Showing papers by "Lenox Hill Hospital published in 1976"

A study of thigh muscle weakness in different pathological states of the lower extremity

Abstract: from a study of the lower body strength of 806 West Point Cadets that &dquo; ... individuals who have strength differences greater than 10% between the limbs, and also those in the lower quartile strengthwise, are more likely to be injured than are those who possess normal strength levels.&dquo; These studies were limited to isometrics, with the subjects tested according to the multiple angle testing method and then exercised with

The immune response at the tumor site in lung carcinoma.

Abstract: The local immune response to lung cancer was investigated by histologic and immunologic means. Distinctive patterns of stromal cellular reaction, characteristic for different histologic types of lung carcinoma, were recognized. The amount of cellular infiltration was highest in squamous cell carcinomas and lowest or nonexistent in oat cell carcinomas. Within the various histologic categories the well-differentiated tumors appeared to be accompanied by more reactive cells than the poorly differentiated ones; there was no relation between tumor necrosis and cellular infiltration. The plasma cells were distinctly associated with squamous cell carcinomas; their number in the stroma was proportionate to the degree of differentiation and the presence of keratin produced by the tumors. Eluates with a high content of immunoglobulins were recovered from pleural effusions and from solid lung carcinomas by dissociation of antigen-antibody complexes. These preparations reacted positively in indirect immunofluorescence tests with tissue cultures and with fresh suspensions of lung carcinoma cells, but not with tissue culture cells of most nonpulmonary tumors or with cell suspensions of normal adult and fetal lung. Similarly prepared fractions of noncarcinomatous pleural effusions did not react with lung cancer cells.

Decreased T-lymphocytes in patients with mammary cancer.

Abstract: The levels of thymus-derived lymphocytes (T-cells) in samples of peripheral blood from 47 patients with carcinoma of the breast, 36 patients with benign mammary lesions, and 33 matched normal controls were determined. Results were analyzed with three statistical tests. It was found that the mean percentages of T-lymphocytes differed significantly among the three groups of patients (p less than 0.001). The mean percentages of rosette-forming lymphocytes were 72.8 for the normal group, 60.6 for patients with benign mammary lesions, and 45.1 for the patients with carcinoma. The finding of lower levels of T-lymphocytes in the peripheral blood of individuals with mammary cancer is of particular significance since all the patients in this study were otherwise in apparently good general health and undergoing no treatment.

Responses to drug therapy in ulcerative colitis. Evaluation by rectal biopsy and mucosal cell counts.

Abstract: Rectal biopsies of active untreated ulcerative colitis and treated cases with positive or negative sigmoidoscopic findings were analyzed to evaluate responses to medical therapy. Effects of the administration of salicylazosulfapyridine, prednisone, and 6-mercaptopurine, singly and in combinations, were investigated by mucosal cell counts, comparing ulcerative colitis and noncolitis control groups statistically. Active disease was associated with decreased epithelial goblet cells and increased fragmented nuclei. Lamina propria eosinophils decreased with successful responses to therapy. Prednisone was associated with significantly diminished acute inflammation as reflected by decreased neutrophils; salicylazosulfapyridine was correlated with reduced chronic inflammation as indicated by fewer plasma cells; and 6-mercaptopurine therapy was followed by a reduction in both acute and chronic inflammation and an increase in mast cells. Macrophages, indicators of resolving inflammation, were most significantly increased after drug combinations that included 6-mercaptopurine.

Malignant duodenocolic fistula: Report of two cases, each with one or more other synchronous gastrointestinal cancers

Abstract: Two patients had duodenocolic fistulas, each following a carcinoma of the colon in the area of the hepatic flexure that had perforated into the duodenum. The first patient was treated by a radical pancreatoduodenectomy with right colectomy; the second by subtotal colectomy with excision of the duodenal wall and suture. Both patients are alive and without evidence of recurrent disease. In addition, the first patient had two other primary carcinomas, in the cecum and in the stomach, and the second patient had another primary in the sigmoid. The definitive procedure had to be adjusted to encompass all lesions. The radical operation in one stage seems to be the preferred procedure and certainly is most satisfactory as a cancer operation. Our patient treated by this procedure has survived more than 11 years. An intestinal fistula related to colonic carcinoma, even though rare, should not be considered as a separate entity. Treatment of the cancer with anen-bloc resection of the communicating organs should be employed if possible.

Current status of the treatment of gynecologic cancer by site: ovary.

Abstract: Cancer of the ovary is the leading cause of death from gynecologic cancer. The constant challenge presented by ovarian cancer is that about 11,000 women die from ovarian cancer each year and the results in 1974 are no better than have been achieved in the previous two decades. Standard practice of treatment for truly invasive common epithelial ovarian cancer includes total hysterectomy, bilateral salpingo-oophorectomy, appendectomy, omentectomy, and post-surgical insertion of tubes and administration of P32 (if the disease is of limited extent). Although it is occasionally necessary to resect isolated segments of bowel, exenterative or ultraradical surgery in the management of ovarian cancer is not usually chosen because of the natural history of the disease. However, aggressive surgery is indicated not so much because it is curative, but because it potentiates other forms of treatment. All stages I through IV are treated surgically, to remove as much tumor as possible without running a risk of a gastrointestinal or genitourinary fistula. Radiation therapy has been utilized in addition to the surgical therapy in stage IV to control supraclavicular and/or inguinal node involvement. Single agent alkylating chemotherapy is chosen for the treatment of common epithelial ovarian cancers. Combination chemotherapy does not produce better results at this time, except in the treatment of embryonal tumors. The treatment of the common epithelial tumors by stage is outlined. The treatment of germ cell tumors, gonadal stromal tumors, ovarian tumors in childhood, ovarian tumors in pregnancy, as well as tumors not specific for the ovary, will also be discussed.

Chronic ulcerative colitis complicated by colonic lymphoma: report of a case.

Abstract: THE INCREASE in the incidence of development of colonic carcinoma in patients with chronic ulcerative colitis is well known. Factors influencing the development of carcinoma in patients with ulcerative colitis have been elaborated upon by many investigators, wtto have established: The risk of malignant change is five to ten times greater than in those without ulcerative colitis. Patients in whom colitis involves the entire colon are at most risk, and those who have only rectosigmoidal colitis have almost an insignificant chance of developing carcinoma. The incidence of cancer in patients whose colitis develops before 25 years of age is twice as great as that in those whose colitis develops after 25 years of age. After this the annual risk is about 6 per cent. De Dombal et al. s estimate that the cumulative risk for ten years is 5 per cent; after ten years and over a 25-year period the risk is not less than 40 per cent. For patients who have long histories of colitis involving the entire colon, the case for total proctocolectomy as a prophylactic measure seems hard to counter. 8 In children there is greater risk, as more children have colitis involving the entire colon. The incidence of malignant disease

Computerized pharmacy services in a large community hospital

Abstract: A computerized pharmacy system dealing with drug distribution, clinical services and administrative services is described. Present systems, implemented for 50% of the institution's beds, are discussed fully. Future applications of the system are outlined.