Biomedical subjects
Publications and source records attributed to P Ray.
The results of pelvic lymph node dissections in 105 prostate cancer patients were analyzed to compare the clinical with the pathologic stages. Twenty-four per cent of patients clinically believed to be node-negative had positive nodal involvement with cancer.
There is some question on the accuracy of staging in large epidemiological studies of prostatic cancer that rely on hospital tumor registry data. In an effort to assess the accuracy of tumor registry information in our institution registry staging was compared to surgical staging in 100 consecutive prostatic cancer patients. The tumor registry data had a 30 per cent understaging error. Other institutions may have the same problems.
A non-opioid peptide derived from adrenal proenkephalin has been isolated and sequenced. The sequence of this peptide is Ser-Pro-His-Leu-Glu-Asp-Glu-Thr-Lys-Glu-Leu-Gln (Proenkephalin 168-180). This sequence represents the portion of Peptide I that is cleaved to yield Peptide E. This peptide is processed in a similar manner to the opioid peptides and is present at approximately the same level as Peptide E.
In an attempt to evaluate the relationship of prostate cancer to the multiple primary malignant neoplasm syndrome, 626 prostate cancer cases were reviewed. Patients with one malignant tumor appear to be no more at risk of developing a prostate cancer than individuals who have never had a tumor.
Pretreatment of rats with isopropanol enhanced both hepatotoxicity and calcium pump inhibition after CCl4 exposure in vivo or in vitro. Animals were given isopropanol (1.25 ml/kg) 18 hr before CCl4 (0.01 to 1.0 ml/kg). CCl4 hepatotoxicity, judged as increased appearance of glutamic-pyruvate transaminase in serum, was enhanced by isopropanol pretreatment. Pretreatment of rats with isopropanol made CCl4 as much as 20- to 30-fold more potent as an inhibitor of the calcium pump. Inhibition of another endoplasmic reticulum enzyme, glucose 6-phosphatase, was also enhanced by isopropanol pretreatment. In contrast to the effect of CCl4 in control animals, in isopropanol-pretreated rats given CCl4, depletion of liver glutathione was observed. Altered CCl4 metabolism in isopropanol-pretreated animals may result in production of increased amounts of phosgene (or other metabolites) responsible for inhibition of the liver microsome calcium pump and glutathione depletion.
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A case is presented of a patient with separate primaries of the cervix, breast, bladder, and kidney. In a review of 352,073 cancer patients in the literature, the genitourinary system appears to be at a greater risk of this phenomenon. The entity of multiple primary malignant neoplasms is reviewed with an analysis of the involvement of the genitourinary system.
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Various cryoprotective agents [glycerol, dimethylsulphoxide, polyvinylpyrrolidone (PVP 40)], all dissolved in Krebs phosphate medium were tested for their effects on cytoplasmic preservation in oligodendroglia isolated from bovine white matter sorted at -30 degrees C. Of these agents, only PVP 40 (15% wt/vol) produced a significant improvement in recovery of oligodendroglial cytoplasm compared with untreated frozen brain. Cels isolated after PVP 40 pretreatment contained levels of membrane-bound enzymes similar to those found in cells isolated from fresh white matter. There was however, some loss of soluble protein. Studies of galactocerebroside synthesis in neuronal and oligodendroglial perikarya have shown that the glial cells contain ceramide galactosyltransferase at much higher specific activity than the neurones.
A series of 205 patients with inoperable, non-oat cell carcinoma of the lung were treated with three different dose-fractionation schedules. Fifty-six patients received 5000 rads in 25 fractions over five weeks (continuous, A); 79 patients received 2000 rads in five fractions over five days, with two weeks' rest, followed by 2000 rads in five fractions over five days (split-course, B); 70 patients received 3000 rads in 10 fractions over two weeks, followed by three weeks' rest and another 3000 rads (split course, C). The 24-month survival was 33% for A, 15% for B and 25% for C. The split course was better tolerated and radiation fibrosis was dose-related.
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Evaluation of regional node involvement in patients with bronchogenic carcinoma is a crucial step in determining therapy and prognosis. Mediastinoscopy has been recommended for staging all potentially operable cases, but technical limitations and the need for anesthesia make this impractical. Gallium-67 scanning and chest radiography were prospectively compared as noninvasive means of evaluating spread to regional nodes in 75 patients with bronchogenic carcinoma in whom histologic evaluation of hilar and mediastinal nodes was performed. Gallium scanning was more accurate than chest radiography in assessing regional nodes (overall accuracy 85.3% vs. 56%, P less than 0.05). When positive, both procedures correctly indicate malignant involvement of regional nodes (85% vs. 87.3%). A negative gallium scan, however, was significantly more accurate in predicting the absence of such involvement (80% vs. 40%, P less than 0.01). Gallium scanning appears to be a reliable, noninvasive means of assessing mediastinal spread of bronchogenic carcinoma and when used in conjunction with radiographic findings, allows selection of appropriate patients for surgical staging procedures.
Since August 1975, 69 patients with localized pancreatic carcinoma (extent of tumor confined to a 15 cm x 15 cm radiotherapy port) have received either Regimen A, comprising radiotherapy (6,000 rad) to the tumor area with simultaneous combination chemotherapy utilizing methyl-CCNU, 125 mg/m2 orally, every six weeks, and 5-fluorouracil, 400 mg/m2 intravenously, weekly; or Regimen B, comprising Regimen A with the addition of testolactone, 200 mg, orally every day. Thirty-eight patients on Regimen A and 30 patients on Regimen B are currently evaluable. Median survival, which appeared not to be affected by the addition of testolactone, was 38 weeks for those on Regimen A and 30 weeks for those on Regimen B (P = 0.677). The median survival time for all patients was 38 weeks. Good performance status did correlate with improved survival vs. poor performance status (46 weeks vs. 20 weeks, P = .008). Fifteen patients have survived for more than 52 weeks, with the longest survival time being 160 + weeks, and in 3 cases all therapy has been discontinued. However, most patients experienced moderate to severe hematologic toxic reactions. There was one treatment-related death and significant gastrointestinal bleeding developed in 6. Because of the toxic reactions of this program, it should not be considered in favor of similar less aggressive programs.
The mean number of lymphocytes, response to phytohemagglutinin (PHA), and response to concanavalin A (Con A) in whole-blood cultures for 106 patients with head and neck cancer were 83%, 73%, and 64%, respectively, of values for healthy control individuals. During radiotherapy, lymphocyte counts declined to 44% and PHA and Con A responses declined to about one third of control values. Lymphocyte counts slowly increased after treatment to 77% of control values after two years, but responses to mitogens remained at about 40%. Responses to PHA and Con A for 38 patients who lived beyond 18 months were significantly greater before and after treatment than responses for 39 patients who died within 18 months. In general, a poor pretreatment response to PHA and Con A correlated with a poor clinical course, whereas responses near the control level indicated a good clinical course.
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