Factors influencing the outcome of successive IVF treatment cycles in attaining a follicular puncture.

An analysis has been made on data from 576 cycles in 300 patients regarding the chances of various superovulation protocols attaining a puncture in successive cycles. The cumulative proportion of patients with at least one successful stimulation increased from 77% at the first attempt, to 98% at the fifth attempt. Of the 576 stimulations, 440 (76%) resulted in a puncture.

Bronchoalveolar lavage in extrapulmonary sarcoidosis.

Twenty-one patients presenting with extrapulmonary sarcoidosis, 20 patients with pulmonary sarcoidosis, and 12 healthy volunteers were investigated. They were evaluated for roentgenographic findings, as well as for immunologic marker expression of cells in bronchoalveolar lavage (BAL) fluid. The patients presenting with extrapulmonary sarcoidosis could be divided in two groups: nine of 21 (43 percent) presented with a stage 1 or stage 2 chest x-ray film, while 12 of 21 (57 percent) had no chest x-ray film abnormalities (stage 0).

Consequences of blood loss on growth of artificial metastases.

Previous studies have shown that lung metastases from a nonimmunogenic sarcoma (LS175) in BN (homozygous for RTln) rats were stimulated by blood transfusions. Enhanced growth was also observed after abdominal surgery combined with allogeneic blood transfusions while syngeneic blood transfusions had no effect. These experimental findings have been confirmed in retrospective clinical studies.

Tobramycin in patients with cystic fibrosis. Adjustment in dosing interval for effective treatment.

The efficacy of the dosing regimen of tobramycin was investigated in 28 patients with cystic fibrosis who had an acute exacerbation of chronic pulmonary infection with Pseudomonas aeruginosa. The initial dose of tobramycin was 3.3 mg/kg of body weight three times daily (ie, 10 mg/kg/day).

Grading of prostatic cancer: II. The prognostic significance of the presence of multiple architectural patterns.

This second report in a series of three deals with the prognostic importance of the presence of multiple, histologically identifiable architectural patterns in prostatic carcinomas. In the previous paper three of 12 parameters studied were identified as being prognostically significant in patients with single architectural patterns (formations) present in their tumors. The three parameters are nuclear anaplasia, architecture ("glands"), and mitoses, if present.

Grading of prostatic cancer: III. Multivariate analysis of prognostic parameters.

This work is based on the two previous publications which are concerned with grading prostatic carcinoma. In the present communication the technique of multivariate analysis is applied to quantify the prognostic importance of parameters which were earlier identified as contributing in a significant manner to grading. The results of this analysis are used to construct a scoring system which differentiates five significantly different prognostic groups.

Grading of prostatic cancer (I): An analysis of the prognostic significance of single characteristics.

This paper contains the first part of an attempt to quantitate the impact on prognosis of various parameters used in grading of prostatic cancer. Out of 346 patients of Elmer Belts series, 113 were identified whose tumors showed homogeneity with respect to single characteristics of a total of 12 parameters applied for grading in Mostofi's system. By this procedure it was possible to eliminate the possible influence on prognosis of the presence of several tumor formations within the same tumor.

Prognostic scoring using cytomorphometry and lymph node status of patients with breast carcinoma.

Applying morphometry on FNA smears may lead to meaningful prognostic subgrouping of breast carcinomas. A statistical analysis of the cytomorphometric and clinical data of 73 patients with breast carcinoma was performed. By multivariate analysis, taking into account various prognostic factors, it was shown that variations in nuclear area and the presence of axillary metastases were the most important prognosticators.

Treatment of metastatic breast cancer patients with different dosages of megestrol acetate; dose relations, metabolic and endocrine effects.

Megestrol acetate (MA) is of therapeutic value in breast cancer patients. This study was designed to evaluate the effects of different dosages of MA on endocrine events potentially influenced by the drug in relation to plasma level of MA and clinical effects in patients with advanced breast cancer. Eighteen postmenopausal patients were randomly distributed over six groups to receive daily 90, 180 or 270 mg of MA (niagestin) orally in a cross-over study consisting of 3 periods of 6 weeks.

The influence of intramedullary nailing upon the development of metastases in the treatment of an impending pathological fracture: an experimental study.

An experimental model has been developed in which the effects of a pathological fracture and intramedullary nailing on metastatic spread have been investigated. The endpoint used was the production of lung metastases in rats inoculated intracortically with a rhabdomyosarcoma. We have found that a pathological fracture markedly increases the incidence of lung metastases and that intramedullary nailing, by decreasing the incidence of fractures, decreases the incidence of lung metastases.

Irradiation of true pelvis for bladder and prostatic carcinoma in supine, prone or Trendelenburg position.

Small bowel transit was performed in 50 patients with bladder or prostatic carcinoma. The patients were all examined in supine and prone positions; some were also studied in 25 degrees Trendelenburg position and 25 degrees inclined procubitus to investigate the effect of the various positions on the displacement of the small bowel loops out of the true pelvis. The prone position proved to be superior to the supine position in 78% of patients.

Cancer of the urinary bladder category T2, T3, (NxMo) treated by interstitial radium implant: second report.

Three-hundred-twenty-eight patients with bladder cancer category T2NxMo and 63 patients with category T3NxMo have been treated by 3 times 3.5 Gy external irradiation followed by a radium implant. Overall 5- and 10-year survival in the T2 category are 56%.

Carcinoma of the tonsillar region. A review of 78 cases.

The results of treatment of 78 patients with carcinoma of the tonsillar region treated in the Rotterdam Radiotherapy Institute in the period of 1970 to 1980 are discussed. Patients were classified according to UICC criteria [16]. An increasing local recurrence rate was noted with increasing T-category.

Carcinoma of the urinary bladder category T3NxMo treated by the combination of radium implant and external irradiation: second report.

Forty-one patients with bladder cancer, T3NxMo, with a diameter not exceeding 5 cm, were treated by 3 times 350 rad external irradiation, radium implant at reduced dose, and an additional 3000 rad external irradiation ("Radium 55%"). Survival is excellent where there is a high or medium degree of differentiation without vascular invasion in the biopsy specimen; prognosis is poor if a low degree of differentiation is combined with vascular invasion. The future therapeutic approach will be adapted to this finding.

Carcinoma of the urinary bladder T3NxMo treated by preoperative irradiation followed by simple cystectomy.

One hundred eighty-three patients with bladder cancer category T3NxMo (the diameter of the primary exceeding 5 cm), were treated by preoperative 40 Gy and simple cystectomy. Using only pretreatment information, the group with the best prognosis was characterized by a T3A-growth with a normal intravenous pyelography, with about a 75% cure rate. Before cystectomy, after irradiation the combination of a clinically assessed radiation-downstaged growth (T40GY less than 3) with normal urography, predicted the best chance of cure at about 80%.

The influence of intramedullary nailing on the development of metastases in the treatment of an impending pathologic fracture: an experimental study.

An experimental model was developed to study the effects of a pathologic fracture and intramedullary nailing on metastatic spread. The end point used was the production of lung metastases in rats inoculated intracortically with a rat rhabdomyosarcoma. We found that a pathologic fracture markedly increases the incidence of lung metastases and that intramedullary nailing, by decreasing the incidence of fractures, decreases this incidence.

Reflux--a retrospective study of 100 ureteric reimplantations by the Politano-Leadbetter method and 100 by the Cohen technique.

The results of 100 consecutive ureteric reimplantations using the Politano-Leadbetter technique were compared with those of 100 cases operated on by the Cohen technique. This retrospective study was concerned only with the effect of the operation on the ureterovesical junction. Cure of reflux was achieved in 88 Politano-Leadbetter reimplantations and in 97 Cohen reimplantations.

Radiation therapy of testicular non-seminomas.

The prognosis of 121 patients with a non-seminoma testicular tumor MTI or MTU was assessed. The clinical lymph node involvement and the T-category of the primary had a significant bearing on prognosis, which is completely determined by pulmonary relapse. The low-risk group (9% pulmonary relapse, all curable) is characterized by a primary category T1 or T2 with negative lymphangiography.