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  • Blackwell Scientific Publications Inc.  (26)
  • 1990-1994  (26)
  • 1985-1989
  • 1970-1974
  • 1992  (26)
  • 1
    Electronic Resource
    Electronic Resource
    Three Cambridge Center, Massachusetts 02142, USA : Blackwell Scientific Publications Inc.
    ISSN: 1525-1438
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 2
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    Electronic Resource
    Three Cambridge Center, Suite 208, Cambridge, MA 02142, USA : Blackwell Scientific Publications Inc.
    ISSN: 1525-1438
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: In a histopathological review of a total population, 1974 cases of endometrial carcinoma were found from 1970 to 1977. Of these 1566 (79.3%) were adenocarcinomas of the endometrioid type, 181 (9.2%) adenoacanthomas, 97 (4.9%) clear cell carcinomas, 74 (3.7%) adenosquamous carcinomas, 31 (1.6%) undifferentiated carcinomas, 22 (1.1%) serous papillary carcinomas and 3 (0.1%) squamous cell carcinomas. Thirty percent of the tumors were well differentiated, 44% moderately and 25.9% poorly differentiated. The mean age at diagnosis was 62.0 years (range 32–93 years). Age was clearly related to histologic type, grade and extent of myometrial infiltration. Crude 5- and 10-year survival rates for the entire group were 73.1 and 61%. For the different subtypes of endometrial carcinoma the 5- and 10-year crude survival rates were as follows: adenoacanthoma 91.2 and 79.6%, adenocarcinoma of the endometrioid type 74.1 and 62.2%, adenosquamous carcinoma 64.9 and 52.7%, undifferentiated carcinoma 58 and 48%, clear cell carcinoma 42.3 and 30.9% and serous papillary carcinoma 27 and 14%. All three patients with squamous cell carcinoma died within a year. The 5- and 10-year survival rates were 87.8 and 79.7% for grade 1 tumors, 76.6 and 62.1% for grade 2, and 60.1 and 48.6% for grade 3. The extent of myometrial infiltration was a string predictor of prognosis. The 5- and 10-year survival rates of patients with intramucosal tumors and tumors infiltrating the inner half of the myometrium were, respectively 89.6 and 82.5%, and 84.7 and 72.7%. Only 48.3 and 29.3% of the patients with tumors reaching the serosa survived, respectively 5 and 10 years. Patients without demonstrable vessel invasion had a significantly better prognosis than those with vessel invasion with a survival rate of 83.5 and 61.1% at 5- and 10-years, compared with 64.5 and 53.8%, respectively. Age at the time of diagnosis was an important prognostic factor for crude survival. Surgico-pathological staging was significantly better than clinical staging in predicting prognosis only in advanced stages.
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  • 3
    ISSN: 1525-1438
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Etoposide (VP16) was administered intravenously at a dose of 150 mg/m2 daily for 2 days every 2 weeks to 24 patients with progressing epithelial ovarian carcinoma which was resistant to platinum analogues. Using standard response criteria there were five clinical partial responses (21%, 95% confidence limits 5–37%) and three disease stabilizations. However, the aim of our study was to determine if etoposide was non-cross-resistant with platinum analogues and therefore we also developed additional response criteria based on serial CA 125 levels. This was to enable us to differentiate within the heterogeneous group of responses that form the stable disease category. Nine of 23 patients (39%, 95% confidence limits 19–59%) demonstrated a fall (all rising prior to etoposide) and of these, three had a serologic partial remission (65% or greater fall). The serologic and clinical responses were strongly correlated. Falling CA 125 levels occurred in the eight patients with either clinical partial responses or disease stabilizations.
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  • 4
    ISSN: 1525-1438
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Safety and feasibility of tumor targeting with radiolabeled monoclonal antibodies was studied in 28 patients suspected of having ovarian carcinoma, after i.v. administration of 1 mg F(ab′)2 fragments of the murine monoclonal antibody OV-TL 3, labeled with 150 MBq Indium-111. There were no adverse reactions, hematological and biochemical serum parameters were stable. In one patient a (subclinical) HAMA-response was found. Plasma clearance of the immunoconjugate was biphasic with half lives of t½}α = 1.4±0.8 h and t½}β = 25.1±3.7 h, resulting in an optimal time period for immunoscintigraphy at 24–48 h after administration. In 20 patients, undergoing extensive explorative surgery, a total of 271 samples of tumorous and normal tissues were analyzed for radiolabel uptake and tumor presence. The mean uptake in tumor deposits was 5.6 times (range 2.2–19.3) as high as the uptake in normal tissues (fat, peritoneum, muscle, skin). The diagnostic accuracy of immunosctigraphy was compared with that obtained with computer tomography, magnetic resonance imaging, ultrasonography and physical examination. While pelvic localizations were equally well detected by all methods, 48% of the abdominally located tumor deposits were correctly diagnosed by immunoscintigraphy, with only 12% detected by ultrasonography, 8% by CT-scanning and physical examination, and 6% by MRI. Immunoscintigraphy has potential as a diagnostic tool in ovarian cancer patients and biolocalization results justify further research into the therapeutic application of labeled monoclonal antibodies.
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  • 5
    Electronic Resource
    Electronic Resource
    Three Cambridge Center, Suite 208, Cambridge, MA 02142, USA : Blackwell Scientific Publications Inc.
    ISSN: 1525-1438
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Seven human serous ovarian atypically proliferating tumors (tumors of borderline malignancy) were grown in primary culture and compared morphologically with established cell lines derived from serous carcinomas (stage III–IV). Several parameters were investigated in order to establish the place of these tumors in a neoplastic spectrum between benign and frankly malignant serous neoplasms. The atypically proliferating tumors showed serous features, including prominent microvilli and multiple cilia, similar to those found in the malignant serous cells. DNA flow cytometric studies of the atypically proliferating tumors showed them to be diploid. Keratins were strongly expressed immunohistochemically by all the atypically proliferating tumors. Vimentin was also detected in six of the original tumors but only in one primary culture. The capacity to culture and study cells which represent possible intermediate stages in the evolution of ovarian malignancy may prove useful as an in vitro model for this disease.
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  • 6
    Electronic Resource
    Electronic Resource
    Three Cambridge Center, Suite 208, Cambridge, MA 02142, USA : Blackwell Scientific Publications Inc.
    ISSN: 1525-1438
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Eighty-four women with vulval warts and 46 controls were examined for cervical epithelial abnormalities by cytology and colposcopy. The prevalence of colposcopically detected abnormalities was the same in the two groups. Minor cytologic abnormalities (less than moderate dyskaryosis) were more common among women with warts than among controls. It is concluded that women with vulval warts are no more likely than controls to have evidence of cervical epithelial abnormalities. These findings are discussed in the light of apparently contradictory findings by other workers.
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  • 7
    Electronic Resource
    Electronic Resource
    Three Cambridge Center, Cambridge, Massachusetts 02142, USA : Blackwell Scientific Publications Inc.
    ISSN: 1525-1438
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: A patient diagnosed as having a myxoid liposarcoma of the broad ligament is presented. She was treated with surgical resection and radiation therapy and is free of disease 2 years after completing surgery.
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  • 8
    Electronic Resource
    Electronic Resource
    Three Cambridge Center, Massachusetts 02142, USA : Blackwell Scientific Publications Inc.
    ISSN: 1525-1438
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: An evaluation was made of factors that affect the recurrence of cervical cancer after primary surgery, these including age, clinical stage, histology, grade, involvement of uterine body, parametrium or vagina and lymph node metastases. During a period of at least 3 years, 702 of 1508 patients who underwent radical hysterectomy and pelvic lymph node dissection were studied by using a scoring system. A comparison between the group of women scored at or greater than 13 that scored less than 13 revealed that the risk of recurrence was higher in the former group. One hundred and twenty five of 702 patients found to have positive pelvic node involvement scored greater than 13, which rendered them eligible for further mangement as follows: the recurrence rate in 99 patients receiving multi-agent chemotherapy was 34.4%, compared with 65.4% in 26 patients receiving no treatment (P 〈 0.01). Applying this score to other patients in planning adjuvant therapy, the recurrence rate may be reduced further. The number of patients needlessly exposed to the toxic effects of multi-agent chemotherapy may be reduced also.
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  • 9
    ISSN: 1525-1438
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Eighty primary endometrial carcinomas were analyzed for the presence of epidermal growth factor receptors (EGF-R) by the use of a single point (1ng 125I-EGF) EGF-R assay. Fifty percent of the analyzed specimens were EGF-R positive (EGF-R(+)) with binding capacities 〉 1 fmol mg−1 and 15% bound 〉 7 fmol mg−1. The EGF-R status was correlated with different clinically relevant prognostic factors and the survival rates were analyzed. The correlations revealed no significant differences in the grade of tumor differentiation and in the depth of myometrial invasion. The advanced tumor stages III and IV and tumors with a squamous cell component in the histologic examination expressed EGF-R in a higher percentage. Between the EGF-R and the steroid receptor status existed a weak negative correlation. Estrogen receptor positive tumors were in 47% and progesterone receptor positive tumors in 45% EGF-R (+). The corresponding number for the receptor negative tumors were 57 and 65%. Life table analyses were performed with different cut-off limits for specific EGF binding ranging from 〉 1, 〉 3, 〉 5 and 〉 7 fmol mg−1. Dependent on the cut-off limits the analysis demonstrates a reduced survival probability for patients with EGF-R+ tumors. These differences were mainly found in the small group with a high number of EGF-R’s (〉 7 fmol). The analysis of tissue extracts for the presence of factors binding to the EGF-R revealed in some specimens high concentrations of EGF-like factors. By the use of TGFa (transforming growth factor alpha) immunohistochemistry we were able to demonstrate that the tumor cells produce TGFa, whereas the stroma is TGFa negative. We assume that the EGF-like factors consist mainly of TGFa.
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  • 10
    Electronic Resource
    Electronic Resource
    Three Cambridge Center, Massachusetts 02142, USA : Blackwell Scientific Publications Inc.
    ISSN: 1525-1438
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Patients with squamous cell carcinoma of the cervix FIGO stages IB to IV (n = 306) were compared to patients with adeno(squamous) carcinoma (n = 70). There was no difference between the mean ages of the groups. In the patients who underwent radical surgical treatment, whether or not in combination with radiotherapy (n = 209), stepwise regression analysis showed that a positive lymph node status was the most unfavorable prognostic factor, followed by the histologic type (adeno(squamous) carcinoma) and the tumor diameter (〉 3 cm). Vascular-space invasion had no additional prognostic value. Patient’s age did not affect the prognosis. Distant metastases were not found to be more prevalent in the patients with adeno(squamous) carcinoma. In patients with adeno(squamous) carcinoma and positive lymph nodes, it is worth considering more intensive locoregional treatment than is usually prescribed for these patients and/or adjunctive chemotherapy, because there is a high risk of tumor recurrence.
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  • 11
    ISSN: 1525-1438
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: A review of all available cervical smears from 96 women who subsequently developed invasive cervical carcinoma was undertaken. The aim of the study was to determine the incidence of confirmed negative smears prior to the histologic diagnosis of carcinoma and investigate the relationship between the duration and grade of smear abnormality, the patients’ age and the histologic types of cervical carcinoma. The results indicate that only 10% of women had confirmed negative smears, the majority occurring more than 7 years before the diagnosis of carcinoma. In contrast, 89% of young women (under 40 years of age) had a significant abnormality (moderate dyskaryosis or worse) up to 6 years before diagnosis. There is evidence to suggest that the preinvasive phase of cervical carcinoma may be shorter in younger women and that the less common types of cervical carcinoma occur more frequently in this group. The combination of inadequate clinical follow up and false negative cytology may have allowed a significant proportion of these women to develop invasive cervical carcinoma. Possible reasons for false negative smears have been identified and methods aimed at decreasing their frequency are discussed.
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  • 12
    ISSN: 1525-1438
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The tumor growth phenotype was characterized in relation to concentration of circulating estradiol, estradiol receptor (ER) activation and progesterone receptor (PgR) induction. Ten tumor pieces from an ER and PgR positive human endometrial adenocarcinoma grown in non-oophorectomized nude mice for one year were randomly selected to grow during a preparation phase of 4 weeks either in oophorectomized nude mice — to adapt tumor growth to the absence of estradiol (group A), or in non-oophorectomized nude mice (group B). For the experimental phase, tumor pieces from each group were again randomly assigned to either of two subgroups (i.e., 4 subgroups in all): with estradiol treatment (subgroups A+ and B+), or without (subgroups A− and B−) as control subgroups. There were no differences in take rate or tumor growth rate between the control subgroups (A− vs. B−), indicating tumor growth to be estradiol-independent. The tumor was estradiol-sensitive, however, as tumor growth could be stimulated by estradiol. Despite its estradiol-independence of growth, the tumor’s estradiol-binding capacity varied according to whether the host animals were oophorectomized or not; and despite the similar growth patterns during the experimental phase, the values of high affinty bound ER (ER activation) were greater for tumors grown in non-oophorectomized mice during the preparation phase than for those grown in oophorectomized mice. Thus, our findings show that an ovarain (estradiol) independent but responsive phenotype of tumor growth is present in human endometrial adenocarcinomas growing in nude mice. This growth phenotype may represent an intermediate state of tumor progression to hormone independence and resistance, which has hitherto been observed only in rodent tumors.
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  • 13
    Electronic Resource
    Electronic Resource
    Three Cambridge Center, Massachusetts 02142, USA : Blackwell Scientific Publications Inc.
    ISSN: 1525-1438
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The relevance of flow cytometric DNA analysis in neoplasia of the female genital tract is reviewed. The virtues and limitations of the technique are discussed. There is good evidence, mainly from retrospective studies, that DNA ploidy and/or the tumor S-phase fraction are valuable prognostic indicators in patients with carcinoma of the ovary and endometrium. Further prospective studies are needed, however, to establish the precise value of flow cytometric DNA analysis before it can be used safely for stratification of therapeutic regimes.
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  • 14
    Electronic Resource
    Electronic Resource
    Three Cambridge Center, Massachusetts 02142, USA : Blackwell Scientific Publications Inc.
    ISSN: 1525-1438
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The 235 patients with stage IB/IIA cervical carcinoma treated by Wertheim’s hysterectomy, as a primary procedure, at St Mary’s Hospital, Manchester between 1975 and 1989 inclusive, form the basis of this study. Using Cox’s regression model, four variables were shown to have independent prognostic significance. These were: (1) lymphatic permeation (adjacent to the tumor); (2) tumor volume; (3) being pregnant at diagnosis and (4) lymph node metastases. A heuristic model was formulated which was based upon these four factors and by using this information it was possible to separate the patients into four distinct prognostic groups. It is suggested that this model may prove useful in identifying those patients at a higher risk of dying of disease and who would benefit from early adjuvant systemic therapy.
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  • 15
    Electronic Resource
    Electronic Resource
    Three Cambridge Center, Massachusetts 02142, USA : Blackwell Scientific Publications Inc.
    ISSN: 1525-1438
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
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  • 16
    ISSN: 1525-1438
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Fifty-three patients with histologically proven ovarian cancer were treated with intraperitoneally administered cisplatin or human recombinant interferon-alpha through a totally implanted peritoneal access port. A total of 281 treatment courses were given. No complications related to surgical implantation of the port were seen. Infectious complications, intra-abdominal problems or subcutaneous drug extravasation did not occur. In two patients the number of treatment courses was limited due to inflow obstruction. A totally implanted peritoneal access port proves to be a reliable route for the intraperitoneal treatment of patients with ovarian cancer. The strict aseptic technique we used contributes to its safety by preventing intra-abdominal infections.
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  • 17
    Electronic Resource
    Electronic Resource
    Three Cambridge Center, Cambridge, Massachusetts 02142, USA : Blackwell Scientific Publications Inc.
    ISSN: 1525-1438
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: One hundred and thirty-one squamous cell carcinomas of the vulva were examined by FCM-DNA measurements. Samples were prepared from paraffin-embedded tissue. Of these, 66 were found to be diploid, 52 aneuploid and 13 could not be evaluated. The 5-year crude survival rate was 62% for the diploid and 23% for the aneuploid tumors (P 〈 0.001). The aneuploid tumors without lymph node (LN) metastases showed a 5-year cancer-related survival rate of 44% as compared to 58% for the diploid tumors with LN metastases. In a multivariate Cox regression analysis the most important independent prognostic parameters were (1) LN involvement (P 〈 0.0001), (2) tumor ploidy (P = 0.0001) and (3) tumor size (P = 0.0039). By using ploidy and lymph node involvement in this way as prognostic factors we are able to identify high- and low-risk groups of patients. We strongly believe that these results should lead to a different attitude towards therapy in vulva cancer patients.
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  • 18
    Electronic Resource
    Electronic Resource
    Three Cambridge Center, Cambridge, Massachusetts 02142, USA : Blackwell Scientific Publications Inc.
    ISSN: 1525-1438
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: In a group of 367 women treated for invasive carcinoma of the cervix tumor recurrence was discovered at an asymptomatic stage in 16 (23%) patients. The tumor recurrence was localized to the pelvis in 29 (41%) cases, in the vaginal wall in 3 (4%) cases, and 39 (55%) patients had distant metastases (with or without recurrent tumor in the pelvis). Curative treatment (surgery, n = 2; radiotherapy, n = 8) was applied in 5/29 (17%) patients whose recurrent disease was confined to the pelvis, in all 3 patients with vaginal recurrence and in 2/39 (5%) of the patients with distant metastases. Permanent remission (follow-up 〉 36 months) was observed in 2 patients with vaginal recurrence and in one with central recurrence. Temporary complete remission (mean 22 months, range 12–30 months) was observed in 3 patients (2 with central recurrence and one with vaginal recurrence). In 20 (69%) of the patients with central or locoregional recurrence, the primary treatment had been so radical (including adjuvant postoperative or full radiotherapy) that surgical treatment or radiotherapy of the recurrence was not considered possible or worthwhile; moreover, 4 of the patients were older than 80 years of age. In retrospect, exenterative treatment could have been considered in 14 patients (〈 70 years) and based on 50% operability, could have led to a cure in 2 to 4 patients with tumor recurrence in the pelvis without distant metastases. Chemotherapy was applied to 10 patients, one of whom went into complete remission of lung metastases (follow-up 108 months).
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  • 19
    ISSN: 1525-1438
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Nuclear morphometry was performed on the diagnostic biopsy in 65 cases of non-mucinous ovarian carcinoma (FIGO stage IIB–IV) and its prognostic value regarding patient survival after the second-look operation was compared to that of morphology and clinical observations. In a univariate Cox survival analysis four morphometric factors were found to be significant predictors of survival (the standard deviations (SD) of the nuclear area, perimeter, largest perpendicular axis, and largest axis). Age, the size of residual tumor after the primary operation, and a combined variable describing the status at the second-look operation and also the result of tumor reduction were significant clinical variables. None of the morphologic variables proved to be significant. In the multivariate Cox analysis the SD of the largest perpendicular nuclear axis gave independent prognostic information together with either the size of residual tumor after the primary laparotomy (P = 0.00004) or the second-look variable (P 〈 0.00001). When the SD of the largest perpendicular nuclear axis and the second-look variables were included in the model the size of residual tumor after the primary operation added no further prognostic information. We conclude that nuclear morphometry is a simple, easily implemented and cheap quantitative method which gives objective and valuable prognostic information regarding survival in advanced ovarian cancer.
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  • 20
    ISSN: 1525-1438
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
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  • 21
    Electronic Resource
    Electronic Resource
    Three Cambridge Center, Suite 208, Cambridge, MA 02142, USA : Blackwell Scientific Publications Inc.
    ISSN: 1525-1438
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: A case of a 42-year-old woman with peritoneal leiomyomatosis (PL) unrelated to pregnancy or any other obvious hormonal source is presented. After treatment with leuprolide acetate for six months, a second-look operation revealed that the majority of the nodules totally regressed. The few remaining ones were substantially reduced in size and exhibited histopathologic evidence of fibrotic change. This response to treatment is documented here for the first time. Since this case was not associated with initial abnormally raised hormonal levels, the regression was caused solely by the treatment and not by the removal of any hormonal stimulus. The usefulness of GnRH analogues in the treatment of PL is proposed.
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  • 22
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    Electronic Resource
    Three Cambridge Center, Suite 208, Cambridge, MA 02142, USA : Blackwell Scientific Publications Inc.
    ISSN: 1525-1438
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The Retinoblastoma (Rb-1) and p53 genes appear to play an important role in controlling cell division, and mutations in Rb-1 and p53 have been reported widely in non-gynecological cancers. Unlike other cancer-related genes, which become activated during carcinogenesis, it is the loss of wild type p53 and Retinoblastoma protein (RB) function that is thought to contribute to cancer development. These genes therefore, have been called tumor suppressor genes since normal function appears to be necessary for negative control of cell growth. Several viral oncoproteins have been shown to interact with RB and p53. It seems likely that the formation of these complexes inactivates the cellular protein resulting in an overall effect similar to somatic mutation of the Rb-1 or p53 genes. The HPV16 transforming proteins E7 and E6 complex with protein products of Rb-1 and p53, respectively. In HPV positive anal and cervical tumors the normal function of RB and p53 may be inhibited by these viral proteins and so mutation within the RB-1 and p53 gene coding sequences would not appear to be a necessary step in the genesis of these tumors. However, in HPV negative tumors from the same tissues, loss of wild type Rb-1 and p53 activity may only be achieved by somatic mutation of these genes.
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  • 23
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    Electronic Resource
    Three Cambridge Center, Cambridge, Massachusetts 02142, USA : Blackwell Scientific Publications Inc.
    ISSN: 1525-1438
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The Tenckhoff catheter provides useful access to the peritoneal cavity for chronic peritoneal dialysis and treatment of intraperitoneal malignancy. The usual methods of placement of Tenckhoff catheters include: blind insertion, open surgical implantation and peritoneoscopic guided placement. This is a description of a technique for percutaneous introduction using a trocar. Sonographic guidance is used to assure a safe insertion and proper location. This technique has been used in the office to provide access to the peritoneal cavity to allow palliative management of massive, intractable malignant ascites. The patient or selected caretaker can care for and access the catheter intermittently at home for relief of symptoms.
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  • 24
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    Electronic Resource
    Three Cambridge Center, Cambridge, Massachusetts 02142, USA : Blackwell Scientific Publications Inc.
    ISSN: 1525-1438
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Of 50 patients with borderline epithelial ovarian tumors, 32 (64%) had serous, 17 (34%) had mucinous and one (2%) had endometrioid tumor. All patients with mucinous tumor had stage I disease, whereas 4 patients with serous tumor had stage II–III disease. Five patients (10%) were pregnant at the time of diagnosis. Seventeen patients (34%) had initial surgery with ovarian conservation and 7 of them were not subjected to further surgery. Five patients (10%) received adjuvant chemotherapy. Five-year survival and 5-year disease-free survival rates were 100% and 96.4%, respectively. It is concluded that for patients with stage IA disease unilateral salpingo-oophorectomy seems to be adequate treatment and for those with more than stage IA disease, surgery should include total abdominal hysterectomy and bilateral salpingo-oophorectomy. Although the effectiveness of chemotherapy in these tumors is uncertain, adjuvant chemotherapy is advocated for patients in whom spread of the tumor beyond the ovaries has occurred.
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  • 25
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    Electronic Resource
    Three Cambridge Center, Cambridge, Massachusetts 02142, USA : Blackwell Scientific Publications Inc.
    ISSN: 1525-1438
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: A retrospective study of recurrent cancer of the cervix was carried out on patients who attended the Gynaecologic Oncology Unit, Royal Brisbane Hospital, between the years 1982 and 1986. Ninety-four recurrences were assessed out of 526 patients (17.7%). The likely recurrence was related to stage. Sixty-seven percent had pelvic recurrences with 33% recurring in extrapelvic sites alone. The most common site of tumor recurrence was central pelvis (47%). Histopathology recurrences were analyzed and recurrence was found to be more common with the rare tumor types. Mortality of recurrent carcinoma of the cervix is high. Multivariate analysis shows lymph node metastases and histologic status of resection margins to be independent variables predictive of recurrence. Lymphvascular space involvement has not been an independent variable after adjusting for nodes and margins. Cytology of vaginal vault or residual cervix smear shows that 58% of patients with central recurrence had an abnormal smear. The relative literature was discussed in relation to the findings of our unit.
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  • 26
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    Electronic Resource
    Three Cambridge Center, Cambridge, Massachusetts 02142, USA : Blackwell Scientific Publications Inc.
    ISSN: 1525-1438
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Sixteen patients with advanced cervix cancer have been treated in a phase I/II study of concurrent radiotherapy and cisplatin chemotherapy. The external beam radiotherapy was given as a ‘split course’ because of initial concerns about acute toxicity. The treatment was well tolerated with all patients completing the prescribed radiotherapy and all patients received the intended four doses of cisplatin. One of 5 patients with stage IVB disease is alive and disease free 35 months after treatment. Six of the 11 patients with disease confined to the pelvis are alive and disease free between 28 and 53 months after treatment. One patient has required surgery for a recto-sigmoid stricture.
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