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Biomedical subjects

R D Hilgers

Publications and source records attributed to R D Hilgers.

89 records · Page 5Linked to original sources
PubMed1983

The Syed-Neblett interstitial template in locally advanced gynecological malignancies.

Twenty-eight patients with locally advanced malignancies of the cervix and vagina were treated with a combination of external radiation therapy and afterloading Syed-Neblett iridium template. There were 22 patients with squamous cell cancer and two patients with adenocarcinomas of the cervix. Four patients with squamous cell cancer of the vagina were treated with this method. Only patients with locally advanced disease (cervical lesion greater than 4 cm in diameter) and poor vaginal anatomy were selected for this modality of therapy. In our series the incidence of distant failures of 39% seems to confirm the significance of local volume of disease as a prognostic indicator; despite a local control rate of 59%, only 33% of our patients are alive from 25-51 months. Complications occurred in 12 patients (42%). Six patients (22%) developed severe rectal stricture or rectovaginal fistula necessitating diverting sigmoid colostomy; five patients (18%) developed hemorrhagic proctitis with diarrhea and tenesmus; one patient developed vaginal vault necrosis. Complications occurred 7 to 24 months following therapy. Six of the 12 patients developing complications are dead of disease. On the basis of this study and because of the low cure rate and high incidence of complications, the value of the Syed-Neblett template in locally advanced gynecologic malignancies should be reconsidered.

Adenocarcinoma↗
PubMed1983

m-AMSA in epithelial carcinoma of the ovary. A Southwest Oncology Group study.

Twenty-three patients with advanced heavily pretreated epithelial carcinoma of the ovary were treated with m-AMSA. Eleven patients received a mean of 2.3 courses at a dose of 40 mg/m2 X 3 days q 21 days and 12 patients received a mean of 4.3 courses at a dose of 30 mg/m2 X 3 days q 21 days intravenously. One (5%) partial response in 22 fully evaluable patients was observed. Toxicity was mild and well tolerated. We conclude that m-AMSA is a relatively inactive drug in the treatment of epithelial ovarian carcinoma.

Aminoacridines↗
PubMed1979

Combination chemotherapy for alkylator-resistant ovarian carcinoma: a preliminary report of a Southwest Oncology Group trial.

The Southwest Oncology Group has carried out a phase III study of combination chemotherapy in patients with advanced epithelial ovarian cancer who had become resistant to prior drug treatment. Patients previously treated with only alkylating agents were given adriamycin-5-fluorouracil-hexamethylmelamine-cis-dichlorodiammineplatinum(II) combination. There have been 12 partial and two complete responses among 29 evaluable patients (at least one full treatment course) entered in this four-drug combination, for a 48% response rate. Two (7%) additional patients showed objective improvement. The median duration of response was 5.8 months. Ten (34%) of 29 patients have died. The median duration of survival was 12+ months. Patients who had previously received adriamycin plus alkylating agent therapy were treated with 5-fluorouracil-hexamethylmelamine-cis-dichlorodiammineplatinum(II). Only 23 (31%) of these 74 patients have had partial responses while an additional 7% have had objective "improvement"; 27 (36%) of these patients have died. The median duration of survival was 14 months. Both drug regimens were well-tolerated. There were no drug-related deaths. Although thrombocytopenia was dose-limiting in up to 40% of the patients, the mean lowest platelet counts in the four- and three-drug regimens were 116,000 and 123,000/mm3, respectively. There were no cases of serious azotemia (ie, BUN level greater than 40 mg/100 ml) or severe peripheral neuropathy.

Alkylating Agents↗
PubMed1978

Squamous cell carcinoma of the vagina.

Squamous cell carcinoma of the vagina is one of the least understood malignant tumors arising from the female genital tract. Vital facts on its clinical and biologic behavior are difficult to collate in a cumulative way. Its intermediate position in the pelvis makes it a difficult site to which to apply conventional methods of treatment without associated morbidity; its rareness precludes developing expertise by no more than a few therapists and allows few the opportunity to test new ideas encased in research protocols; and its variegated presentations invite individualization as the only therapeutic approach. Squamous cell carcinoma of the vagina remains an enigma among gynecologic neoplasms.

Aged↗
PubMed1976

A malignant tumor of the vagina resembling synovial sarcoma: a light and electron microscopic study.

A malignant tumor arising in the upper lateral vaginal mucosa in a 24-year-old white woman, hitherto undescribed in the literature, was studied by light and electron microscopy. The main part of the tumor was epithelioid, forming a tubular or acinar pattern. At the periphery, the tumor cells were more spindly and formed sheets resembling fibrosarcoma. The tumor cells contained occasional material positive for mucicarmine, alcian blue, and PAS stains, and the nests of the cells forming acini were surrounded by reticulin fibers. The tumor ultrastructure consisted of a single type of cell with large cytoplasmic vacuoles and occasional perinuclear intracytoplasmic filaments. Slender long microvilli projecting into the lumina were also characteristic. Basal laminae were occasionally present around the acini. The findings suggested that the tumor was of mesenchymal origin, closely related to synovial sarcoma.

Adult↗
PubMed1975

Pelvic exenteration for vaginal embryonal rhabdomyosarcoma: a review.

The English language literature for the years 1935-1972 was reviewed to assess the effect of pelvic exenteration on vaginal embryonal rhabdomyosarcoma. Twenty-one cases were determined eligible for review. Tumor was confined to the vagina in 8 cases and extended beyond the vagina in 13 cases. Treatment by pelvic exenteration was found to be relatively ineffective means of curing patients with tumor extending beyond the limits of the vagina. Recent evidence from the literature indicates that better results can be obtained by coordinated treatment, ie, surgery, radiation therapy, and/or chemotherapy, than by surgery alone.

Age Factors↗
PubMed1974

Gestational trophoblastic neoplasms.

A review of the classification, biological behavior, clinical diagnosis, and treatment of gestational trophoblastic neoplasms is presented. The events which followed the utilization of chemotherapy as a successful means of therapy are included. Especially important has been the recent recognition that high risk patients, i.e., patients with HCG titers greater than 100,000 IU/24 hr, duration of symptoms greater than four months, and metastasis to the brain and/or liver, with metastatic trophoblastic disease can be managed successfully if treated initially with combination chemotherapy and adjuvant measures including radiation and infusional therapy. Detectable levels of human chorionic gonadotropin are necessary for diagnosis and management of patients with this disease. The lack of sensitivity of commercially available pregnancy tests and the recent ability to determine HCG by means of an antigenically different beta-subunit are discussed.

Cell Transformation, Neoplastic↗
PubMedDate not supplied

The normalised rim/disc area ratio line.

The assessment of the cup of the optic disc depends, among other criteria, on the disc area. A small cup in a small optic disc can indicate an advanced glaucomatous lesion, on the other hand a large cup in a large optic disc can be normal. Therefore, an individual normalised rim/disc area ratio line together with the curves of 50th percentile and the 95th percentile of normal could help to better distinguish between glaucomatous and normal optic cups. The aim of our study was to calculate and to evaluate such a normalised rim/disc area ratio line. Heidelberg Retina Tomograph examinations of the optic nerve head of 100 randomly selected eyes of 100 normal subjects were evaluated. We calculated the disc area adjusted rim/disc area ratio in sectors of 10 degrees. The 95th percentile and the 50th percentile of each of the 36 sectors were calculated. Based on these normal percentile lines it was possible to display an individual normalised rim/disc area ratio line in the topographic images of an individual optic disc examination. Here we demonstrated examples of a normal optic disc, optic nerve heads with moderate and advanced lesions and a small optic disc with glaucomatous damage. We present a new display mode of the results of Heidelberg Retina Tomograph optic nerve head examination, which may be helpful for an easy and reliable assessment of glaucomatous optic nerve head damage only looking at topographic images.

Adolescent↗
PubMedDate not supplied

Slow axonal regrowth but extreme hyperinnervation of target muscle after suture of the facial nerve in aged rats.

Unilateral transection and suture of the facial nerve was performed in 60 old rats (20 months of age). The time course of mimetic reinnervation was studied by counting all retrogradely labeled motoneurons in the facial nucleus after injection of HRP into the whiskerpad muscles for 14-112 days post operation. The comparison between these neuron counts and data for young rats yielded four conclusions. First, the qualitative equivalent of the phenomenon "misdirected reinnervation" in aged rats was the same as in young adults: HRP-labeled motoneurons were scattered throughout the facial nucleus lacking myotopic organization from 18 until 112 days post operation. Second, no age-related loss of motoneurons was detected. Third, the axonal regrowth was delayed in aged rats. Fourth, the postoperative hyperinnervation (the projection of more motoneurons into a muscle than under normal conditions, i.e., the quantitative aspect of misdirected reinnervation) was more than two times higher than in young rats. These data may provide reasonable explanations for the poor functional recovery after reconstructive surgery on the facial nerve in old patients.

Aging↗
PubMedDate not supplied

Correlation study of two methods for evaluating corneal endothelial damage in vitro: the Janus green photometry technique versus cell counting.

Counting of endothelial cells after vital staining is a time-consuming method which, in addition, requires considerable experience and does not normally allow for the study of the entire endothelial cell surface. However, the Janus green photometry technique (JGPT) is an objective, time- and personnel-saving procedure which also has the advantage of allowing for the evaluation of the whole endothelial cell surface. A comparative simultaneous experimental study of the two methods had not been reported. Freshly excised pig corneas (n = 58) were preserved in MK storage medium for 4, 7, 14 and 20 days at 4 degrees C. All corneas were stained with Janus green and alizarin red. A 7-mm corneal button corresponding to an endothelial surface of 38.46 mm2 was punched out. The percentage of damaged cells was determined with cell counting (CC) and with JGPT, and the results were statistically compared. Two methods for CC were used. Cells were counted either directly under the microscope or in photomicrographs. The overall correlation between the results of CC and JGPT was R = 0.98. However, when endothelial cell damage was higher than 30%, CC became an estimation by approximation, since necrotic areas were confluent, whereas with JGPT the results were usable even when the damage was 100%. Thus it appears that although the two methods can be used interchangeably, JGPT may in some instances be the method of choice.

Animals↗
PubMedDate not supplied

Anticancer activity of rViscumin (recombinant mistletoe lectin) in tumor colonization models with immunocompetent mice.

The antitumoral and immunostimulating properties of rViscumin (recombinant mistletoe lectin) were investigated in two mouse tumor models. After intravenous inoculation with RAW-117-P or L-1 sarcoma cells in Balb/c mice, rViscumin was given s.c. at non-toxic doses ranging from 0.3 to 150 ng rViscumin/kg. One set of experiments was performed to investigate the survival of rViscumin-treated animals. Another set was carried out to analyze the effect of rViscumin treatment on the number of tumor colonies in infiltrated lungs (RAW-117P) or liver (L-1) and the activation of immune cell subsets, respectively. An overall prolonged survival time after treatment with rViscumin and a reduction in the number of tumor colonies after administration of certain rViscumin doses was observed. Immunophenotyping of the peripheral leukocytes of treated mice revealed increased numbers of T-lymphocytes, pan-NK cells and activated monocytes. The results indicate that rViscumin has antineoplastic properties and might therefore be a promising candidate in cancer therapy.

Adjuvants, Immunologic↗
PubMedDate not supplied

Fracture toughness of pin-retained class 4 restorations.

Standardized class 4 cavities were prepared in bovine incisors and restored with a microfilled composite resin. The composite restorations were retained either by acid etching technique (AET) alone or by acid etching technique in combination with a self-threading retentive pin. Pins covered with a bonding/opaquer coating (PCR pin) and uncovered pins (FO pin) were used. After having been aged for 3 days, the fracture resistance of the restorations was determined with a Universal Testing Machine. The restorations were loaded at an angle of 45 degrees. The restorations retained by AET and a PCR pin showed the highest failure load. The restorations accomplished with AET and a FO pin yielded the lowest fracture load. The fracture toughness of the restorations retained by AET and a PCR pin was slightly but statistically significant, higher compared to the restorations exclusively attached by acid etching technique. It was concluded that there was only a small increase of fracture toughness of large class 4 composite restorations if the acid etching technique was combined with the application of bonding/opaquer-covered retentive pins.

Acid Etching, Dental↗