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Biomedical subjects

T Samuels

Publications and source records attributed to T Samuels.

12 recordsLinked to original sources

A durable response to cytarabine in advanced breast cancer.

Cytarabine is a useful agent in the management of acute leukaemias, but is not thought to have activity in solid tumours. We describe the case history of a woman with advanced breast cancer, presenting with superior vena cava obstruction occurring after radiotherapy and chemotherapy, who had a durable remission following inadvertent dosing with cytarabine. A review of the literature reveals that this is the first documented case of a meaningful response to cytarabine in metastatic breast cancer.

Antimetabolites, Antineoplastic↗

Cortisol concentrations in post competition horse urine: a French and British survey.

The purpose of the present report was to estimate the population parameters of cortisol concentrations in urine, an endogenous hormone used as a 'doping' agent and for which an international threshold (1.0 micrograms/ml) has been proposed. Two data bases (French and UK) corresponding to 112 and 142 samples, respectively were considered. Urine was collected under specific post competition conditions. Cortisol concentrations were obtained by validated methods (HPLC for the French samples, and GC-MS for UK samples). No difference was observed between the 2 data sets and statistical analyses were carried out on the two merged files. The overall geometric mean cortisol concentration was 48 ng/ml. Distribution was not Gaussian. A log-normal distribution was not rejected (for P > 0.05). Using the log-normal distribution, it was calculated that the probability of exceeding a cortisol concentration in urine of 1.0 micrograms/ml was 1.1 x 10(-4). It was concluded that the actual international threshold is specific i.e. robust with regard to the risk of erroneously declaring an unmedicated horse as positive.

Animals↗

Respiratory function after injection sclerotherapy of oesophageal varices.

Arterial oxygen tension (Pao2), carbon dioxide tension (PaCO2), and vital capacity were measured preoperatively and one day postoperatively in patients with chronic hepatic cirrhosis having elective oesophageal injection sclerotherapy under general anaesthesia. The results were compared with the same measurements made in patients with chronic cirrhosis anaesthetised and scheduled to have injection sclerotherapy under general anaesthesia but who, because of variceal obliteration, only had an oesophagogastroscopy. In the injected group PaO2 decreased by 9.3 (3.0) mm Hg (1.2 (0.4) kPa) (mean (SEM)) (p < 0.02) but in the controls did not change. The difference between the two groups was significant (p < 0.02). Vital capacity decreased by 0.39 (0.08) litres (BTPS) (p < 0.01) after injection sclerotherapy but in the controls did not change. Again the difference between the two groups was significant (p < 0.02). In the injected group there was a significant correlation between the change in PaO2 and the percentage change in vital capacity (r = 0.787, p < 0.01) but no such relation was seen in control subjects. These results suggest that oesophageal injection sclerotherapy is associated with a restrictive defect in respiratory function one day after the injection caused, possibly, by sclerosant embolising to the lung.

Esophageal and Gastric Varices↗

Cystosarcoma phylloides: calcified pulmonary metastases detected by computed tomography.

We report the appearance of calcifications on computed tomography (CT) images of pulmonary metastases from a rare breast tumor, malignant cystosarcoma phylloides. Histologic examination of the pulmonary masses revealed malignant spindle cells with osteoid and cartilage components in the cellular stroma. This appearance has not been described previously.

Aged↗

Practical aspects of mammographic-pathological correlation: experience with needle localization.

Preoperative mammographic needle localization of a lesion and specimen radiography facilitate accurate excisional biopsy of a nonpalpable breast lesion. The pathological diagnosis must be correlated with the mammographic indication for biopsy to ensure optimal patient care. We describe our approach to pathological correlation and outline the practical aspects and potential pitfalls of our practice. Optimal mammographic-pathological correlation requires cooperation between radiologist, surgeon and pathologist.

Adult↗

Calcification in bronchopulmonary sequestration.

We report an unusual complication in a patient with intralobar bronchopulmonary sequestration. Chest tomography, computed tomography, and specimen radiography showed a mass containing numerous round calcifications in the posterior basal segment of the left lower lobe. Pathologic examination disclosed an Exophiala fungus infection and broncholiths within bronchiectatic cavities in the sequestered segment.

Adult↗

Skeletal lymphoma.

The records of forty-two patients with lymphoma of bone [.11 with Hodgkin disease (HD), 31 with non-Hodgkin lymphoma (NHL)] were retrospectively reviewed to correlate histologic type with sites of osseous involvement, radiographic patterns of bone destruction, and prognosis. The vertebral column was the most frequent site of axial involvement and the femur was the commonest site overall. In HD, the most frequent radiographic pattern was vertebral sclerosis, while periosteal reaction was noted in two focal femoral lesions and hypertrophic pulmonary osteoarthropathy in one patient. In NHL, permeative destruction predominated, while unusual layered periosteal reaction and eccentric cortical destruction were each seen in two patients. Radiographic patterns of bone involvement alone cannot be used to predict histologic type or prognosis. Staging remains the most important prognostic indicator. For skeletal lymphoma, instead of the traditional Ann Arbor Staging System, we prefer the more specific Mayo Staging System which relates the temporal appearance of osseous disease to nodal or soft-tissue disease or both.

Adult↗

An analysis of imaging studies and liver function tests to detect hepatic neoplasia.

A retrospective study was conducted to determine the sensitivity, specificity, and accuracy of scintigraphy, ultrasound, and CT scanning in conjunction with biochemical tests in the detection of liver neoplasia. Sixty-three patients with metastatic liver disease and 45 patients with nonmalignant liver disease received a total of 46 liver/spleen scans, 61 ultrasounds, and 49 CT scans. The sensitivities of liver/spleen scan, ultrasound, and CT scan were 72, 73, and 81%, respectively; the specificities were 86, 94, and 83%, respectively; and, the accuracies were 78, 84, and 82%, respectively. No statistically significant difference in specificity, sensitivity, or accuracy was seen between the three imaging studies. The serum alkaline phosphatase was significantly more accurate than total bilirubin and SGOT in detecting liver metastasis. However, 19 and 13% of the malignant and nonmalignant groups, respectively, had normal biochemical tests. The sensitivity, specificity, and accuracy of the imaging studies in the presence of an abnormal alkaline phosphatase, SGOT, or total bilirubin were not significantly different than in the presence of normal biochemical tests. These results suggest that other factors such as cost, reproducibility, and availability of skilled interpreters should be considered in the selection of imaging studies for the detection of neoplastic liver disease.

Alkaline Phosphatase↗

Imaging studies and the prognostic value of serum calcitonin in staging small-cell lung cancer.

The controversial prognostic significance of serum calcitonin in small-cell lung cancer (SCC) prompted this retrospective study relating serum levels to (1) stage of disease [limited disease (LD) vs. extensive disease (ED)], (2) imaging studies of metastases to bone, liver, and brain, and (3) survival. Of the 127 previously untreated patients with SCC presenting from 1979 to 1984, calcitonin levels could be compared to the stage of the disease in 69 patients (25 LD and 44 ED) and to various staging procedures including 99mTc methylene diphosphonate bone scans (63 patients), 99mTc sulfur colloid liver-spleen scans (64 patients), computed tomography of the head (63 patients) and serum calcium (61 patients). 71% (49/69) of patients had elevated calcitonin of whom 65% (32/49) had ED. 29% (20/69) had normal levels of whom 60% (12/20) had ED. 40% (18/45) of patients with raised calcitonin had liver metastases. 100% (19/19) with normal calcitonin had no liver involvement. Two patients with hypercalcemia and increased calcitonin had extensive bony metastases. The survival experiences of patients with normal and elevated serum calcitonin levels were analyzed. No significant differences were found within each stage or in the group overall. The positive correlation of serum calcitonin to liver metastases was statistically significant. No such relationship could be demonstrated with stage of disease, bone metastases, brain metastases, or survival.

Calcitonin↗