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Query: UMLS:C0016632 (Fox)
 1,461 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Controlled trials to evaluate mass screening programs for cancer detection have been singularly lacking. High cost, lack of medical manpower, and low yield have contributed to this problem. A new program in cancer detection (CANSCREEN) has been developed jointly by The Fox Chase Cancer Center in Philadelphia and the Preventive Medicine Institute in New York City. This program attempts to provide a quality cancer-detection examination with increased cost effectiveness. Features include: 1) a self-administered questionnaire on medical history, symptoms, and risk factors; 2) nonphysican examiners; 3) risk-facotr analysis with a predetermined decision logic to determine type and periodicity of examination; and 4) primary intervention (health education). This collaborative program between two institutions in two cities demonstrates the feasibility of introducing similar programs elsewhere. A data base shared by cooperating centers permits information on all patients to be used for evaluation of new techniques, end results, etc. A randomized controlled trial has been designed to evaluate the effectiveness and efficiency of the questionnaire alone and of the questionnaire and examination.
Cancer 1976 Sep
PMID:Population cancer screening. 95 74

The incidence of breast cancer increases with age, but women's participation in breast screening decreases with age. National and regional surveys indicate a number of barriers. Women over age 65 are more likely to say they have never heard of mammograms, that they did not know they needed them, and that their doctors did not recommend them. In a study conducted at Fox Chase Cancer Center, in Philadelphia, participation in an HMO-sponsored breast screening program appeared to reverse the usual age-related decrease in mammography. If mammography utilization is to increase in women over age 65, physicians must offer unambiguous referrals to older women. In addition, health education interventions are needed to improve knowledge and beliefs of older women and their physicians. And, finally, strategies also are needed to enhance access. With the advent of Medicare coverage, payment will be less of a barrier. But other barriers remain.
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PMID:Older women's participation in breast screening. 143 Aug 90

As a component of treatment planning for thoracic irradiation (RT), 210 bronchogenic carcinoma patients seen at the Fox Chase Cancer Center from 1983 to 1990 underwent quantitative perfusion scans, superimposition of their RT treatment fields onto these scans, and pulmonary function testing. These studies were used to prospectively estimate the influence of the planned thoracic irradiation on pulmonary function, as measured by the forced expiratory volume in one second (FEV1). Among the 156 patients with unresected lesions, the mean pre-RT FEV1 was 1.71 +/- 0.67 liters (+/- standard deviation), and the mean percentage of total lung perfusion within the treatment field was 31.0 +/- 12.1%. Mean values for the 54 patients treated post-operatively were 1.79 liters (pre-RT FEV1) and 28.8% (% perfusion within RT field). Using this technique, the prospectively predicted post-RT FEV1 is the product of the pre-RT FEV1 (1% of total lung perfusion within the treatment field). The mean predicted post-treatment FEV1 for the nonoperative patients was 1.15 +/- 0.43 liters and 1.25 +/- 0.41 liters for the postoperative patients. Forty-three nonoperative and 19 postoperative patients had FEV1 determinations following RT, at a mean post-RT interval of 11 months for nonoperative patients and 23 months for post-operative patients. Among nonoperative patients, 53% had no change in post-RT FEV1, 19% improved, while 22% had readings declining toward the predicted value. Only 5% had readings below predicted. Among postoperative patients, 37% had no change or improvement, 37% declined toward the predicted, 10% declined to predicted, and 11% had values worse than predicted. This technique of superimposing RT fields onto lung perfusion scans predicts for a degree of pulmonary impairment which is observed in only a minority of patients (10%) and which is rarely exceeded (6%).
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PMID:Observations on the predictive value of perfusion lung scans on post-irradiation pulmonary function among 210 patients with bronchogenic carcinoma. 836 41

Distributed computing can be applied to CT or MRI scanner image acquisition, printing, and archiving by interfacing the scanner with a computer network. Also on the network must be a computer workstation that has image management software to capture the images sent over the network by the scanner. This software must also allow the radiology staff to print and archive the images. Several benefits are realized by this network configuration. First, the scanner console is solely used for scanning patients; delays are not encountered because the console is being used for printing and archiving images. Also, the workstation printing software can be developed so that useful features not available at the scanner console can be incorporated. Finally, sophisticated archiving strategies can be implemented at the workstation. We have developed a network image management station at the Fox Chase Cancer Center using a reduced instruction set computer (RISC) workstation. Hardware and software is utilized to convert all scanner image data to the American College of Radiology-National Electrical Manufacturers Association format. All workstation software is developed using the open X-Windows standard. Digital audio tape is used for image archiving.
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PMID:A network scanner image management station. 155 61

We report 11 cases of malignant lymphoma of the gonad collected during the past 31 years in our hospital. 8/11 cases conformed well to Fox's criteria for primary gonadal malignant lymphoma. Clinically, they often manifest as a mass in the gonad without any symptoms. Histologically, diffuse NHL of intermediate or high malignancy was observed. According to morphologic criteria of the working formulation in combination with the immunohistochemical study, five cases were designated as T-cell lymphoma. This frequency in Chinese is different from that reported in the western countries.
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PMID:[Pathologic and immunohistochemical study of 11 patients with malignant lymphoma of the gonad]. 161 82

The Medical Computer Facility at the Fox Chase Cancer Center has installed X-terminals in patient examination rooms and at nursing stations for clinical data access by physicians and nurses. The X-terminals are connected to UNIX operating system RISC processors via Ethernet. The RISC processors communicate with databases on a minicomputer cluster. Simultaneous presentation of textual (e.g., pathology and radiology reports) and graphical (e.g., clinical laboratory results) clinical data is provided under X-Windows. CT and MRI images can also be displayed in windows. Our experiences implementing X-terminal clinical workstations in a production environment will be discussed.
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PMID:The use of X-terminals as clinical workstations. 174 47

The Cancer Information Service at the Fox Chase Cancer Center receives over 8,000 calls per year requesting referrals to local health care services. We developed a multi-user microcomputer-based system for entering, storing, updating and retrieving cancer referral resource information. Counselors use a menu-based system to retrieve referral resources by agency name, subject, state, county, city, telephone area code, zip code, or fee code. The system also includes menus for expediting database management: data entry, updating, browsing, and report generation. A data entry screen allows records to be entered or edited. The system can print mailing labels and update sheets for each agency. This system enhances our ability to disseminate high-quality information to the public.
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PMID:Fox Chase Cancer Center Referral Resource Directory. 180 48

When human peripheral blood lymphocytes (PBLs) from Epstein-Barr virus (EBV)-seropositive donors are injected intraperitoneally into SCID mice, EBV+ B cell tumors develop within weeks. A preliminary report (Mosier, D. E., R. J. Gulizia, S. M. Baird, D. D. Richman, D. B. Wilson, R. I. Fox, and T. J. Kipps, 1989. Blood. 74(Suppl. 1):52a) has suggested that such tumors resemble the EBV-positive malignancy, Burkitt's lymphoma. The present work shows that generally the human (hu) PBL-SCID tumors are distinct from Burkitt's lymphoma and instead resemble lymphoblastoid cell lines (LCLs) generated by EBV-infection of normal B cells in vitro in terms of: (a) their cell surface phenotype, with expression of B cell activation antigens and adhesion molecules, (b) normal karyotype, and (c) viral phenotype, with expression of all the transformation-associated EBV latent proteins and, in a minority of cells, productive cycle antigens. Indeed, in vitro-transformed LCLs also grow when inoculated into SCID mice, the frequency of tumor outgrowth correlating with the in vitro growth phenotype of the LCL which is itself determined by the identity of the transforming virus (i.e., type 1 or type 2 EBV). Histologically the PBL-derived hu-SCID tumors resemble the EBV+ large cell lymphomas that develop in immuno-suppressed patients and, like the human tumors, often present at multiple sites as individual monoclonal or oligoclonal foci. The remarkable efficiency of tumor development in the hu-SCID model suggests that lymphomagenesis involves direct outgrowth of EBV-transformed B cells without requirement for secondary genetic changes, and that selection on the basis of cell growth rate alone is sufficient to explain the monoclonal/oligoclonal nature of tumor foci. EBV+ large cell lymphoma of the immunosuppressed may arise in a similar way.
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PMID:Epstein-Barr virus (EBV)-associated lymphoproliferative disease in the SCID mouse model: implications for the pathogenesis of EBV-positive lymphomas in man. 184 72

We analyzed the complications in 310 patients with pathologically documented endometrial carcinoma who received adjuvant radiation therapy (RT) at Fox Chase Cancer Center between 1970 and 1986. Variables included timing of treatment, technique, total dose, age, diabetes, previous abdominal surgery, hypertension, prior bowel pathology, and lymphadenectomy. According to the FIGO (1985) system, 258 patients had Stage I disease, 48 had Stage II, and one had Stage III. One hundred seventy patients received preoperative (preop) RT, 138 received postoperative (postop) RT, and 2 received preop and postop RT. A 4-field technique was used for 212 of 235 patients receiving external-beam (EX) RT, and 75 patients were treated with intracavitary (IC) RT only. Median follow-up was 5.5 years. Actuarial survival of all 310 patients was 78% at 5 years. Thirty-two complications occurred, involving the rectum, small bowel, femur, or lower extremity. Complications were graded according to the ECOG scoring system as grade 2 (mild) and grades 3, 4, or 5 (serious). One of 75 patients treated with IC RT only experienced a grade-2 complication (proctitis). Of 71 patients receiving 4-field EX RT only, 25 preop (16%) and 14 postop (14%) patients had complications. Of 139 patients treated with both EX and IC RT, grade-2 complications were seen in 5% of 87 preop patients and 12% of 52 postop patients (p = 0.17), whereas serious complications were observed in 4% of each group. Univariate analysis of the variables of interest revealed that the incidence of complications was associated with a lymphadenectomy (p = .03), use of external RT (p less than .01), and decreasing age (p = .04). Multivariate analysis confirmed that use of external RT was the most significant predictor for complications. In conclusion, similar complication rates were found in patients treated with either preop or postop 4-field EX RT. While pelvic RT clearly decreases pelvic relapse in patient with endometrial carcinoma, the risk benefit ratio for treatment of these patients should be carefully considered when recommending adjuvant RT for pelvic control.
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PMID:Analysis of complications in patients with endometrial carcinoma receiving adjuvant irradiation. 191 20

Between 1974 and 1989, 58 patients with clinical Stages I and II non-Hodgkin's lymphomas of the head and neck were treated with radiation at the Fox Chase Cancer Center. Forty-one treated with radiotherapy alone form the basis for this retrospective analysis of outcome and prognostic factors. With a mean radiation dose of 4400 cGy, the 5-year actuarial local control rate is 92%. Only one patient failed within an irradiated field. The 5-year actuarial survival and relapse-free survival rates are 85% and 54%, respectively. In a univariate analysis, poor survival was significantly correlated with involvement of Waldeyer's ring, postoperative tumor size greater than 3 cm, and greater than two involved lymph nodes and extranodal sites (p less than 0.02). No such correlations were seen for stage, histologic grade, the presence of extranodal disease, or any of the other parameters that were examined. Relapse free survival was significantly correlated only with the total of the number of involved nodes and extranodal sites. Patients with one or two involved nodes and sites had a 68% chance of remaining disease-free at 5 years compared to 0% for patients with greater than two (p = .02). Again, significant trends were not seen for the other parameters analyzed. These data demonstrate excellent local control, survival, and relapse-free survival using radiation alone with doses of 3000-5000 cGy. In our group of clinically staged patients preselected for treatment with radiation alone, the total of the number of involved nodes and extranodal sites, involvement of Waldeyer's ring, and tumor size after resection correlated strongly with relapse-free survival and overall survival. In patients with early stage non-Hodgkin's lymphomas of the head and neck, initial management with external beam radiotherapy should be considered in particular for those with one or two involved nodes and extranodal sites that are less than 3 cm following resection and that do not involve Waldeyer's ring.
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PMID:Prognostic factors in patients with early stage non-Hodgkin's lymphomas of the head and neck treated with definitive irradiation. 199 30


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