Abstract:

Dedrick et al. published a mathematical model in 1978 that described the theoretical rationale for intraperitoneal administration of chemotherapeutic agents. Numerous authors have provided substantial clinical and experimental evidence supporting Dedrick's model. Lukas et al. and Torres et al. have described the pharmacokinetics involved in the transport of drugs from the peritoneal cavity into the portal and systemic circulation. These investigations and others gave birth to the pharmacologic concept known as the peritoneal plasma barrier (PPB). The PPB has been described as a complex diffusion barrier, consisting of the endothelium, the mesothelium, and the intervening interstitium, along with the fluid in the blood and the dialysate. This physiologic barrier limits the resorption of hydrophilic drugs such as mitomycin C, doxorubicin, and cisplatin from the peritoneal cavity into the blood.

Authors:

Paul H. Sugarbaker, M.D., F.A.C.S., Andrew M. Averbach, M.D., Pierre Jacquet, M.D., O. Anthony Stuart, Arvil D. Stephens, Washington Cancer Institute, Washington, D.C.

For Direct IP Access please click this link

Abstract:

The RIGS system is a technology which was developed to provide a more sensitive and accurate method of detecting colorectal cancer during surgery. One of the components of this system is the hand-held, gamma-detecting probe [Neoprobe Model 1000instrument; Neoprobe Corporation, Dublin, Ohio), used by the surgeon to identify preadministered, radiolabeled monoclonal antibody which has localized to diseased tissue. RIGSuses sound-directed gamma detection to identify and locate cancer which may not be seen or felt by the surgeon. The success of RIGS has been largely due to the remarkable sensitivity of the gammadetecting probe in detecting small amounts of low-energy radioactivity. This attribute has led to the use of the probe for other surgical applications including pre- and intraoperative lymphatic mapping, and parathyroid localization. Surgery for melanoma, breast cancer, parathyroid disease, and colorectal cancer has been affected by the increased use of the gamma-detecting probe both in clinical trials and practice. This chapter will review the many applications of this new technology.

Authors:

William E. Burak, Jr., M.D., Martin Boso, Marlin O. Thurston, Ph.D., Edward W. Martin, Jr., M.D., The Arthur G. James Cancer Hospital and Research Institute, The Ohio State University, Columbus, OH

For Direct IP Access please click this link

Abstract:

Surgical biopsy of the breast has long been the most commonly accepted method of determining the nature of a clinical or mammographic abnormality. Because this method carries with it certain cost and morbidity drawbacks, physicians have investigated less invasive alternatives. Until recently, however, there has not been sufficient confidence in the minimally invasive techniques to supplant surgical breast biopsy. Fine needle aspiration (FNA) of the breast has been available for decades and, in some hands, performed reliably enough to avoid surgical biopsy in certain instances. For the most part, however, surgeons and other physicians have been reluctant to base definitive decision making upon the results of FNA.This is understandable in that FNA carries significant insufficient tissue and false negative rates. As a result, FNA frequently represented an additional test and attendant cost without obviating the need for surgical biopsy.

Authors:

Steve H. Parker, M.D., Radiology Imaging Associates, Denver CO; Philip Z. Israel, M.D., F.A.C.S., The Breast Center, Marietta, GA

For Direct IP Access please click this link

Abstract:

Sonographic examinations of the female mammary gland within the frameworks of the diagnosis of breast cancer play a fundamental role in the early detection of benign and, in particular, of malignant growths. Sonographic blood flow determinations can be used as an auxiliary noninvasive examination method. This is based on the fact that malignomas differ from benign tumors in that they display a pathological increase in vascularization. These changes of the circulatory conditions can be utilized in the diagnosis of the dignity of breast cancer.

Authors:

Dr. med. Cristof Sohn, Dr. med. Frank Beldermann, Dr. med. Monika Schieber, University of Heidelberg, Heidelberg, Germany; Prof. Dr. med. Manfred Kaufmann, University of Frankfurt, Frankfurt, Germany; Prof. Dr.Dr. h.c. Gunther Bastert, University of Heidelberg, Heidelburg, Germany

For Direct IP Access please click this link