Showing papers by "University of Texas System published in 1986"
TL;DR: The International Staging System for Lung Cancer provides for classification of six levels of disease extent in five stage groups that relate to patient management and prognosis and can be readily applied in a broad spectrum of clinical and teaching environments.
1,533 citations
TL;DR: This work has localized a nuclear matrix association region (MAR) within the mouse immunoglobulin kappa gene that contains two topoisomerase II sites and is adjacent to the tissue-specific enhancer.
857 citations
TL;DR: Sixteen patients presenting with granulocytic sarcoma without evidence of acute leukemia were seen and diagnosed at The University of Texas M. D. Anderson Hospital and Tumor Institute at Houston from 1962 to 1985 and did not develop acute leukemia.
Abstract: Sixteen patients presenting with granulocytic sarcoma without evidence of acute leukemia were seen and diagnosed at The University of Texas M.D. Anderson Hospital and Tumor Institute at Houston from 1962 to 1985. Seven of them (44%) did not develop acute leukemia. Of these seven, four are alive with no evidence of disease 3.5 to 16 years after initial presentation; the remaining three patients died of their disease within 2 to 8 months of presentation. Two of 16 patients were diagnosed within the last 15 months and do not have adequate follow-up. The seven remaining patients developed acute leukemia within 1 week to 13 months of the diagnosis of granulocytic sarcoma. Six of them died 5 weeks to 16 months after diagnosis; one patient has been in complete remission for 8 years. Twelve of these 16 cases (75%) were initially misdiagnosed, most frequently as large cell lymphoma. The remaining four cases were correctly diagnosed as granulocytic sarcoma. The naphthol-ASD-chloroacetate esterase stain was required to make the correct diagnosis in all cases. Contrary to findings in other series, granulocytic sarcoma arising in nonleukemic patients does not necessarily progress to acute leukemia. At least four of 16 (25%) patients in this series did not develop acute leukemia during the 3.5 to 16 years they have been followed. No prognostic factors were identified in this series to predict which patients would develop acute leukemia and which ones would not.
392 citations
TL;DR: Although high-dose melphalan was of limited benefit to patients with refractory myeloma, further studies are necessary to clarify its role during earlier phases of disease.
338 citations
TL;DR: The findings suggest that it may be useful to use parental surname as an indicator for Mexican-American ethnicity in research involving vital statistics and to add parental surnames to other health records frequently used in secondary analyses.
Abstract: Because the issue of how to empirically identify Mexican Americans in health-related research is still unresolved, the authors compared the performance of three indicators for identifying Mexican Americans across five distinct population subgroups: men and women in two age strata, and residents in low, middle, and high socioeconomic neighborhoods. Individual surname had the lowest sensitivity, specificity, and predictive values in the pooled population sample and varied the most widely on these parameters across population subgroups. Parental surnames, which are available on vital statistics and could easily be added to other health records used in secondary analyses, offered a significant improvement over individual surname in classifying persons as Mexican American. The San Antonio Heart Study (SAHS) algorithm, a nine-item indicator which uses parental surnames, birthplace of both parents, self-declared ethnic identity, and ethnic background of grandparents, had the highest sensitivity, specificity, and predictive values and varied the least on these parameters across different sex, age, and socioeconomic status population subgroups. The performance of all indicators was lower at the higher socioeconomic status levels. The findings suggest that it may be useful to use parental surnames as an indicator for Mexican-American ethnicity in research involving vital statistics and to add parental surnames to other health records frequently used in secondary analyses. Since the SAHS algorithm can be adapted for use with non-Mexican origin Hispanic subgroups, it may be a useful indicator for Mexican-American (or other Hispanic) ethnicity in survey research.
204 citations
TL;DR: It is reported that two extracellular matrix glycoproteins, fibronectin and laminin, when individually precoated on tissue culture plates promoted in vitro attachment and outgrowth of mouse blastocysts in serum-free medium.
187 citations
TL;DR: Alpha-mercaptopropionylglycine has a definite therapeutic role in cystinuric patients with toxicity to D-penicillamine and was equally as effective in reducing cystine excretion.
184 citations
TL;DR: Stromal overgrowth is a significant histologic indicator of malignant behavior in cystosarcoma phyllodes and was significant at P levels of 0.0014 and 0.02, respectively.
Abstract: Twenty-six cases of cystosarcoma phyllodes diagnosed at M. D. Anderson Hospital were reviewed. The following criteria were evaluated for possible correlation with local recurrence, uncontrolled local recurrence, metastasis, and tumor death: tumor size, stromal overgrowth, tumor necrosis, mitotic rate, stromal cellularity, nuclear size and pleomorphism, the presence of specialized stroma, and initial therapy. Of the 26 tumors, seven caused death. Five patients developed metastatic spread, and all of them died of tumor. Five patients had local recurrence, which was uncontrolled in three (two patients died with uncontrolled recurrence alone, and one with uncontrolled recurrence and metastasis). Stromal overgrowth was present in eight cases. Six of the seven patients who died of tumor had stromal overgrowth, including all five with metastasis. Correlation of stromal overgrowth with meta static spread and tumor death was significant at P levels of 0.0014 and 0.02, respectively. It is concluded that stromal overgrowth is a significant histologic indicator of malignant behavior in cystosarcoma phyllodes.
169 citations
TL;DR: Findings indicate that the activation of protein kinase C and mobilization of Ca2+ evoked by PMA and A23187 respectively are synergistically effective for eliciting a full physiological response of EC in the generation and release of O2−.
Abstract: In order to study the signal transduction mechanism of human endothelial cells (EC), the regulation of superoxide anion (O2−) release in EC has been investigated using the calcium ionophore A23187 and phorbol myristate acetate (PMA), a potential activator of the Ca2+ activated, phospholipid-dependent protein kinase, designated “protein kinase C.” PMA enhanced O2− release from EC, and this enhancement occurred regardless of the presence or absence of extracellular Ca2+. A similar increase was produced by A23187; omission of extracellular Ca2+ prevented this increase. Simultaneous stimulation with PMA and A23187 produced a large increase in O2− release at submaximal concentrations of these agents, which, when added separately, caused minimal effects. These findings indicate that the activation of protein kinase C and mobilization of Ca2+ evoked by PMA and A23187 respectively are synergistically effective for eliciting a full physiological response of EC in the generation and release of O2−.
163 citations
157 citations
TL;DR: Overall absolute clinical efficacy was limited, as only four treated subjects showed a full remission of binge episodes, and longer treatment with more specifically tailored cognitive- behavioral techniques may be warranted in the search for more efficacious results for bulimia.
Abstract: The efficacy of 6 weeks of twice-weekly, cognitive-behavioral group therapy (n = 15) was compared with a waiting list control (n = 15) in 30 women with bulimia by DSM-III. Relaxation techniques and group discussions to alter dysfunctional attitudes regarding eating and appearance was used. A significant decrease in both binge and purge frequency was found in the treated compared with the wait-listed group. Treated subjects who decreased their binging and purging maintained improvement 4 months after treatment termination. However, overall absolute clinical efficacy was limited, as only four treated subjects showed a full remission of binge episodes. Longer treatment with more specifically tailored cognitive- behavioral techniques may be warranted in the search for more efficacious results for bulimia.
TL;DR: The intranuclear organization observed in this study suggests that neuronal activity in distinct regions of the DR nucleus may independently influence discrete populations of cerebrocortical cells.
Abstract: The present study was conducted to examine the spatial organization of dorsal (DR) and median (MR) raphe neurons that project to rostrocaudally aligned areas of the rat cerebral cortex. An additional goal was to determine if individual DR cells that send efferents to forelimb sensorimotor or visual regions of the neocortex also send axon collaterals to forelimb (crus II) or visual (paraflocculus) areas of the cerebellum. Long-Evans hooded rats received unilateral pressure injections of horseradish peroxidase (HRP) in either motor (n = 4) or sensorimotor (n = 5) or visual (n = 4) cortex to determine the intranuclear location of DR and MR neurons that project to specific neocortical regions. Coronal sections (40-100 microns) through the pons and midbrain were examined by light microscopy after the tetramethyl benzidine reaction and neutral red counterstaining were carried out. The locations of retrogradely labeled cells were recorded relative to a three-dimensional biological coordinate system maintained by a computer linked to the light microscope. For double labeling studies, unilateral injections of fast blue and nuclear yellow were made in paired motor (sensorimotor cortex and crus II of the lateral cerebellum) or visual (cortical area 17 and paraflocculus) areas of the CNS. Coronal tissue sections (35 microns) were collected on coverslips and examined on a Leitz fluorescence microscope (wavelength = 365 nm). DR neurons labeled from cerebrocortical injections of HRP were concentrated in the rostral two-thirds of the nucleus. HRP-filled neurons were distributed such that individual groups of neurons projecting to motor, sensorimotor, or visual cortex were aligned in a partially overlapping, rostral to caudal array. In the dorsoventral dimension, retrogradely labeled cells were clustered in three distinct groupings such that neurons projecting to the motor, sensorimotor, and visual areas were concentrated in dorsal, intermediate, and ventral portions of the DR nucleus, respectively. For all cases, the majority of HRP-filled cells were positioned along the midline or displaced to the side of the nucleus that was ipsilateral to the cortical injection site. A small number of retrogradely labeled neurons were observed in the MR following injections in the motor cortex. Computer-assisted reconstruction of the neuroanatomical data facilitated the visualization of spatial relationships between groups of DR neocortical projection neurons.(ABSTRACT TRUNCATED AT 400 WORDS)
TL;DR: It is indicated that patients with duodenal ulcer disease secrete excessive amounts of gastric acid during the day and night and throughout an entire 24-h period.
TL;DR: In this article, a CT-guided needle biopsy of deep parenchymal lesions contributed to the diagnosis of primary central nervous system (CNS) lymphoma, integrating the techniques of needle brain biopsy, immunohistochemical staining for monoclonal antibody and chemotherapeutic drug delivery in association with blood-brain barrier modification.
Abstract: Current experience with 12 patients studied prospectively suggests a new approach in the diagnosis and treatment of primary central nervous system (CNS) lymphoma, integrating the techniques of needle brain biopsy, immunohistochemical staining for monoclonal antibody and chemotherapeutic drug delivery in association with blood-brain barrier modification. Computed tomography (CT)-guided needle biopsy of deep parenchymal lesions contributed to the diagnosis in six patients. Immunohistochemical staining methods detected monoclonal immunoglobulins in those patients so tested. Following diagnosis, the patients have been treated with multi-agent chemotherapy in conjunction with osmotic blood-brain barrier modification (five without antecedent cranial irradiation) with an initial complete response rate by CT scan in nine patients, a median follow-up of 19 months from diagnosis, and a 1-year survival of 75%. This experience emphasizes the value of CT-guided stereotaxic or CT-guided needle biopsy, which limits the need for therapy without a diagnosis or the need for a major craniotomy in what are commonly deep, paraventricular lesions. Immunoperoxidase cytochemical stains can detect monoclonal immunoglobulin characteristic of CNS B-cell malignant lymphomas and provide an important diagnostic aid when only modest quantities of tissue or cells are obtained. Finally, chemotherapy administered in conjunction with osmotic blood-brain barrier modification results in a clinical response rate and survival that are at least as effective as radiotherapy as a primary therapeutic modality.
TL;DR: It is concluded that keratin is the most useful single discriminating marker in the separation of neuroendocrine (Merkel cell) carcinoma of the skin from lymphoma, melanoma and, when the characteristic inclusion‐like pattern is seen, from metastatic oat cell carcinoma.
Abstract: Paraffin sections of formalin-fixed tumor samples from 26 patients with neuroendocrine (Merkel cell) carcinoma of the skin (NECS) were studied immunohistochemically with three monoclonal antibodies to low molecular weight keratin (MAB-K) and with antibodies to leukocyte common antigen (LCA), neurofilament (NF), neuron-specific enolase (NSE), S100 protein (S100), and chromogranin (CGN), to investigate the relative diagnostic value of these antibodies. Samples from 20 lymphomas, 10 non-oat cell undifferentiated carcinomas, 10 oat cell carcinomas, and 10 melanomas served as controls. Keratin was found in 25 of the 26 NECS and in all undifferentiated and oat cell carcinomas. A ball-like immunostaining for keratins, resembling an inclusion body was seen only in cases of NECS and some carcinoids. Neurofilament, NSE, and CGN were expressed by fewer NECS than was keratin and all NECS were negative for LCA and S100. None of the lymphoinas and melanomas contained detectable keratin, NF, NSE, or CGN. Only the lymphomas stained with LCA. Only the melanomas were S100-positive. It is concluded that keratin is the most useful single discriminating marker in the separation of neuroendocrine (Merkel cell) carcinoma of the skin from lymphoma, melanoma and, when the characteristic inclusion-like pattern is seen, from metastatic oat cell carcinoma. Cancer 58:1040-1049, 1986.
TL;DR: A clone containing the complete human glucagon gene was isolated and sequenced and found that there is 88% nucleotide sequence homology between the proximal 130 base pairs of the 5' flanking regions of the human and rat glucagon genes.
Abstract: A clone containing the complete human glucagon gene was isolated and sequenced. The gene is approximately 9.4 kilobases in length and comprises six exons and five introns. The putative preproglucagon encoded by this gene, 180 amino acids in length and containing glucagon and two glucagon-like peptides, is very similar to that of other mammalian species (greater than 90% amino acid sequence homology). There is 88% nucleotide sequence homology between the proximal 130 base pairs of the 5' flanking regions of the human and rat glucagon genes. These sequences, highly conserved throughout evolution, are likely involved in the regulation of glucagon gene transcription.
TL;DR: It is demonstrated that nuclear matrices prepared from the yeast Saccharomyces cerevisiae will specifically bind an MAR sequence derived from the mouse kappa light chain immunoglobulin gene, suggesting that both MAR sequences and their binding sites have been strongly evolutionarily conserved.
TL;DR: There is no reason to suspect that recipients of live varicella vaccine would be more likely to acquire herpes zoster than children who get variceella.
Abstract: A study was undertaken to determine whether children immunized with live varicella vaccine are at greater risk of acquiring herpes zoster than children who have had varicella. Children with acute lymphocytic leukemia who had had varicella were compared with those who received live varicella vaccine. During the period of observation, 15 of 73 children who had varicella acquired herpes zoster and none of the 34 children who had been vaccinated. If the time of observation was adjusted for and the vaccinees who failed to have a sustained antibody response or who acquired chickenpox were removed, the risk of herpes zoster was still less in vaccinees (P = .0075). Because herpes zoster is common in children with acute lymphocytic leukemia, differences in the two groups could be discerned more readily than if normal children were compared. There is no reason to suspect that recipients of live varicella vaccine would be more likely to acquire herpes zoster than children who get varicella.
01 Jan 1986
TL;DR: No discernible relationships were noted between thrombus associated with recurrent lesions and the presence or absence of symptoms, treatment with antiplatelet agents, and hypertension, suggesting that throm Bus was a continuous and intrinsic component of recurrent disease rather than a secondary, complicating feature.
TL;DR: The twelve cases in this report represent the largest recorded series to date and are distinguishable from the more frequently occurring carcinomas ex pleomorphic adenoma.
TL;DR: The data suggest that early CCl4 toxicity is adirect consequence of its solvent properties and is partially reversible; subsequent damage may be mediated by lipid peroxidation.
TL;DR: It is concluded that aromatase is under multifactorial regulation in human adipose stromal cells and is suppressed by growth factors such as EGF, FGF, and PDGF, whose actions are believed to be mediated by receptor-linked tyrosine kinase activity.
Abstract: In previous studies, we observed that the stimulatory effect of (Bu)2cAMP on aromatase activity of human adipose stromal cells was markedly attenuated when fetal calf serum was present in the culture medium. To determine whether growth factors may be the inhibitors of (Bu)2cAMP-stimulated aromatase activity in serum, the effects of growth factors and phorbol esters on aromatase activity of human adipose stromal cells in monolayer culture were investigated. Epidermal growth factor (EGF), fibroblast growth factor (FGF), and platelet-derived growth factor (PDGF) were all without effect on aromatase activity when added by themselves, but markedly inhibited aromatase activity stimulated by (Bu)2cAMP. On the other hand, nerve growth factor, multiplication-stimulating activity, relaxin, and insulin had no effect on aromatase activity, either by themselves or in the presence of (Bu)2cAMP. Thus, EGF, PDGF, and FGF can mimic the inhibitory action of fetal calf serum on (Bu)2cAMP-stimulated aromatase activity of these cells. By contrast, none of these substances was capable of mimicking the effect of serum to facilitate the stimulatory action of dexamethasone on aromatase activity of these cells. The phorbol esters phorbol-12-myristate-13-acetate, phorbol-12,13-didecanoate, and phorbol-12,13-diacetate were also capable of facilitating the action of (Bu)2cAMP to stimulate aromatase activity, but had little or no action on dexamethasone-stimulated aromatase activity or when added by themselves. It is concluded that aromatase is under multifactorial regulation in human adipose stromal cells. The activity is induced by glucocorticoids and by agents that stimulate cAMP-dependent protein kinase; the latter effect is potentiated by factors that stimulate protein kinase C, but is suppressed by growth factors such as EGF, FGF, and PDGF, whose actions are believed to be mediated by receptor-linked tyrosine kinase activity.
TL;DR: The location and frequency of metastases to the lymph nodes were documented in a review of 200 patients with bronchogenic carcinoma who underwent pulmonary resection and total lymph node resection, andnexplained findings were the higher prevalence of mediastinal nodal metastases in adenocarcinoma vs squamous cell carcinoma and a much higher frequency of mediastsinal metastases without lobar or hilar involvement.
TL;DR: It is suggested that endogenously released 5-HT and NE may exert complementary modulatory-type actions on neuronal responsiveness as a means of regulating the transfer of sensory information through local cerebrocortical circuits.
TL;DR: A higher incidence of clinical leukoencephalopathy in patients receiving intracarotid chemotherapy in the treatment of brain tumors and in Patients receiving combination chemotherapy for central nervous system relapse of adult leukemia suggests a need for further investigation.
Abstract: Forty cancer patients with bilateral diffuse cerebral white matter hypodensities on computerized tomography (CT) scan were reviewed. Brain irradiation and/or chemotherapy were considered responsible for the CT abnormalities in all patients but one, whose changes were presumably due to demyelination related to the aging process. Among these 39 patients, 7 had clinical symptoms of leukoencephalopathy. Two patients had acute transient leukoencephalopathy, and one of them experienced permanent neurologic changes after continuing treatment. Six additional patients had delayed leukoencephalopathy. The interval between whole-brain irradiation (WBXRT) alone and the CT detection of white matter hypodensities was almost always longer than 1 year. This interval was shortened to less than 1 year in a significant number of patients when WBXRT was followed by various chemotherapeutic protocols. More importantly, there was an increased incidence of clinical leukoencephalopathy. A higher incidence of clinical leukoencephalopathy in patients receiving intracarotid chemotherapy in the treatment of brain tumors and in patients receiving combination chemotherapy for central nervous system relapse of adult leukemia suggests a need for further investigation.
TL;DR: Low values for serum alkaline phosphatase activity were observed early in the course of two patients with Wilson's disease presenting with the combination of severe liver disease and Coombs' negative acute hemolytic anemia, and the mechanism responsible for the decrease is uncertain.
TL;DR: Between 1968 and 1980, radiotherapy was part of the treatment of 120 patients with cervical nodes from an unknown primary tumor, and in 86 of 93 patients there was eventual control of disease above the clavicles; 22 of the 93 patients died of disease, whereas 36 died of other causes.
Abstract: Between 1968 and 1980, radiotherapy was part of the treatment of 120 patients with cervical nodes from an unknown primary tumor. Thirteen patients presented with supraclavicular nodes only and 14 presented with massive adenopathy; they are analyzed separately. The remaining 93 patients are analyzed in this report with emphasis on the applied radiotherapeutic techniques. Twenty of the 93 patients received radiation treatment to the neck only, 26 to the naso- and oropharynx and neck, and 47 to the naso-, oro-, and hypopharynx and neck. Fourteen patients subsequently developed a tumor at a primary site or a recurrence of metastases in the neck; in nine patients the disease recurrence was in areas that had not been irradiated. There was an increase in failures above the clavicles in patients who received irradiation to the neck alone. No correlation was found between initial tumor staging and subsequent failure, nor between types of surgical procedures and failure. In 86 of 93 (92.5%) patients there was eventual control of disease above the clavicles; 22 of the 93 patients died of disease, whereas 36 died of other causes. The determinate survival rate for the 93 patients treated with curative intent is 70% at 10 years. Guidelines for selection of techniques based on tumor and patient factors are discussed.
TL;DR: A number of clinical trials using different species of interferon at different doses and treatment schedules were initiated, and the preliminary results of these trials are reported here.
Abstract: Malignant melanoma is one of the several human tumors against which interferons have demonstrated significant antitumor activity. Such activity was first observed in early clinical trials with natural human leukocyte interferon; 4 of 75 patients in different institutions achieved partial response to treatment and 5 patients showed minor regression of disease. Subsequentlyin a number of trials conducted with recombinant leukocyte interferonsantitumor activity against melanoma was observed consistently. Recombinant interferons have also revealed remarkable activity against malignant melanoma in the human tumor stem-cell assaywith 18 of 60 samples (30%) showing marked inhibition in tumor growth. Recombinant interferons from two different sources were tested in Phase I and Phase II trials against malignant melanoma. In one Phase I trial with interferon alfa-2b, 4 of 23 patients responded to treatment. In another Phase I study using recombinant interferon alfa-2a, 3 of 20 patients achieved objective responses. More recentlya number of Phase II trials were initiated and the detailed results of two Phase II studies have been published. In the first trial using recombinant leukocyte interferon at a dosage of 50 × 106 U/m2 three times a weekobjective regression of tumor was observed in 7 of 31 patientsfor a response rate of 22%. Because of severe toxicity associated with this dosagea second Phase II trial was conducted using a dosage of 12 × 106 U/m2 three times a weekand 6 of 30 patients experienced objective regression of diseasefor a response rate of 20%. Based on the results of these early trials with recombinant leukocyte interferona number of clinical trials using different species of interferon at different doses and treatment schedules were initiated. The preliminary results of these trials are reported here.
TL;DR: The presence of the DR antigen in the RA synovial membrane is demonstrated on phagocytic cells of the lining area, lymphocytes and small numbers of IDC-like cells in dense, lymphocyte-rich areas, large numbers of macrophage- like cells in transitional or plasma cell-containing areas, and 4) histiocytic Cells in uninfiltrated interstitial areas.
Abstract: We examined synovial membrane samples from 6 rheumatoid arthritis (RA) and 3 osteoarthritis patients and from 1 normal subject, by an immunoelectron microscopic technique using anti-HLA-DR (anti-Ia) and anti-monocyte/macrophage (63D3) monoclonal antibodies. In the lining layer, the type A macrophage-like cells were strongly DR+ and 63D3+, whereas the type B fibroblast-like cells were almost completely negative. Lymphocyte-rich areas (containing more than 90% densely packed lymphocytes) showed weak and patchy DR staining of the lymphocytes. In these areas, 3-5% of the cells were macrophage-like cells which were 63D3-, a type of staining compatible with that of the interdigitating cell (IDC). In the plasma cell-containing (transitional) areas, many strongly DR+ macrophage-like cells were observed in close contact with lymphocytes and plasma cells. Ten to twenty percent of these cells were 63D3-, which suggests that they were IDC. Cells with the structural appearance of IDC were most frequently seen in those transitional areas which contained elevated concentrations (50-70%) of lymphocytes. In uninfiltrated interstitial areas, approximately 50% of the cells stained strongly with both anti-DR and 63D3 antibody, indicating that they were cells of monocyte/macrophage lineage, presumably histiocytes. This investigation has demonstrated the presence of the DR antigen in the RA synovial membrane on 1) phagocytic cells of the lining area, 2) lymphocytes and small numbers of IDC-like cells in dense, lymphocyte-rich areas, 3) large numbers of macrophage-like cells, of which some had the morphologic appearance of IDC, in transitional or plasma cell-containing areas, and 4) histiocytic cells in uninfiltrated interstitial areas. The observation of large numbers of DR+ macrophages and IDC-like cells in close contact with lymphocytes and plasma cells in the RA synovial membrane emphasizes their role in an active immune response. The observation of substantial numbers of potentially immunocompetent, DR+ histiocytic cells in uninfiltrated regions of the synovial membrane suggests that such cells may play a role in the progression of the synovial inflammatory reaction.