Bladder mucosal grafts: experiments with allografts in repairing bladder wall defects.

Free patch grafts of bladder mucosa and underlying lamina propria have been used to cover large defects in canine bladder walls. Both autografts and allografts were successfully transferred. Sex chromatin studies showed the final urothelial covering was from the recipient and not the donor bladder.

Treatment of advanced endometrial carcinoma with doxorubicin and cisplatin: effects on both untreated and previously treated patients.

Sixteen patients with advanced (International Federation of Gynecology and Obstetrics stage III and IV) adenocarcinoma of the endometrium were treated with twelve 28-day cycles of doxorubicin and cisplatin. Response was achieved in 92% of patients (11 responses among 12 patients) who had received no prior chemotherapy and in 50% (two responses among four patients) of previously treated patients. Median survival was 10 months. Doxorubicin and cisplatin were readily administered on an outpatient basis with comparatively low major toxic effects, primarily hematologic, renal, and gastrointestinal. These results indicate that doxorubicin and cisplatin combination therapy is effective with acceptable toxicity in patients with advanced endometrial carcinoma.

Experimental use of free grafts of bladder mucosa in canine bladders. Successful closure of recurrent vesicovaginal fistula utilizing bladder mucosa.

Three to 4 cm-diameter, circular-shaped full thickness sections of the anterior wall of canine bladders were resected. Free grafts of bladder mucosa were lifted from the muscular wall and sewn back as a patch onto the original defect. Fusion of the graft and normal urothelium occurred, and at eight weeks a dense fibrotic external layer and normal urothelium was observed. No diverticuli occurred. A successful closure of recurrent multiple vesicovaginal fistulas in a woman using mucosa alone is reported.

Treatment of advanced ovarian carcinoma with hexamethylmelamine, doxorubicin, and cis-platinum (HAC): results in both untreated and previously treated patients.

Twenty-two patients with advanced (FIGO stages III and IV) adenocarcinoma of the ovary were treated with 28-day cycles of hexamethylmelamine, doxorubicin, and cis-dichlorodiamine-platinum (II) (HAC). After 45 months, there were 21 evaluable patients. The median survival was 16 months. Response was achieved in 82% (9/11) who had received no prior chemotherapy, and in 50% (5/10) previously treated. HAC therapy was readily administered on an outpatient basis, with comparatively low major toxicities, primarily hematologic, neurologic, and gastrointestinal. These results indicate that HAC therapy is an effective regimen for patients with advanced ovarian carcinoma, regardless of their prior treatment status.

Bladder mucosal grafts: experimental use as a ureteral substitute and observation of certain physical properties.

Free bladder mucosal grafts were evaluated as material for ureteral substitution. Surgical replacement of the ureter with free bladder mucosa in dogs demonstrates the feasibility of this technique. Graft patency with preservation of urothelial lining and regeneration of smooth muscle was observed. Physical properties observed during the experiment indicate a good potential for long term preservation of the graft material.

Administration of a complex chemotherapy regimen: inpatient versus outpatient treatment.

The ability to administer a complex chemotherapy regimen, adriamycin and cis-platinum, was evaluated in two different settings, inpatient and outpatient. On comparison, outpatient administration proved superior. This resulted from the interest and experience of the staff administering the medications. It is recommended that outpatient administration of chemotherapy, even with complex protocols, be employed whenever feasible.