PubMed Health⌕ Search

Biomedical subjects

C M Jan

Publications and source records attributed to C M Jan.

47 records · Page 3Linked to original sources

Local anesthetics: 2-N,N-dialkylaminoacyl-2'-methyl (or 2',6'-dimethyl)-4'-butylaminoanilides.

A series of tetracaine analogs based on the lidocaine structure, having a 2'-methyl-(or 2',6'-dimethyl)-4-butylaminoanilide moiety with alpha substitution on the dialkylaminoacyl function, has been synthesized. Local anesthetic activity was found with the N-butyl derivatives in both the 2'-methyl and 2',6'-dimethyl series using both the method of rabbit cornea loss of reflex and spinal anesthesia in sheep. Duration of activity of the compounds was greater than that of lidocaine, but less than that of tetracaine, with comparable dosage levels.

Anesthesia, Spinal↗

Weekly 24-hour infusion of high-dose 5-fluorouracil and leucovorin in the treatment of advanced gastric cancers. An effective and low-toxic regimen for patients with poor general condition.

Systemic chemotherapy for advanced gastric cancer is frequently associated with significant treatment-related toxicity, which is particularly serve in patients presenting with a poor general condition. A search for effective and low-toxic regimens for this group of patients is mandatory. A weekly 24-hour infusion of high-dose 5-fluorouracil (5-FU) and leucovorin (HDFL) has previously been demonstrated to be an effective treatment for advanced colorectal cancer with minimal toxicity. In the past 3 years, this regimen has been tested at our institutes in patients with advanced gastric cancer, the general condition of whom had made the use of intensive combination chemotherapy impossible. The regimen consisted of a weekly 24-hour infusion of 2,600 mg/m2 of 5-FU and 300 mg/m2 of leucovorin. From August 1992 to December 1995, 34 patients had been treated with this regimen for a total of 488 courses (average: 14.4 per patient). Hematological toxicity of this regimen was minimal, with grade 3 or 4 leukopenia developing in only 1 (2.9%) patient. Other nonhematological toxicities were also negligible except a reversible neurotoxicity which developed in 2 patients. Twenty-five patients were eligible for response analysis. One complete response, 11 partial responses, 5 stable diseases, and 8 progressive diseases were observed. The response rate was 48% (32-72%, 95% CI). The median overall survival (OS) of the whole group was 7 months (range: 1-18+). The median OS and time to progression of the responders were 8.5 months (range: 2-18) and 5 months (range: 2-10+), respectively. The palliative effect was satisfactory with the Karnofsky performance status of the responders improving from a median of 50% (range: 20-90%) to 70% (range: 50-100%). Our retrospective data suggested that HDFL is an effective and low-toxic palliative treatment even in patients with a very poor general condition. We advocated that this regimen should be further tested in ordinary patients with advanced gastric cancer.

Adult↗

Utility of brushing cytology in the diagnosis of Helicobacter pylori infection.

OBJECTIVE: We performed brushing cytology during routine gastroendoscopic examinations to evaluate the utility of gastric brushing cytology in the diagnosis of Helicobacter pylori infection. STUDY DESIGN: The brushing cytology materials were obtained from the antrum of the stomach in 107 patients. The urea breath test, biopsy urease test and histology with hematoxylineosin staining were also performed on each patient. We then compared the results of brushing cytology with those of the three other tests (13C urea breath test, biopsy urease test, histology). RESULTS: Fifty-nine of 103 patients (57%) were diagnosed as positive for H pylori organisms using brushing cytology. Using positive or negative results from any two of the other three tests as the gold standard, a true positive result was found in 57 cases, a true negative in 43 cases, a false positive in 2 cases and a false negative in 1 case. The sensitivity and specificity of brushing cytology were 98% and 96%, respectively. CONCLUSION: Gastric brushing cytology provides an accurate, inexpensive and easy technique in the rapid detection of H pylori infection. Brushing cytology also has the advantage of being applicable to diagnostic endoscopy without waiting days for results.

Biopsy↗

Evaluation of an office-based urine test for detecting Helicobacter pylori: a Prospective Pilot Study.

BACKGROUND/AIMS: To ascertain the reliability of a newly developed office-based urine test, the RAPIRUN test, used for detection of H. pylori infection. METHODOLOGY: Urine specimens from 142 consecutive patients undergoing gastroendoscopy (77 men, 65 women; mean 52.0 years) were tested with RAPIRUN at the same time. The total reaction time for the urine test is 20 min. None of the patients had received any H. pylori eradicating treatment. The H. pylori status was evaluated based on 5 different tests: culture, histology, biopsy urease test, 13C-urea breath test, and the RAPIRUN test. A commercial office-based kit using an immunochromatographic technique was used to examine urine samples for H. pylori antibody. H. pylori status was defined as positive when the culture was positive or if 2 of the other 3 tests (histology, biopsy urease test, and 13C-urea breath test were positive. RESULTS: Of 93 patients with H. pylori infection, 88 were tested as positive by RAPIRUN (sensitivity 94.6%). Of 48 patients without infection, 43 were found to be negative by RAPIRUN (specificity 89.6%). One case with an invalid urine test was excluded. CONCLUSIONS: This urine test is a rapid, inexpensive, reliable and easy-to-use tool for the diagnosis of H. pylori infection in untreated patients. It can be used for mass screening of patients' H. pylori status, particularly in children, postgastrectomy patients, uncooperative patients, and patients undergoing bismuth or proton pump inhibitor treatment.

Adenocarcinoma↗