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Biomedical subjects

C Liu

Publications and source records attributed to C Liu.

At least 883 records · Page 49Linked to original sources

Acute myelogenous leukemia as a second malignant neoplasm following the successful treatment of advanced Hodgkin's disease.

Of 209 Hodgkin's disease patients treated at least 6 months with a five-drug combination of induction chemotherapy and having a complete remission, four patients developed acute myelogenous leukemia (AML) as a second malignant neoplasm. The overall relative risk for development of AML is 185.0 (P less than 0.05) and the mean time to occurrence of AML is 5.3 years (median, 5.25 years). When examining patient subgroups, the highest relative risk noted was 338.5 (P less than 0.05) for that group of patients receiving an additional 6 months of postinduction MOPP (nitrogen mustard, vincristine, procarbazine, and prednisone). Patients receiving only 6 months of induction BVCPP (BCNU, vinblastine, cyclophosphamide, procarbazine, and prednisone) had a relative risk of 166.2 (P less than 0.05). These data results are consistent with previous reports that patients treated for Hodgkin's disease are at high risk for development of AML. However, to date, no patients in this series have developed second malignancies other than AML.

Adult↗

Postmastectomy adjuvant chemotherapy with or without radiation therapy in women with operable breast cancer and positive axillary lymph nodes: the Southeastern Cancer Study Group experience.

Between September 1976 and June 1982, 308 patients with operable breast cancer with 1-3 involved axillary nodes were stratified according to institution, type of mastectomy, and time from surgery to protocol entry, and then randomized to receive either six or 12 months of adjuvant chemotherapy with cyclophosphamide, methotrexate, and 5-fluorouracil (CMF). With a median time of follow-up of 33 months, relapse rates among 181 reviewed and evaluable patients are 20/85 (23.5%) for pre- and 23/96 (24%) for postmenopausal patients. Results for premenopausal women, while better than historical controls at a similar time interval, appear inferior to other published adjuvant studies (e.g., NSABP and Milan). Although total relapse rates were 23/100 (23%) for six months and 20/81 (25%) for 12 months of therapy, suggestive differences were encountered by menopausal status with early trends favoring 12 months of treatment for premenopausal patients and six months of treatment for postmenopausal patients. During this same period, 283 patients with four or more involved axillary nodes were randomized to 1-3 treatment arms: six months of CMF, six months of CMF preceded by local-regional x-ray therapy (XRT), or 12 months of CMF. The latter arm was closed in February 1980 while the two six-month chemotherapy arms remain open as of January 1983. Relapse rates for 174 reviewed and evaluable patients on the three arms include: 27/76 (36%) for six months CMF, 15/54 (28%) for XRT and CMF, and 24/44 (45%) for 12 months CMF. Local-regional relapse rates were 12/120 (10%) for the combined two non-XRT arms and 3/54 (6%) for the XRT treatment arm (p = 0.34). Thus, at this early stage of follow-up there are still no statistically significant differences between six or 12 months of adjuvant CMF therapy and neither definite beneficial nor detrimental effects of prechemotherapy adjuvant radiation therapy. Longer follow-up will be needed to provide definitive conclusions.

Adenocarcinoma↗

Effects of age on responses to treatment and survival of patients with multiple myeloma.

The elderly patient with malignancy is often considered a poor risk for treatment. To assess the effect of age on the treatment of one such disease, multiple myeloma (a disease with increased incidence in the elderly), a study was made of 280 patients treated with 1,3-bis(2-chloroethyl)-1-nitrosourea (BCNU), cyclophosphamide and prednisone on a Southeastern Cancer Study Group protocol. Initial response rates after six months of treatment were equivalent for the older compared with the younger age groups, with a slightly longer remission duration for those over 70. Likewise, survival was equivalent for the older patients. This was not the result of selection of older patients with less advanced disease, since the proportion with both good and poor risk factors are not significantly different in the various age groups. Moreover, for patients with each of the prognostic factors, older patients responded at least as well as younger patients. There were no significant differences among the age groups in gastrointestinal, skin, hair, or hematologic toxicity, although there was a slightly higher incidence of mild granulocyte and platelet toxicity in patients over 60. These findings are in contrast to the widely held belief that older patients cannot tolerate chemotherapy. On the contrary, they suggest that the elderly patient with myeloma may be expected to respond and survive, without excessive toxicity, at least as well as a younger counterpart with similar prognostic factors.

Aged↗

Bacteriological study in chronic maxillary sinusitis.

The bacterial findings of 73 maxillary sinuses in 48 patients with chronic maxillary sinusitis, together with 7 non-inflamed sinuses, are reported. Employing an intraoperative technique and simultaneous collection of 3 different types of specimens in the present investigation made possible comparison of their bacterial characteristics. The results indicated that intraoperative culture of antral mucosa seems to provide the most reliable finding of bacterial flora in chronic maxillary sinusitis. The anaerobic bacteria were never found in the mucosal culture of non-inflamed sinus. The anaerobes appeared to invade the sinus cavity following the sealing of the ostium through the lymphatic or venous system and maintain the inflammatory process. Microbiological analysis of the results between the infected and non-inflamed sinuses established anaerobic bacteria as the most important pathogen in chronic maxillary sinusitis. The predominant anaerobes recovered in descending order of frequency were Veillonella sp., Peptococcus sp., Propionibacterium acne and anaerobic nonspore-forming GPB. Statistical analysis of the results of mucosal culture of inflamed and control materials demonstrated that those aerobic and faculatative bacteria recovered in the inflamed sinus appeared to be the normal inhabitants of non-inflamed sinus mucosa. The presence of normal flora in the normal healthy sinus mucosa may explain the chain of events that follows the occlusion of the ostium. These aerobic bacteria may become pathogenic and play a role in the pathogenesis of sinusitis.

Adolescent↗

Herpes simplex encephalitis. Clinical Assessment.

Continuing evaluations of antiviral agents for treatment of herpes simplex encephalitis (HSE) provided an opportunity to collect clinical data from 113 patients in whom the diagnosis was proved by viral isolation. Occurrence of HSE was in all ages and in both sexes and was nonseasonal. Characteristically, patients had behavioral changes, fever, confusion, speech disturbances, and, less frequently, seizures. The EEG was the most useful neurodiagnostic aid followed by technetium and computed axial tomographic scans. Employing a logistic regression model for variable selection, the diagnosis could be predicted by clinical findings and neurodiagnostic tests in 83% of the proved cases, but the evidence in 25% was falsely positive. There was evidence of localization by either clinical or neurodiagnostic assessment in all patients with proved disease. Among patients wtih negative findings for HSE, similar focal findings predominated in all but a few. The CSF and brain scans were normal in many patients with proved HSE. This extensive clinical experience in patients wtih diagnosis proved by viral isolation shows that diagnosis cna be confirmed only by brain biopsy.

Adolescent↗

Hidradenitis suppurativa: evidence for a bactericidal defect correctable by cholinergic agonist in vitro and in vivo.

Hidradenitis suppurativa (HS) affects the apocrine sweat glands, giving chronic recurrent abscesses of axillary and perineal areas. We report a patient who had a defect in polymorphonuclear leukocyte killing of bacteria associated with low levels of intracellular cyclic GMP. This defect was corrected with a cholinergic agonist in vitro. Treatment of the patient with a cholinergic agonist, bethanechol chloride, resulted in prolonged clinical improvement, normal bactericidal function, and normal levels of intracellular cyclic GMP. The possible mechanisms responsible for the bactericidal defect and for the patient's improvement are discussed.

Aged↗

Antiviral drugs.

Explore the source record for details and available documents.

Acyclovir↗

Simultaneous Streptococcus and picornavirus infection. Muscle involvement in acute rhabdomyolysis.

Streptococci seldom invade muscle in healthy people with intact integument. However, infection with another agent simultaneously may change this general observation. In a two-week period we encountered dual infections with group A, beta-hemolytic streptococci and a picornavirus in each of two hospitalized patients. Both were acutely ill; one died. Renal failure developed in the patient who survived and rhabdomyolysis was demonstrated in the patient who died. Picornavirus titer increases were demonstrated in the patient who survived, and viral inclusions in muscle cells were demonstrated by light microscopy in necropsy specimens and confirmed by electron microscopy in the second patient. We believe that streptococcal invasion of muscle may be facilitated during an outbreak of certain picornavirus infections.

Acute Disease↗

Mutagenicity of nitrosated cimetidines.

Dinitrosocimetidine and mononitrosocimetidine were tested in a series of short term assay systems. Both compounds were mutagenic in the absence of rat liver microsomes. The dinitrosocimetidine produced higher mutagenic or clastogenic effects at concentrations that were 50 to 500 times lower than the concentrations at which the mononitrosocimetidine produces its maximum effects. The most sensitive short term assay system was the Chinese hamster ovary cell culture system. Dinitrosocimetidine caused sister chromatid exchanges at a concentration of 10(-8) M and chromosome aberrations at 10(-7) M in this system. Dinitrosocimetidine had moderate activity in the bacterial short term assay systems. In the Ames test, strain TA 100 was the most sensitive. The compound was of lower activity in the E. coli WP-2 and the E. coli rec- systems.

Animals↗

Isolation of novel antibiotics X-14667A and X-14667B from Streptomyces cinnamonensis subsp. urethanofaciens and their characterization as 2-phenethylurethanes of monensins B and A.

Antibiotics X-14667A (1) and X-14667B (2) are novel monovalent polyether antibiotics of the spiroketal type isolated from fermented cultures of Streptomyces cinnamonensis subsp. urethanofaciens together with monensin (3), its lower homolog, factor B (4) and 1,3-diphenethylurea (6). By a combination of microanalysis, mass spectrometry and 13C nmr, antibiotics X-14667A and B have been shown to be natural 2-phenethylurethanes of monensin B and A respectively. Both structures have been confirmed by reacting the appropriate monensin with 2-phenethylisocyanate to yield semi-synthetic compounds that are identical to the natural products.

Anti-Bacterial Agents↗

Comparative activities of moxalactam (LY 127935) a new semisynthetic 1-oxa-beta lactam antibiotic with 7 other antibiotics against type b Haemophilus influenzae.

A total of 59 clinical isolated strains of Haemophilus influenzae type b, including 22 beta-lactamase-positive strains, were tested against moxalactam (LY 127935), a new 1-oxa-beta-lactam antibiotic and compared with other antibiotics: cefamandole, cefoxitin, ceforanide, ampicillin, ticarcillin, chloramphenical and trimethoprim/sulfamethoxazole (TMP/SMZ) by using an agar dilution susceptibility test and bacterial killing rate study. With beta-lactamase negative H. influenzae all 37 strains were inhibited by ampicillin at concentration less than or equal to 0.2 microgram/ml, in contrast all beta-lactamase positive strains were exhibited by a range from 3.2 micrograms/ml to 25 micrograms/ml. Ticarcillin inhibited 100% of non-beta lactamase strains at 0.4 micrograms/ml in contrast to those beta-lactamase producing strains the range was from 0.8 microgram/ml to 12.5 micrograms/ml. All strains were inhibited by 0.8 microgram/ml of chloramphenicol and by 0.078/1.56 microgram of TMP/SMZ per ml. Among the beta-lactam antibiotics, moxalactam (LY 127935) show 100% inhibited all strains by 0.1 microgram/ml in comparison with cefamandole, cefoxitin and ceforanide most strains inhibited by 0.4 microgram/ml, 2 micrograms/ml and 4 micrograms/ml, respectively. From the killing curve study, during the first 6 hours, each antibiotic had the effect of inhibition growing of both strains of H. influenzae. But after 24 hours incubation, only moxalactam (LY 127935) showed bactericidal effect. These data indicate that moxaladam, a new 1-oxa-beta-lactam antibiotic, had superior inhibitory activity and killing effect against both beta-lactamase producing and non-beta-lactamase producing strains of H. influenzae type b.

Anti-Bacterial Agents↗