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Biomedical subjects

S Kramer

Publications and source records attributed to S Kramer.

At least 91 records · Page 5Linked to original sources
PubMed1983

The dissemination of cancer by transurethral resection of locally advanced prostate cancer.

In 1973 a study was done on 443 patients treated with radiation therapy for cancer of the prostate. An actuarial analysis was done on survival comparing patients whose cancer was diagnosed by transurethral resection of the prostate to those diagnosed by needle biopsy. This analysis indicated a doubling of recurrence and of deaths of patients diagnosed by transurethral resection of the prostate. This effect of transurethral resection of the prostate was observed in patients with T3 and T4 cancer of intermediate, poor or unstated differentiation. It was not observed in those with well differentiated cancer. The effect was not caused by a difference in the extent of cancer or a distribution of histologic subtypes between the 2 diagnostic groups. Therefore, it appears that transurethral resection of the prostate causes dissemination on locally advanced prostatic cancer and clinical studies are suggested to avoid or minimize this effect.

Biopsy↗
PubMed1983

Assessment of the quality of life in long-term survivors after definitive radiotherapy.

An interview questionnaire was developed to assess quality of life both in objective and subjective terms in cancer patients. Standardized measures were employed and allowed for comparison with a national baseline. Three hundred thirty-nine patients who were alive without evidence of disease 3 or more years following initial treatment were interviewed. There was no difference in terms of educational level, marital status, or satisfaction with local government, family, job, friends, community, health, recreation, or activities when compared to the age-adjusted national baseline. The patients were more satisfied with region, self, and life as a whole. There was no evidence of a diminished quality of life in these patients.

Adolescent↗
PubMed1983

Protoporphyrinogen oxidase and ferrochelatase in porphyria variegata.

Protoporphyrinogen oxidase activity and ferrochelatase activity were measured in leucocytes from patients with porphyria variegata. The mean activity of protoporphyrinogen oxidase (PPO) in porphyria variegata (PV) was about 50% of normal (P less than 0.05). The mean activity of ferrochelatase with 59Fe2+ sulphate and protoporphyrin as substrates (in the presence of ascorbic acid) was reduced by 40% (P less than 0.009). The mean activity of ferrochelatase with 59Fe3+ chloride and protoporphyrin as substrates (in the presence of reduced glutathione) was increased by 65% (P less than 0.005). Both are statistically highly significant. The findings are interpreted as follows: (a) The occurrence of a low level of protoporphyrinogen oxidase in PV is confirmed. (b) The findings indicate a concurrent structural change in ferrochelatase (this may be structurally related to (a) but no evidence of this is at present available).

Adult↗
PubMed1983

Locally recurrent breast carcinoma: the effect of adjuvant chemotherapy on prognosis.

A group of 72 patients who had received radiotherapy between 1972 and 1980 for isolated local-regional recurrence of breast cancer was studied; 38 had received adjuvant chemotherapy and 34 had not. The two groups were comparable except for the initial nodal status and median time from mastectomy to recurrence. Outcome was not significantly different for the two groups in terms of response to radiotherapy, incidence of re-recurrence, distant metastases, and three-year survival. The length of the disease-free interval and the response to radiotherapy were the only factors studied that were significantly related to survival.

Antineoplastic Agents↗
PubMed1983

Survival in childhood acute lymphocytic leukemia: effect of protocol and place of treatment.

The objective of this study was to determine the effect of place and type of initial treatment on survival from acute lymphocytic leukemia (ALL). Every one of the 327 children under 15 years of age diagnosed with ALL from 1970 to 1975 in a 31-county area designated the Greater Delaware Valley, were studied. Treatment according to protocol was associated with improved survival, yielding a 4 year survival of 60% vs 19% for nonprotocol treated patients (p less than 0.001). There was also a significantly improved survival rate among patients treated in a cancer center, especially for those with a low white blood count (WBC) at diagnosis. The prognostic importance of WBC, age, and sex was confirmed.

Adolescent↗
PubMed1983

Incidence of childhood cancer: experience of a decade in a population-based registry.

Incidence rates of cancer among children aged 0-14 for the period 1970-79 have been generated with the use of data from the Greater Delaware Valley (GDV) Pediatric Tumor Registry. This population-based registry covers a 31-county area and has a pediatric base population of 2 million. During the period, approximately 2,300 cases of childhood cancer were diagnosed in the region. Incidence rates for all histologic types combined are similar to rates from other large surveys conducted in the United States and Western Europe. However, certain histology-specific rates in the GDV vary by race. In the GDV nonwhites relative to whites have higher rates of Wilms' tumor, soft tissue sarcomas other than rhabdomyosarcoma, and retinoblastoma. These contrasts are supported by surveys in African populations showing relatively higher rates of these tumors among African black children. GDV whites exceed nonwhites in incidence of acute leukemia, neuroblastoma, and Ewing's sarcoma. African black children also experience low rates of these tumors. The frequency of central nervous system tumors is similar for GDV whites and nonwhites, despite reports of a rarity of these neoplasms in African blacks. Variations in incidence rates reveal population subgroups with particular tumor susceptibilities and may provide clues as to the relative influence of heredity and environment on patterns observed.

Adolescent↗
PubMed1982

Pancreatic tumours in patients with previous malignancy.

One hundred and ten patients were seen in the Department of Radiation Therapy at Thomas Jefferson University Hospital for pancreatic tumours between January 1975 and June 1980. Twelve patients had previously been treated for a non-pancreatic malignancy. Pancreatic biopsies were performed in nine patients and were interpreted as pancreatic carcinoma. When the previous pathological material was compared to the pancreatic biopsy, the diagnosis was changed in five of the 12 patients to recurrent non-pancreatic malignancy. We emphasise the importance of the distinction between primary pancreatic malignancy and metastatic disease in the pancreas.

Adenocarcinoma↗
PubMed1982

Assessment of the long-term effects of primary radiation therapy for brain tumors in children.

One-hundred-twelve children with primary brain tumors received definitive radiotherapy between the years 1958--1979. Sixty-nine patients were alive at intervals of 1--21 years. Thirty-eight patients underwent neurologic and endocrine evaluation, psychologic and intelligence testing, and assessement for second malignancy post-treatment. A second intracranial malignancy developed in one child, for an incidence of 1.6%. Performance status was good to excellent in 89% of the patients studied. Seventeen percent of the group were mentally retarded. Behavioral disorders were identified in 39% of the patients, 59% of the mothers, and 43% of the fathers. Of the 23 patients with nonparasellar tumors, six were found to have growth hormone deficiency, including two patients with panhypopituitarism. Disability was related to age under 3 years at the time of treatment and tumor extension to the hypothalamus.

Adolescent↗
PubMed1982

Does preoperative irradiation increase the rate of surgical complications in carcinoma of the head and neck? A Radiation Therapy Oncology Group Report.

This is a comparison of the rate of surgical complications in a group of patients with advanced but operable carcinoma of the head and neck who underwent surgery after preoperative radiotherapy (5000 rad in five weeks, 200 rad fractions, directed to the primary tumor area and neck) versus another group operated without prior irradiation. Both groups of patients formed part of a randomized prospective multiinstitutional trial of the Radiation Therapy Oncology Group (73-03). Of 229 patients who had planned operations, 88 (38%) developed some degree of surgical complications, and in 28 (12%) the complications were rated as severe. The most frequently reported complications were delayed healing and fistula formation each occurring in approximately one-fourth of each of the two treatment groups. Carotid blow-out occurred in 5% or less of the cases. No significant statistical difference between treatment groups was noted for the overall complication rate or specific type of surgical complications. A trend was noted towards more complications in the preoperative group for patients with lesions in the oropharynx and supraglottic larynx. However, an opposite trend towards more complications in the no prior irradiation group was observed among patients with lesions in the oral cavity and hypopharynx. Surgical mortality and postoperative hospital stay were not significantly different between treatment groups. We conclude that preoperative irradiation for carcinoma of the head and neck, with the stated dose, followed by surgery in 4-6 weeks, does not substantially increase the rate of overall or specific type of surgical complications, surgical mortality or hospital stay versus those patients operated without prior irradiation.

Aged↗
PubMed1982

The effect of folates on the reflex activity in the isolated hemisected frog spinal cord.

Folates may play a role in epileptic phenomena and may also be involved in synaptic events. Recently methyltetrahydrofolate was found to be a potent competitor for 3H-kainic acid binding sites in the cerebellum. The effects of 1 mM methyltetrahydrofolate (MTHF), 1 mM formyl-tetra-hydrofolate (FTHP) and 1 mM Na-folate (Na-F) were tested on the reflex activity of the isolated hemisected frog spinal cord. MTHF and FTHP were found to have an initial excitatory effect on the evoked ventral root responses. This was followed by a gradual decrease in the amplitudes of the ventral root responses. Sodium folate had only an inhibitory effect on these responses. When the evoked ventral root responses were totally inhibited by the folates the preparations did not respond to any of the following substances: (a) Kainic acid (KA), (b) L-glutamic acid (LG), (c) picrotoxin or (d) strychnine. All the folates had an inhibitory effect on the dorsal root responses. In most preparations neuronal activity was only partially restored by perfusion with normal Ringer solution. When the isolated spinal cords were bathed in either 0,5 mM KA or 1 mM LG similar results were obtained to that found with MTHF and FTHF. Glutamic acid diethyl ester (GDEE, 1 mM), however, yielded similar results to that seen with Na-F. It seems that the glutamates and related substances differ in their ability as neuroexcitants, but all share the common ability to inhibit synaptic activity when nervous tissue is exposed to the substances for long periods. Some of the folates share with KA some degree of neurotoxicity. These experiments could also not point out a separate kainic receptor in the frog spinal cord.

Animals↗
PubMed1982

Combined pre and postoperative radiation for carcinoma of the rectum.

Since 1976, a new approach to adjuvant radiation therapy in carcinoma of the rectum has been used at Thomas Jefferson University Hospital. Seventy-eight patients with biopsy-proven invasive carcinoma of the rectum have been treated with low dose preoperative radiation, 500 rad given either on the day of or the day before surgery. Following surgery, the lesions were pathologically staged according to Astler-Coller's Modification of Duke's staging. Patients with good prognostic features (Stage A or B1) were followed with no further treatment while patients with poor prognostic characteristics (Stage B2, C1 and C2) were treated with aggressive postoperative pelvic radiation, 4500 rad delivered in five weeks. All patients entered into this study received the preoperative dose of 500 rad. Fifty-six patients underwent an A-P resection, four patients underwent a low anterior resection and ten patients had a combined abdominal transsacral resection. Eight patients were found to have liver metastasis at laparotomy and underwent a colostomy followed by palliative therapy. Twenty-nine patients were found to have early disease, Stage A or B1, and were given no further therapy. Of 41 patients with Stage B2 or C, 25 patients received the full course of postoperative radiation. Sixteen patients did not receive postoperative radiation for a variety of reasons. Follow-up in these patients ranges from six months to a maximum of 48 months with a median follow-up of 18 months. Sixty-nine of the total group of 78 patients are currently alive. Two patients with early tumor (Stage A or B1) have died of metastasis. One other patient with Stage A carcinoma died of unrelated causes. Two of the 25 patients receiving postoperative radiation developed metastatic disease, but none of the patients developed local recurrence in the pelvis. Six of 16 patients who should have received postoperative radiation, but did not recurred. Four of these six recurrences have been in the pelvis. Both the incidence of failure and the pattern of recurrence between these two groups of patients who did not receive postoperative radiation is suggestive of a better effect in the PR unrelated group. Survival of patients treated with this approach appears to be improved.

Follow-Up Studies↗
PubMed1982

Patterns of incidence and trends in diagnostic classification of cerebrovascular disease in Washington County, Maryland, 1969-1971 to 1974-1976.

A study was conducted to provide baseline data on patterns of cerebrovascular disease incidence in the community of Washington County, Maryland, over two time intervals--1969-1971 and 1974-1976--and to evaluate any temporal trends with regard to their possible relation to reported declines in stroke death rates. Among the statistically significant changes in incidence between 1969-1971 and 1974-1976 were a decline in the rate of cerebral thrombosis and a concomitant increase in frequency of cerebrovascular disease-unspecified, most likely a reflection of a change in diagnostic terminology. In addition, the findings of a significant decrease in incidence of cerebral hemorrhage (for all ages over 55 years and both sexes) and a non-significant decrease in incidence rates for all types combined among those in the oldest age category between the two study periods support the role of changing incidence rates in the stroke death rate decline. It is clear, however, that monitoring of this community over a longer period of time will be necessary before the validity of these trends can be established and their causes elucidated. The need for more complete recording of historical data and clinical findings on admission, as well as adherence to standardized diagnostic and classification protocols was underscored by this study.

Adult↗
PubMed1982

Patterns of care outcome survey: national outcome data for six disease sites.

This paper reports the results of the PCS Outcome Surveys for radiation therapy treatment in six disease sites: cervix, Hodgkin's disease, seminoma of the testis, anterior two-thirds of tongue and floor of mouth, larynx and prostate. The survey reflects data obtained for patients treated in 1973. Results for early stages of disease are generally favorable in cancer of the cervix, prostate, testis, larynx and Hodgkin's disease. Control of disease in anterior two-thirds of tongue and floor of mouth was less favorable, but data suggest that more aggressive radiation therapy may contribute to better outcome for this site.

Clinical Trials as Topic↗
PubMed1982

Radical irradiation in the primary management of localized breast carcinoma.

One hundred-twelve females with stage I-III breast carcinoma were treated primarily with radical megavoltage irradiation. The loco-regional area received 50 Gy/5 weeks with a boost to the primary site of 10 Gy/1 week to 20 Gy/2 weeks. Local control rates were as follows: 94 per cent in stage I, 86 per cent in stage II and 69 per cent in stage III. Survival rates were comparable to those reported by other authors. Complications correlated with disease stage and extent of radiation fields.

Adenocarcinoma↗