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S Kaushal

Publications and source records attributed to S Kaushal.

43 records · Page 3Linked to original sources
PubMed1984

The effect of anti-cancer drugs on pharmacokinetics of antipyrine in vitamin A deficiency.

The pharmacokinetics of orally and intravenously administered antipyrine-14C in individual rats were investigated to examine the effects of vitamin A deficiency and/or cytotoxic anti-cancer drugs, like cyclophosphamide, methotrexate, 5-fluorouracil and actinomycin-D. Both vitamin A deficiency and pretreatment of rats with anti-cancer drugs led to impairment in the absorption from the gastro-intestinal tract and the plasma elimination of antipyrine. Pretreatment of vitamin A deficient rats with anti-cancer drugs further retarded the absorption and plasma clearance of antipyrine. Apparent volume of distribution of antipyrine was reduced (P less than 0.001) by inducing vitamin A deficiency in rats, whereas pretreatment of rats with anti-cancer drugs did not show any effect. Cytotoxic drugs, and vitamin A deficiency increased the area under the plasma concentration vs. time curve of orally administered antipyrine (AUCoral). In vitro findings suggest that the most probable cause of delayed clearance/prolonged half-life and increased AUCoral values was the reduction in hepatic cytochrome P-450 dependent mixed function oxidase system.

Animals↗
PubMedDate not supplied

Resected adenocarcinoma of the pancreas-616 patients: results, outcomes, and prognostic indicators.

This large-volume, single-institution review examines factors influencing long-term survival after resection in patients with adenocarcinoma of the head, neck, uncinate process, body, or tail of the pancreas. Between January 1984 and July 1999 inclusive, 616 patients with adenocarcinoma of the pancreas underwent surgical resection. A retrospective analysis of a prospectively collected database was performed. Both univariate and multivariate models were used to determine the factors influencing survival. Of the 616 patients, 526 (85%) underwent pancreaticoduodenectomy for adenocarcinoma of the head, neck, or uncinate process of the pancreas, 52 (9%) underwent distal pancreatectomy for adenocarcinoma of the body or tail, and 38 (6%) underwent total pancreatectomy for adenocarcinoma extensively involving the gland. The mean age of the patients was 64.3 years, with 54% being male and 91% being white. The overall perioperative mortality rate was 2.3%, whereas the incidence of postoperative complications was 30%. The median postoperative length of stay was 11 days. The mean tumor diameter was 3.2 cm, with 72% of patients having positive lymph nodes, 30% having positive resection margins, and 36% having poorly differentiated tumors. Patients undergoing distal pancreatectomy for left-sided lesions had larger tumors (4.7 vs. 3.1 cm, P < 0.0001), but fewer node-positive resections (59% vs. 73%, P = 0.03) and fewer poorly differentiated tumors (29% vs. 36%, P < 0.001), as compared to those undergoing pancreaticoduodenectomy for right-sided lesions. The overall survival of the entire cohort was 63% at 1 year and 17% at 5 years, with a median survival of 17 months. For right-sided lesions the 1- and 5-year survival rates were 64% and 17%, respectively, compared to 50% and 15% for left-sided lesions. Factors shown to have favorable independent prognostic significance by multivariate analysis were negative resection margins (hazard ratio [HR] = 0.64, confidence interval [CI] = 0.50 to 0.82, P = 0.0004), tumor diameter less than 3 cm (HR = 0.72, CI = 0.57 to 0.90, P = 0.004), estimated blood loss less than 750 ml (HR = 0.75, CI = 0.58 to 0.96, P = 0.02), well/moderate tumor differentiation (HR = 0.71, CI = 0.56 to 0.90, P = 0.005), and postoperative chemoradiation (HR = 0.50, CI = 0.39 to 0.64, P < 0.0001). Tumor location in head, neck, or uncinate process approached significance in the final multivariate model (HR = 0.60, CI = 0.35 to 1.0, P = 0.06). Pancreatic resection remains the only hope for long-term survival in patients with adenocarcinoma of the pancreas. Completeness of resection and tumor characteristics including tumor size and degree of differentiation are important independent prognostic indicators. Adjuvant chemoradiation is a strong predictor of outcome and likely decreases the independent significance of tumor location and nodal status.

Adenocarcinoma↗