Truth telling in medicine.
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Biomedical subjects
Publications and source records attributed to D Morris.
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Fifty-one patients with stage III or IV squamous cell carcinoma of the head and neck who received induction chemotherapy with cisplatin and bleomycin sulfate with and without high-dose methotrexate were studied. The relationship of the prechemotherapy levels of serum alkaline phosphatase, lactic dehydrogenase, SGOT, SGPT, BUN, creatinine, calcium, total protein, albumin, hemoglobin, uric acid, and bilirubin and the WBC and platelet counts was correlated with the response rate. The overall response rate was 65%. No notable relationship between any of the laboratory values and the response rate was found. In contrast to an earlier report, patients with a low alkaline phosphatase level responded as well as patients with an elevated serum alkaline phosphatase level.
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Thirty patients with refractory advanced breast cancer who had no prior treatment with doxorubicin or VP-16-213 received doxorubicin 45 mg/m2 I.V. on day 1 and VP-16-213 50 mg/m2 I.V. on days 1 through 5. Courses were repeated every 21 days when hematologic recovery permitted. Among 30 evaluable patients, one had a complete response and 11 had a partial response. Four patients had stabilization of their disease. There was thus a 40% response rate with a median response duration of 146 days (range 35-540). Toxicity included moderate to severe myelosuppression, infections, hemorrhage, and mucositis. In these poor prognoses in previously treated patients, the combination of doxorubicin and VP-16-213 appears to be an effective secondary treatment for metastatic breast cancer.
A randomized double-blind trial was conducted in 143 out-patients with allergic conjunctivitis (281 eyes). Active sodium cromoglycate collyre was compared with placebo in parallel groups over a four-week period. Highly significant advantage for active drug was demonstrated for subjective and objective symptoms as well as for overall assessment by patients and physicians. Results were compared with international data concerning this well-known anti-allergic compound.
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The cells of the B lymphocytic leukaemia (L2C) of strain 2 guinea-pigs have IgM on their surfaces but produce insufficient monoclonal IgM in vivo to be detectable by conventional serum electrophoresis. A radioimmunoassay, using anti-idiotypic antibody raised against the surface IgM of these cells, has been used to estimate levels of extracellular IgM produced both in vitro and in vivo. Analyses of the contributions to such IgM from the cell surface and from an export pathway have been made by examining the effect of prior removal of surface Fab mu by papain, and by following the fate of radio-iodinated surface IgM. Results suggest that the extracellular IgM arises predominantly from an export pathway, being exported in both pentameric and monomeric forms. Only a minute contribution, possibly in the form of vesicle-bound monomeric IgM, appears to derive from the cell surface. Radioimmunoassay was used to monitor the increasing levels of this leukaemic cell product during the course of the disease. Idiotypic IgM was detectable when the body load of neoplastic cells was approximately 4% of that detectable by an increased white cell count in the blood.
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Mitral anulus calcification (MAC) and mitral valve prolapse (MVP) are frequently diagnosed conditions. We studied two patients with mild or moderate mitral regurgitation who demonstrated both MAC and MVP on angiography and echocardiography. M-mode echocardiography is probably the definitive test for confirming the presence of MVP. Echocardiography is moderately sensitive in the diagnosis of cardiac calcification, such as MAC, but M-mode echocardiography may not detect the MAC in the majority of patients with both MVP and MAC demonstrated by angiography.
Immunoadsorbents were used to purify a number of antibodies. Using pH 2.0 acid conditions alone it was possible to elute antibodies raised against human growth hormone (HGH) and Fc fragments from such immunoadsorbents with 50% or better recovery of antibody activity. However, to elute antibodies raised against triiodothyronine and cortisol required 6 M guanidine HCl, pH 2.0. The avidities of the purified antibodies were similar to those of the non-purified antibodies. The purified antibodies were stable in solution at 4 degrees C for at least six months.
Plasmid R91a of Pseudomonas aeruginosa strain 9169 is homologous with RP1. Plasmid R91 carried by the same strain is related in the Tn1 region but is otherwise unrelated to R91a.
The authors present a case of acute intermittent porphyria (AIP) in an almost fatal relapse with quadriplegia, bulbar paralysis and coma. Intravenous hematin produced an immediate arousal from coma and allowed a gradual resumption of bulbar and autonomic functions. Persistent tachycardia and hypertension necessitated huge doses of intravenous propranolol. Both hematin and propranolol administrations were followed by a remarkable decrease in urinary amino-levulinic acid and porphobilinogen excretion. Nevertheless, after the acute stage, the patient was left with a severe generalized muscle wasting. After 7 months of intensive physical therapy, complete recovery of all neuromuscular functions was achieved. The modern aspects of the management of AIP are presented; the efficacy and the limits of hematin and propranolol therapy are discussed.
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Explore the source record for details and available documents.
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