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[Treatment of advanced neoplasms in the jaw].

Report is made about the combined therapy with cytostatics (methotrexate - bleomycin) and irradiation in patients with extended tumors in the gnathic region. Ten patients in whom a radical therapy with conventional methods did not promise any success, were treated with intra-arterial infusions of methotrexate and bleomycin and simultaneous irradiation. At present, eight patients are tumor free (observation time 4-14 months after termination of therapy). Although radiation doses and doses of cytostatics were high, only insignificant side effects were stated; consequently, the treatment had to be terminated in none of the patients.

Adult↗

[Palliative treatment of liver neoplasms I: localized infusion of antimitotics: premises, technical procedure and limitations].

A hepatic localised antiblastic chemotherapic technique combining limited discomfort for patients with appreciable palliative results is illustrated; a short description of the surgical procedure of intubation of the hepatic artery itself and of some auxiliary procedures is given. Lastly the possible complications and the results are illustrated.

Antineoplastic Agents↗

[Palliative treatment of liver neoplasms II: dearterialization of the liver: indications, premises, technic and limitations].

Hepatic arterial vascularisation, as described by Michels in 1954, is outlined; the importance of selective angiography in preparation of the hepatic de-arterialisation operation is then stressed, and its theoretical foundations and the surgical technique are illustrated; other procedures which can usefully be combined are also indicated. Lastly an evaluation of the limits and results of this therapy is given.

Antineoplastic Agents↗

Combined therapy with bleomycin and selective intra-arterial infusion of mitomycin C in lung cancer.

Bronchial artery infusion of mitomycin C might be very effective in treating minor tumors but, as a rule, less effective in the treatment of larger tumors. In order to achieve improved effect of treatment, 21 cases (stage II-III/TNM) were given supplementary chemotherapy with bleomycin or vincristine-bleomycin. Preoperative treatment was given to 11 cases in which indications for surgical treatment were primarily uncertain or absent. The other group consisted of 10 patients with inoperable lesions. Combined treatment has proved to have a strong but mainly local effect. Repeated courses (up to 5 times) were more effective than a single one. The regional effect, i.e: on overgrowth onto the mediastinum, pericardium or thoracic wall was weak. The system effect was negligible. Penetrating data about objective response are given.

Adenocarcinoma↗

[Florid oral papillomatosis. A contribution to cytostatic therapy].

Based on the recent clinical experience in treating florid oral papillomatosis (FOP), the only successful therapy appears to be the use of cytostatic agents. The case report of a patient with clinically and histologically confirmed FOP is described to emphasize the advantages of administering Bleomycin intra-arterially (external carotid artery) by means of a Holter catheter. This catheter is used to release pressure in the treatment of internal hydrocephalus and is designed to remain in place for a number of years. The successful treatment of FOP points out the possibility of employing a Holter catheter for administering cytostatic agents in the treatment of malignant neoplasms in the facial area. Cytophotometric examinations of the prickle cells within the FOP mass showed a diploid pattern of DNA distribution similar to that of benigh tumors. However, it is not possible to definitely establish the malignant or benign nature of FOP in this manner.

Alopecia↗

Superficial anastomoses of blood vessels in the human heart.

We investigated superficial interarterial, intra-arterial, arterio-venous and veno-venous anastomoses in 100 hearts from men and women taken at random who died at 20-85 years of age. By means of careful dissection and injection into the blood vessels of a differently stained 12% solution of vinilit in acetone, we studied the number and localization of the anastomoses and their appearance. Interarterial anastomoses, i.e. anastomoses between the ramification of the left and the right coronary artery, were detected in 33 hearts. Intra-arterial anastomoses, i.e. anastomoses between the ramifications of one and the same artery, were seen in 5 hearts. Arterio-venous anastomoses were found in 39 hearts. Veno-venous anostomoses were found in 49 hearts. The veno-venous anastomoses display a great many variations, being commonly the regular finding in human veins.

Adult↗

Tricyclic antidepressant drugs as antagonists of muscarinic receptors in sympathetic ganglia.

Close arterial injection of McN-A-343 into the superior cervical ganglion of the cat resulted in contractions of the nictitating membrane. The ganglionic effects of McN-A-343 but not those of DMPP were antagonized in a dose-related manner by 2-10 mug of desipramine, imipramine, chlorimpramine, iprindole and viloxazine. No correlation was found between the dose of each drug which blocked the effects of McN-A-343 and that required to potentiate the responses of the nictitating membrane to intra-arterial administration of noradrenaline. It is concluded that clinically effective antidepressant agents can block muscarinic receptors in neural tissue, even if they do not do so in smooth muscle and gland cells.

(4-(m-Chlorophenylcarbamoyloxy)-2-butynyl)trimethy↗

Effect of adenosine triphosphate and some derivatives on cerebral blood flow and metabolism.

1. Responses of cerebral blood vessels to peri- and intravascular doses of ATP (adenosine triphosphate) and some derivatives were studied in cat and baboon. 2. Perivascular application of ATP to cat pial arterioles gave a threshold dilatory effect at a concentration of 10(-11) M. This figure is comparable to the amount of ATP calculated to be released from electrically stimulated brain slices. 3. It is concluded that adenine nucleotides have a major role to play in the local control of cerebral blood flow. 4. Intracarotid injection of ATP showed a calculated threshold effect at 4 x 10(8) M in the cat and 4 x 10(-9) M in the baboon. 5. The threshold response of the vasculature to intracarotid adenosine lay between 4 x 10(-7) M and 4 x 10(-6) M in the baboon. Little effect was produced with AMP, pyrophosphate and inorganic phosphate. 6. Intracarotid ATP increased the oxygen consumption of the baboon brain parenchyma. This effect was attributed in part to an elevation of the cellular cyclic AMP levels. 7. Osmotic disruption of the blood-brain barrier in baboon did not affect the vasodilatory or metabolic effect of intracarotid ATP. 8. It is postulated that circulating purine compounds mediate a form of metabolic communication inthe body. Also, release of purine compounds from active local nerves might influence cerebral blood flow.

Adenosine Triphosphate↗

Cerebral arterial lesions resulting from inflammatory emboli.

In order to study the effects of septic embolism on the brain, silicone rubber emboli of various types were injected into the carotid arteries of 35 dogs. Pathologic and angiographic studies were performed to assess the resultant arterial and parenchymal lesions. Pure silicone rubber emboli (14 dogs) produced occasional intra-arterial thrombosis but no arteritis. Sterile and bacterially contaminated emboli containing a lead-chromate pigment (similar to those used in previous studies of septic embolism) (11 dogs) and pure silicone rubber emboli with transversely oriented canals (10 dogs), after brief placement in a bacterial suspension, were associated with intense inflammatory arteritis. This was accompanied by focal meningitis, subarachnoid hemorrhage, thrombosis, and cerebritis of the underlying cortex. The findings resembled those found in mycotic aneurysm. Aneurysmal dilatation was observed in one postmortem angiogram. In previous models of mycotic aneurysm, the inflammation attributed to bacterial contamination was probably due to the lead-chromate pigment used.

Animals↗

[Thrombolytic treatment of arteriopathies].

Systemic streptokinase has shown its effectiveness in the treatment of recent arterial obstruction of the limbs. The haemorrhagic and embolic complications of this type of treatment nevertheless limit its indications. Streptokinase should be reserved for acute thromboses present for less than two months, and responsible for severe ischaemia without the possibility of surgical treatment. The intra-arterial administration of urokinase limits the risks of systemic fibrinolysis, though the effectiveness of the therapeutic protocols proposed has yet to be demonstrated.

Arterial Occlusive Diseases↗