included patients with complete or partial regression as well as stable disease. The response rates were 35 per cent for cyclophosphamide, 30 per cent for methyl-chloroethyl-cyclohexy-nitrosourea and 15 per cent for hydroxyurea. Subjective response parameters included improvement in performance status and relief of pain. Pain was improved in a fifth of the patients on each treatment area. Methyl-chloroethyl-cyclohexy-nitrosourea and hydroxyurea showed activity in advanced prostatic cancer patients but at the expense of excessive toxicity. Cyclophosphamide continues to be the most active single agent in this type of patient, particularly with regard to duration of response and survival. There was a statistically demonstrable advantage for cyclophosphamide over hydroxyurea and a marginal advantage over methyl-chloroethyl-cyclohexy-nitrosourea in survival experience.

Acid Phosphatase↗
PubMed1980

Urothelial susceptibility to tumor cell implantation: influence of cauterization.

In an effort to determine whether transitional tumor cells will preferentially implant on the cauterized urothelial surface, a reproducible technique for cauterization of a portion of the murine bladder was established. This technique simulated a transurethral fulguration of a bladder tumor in humans. Transplantable tumor cells (1 X 10(6)) were placed transurethrally into the bladder of 50 mice. Twenty-five of these mice each had a portion of their bladder cauterized prior to insertion of tumor cells. Implantation with subsequent tumors occurred in 54% of mice with cauterization, in contrast to 12% of mice with an intact urothelial surface (P less than 0.005). Intravesical thio-tepa, mitomycin C, and cis-platinum were capable of significantly reducing the incidence of implantation. These results suggest that seeding may be a contributing factor to the high recurrence rate following endoscopic resection or fulguration of bladder tumors and that intravesical chemotherapy initiated shortly after surgery may reduce the incidence of implantation.

Animals↗
PubMed1980

The effect of thio-TEPA on developing and established mammalian bladder tumors.

The inhibitory effect of thio-TEPA on both developing and established mammalian bladder cancer was tested in the FANFT model system using female C3H/He mice. This model allows the histologic evaluation of the entire target organ, a major advantage over clinical trials, which have relied largely on endoscopic appearance for determination of response. A powerful carcinogen, FANFT is known to cause bladder carcinoma in at least 90% of these animals within 12 months. The tumors develop through a spectrum of morphologic changes including hyperplasia, dysplasia, and carcinoma in situ. Animals were divided into equally sized control and test groups and either thio-TEPA or saline was administered on a schedule designed to correspond to that used in clinical trials. Bladders from 159 mice were evaluated grossly, microscopically and in some instances, ultrastructurally, for the presence of tumor or other intraepithelial lesions. When compared to controls, thio-TEPA had no statistically significant inhibitory effect on either developing or established bladder tumors. The drug did, however, cause a statistically significant decrease in the frequency of high-grade, high-stage lesions when given during tumor development and may retard the evolution of such neoplasms from low-grade noninvasive carcinomas. The correlation of these experimental findings with the reportedly beneficial results of clinical trials is discussed.

Animals↗
PubMed1980

Retroperitoneal fibrosis and aortic aneurysm.

A case of bilateral ureteral obstruction associated with an abdominal aortic aneurysm is presented. The increasing frequency of this association suggests investigation of the upper urinary tract in patients with an abdominal aortic aneurysm and abdominal ultrasound in patients with bilateral ureteral obstruction.

Aged↗
PubMed1980

Malignant fibrous histiocytoma of the kidney.

We report on a 33-year-old woman with malignant fibrous histiocytoma of the kidney. This malignant mesenchymal tumor is indistinguishable clinically and radiologically from a renal cell carcinoma. In our patient the tumor recurred locally following nephrectomy and metastasized to the lung. Post-nephrectomy radiation and chemotherapy may not alter the poor prognosis.

Adult↗
PubMed1980

Medroxyprogesterone in metastatic renal cell carcinoma.

We have described a patient in whom complete regression of pulmonary metastases from renal cell carcinoma (RCC) followed treatment with medroxy-progesterone acetate (Depo-Provera). Although the reported rate of objective response to progesterone therapy in RCC is only 10% to 15%, the occasionally dramatic results, especially in men, warrant a trial of this agent. Other more toxic agents have consistently failed to provide significant responses.

Adenocarcinoma↗
PubMed1980

Potential effects of edema on the pharmacokinetics of platinum in patients treated with cis-dichlorodiammine platinum (II).

The pharmacokinetics of platinum have been studied in an edematous patient and a non-edematous patient of equivalent body weight and renal function after each was treated with cis-dichlorodiammine platinum (II) for metastatic bladder cancer. Following each 15 minute intravenous CDDP infusion, the disposition of platinum was biexponential with a rapid distribution and slow elimination. While the rate of equilibration with peripheral fluids and tissues (lambda 2 phase) was slower in the edematous patient, the volumes of platinum distribution (V1 and Varea) were greater. This suggests that the increased fluid levels in the edematous patient serve as a platinum reservoir in both central and peripheral body areas. Moreover, it appears that platinum diffuses relatively slowly into peripheral edema fluid resulting in a slower distribution phase. An increased rate of platinum elimination (lambda 1 phase) was observed in the edematous patient. However, this observation was not anticipated and cannot be readily explained. Although further studies are indicated, these findings suggest that the increased volumes of platinum distribution in the edematous patient, coupled with the faster elimination, might require an adjusted CDDP dosage regimen for edematous patients.

Aged↗
PubMed1980

Morphological effects of mitomycin C administered intravesically to normal mice and mice with N-[4-(5-nitro-2-furyl)-2-thiazolyl]-formamide-induce bladder neoplasms.

The intravesical administration of mitomycin C to normal and N-[4-(5-nitro-2-furyl)-2-thiozolyl]formamide-induced bladder tumor-carrying mice at initial concentrations of 2 and 5 mg/ml for 2 hr resulted in marked morphological effects including cytoplasmic and nuclear abnormalities and disruption of surface architecture. Tumors cells and normal urothelial cells were sensitive to the effects of mitomycin C. These effects were limited to epithelial cells.

Animals↗
PubMed1979

Proximal stent displacement as complication of pigtail ureteral stent.

The indwelling ureteral stent recently introduced by Cook offers relative ease of placement with a self-curling end which prevents migration down the ureter. We have seen 4 cases of proximal migration of these stents. The reasons for this event are described. Our experience suggests the placement of a suture in the distal portion of the catheter to allow retrieval of the catheter should migration occur.

Adult↗