C. Julian Rosenthal

Pseudolymphoma with mycosis fungoides manifestations, hyperresponsiveness to diphenylhydantoin, and lymphocyte disregulation

Three patients receiving diphenylhydantoin (DPH) were seen with a reversible process suggesting mycosis fungoides. Clinical and laboratory manifestations included generalized pruritic exfoliative erythroderma, eosinophilia, lymphadenopathy, hepatosplenomegaly, circulating Sézary cells, epidermal Pautriers microabscesses on skin biopsy, and moderate liver dysfunction. Studies of the distribution and function of the various lymphocyte subpopulations from these patients showed: (1) an increase in the relative and absolute number of T lymphocytes (85–92%); (2) significant stimulation of lymphocyte‐blastic transformation by DPH and low response to pokeweed mitogen stimultion; (3) the impaired ability of Tγ lymphocytes to suppress B‐cell differentiation and immunoglobulin production. With only one exception, 15 symptom‐free patients on DPH showed none of these abnormalities. The clinical manifestations and immunologic abnormalities of patients with this pseudo mycosis fungoides syndrome remitted three to four weeks after DPH administration was discontinued. The proliferation of T lymphocytes and the inhibition of the function of Tγ‐suppressor lymphocytes noted in these patients may be significant to the development of other types of pseudolymphoma and to that of true lymphoma.

Non-Small-Cell Carcinoma of the Lung

It is estimated that in the United States during 1989, 155000 cases of carcinoma of the lung will occur and that close to 142000 of these patients will die within 1 year from their disease (Silver-Berg and Lubera 1989). At present in the United States, the incidence and death rate from this disease for females has surpassed that for breast cancer in the 55–74 year age group (Silverberg and Lubera 1989) and is directly related to cigarette smoking. There is clearly an overwhelming need for the implementation of programs directed at the prevention of this disease. Meanwhile, in the face of current statistics, it is a priority among multispecialty cancer physicians to improve and discover new treatment modalities for this most intractable form of the disease.

The Development of Chemotherapy Drugs as Radiosensitizers: an Overview

The last three decades have seen the development of chemotherapy from being a means of palliating cancer symptoms and occasionally prolonging survival times, to being a means of effecting a cure. However, even now, only 15% of patients with advanced cancer can be cured by the use of chemotherapy alone.

Transthyretin Pro 36 associated with familial amyloidotic polyneuropathy in an Ashkenazic Jewish kindred

SummaryMutations in the serum protein transthyretin (TTR) cause amyloidosis involving the peripheral nerves, heart, and other organs. In Ashkenazic Jews, the only TTR variant described to date has been TTR Ile 33. We have studied DNA from another Ashkenazic Jewish kindred with familial amyloidotic polyneuropathy. Singlestrand conformation polymorphism analysis, DNA sequencing, and restriction analysis indicated that this kindred has the TTR Pro 36 variant, previously described only in a Greek kindred.

Concomitant Continuous Infusion Adriamycin and Radiation: Evidence of Synergistic Effects in Soft Tissue Sarcomas

The current lack of effective therapy against most malignant tumors in advanced stages is due, primarily, to its lack of specific cytotoxicity for neoplastic cells. In order to circumvent this problem various chemotherapeutic agents have been used in combinations aiming to increase their overall therapeutic index.

Hepatic Metastases from Gastrointestinal Malignancies and Hepatocellular Carcinoma

The liver is the primary site of distant metastases of colorectal carcinoma and as such becomes of significant concern to the oncologist in not only advanced local disease but also the planning of early stage adjuvant therapy. Welch and Donaldson (1979), through a study of autopsy series, estimated that more than 80% of patients with metastatic colorectal cancer had tumor involvement of the liver. It was also estimated that in more than half of those dying of metastatic disease, the liver was the only site of involvement with the disease. This finding prompted the surgical resection of solitary metastases which yielded a relatively high 5-year survival rate of up to 33% (Adson et al. 1984; Cady and McDermott 1985). Untreated patients, however, have a poor prognosis. Jaffe et al. (1968) studied the natural history of 390 patients with untreated liver metastases and estimated that the median survival of such patients was only 75 days. Later, Woods et al. (1976) also showed a poor survival of 6–20 weeks for patients with liver metastases secondary to colorectal cancer if the liver remains untreated.

Locally Advanced Paranasal Sinus and Nasopharyngeal Cancers — Effects of Hyperfractionated Radiation and Concomitant Continuous Infusion Cisplatin

Management of advanced cancers involving the paranasal and nasopharyngeal complex is complicated by the locally invasive nature of this tumor. The spread of this disease is along mucosal linings and often extends directly into the orbit, or involves the base of skull with cranial nerve dysfunction. The role of surgery is limited because of the structures involved in these strategic locations. Conventional radiotherapy, as pointed out by Lederman (1970), has difficulty in sterilizing malignant cells in compact facial and base of skull bones due to physical and radiobiological limitations. In addition, there is the therapeutic dilemma of producting optic nerve, chiasmal, and brain damage. A successful treatment regimen must improve the local control of this disease with a higher therapeutic ratio.

Infusion Adriamycin and Radiation in Hepatomas

Hepatocellular carcinoma is a highly malignant tumor with a median survival time of only 4 months from the onset of symptoms and 2 months from the diagnosis (Nagasue et al. 1984; Falkson and Coetzer 1986). While radiation has some activity, its effectiveness is limited by the liver tolerance (zum Winkel et al. 1986). Cytotoxic chemotherapy has usually produced disappointing results (Falkson and Coetzer 1986). New approaches are needed for the treatment of this disease. One such new approach is the concomitant use of hepatic radiation and chemotherapy. The optimal chemotherapy would be drugs which are both individually active in the treatment of hepatocellular carcinoma as well as having a potential for radiation sensitization.