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Biomedical subjects

S Swaroop

Publications and source records attributed to S Swaroop.

10 recordsLinked to original sources

Intermediate-dose methotrexate and cisplatin in the treatment of advanced epidermoid esophageal carcinoma. Response rate and disease-free survival.

Seventeen patients with inoperable locoregional disease (epidermoid carcinoma of the esophagus) were treated only with two courses of intermediate-dose methotrexate (200 mg/m2 on day 1) and cisplatin (20 mg/m2/d for 5 days). According to the response criteria, 14 (82.4%) achieved a good response (GR) and 3 (17.6%) showed no response (NR). The median recurrence-free survival time was 5 months (range, 2 to 16 months) in seven patients with regular follow-up. Three patients are still alive and disease-free at 37+, 44+, and 51+ months. No patient received radiotherapy or surgery after chemotherapy until recurrence. This combination schedule appears to be effective in advanced esophageal carcinoma.

Antineoplastic Combined Chemotherapy Protocols

Inhibition of human colonic epithelial cell proliferation in vivo and in vitro by calcium.

Nine patients at high risk of developing colon cancer were placed on daily p.o. supplementation of 1500 mg of calcium for 4-8 weeks. The colonic epithelial cells in six of these patients showed a statistically significant decrease in their [3H]thymidine labeling indices in tissue culture so that they resembled those of patients at low risk of developing colon cancer. The three nonresponders had similar labeling indices before and after calcium supplementation. Biopsies from each of nine high-risk patients exhibited a decrease in proliferation when they were cultured in vitro with a high level of CaCl2 (2.2 mM compared with the 0.1 mM optimum value for proliferation). Two adenomas and two carcinomas showed a different pattern of response than normal cells, exhibiting no inhibition of growth at 2.2 mM CaCl2. These data indicate that the growth inhibition induced by high levels of extracellular calcium levels is lost at a stage in tumor development before cells become malignant.

Calcium, Dietary

Anterior chemotherapy in esophageal cancer.

Front loading chemotherapy using methotrexate (200 mg/m2) alone or methotrexate (200 mg/m2) with cisplatin (20 mg/m2 daily for 5 days) was used in epidermoid carcinoma of esophagus. Evaluation after two courses showed objective response of 50% or greater in 48% of patients with methotrexate alone. Response rate was increased to 76.2% with addition of cisplatin to methotrexate. Small lesions (less than 10 cm) showed better response as compared to advanced cases. Therapy was generally well tolerated and good palliation was obtained even after the first course. Postchemotherpy treatment either with surgery or radiotherapy was tolerated without any major complications. The data confirm the short-term usefulness of initial chemotherapy with methotrexate and cisplatin in esophageal cancer. Results of prolonged follow-up will help to evaluate the role of front loading chemotherapy on long-term survival.

Adult

Immunity in esophageal carcinoma.

In carcinoma of the esophagus, response to in vivo sensitization with recall antigens and DNCB was markedly depressed with 13% and 16% positivity respectively. Similarly, the number of T-cells was found to be significantly low (24 +/- 14) as compared to normal control (61 +/- 23). Blastogenesis index with PHA was only 1.75 +/- 1.04 in contrast to normal of 6.79 +/- 2.57. This depression was independent of serum albumin level and body weight. Cell-mediated immunity was further depressed following radiotherapy and did not improve following enteral alimentation for 3 weeks. In untreated patients, there was a significant rise in levels of IgA (298 +/- 184 mg/100 ml) as compared to normal (154 +/- 54 mg/100 ml). Levels of IgA did show a downward trend following enteral hyperalimentation. Circulating immune complexes and serum CEA level were elevated in almost 50% of patients. These data confirm the influence of tumor-related impairment of cell-mediated immunity while nutrition appears to affect IgA levels.

Adult

Pulmonary artery dissection and rupture in Eisenmenger's syndrome.

A patient with ventricular septal defect and pulmonary arterial hypertension (Eisenmenger's syndrome) associated with aortic coarctation with follow-up for 19 years, and with rupture of an aneurysmatic pulmonary artery is described. An incident of extreme fright with a possible transient systemic hypertension may have precipitated the dissection of the pulmonary arterial intima and the rupture.

Adolescent

A new approach to the management of burn injuries using PVP + neosporin.

Treating superficial burns by forming a "crust" using povidone iodine (PVP) lotion and neosporin powder (N) is markedly superior to other known methods as shown by the minimal infection rate and markedly reduced healing time. This is basically because of the wide spectrum of action, tenning effect of PVP and attainment of a dry burn surface. At the same time the subescharal injection of PVP shows a distinct reduced septicaemia and local infection rates, early escharolysis followed by early graft take up and subsequent healing. In addition being an open method of treatment psychological advantage is also notable in the absence of pain during dressing.

Adult