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Biomedical subjects

H J Votava

Publications and source records attributed to H J Votava.

6 recordsLinked to original sources
PubMed1991

Giant epignathus. A case report.

We report the successful treatment of a 2.8 kg female infant born with a giant epignathus, and we present our current prenatal and neonatal recommendations for managing this problem. We recommend that the delivery be done by cesarean section, that an adjacent operating room be ready for the baby, and that a neonatologist, anesthesiologist, and pediatric surgeon be standing by. The term epignathus now commonly applies to a teratoma protruding from a newborn's mouth. The survival of these otherwise normal children has been very low. We discuss the perinatal, neonatal, and operative care necessary to improve survival, as evidenced by the case presented.

Biomarkers, Tumor↗
PubMed1989

Randomized clinical trial of CFP versus CMFP in women with metastatic breast cancer.

A randomized trial was performed to determine relative efficacy and toxicity of two first-line combination chemotherapy regimens in women with metastatic breast cancer: CFP (cyclophosphamide, 5-fluorouracil, prednisone) and CMFP (cyclophosphamide, 5-fluorouracil, methotrexate, prednisone). Both regimens have reported efficacy in this setting but differ in dosages and scheduling of the agents they have in common. Three hundred thirty-six women with no prior chemotherapy for metastatic disease were eligible and evaluable, and 309 had either measurable or evaluable disease and were assessable for objective response. Responses were seen in 65 of 153 (42%) on CFP and 83 of 156 (53%) on CMFP (two-sided P = 0.06). Median durations of response were 7.1 months for CFP and 8.5 months for CMFP (log-rank, two-sided P = 0.67). Considering all 336 patients, the median times to disease progression were 4.7 months for CFP and 6.2 months for CMFP (log-rank P = 0.31) and median survivals were 15.2 and 14.9 months, respectively (log-rank P = 0.88). Covariate analysis did not alter these findings. Median leukocyte nadirs were 1800 for CFP and 1500 for CMFP, with 22% and 21%, respectively, having nadirs less than 1000/microliters. Emesis was more frequent on CFP (49%) than on CMFP (26%) but was severe in only 7% and 5%, respectively. It is concluded that despite a higher response rate on CMFP and some differences in toxicities including a higher reported incidence of emesis on CFP, there was no substantial difference in efficacy or tolerability between the two regimens.

Adult↗
PubMed1988

Randomized trial of observation versus adjuvant therapy with cyclophosphamide, fluorouracil, prednisone with or without tamoxifen following mastectomy in postmenopausal women with node-positive breast cancer.

Following mastectomy for node-positive breast cancer, 261 postmenopausal women were randomized to observation or adjuvant treatment with cyclophosphamide, fluorouracil, prednisone (CFP) alone or combined with tamoxifen (T). Doses used were: C, 150 mg/m2 intravenously (IV) days 1 to 5; F, 300 mg/m2 IV days 1 to 5; P, 10 mg by mouth 3 times daily on days 1 to 7; and T, 10 mg by mouth 2 times daily. A total of ten courses of treatment, administered every 6 weeks, was planned and T was stopped 6 weeks after the last course of CFP. Two hundred thirty-four patients were fully eligible and evaluable. With a median observation time slightly in excess of 5 years, the proportion of recurrences on each arm were: CFP, 29 of 75 (39%); CFPT, 29 of 71 (41%); and observation, 50 of 88 (57%). Relapse-free survival distributions for both CFP and CFPT were superior to observation (both two-sided P = .01). Considering prognostic factors in covariate analysis revealed two-sided P = .0006 for CFP v observation and P = .0003 for CFPT v observation. No substantial difference was identified between CFP and CFPT. Survival data are not yet mature with 31% dead; and, although slight separations of the curves exist in favor of the treatment arms, no significant differences in survival have been seen. Both adjuvant therapy programs are well tolerated and there were no treatment-related deaths. Further maturation of the data is required to determine if the advantages in relapse-free survival will be translated into any overall survival benefit which must be considered the goal of primary interest.

Aged↗
PubMed1978

Therapy of Candida peritonitis: penetration of amphotericin B into peritoneal fluid.

Candida albicans peritonitis developed in a 48-year-old man with a perforated gastric ulcer who subsequently was treated with intravenous amphotericin B. The drug penetrated well into the inflamed peritoneal cavity and eradicated the organism from the peritoneal fluid. Nevertheless, at post-mortem, Candida organisms were demonstrated in a gall-bladder empyema and within the gall-bladder wall. Because intra-abdominal organs may be involved in Candida peritonitis, the use of high dose amphotericin B administered either intravenously, intraperitoneally, or both intravenously and intraperitoneally is recommended.

Amphotericin B↗
PubMed1975

A proposed mechanism of zinc absorption in the rat.

Studies were conducted at the cellular level in an attempt to describe the processes involved in zinc absorption from the intestine. A low-molecular-weight zinc-binding ligand was identified in the pancreas of rats and pancreatic secretions from a dog. The whole-body absorption of 65Zn in rats in which the common bile duct was ligated was significantly less than the absorption of 65Zn in rats in which the hepatic bile duct was ligated. The uptake of 65Zn by epithelial cells from everted intestinal segments was markedly increased in the presence of the zinc-binding ligand fraction from pancreatic secretions. Following in vivo labeling, 30% of the 65Zn in the epithelial cell was associated with the partially purified basolateral plasma membrane. When labeled basolateral plasma membranes were incubated in a medium that contained zinc-free albumin, approximately 96% of the 65Zn was transferred to the medium while less than 30% of the isotope was released to media that contained either no albumin or a 3:1 zinc: albumin complex. In rats fed a zinc-deficient diet, 65Zn absorption was inversely proportional to the serum zinc concentration, and both zinc and copper injections produced a marked decrease in 65Zn absorption. These results suggest that zinc absorption consists of interactions among a low-molecular-weight ligand, recpetor sites on the basolateral membrane, and metal-free albumin.

Albumins↗