PubMed Health⌕ Search

Biomedical subjects

R T Senie

Publications and source records attributed to R T Senie.

At least 37 records · Page 2Linked to original sources
PubMed1990

Malignant peripheral nerve sheath tumors of the buttock and lower extremity. A study of 43 cases.

Using strict clinical and pathologic criteria for the inclusion of cases, the authors have reviewed the clinicopathologic features of 43 malignant peripheral nerve sheath tumors of the buttock and extremity seen over a 35-year period. Twenty-three (53%) of the patients had neurofibromatosis (VRN), whereas 20 (47%) did not. Fifty-one percent of the patients were women. The mean age at presentation was 36 years for patients with VRN and 44 years for patients without VRN. A nerve of origin was identified for 72% of the cases and an associated neurofibroma for 44% (65% with VRN and 20% without VRN). The mean greatest dimension of the tumors was 12.3 cm, and this did not differ significantly between the two groups. The predominant histologic pattern in 86% of the tumors was that of tightly packed spindle cells in an interlacing and woven pattern; heterologous sarcomatous elements were noticed in 12% of the cases. Surgical resection was the main modality of treatment for all patients; 65% also received adjuvant therapy. Follow-up evaluation was done in every case. An unexpected finding was the absence of a significant difference in survival rates between patients with and without VRN. Overall, 63% of the patients died of tumor: 65% of the patients with VRN and 60% of the patients without VRN. Large tumor size and high mitotic rate (greater than 20 per 10 high-power fields) portended a poor prognosis, as did the need for resection by amputation. Adjuvant radiation therapy and chemotherapy did not affect survival rates.

Adolescent↗
PubMed1989

Early abortion and breast cancer risk among women under age 40.

In New York State, incidence of cancer and fetal death are reportable health events mandated by state law. These data enabled a population-based record linkage study of the effect of early pregnancy termination on breast cancer risk to be conducted. In upstate New York 1451 cases under age 40 were reported to the Cancer Registry during 1976-1980. Cases were matched with 1451 population controls by year of birth and by residence using zip codes. All names including those changed by marriage were matched with the reports of fetal deaths occurring between 1971 and 1980. Matched pairs analyses revealed an excess of early pregnancy terminations among cases in all categories. Odds ratios (OR) were significantly elevated among those with an induced abortion (OR = 1.9) and a spontaneous abortion (OR = 1.5). Elevated risks were also noted for consecutive abortion events without intervening livebirths.

Abortion, Incomplete↗
PubMed1988

One-year follow-up of infants with abstinence-associated seizures.

Fourteen infants with neonatal abstinence-associated seizures were assessed neurodevelopmentally during the first year of life. Despite abnormal neurologic examination results in eight of 12 infants at 2 to 4 months of age, nine of 12 infants had normal neurologic examination results at follow-up (two infants were unavailable for follow-up; one infant died of acquired immunodeficiency syndrome). Nine neonatal electroencephalograms were abnormal; seven of eight of these abnormal tracings normalized during the follow-up period. Bayley developmental scores remained normal during the first year of life and did not differ from either passively addicted infants without seizures or from published population norms. This short-term favorable prognosis for abstinence-associated seizures differs from that associated with neonatal seizures due to other causes. This observed improvement in neurologic function may be based on replenishment of neurotransmitters following transient depletion in the neonatal period.

Female↗
PubMed1988

Neonatal neurologic and electroencephalographic effects of intrauterine cocaine exposure.

Thirty-nine infants with intrauterine exposure to cocaine were examined for neurologic and electroencephalographic (EEG) abnormalities. Of the 39 infants, 34 displayed central nervous system irritability, but only two of the infants required sedation. The EEGs were abnormal in 17 of 38 infants during the first week of life; abnormalities were characterized as showing central nervous system irritability. The EEG abnormalities could not be predicted on the basis of clinical neurologic dysfunction or perinatal variables. On follow-up, 9 of the 17 abnormal EEGs remained abnormal during the second week of life. One infant had an abnormal first EEG at 13 days of age. By 3 to 12 months of age, however, 9 of the 10 previously abnormal tracing had normalized and one is pending. These transient clinical and EEG abnormalities may be the result of changes in neurotransmitter availability and function.

Adolescent↗
PubMed1988

Hepatitis D virus and human immunodeficiency virus antibodies in parenteral drug abusers who are hepatitis B surface antigen positive.

We studied unselected, hepatitis B surface antigen (HBsAg)-positive parenteral drug abusers for antibody to hepatitis D virus (anti-HD) and antibody to human immunodeficiency virus (HIV). The prevalences of anti-HD and antibody to HIV were 67% and 58%, respectively, and there was no association between positivity for these two markers. In a logistic regression model, anti-HD was associated with older age (P = .001), longer duration of drug abuse (P = .045), and the presence of liver disease (P = .002). Antibody to HIV was associated with a younger age (P = .003) and increased serum globulin levels (P less than .001). In patients infected with HIV, the severity of hepatic dysfunction remained correlated with anti-HD. In anti-HD-positive patients, most indices of hepatic dysfunction were similar whether or not antibody to HIV was present, but serum aspartate aminotransferase levels were significantly higher in patients with both anti-HD and antibody to HIV. (124 +/- 16 vs. 74 +/- 11, P less than .05).

AIDS-Related Complex↗
PubMed1987

Clinical and demographic features of patients admitted to a new chemical dependency program in New York City.

We reviewed the clinical and demographic features of all 128 patients who were admitted to a new 28-day in-patient chemical dependency program in New York City during the first six months of operation. The medical records were reviewed retrospectively. Alcohol, cocaine, heroin, marijuana and diazepam were the most common substances abused. Parenteral drug abuse at any time was reported by 51 (40%) of the 128 patients, and 42 (33%) were current parenteral drug abusers. Abusers of alcohol only were significantly older than parenteral drug abusers or non-parenteral drug abusers. Patients who were employed at admission had a significantly longer mean length of stay and a higher rate of completion of the program than those who were not employed. We conclude that: (1) parenteral drug abuse is likely to be commonly seen in chemical dependency programs serving middle-income patients in urban areas, (2) alcohol abusers are older than abusers of other drugs, (3) a higher educational level is associated with successful completion of the chemical dependency program, and (4) evaluation programs are needed in all types of chemical dependency treatment.

Adult↗
PubMed1985

Association of vaginal smear cytology with menstrual status in breast cancer.

The relationship of clinically defined menstrual categories and an independent measure of hormonal stimulation, maturation index of vaginal smear cytology, was studied. Analysis of 596 smears obtained at the time of breast cancer diagnosis revealed a statistically significant association between menstrual status and maturation index. However, within each menstrual group varying levels of maturation were noted. Estrogenic effect in the absence of exogenous hormone administration was found in 11% of patients following bilateral oophorectomy and among 24% of women whose natural menopause occurred 20 years or longer prior to diagnosis. Endogenous estrogen production appears to continue for many years among some women. Clinical factors such as obesity, diabetes and/or hypertension may stimulate high squamous maturation in some patients. Others of the same age and with similar clinical histories were found to have atrophic smears. The differences in maturation index may be due to individual variations in: endogenous hormone levels; sensitivity of the vaginal mucosa to similar hormonal stimuli; use of certain medications; or unidentified exogenous factors. The maturation index was found to be significantly associated with the following prognostic factors: weight relative to height, tumor size and estrogen receptor content of the primary tumor. These findings indicate that vaginal smear cytology may define specific subsets within menstrual categories which may be relevant to therapy and prognosis in breast cancer.

Adult↗
PubMed1984

A comparison of primary breast cancer management in small, intermediate and large community hospitals and a comprehensive cancer center.

The results presented above indicate clearly that the size of a hospital is associated not only with the type of patient population treated there in terms of demographic and disease related characteristics but also with the type of treatment given. Smaller hospitals were more likely to have older and later stage disease patients for whom they used fewer diagnostic tests and less conservative surgical procedures than larger hospitals. The patients in smaller hospitals also tended to stay for longer periods of time. Interestingly, in terms of the comparison between the community hospital groups and the comprehensive cancer center, no consistent pattern was found. Large hospitals were more like MSKCC in their patient population and length of stay, but the small hospitals were more like MSKCC in the number of tests and type of surgical procedures performed.

Aged↗
PubMed1982

Epidemiology of breast carcinoma III: relationship of family history to tumor type.

Previous breast carcinoma in at least one female relative was reported by 31% of 1024 women treated consecutively for breast carcinoma at Memorial Hospital. Eighty (7.9%) of their mothers had had breast cancer. Maternal breast cancer was significantly (P less than 0.006) more frequent among women with medullary carcinoma than those with other tumor types and among those who were pre- or perimenopausal at diagnosis (P less than 0.001). Among the 727 patients who had one or more sisters, 12% had a sister who had been treated for breast cancer. The highest frequency of carcinoma in at least one sister occurred in patients with lobular carcinoma while the medullary carcinoma group had the least number of patients with an affected sister (P less than 0.03). Occurrence of breast cancer in a sister was almost twice as common in patients who were postmenopausal at diagnosis (P less than 0.005) than in premenopausal patients. When stratified by histologic type, the mean age at diagnosis of the patients did not differ appreciably from the age at diagnosis of their sisters. Detailed analyses of histologic type and other more distant familial relationships were also obtained but were considered to be less reliable because of problems in ascertainment and there were fewer affected relatives. No single histologic type of carcinoma was consistently linked to a disproportionately high or low frequency of carcinoma in all classes of relatives. It is possible that studies of family history limited to information available when the patient is first treated present an incomplete picture of familial aggregation. Further follow-up after diagnosis is needed to obtain a more reliable measure of the extent to which relatives are affected by breast cancer and patterns of family distribution associated with specific tumor types.

Adult↗
PubMed1982

Epidemiology of breast carcinoma IV: age and histologic tumor type.

The purpose of this study was to correlate major chronologic events known to have a bearing on the risk for developing breast carcinoma with histologic tumor type. Data were obtained for 1024 consecutively treated patients with the seven most common forms of mammary carcinoma. The age of occurrence of the following events was determined: menarche; first marriage; first pregnancy and first childbirth; last pregnancy and last childhood; diagnosis. The interval between each of these events and diagnosis of breast cancer was also calculated. Patients with medullary carcinoma had a significantly lower mean age at diagnosis than those with any of the other tumor types. Because of the lower mean age at diagnosis, medullary carcinoma patients were found to have significantly shorter intervals between age at diagnosis and the following: menarche, first pregnancy or first childbirth, and last pregnancy or last childbirth. Intervals between age at diagnosis and these other events were not significantly different among patients with other types of carcinoma. The ages of menarche, marriage, or pregnancy were not related independently to any tumor type. These data indicate that except for current age, the age of occurrence of major risk factors for developing breast cancer is unrelated to the histological type of tumor a patient develops.

Adult↗
PubMed1981

Estrogen and progesterone receptors in breast carcinoma: correlations with epidemiology and pathology.

Analysis of estrogen receptor protein (ERP) was carried out on 784 patients with primary breast carcinomas. Significant relationships were found with the following epidemiologic features; age at diagnosis, menstrual status, race, and use of exogenous hormones (contraceptive and menopausal estrogens). Patients taking either type of hormone at diagnosis had lower median total ERP binding levels. Although the data do not explain how recent hormone usage affects tumor ERP, it seems advisable to discontinue these hormones as early as possible before a breast biopsy because they may cause spuriously low ERP levels. Correlation with pathology variables confirmed most prior observations relating to tumor type, histologic grade, and lymphocytic infiltrate. However, in this large series, infiltrating lobular carcinomas were not ERP-positive more frequently than duct carcinomas to any significant degree. The pattern of progesterone receptors (PRP) did not vary significantly with menstrual status, but in other respects correlations of epidemiologic and pathologic variables were similar for ERP and PRP.

Age Factors↗
PubMed1981

Breast self-examination and medical examination related to breast cancer stage.

The frequency and type of breast examinations reported by 1,216 primary breast cancer patients was studied in relation to local stage of disease. No significant relationship was found between the reported frequency of breast self-examination (BSE) and stage of disease; however, annual medical examination was significantly associated with small tumor size (P less than .04) and absence of axillary lymph node metastases (P less than .001). Regardless of the frequency of any method of examination, the majority (80 per cent) of tumors were first detected by the patients. Among those who detected their lesion, a greater frequency of medical examination was associated with an earlier pathological stage of disease (P less than .001). Patients who were examined more frequently by a physician appeared to be more sensitive to clinically significant breast abnormalities. These findings underscore the importance of examiner skill in the successful use of palpation to detect breast cancer. Instruction in BSE by a health professional during periodic examinations may provide the optimal opportunity for improved proficiency in self-examination.

Adult↗
PubMed1980

Epidemiology of breast carcinoma II: factors related to the predominance of left-sided disease.

A study of the laterality of 980 patients with unilateral breast carcinoma revealed a left/right ratio of 1.26. Detailed analysis disclosed a significant association between left predominance and the following clinicopathologic features: menarch after age 13, age at diagnosis, parity especially among those between ages 40 and 54, and all histologic types except medullary tumors. When asynchronous bilateral carcinoma was documented, the disease first occurred more often in the left breast. Patients with simultaneous bilateral disease usually had a larger tumor on the left. Because differences in breast size were considered a contributing factor, relative breast volumes were computed from the mammograms of 174 healthy women; 55% were found to have a larger left breast. These data and other observations cited in the literature suggest that the asymmetry of breast carcinoma reflects differences in the sensitivity of the mammary glands to hormonal stimulation, resulting in unequal volumes of tissue at risk to develop carcinoma.

Adolescent↗
PubMed1979

Epidemiology of breast carcinoma: Age, menstrual status, and exogenous hormone usage in patients with lobular carcinoma in situ.

Lobular carcinoma in situ (LCIS) of the breast is a neoplastic condition associated with premenopausal women and it is largely for this reason that LCIS has been considered to be an estrogen-dependent lesion. In this report we present the results of a study of age at diagnosis, menstrual status, and exogenous hormone usage in 59 women with LCIS and in 190 patients with duct carcinoma. When LCIS was associated with duct carcinoma, 46% of patients were postmenopausal and in the group that also had infiltrating lobular carcinoma 71% were postmenopausal. Nine of 39 (23%) patients whose only carcinoma was LCIS were postmenopausal, 56% were premenopausal and 21% were menopausal. Seven of the nine postmenopausal women had never used a hormone-containing medication. In a comparison group with only duct carcinoma, 59.4% were postmenopausal and 35.2% had taken a hormone preparation. The high proportion of postmenopausal patients with LCIS leaves considerable doubt as to whether all lesions termed LCIS are equally dependent on estrogens at all stages in their evolution. We found no evidence to link LCIS with exogenous hormone usage in postmenopausal women. Prospective studies of hormone levels in patients with LCIS and in their relatives may provide an explanation for persistence of the lesion in postmenopausal women and could aid in identifying women at risk of developing invasive carcinoma.

Adult↗