Effective salvage therapy for refractory disseminated breast cancer with 5-fluorouracil and high-dose continuous infusion folinic acid.
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Adenocarcinoma↗
Biomedical subjects
B Carr
Publications and source records attributed to B Carr.
Etoposide (VP-16) and cytosine arabinoside in the treatment of relapsed small-cell lung cancer.
Seventeen patients with small-cell lung cancer refractory to combination chemotherapy were entered in a study of VP-16 and infusional Ara-C. All patients were evaluable for response and 14 were evaluable for toxicity (three deaths that occurred after the first cycle of therapy were due to progressive tumor, and toxicity could not be evaluated in these three patients). Ara-C was given as a continuous intravenous infusion of 45 mg/m2/day for 72 h; VP-16 was given as three daily intravenous bolus doses of 50 mg/m2 at hours 12, 36, and 50 of the 72-h Ara-C infusion. Because of excessive myelotoxicity in the first six patients, the last 11 patients began treatment at a lower dose of Ara-C, 25 mg/m2/day. Six of 17 patients had previously been exposed to VP-16 as part of their initial chemotherapy regimen. The 17 patients received 32 cycles of therapy. Myelotoxicity was severe, with nadir granulocyte counts less than 500/microliters or platelet counts less than 30,000/microliters in four treatment cycles (including two at the lower Ara-C dose). No patient experienced an objective response to this therapy. We conclude that the combination of VP-16 and infusional Ara-C at these doses is excessively toxic and does not warrant further investigation in refractory small-cell lung cancer.
Aged↗
Relationship of clinical and immunological abnormalities in haemophilia A to F VIII therapy and HIV exposure: a longitudinal study.
This study was established to examine the longitudinal consequences of F VIII therapy on immune function in 24 patients with haemophilia A. Antibodies to the human immunodeficiency virus (HIV) were found in 15 of 16 patients with severe haemophilia and in 2 of 8 patients with mild disease. The principal clinical and immunological abnormalities were restricted to the HIV antibody-positive patients: T helper cell lymphopenia (less than 0.55 x 10(9)/l) in 10 patients, persistent glandular lymphadenopathy in 4 patients and depressed response to skin recall antigens in 7 of 9 HIV-positive patients tested. Although no extension of these immunological and clinical abnormalities developed in the 18-month period of monitoring, T helper cell counts and platelet counts were significantly lower in a group of patients with established long duration HIV seropositivity (since 1982/1983) in comparison with the remaining seropositive patients. This suggests that a progressive pathological process is associated with infection by this virus, but the factors which determine the long-term sequelae are still unknown.
Adolescent↗
Preliminary analysis of a randomized comparison of 5-fluorouracil versus 5-fluorouracil and high-dose continuous-infusion folinic acid in disseminated colorectal cancer.
In this study, 50 patients were randomly assigned to treatment with 5-fluorouracil (FUra) or FUra plus high-dose continuous-infusion folinic acid. Five of 27 evaluable patients in the FUra group versus 10 of 21 patients in the FUra plus folinic acid arm of the study had objective partial remissions, P = 0.02. Time to progression was 3.9 months for FUra and 8.0 months for FUra and folinic acid, P = 0.006; however, median survivals (11.9 versus 14.5 months) were not different in this crossover study. Toxicity in both treatment arms was mild, although patients receiving FUra plus folinic acid experienced significantly more stomatitis than patients treated with FUra alone. This study suggests that high-dose, continuous-infusion folinic acid, which produces a steady-state level of biologically active folates of 10 microM, significantly increases the therapeutic activity of FUra.
Adenocarcinoma↗
Cell cycle kinetic measurements in an irradiated rat rhabdomyosarcoma using a monoclonal antibody to bromodeoxyuridine.
Cell cycle kinetics after X-irradiation were studied in a solid rat rhabdomyosarcoma using a monoclonal antibody to bromodeoxyuridine (BrdUrd) in cells in which the DNA was labeled by BrdUrd. It could be shown that this tumor was composed of about 80% diploid host cells, and only 20% of the cells in the dissociated tumor were actually tetraploid tumor cells. When rats were injected intraperitoneally with BrdUrd to label S-phase cells in the tumor, only a fraction of both types of cells became labeled with BrdUrd during S-phase, even 24 h after injection. The diploid BrdUrd-labeled cells progressed rapidly into cycle; 4 h after injection of BrdUrd, labeled diploid G1-phase cells could be observed. Only 25% of the tetraploid S-phase cells could be labeled by a single injection of BrdUrd (160 mg/kg body weight). These labeled tetraploid cells progressed through the cell cycle with similar velocities as did labeled diploid cells. Using a "Mini Osmotic Pump" containing bromodeoxycytidine (BrdCyd) at high concentration (0.3 mol/L) that released BrdCyd continuously into the organism where it was converted to BrdUrd, it could be shown that after 2 days about 60% of cells in S-phase and 70% of cells in G2-phase were labeled. The fraction of labeled G2-phase cells in irradiated tumors (D = 10 and 20 Gy) was enhanced between 10 and 50 h after irradiation due to a radiation-induced G2 block in cycling tetraploid tumor cells.(ABSTRACT TRUNCATED AT 250 WORDS)
Animals↗
Bone and joint infections caused by gram-positive bacteria: treatment with cefotaxime.
Cefotaxime treatment was evaluated in 41 patients with serious bone and joint infections. Septic arthritis and bursitis (8), acute and chronic osteomyelitis (33) were treated with 3 to 12 g of cefotaxime per day for three to 52 days. The diagnosis of osteomyelitis or septic arthritis was made on the basis of clinical and roentgenographic evidence of infection. The diagnosis of a joint infection was confirmed by a positive culture of a joint aspirate sample. The diagnosis of a bone infection was confirmed by either a positive culture of a bone biopsy or of blood in combination with a positive bone scan or roentgenogram. Staphylococcus aureus was the most frequently isolated pathogen. Overall, 36 of 41 patients, who met all criteria for evaluation, had satisfactory responses to cefotaxime. The drug was well tolerated by all patients. However, six patients had a direct Coomb's test, two patients were noted to be neutropenic and two patients developed a macular rash. It is concluded that cefotaxime is a useful and safe antibiotic for the treatment of osteomyelitis and septic arthritis.
Adolescent↗
Magnetic resonance imaging of lymphomas in children.
Magnetic resonance imaging has been used to evaluate 10 children with lymphomas and was able to identify disease in all 10 cases and monitor response to therapy in all three patients with follow-up studies. It could not distinguish between the different histological types of lymphoma. The image intensity of a diseased spleen in one case was different from that of five other normal spleens in six children with Hodgkins disease. Magnetic resonance imaging compared well with computed tomography and it was especially good at identifying blood vessels.
Adolescent↗
Enterococcal superinfection and colonization with aztreonam therapy.
Patients were given aztreonam (SQ 26,776) parenterally for the treatment of various gram-negative infections. During or shortly after therapy, 8 (17.8%) of 45 patients became infected with or colonized by enterococcus. These eight cases included eight urinary tract isolates; one of these cases subsequently developed bacteremia. Five patients required further antimicrobial therapy directed against enterococcus. Patients receiving aztreonam are at risk for the development of enterococcal superinfection or colonization.
Anti-Bacterial Agents↗
Magnetic resonance imaging of neuroblastoma with a 0.15-T magnet.
Magnetic resonance imaging (MRI) in nine children with neuroblastoma showed that MRI can effectively demonstrate primary and metastatic disease and aid in predicting tumor resectability. MRI can show changes in tumor size and intensity in response to chemotherapy or radiation therapy. Neuroblastomas have an image intensity much lower than that of liver and muscle on inversion-recovery scans. On spin-echo 500/30 scans, the tumors have a greater intensity than muscle and a similar or slightly greater intensity than liver. On spin-echo 1000/60 scans, they are always of greater intensity than liver or muscle. At this stage, the overall accuracy of MRI as compared with other imaging methods is not known.
Adrenal Gland Neoplasms↗
In-vitro and in-vivo comparison of mezlocillin and cefoxitin.
The efficacy, toxicity, microbiology and pharmacology of cefoxitin and mezlocillin were compared in a clinical and laboratory study. In 81 patients treated with cefoxitin and 83 treated with mezlocillin, clinical and bacteriological cures were achieved in 79.2% and 85.5% respectively. Both antibiotics were effective in the treatment of septicaemia, pulmonary infections, urinary tract infections, intra-abdominal and pelvic infections and skin and soft-tissue infections. Both were also effective in the treatment of anaerobic infections. No major haematological, hepatic, or renal toxicity was encountered in patients treated with either drug.
Adolescent↗
Comparative clinical evaluation of mezlocillin and cefoxitin.
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Adult↗
A bioassay for a water-soluble benzodiazepine against sodium thiopental.
The authors performed a bioassay of midazolam maleate, an investigational, water-soluble benzodiazepine; to determine the duration of sleep after a single intravenous dose. Sodium thiopental was the standard against which the midazolam maleate was assayed. Prior to operation 60 surgical patients were randomly given one of five doses of drugs, either thiopental, 180 or 270 mg, or midazolam maleate, 6.6, 10, or 15 mg. The designated drug was infused intravenously over 20 sec in a double-blind fashion. Sleep was defined as commencing when the patients stopped counting, and ending when they could respond appropriately to verbal commands. Midazolam maleate, 10 mg (9--12 mg represents 95 per cent confidence limits), was found to be equivalent to thiopental, 200 mg, in the duration of sleep induced. Apnea following the infusion was less frequent and of shorter duration after midazolam maleate than after thiopental. It is concluded that midazolam maleate is a satisfactory agent for the induction of anesthesia, and that it is about 20 times as potent as thiopental.
Adolescent↗
Lactic acidosis associated with metastatic breast carcinoma.
Occurrence of lactic acidosis with adequate tissue oxygenation (type B lactic acidosis) has been described in association with leukemia, lymphoma and a single case of Hodgkin's disease. No cases of this type have been reported in association with solid tumors. A case of type B lactic acidosis in a woman with rapidly progressing metastatic breast carcinoma is described.
Acidosis↗
Polyploidy, plants, and electrophoresis.
Investigations of polyploidy using electrophoresis are at present severely limited by several areas of difficulty which limit all applications of this technique. The technical problems inherent in electrophoresis of plants, namely extraction of active extracts and maximizing resolution of electrophoretic variants through investigation of gel and especially assay conditions, have never been addressed explicitly. No rationale for initiating work on a new species is available. Analytical approaches to defining the conditions which limit resolution are rare. Gel-to-gel variation is poorly controlled, seldom monitored. The individual nature of electrophoretic investigations limits the comparability of data among labs. In short, "hit-and-miss" approaches predominate, and these limit investigation. Techniques are now available which one can hope will greatly improve the experimental situation.
Animal Population Groups↗
Specific glucocorticoid inhibition of growth promoting effects of prostaglandin F2alpha on 3T3 cells.
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Cell Division↗
Radiologic seminar. XC: intracranial arteriovenous malformations.
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Arteriovenous Fistula↗
Liver transplantation for hepatocellular carcinoma.
Total hepatectomy plus liver transplantation was performed on 105 patients considered unsuitable for liver resection. Postoperative 5-year actuarial survivals correlated with the pathologic stage of the tumor: stage I 75%, stage II 68%, stage III 52.1%, and stage IVA 11%. The overall 5-year survival for all patients was 36%. Nodal disease, bilobar tumor, and macroscopic venous invasion were significant poor-prognosis features. In addition, 12 patients with pT4N1M0 lesions (also stage IVA) had hepatectomy plus more extensive en bloc regional resection (Whipple procedure or cluster resection) plus transplantation in an effort to prevent local recurrence. Only 2 of these 12 patients (16.7%) are alive and free of disease after 2 years. Seven patients (58%) have died from tumor recurrence usually originating from distant metastases an average of 10.6 months after transplantation. Successful transplantation for hepatoma depends on screening programs to identify early stage disease. Successful outcome of transplantation for late stage disease, which includes most of the patients in our series, awaits the development of neoadjuvant therapy to control distant microscopic metastases, which are almost certainly present though not apparent at the time of transplantation.
Adolescent↗