1/156. Radiation therapy treatment planning and delivery.OBJECTIVES: To provide an overview of radiation therapy treatment planning and delivery, and discuss technologic advances and their importance in present and future oncologic care. DATA SOURCES: radiation oncology textbooks and radiation physics and treatment planning textbooks. CONCLUSIONS: The increased sophistication and complex abilities of modern radiation therapy planning and delivery are steadily improving cancer treatment outcomes and quality of life. Radiation is now an essential and integral part of cancer care and may be used alone or as part of combined modality therapy. Further technologic advances will allow improvement in the ability of radiation therapy to cure cancer and improve quality of life for an ever-increasing variety of patients. IMPLICATIONS FOR nursing PRACTICE: Oncology nurses with an understanding of the components of radiation treatment plans and their delivery will be able to provide appropriate education for patients offered radiation and prepare them for the lengthy and complex process of radiation therapy.- - - - - - - - - - ranking = 1keywords = complex (Clic here for more details about this article) |
2/156. hypokalemia associated with antibiotic treatment. Evidence in children with malignant neoplasms.A patient with acute lymphocytic leukemia developed hypokalemia during two separate courses of antibiotic therapy. In a review of 33 children from our institution with various malignant neoplasms, 24 of 48 antibiotic courses were associated with hypokalemia that could not be explained by gastrointestinal fluid losses. carbenicillin disodium, gentamicin sulfate, and methicillin sodium or nafcillin sodium combination therapy was associated with hypokalemia in 23 of 35 courses in which serum electrolytes were monitored. No correlation between hypokalemia and the stage of the basic disease or the use of antineoplastic agents was found with this antibiotic combination. Our data and a review of the literature suggest that carbenicillin produces hypokalemia through an impermeant anion effect on the renal tubule. Children receiving carbenicillin should be monitored with frequent serum potassium determinations.- - - - - - - - - - ranking = 1546.4942771827keywords = neoplasm (Clic here for more details about this article) |
3/156. nijmegen breakage syndrome. The International nijmegen breakage syndrome Study Group.BACKGROUND: nijmegen breakage syndrome (NBS) is a rare autosomal recessive disorder. NBS-1, the gene defective in NBS, is located on chromosome 8q21 and has recently been cloned. The gene product, nibrin, is a novel protein, which is member of the hMre11/hRad50 protein complex, suggesting that the gene is involved in DNA double strand break repair. AIMS: To study the clinical and laboratory features of NBS as well as the genotype-phenotype relation. methods: Fifty five patients with NBS, included in the NBS registry in Nijmegen were evaluated. The majority of the patients were of eastern European ancestry. Most of them had shown a truncating 5 bp deletion 657-661 delACAAA. Four further truncating mutations have been identified in patients with other distinct haplotypes. RESULTS AND CONCLUSIONS: Essential features found in NBS were microcephaly, usually without severe retardation, typical facial appearance, immunodeficiency, chromosomal instability, x ray hypersensitivity, and predisposition to malignancy. In 40% of the patients cancer was noted before the age of 21 years. Important additional features were skin abnormalities, particularly cafe au lait spots and vitiligo, and congenital malformations, particularly clinodactyly and syndactyly. Congenital malformations, immunodeficiency, radiation hypersensitivity, and cancer predisposition were comprehensible in case of dysfunctioning of dna repair mechanisms. No specific genotype-phenotype relation could be found. patients with the same genotype may show different phenotypes and patients with different genotypes may express the same phenotype. Specific mutations did not lead to specific clinical features.- - - - - - - - - - ranking = 0.5keywords = complex (Clic here for more details about this article) |
4/156. Intravascular occlusive therapy: use of interventional radiology in cancer patients.Selective transcatheter intravascular occlusion in the treatment of cancer patients is a valuable extension of interventional diagnostic radiology. Intra-arterial embolization may be performed with various substances, including autologous clot, autologous subcutaneous tissue, Gelfoam, and stainless steel coil. Clinical applications in cancer patients include control of gastrointestinal and genitourinary hemorrhage, preoperative reduction of tumor vascularity, control of local symptoms, and therapeutic reduction of tumor bulk. The technique has been used for preoperative and palliative treatment of neoplasms of the head and neck, kidney, liver, spleen, and soft tissue and bone. Transcatheter intravascular occlusion should be performed only by radiologists experienced in angiographic techniques. Inadvertent occlusion of a normal vessel and thromboembolism are possible complications.- - - - - - - - - - ranking = 309.29885543655keywords = neoplasm (Clic here for more details about this article) |
5/156. Detailed genome-wide screening for inter- and intrachromosomal abnormalities by sequential G-banding and RxFISH color banding of the same metaphase cells.While the now-classic chromosome banding methods, such as G-banding, remain the techniques of choice for the initial screening for karyotypic abnormalities, sometimes chromosomal rearrangements involve segments too small or too similarly banded to be detected or described adequately by these techniques. The necessity to use a genome-wide, fluorescence in situ hybridization (FISH)-based screening technique as a complement to G-banding is especially obvious in cases where the information obtained by the latter analysis does not provide an adequate guide to the choice of probes for chromosome-specific FISH. Furthermore, the same metaphase cells should ideally be used for both G-banding and FISH analysis to overcome the scarcity of metaphases observed in many cases and to ensure the correct interpretation of chromosomal aberrations in cytogenetically unstable neoplasms with massive cell-to-cell karyotypic variability. We describe a protocol which enables cross-species color banding (RxFISH), a new FISH-based screening technique that simultaneously imparts specific color banding patterns on all chromosomes, of preparations that have been G-banded and mounted for up to several years, as well as a procedure allowing chromosome-specific painting of the same metaphase cells to resolve whatever doubts persist after the preceding G-banding and RxFISH analyses. This approach makes possible a detailed, genome-wide screening for inter- and intrachromosomal abnormalities including archival cases whose karyotypic rearrangements had been incompletely identified by G-banding.- - - - - - - - - - ranking = 309.29885543655keywords = neoplasm (Clic here for more details about this article) |
6/156. adult Henoch-Schonlein purpura associated with malignancy.OBJECTIVE: Malignancies are among the well-established causes of vasculitis. We studied the association between adult Henoch-Schonlein purpura (HSP) and malignant neoplasms. methods: We retrospectively reviewed 14 cases of adult HSP diagnosed during a 6-year period and found a malignant neoplasm in four. Fifteen reports of adult HSP with malignant disease were identified in the literature. These 19 cases were compared with 158 adults who had HSP but no malignancy and who where reported in the literature. RESULTS: Most (63%) of the malignant neoplasms associated with adult HSP were solid tumors: lung, n = 6; prostate, n = 2; breast, n = 1; renal, n = 1; stomach, n = 1; and small bowel, n = 1. Hematologic malignancies (37%) included non-Hodgkin lymphoma, n = 2; hodgkin disease, n = 2; IgA multiple myeloma, n = 1; myeloproliferative disease, n = 1; and myelodysplastic syndrome, n = 1. patients with malignancy were older (median age, 59 years), were more likely to be male (M/F = 8.5), had joint involvement more frequently (95%), and had a lower frequency of prior acute infection than those without malignancy. A typical paraneoplastic course was documented in only two cases. CONCLUSIONS: Epidemiological studies are needed to determine the association between adult HSP and malignancy. In practice, it may be wise to suspect a malignancy in men older than 40 years of age who develop HSP in the absence of a precipitating factor. Pathogenic hypotheses involve tumor antigens or abnormal IgA production leading to immune complex formation.- - - - - - - - - - ranking = 928.39656630965keywords = neoplasm, complex (Clic here for more details about this article) |
7/156. Spindle cell lipoma of the foot and the application of CD34 immunohistochemistry to atypical lipomatous tumors in unusual locations.Spindle cell lipoma demonstrates a distinctive histologic appearance and characteristic clinical presentation. We recently observed two cases of solitary subcutaneous neoplasm of the foot with histologic features of spindle cell lipoma that in one case includes a minor component of the overlapping tumor, pleomorphic lipoma. Because the foot is an unusual location for these neoplasms, immunoperoxidase and cytogenetic studies were performed. In both cases, staining was strongly positive for CD34 and negative for smooth muscle actin. Cytogenetic studies from the tumor with a pleomorphic component revealed features consistent with a lipomatous neoplasm, but are otherwise diagnostically nonspecific. An analysis of the literature reveals that although CD34 immunoreactivity is characteristic of spindle cell lipoma and helps exclude nonlipomatous neoplasms, it does not clearly eliminate other well-differentiated lipomatous tumors. Accordingly, without the aid of classic tumor location, the diagnosis of the spindle cell/pleomorphic lipoma group relies primarily on histologic features, with supportive but not definitive information provided by immunoperoxidase and cytogenetic studies. Obscuring this issue, however, are the imprecise histologic distinction between these tumors and those of the atypical lipoma/atypical lipomatous tumor/ well-differentiated liposarcoma group and the nomenclature controversy that surrounds the latter group of neoplasms. Despite these obstacles, both groups of well-differentiated lipomatous tumors are clinically benign when subcutaneously located.- - - - - - - - - - ranking = 1546.4942771827keywords = neoplasm (Clic here for more details about this article) |
8/156. Composite dendritic cell neoplasm (NOS) and small lymphocytic lymphoma.This report describes a composite (or "collision") of a dendritic cell neoplasm and small lymphocytic lymphoma. It represents the seventh example of dendritic cell neoplasia occurring in the setting of low-grade B-cell malignancy and the third example of a composite tumor, in which both neoplasms were present within the same lymph node. The small lymphocytic lymphoma component exhibited a typical CD20 , CD5 , and CD23 immunophenotype. The dendritic cell neoplasm exhibited reactivity with CNA-42, but nonreactivity for CD21, CD35, smooth muscle actin, desmin, and epithelial membrane antigen (EMA). Equivocal cytoplasmic staining was seen for S100p, CD68, and factor xiiia. Ultrastructurally, the dendritic cell neoplasm exhibited desmosomes, rough endoplasmic reticulum, cytoplasmic intermediate filaments, and intercellular collagen. Because the immunophenotype and ultrastructure did not correspond to one of the five recognizable dendritic cell subtypes, the neoplasm was designated dendritic cell neoplasm, not otherwise specified (NOS). polymerase chain reaction (PCR) analysis for immunoglobulin heavy chain gene rearrangements performed on individual components of the composite tumor demonstrated rearrangement within the small lymphocytic lymphoma component, but none in the dendritic cell component. The lack of an immunoglobulin heavy chain gene rearrangement within the dendritic cell component argues against a transformational event and supports the concept that these separate neoplasms represent a true "collision" or composite lesion.- - - - - - - - - - ranking = 3402.287409802keywords = neoplasm (Clic here for more details about this article) |
9/156. pain management in cancer rehabilitation.Significant pain is experienced by the majority of cancer patients during the course of their illness. Despite the widespread availability of effective therapy, undertreatment remains common. Opioid pharmacotherapy has emerged as the mainstay of cancer pain management. Coanalgesic administration, disease-modifying therapies, and interventional strategies may be used concurrently to augment pain relief. Adequate pain management is a requisite condition for successful rehabilitation of patients with neoplasms. overall ARTICLE OBJECTIVE: To describe common cancer- and treatment-related pain syndromes and the analgesic approaches commonly utilized in the management of cancer pain.- - - - - - - - - - ranking = 309.29885543655keywords = neoplasm (Clic here for more details about this article) |
10/156. Microfilariae in association with neoplastic lesions: report of five cases.Microfilariae and adult filarial worms have occasionally been detected in association with neoplastic lesions in cytological smears. The presence of microfilariae along with neoplasms is generally regarded as a chance association, yet some authors suggest that such parasitic infestations may be a causative factor for tumourigenesis. There are only a few reported cases in cytology literature documenting this association. We report the presence of microfilariae in routine cytology smears from one benign and four malignant tumours. Microfilariae could not be identified on histopathology available in four of these cases.- - - - - - - - - - ranking = 309.29885543655keywords = neoplasm (Clic here for more details about this article) |
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