William E. Crisp

An analysis of “long-term” follow-up results in patients with cervical intraepithelial neoplasia treated by cryotherapy

Two thousand eight hundred thirty-nine patients who had been treated by cryotherapy for cervical intraepithelial neoplasia (CIN) in nine different institutions were followed longitudinally after three negative Papanicolaou smears to ascertain the risk of recurrence. The cumulative risk of developing CIN after successful cryotherapeutic management of CIN was 0.41% at year 5, 0.44% at year 10, and 0.44% at year 14. There was no significant difference in risk between patients originally treated for CIN 1, CIN 2, or CIN 3.

The computerized digital imaging colposcope: future directions.

A computer-aided colposcope has been developed for enhancement and analysis of colposcopic images. There are numerous possible applications of this system, including image archiving, image enhancement and processing, and quantitative measurements of various features in the images. In addition, a wide range of digital filters can be applied to the system that may be used to detail different aspects of the image. The method for a new mode of applying digital and optical filters to the colposcope is discussed and future directions for the system are suggested.

Cryosurgical treatment of premalignant disease of the uterine cervix.

Cryosurgery has been utilized as primary treatment in 114 patients with premalignant disease of the uterine cervix. It has been found to be a rapid, safe, economical, and, to date, effective therapy.

The immunologic therapy of squamous cell carcinoma: A preliminary report

Abstract A preliminary report has been presented in which 37 of 39 cows (94.8 per cent) with ocular invasive squamous cell carcinoma showed arrest and resolution of the tumor within 8 weeks of receiving a single intermuscular injection of a concentrated saline-phenol extract of fresh tumor tissue. Although it is postulated that this represents active specific immunotherapy with a resultant cell-mediated immune reaction, the exact mechanism of action and the active antigenic substance have not been identified. Although tumor immunology is a field still plagued by paradox, the application of specific active immunotherapy to cancer in man is the hope of the future.

Choriocarcinoma of The Fallopian TubeCoincident with Viable Pregnancy

Summary A case is reported in which a choriocarcinoma of the Fallopian tube coexisted with a living fetus Addendum.—The patient continued to do well until Nov. 16, 1954, when, on repeat x-ray survey, a 5 cm. density was found in the lower lobe of the right lung. A serum gonadotrophin assay was positive in a 1 to 10 dilution. On November 21 she experienced a paroxysm of coughing which was accompanied by hemoptysis, dyspnea, and pain in the right chest. X-ray confirmed the physical findings of a right pleural effusion. Thoracentesis abated the symptoms. The fluid was positive for tumor cells. On November 30 the patient was given 12.6 mg. of nitrogen mustard intravenously. She responded well as evidenced by a dramatic clinical improvement, the leukocyte response, and negative hormone titers. From December 10 to December 30, she received as an outpatient a total dose of 3,200 r over the anterior and posterior right chest. Because of upper abdominal and right chest pain, she was readmitted on Jan. 3, 1955. On January 7, 10 mg. more of nitrogen mustard was given. Despite her subjective improvement, she became more cachectic and died on January 31, five and one-half months after her first admission. Autopsy disclosed extensive metastases to the liver, lungs, and adrenal glands.

Multiagent chemotherapy in relapsing ovarian cancer.

Abstract A multiagent regimen (vinblastine, bleomycin, hexamethylmelamine, and cis -platinum) partly designed on the basis of data from a human tumor stem cell assay was used to treat 36 patients with relapsing epithelial ovarian cancer. All patients included in this study had previously received alkylating agent therapy, and 78% (2836) had also received Adriamycin. Thirty-five patients were clinically evaluable for response; eight achieved complete clinical remission, and nine achieved partial remission, for an overall response rate of 49%. The median duration of response was 10 months, and three of the complete responders are in remission at 10+, 17+, and 22+ months. Mild to moderate peripheral neuropathy was the major side effect, occurring in 11% (435) of patients. Myelotoxicity was well tolerated. We conclude that this four-drug regimen is effective in the treatment of relapsing ovarian cancer patients and should be considered for study as a front-line combination chemotherapy for previously untreated patients.

Preoperative diagnosis of primary carcinoma of the fallopian tube

Abstract Two instances of primary carcinoma of the Fallopian tube, the diagnosis of both of which was made preoperatively on the basis of inexplicable postmenopausal metrorrhagia, are herewith reported.

Postpartum hysterectomy for sterilization

A prospective study to evaluate 2 forms of postpartum sterilization (elective cesarean hysterectomy and postpartum abdominal hysterectomy) was undertaken. Of 241 patients who had elective total abdominal hysterectomy after delivery, 108 underwent cesarean hysterectomy and 133 postpartum hysterectomy. Morbidity was highest in the cesarean- hysterectomy group and lowest when the hysterectomy was done on the third postpartum day. 95% of the patients went home within a week of surgery. Acceptance was high. 58% had no complications.