Biomedical subjects
Publications and source records attributed to H Schipper.
Administration of methotrexate (MTX), 5-FU, and leucovorin rescue in 29 patients with metastatic colorectal cancer produced an objective response rate of 41.7%, with two complete remissions. Two patients developed fatal toxic effects and three others had severe toxic effects. This trial, however, supports the evidence for the synergistic effect of this drug combination.
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Colon carcinomas develop at the site of implantation in approximately 6% of patients who undergo ureterosigmoidostomy for benign conditions. Generally, the obstruction of a long-functioning ureterosigmoidostomy heralds the presentation of the malignancy. The development of a carcinoma of the colon at the site of the ureteral stump 22 years after conversion to ileal conduit in a ureterosigmoidostomy, which had been in place for only nine months, raises fundamental questions about the pathogenesis of the tumor. The long-assumed role of urine in the induction of these iatrogenic tumors must be questioned. This issue and suggestions for management and prevention are discussed.
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Lymphocyte-depleted Hodgkin's Disease (LDHD) is a very aggressive form of cancer that presents at an advanced stage and for which no increase in overall survival has been demonstrated with the advent of multiple agent chemotherapy. All cases of Hodgkin's disease diagnosed in the Province of Manitoba between 1971 and 1977 were reviewed. Those cases identified as LDHD were reviewed by a single pathologist, and data was abstracted to obtain a clinical profile. Survival curves were constructed comparing the LDHD group to those with other types of Hodgkin's disease. The LDHD group was also compared with an earlier LDHD group treated with single agent chemotherapy in the 1960s. The LDHD group had a significantly shortened survival compared with the other histologies. This was just as significant when mixed cellularity Hodgkin's was compared with LDHD and matched for Stage B symptomatology. Furthermore, there was no difference in survival between the earlier LDHD groups treated with single agent chemotherapy and the later group treated with multiple agent chemotherapy.
Chagas' disease, or South American trypanosomiasis, is an endemic South American disease now being seen in Canada in both acute and chronic forms. It is characterized by an initial parasitemia that elicits a brisk immune response. Evidence is mounting that the debilitating chronic form, which is characterized by cardiac and visceral organ failure, results from antigenic cross-reactivity between the parasite and the human host, which generates an aberrant, destructive, cell-mediated immune response. Diagnosis, treatment and potential areas for investigation are discussed.
The effects of estradiol valerate and constant light exposure on the histological appearance of the arcuate nucleus were assessed in female rats. Both of these treatments caused significant increases in the numbers of reactive microglial cells and astrocytic granules in the nucleus. Ovariectomy before either treatment prevented the glial reaction, indicating that the experimental manipulations triggered the secretion of an ovarian product which appears to be selectively toxic to the arcuate nucleus. The fact that monthly injections of estradiol valerate in male rats produced the same profile of degeneration in the arcuate nucleus suggests that the neuropathological agent may itself be estradiol. Ovariectomy also significantly reduced arcuate microglial reactivity associated with normal aging, which suggests that cyclic surges of endogenous estradiol may be capable of gradually producing an arcuate lesion. This phenomenon may accout for the hypothalamic reproductive failure associated with normal aging in the rat.
Split course radiation and kinetically based combinations of chemotherapy as suggested by Price, et al have been used for treatment of Stage III and Stage IV squamous cell carcinoma of the head and neck region. Twenty-nine patients were eligible for evaluation. Twenty-three out of 29 patients had complete remission of their primary tumor, three patients presented with N1 of which all had complete remission. Fourteen patients who presented with N2 neck nodes--three had complete regression and seven had partial response. Five patients who presented with lung lesion at the beginning; proved to be a second primary rather than metastases from the head and neck cancer. Subsequently, three patients had lung resection. At one year these three patients have remained free from recurrence from both the primaries. Toxicities had been noted due to combinations of two modalities which however had been within acceptable limits. Eighteen out of 29 patients had considerable persistent soft tissue edema in the irradiated area.
In serum obtained from 28 women before, during, and after normal labor and delivery, creatine kinase activity was seen to be distinctly elevated immediately after labor and 24 h later, but had returned to normal six weeks later. In most cases the increase was due to the MM isoenzyme and was attributed to skeletal-muscle damage associated with labor. In 15 cases, the BB isoenzyme was observed, and in three patients the MB isoenzyme. Cord blood, which contains all three isoenzymes, may be the source of the MB and BB isoenzymes. Uterine muscle contains exclusively BB isoenzyme, and therefore uterine muscle damage is a likely source of the serum BB isoenzyme. The relationship among these isoenzymes in serum after delivery must be recognized, to avoid misdiagnosing myocardial infarction at this critical time.
In five patients with atheromatous embolic disease, the diagnosis was made before death in four -- on the basis of cholesterol emboli in the retina in three and from renal pathologic features in 1. Muscle biopsy demonstrated emboli in one patient, and emboli were seen in the vessels of amputated toes in two. All patients died of renal failure, but there was evidence of multisystem involvement in addition. Autopsy in four cases showed characteristic cholesterol emboli in many organs.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
One hundred twenty patients about to receive their first treatment with potentially nauseant cancer chemotherapy were randomized to one of six antiemetic treatments: (1) no treatment; (2) placebo; (3) prochlorperazine (PCPZ), 10 mg; (4) delta 9-tetrahydrocannabinol (THC), 5 mg; (5) THC, 10 mg; (6) THC, 15 mg. Four doses of each medication were given orally at 4-hour intervals starting 2 hours before chemotherapy. A study nurse was responsible for both objective (nurse) and subjective (patient) symptom questionnaires. Serum levels were obtained at intervals for cross-reacting cannabinoids. Physiologic measurements including intraocular pressure (IOP), blood pressure, and pulmonary function were also recorded. In summary, the patients were remarkably free of adverse physiologic effects. All intraocular pressures before and after treatment were within the normal range, although a surprising statistically significant increase in IOP occurred in the group receiving 5 mg THC.
A phantom is proposed for quality control and calibration of instruments used for transillumination of the breast for early detection of cancer. A container is filled with a material having optical properties very similar to those of breast tissue, and internal objects are viewed by transmitted light. The phantom can be used to optimize operating conditions for the visualization of small or deep-seated lesions.
Eighteen primary human malignant mesotheliomas obtained from 18 patients were screened for point mutations and microdeletions/insertions in all exons of the tumour suppressor gene PTEN/MMAC1 by SSCP analysis. No mutation could be found. Our preliminary data indicate that disarrangements of PTEN/MMAC1 are at least not frequently involved in mesothelioma formation.