Objective: to review clinical presentation and outcome of patients with a diagnosis of renal cell carcinoma at a district general hospital and assess whether older patients were more likely to present in a non-specific manner or receive more conservative management and whether their survival was less favourable. Subjects and methods: 39 patients presenting with a diagnosis of renal cell carcinoma between 1987 and 1995 were identified from hospital activity analysis data and histopathology records. We divided the subjects into young patients (< 69 years: n = 27) and elderly patients (>70 years: n = 10), and made a retrospective analysis of clinical features, laboratory results, pathology, staging, treatment and survival from hospital records. Results: anaemia, hypertension and weight loss were common clinical features in both young and elderly groups. The prevalence of non-urological symptoms did not differ between study groups. Anaemia was frequently microcytic and hypochromic. Hypertension was present in 46% of patients and one-third of these were newly diagnosed. In 19% of patients with renal cell carcinoma, the diagnosis was made incidentally while imaging for other indications. Elderly patients were as likely to receive surgical treatment as younger patients. Survival differed with stage but not age. Conclusions: neither clinical presentation, management nor survival differed between the young and elderly subjects. Renal cell carcinoma should be considered in elderly patients with systemic features such as malaise or weight loss associated with anaemia, hypertension and raised erythrocyte sedimentation rate.
This paper describes a study of hematopoiesis in parathion-treated mice. Adult mice (48 C57B1/6) were given a daily dose of parathion (4 mg/kg p.o.) or corn oil vehicle (5 ml/kg p.o.) for 14 days. During the pesticide and the examination period, treated animals showed no signs of poisoning and had normal body weights. On days 2, 5, 7, 9, 12 and 14 following parathion or corn oil, femoral marrow cells were assayed in vitro for granulocyte/monocyte (CFU-gm), erythroid (CFU-e and BFU-e), megakaryocyte (CFU-meg), stromal (CFU-str) and multipotential (CFU-mix) hematopoietic stem cells. Leukocyte counts were elevated on days 2 and 5, while platelet counts were not increased until day 12. No change was observed in either hematocrits or numbers of marrow cells. BFU-e were reduced (23% of control) by day 7, then increased to 137% of control by day 14. CFU-e were reduced (41% of control) on day 9, then increased to 71% of control by day 14. CFU-mix were 130% of control (day 2), then declined to control values by day 5. On days 12 and 14, CFU-mix colonies decreased to 40% of control. CFU-str were reduced at all time points examined. CFU-gm were 123%, 136% and 130% of control on days 7, 12 and 14, respectively, while CFU-meg were increased (145% of control) on day 7. The data suggest that parathion alters the cloning potential of bone marrow precursor stem cells.
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