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Biomedical subjects

R Fruchter

Publications and source records attributed to R Fruchter.

13 recordsLinked to original sources
PubMed1996

Age and race as prognostic factors in endometrial carcinoma.

This research was undertaken to evaluate the effects of age and race on prognosis of patients with endometrial carcinoma. A total of 279 patients with endometrial carcinoma treated at State University of New York-Health Science Center and Kings County Hospital Brooklyn, New York from 1975 to 1990 were retrospectively analyzed. Patients were arbitrarily divided into young and old groups (< or = 60 years or > 60 years old, respectively). The distribution of grade, clinical stage, and extent of myometrial invasion by age was determined for the entire group and for black and white patients, respectively. Young and old patients were stratified by clinical stage, grade, and extent of myometrial invasion. The corrected median survival of young and old patients by race was evaluated by Kaplan Meier's method of analysis. Older patients in general had higher clinical stage, higher grade, and greater depth of myometrial invasion than younger patients. Also, black patients had higher clinical stage, higher grade, and greater depth of myometrial invasion than white patients. Older black patients had the least favorable distribution of prognostic factors. Overall younger patients had a median survival of 200 months compared to 90 months for older patients (p = 0.0085). The overall corrected median survival for whites was 232 months compared to 108 months for blacks (p = 0.0001). The median survival of older black patients was worst at 40 months, compared to 155 months for older white patients (p = 0.0005). Age is a very important prognostic factor in endometrial carcinoma for both blacks and whites, and it appears to be more pronounced in older black patients.

Adult↗
PubMed1993

Available epidemiologic data on New York's Latino population: a critical review of the literature.

The increasing diversity of New York's Latino population creates complex challenges for the health care provider and planner, such as how to plan for divergent health risks, disease patterns, and health behaviors. However, most research on Latinos has been done in the southwestern United States. This paper reviews the epidemiologic data published since 1980 on Latino groups in New York State. The review covers the following areas: maternal and child health, infectious diseases, depression, tobacco and substance use, chronic diseases, neoplasms, and mortality statistics. We compare New York data with studies done in other areas of the United States. We identify serious methodological shortcomings in the epidemiological assessment of New York's Latino population, including (1) imprecise definition of "Latino," (2) misclassification, (3) census undercount of minority groups, and (4) lack of data on socioeconomic status. We argue that the epidemiological and cultural diversity of Latino groups demands the inclusion of such variables as place of birth, length of stay, and language preference in research and service statistics. This would facilitate targeted program planning and help to determine environmental, sociopolitical, behavioral, and genetic influences on diseases.

Adult↗
PubMed1991

Selection for percutaneous nephrostomy in gynecologic cancer patients.

For patients with gynecologic cancers who present with ureteral obstruction, it is often difficult to determine whether intervention with nephrostomy tube is appropriate. This study was designed to determine if evaluation prior to percutaneous nephrostomy could accurately predict patients who would benefit from intervention. Twenty-two gynecologic cancer patients with bilateral ureteral obstruction were evaluated. Criteria contraindicating intervention included disease progression while on therapy, potentially life-threatening medical problems, Zubrod performance status greater than 2, no available efficacious therapy, noncompliance, and poor pain control. A single criterion was sufficient to contradindicate percutaneous nephrostomy placement. Including replacement nephrostomies, a total of 46 percutaneous nephrostomies and four stents were placed in 19 patients. Three patients had no intervention. Only 9 patients did not have any contradictions to placement of percutaneous nephrostomy, based on predictive criteria. Patients without contraindications to percutaneous nephrostomy survived longer (median days, 242 versus 37; P less than 0.05), had improved quality of life (median days at home, 164 versus 2; P less than 0.05), and had a better chance of receiving therapy after percutaneous nephrostomy (9 versus 2 patients; P less than 0.05). Assessment prior to percutaneous nephrostomy maybe helpful in guiding the physician in recommending intervention.

Combined Modality Therapy↗
PubMed1990

Mucoepidermoid carcinoma of uterine cervix stage IB. Long-term follow-up, histochemical and immunohistochemical study.

Twelve women with mucoepidermoid carcinoma of the cervix uteri were followed for 2-15 years after diagnosis. Three patients died within 14 months. All had lymph node metastases and/or vascular involvement and exhibited tumor invasion to a depth of 1.2-3.2 cm. Mucoepidermoid carcinoma is defined as a tumor with the appearance of squamous cell carcinoma without any glandular pattern and with demonstrable intracellular mucin. The mucin is best demonstrated by alcian blue and periodic acid-Schiff-diastase. In 265 cases of squamous cell carcinoma, stage IB, lymph node metastases were present in 14%. In the cases of mucoepidermoid carcinoma, the prevalence of nodal metastases was 33%. Because mucoepidermoid carcinomas appear to be more aggressive lesions than squamous cell carcinomas are, it may be advisable to stain all cervical squamous carcinomas for mucin if they demonstrate finely vacuolated cytoplasm and lack peripheral palisading. Immunohistochemical studies for carcinoembryonic antigen (CEA), keratin, and epithelial membrane antigen were positive in all tumors to varying degrees. The detection of CEA may be of additional help in establishing a diagnosis.

Adult↗
PubMed1989

Immunocytochemical assay of progesterone receptors in paraffin-embedded specimens of endometrial carcinoma and hyperplasia: a preliminary evaluation.

An immunohistochemical method for the detection of progesterone receptors (PgR) using the monoclonal anti-PgR antibody KD 68 was utilized to study paraffin-embedded tissue sections from women with endometrial carcinoma and hyperplasia. Stromal as well as myometrial nuclear PgR were nearly always apparent. In carcinoma, 11/24 (46%) of cases showed epithelial positivity, whereas in hyperplasia 8/9 (89%) were PgR-positive (P less than 0.05). Initial biochemical PgR assays by the dextran-coated charcoal method were compared with results of PgR-immunocytochemical assays (ICA) in the paraffin-embedded tissue and were in concordance in 92%. In the one discordant specimen, PgR-ICA-negative tumor cells were seen infiltrating PgR-ICA-positive myometrium, and the biochemical assay was thus felt to be falsely positive. Twelve additional cases of endometrial carcinoma were also studied for estrogen receptor (ER) by immunocytochemistry. Two were positive for both ER and PgR, while five were negative for both receptors. The immunocytochemical methods described allow for analysis of routinely fixed, paraffin-embedded specimens, thus permitting analysis of very small specimens and archival material.

Adult↗
PubMed1984

Multiple primaries among gynecologic malignancies.

Seventy-eight synchronous or metachronous tumors among 2362 patients followed by the Downstate Gynecologic Tumor Registry are reviewed. Significant synchronous tumor pairs include cervix (invasive and in situ)-ovary, cervix (in situ)-uterus, cervix (in situ)-kidney, endometrium-ovary, endometrium-rectosigmoid, and ovary-breast. Significant metachronous pairs include cervix (invasive and in situ combined)-lung, cervix (invasive and in situ combined)-upper alimentary tract, and cervix (invasive)-rectosigmoid. In the case of in situ and invasive cervical cancer-lower genital tract, significance was determined for both synchronous and metachronous pairs. Long survival is an important factor in the appearance of a second tumor as demonstrated in patients with cervical carcinoma. Synchronous data prove to be valuable in assessing in risk of second primaries in patients surviving for short periods. The roles of cigarette smoking, hormones, immunosuppression, radiotherapy, and screening are discussed.

Carcinoma in Situ↗
PubMed1983

Association of human papillomavirus infection with cervical intraepithelial neoplasia.

Human papillomavirus infections of the cervix were assessed in patients attending a colposcopy clinic. Of 348 patients with cervical biopsies, 134 (38.5%) had human papillomavirus infections, and of 251 patients with cervical intraepithelial neoplasia (CIN) 112 (44.6%) had human papillomavirus. The majority of patients with human papillomavirus had concurrent CIN (83.6%; 112/134). Patients with human papillomavirus were significantly younger than patients without human papillomavirus (24.4 versus 29.9 years mean age; P less than .001), had significantly milder degrees of CIN (84% versus 43% mild/moderate dysplasia; P less than .001), and had a significantly lower mean number of pregnancies (2.16 versus 3.05; P less than .001). A matched pairs analysis of 69 pairs showed the same distribution of CIN in both human papillomavirus and nonhuman papillomavirus patients. Electron microscopy of human papillomavirus--specific koilocytes confirmed the presence of human papillomavirus particles in the nuclei.

Adult↗
PubMed1981

The significance of atypical vessels and neovascularization in cervical neoplasia.

The relationship between atypical vessels seen colposcopically and dysplasia, carcinoma in situ (CIS), microinvasion, and frank invasion was studied quantitatively. No atypical vessels were found with dysplasia, but 2.8% of patients with CIS had atypical vessels. Half of the patients with microinvasion and all of the patients with frank invasion, in whom the entire zone of transformation was viewed, had atypical vessels. Eight-two percent of the patients with atypical vessels had invasion. The conclusions are: (1) Atypical vessels are not present with dysplasia and rarely present with CIS. (2) Atypical vessels may be associated with microinvasion, but are required for frank invasion to occur. (3) Because atypical vessels are usually associated with invasion, which can be in or near the field of atypical vessels, diagnosis cone biopsy should be performed if atypical vessels are seen and colposcopic biopsies do not show frank invasion. (4) Microinvasion without atypical vessels may be a localized disease.

Adult↗
PubMed1980

The significance of residual disease after radiotherapy in endometrial carcinoma: clinicopathologic correlation.

The extent and location of residual disease after radiotherapy in 91 patients with early invasive endometrial carcinoma was related to tumor grade, clinical stage, and outcome. In 20% the grade (according to the International Federation of Gynecology and Obstetrics) differed in curettage and hysterectomy specimens. In at least 12% the clinical stage was unreliable. Death from endometrial carcinoma was significantly more frequent in patients with residual disease after radiotherapy than in those without residual disease. The poorest prognostic features were blood vesel invasion in the myometrium, irrespective of depth of invasion, and residual disease outside the uterus. Treatment of endometrial carcinoma should be based on accurate knowledge or prognostic features determined by initial surgery.

Carcinoma↗
PubMed1977

Incidence, significance, and follow-up of para-aortic lymph node metastases in late invasive carcinoma of the cervix.

One hundred and four patients with Stages II and III of cervical carcinoma underwent para-aortic node biopsies. Of these, 12.5 per cent of patients with Stage IIA, 14.9 per cent of patients with Stage IIB, and 38.4 per cent of patients with Stage III carcinoma of the cervix had positive para-aortic nodes. They subsequently recieve 6,000 rads to the para-aortic area. The radiotherapy complication rate was high. Within four years, 50 per cent of the patients with positive para-aortic nodes had other distant metastases. The two- and four-year follow-up is presented. Only one of 13 patients with positive para-aortic nodes was alive at the end of four years.

Aorta, Abdominal↗
PubMedDate not supplied

A colposcopic study of the effect of IUDs on cervical epithelium.

A case-control study was undertaken to investigate the effects of intrauterine contraceptive devices (IUDs) on the histology of cervical epithelium. Ninety-one women who had used IUDs for 2--13 years were case subjects and were compared with the same number of women who had never used any form of contraception (control subjects). Two subgroups were investigated, group A and group B. Group A consisted of 53 IUD users and 53 controls coming to family planning and gynecology clinics, and group B consisted of 38 IUD users and 38 controls from dysplasia clinics. Cervical cytology and colposcopically directed cervical biopsies were taken in all women. There was no difference between IUD users and control subjects in the proportion or the severity of dysplasia in either group A or group B. There was no evidence of an increase in the prevalence or severity of dysplasia with prolonged IUD use.

Adult↗