Early Clinical Disease Research Articles

Endometrial cancer with para-aortic adenopathy: Patterns of failure and opportunities for cure

Purpose:To examine the outcome of patients with advanced endometrial cancer whose para-aortic involvement was diagnosed pathologically or lymphographically. Methods and Materials. Fifty patients from four institutions were treated between 1959 and 1990 with preoperative, post-operative, and primary radiotherapy. Para-aortic disease was diagnosed pathologically in 26 patients and lymphographically in the remaining 24 patients. Pathologically diagnosed patients underwent debulking of grossly involved nodes. All patients received external beam treatment through pelvic and para-aortic portals. Median prescribed dose to the pelvic and para-aortic fields was 50 and 47 Gy, respectively. Those treated with primary or pre-operative irradiation also received intrauterine brachytherapy. Results: The actuarial 5-year disease-free survival was 46% for all patients. Para-aortic failure was significantly decreased among patients undergoing lymph node resection (13% versus 39%, respectively). Relapse-free survival and pelvic control tended to improve among patients receiving surgery plus irradiation in comparison to those treated by irradiation alone. Distant metastases were most common among patients with high grade lesions. Conclusions: Long-term disease-free survival is achievable in endometrial cancer patients with para-aortic lymphadenopathy who are treated with extended-field radiotherapy. Cure is most attainable among patients with well differentiated, early clinical stage disease who receive combined modality treatment. Survival and local failure are similar for radiologically and pathologically diagnosed patients; however, para-aortic failure as a component of local failure was increased in patients who did not undergo surgical debulking of the adenopathy.

Alterations in T-Lymphocyte Subpopulations in Patients With Head and Neck Cancer: Correlations With Prognosis

Impaired cell-mediated immunity has been consistently demonstrated in patients with advanced head and neck squamous cancer (HNSC); however, the results of prior studies of correlations of cellular immune parameters with treatment outcome have been inconsistent, and routine assessment of immune parameters has been of limited clinical use. To determine the prognostic importance of alterations in the proportions of various T-lymphocyte subpopulations in the peripheral blood of patients with HNSC, levels of T3, T4, T6, T8, T9, T10, T11, and Leu 7 cells were quantitated by flow cytometry in 80 previously untreated patients and prospectively correlated with tumor characteristics and clinical course (median length of follow-up, 27 months). The mean helper/suppressor cell ratio (T4/T8) increased progressively with increasing tumor stage and was significantly elevated among patients with cancer as a group and in patients with advanced (stage III or IV) disease compared with 40 normal subjects. Decreased disease-free survival was significantly associated with elevated T4/T8 ratios and low percent T8 and T11 cell levels. The prognostic significance of percent T8 (cytotoxic/suppressor) cell levels persisted even after adjusting for known prognostic factors of tumor stage, T class, N class, and tumor site. These correlations provide new insight into immune alterations in HNSC that may prove useful in identifying patients with early clinical disease who have a poor prognosis.

Comparison of long acting Oxytetracycline and parvaquone in immunisation against East Coast fever by infection and treatment

Two groups of five cattle were immunised with a field isolate of Theileria parva as stabilate and simultaneously treated with long acting oxytetracycline or parvaquone in early clinical disease. The oxytetracycline group suffered a marked fall in leucocyte count and one animal died during immunisation. The parvaquone group suffered a less severe fall in leucocyte count and all survived. The surviving immunised cattle were immune to homologous challenge but susceptible to subsequent challenge with T p lawrencei.

Detection of individual susceptibility toward coronary disease

Current views on the usefulness of pre-clinical markers to detect susceptibility toward coronary heart disease have been presented, including the role of the hyperlipidemias, hypertension, hyperglycemia, obesity, family history and several other personal attributes. In addition, various clinical, electrocardiographic and other indices of early clinical disease serve as premonitory warning signals toward myocardial infarction and sudden death. Individuals harboring one or more of these risk factors should be detected and protected by means of preventive measures.

The Lilly Lecture: Can We Prevent Heart Disease?

Meeting Abstracts1 May 1970The Lilly Lecture: Can We Prevent Heart Disease?Lars WerköLars WerköSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-72-5-775_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptIn order to be able to prevent disease, knowledge about the cause and pathogenesis is necessary. Some information regarding the cause of congenital heart disease, rheumatic heart disease, and some forms of arterial hypertension is available. At least some of these diseases ought to be preventable, although the knowledge has only been applied in some societies and with uncertain results.The commonest cardiovascular disorders, atherosclerosis and arterial hypertension with their various clinical manifestations, still remain etiological enigmas. Some "risk factors" have been identified that characterize the individuals who are prone to early clinical disease and premature death. Interfering with these... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Göteborg Sweden PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 May 1970Volume 72, Issue 5Page: 775-775KeywordsAtherosclerosisCardiovascular therapyCongenital heart diseaseHypertensionMedical risk factorsPathogenesis Issue Published: 1 May 1970 PDF DownloadLoading ...

Routine tuberculin testing in infants and young children. An appraisal of its necessity and effectiveness.

IN HIS REVIEW of the natural history of tuberculosis Myers 1 emphasized that although there has been a marked decrease in the mortality, morbidity and infectious rates in children, the control of the disease in the younger age groups remains a major challenge to preventive medicine owing to the continued presence in most communities of large numbers of infected adults, 30% to 50% of whom have potentially infectious disease. In view of the ease with which early infection and demonstrable clinical disease can now be detected and successfully treated, he concluded that routine periodic tuberculin testing of infants and young children should be instituted to detect infections which do occur. His argument is amply justified when the lethal and sublethal effects of the complications of tuberculous infection in infants and young children are considered. Indeed, his reasoning also points the way to ultimate elimination of the disease, but until this