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Biomedical subjects

A Lipton

Publications and source records attributed to A Lipton.

At least 109 records · Page 6Linked to original sources
PubMed1986

Calcium antagonism by the antioestrogen tamoxifen.

Tamoxifen, an oestrogen receptor antagonist and an effective treatment for breast carcinoma, has recently been shown to possess spasmolytic activity in smooth muscle. Tamoxifen in vitro inhibited the contraction of smooth muscle from rat myometrium and aorta produced by exogenous calcium. At the same concentration tamoxifen did not affect the uptake of calcium into the muscle. The importance of calcium in cell proliferation suggests that some of the unexplained antitumor activity of the oestrogen antagonists may be accounted for by intracellular calcium antagonism.

Animals↗
PubMed1986

Androgen priming and response to chemotherapy in advanced prostatic cancer.

A total of 67 patients with progressive stage D2 prostatic cancer refractory to orchiectomy was entered in a controlled clinical trial to test whether androgen priming enhances the efficacy of cytotoxic drugs. All patients were treated continuously with aminoglutethimide and hydrocortisone to lower adrenal androgen secretion and were given cyclic intravenous chemotherapy. In addition, the 34 patients randomized to the stimulation arm received fluoxymesterone for 3 days before and on the day of chemotherapy. There was 33 controls. The median duration of followup was 24 months. A modestly higher response rate (objective remission plus disease stabilization) was observed in the stimulation arm (85 versus 72 per cent, p less than 0.05) when the analysis was restricted to the evaluable patients. However, a larger fraction of unevaluable patients was present in the stimulation group (41 versus 16 per cent), mostly as a result of toxicity from fluoxymesterone, which prompted early discontinuation of treatment. Thus, when data analysis included all patients the response rate actually was slightly higher in the control than in the stimulation arm (60 versus 50 per cent, p not significant). No difference was observed in median duration of response (9 months in both groups) or over-all survival. Our data suggest that at least in those patients with advanced disease androgen priming does not seem to enhance significantly the antitumor effect of the combination of amino-glutethimide and chemotherapy, and is associated with significant toxicity. These largely negative results may be explained by the large number of hormone-resistant cells present in tumors that have become refractory to orchiectomy.

Aged↗
PubMed1986

Treatment of breast cancer with gonadotropin-releasing hormone.

Analogs of GnRH, given chronically in a continuous fashion, produce a paradoxic inhibition of pituitary gonadotropin secretion and, consequently, gonadal steroidogenesis. Thus, GnRH analogs are an attractive class of compounds for achieving a medical castration in the treatment of hormone-dependent neoplasms. In a group of 25 premenopausal patients with progressive advanced breast cancer, daily sc administration of 1-10 mg Leuprolide [D-Leu6-Pro9GnRH ethylamide (NEt)] induced objective tumor regression in 44% with a median duration of 9 months. All women treated for at least 10 weeks developed amenorrhea. Profound suppression of gonadotropins, estradiol, and progesterone secretion occurred in all patients on chronic therapy and persisted for the whole treatment period. These effects on tumor growth and ovarian hormone levels are similar to those observed after surgical ovariectomy. Other GnRH analogs such as Buserelin and Zoladex have been found to have similar antitumor and hormonal effects which are also comparable to those produced by surgical ovariectomy. The mode of drug administration is important. Consistent suppression of ovarian function has only been observed with sc injections of the analogs. Chronic intranasal therapy has been found to induce an incomplete suppression of ovarian function in most patients, probably as a result of the poor absorption of these compounds through this route (approximately 2%). Treatment of metastatic breast cancer with GnRH analogs has been associated with remarkable absence of significant toxicity. Despite some evidence in favor of a direct antitumor effect independent of suppression of ovarian function, the use of GnRH analogs in the therapy of advanced breast cancer should be restricted to premenopausal women.

Adult↗
PubMed1985

Does medical training affect personality?

We have compared results obtained for psychometric tests (Cattell's 16 PF and Eysenck's personality inventory) on a cohort of medical students who sat the tests in their second medical school year and repeated them in their sixth and final year. Most of the changes were in the direction expected of students maturing through the 19-24 year age period, but there were some significant differences from those obtained by other workers using the same tests on general student populations. Thus, in our study male students became 'brighter', more 'emotionally stable', less 'timid', more 'tough-minded', and more 'self-controlled', all of these to a significantly greater extent than expected with the general student population. Similar changes were observed from females, although except for an increase in emotional stability, these were not significantly different from the values expected in the general population.

Adult↗
PubMed1985

Growth factors and wound healing in the hamster.

We have investigated the effect of topically applied mitogenic preparations on the healing of full-thickness skin wounds in the Syrian hamster. In an attempt to accelerate the healing process, dexamethasone and insulin, platelet-derived growth factor, fibroblast growth factor, thrombin, defined medium F for fibroblasts, liver cell supernatant, epidermal growth factor, and colostrum were applied to the wounds. These mitogens had no significant influence on the rate of wound contraction or on the time to complete healing in full-thickness, noncompromised skin wounds in this animal model.

Animals↗
PubMed1985

Medical castration produced by the GnRH analogue leuprolide to treat metastatic breast cancer.

Leuprolide (Lupron, TAP Pharmaceuticals, North Chicago), a gonadotropin-releasing hormone analogue, was administered to 26 premenopausal women with metastatic breast cancer. Of 25 evaluable patients, 11 (44%) had a partial response with a median duration of 39 weeks and five (20%) remained stable. Six patients showed early rapid progression of their disease. Toxicity was mild and included hot flashes, nausea, vomiting, and headache. Leuprolide induced amenorrhea in all patients who received treatment for ten weeks or longer. We conclude that this GnRH analogue provides a safe and effective means of producing medical castration in premenopausal patients with metastatic breast carcinoma.

Adult↗
PubMed1985

A phase II study of Catrix-S in solid tumors.

Catrix-S is an acidic mucopolysaccharide complex derived from bovine tracheal cartilage. This material was administered by weekly subcutaneous injection (5.0-7.5 g/week) to nine patients with progressive metastatic malignancy. One complete response was seen in a patient with metastatic renal cell carcinoma to the lungs. Eight patients had progression of their disease. No undue toxicity and no consistent immunologic alteration was noted.

Antineoplastic Agents↗
PubMed1985

The in vitro interaction of alpha-difluoromethyl ornithine (DFMO) and several interferons on human cell lines.

The antiproliferative effects of six different human interferons were examined on two human cell lines--HM7 (human melanoma cell line) and MDA-MB-231 (human breast carcinoma cell line). A dose-response curve was developed for each interferon in which the maximum dose applied gave at least 30% growth inhibition of control values after 96-128 h of continuous exposure. An amount of alpha-difluoromethyl ornithine (DFMO) which caused 25% growth inhibition (0.01 mM for HM7 and 0.1 mM for MDA) was added to the cultures with various doses of each interferon. The inhibitory effects of DFMO and each interferon were additive at low concentrations. In no case was a synergistic effect observed. Unlike in the murine B-16 melanoma model, we could not show a synergistic inhibitory effect between DFMO and any of the six different interferons on two human epithelial tumor cell lines.

Antineoplastic Agents↗
PubMed1985

Phase II study of mitolactol in metastatic malignant melanoma.

The Central Pennsylvania Oncology Group conducted a phase II study of mitolactol in advanced metastatic melanoma to determine the overall survival rate and duration of response to this agent. The starting dose was 100 mg/m2/day orally. If no hematologic toxicity was noted on weekly blood cell counts, the dose was increased to 130 mg/m2/day on Day 35, and, if still tolerated, to 160 mg/m2/day on Day 70. Six of 25 evaluable patients (24%) had objective partial response. The median duration of response was 20 weeks, with a range of 10-66 weeks. Six of 25 patients (24%) had stable measurable disease, with a median duration of 9 weeks. The median survival from date of entry in this study was 21 weeks in responding or stable patients compared to 7 weeks in nonresponders. Hematologic toxicity was the dose-limiting factor. This study shows that mitolactol has moderate activity against advanced melanoma, and the drug deserves further study in combination with nonmyelotoxic drugs.

Adult↗
PubMed1985

Aminoglutethimide-induced hematologic toxicity: worldwide experience.

Marked leukopenia and/or thrombocytopenia occurred in 12 of 1333 patients treated with aminoglutethimide (0.9% incidence). Depression of blood cell counts was evident within 7 weeks of starting treatment. No delayed toxicity was encountered. Blood cell counts recovered promptly upon cessation of aminoglutethimide in all but one patient, who died from septicemia and marrow aplasia.

Aminoglutethimide↗
PubMed1984

Nonmedical costs to patients and their families associated with outpatient chemotherapy.

One hundred thirty-nine patients receiving outpatient chemotherapy kept diaries of nonmedical expenses resulting from their disease and its treatment. Diaries were kept for both treatment and nontreatment weeks. Results showed that the mean cost to patients and their families for treatment weeks was $72.81, and for nontreatment weeks it was $45.88. Approximately 45% of these costs were out-of-pocket expenses, and 55% were wages lost. Transportation and food were the largest out-of-pocket expenses. Patients living at greater distance from treatment had higher out-of-pocket costs, and younger patients reported more wages lost. Fourteen percent of the patients were estimated to be spending more than 50% of their weekly incomes on nonmedical expenses, and these patients were found largely in the lower-income categories. A method is proposed for using these data to estimate total nonmedical expenses for different treatment regimens, and also for estimating cancer patients' total nonmedical costs nationally.

Adolescent↗
PubMed1984

Clinical effect of aminoglutethimide, medical adrenalectomy, in treatment of 43 patients with advanced prostatic carcinoma.

The initial treatment of patients with Stage D prostatic carcinoma with orchiectomy or estrogens is successful in giving objective and subjective improvement for variable periods of time. However, after initial endocrine treatment patients generally relapse, and go on to further progression of their disease. However, a subgroup of approximately 22% of these Stage D prostatic cancer patients respond to either surgical adrenalectomy or hypophysectomy, indicating some degree of continued hormonal responsiveness. Forty-three previously castrated patients with Stage D prostatic carcinoma were treated with 1000 mg of aminoglutethimide and 40 mg of hydrocortisone daily and have been evaluated using the criteria of the National Prostatic Cancer Project. Progression of disease after initial hormonal therapy has varied from 3 to 25 months. One patient has had a complete response, and continues in remission after 290 weeks of therapy. Partial objective responses have been observed in 6 patients, and 10 patients have remained objectively stable for an average of 35 weeks in this latter group.

Adenocarcinoma↗
PubMed1984

Symptomatic malignant melanoma of the gastrointestinal tract. Operative treatment and survival.

Malignant melanoma involving the gastrointestinal tract is a common autopsy finding in patients who die with this disease. Melanoma metastatic to bowel infrequently causes symptoms. Some investigators suggest that survival following the onset of gastrointestinal symptoms is very poor and, as a result, surgical intervention to relieve symptoms should be avoided. We reviewed the clinical courses of 15 consecutive patients with symptomatic malignant melanoma of the bowel who underwent resection alone or in combination with bypass of symptomatic intestinal lesions. There were no deaths within 30 days of operation; 14 patients obtained relief of intestinal symptoms; 11 patients survived a mean of 7.9 months; and four patients are alive 2, 7, 22, and 23 months after operation. These results suggest that operations to treat symptomatic intestinal melanoma provide reasonable palliation and survival for patients with this disease.

Adult↗
PubMed1984

Predictors of success in a cohort of medical students.

Secondary school results were compared with personality test scores as predictors of achievement in medical school in a study of a cohort of students, using simple correlation and multiple linear regression. The cohort of 151 students completed 28 courses in the 6 years. We have previously reported that the scores obtained could be reduced to five independent factors: 'physical science'; 'biological science'; 'paraclinical science'; 'basic clinical science'; and 'clinical science'. Both secondary school scores and personality test scores correlated with medical school achievement factors, but school scores correlated best with 'physical' and 'biological' science. Considering secondary school scores, English was the best predictor of 'clinical science', physics was the best predictor of 'basic clinical science' and scores obtained in physics and languages were better predictors of medical school 'biological science' than was school biology. Personality factors were better predictors of 'biological', 'paraclinical' and 'clinical science' than secondary school scores and the combined secondary school score (CSS) was the best predictor of 'physical science' and of 'overall achievement'. We conclude that incorporation of personality measurement with school academic achievement could be of value in selection procedures for applicants for medical school.

Achievement↗