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Biomedical subjects

B Levin

Publications and source records attributed to B Levin.

At least 235 records · Page 13Linked to original sources
PubMed1988

Phase II study of fludarabine phosphate in patients with advanced colorectal carcinoma.

For phase II studies in patients with solid tumors, the National Cancer Institute recommended that the starting dose of fludarabine phosphate be 20 mg/m2/day as a short intravenous infusion for 5 days every 21 days. Twenty-one patients with untreated, advanced, measurable colorectal carcinoma received fludarabine phosphate as a 30-minute infusion at a median dose of 25 mg/m2/day (range 15-35 mg/m2/day) for 5 consecutive days repeated every three weeks. Antitumor response was evaluated following two courses of therapy. No patient achieved complete or partial response. Minor regression of lung metastases occurred for less than 12 weeks in one patient. Therapy was generally well tolerated. Frequent toxicities included lymphopenia, mild nausea and vomiting, mucositis, and anorexia. One patient died of sepsis, bleeding, and progressive disease while she was severely myelosuppressed. Neurotoxicity was not observed in any patient. Fludarabine phosphate at this schedule and dose range is inactive against colorectal carcinoma.

Adult↗
PubMed1988

Acute leukemia occurring after radiotherapy and chemotherapy with a nitrosourea, PCNU.

Secondary acute leukemias can occur in patients who have been treated with chemotherapy. Several reports have shown that treatment with nitrosoureas can result in secondary leukemia, but this is the first report implicating the investigational drug PCNU as a cause. This case is unique because of the cytogenetic findings, the short latency period between the chemotherapy and the diagnosis of leukemia, and the successful treatment of the leukemia with high-dose cytarabine (ara-C).

Adenocarcinoma↗
PubMed1988

Sample size determination in studies with matched pairs.

Two modifications are made in Schlesselman's procedure for determining the total number of pairs to be studied in a case-control study with matching. One is to take account of the use of the continuity correction in the McNemar test statistic, and the other is to incorporate a measure of the degree of association induced by the matching variables between a case's exposure status and that of his or her matched control. The result of both modifications is to increase the required number of pairs above the number produced by Schlesselman's procedure.

Epidemiologic Methods↗
PubMed1988

Clinical and immunological studies of cadaveric renal transplant recipients given total-lymphoid irradiation and maintained on low-dose prednisone.

Twenty-five recipients of cadaveric renal transplants were given total lymphoid irradiation (TLI), perioperative antithymocyte globulin, and low-dose prednisone as the sole maintenance immunosuppressive drug. Nine patients were diabetic, and follow-up was between 19 and 37 months. One-year graft and patient survival was 76% and 87%, respectively, Serious complications included four deaths from cardiovascular disorders, and two deaths from viral infections. Studies of peripheral blood T cell subsets showed a prolonged reduction in the absolute number of helper (Leu-3+) cells, and a rapid recovery of cytotoxic/suppressor (Leu-2+) cells. Analysis of the latter subset, using the monoclonal antibody 9.3, showed that the ratio of suppressor/cytotoxic cells was approximately 10:1. The normal ratio is 1:1. The mean mixed leukocyte reaction remained below 30% of the pre-TLI value for 6 months, and approached 80% at two years. Similar kinetics were observed in the proliferative response to mitogens. The results show that maintenance immunosuppressive drug therapy can be reduced after TLI as compared with conventional drug regimens that use prednisone in combination with cyclosporine and/or azathioprine.

Adult↗
PubMed1988

Ifosfamide and mesna: marginally active in patients with advanced carcinoma of the pancreas.

Ifosfamide, an analogue of cyclophosphamide, has therapeutic activity against a wide variety of human malignancies. In a phase II trial in carcinoma of the pancreas, we treated 31 patients who had not received prior chemotherapy with a median ifosfamide dose of 2 g/m2/d (range, 1.5 to 2 g/m2/d) administered intravenously (IV) over one hour for five consecutive days every 3 weeks. 2-mercaptoethane sulphonate (mesna), an acrolein antagonist with known uroendothelial protective properties, was administered IV at a dose of 400 mg/m2 over 15 minutes before the daily dose of ifosfamide and repeated every four hours for two additional doses. Among 30 evaluable patients, one patient achieved a complete remission (26+ months) and another patient had a partial remission (4 months). The median duration of survival of all patients from the start of ifosfamide therapy was only 3 months (range, 1 to 26+ months). Treatments were generally well tolerated. The most common toxic effects included granulocytopenia, nausea and vomiting, malaise, anorexia, and mild hematuria. Mesna offers an adequate protection against uroendothelial injury caused by ifosfamide. Despite the previously reported response rate of greater than 20% at the same or lower doses of ifosfamide in other studies, our data suggest that ifosfamide is only marginally active against cancer of the pancreas and appears to be of minimal value in the treatment of patients with this tumor.

Adult↗
PubMed1988

Islet cell tumors metastatic to the liver: effective palliation by sequential hepatic artery embolization.

The value of sequential percutaneous hepatic artery embolization with polyvinyl alcohol particles was examined in 22 patients with islet cell carcinoma metastatic to the liver. Nine patients had gastrinoma, 2 had glucagonoma, and 11 had no discernible hormonal secretions or syndromes. Ninety-seven embolizations were done with a median number of 4 (range, 1 to 12) per patient. The interval between embolizations ranged from 1 to 8 months. Twelve of twenty evaluable patients had a partial remission, frequently associated with subjective improvement and decrease in hormone levels. The projected median survival of all 22 patients from the initiation of embolization is 33.7 months (range, 1 to 72). Nausea, vomiting, fever, and abdominal pain occurred with each embolization and subsided usually by day 10 (range, 3 to 35). Sequential hepatic artery occlusion is an effective method for prolonged palliation in this selected group of patients.

Adenoma, Islet Cell↗
PubMed1988

Ulcerative colitis and colon cancer.

Chronic ulcerative colitis is an idiopathic inflammatory disease of the colon associated with an increased incidence of colorectal cancer. Colonoscopy with biopsy for mucosal dysplasia (precancer) can identify individuals with ulcerative colitis who are at increased risk for colorectal cancer. Identification of high-risk individuals can be used to guide clinical decisions regarding the timing and appropriateness of prophylactic colectomy.

Animals↗
PubMed1988

ENT abnormalities associated with Fraser syndrome: case report and literature review.

Fraser syndrome is an uncommon genetic disorder characterized by multiple congenital abnormalities. Newborns afflicted with this syndrome have abnormalities of the eyes, ears, nose, larynx, palate, extremities and urogenital system. A review of the literature shows a deficiency in the description of the ENT abnormalities. Most articles have appeared in the ophthalmologic literature with emphasis on the obvious ocular abnormalities. In this paper we will describe in detail, the ear, nose and throat abnormalities in a two-year-old child with Fraser syndrome.

Child, Preschool↗
PubMed1987

Posttraumatic stress disorder in Israeli combat veterans. Effect of phenelzine treatment.

Twenty-five Israeli combat veterans fulfilling DSM-III criteria for posttraumatic stress disorder (PTSD) participated in an open, prospective trial of phenelzine sulfate administration (median daily dose, 60 mg; range, 30 to 90 mg); three patients withdrew early due to side effects. Treatment was continued for at least four weeks in 22 cases and thereafter for as long as it was felt to be of benefit. Therapeutic efficacy was rated using a new PTSD scale, the Hamilton Depression Scale, and the Hamilton Anxiety Scale administered at four weekly intervals. Six patients completed four to eight weeks of phenelzine treatment; seven patients, nine to 13 weeks; and nine patients, 14 to 18 weeks. Comparison of mean prediscontinuation scores with pretreatment ratings showed, at best, only small (23% to 38%) differences (on the PTSD and Hamilton Anxiety scales) in the group treated for nine to 13 weeks. Two patients with a concurrent diagnosis of panic disorder and two with a concurrent diagnosis of dysthymic disorder were the most improved symptomatically but fell short of clinically significant remission. Although statistically significant improvement was observed on seven of the 12 items of the PTSD scale, sleep disturbance was the only symptom showing a clinically impressive change. These results only partially support previous positive reports of phenelzine treatment of PTSD.

Adult↗
PubMed1987

Gastroduodenal mucosal injury during hepatic arterial infusion of chemotherapeutic agents. Lack of cytoprotection by prostaglandin E1 analogue.

Eighteen colorectal cancer patients with liver metastases receiving hepatic arterial infusion of chemotherapeutic agents (mitomycin-C + 5-FUDR) were randomized to receive misoprostol (a prostaglandin E1 analogue) or placebo as a mode of cytoprotection against inadvertent gastroduodenal mucosal injury. Four of 10 patients on misoprostol and 3 of 8 patients on placebo developed gastroduodenal mucosal injury (p greater than 0.1), which was confirmed by endoscopy. Significant tumor responses to chemotherapy were equally distributed between the two groups. Although our sample size was small and type II error (false-negative trial) cannot be excluded, these data strongly suggest that prophylaxis with misoprostol does not prevent the acute gastroduodenal mucosal injury associated with hepatic arterial infusion of chemotherapeutic agents.

Alprostadil↗
PubMed1987

Selecting the highest of three binomial probabilities.

A sequential elimination procedure for selecting the highest probability in binomial trials, proposed by Levin and Robbins [Levin, B. & Robbins, H. (1981) Proc. Natl. Acad. Sci. USA 78, 4663-4666], is examined further in the special case of trials involving three probabilities. A conjectured inequality relating ratios of selection probabilities to odds ratios is shown to hold only under certain necessary and sufficient conditions. Weaker conjectured inequalities involving the probability of correct selection are shown to hold without restriction.

Journal Article↗
PubMed1987

Hepatitis in patients receiving intraarterial chemotherapy for metastatic colorectal carcinoma.

Fifty-one patients with metastatic colorectal carcinoma confined to the liver received intraarterial chemotherapy through the hepatic artery via a subcutaneous pump. The chemotherapy consisted of sequential 14-day infusions of floxuridine (FUDR) and dichloromethotrexate (DCMTX) or a 14-day infusion of FUDR and bolus mitomycin (MMC). Twenty-four patients (47%) developed hepatitis with an elevation of hepatic serum transaminase (serum glutamic oxaloacetic transaminase, SGOT, or serum glutamic-pyruvic transaminase, SGPT). The median time to develop hepatitis was 11 weeks after initiation of chemotherapy. The morphologic effects of chemotherapy were evaluated in eight patients with hepatitis. All the patients with hepatitis had normalization of the serum transaminases after temporary cessation of chemotherapy. There was a trend toward a greater chance of remission in patients who developed hepatitis. Sixty-seven percent of the patients with a therapeutic response had hepatitis, whereas only 33% of the patients without a response had hepatitis. However, this difference was not statistically significant. The occurrence of hepatitis was not related to FUDR dose, drug program (FUDR-DCMTX vs. FUDR-MMC), pump flow rate, hepatic arterial anatomy, sex, or age of the patients.

Bilirubin↗
PubMed1987

A randomized study of two schedules of copovithane in patients with advanced colorectal carcinoma.

Copovithane (BAY i 7433), a copolymer of 1,3-bis(methylaminocarboxyl)-2-methylenepropanecarbamate and N-vinyl pyrrolidone, has antitumor activity in vitro and in vivo. The mechanism of this polymer is unknown. Thirty patients with advanced colorectal carcinoma with measurable tumors were treated in an open randomized study with two schedules of copovithane (schedule A: 6 g/m2 i.v. over 30 min daily for 5 consecutive days and repeated every 3 weeks; schedule B: 10 g/m2 i.v. over 30 min once a week until progression, unacceptable toxicity, or up to 18 months). Fifteen patients received copovithane on a weekly schedule, and 15 patients received it on an intermittent schedule. None of the patients on either schedule achieved a complete or partial remission. Copovithane was ineffective against colorectal carcinoma by both schedules selected in this study.

Antineoplastic Agents↗