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Biomedical subjects

S J Kapnick

Publications and source records attributed to S J Kapnick.

7 recordsLinked to original sources
PubMed1990

Occult pleural involvement in stage III ovarian carcinoma: role of diaphragm resection.

In a 2-year period 12 diaphragmatic resections were performed on 11 patients with invasive metastases from ovarian carcinoma without significant complications, via transabdominal approach in 10 instances and thoracoabdominal incision in 1. Full-thickness penetration of the diaphragm by tumor occurred in all instances without prior evidence of pleural involvement (occult Stage IV). Six patients had primary disease (Group A) and 5 had recurrent disease (Group B). Ten patients who underwent excision of nonpenetrating diaphragmatic metastases were analyzed for comparison (Group C). Mean diameters of the metastases were as follows: Group A, 7.84 +/- 1.60 cm; Group B, 7.00 +/- 2.24 cm; Group C, 2.51 +/- 1.08 cm. The difference in mean diameter between the penetrating (Groups A and B) and nonpenetrating (Group C) tumors was highly significant (P less than 0.01). Penetrating tumors were 5.0 cm or greater; nonpenetrating tumors were 4.0 cm or less. Invasiveness of diaphragmatic metastases was inversely related to survival in patients with primary but not recurrent disease. Group A patients had a marked survival disadvantage (median survival time of 8 months; range 7-25 months) compared to Group C (median survival time of 26 months; range 13-96+ months; P less than .05). In contrast, Group B patients appeared to gain salutory palliation despite large diaphragmatic masses involving the pleural surface (4/5 alive at 16(+)-33+ months following surgery). Previous reports of response and survival in patients with Stage III Ovarian cancer may have included patients with "occult Stage IV" disease.

Diaphragm↗
PubMed1988

Elevated CA 125 serum levels and epithelial ovarian cancer metastatic to retroperitoneal lymph nodes.

Elevations in CA 125 levels have been reported in approximately 80% of patients with epithelial ovarian cancer. Studies demonstrate that elevations of CA 125 at the time of second-look procedures correlate with the presence of tumor in 100% of cases. Two cases are reported with elevated CA 125 in which clinical examination and noninvasive studies with CAT scans failed to demonstrate tumor. In both cases laparotomy was performed because of the elevation of CA 125. Although intraabdominal exploration did not reveal the source of the CA 125 elevation, extensive retroperitoneal dissection demonstrated microscopic tumor in retrocaval lymph nodes in both cases. The ability to monitor patients with CA 125 is demonstrated and the importance of elevated antigen levels emphasized. Benign conditions associated with falsely positive CA 125 are discussed.

Adenocarcinoma↗
PubMed1986

Ultrasound guidance for selected dilatation and evacuation procedures.

Intraoperative ultrasound was used as an adjunct in difficult dilatation and evacuation (D&E) procedures for first-trimester abortions. This technique was useful in eight technically difficult D&Es in the presence of acute retroflexion, acute anteflexion, cervical stenosis and lower uterine segment fibroids.

Abortion, Therapeutic↗