Abstract. Sera from patients with viral hepatitis were examined for serum vitamin B12 concentration, unsaturated B12 binding capacity, total B12 binding capacity of whole serum and of separate transcobalamin‐I and transcobalamin‐II fractions. It was found that the high serum B12 concentrations observed were associated with an increase in the B12 binding of the transcobalamins. The B12 bound to transcobalamin‐I was found to be two to three times higher than that in normal subjects. The most striking difference was the finding of excessive amounts of B12 bound to transcobalamin‐II, as much as 30 to 40 times the normal. The unsaturated B12 binding capacity of hepatitis sera is usually very low. In addition to the B12 bound to transcobalamins, a considerable part of the elevated serum B12 in hepatitis was in a dialyzable form and was not bound to either transcobalamin‐I or transcobalamin‐II. This dialyzable B12 is apparently bound to a small peptide (M.W less than 10000) which permits its passage through dialysis membrane but makes the B12 molecule unavailable to the microorganism in the bioassay, unless it is released from the peptide complex by boiling.
Eighty-four patients with testicular seminoma were treated at the Northern Israel Oncology Center during the years 1968-1988. Using the staging classification of Hussey, 69 patients (82%) had Stage I, eight (10%) had Stage IIA, four (5%) had Stage IIB, one (1%) had Stage IIIA, and two (2%) had Stage IIIB disease. Sixty-nine patients (82%) had classic pure seminoma, nine (11%) had anaplastic seminoma and six (7%) had spermatocytic seminoma. Seventy-four patients (88%) underwent high inguinal orchiectomy and ten (12%) had a scrotal approach. Seventy-five patients (85%) were treated with postoperative irradiation. Stage I patients received 26-30 Gy to the paraaortic and ipsilateral pelvic lymph nodes. Stage IIA patients were treated in the same manner with a boost to the involved lymph nodes. With a mean follow-up of 97 months, 65 patients (77%) are alive and well with no evidence of disease, 7 patients (8%) are dead due to disease progression. The 5-, 10-, 15-, and 20-year actuarial survival for all patients was 90%, and for early stage patients 94%. Eight patients (14%) relapsed; 3 of them were salvaged by chemotherapy. Serious side effects of irradiation included lethal respiratory failure due to bleomycin-induced pulmonary fibrosis in one patient, peptic ulcer in three patients, hydronephrosis due to paraureteral fibrosis in one patient and recurrent paralytic ileus in one patient. Eight patients (10%) developed nine second cancers, three of them within the previous radiation field.(ABSTRACT TRUNCATED AT 250 WORDS)
A retrospective analysis of 81 stage I seminoma patients irradiated at the Northern Israel Oncology Center between 1968 and 1993 was undertaken. During this period, 5 (6%) patients relapsed, all outside the initial treatment volume, with a median time of 6.6 (range 1–12) months to relapse. Three patients were salvaged with cisplatin-based chemotherapy. The policy of adjuvant radiotherapy resulted in a high probability of cure and decreased relapse rate. Early relapse is a rare event in properly irradiated stage I seminoma which is highly curable with a cisplatin-containing regimen. Recurrences tend to occur outside the treated radiation volume.
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