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Biomedical subjects

A Theologides

Publications and source records attributed to A Theologides.

At least 55 records · Page 3Linked to original sources

CCNU, vinblastine, and delalutin therapy in renal cell carcinoma.

Advanced renal cell carcinoma is relatively resistant to most adequately evaluated chemotherapeutic agents. The combination of CCNU and vinblastine, which has antitumor activity in a frog renal carcinoma model system, has demonstrated activity in initial studies in man. The current study investigated this combination of drugs together with a progestational agent, Delalutin. Seventeen patients with metastatic renal cell carcinoma were treated with CCNU, vinblastine and Delalutin. There were no objective responses. Four patients with stable disease had a mean survival of 18 months compared to 13 patients with progressive disease who had a mean survival of 5 months. The survival of the four patients with stable disease was in large part due to the slowly progressive natural history of their disease.

Adenocarcinoma↗

Prolactin dynamics following transphenoidal hypophysectomy for metastatic carcinoma of the breast.

In nine patients who had undergone trans-sphenoidal hypophysectomy, prolactin dynamics were studied with intravenous thyrotropin releasing hormone (TRH). Residual prolactin secretory reserve was demonstrated in seven. Five patients were TRH tested both before and after trans-sphenoidal hypophysectomy. Hypophysectomy did not alter base line prolactin concentration but did decrease prolactin response to TRH from 55 ng/ml to 21 ng/ml (p less than 0.001). Post-hypophysectomy L-Dopa suppressed baseline prolactin concentrations to undetectable levels. There was no correlation between alterations in prolactin dynamics and tumor response to hypophysectomy. Trans-sphenoidal hypophysectomy is not effective in ablating prolactin secretion and serious doubts are raised about the role of altered prolactin dynamics in inducing breast cancer remission.

Breast Neoplasms↗

Post-hypophysectomy insulin response in patients with advanced breast cancer.

Seven postmenopausal women with metastic breast cancer underwent transsphenoidal hypophysectomy. The rate of disappearance, k*, of iv glucose and insulin following iv glucose and l-arginine infusion was determined before and after the ablation. The k* was estimated with a linear least squares weighted regression method. The insulin secretory capacity of the pancreas before and after the ablation was evaluated with the index of insulinogenic reserve, the index representing the quantity of insulin secreted per unit of glycemic stimulus. Following iv glucose and arginine, there was no significant difference in the mean k* for glucose and insulin, before and after the ablation. The insulinogenic index before was lower than the normal. After hypophysectomy, the index decreased further for the first 30 min following iv glucose. In patients with advanced cancer the index of insulinogenic reserve is lower than normal and is suppressed further by hypophysectomy.

Blood Glucose↗

Nutritional management of the patient with advanced cancer.

Protein-calorie malnutrition, vitamin and other deficiencies, and weight loss frequently develop in cancer patients. Although there is no evidence that aggressive nutritional management prolongs survival, it may improve the quality of life. Efforts should be made to maintain adequate daily caloric intake with appropriate food selection and with control of complications interfering with nutrition. In selected patients, intravenous hyperalimentation can provide adequate nutrition during potentially effective chemotherapy or radiotherapy. Elemental diets also may be a source of complete or supplemental nutrition. Further experience with both approaches will help to clarify their role in the nutritional management of the patient with advanced cancer.

Anorexia↗

Hypereosinophilic syndrome with biventricular involvement.

In a 45-year-old man with hypereosinophilic syndrome, cardiac disease, mainly endocardial thickening and extensive mural thrombosis of both ventricles, was confirmed at autopsy. Early in the course of the disease, right ventricular endocardial biopsy had demonstrated the basic process. Restriction in filling and contraction of the right ventricle were demonstrated by functional studies. By echocardiographic study, progressive reduction in size of the right ventricular cavity and premature opening of the pulmonary valve were demonstrated, while this method was less adequate in identifying the process in the left ventricle.

Autopsy↗

Value of alkaline phosphatase, 5'-nucleotidase, gamma-glutamyltransferase, and glutamate dehydrogenase activity measurements (single and combined) in serum in diagnosis of metastasis to the liver.

We assessed, in 98 patients with cancer, the diagnostic value of measuring serum alkaline phosphatase, 5'-nucleotidase, gamma-glutamyltransferase, and glutamate dehydrogenase activities as an aid to detection of liver metastases. All four enzymes showed diagnostic value, but 5'-nucleotidase appeared to have the greatest. It showed the lowest false-positive results (7.4%) with the highest predictive value of a positive test (85.7%) and agreement (81.3%).. gamma-Glutamyltransferase showed the lowest proportion of false-negative results (2.8%), but was the least specific 35% false-positive results). Analysis of various test combinations showed that the best agreement (77.5%) was obtained when the patients were divided into those who had no or only one abnormal test result, and those who had two or more abnormal test results. However, this was not better than the agreement for 5' nucleotidase alone (81.3%). The agreement of 5'-nucleotidase and gamma-glutamyltransferase (i.e., both tests were positive or negative) was excellent (91.4%), but such agreement included only 67% of the patients with liver metastases.

Alkaline Phosphatase↗

Cancer cachexia.

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Anemia↗

Cancer and diet.

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Diet↗

Neutrophil leukocyte reserves in lymphoreticular malignancies.

The marginal neutrophil leukocyte pool and the bone marrow neutrophil reserves were assessed in 43 patients with lymphoreticular malignancies, using epinephrine and steroid stimulation. Thirty-three patients were studied before staging, following splenectomy, before and after nodal irradiation and during remission induction chemotherapy. Ten patients in partial remission were studied after 12 month or more of chemotherapy. A neutrophil count of 1,500-2,500 cells/mm3 is not a sufficient guide for midifying the chemotherapy. The response to steroid stimulation may be a more dependable guide to evaluate the patient's potential risk for infection.

Adult↗

Anorexia-producing intermediary metabolites.

Major phases of the physiology of food intake regulation remain hypothetical. There is a central regulatory mechanism for hunger and satiety, but the signals and messages that activate the brain centers remain conjectural. The alimentary tract regulation, the regulation by osmoreceptors, the thermostatic, the glucostatic, the lipostatic, the amino acid, and the hormonal food intake regulation theories leave many questions unanswered. Low molecular weight peptides appear to have an important effect on brain functions. Hypothalamic peptides such as thyrotropin-releasing hormone, gonadotropin-releasing hormone, and somatostatin have been assigned new roles in various brain functions. The hypothalamus and probably other parts of the brain produce also anorexigenic peptides. Anorexia is a common manifestation of cancer. It is proposed that peptides, oligonucleotides, and other small metabolites produced by the cancer and by the tumor-bearing host are responsible for the genesis of the anorexia. They produce the anorexia through a peripheral effect on neuroendocrine cells and neuroreceptors and through a direct effect on hypothalamic and other central nervous system sensor and responder cells.

Animals↗

Hemolysis in chronic myelocytic leukemia.

The role of hemolysis in the anemia of chronic myelocytic leukemia (CML) remains controversial. The authors reviewed the records of 68 consecutive CML patients to evaluate occurrence and clinical significance of hemolysis. Thirty-one (46%) had increased fecal urobilinogen excretion, and this hemolysis group was compared with the remaining 37. There was no difference in age, presence of Philadelphia chromosome, thrombocytopenia, bleeding, occurrence of blast crisis, or chemotherapy in the two groups. There was no correlation between spleen size and hemolysis. Infections and administration of corticosteroids were more frequent in the hemolysis group. Hemolysis was a late complication and had an ominous prognosis, with a temporal association with blast crisis.

Anemia↗

The role of continuous flow centrifuge leucapheresis in the management of chronic lymphocytic leukaemia.

Continuous flow centrifuge leucapheresis (CFCL) provides a simple, mechanical technique for removing large numbers of circulating lymphocytes without cytotoxicity. Seven sequences of CFCL were performed on six patients with chronic lymphocytic leukaemia (CLL). In six, the median course consisted of six procedures in 10 days. A median total of 27.7 X 10(11) leucocytes were removed and a 70% drop in leucocyte counts (from 433 X 10(9)/l. to 130 X 10(9)/l.) was observed with little fall in haemoglobin and platelet counts. Tissue massess decreased in two patients. A similar effect was seen in one patient managed less intensively with 21 procedures being performed over 73 days, removing a total of 87.6 X 10(11) leucocytes. The peripheral leucocyte count decreased from 760 X 10(9)/l. to 114 X 10(9)/l. and hepatomegaly diminished markedly. One patient has survived for over 9 months since CFCL but stayed in control only briefly after each of two courses. Short courses of daily CFCL can produce short-term benefit in the management of advanced CLL but at present its main value is as an investigational form of therapy which provides a unique opportunity to study the cytokinetics of advanced CLL without the complications of superimposed cytotoxic therapy.

Aged↗

Why cancer patients have anorexia.

The theory has been advanced that the anorexia of cancer is the result of anorexigenic peptides and of other intermediary metabolites produced by the cancer and the tumor-bearing host. These metabolites are the signals to peripheral receptors and to the brain centers and are responsible for the state of satiety and aversion to food. Although the only effective way to stimulate the appetite of the cancer patient is to control the cancer, efforts should be made to increase the calorie intake even in the presence of anorexia and to maintain a calorie equilibrium. However, controlled studies have not shown that forced feeding can reverse for long periods the progressive tissue wasting process or prolong the cancer patient's survival.

Anorexia↗

The Rebuck skin window as a guide in cancer chemotherapy.

The skin-window inflammatory cell response was studied in 64 adult patients with various malignant neoplasms before initiation of chemotherapy and was repeated when a neutrophil level of 2500 cells/mm3 or less occurred. Of the 21 neutropenic patients, 15 had an abnormal neutrophil cell response and nine had an abnormal mononuclear cell response. Of the nine patients who had infection, eight had an abnormal mononuclear cell response and seven of the eight had a concomitant abnormal neutrophil response. The Rebuck skin window may be a practical clinical test to evaluate the risk for infection in neutropenic patients receiving cancer chemotherapy.

Agranulocytosis↗