Interferon in multiple myeloma--does it pay?
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Antineoplastic Combined Chemotherapy Protocols↗
Biomedical subjects
A Segal
Publications and source records attributed to A Segal.
Gastrointestinal autonomic nerve tumors: a clinicopathological, immunohistochemical and ultrastructural study of 10 cases.
Gastrointestinal Autonomic Nerve Tumors (GANTs) are an underrecognized group of gastrointestinal stromal tumors (GISTs) putatively arising from the neural plexuses of the bowel wall. Approximately 24 cases have been previously reported. Their histogenesis, malignant potential, morphology and phenotypic features are not well defined. We present details of 10 GANTs iterating features, predominantly ultrastructural, allowing distinction from other GISTs. Clinical details are: sex-7M, 3F; age range 31-79 yrs, mean 53; symptoms/signs--abdominal pain 3, GI bleeding 3, mass 2, anemia 2. Follow-up ranged from 1-102 mths, mean 29. Seven tumors involved the small intestine and 3 were gastric. Tumor size ranged from 30-160 mm, mean 79. They were solid and cystic, often transmural and usually involved mesentery and retroperitoneum. Spindled and epithelioid cells were "compartmentalized" by a branching microvasculature. Eosinophilic, PAS positive stromal globules were prominent. Paraffin immunostaining results were (number positive/total): vimentin (8/9), NSE (10/10), S100 protein (6/10), neurofilament protein (0/9), synaptophysin (3/9), desmin (2/9, focal), smooth-muscle actin (0/9). Ultrastructural diagnostic features were elaborate, branching cytoplasmic processes containing microtubules, intermediate filaments and varying numbers of neurosecretory granules. Characteristic features were elaborate smooth endoplasmic reticulum enmeshed with intermediate filaments, pleomorphic mitochondria with lamellar cristae, mitochondrial-RER complexes, confronting RER cisternae, and circumscribed collections of stromal "skeinoid" fibres. There were no features of smooth muscle, Schwannian or perineurial differentiation.(ABSTRACT TRUNCATED AT 250 WORDS)
Adult↗
In vitro reactions of 2-cyanoethylene oxide with calf thymus DNA.
2-cyanoethylene oxide (CEO) is a direct-acting mutagen and the postulated proximate carcinogenic form of acrylonitrile (AN). We have studied the reactions of CEO with 2'-deoxyribonucleosides and in vitro with calf thymus DNA at pH 7.0-7.5 and 37 degrees C for 3 h. Reaction of CEO with dAdo gave 2 adducts, N6-(2-hydroxy-2-carboxyethyl)-dAdo (N6-HOCE-dAdo) (2% yield) and 1,N6-etheno-dAdo (epsilon-dAdo) (11%); reaction with dCyd resulted in the isolation of 3-HOCE-dUrd (22%); reaction with dGuo gave 7-(2-oxoethyl)-Gua (7-OXE-Gua) (31%) and reaction with dThd yielded 3-OXE-dThd (3%). Structural elucidation of adducts was accomplished by ultraviolet spectroscopy, high-field proton NMR spectroscopy and mass spectrometry. Structural confirmation was provided by an accurate mass measurement technique where diagnostic ions in the electron impact mass spectra of trimethylsilyl derivatives were measured to within 0.0007 atomic mass units. The facile Dimroth rearrangement of 1-HOCE-dAdo to N6-HOCE-dAdo and hydrolytic deamination of a dCyd adduct to 3-HOCE-dUrd is postulated to be catalyzed by the hydroxyl group on the 3-carbon side chain of the adduct. Reaction of CEO with calf thymus DNA yielded (nmol/mg DNA) N6-HOCE-dAdo (2); epsilon-dAdo (11); 3-HOCE-dUrd (80); 7-OXE-Gua (110) and 3-OXE-dThd (1). Thus CEO, like its metabolic precursor AN, directly alkylates DNA in vitro but at a much more rapid rate.
Animals↗
PCR amplification of microdissected wheat chromosome arms in a simple 'single tube' reaction.
A novel method for the adaptor-mediated PCR amplification of microdissected chromosome arms is described. This simple and versatile protocol eliminates the need for enzymatic micromanipulation in nanoliter volumes and permits the efficient amplification of as little as two wheat chromosome arms in a 'single tube' reaction.
Base Sequence↗
[Maxime Laignel-Lavastine (1875-1953)].
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France↗
Africa's population and family planning dynamics.
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Africa↗
Psychological adjustment and distress among Soviet immigrant physicians: demographic and background variables.
The goal of the present study was to examine the psychological distress of Soviet immigrant physicians in Israel and to identify risk and resilience factors in the psychological adjustment to immigration. This is a first report on a study conducted among 385 (152 men and 233 women) Soviet immigrant physicians who participated in preparatory licensing courses. The design of the study is described in detail and initial results are presented. These include demographic characteristics of the sample, background variables connected with motivation for immigration and reported absorption difficulties encountered in Israel. Family problems were found to be significantly correlated with depression: the highest rate of reported depression was found among single parents. Subjects who were examined during the second year after immigration reported depression more often than subjects who were in Israel less than a year. The findings suggest that motivational and family factors may enhance or mitigate the psychological distress experienced by immigrants.
Acculturation↗
Chronic granulomatous disease: towards gene therapy.
Failure of a superoxide generating system, the NADPH oxidase, present in neutrophils and other phagocytes gives rise to chronic granulomatous disease (CGD), a group of single gene inherited disorders all characterised by an extreme susceptibility to pyogenic infection, with potentially fatal consequences. About 30% of CGD cases are due to an autosomally inherited deficiency of a 47 kDa cytoplasmic component of the oxidase (p47-phox). Epstein-Barr virus (EBV) immortalised B-lymphocyte lines established from these CGD patients also express this NADPH oxidase defect and consequently are rendered incapable of generating superoxide on stimulation. We have utilised a p47-phox-deficient EBV-transformed B cell line as a recipient for retroviral transfer of a functional p47-phox cDNA. The presence and activity of the retrovirally encoded p47-phox in the transduced cells is demonstrated and we show that this restores their capacity to generate superoxide.
B-Lymphocytes↗
[Epidemiological data on primary open-angle glaucoma and treatment in the department of Marne].
A descriptive cross-sectional epidemiological survey of primary open-angle glaucoma (POAG) was carried out in the department of Marne, France, between October 1990 and May 1991. The aim of the study was to obtain socio-medico-demographic data on glaucoma patients who were treated for a period of one year or more. Fifty per cent of the ophthalmologists in the department of Marne participated in the study by having their patients complete an anonymous questionnaire at home. Eighty-five per cent of the 407 patients replied. This response rate to the investigation did not vary significantly (p > 0.90) with respect to the ophthalmologist. However, forgetting to distribute the questionnaires to the patients was variable from one physician to the other. The prevalence of POAG cases undergoing treatment was between 0.15 and 0.36% for the whole population; between 0.37 and 0.89% for patients over the age of 40 years; 0.67 and 1.67% after the age of 60. The same number of women and men are affected, but the risk is 1.33 times greater for men after the age of 60. The geographical distribution of the patients is identical to that of the general population. Sixty-two per cent of the patients take other drugs as well and this proportion increases with age (p < 0.0001); 24% of the subjects have hypertension and 10.6% are diabetic. Half of the patients have received anti-glaucoma therapy for 6 years or less; 94% take beta-blockers, 18% take miotics and 12% use adrenergic drugs. More women instil their eyedrops on their own (79% vs 57%; p < 0.0001). Ten per cent of patients have had glaucoma operations and this proportion increases with age (p < 0.03). The frequency of laser treatment is 20%. Glaucoma patients seem to be faithful to their ophthalmologist as 65% of them go to the same one for follow-up. Our study shows that this type of investigation is well received by the patients.
Adult↗
[Therapeutic observance and life of patients with primary open-angle glaucoma. Apropos of 341 cases in the department of Marne].
Patient compliance with treatment is an important factor in chronic diseases such as primary open-angle glaucoma (POAG). Among the 404 glaucoma patients included in our study in the department of Marne (France), 341 patients responded by completing an anonymous questionnaire at home in which the psychological effect of the illness, their knowledge about it, compliance with treatment and their relationships with the physician were explored. Sixty-eight per cent of these patients confirmed strict compliance with the treatment prescribed; this rate does not vary with respect to either the ophthalmologist (p = 0.57), or the duration of treatment (p = 0.42). Half of the remaining patients only alter the hours of their treatment and 6% forget to instill the eyedrops on certain days. According to our survey, the principal causes of poor compliance are forgetfulness, time constraints with other duties, poor doctor-patient relationship and lack of sufficient knowledge about the disease and its treatment. The majority of patients (59%) are minimally disturbed by the treatment; 2/3 of the subjects do not feel any change in their moral whereas 15% are more depressed or weakened since the time the illness was discovered. Fifty-six per cent of them observed little or no change in their vision; 32% believe to have a moderate or considerable repercussion and 6% claim a very severe visual deterioration. Generally, patients appear to have a positive attitude towards their illness and do not try to deny it. Thirty-eight per cent of them consider it as a handicap which they can overcome and 42% have either no particular opinion or take it as a minor event.
Activities of Daily Living↗
In vitro reaction of ethylene oxide with DNA and characterization of DNA adducts.
Ethylene oxide (EO) is a direct-acting SN2 alkylating agent and a rodent and probable human carcinogen. In vitro reactions of EO with calf thymus DNA in aqueous solution at neutral pH and 37 degrees C for 10 h resulted in the following 2-hydroxyethyl (HE) adducts (nmol/mg DNA): 7-HE-Gua (330), 3-HE-Ade (39), 1-HE-Ade (28), N6-HE-dAdo (6.2), 3-HE-Cyt (3.1), 3-HE-Ura (0.8) and 3-HE-dThd (2.0). Reference (marker) compounds were synthesized from reactions of EO with 2'-deoxyribonucleosides and DNA bases, isolated by paper and high performance liquid chromatography and characterized on the basis of chemical properties and UV, NMR and mass spectra. In agreement with our earlier studies with propylene oxide (PO) (Chem.-Biol. Interact., 67 (1988) 275-294) and glycidol (Cancer Biochem. Biophys., 11 (1990) 59-67), alkylation at N-3 of dCyd by EO under physiological conditions resulted in the rapid hydrolytic deamination of 3-HE-dCyd to 3-HE-dUrd. The hydroxyl group on the alkyl side chain which forms after epoxide alkylation is mechanistically involved in this rapid hydrolytic deamination. These results may provide important insights into the mechanisms of mutagenicity and carcinogenicity exhibited by EO and other SN2 aliphatic epoxides.
Animals↗
Premedication with metoclopramide decreases the frequency of methohexital induced hiccup.
Metoclopramide is one of many drugs that have been recommended for the treatment of intractable hiccup. Methohexital may produce hiccup during induction of general anesthesia. 211 women received methohexital for induction and maintenance of general anesthesia for short gynaecological procedures. All the patients were premedicated with fentanyl, diazepam and atropine. 109 patients were randomly selected to receive metoclopramide before induction of anesthesia; the remaining 102 patients served as a control group, and were anesthetized without metoclopramide premedication. The frequency of hiccup was compared between the two groups. 7 patients had hiccup in the metoclopramide premedicated group, as compared to 17 patients in the control group. This difference was statistically significant. We conclude that metoclopramide reduces the frequency of methohexital induced hiccup, and recommend that metoclopramide be routinely used for the premedication of methohexital injection.
Clinical Trial↗
Lidocaine pretreatment effectively decreases the incidence of hiccups during methohexitone administration for dilatation and curettage.
The efficacy of lidocaine 1 mg.kg-1 for prevention of methohexitone-induced hiccups was assessed in a double-blind fashion in 200 patients undergoing dilatation and curettage for pregnancy interruption. The patients were randomly assigned to receive either lidocaine 1% or saline 0.9% in a similar way (1 ml for every 10 kg of body weight). The incidence of hiccups was 16% in the control group compared to 6% in the lidocaine group. We speculate that this reduction in the methohexitone-induced hiccup ratio is related to lidocaine's membrane-stabilizing properties, which decrease the excitability of all the nervous structures involved in this reflex.
Abortion, Induced↗
[Prevalence of eye diseases in Basedow disease. Apropos of a prospective study with 85 cases].
The authors report the results of a prospective study, conducted between March 1990 and March 1991, on 85 patients suffering from Graves' disease, who were systematically examined to evaluate the prevalence of ophthalmopathy in Graves' disease. They were graded according to the Nospecs classification: 32 patients had no ophthalmopathy; 21 had only eyelid retraction (grade I in the Nospecs); 32 had a real ophthalmopathy (Grade II) or more in the Nospecs: 27 patients had signs of inflammation (grade II), that were often minor, 14 patients a moderate or intermediate exophtalmos (grade III), 4 patients had corneal injuries (grade V). The authors discuss the problems caused by this classification.
Adolescent↗
Nitrogen mustard as induction therapy for rheumatoid arthritis: clinical and immunologic effects.
We treated 5 patients diagnosed with rheumatoid arthritis (RA) with nitrogen mustard (HN2) and monitored clinical and immunologic variables. HN2, 0.3 mg/kg ideal body weight was given over 7 days. Disease activity and immune function were monitored during and after treatment. Duration of morning stiffness (p = 0.0044), joint count (p = 0.0140), and assessment of pain (p = 0.0264) and function (p = 0.0057) improved by Day 6. T lymphocytes (p = 0.0060), especially T memory cells (CD4CD29; p = 0.0017) fell dramatically. HN2 is effective for rapidly gaining control of active RA. This effect is T cell specific.
Aged↗
[Effectiveness and tolerance of cefixime in the treatment of acute pyelonephritis].
In a prospective, open clinical study, 50 urological patients with acute pyelonephritis were treated with the oral cephalosporin cefixime. The medication (2 x 200 mg/day) was given for seven to ten days. Clinical, bacteriological as well as hematological examinations were carried out prior to, during and immediately after therapy. A late check-up was performed five to nine days after the end of therapy. 46 of the 50 cases were evaluable for efficacy, and all 50 patients were included in safety evaluation. The most frequent pathogens isolated prior to therapy were Escherichia coli (34 times), Proteus mirabilis (six times), Klebsiella pneumoniae (twice) and coagulase-negative staphylococci (twice). Immediately after the end of therapy the pathogens were eradicated in 44 (97.5%) patients. At the late check-up the urine was sterile in 29 (63%) patients. A relapse was observed in 11 patients, a reinfection in four and the initially isolated pathogens had persisted in two. Immediately after the end of therapy 44 (95.7%) patients were clinically cured and two patients had improved. At the late check-up 41 patients were classified as clinically cured, three showed improvement, and two improvement with relapse. Adverse reactions (one case nausea and exanthem, and one case of meteorism) occurred in two patients. No changes in the blood counts or in the liver and kidney functions were observed. In the study described here cefixime proved to be an effective and well tolerated antibiotic for the treatment of upper urinary tract infections; it is of particular interest that 16 of the 50 patients presented with underlying disease favoring infection.
Acute Disease↗
A numerical analysis of steady flow in a three-dimensional model of the carotid artery bifurcation.
A finite element approximation of steady flow in a rigid three-dimensional model of the carotid artery bifurcation is presented. A Reynolds number of 640 and a flow division ratio of about 50/50, simulating systolic flow, was used. To limit the CPU- and I/O-times needed for solving the systems of equations, a mesh-generator was developed, which gives full control over the number of elements into which the bifurcation is divided. A mini-supercomputer, based on parallel and vector processing techniques, was used to solve the system of equations. The numerical results of axial and secondary flow compare favorably with those obtained from previously performed laser-Doppler velocity measurements. Also, the influence of the Reynolds number, the flow division ratio, and the bifurcation angle on axial and secondary flow in the carotid sinus were studied in the three-dimensional model. The influence of the interventions is limited to a relatively small variation in the region with reversed axial flow, more or less pronounced C-shaped axial velocity contours, and increasing or decreasing axial velocity maxima.
Blood Flow Velocity↗
In vitro reactions of isopropyl methanesulfonate with DNA and with 2'-deoxyribonucleosides.
Isopropyl methanesulfonate (IPMS), an SN1 alkylating agent, is a direct-acting mutagen in bacteria. We recently reported that s.c. and topical administration of IPMS to mice resulted in the rapid induction of thymic lymphomas. Thymic lymphoma induction was not observed following administration of the SN2 alkylating agents methyl methanesulfonate (MMS) and ethyl methanesulfonate (EMS). We have studied the reactions of IPMS with dAdo, dCyd, dGuo and dThd at pH 6.5 to 7.5 and 37 degrees C for 3 h. IPMS formed the following isopropyl (IP) adducts: 7-IP-Gua (4% yield), O6-IP-Gua (8%), O2-IP-Cyt (1%), O2-IP-dThd (2%), 3-IP-dThd (1%), and O4-IP-dThd (0.4%). Adducts were characterized from UV and mass spectra. IPMS was reacted in vitro with calf thymus DNA (pH 6.5 to 7.5, 37 degrees C, 3 h) and yielded (nmol/mg DNA): 7-IP-Gua (22) O6-IP-dGuo (11), O2-IP-Cyt (9), O2-IP-dThd (2), O4-IP-dThd (2), 3-IP-Ade (0.2) and 3-IP-dThd (0.2). The relatively greater alkylation of exocyclic oxygen atoms in DNA by IPMS compared to values for MMS and EMS reported by others, may play a role in the induction of thymic lymphomas in mice by IPMS and the lack of such activity by MMS and EMS.
Alkylating Agents↗