Hematocolpos with urinary tract obstruction in an adult.
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Biomedical subjects
Publications and source records attributed to M S Soloway.
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The suggested activity of doxorubicin hydrochloride (Adriamycin), cyclophosphamide, and 5-fluorouracil as single agents in the treatment of advanced prostate and/or transitional cell carcinoma led us to examine the response to these drugs used in combination. Combination chemotherapy has the theoretical advantages of additive antitumor effect without additive toxicity to the host. One of 8 patients with Stage D, endocrine unresponsive prostatic adenocarcinoma achieved an objective response. There were five stable and one subjective responses. Only 1 patient showed progression during the initial six-week trial. Two of 3 patients with transitional cell carcinoma had an objective response. This three-drug combination was well tolerated by elderly patients and on the basis of this small series further trials are warranted.
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Several antitumor agents have been evaluated for their effectiveness in reducing the implantation and progressive growth of transitional cell carcinoma in an animal model. This system allows the evaluation of both the topical cytotoxic action as well as the systemic toxicity of the drugs given intravesically. Systemic cyclophosphamide and intravesical epipodophyllotoxin significantly reduced the incidence of tumor cell implantation.
This study sought to determine if tumor immunity was impaired by regional lymphadenectomy when performed at different stages of tumor growth. Regional lymphadenectomy significantly reduced tumor specific immunity when performed soon after tumor inoculation. However, removal of the regional lymph nodes later but before the tumor was clinically detectable did not affect the development of tumor immunity. Similarly, regional lymphadenectomy after the tumor was palpable did not decrease tumor immunity. Therefore, prior to the time that the tumor is clinically detectable, immunologic sensitization has become a systemic phenomenon and is no longer confined to the regional lymph nodes.
Single and combination chemotherapy was evaluated for antitumor activity against N-[4-(5-nitro-2-furyl)-2-thiazolyl] formamide (FANFT)-induced bladder carcinoma in syngeneic mice. Two hundred fifty C3H/He mice having ingested FANFT for 10 months were randomly divided into groups of 30, and the following regimens initiated: cyclophosphamide (Cy), cis-diam-minedichloroplatinum (cis-Pt-II), dactinomycin, adriamycin, Cy plus cis-Pt-II, Cy plus 5-fluorouracil, and Cy plus adriamycin. The drugs were administered for 3 weeks. Each regimen was capable of producing a significant reduction in the mean bladder weight (MBW) when compared to a groups not receiving therapy (108.3 mg). Adriamycin (MBW equal 69.5), dactinomycin (49.6), and cyclophosphamide (42.9) were the best single agents, but the greatest inhibition of tumor growth was achieved by the combination of cyclophosphamide with 5-fluorouracil (38.3) or adriamycin (37.3). These combination chemotherapeutic regimens were able to effect a significant reduction in the number of bladders with Stage C tumors. It is hoped that information gained from this new animal model which allows evaluation of many antitumor drugs within a relatively short period of time will lead to therapeutic trials in patients with locally advanced or metastatic bladder cancer.
This study sought to determine whether or not transitional carcinoma cells can adhere and progressively grow on normal or inflamed bladder urothelium. Inflammation was produced by intravesical N-methyl-N-nitrosourea. Tumor cell implantation occurred in only 13 per cent of mice with normal bladder, whereas in the presence of an altered urothelial surface ther was a 60 per cent incidence of tumors. This study not only has clinical implications but also offers a model to investigate modalities to prevent tumor cell implantation.
L-ascorbic acid has been shown to reduce the elevated level of urinary chemiluminescence found in patients with bladder cancer. Thus, it has been suggested that vitamin C might be efficacious in bladder tumor prophylaxis. However, there is no clinical evidence to support this thesis. We evaluated whether L-ascorbic acid given concomitantly with the urinary carcinogen FANFT was capable of reducing the incidence of subsequent bladder tumors. No inhibitory effect was observed. Unless evidence is obtained demonstrating bladder tumor prevention by L-ascorbic acid its routine administration to patients with bladder cancer is not indicated.
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