Showing papers in "JAMA in 1965"
TL;DR: Patients who receive large numbers of transfusions for anemia and other causes may develop precipitins in their blood, which were thought to be antibodies against serum lipoproteins which developed in the patients as a result of the repeated transfusions.
Abstract: Patients who receive large numbers of transfusions for anemia and other causes may develop precipitins in their blood. These precipitins may react in agar gel double diffusion experiments with specific human serum lipoprotein found in the blood of other individuals. Since these precipitins were found only in patients who had received transfusions they were thought to be antibodies against serum lipoproteins which developed in the patients as a result of the repeated transfusions. The precipitin is referred to as an isoprecipitin since it develops against a specificity found in an individual from the same species. The antilipoprotein isoprecipitin1,2developed in approximately 30% of 47 patients with thalassemia who had received transfusions. Isoprecipitins also developed in smaller number of transfused patients with other diseases. All precipitins stained with sudan black, a dye specific for lipid. Immunoelectrophoretic and ultracentrifugal studies showed that the protein with which the isoprecipitins reacted was a
1,187 citations
TL;DR: A group of 22 patients, previously addicted to diacetylmorphine (heroin), have been stabilized with oral methadone hydrochloride, and with this medication, patients have shown marked improvement; they have returned to school, obtained jobs, and have become reconciled with their families.
Abstract: A group of 22 patients, previously addicted to diacetylmorphine (heroin), have been stabilized with oral methadone hydrochloride. This medication appears to have two useful effects: (1) relief of narcotic hunger, and (2) induction of sufficient tolerance to block the euphoric effect of an average illegal dose of diacetylmorphine. With this medication, and a comprehensive program of rehabilitation, patients have shown marked improvement; they have returned to school, obtained jobs, and have become reconciled with their families. Medical and psychometric tests have disclosed no signs of toxicity, apart from constipation. This treatment requires careful medical supervision and many social services. In our opinion, both the medication and the supporting program are essential.
1,063 citations
TL;DR: Major causes of death in acute leukemia were infection in 70% of patients and hemorrhage in 52%.
Abstract: Major causes of death in acute leukemia were infection in 70% of patients and hemorrhage in 52%. In 38% of the patients there was more than one cause of death. Striking changes took place during the ten-year-study period. Fatal hemorrhage declined to nearly half the early rate, and fatal staphylococcal infection from 23.5% to 3.1%. At the same time fatal infections due to fungi increased from 8.2% to 23.2%.
463 citations
TL;DR: The longer a woman's family had been in this country, the less likely she was to be obese and opportunities for more effective weight control measures through programs specially tailored for populations at high risk are suggested.
Abstract: The relationship between obesity and several social factors was investigated among 1,660 adults representative of a residential area in midtown Manhattan. An inverse relationship previously described between obesity and parental socioeconomic status was also found between obesity and one's own socioeconomic status. Obesity was six times more common among women of low status as compared to those of high status. Furthermore, upwardly mobile females were less obese (12%) than the downwardly mobile (22%). Finally, the longer a woman's family had been in this country, the less likely she was to be obese. Similar but less marked trends obtained for the men. Suggestive relationships between ethnic and religious factors and obesity were also found for both sexes. These findings suggest opportunities for more effective weight control measures through programs specially tailored for populations at high risk.
391 citations
TL;DR: This is probably the most complete and concise account so far published devoted to this subject and the techniques available for its assessment and the subject matter is excellently characterized by its pithy title Lung Function.
Abstract: The subject matter and literary style of this book are excellently characterized by its pithy title Lung Function. It is probably the most complete and concise account so far published devoted to this subject and the techniques available for its assessment. There are outstanding sections on the historical aspects of lung diseases; the subdivisions of the lung volumes; the distribution of ventilation and perfusion, particularly the differences in respiratory exchange rates and alveolar-toarterial nitrogen gradients; and an excellent discussion of factors that limit exercise. There are also reasonably good accounts of such subjects of recent investigative interest as the use of hyperbaric oxygenation, application of gas chromatographic and electrode techniques for respiratory gas analysis, the surface active properties of lung tissue, the effect of respiratory gas and hydrogen-ion concentration on the pulmonary circulation, and the use of radioactive gases to evaluate pulmonary function.In general, however, this book lacks the
350 citations
TL;DR: DMSO is a highly polar, stable, hygroscopic organic liquid with exceptional solvent properties that includes enhancement of penetration through plant and animal membranes and preservation of living cells and tissues during freezing.
Abstract: Dimethyl sulfoxide (DMSO) is an extraordinary chemical, a derivative of lignin, synthesized more than 75 years ago It is a highly polar, stable, hygroscopic organic liquid with exceptional solvent properties Miscible with water, lipoids, and organic solvents, it can bring into solution an extraordinary variety of inorganic and organic chemicals Its industrial application are numerous and diverse: it is used (1) as a solvent for resins, fungicides, dyes, pigments, etc, (2) as a reactant for chemical synthesis, (3) as an extractant, and (4) as a reaction medium to accelerate rates of chemical combination Its unequivocally demonstrated spectrum of biologic activities includes enhancement of penetration through plant and animal membranes 1 and preservation of living cells and tissues during freezing 2 It is exceptionally nontoxic The acute median lethal dose values for mice are, for example, ( a ) 21,400 mg/kg (oral administration), ( b ) 3,820 mg/ kg (intravenous administration), and ( c ) 20,500 mg/kg
313 citations
TL;DR: Reflected ultrasound was found to be a highly effective and simple method of making this differential diagnosis of a large, dilated heart and pericardial effusion.
Abstract: The differentiation between a large, dilated heart and pericardial effusion is essential but frequently difficult. The clinician must often resort to diagnostic procedures which offer some hazard to the patient. The use of reflected ultrasound was found to be a highly effective and simple method of making this differential diagnosis. In five dogs with artificially produced pericardial effusion it was noted that without pericardial fluid only one ultrasound echo was produced in the vicinity of the posterior heart wall. When fluid was introduced, one detected two echoes, one which moved with cardiac action, the posterior heart wall, and another which moved only with respiration, the pericardium. The space between the two signals represented the pericardial fluid. Subsequent clinical studies confirmed the accuracy, reliability, and simplicity of this diagnostic procedure.
253 citations
TL;DR: Antibodies to an intercellular substance of stratified squamous epithelium were detected by indirect immunofluorescent (IF) staining in the sera of eight out of 16 patients with pemphigus vulgaris and by direct IF staining of biopsies, γglobulin was demonstrated in the inter cellular areas of the epidermis.
Abstract: Antibodies to an intercellular substance of stratified squamous epithelium were detected by indirect immunofluorescent (IF) staining in the sera of eight out of 16 patients with pemphigus vulgaris. The autoantibody nature of these antibodies could be demonstrated by testing the patient's skin with the patient's own serum. The sera of three of six patients with chronic bullous dermatosis contained antibodies to a substance in the basement zone of the epidermis. By direct IF staining of biopsies, γglobulin was demonstrated in the intercellular areas of the epidermis of three patients with pemphigus vulgaris and in the basement zone of a patient with chronic bullous dermatosis. Intradermal injection of monkeys with human sera containing antibodies of the intercellular substance resulted in binding of γ-globulin to the intercellular substance of the epidermis.
243 citations
TL;DR: The hyperviscosity syndrome commonly includes mucous membrane bleeding, retinopathy and loss of vision, and neurological disorders associated with elevated serum viscosity, and is frequently seen in patients with macroglobulinemia, with or without demonstrable lymphoma, but only rarely with multiple myeloma.
Abstract: The hyperviscosity syndrome commonly includes mucous membrane bleeding, retinopathy and loss of vision, and neurological disorders associated with elevated serum viscosity. These changes can be lethal. Hyperviscosity, however, can be relieved by adequate plasmapheresis, and recognition of the hyperviscosity syndrome is important for the institution of the proper therapy. The association of elevated serum viscosity with marked hypergammaglobulinemia has been recognized for more than 30 years. Between 1932 and 1937 Reismann,1Magnus-Levy,2and Albers3reported increased serum viscosity in several patients with multiple myeloma. In 1944 Waldenstrom described an elevated serum viscosity in patients with macroglobulinemia.4These findings have been extended in recent years by the delineation of a group of clinical symptoms attributable to increased viscosity of the blood.5-10 The hyperviscosity syndrome is frequently seen in patients with macroglobulinemia, with or without demonstrable lymphoma, but only rarely with multiple myeloma. Manifestations of the hyperviscosity
235 citations
TL;DR: Mainly through the screening of cases of ectopia lentis or presumed Marfan syndrome, 38 cases of homocystinuria distributed in 20 families were ascertained and studied, it is found that mental retardation and cutaneous flushing are found in homocyStinuria and not in the Marfan Syndrome.
Abstract: Mainly through the screening of cases of ectopia lentis or presumed Marfan syndrome, or both, 38 cases of homocystinuria distributed in 20 families were ascertained and studied. About 5% of cases of nontraumatic ectopia lentis have homocystinuria. Ocular, skeletal, and vascular changes in homocystinuria simulate those of the Marfan syndrome, but osteoporosis and thrombosis are distinguishing features of homocystinuria. Furthermore, mental retardation and cutaneous flushing are found in homocystinuria and not in the Marfan syndrome. Elucidation of the biochemical defect in homocystinuria opens up possibilities of successful therapy.
235 citations
TL;DR: It became increasingly clear to us that the authors' own insistence on the demonstration of persistent hypokalemia as a major diagnostic was becoming increasingly clear.
Abstract: In the recent past, one of us 1 has marshaled circumstantial evidence to support his conviction that about 20% of patients with "essential" hypertension harbor a small, aldosterone-secreting adrenal cortical tumor as its cause. Careful retrospective study, during the past 11 years, of our cases of proved primary aldosteronism had convinced us that many of these patients had not had hypokalemia until shortly (one to two years) before we saw them. Yet hypertension had been present for 10 to 15 years and was cured by removal of the adrenal adenoma. This meant that such patients would have had to be classified as having "essential" hypertension during those preceding years, and that hypokalemia and severe potassium depletion are late manifestations of an underlying process which has been active for many years. It became increasingly clear to us that our own insistence on the demonstration of persistent hypokalemia as a major diagnostic
TL;DR: Three patients had many episodes of an acute interstitial pneumonitis after exposure to pigeons which they bred as a hobby, and Laboratory examinations showed leukocytosis and elevated γ-globulin, but no evidence of specific infections.
Abstract: Three patients had many episodes of an acute interstitial pneumonitis after exposure to pigeons which they bred as a hobby. Laboratory examinations showed leukocytosis and elevated γ-globulin, but no evidence of specific infections. Inhalation of pigeon feathers or aerosols of pigeon droppings or serum in the hospital reproduced an episode of the disease. Each patient had high titers of precipitating antibody to extracts of pigeon feathers or droppings and to pigeon serum or egg. Skin tests with these antigens produced neither immediate nor delayed reactions. The disease is considered to be of allergic origin, similar to the illness produced by other antigens in farmers' lung, bagassosis, mushroom-pickers' disease, and maple-bark strippers' disease.
TL;DR: It is wished to reemphasize that progressive involution does occur with eventual complete regression in the majority of cutaneous hemangiomas, and that active treatment was not used in patients.
Abstract: Hemangiomas in infants and children are managed best by intelligent neglect. Other entities in this category are umbilical hernia, lingua fraenata (tonguetie) and the small ventricular septal defect. Vascular birthmarks pose a common management problem to physicians of almost every speciality because parents frequently seek treatment for such lesions. Although the phenomenon of spontaneous involution of hemangiomas in children was reported 77 years ago and further emphasized in recent articles,1-6many authors7-10continue to advocate or discuss active treatment. During the past seven years we have followed the course of 210 patients will 336 hemangiomas. Active treatment was not used in our patients. Some of the unfortunate complications of active treatment which occurred in children who received therapy elsewhere will be noted. We wish to reemphasize that progressive involution does occur with eventual complete regression in the majority of cutaneous hemangiomas. Description of Hemangiomas The subjects comprised 210
TL;DR: The present volume represents a revision of this, with a new chapter on therapy which includes many brief case histories and states that Dr. Frankl is concerned with a "psychotherapy in spiritual terms."
Abstract: Even before Dr. Frankl's appalling experience in the concentration camps at Auschwitz and Dachau, he was searching for a psychotherapy which would go beyond that of Freud or Adler. His wartime experiences evidently helped him to formulate his ideas and methods. In 1946 he published two books in German, both of which describe his philosophy and methods. The first is a short, somewhat autobiographical account which was translated into English as From Death-Camp to Existentialism . The other, somewhat longer with more explanation of his ideas and more clinical examples, was first translated into English in 1955 as The Doctor and the Soul . The present volume represents a revision of this, with a new chapter on therapy which includes many brief case histories. Frankl states that he is concerned with a "psychotherapy in spiritual terms." Believing that the distress of many patients is due not so much to neurosis as to
TL;DR: The subnormal number of cells in many body organs provides a partial explanation for the long-term physical and mental retardation encountered in some persons who have had congenital rubella.
Abstract: A quantitative study has been made of organ and cellular development in eight newborn and seven older infants with congenital rubella. The infants were subnormal in size at birth due to retarded intrauterine growth. A further retardation of growth was observed in the postnatal period. The basis of growth retardation in such infants is a subnormal number of cells in many body organs. The cause of the growth disturbance appears to be an activity of the proliferating virus which inhibits cell multiplication. Necrotic or inflammatory changes in the tissues are rare. The subnormal number of cells in many body organs provides a partial explanation for the long-term physical and mental retardation encountered in some persons who have had congenital rubella.
TL;DR: Although deficits in interhemispheric integration could be demonstrated under specialized testing conditions, the patient's well-being and general behavior were improved and he has not had a generalized convulsion since that operation (Feb 6, 1962).
Abstract: THE SIZE and the location of the corpus callosum and anterior commissure suggest an important role in propagation of seizures from one side of the brain to the other. In 1940, Van Wagenen and Herren1cut the corpus callosum to various extent in two dozen patients; only one had complete section of both corpus callosum and anterior commissure. The subsequent report by Akelaitis2on these patients indicates that a number of them were improved. Complete section of corpus callosum and anterior commissure was therefore offered to an apparently hopeless epileptic having one to three generalized convulsions per week, with best medical control.3He has not had a generalized convulsion since that operation (Feb 6, 1962). Furthermore, although deficits in interhemispheric integration could be demonstrated under specialized testing conditions,4the patient's well-being and general behavior were improved. Because of his excellent response, five more patients underwent this
TL;DR: Cholestyramine resin, a bile-acid-sequestering agent, was administered to nine hypercholesteremic patients for periods of one month to four years and produced occasional gastrointestinal discomfort, but systemic side effects were not encountered.
Abstract: Cholestyramine resin, a bile-acid-sequestering agent, was administered to nine hypercholesteremic patients for periods of one month to four years. By promoting fecal excretion of bile acids, the resin appears to induce an increase in the rate of cholesterol conversion to bile acids in the liver, often resulting in a diminution of plasma cholesterol levels. During daily treatment with 13.3 gm of cholestyramine, eight of the subjects achieved mean serum total cholesterol levels that ranged from 80% to 50% of the average control values. The decreases were sustained for the duration of treatment. Two patients and one normal subject exhibited marked increases in fecal bile-acid excretion during resin administration, but neutral sterol output did not change consistently. The preparation produced occasional gastrointestinal discomfort; however, systemic side effects were not encountered.
TL;DR: Six cases of sudden death occurred in otherwise healthy patients following treatment with phenothiazine derivatives in the fairly large doses customarily given to psychiatric patients, and this mode of death appears to be definitely associated with drug therapy.
Abstract: Six cases of sudden death occurred in otherwise healthy patients following treatment with phenothiazine derivatives in the fairly large doses customarily given to psychiatric patients. In each instance, postmortem findings were inadequate to explain the death. Clinically, the attack begins with a syncopal-seizure episode, followed quickly by cessation of heartbeat and respirations. Resuscitation was temporarily accomplished in one patient, allowing for documentation of irreversible ventricular fibrillation. Compared with past experience with deaths in hospitalized psychiatric patients, this mode of death appears to be definitely associated with drug therapy. The predominant mechanism is probably ventricular fibrillation, though asphyxia during a drug-induced seizure or from aspiration of food is another possibility. The nature of the cardiac disturbance is still unexplained, though recent reports of electrocardiographic abnormalities and pigment deposits in the myocardium in patients on long-term treatment with phenothiazines may be related to this complication.
TL;DR: Because of the apparent simplicity but actual complexity of the extrahepatic biliary tree, there are few areas of the abdomen in which the challenge to the surgeon's imagination and technical skill is high.
Abstract: Surgery of the extrahepatic biliary tree constitutes a significant proportion of the work of the general surgeon. In addition, many practitioners who would ordinarily not attempt "major" operative surgery, consider cholecystectomy fair game. As the editors of this text point out, there are three ways in which poor results from biliary tract operations may be incurred: (1) The operation should not have been performed in the first place, eg, when it is done for symptoms actually arising from another cause. (2) The operation may be inadequately performed, eg, when calculus material is left residual in the common duct. (3) The operation is improperly performed, eg, when damage to the right hepatic artery or the common duct is sustained. Because of the apparent simplicity but actual complexity of the extrahepatic biliary tree, there are few areas of the abdomen in which the challenge to the surgeon's imagination and technical skill is
TL;DR: Dietary manipulations of vitamin K produced a profound and predictable effect on anticoagulation stability, and this fat soluble vitamin is apparently not absorbed from the colon, probably the site of most bacterial synthesis.
Abstract: Available vitamin K was studied by serial prothrombin tests in ten anticoagulated and ten healthy subjects in one approach to the problem of long-term anticoagulation instability. Dietary manipulations of vitamin K produced a profound and predictable effect on anticoagulation stability. This fat soluble vitamin (K) is apparently not absorbed from the colon, probably the site of most bacterial synthesis. Foods, rather than intestinal bacterial synthesis, probably provide most vitamin K for humans.
TL;DR: This compact volume of some 300 pages makes available to English readers abundant information on the pathology of intracranial tumors, much of it derived from the author's long personal experience with these growths in Germany.
Abstract: This compact volume of some 300 pages makes available to English readers abundant information on the pathology of intracranial tumors, much of it derived from the author's long personal experience with these growths in Germany. Although there are still many points of disagreement as to the origin, nature, and proper terminology of the neoplasms, decades of study by many workers have dispelled much of the early confusion. The viewpoints expressed in this work will probably be found acceptable in large part by most American neuropathologists. Approximately half of the book is devoted to what is referred to in the subtitle as the "biology" of brain tumors. This includes, among others, such topics as the criteria for classification, frequency of occurrence, preferred sites of origin, manner of growth and secondary effects on the brain. The associated clinical phenomena, which might equally well be considered among the "biological" attributes of these neoplasms,
TL;DR: A complement-fixation antibody test using a chloroformmethanol solvent-extracted antigen from broth-grown M pneumoniae was found to be highly sensitive and specific and should replace the cold-agglutinin test for routine diagnosis.
Abstract: Mycoplasma pneumoniae (Eaton agent) caused a significant amount of acute febrile respiratory disease in Seattle during 1962 and 1963. The agent was isolated from 20% of 215 pneumonia patients and from 7% of 248 patients with febrile respiratory disease without pneumonitis. The highest isolation rate was from persons 10 to 25 years of age and the lowest from children under 5 years old. The pneumonia cases were similar clinically to previous descriptions of cold-agglutinin-positive primary atypical pneumonia. These infections occurred at all seasons of the year and were more frequent in males. A complement-fixation antibody test using a chloroformmethanol solvent-extracted antigen from broth-grown M pneumoniae was found to be highly sensitive and specific. The complement-fixation test is simple and inexpensive and should replace the cold-agglutinin test for routine diagnosis.
TL;DR: Allopurinol [4-hydroxypyrazolo(3,4-d)pyrimidine], a potent inhibitor of xanthine oxidase, was given orally to patients with leukemia and lymphoma in whom marked hyperuricemia was present or was to be expected as a result of cytolytic therapy.
Abstract: Allopurinol [4-hydroxypyrazolo(3,4-d)pyrimidine], a potent inhibitor of xanthine oxidase, was given orally to patients with leukemia and lymphoma in whom marked hyperuricemia was present or was to be expected as a result of cytolytic therapy. There was a decrease in serum uric acid in each patient, and a decrease in urine uric acid excretion in each of the ten patients in whom it was measured. This was accompanied by only a moderate increase in urinary oxypurines and no evidence of renal, hematologic, gastrointestinal, or hepatic toxicity.
TL;DR: The use of a disposable unit, combining a continuous venous pressure monitor and a standard venous infusion set, makes this an accurate, simple, and reliable measurement which may be used routinely in critically ill patients.
Abstract: Measurement of central venous pressure is of practical aid in evaluating the patient in shock. The use of a disposable unit, combining a continuous venous pressure monitor and a standard venous infusion set, makes this an accurate, simple, and reliable measurement which may be used routinely in critically ill patients. Venous pressure does not accurately reflect blood volume but indicates the competence of the heart to accept and expel the blood returned to it. As such it is an excellent guide to "safe" volume repletion. A quantitative measure of blood volume is useful in the management of shock, but pulse rate, hemoglobin, and hematocrit values fail as dependable guides for the bedside physician.
TL;DR: The variable absorption of drugs in enteric-coated tablets appears to be due to wide differences in gastric retention time of solid objects, which constitutes an inherent limitation in the absorption efficacy of allEnteric- coated tablets.
Abstract: Variations in the absorption pattern of aspirin in enteric-coated tablets and in solution were compared between subjects and between doses in any one subject. Absorption of enteric-coated tablets was complete but the rate was extremely variable. On the other hand, administration of aspirin in solution was not only complete, but also yielded well-reproducible salicylate plasma levels. The variable absorption of drugs in enteric-coated tablets appears to be due to wide differences in gastric retention time of solid objects. Since this aspect of gastrointestinal physiology is not affected by the type and quality of the tablets or the medicinal agent, it constitutes an inherent limitation in the absorption efficacy of all enteric-coated tablets. There was no significant difference in the metabolic fate of aspirin administered in solution or in the enteric-coated tablets used in this study.
TL;DR: Sixty-one cases of surgically verified thoracic-disk protrusions (0.5% incidence) revealed that this condition affected both sexes equally, and that it was most common in patients in the fourth to sixth decade and at the lower fourThoracic interspaces.
Abstract: Sixty-one cases of surgically verified thoracic-disk protrusions (0.5% incidence) revealed that this condition affected both sexes equally, and that it was most common in patients in the fourth to sixth decade and at the lower four thoracic interspaces. The most common symptoms were pain, motor weakness, numbness, and visceral disturbances. Physical examination often revealed sensory loss, spastic paraparesis, hyperreflexia, and Babinski reflexes. Myelography was the most useful diagnostic aid, giving positive results for an intraspinal mass in 49 of 50 patients. The diagnosis is difficult to make clinically because thoracic-disk protrusion mimics many diseases. The surgical procedure most frequently used was complete laminectomy, and when possible the disk was removed extradurally. Postoperative results in patients with minimal neurological deficit have been gratifying, but in those with severe deficits they have been rather discouraging.
TL;DR: There has been confusion in the medical literature as to the prevalence of varicella pneumonia, and it is suggested that the condition may be more prevalent than generally suspected.
Abstract: THERE HAS BEEN considerable interest during the past several years in the pneumonic processes associated with viral diseases. Recurrent epidemics of influenza have provided the primary stimulus to Investigations1,2in this area. Of the viral illnesses causing pneumonia, varicella lends itself well to study, particularly because of the ease with which an accurate clinical diagnosis may be established without detailed laboratory investigation. In spite of this, there has been confusion in the medical literature as to the prevalence of varicella pneumonia. Earlier reports3,4emphasized the rarity and severity of this complication while others5-7more recently have observed that varicella pneumonitis could be mild (often unrecognized) and suggested that the condition may be more prevalent than generally suspected. That varicella pneumonia is not common in childhood was demonstrated by Bullowa and Wishik8who observed only 21 cases of pneumonia in 2,534 hospitalized children with chickenpox. Mermelstein et al
TL;DR: Therapy with topically applied hydroquinone did not lead to complete disappearance of pathological hypermelanosis, but results were satisfactory enough to help most patients become less self-conscious about their pigmentary abnormalities.
Abstract: Hydroquinone is known to inhibit melanogenesis both in vitro and in vivo. In this study, 2% and 5% hydroquinone creams were topically applied to the hyperpigmented skin of 56 patients. Used in this way, hydroquinone was a moderately effective depigmenting agent in 80% of cases. The 2% cream appeared to be as effective therapeutically as the 5% cream and to evoke untoward side effects (primary irritation) much less often. Therapy with topically applied hydroquinone did not lead to complete disappearance of pathological hypermelanosis, but results were satisfactory enough to help most patients become less self-conscious about their pigmentary abnormalities.
TL;DR: From 70% to 88% of consecutive, unselected bronchogenic carcinoma patients, when first seen in general hospitals, are found to have nonresectable lesions, about 12% to 15% of these after thoracotomy.
Abstract: Bronchogenic carcinoma is a deadly disease with steadily increasing incidence especially in men, 1,2 and high early mortality rates reported for treated and untreated patients, even for those with supposedly small, asymptomatic lesions. From 70% to 88% of consecutive, unselected bronchogenic carcinoma patients, when first seen in general hospitals, are found to have nonresectable lesions, about 12% to 15% of these after thoracotomy. Periodic x-ray screening has revealed that survival after the last negative x-ray finding was so poor as to suggest that metastases in many cases have occurred before a pulmonary mass is detectable by present methods. 3 Multiple forms of therapy have been reported in the past, usually in small groups of patients and without adequate controls. Case reports of single or small numbers of patients who have survived for periods of time beyond the expected have often led to the erroneous conclusion that the therapy used in
TL;DR: The findings of this study indicate that the concurrent use of vincristine sulfate and cyclophosphamide can produce prolonged, symptom-free survival of some children with neuroblastomas.
Abstract: Vincristine sulfate and cyclophosphamide were administered concurrently to nine consecutive children with unresectable neuroblastomas. Objective tumor regression was observed in all nine children and complete remission was obtained in seven. The findings of this study indicate that the concurrent use of vincristine sulfate and cyclophosphamide can produce prolonged, symptom-free survival of some children with neuroblastomas. The findings also indicate that some unresectable neuroblastomas will respond to chemotherapy alone or chemotherapy followed by radiation therapy to an extent that allows complete surgical excision.