Factors predictive of completion of treatment and survival after palliative radiation therapy.

Ninety-seven patients who underwent radiation treatment for metastatic carcinomas and sarcomas were evaluated to define prognostic factors that may reliably help determine survival and probability of completing a course of palliative radiation therapy. Actuarial and logistic models were used for analysis. Predictor variables included age; sex; symptoms; primary site of disease; pathologic diagnosis; prior metastatic disease, treatment, and response; solitary versus multiple metastatic sites; location of metastasis; status of primary lesion; interval between initial diagnosis and treatment for metastatic disease; and Karnofsky performance score (KPS).

Sequential therapy--a prospective randomized trial of MALG versus OKT3 for prophylactic immunosuppression in cadaver renal allograft recipients.

We prospectively studied the use of prophylactic Minnesota antilymphocyte globulin vs. OKT3 in kidney transplant recipients. Between 7/1/87 and 9/1/90, 138 adult kidney and 35 kidney-pancreas recipients were randomized after stratification for age (18-49 vs.

Computed tomography of gynecologic neoplasms.

Both CT and MR imaging have had a major impact on gynecologic oncologic imaging, and new technology and imaging techniques are still being introduced. CT maintains a role in gynecologic pelvic cancer imaging because of cost-effectiveness, high spatial resolution, fast examination time, and wide availability. CT is particularly advantageous for lymph node metastasis screening and guided-biopsy of metastases and recurrent tumor.

Prognosis for patients with prenatally diagnosed posterior urethral valves.

Children in whom posterior urethral valves are diagnosed shortly after birth are at higher risk for renal failure than children in whom posterior urethral valves are diagnosed later in life. The influence of prenatal diagnosis of posterior urethral valves on clinical outcome has not been established. We collected data on children with posterior urethral valves treated since birth at our hospital between 1975 and 1990.

Unrelated donor bone marrow transplantation for correction of lethal congenital immunodeficiencies.

Unrelated donor marrow transplantation was undertaken in eight infants with severe combined immunodeficiency (SCID) and two children each with Wiskott-Aldrich syndrome (WAS) and Chediak-Higashi syndrome (CHS) who did not have histocompatible siblings. Donors for three patients were phenotypically matched at all HLA-A, B, Dr, and Dw loci, whereas nine donors were mismatched from the recipients at one of the HLA-A or B loci but phenotypically identical at evaluable D loci. All but one patient received conditioning chemotherapy and/or radiotherapy before infusion of donor marrow, which was not T-cell depleted.

Randomized double-blinded comparison of three intravenous immunoglobulin products in bone marrow transplantation.

We have used samples from the in vivo situation to compare antibody levels provided by the infusion of different IVIG products, a measure, albeit indirect, of potential therapeutic efficacy. The further correlation of in vivo antibody titers with functional activities of these antibodies (eg, opsonization and viral neutralization) would provide additive valuable information about the usefulness of this therapy.

Clinical trial of a simplified vacuum erection device for impotence treatment.

Thirty-one men participated in a clinical trial of a simplified vacuum erection device (Catalyst) in which the pump and penile cylinder have been combined to facilitate the pumping required to induce a vacuum. Of the 28 men who completed the three-month trial, 26 (93%) reported overall satisfaction with the device and an intention to continue its use, and 2 men were unable to maintain a satisfactory erection. Episodes of mild bruising or development of petechiae occurred in 9 men.

Radiologic case study. MRI in the diagnosis of synovial disease.

Fourteen patients with various synovial diseases were imaged using conventional radiographic techniques and MRI. We had five patients with synovial tumors, including two each with PVNS and synovial osteochondromatosis. We had five patients with infections and four patients with various other forms of arthritis.

Preventing HIV transmission. Strategies to protect clinicians and patients.

Human immunodeficiency virus (HIV) transmission to healthcare workers arises primarily from percutaneous injury by sharp devices recently contaminated with infected blood. The danger is small but real, and substantial effort to reduce this risk is justified. The risk of transmission to patients from HIV-infected healthcare workers is much smaller.

Effects of endothelial cell growth factor on vascular compromised skin flaps.

Angiogenic growth factors have the potential to accelerate vascularization in soft tissue. This study explored the vascular effects of endothelial cell growth factor (1800 micrograms/mL) with heparin (7 micrograms/mL) in gelatin sponge (Gelfoam) in two settings of vascular compromise. On days 2 and 3 ligated skin flaps in the rabbit ear model, peripheral neovascularization, and flap viability were quantitatively documented by digital angiographic analysis and by polar planimetry.

Use of ganciclovir for cytomegalovirus infection.

Ganciclovir (9-(1,3-dihydroxy-2-propoxymethyl) guanine, DHPG) is an acyclovir analog with excellent antiviral activity against human cytomegalovirus (CMV). Clinically, CMV infection occurs in from 60 to 90% of all renal transplant recipients and it is responsible for significant patient morbidity and graft loss. The likelihood of infection is closely related to the CMV status of both donor and recipient, with the greatest risk arising in the combination of a seronegative patient receiving a seropositive organ.

Spontaneous regression of juvenile nasopharyngeal angiofibroma.

There is debate concerning the natural history of juvenile nasopharyngeal angiofibromas, especially whether or not they can spontaneously regress. Often claimed, spontaneous regression has not been well documented. To our knowledge, this is the first report in which a biopsy-proven juvenile nasopharyngeal angiofibroma spontaneously resolved.

Safety considerations in the power injection of contrast media via central venous catheters during computed tomographic examinations.

Rationale And Objectives: This study addresses the theoretical, experimental, and clinical application of using a central venous catheter system (CVS) for the rapid injection of contrast media during computed tomography (CT).

Methods: Application of Poiseuille's law and the Reynolds equation yielded theoretical data. In-line pressures were measured in experimental models and patients undergoing CT.

Early detection of local disease progression from stage A1 prostate carcinoma by transrectal ultrasonography.

Fifty-two patients with Stage A1 prostate cancer diagnosed by transurethral resection performed between 1975 and 1989 were re-examined by transrectal ultrasonography and ultrasonographically guided biopsies. Follow-up after the initial diagnosis ranged from 1 to 15 years (mean, 5.8 years).

Peripheral (extracranial) nerve tumors: correlation of MR imaging and histologic findings.

Magnetic resonance (MR) images of 16 peripheral nerve tumors (14 patients) were correlated with histopathologic appearance. Thirteen patients had surgically proved neuro-fibromatosis. There were 10 neurofibromas, four schwannomas, and two neurofibrosarcomas.