PubMed Health⌕ Search

Biomedical subjects

W R Jewell

Publications and source records attributed to W R Jewell.

At least 19 recordsLinked to original sources
PubMed1992

Breast cancer with extensive intraductal component: treatment with immediate interstitial boost irradiation.

Extensive intraductal component (EIC) has been reported to have a prominent role in local recurrence after treatment of early-stage breast cancer with lumpectomy and irradiation. Pathologic specimens from 250 breasts (245 patients) treated between June 1982 and June 1990 with lumpectomy, immediate (boost) interstitial iridium-192 to 15-20 Gy, and external-beam irradiation to the entire breast to 45-50 Gy were reviewed. EIC was present in 61 breasts. At a median follow-up period of 58 months (range, 14-110 months), there were 10 recurrences in the 250 treated breasts. Of these 10, three were in patients from the group with EIC. The 10-year actuarial recurrence rates in breasts with and without EIC were 9.1% and 5.2%, respectively. The difference between the two rates was not significant. If an immediate boost with interstitial iridium is used in therapy, the influence of EIC on local failure is insignificant.

Adult↗
PubMed1979

The radiological spectrum of gastric bypass complications.

Gastric bypass is now the operation of choice for surgical management of morbid obesity. Prompt and accurate radiological diagnosis in the early postoperative period is critical for proper management of suspected gastrojejunal anastomotic leakage, abscess formation, and acute distension of the excluded stomach and afferent loop. Inadequate weight loss may indicate an increase in the gastric pouch and anastomosis or dehiscence of the staple line. Gastric and jejunal ulceration and anastomotic narrowing also require radiological and endoscopic evaluation.

Afferent Loop Syndrome↗
PubMed1979

Scintiscans in the evaluation of patients with malignant melanomas.

In an attempt to define the role of scintiscanning in patients with a malignant melanoma, 349 liver, bone and brain scans in 136 patients have been reviewed. No patient with clinical Stage I or II disease was found to have occult metastases detected by scintiscans. All patients with proved positive scans demonstrated clinical symptoms consistent with the results of scintiscanning. Scintiscans in patients with a malignant melanoma are most effectively used to evaluate the symptomatic patient with Stage I or II disease and all patients with Stage III disease. Histologic verification of positive scans in patients with Stage I and II disease avoids unwarranted therapeutic decisions. There is, however, practical value in being able to predict accurately the absence of metastatic involvement. In only two of 249 examinations did the scans fail to detect metastases. A normal scan is a strong indicator of the absence of metastatic disease.

Adolescent↗
PubMed1978

Localization of Fc receptors in human and rat malignant tissues.

Three human malignant tumors and a rat carcinoma (Walker 256), which all showed strong Fc receptor activity in tests with sheep erythrocytes (E) sensitized with rabbit IgG antibodies (A), were used to study the distribution of the receptor in subcellular fractions isolated by differential centrifugation. Smears of the three crude sediments obtained (nuclei, mitochondria rich and membrane rich) all possessed receptor activity. EA incubated in the suspension of cell fractions did not attach to Fc receptor positive tissue sections or to cells in suspension. Cells from which the surface receptors had been eluted still showed activity in sections of cell pellets. Apparently the Fc activity is connected with both external and internal membranes.

Adsorption↗
PubMed1978

Preoperative diagnosis of potentially precancerous breast lesions by computed tomography breast scanner: preliminary study.

Eighteen cases of severe atypical epithelial hyperplasia of the breast were detected preoperatively by computed tomography breast scanner (CT/M) with contrast enhancement. The CT number before enhancement ranged from -17 to +31 and increased to 26 to 42 after enhancement (5.2-8.4% increase in attentuation). These data suggest that CT/M can differentiate these potentially precancerous lesions from benign fibrocystic disease.

Adult↗
PubMed1977

Tricuspid stenosis secondary to metastatic melanoma.

Cardiac metastases from malignant melanoma are frequent, usually asymptomatic and occur terminally. When responsible for symptoms, close evaluation of the patient is imperative for correct diagnosis and subsequent therapy. Surgical intervention where indicated in combination with chemotherapy and judicious use of irradiation constitutes optimal therapy.

Adult↗
PubMed1977

Endodermal sinus tumor of the ovary and alpha fetoprotein: a case report.

Yolk sac tumors of the ovary are associated with elevations in serum levels of alpha fetoprotein (AFP). Thus, an antigenic marker is provided for evaluating therapeutic results in selected patients. A patient with a pure endodermal sinus tumor of the ovary is presented who underwent serial determinations of AFP. The effectiveness and limitations of serial AFP levels as demonstrated by this case are discussed in addition to the surgical and chemotherapeutic management of patients with yolk sac tumor of the ovary.

Adult↗
PubMed1977

Management of the morbidly obese patient after small bowel bypass failure.

Fourteen patients underwent small bowel bypass (SBB) takedown for complications such as chronic nausea and vomiting, excessive flatus, intractable diarrhea, liver dysfunction, electrolyte imbalance, hyperoxaluria with renal stones, and arthritis. The average weight loss in these 14 patients after SBB was 93 pounds (34% of initial weight), with a mean follow-up of 23 months. Four of the 14 patients had SBB takedown only and gained an average of 36 pounds over the ensuing 14 months. Similarly, three patients had SBB takedown with delayed (asynchronous) gastric bypass (GB) and gained an average of 55 pounds during the 14 months prior to GB. Following GB these three patients lost only an additional 8 pounds over a 12 month period, leaving them 47 pounds heavier than at the time of SBB takedown. In contrast, seven patients treated with SBB takedown and synchronous GB not only maintained the weight reduction obtained with SBB, but, in addition, had further modest weight reductions (average, 18 pounds), for a mean follow-up of 8 months. There were no serious operative or late complications with any of the above operations. In addition, the complications leading to SBB takedown resolved in each case. It is concluded that synchronous GB is an effective means of maintaining the weight reduction in the morbidly obese patient after SBB takedown.

Adult↗
PubMed1976

The metastatic potential of metastases: a case report.

Confirmation of the potential for metastases to metastasize in humans, especially those patients with a well controlled primary, should alter present approaches to patients with malignant disease and isolated recurrences. Reported herein is a case clearly demonstrating the metastatic potential of metastases.

Abdominal Neoplasms↗
PubMed1976

Critical analysis of treatment of stage II and stage III melanoma patients with immunotherapy.

Over the past 8 years, 244 patients with Stage II or III melanoma have been treated by cutaneous injection of a crude acellular homogenate of allogeneic melanoma cells (V-I) or a more concentrated fraction (V-II), followed in most patients by exchanges of WBC between paired partners. Patients with Stage III disease exhibited an overall response rate of 24% and prolongation of survival compared with control data. Stage II patients also had prolonged survival and reduced rate of recurrence over historic peers' data. Breakdown of subgroup data revealed that V-II plus exchange of WBC is similar to V-I plus exchange or V-II alone. However, recent experience of LTF suggests a higher response rate than in either V-I or V-II groups, particularly when autochthonous tumor is used for cross-immunization. The most meaningful immunologic data resulted from analysis of DNCB and MIF data. Patients negative to DNCB rarely respond to immunotherapy. A positive pretreatment MIF or positive conversion following treatment correlates with response, whereas, conversion of positive to negative predicts poor clinical performance.

Antigens, Neoplasm↗
PubMed1976

Tumor Fc receptors and tumor-associated immunoglobulins.

Tissue sections and cell suspensions from ten malignant tumors were tested for Fc receptors using sheep erythrocytes sensitized by rabbit IgG antibodies. Surface bound IgG on cells from the same tumors were estimated using an antiglobulin consumption test with 125I labelled human IgG as reference. The amount of IgG present per 10(6) cells varied from less than 100 ng to approximately 600 ng. When these amounts of IgG were plotted against the Fc receptor activity of corresponding tumors, seven of the tumors were distributed along a line showing an inverse linear relationship; i.e. tumors with large amounts of IgG on their cell surfaces had the lowest Fc reactivity and vice versa. Cells from three of the tumors had lower amounts of IgG on their surface than expected from this relationship. However, the lack of correlation could be explained by the focal distribution of the Fc positive tissue within non-reactive tissue. The cells from these areas presumably carry less IgG on their surface and thereby reduce the quantity of IgG calculated per 10(6) cells. Prolonged washing of tumor sections resulted in stronger Fc receptor activity, and correspondingly washed cells had lower amount of IgG on their surface. Presumably the Fc receptor can bind IgG in vivo.

Animals↗
PubMed1976

Gastric bypass for morbid obesity: results and complications.

Seventy-five patients underwent a 90 percent distal gastric bypass for morbid obesity. The average weight was 121.4 kilogram, height 164 centimeters, and age 31.4 years in these 70 women and five men. There was a total of 20 surgical complications in the 75 patients, with wound infection being the most common. Sixteen chronic complications were noted and consisted of vomiting, diarrhea, reflux esophagitis, dysphagia, and vitamin deficiencies. None of the above complications were life-threatening or required dismantling of the bypass. Of 54 patients followed for 12 months or more after gastric bypass, there was a 24.5 percent average weight decrease at 6 months, and this progressed to 35.8 percent by 12 months. Fifty-two patients undergoing small bowel bypass previously at the same institution had a 25.4 percent weight reduction at 12 months. Of 54 patients, 83 percent followed for one or more years after gastric bypass have had an excellent or good clinical result, whereas only 42 percent of the 52 patients undergoing small bowel bypass have had an excellent or good clinical result with the same criteria. It is concluded that the Mason 90 percent distal gastric bypass is a suitable form of surgical treatment for the morbidity obese patient who cannot lose weight by dietary measures.

Adolescent↗