Because of their low incidence and frequent grouping with what are now considered to be other sarcoma types, past findings on the clinical behaviour, proper treatment, and prognosis of UPS may be revised with further study.The majority of UPS tumors are highly aggressive, often recur after surgical removal, and often metastasize. They are treated with a combination of surgical resection, radiotherapy, and/or chemotherapy. More recently, UPS tumors have been treated with antibody therapy, i.e. antibodies which in the case of UPS bind to specific antigens on the surface of T-cells (a type of lymphocyte) and thereby promote the ability of these T-cells to organizes an attack on UPS tumor cells. Presentation
UPS commonly presents as a deep-seated, rapidly enlarging, painless mass in individuals aged 50 to 70 years. These masses are rarely superficial lesions and rarely occur in the pediatric population. In a retrospective study of 266 individuals, UPS tumors ranged from 1–55 cm in greatest diameter (average 8.8 cm with 25%, 38%, and 38% having greatest diameters of 0–1, 5–9, and ≥10 cm, respectively). In a study of 205 individuals (median age 59 years) diagnosed with UPS, the tumors were located in the arm or leg (47.3% of cases), abdomen or pelvis (26.8%), thorax (17.6%), and head or neck (8.3%) areas. In rare cases, these tumors have also presented in other sites such as the retroperitoneal space, liver, pleura of the lung, heart, and small intestine. In a retrospective study, distant metastases were detected at the time of initial diagnosis in 6.4% of 266 individuals.
Case 21 included several children and adults. Crucially all of at least four whom Jenner deliberately inoculated with smallpox virus resisted it. These included the first and last patients in a series of arm-to-arm transfers. He concluded that cowpox inoculation was a safe alternative to smallpox inoculation, but rashly claimed that the protective effect was lifelong. This last proved to be incorrect. Jenner also tried to distinguish between True cowpox which produced the desired result and Spurious cowpox which was ineffective and/or produced severe reaction. Modern research suggests Jenner was trying to distinguish between effects caused by what would now be recognised as non-infectious vaccine, a different virus (e.g. paravaccinia/milkers nodes), or contaminating bacterial pathogens. This caused confusion at the time, but would become important criteria in vaccine development. A further source of confusion was Jenners belief that fully effective vaccine obtained from cows originated in an equine disease, which he mistakenly referred to as grease. This was criticised at the time but vaccines derived from horsepox were soon introduced and later contributed to the complicated problem of the origin of vaccinia virus, the virus in present-day vaccine. : 165–78 The introduction of the vaccine to the New World took place in Trinity, Newfoundland, in 1798 by Dr. John Clinch, boyhood friend and medical colleague of Jenner. The first smallpox vaccine in the United States was administered in 1799. The physician Valentine Seaman gave his children a smallpox vaccination using a serum acquired from Jenner.