Chronic granulocytic leukemia in a patient with sickle cell anemia.
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Adult↗
Biomedical subjects
G Phillips
Publications and source records attributed to G Phillips.
A phase II clinical trial of diaziquone in the treatment of patients with recurrent endometrial carcinoma. A Gynecologic Oncology Group study.
Twenty-six patients with measurable endometrial cancer refractory to standard therapy received AZQ [1,4-cyclohexadiene-1,4-dicarbamic acid, 2,5-bis(1-aziridinyl)3,6,dioxo,diethyl ester, NSC 182986] 22.5 mg/m2 diluted in 150 ml normal saline intravenously every three weeks. Thirteen patients experienced no toxicity and the dose in those patients was increased to 30 mg/m2 after the first course. The median number of courses given was 2.5 (range 1-9). The leukocyte count fell below 3000/microliter in 12 patients, and below 1000/microliter in two. The platelet count fell below 100,000/microliter in 12 patients, and below 25,000/microliter in one. Cumulative hematologic toxicity was not seen. One clinical complete response and one partial response were observed. Eight patients had stable disease. Median time to disease progression was 2 months. Median survival was 5.9 months. At this dose and schedule AZQ does not appear to have significant activity in recurrent endometrial cancer.
Aged↗
Loss of antibiotic activity caused by photodegradation: in vivo studies.
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Ciprofloxacin↗
Percutaneous sonographic needle aspiration biopsy of endoscopically negative gastric carcinoma.
We report here the use of ultrasound-guided percutaneous fine needle aspiration gastric biopsies in three patients with endoscopically negative biopsies. Two men, ages 60 and 64, and one woman, age 64, with signs and symptoms of weight loss, abdominal pain, and early satiety, had barium contrast studies suggestive of thickened gastric walls of the antrum and cardia, yet multiple endoscopic biopsies were negative for malignancy. Using real time sector B-scan ultrasonography, percutaneous fine needle aspiration biopsy retrieved signet cell carcinomatous cytologic material in all three patients. No complications were noted. In patients with clinical and radiographic findings compatible with an infiltrative process but negative endoscopic biopsies, in whom sonography can identify a thickened stomach wall, we suggest that percutaneous fine needle aspiration biopsy be attempted.
Adenocarcinoma, Mucinous↗
Continuous infusion epidural analgesia in labor: the effect of adding sufentanil to 0.125% bupivacaine.
The purpose of this study was to determine if the addition of sufentanil would improve the quality of analgesia obtained with 0.125% epidural bupivacaine infusions given to women in active labor. Forty healthy laboring women were randomly assigned to two equal groups. Group 1 had epidural analgesia instituted with the bolus injection of 10-15 ml 0.125% bupivacaine containing sufentanil 2 micrograms/ml, followed 30 minutes later by initiation of an epidural infusion of 0.125% bupivacaine containing sufentanil 1 microgram/ml at a rate of 10 ml/hr. Group 2 had epidural analgesia instituted with 10 or 15 ml of 0.25% bupivacaine with an epidural infusion of 0.125% bupivacaine begun 30 minutes later at a rate of 10 ml/hr. Infusion rates were altered as required to maintain an analgesic level to the tenth thoracic dermatome. Analgesia assessed by visual analog pain scores was significantly better in group 1. Significantly fewer epidural injections were required in group 1, and less motor weakness occurred in these patients. The addition of sufentanil to epidural bupivacaine infusions given in labor improves analgesia and reduces "top-up" requirements.
Analgesics↗
A fully synthetic route to the papulacandins. Stereo-specific spiroacetalization of a C-1-arylated methyl glycoside.
Lewis acid-catalyzed, hetero Diels-Alder reaction of (E)-1-methoxy-3-trimethylsilyloxy-1,3-butadiene with 6-benzoyloxymethyl-2,4-dibenzyloxy benzaldehyde afforded 2-(6-benzoyloxymethyl-2,4-dibenzyloxyphenyl)-2,3-dihydro-4H- pyran-4-one. This was converted into a derivative of papulacandin D by a stereo-specific, spiroacetalization of a C-1 methoxylated aryl glycoside, [3,5-dibenzoyloxy-(methyl 3-O-acetyl-4,6-di-O-benzoyl-DL-glucopyranosid-1-yl)phenyl]methyl benzoate.
Aminoglycosides↗
What happens to opiate addicts immediately after treatment: a prospective follow up study.
In the first British study to investigate systematically what happens to opiate addicts after treatment 50 opiate addicts admitted for inpatient treatment of their drug dependence were followed up for six months after discharge. All had been withdrawn from opiates before follow up. Six months later 26 were not using opiates: 12 had not used opiates at any time since discharge. When subjects in hospital or in prison were excluded from the analysis 21 (47%) of the subjects living in the community were not taking opiates. Many subjects used opiates within days of leaving the inpatient unit, but this first lapse did not necessarily lead to a full relapse into addictive use. During the six months after discharge several subjects used opiates on a less than daily basis. During each two month period throughout the six months of follow up the proportion of subjects who were occasional users fell, the proportion of abstinent subjects grew, and the proportion of daily users (assumed to be readdicted) remained constant. Although many of the addicts relapsed soon after treatment, it was encouraging that almost half were opiate free after six months. These results have important implications for the treatment of drug addicts.
Adolescent↗
Comparison of intraoperative ultrasonography and cholangiography in detection of small common bile duct stones.
High-resolution intraoperative ultrasonography was compared with conventional radiographic imaging in the detection of small common bile duct (CBD) stones (less than 5 mm in diameter). Sixteen mongrel dogs had laparotomy and ligation of distal CBD; 1 week to 10 days later, 0-3 gallstones of varying sizes (2-5 mm) were introduced into the dilated CBD (6-16 mm). High-resolution intraoperative ultrasonography of the CBD and a conventional intraoperative cholangiogram were performed to detect the presence and number of stones. The results of these two tests were evaluated independently by two ultrasonographers and two surgeons. There were 21 true-positive and five false-negative readings by sonogram compared with 17 and 9, respectively, by cholangiogram. Sensitivity of the sonogram was 81% and 65.4% by cholangiogram. Score of accuracy was 1.06 and 1.62 by cholangiogram and 0.81 and 0.87 by ultrasound (p less than 0.05). Intraoperative ultrasonography was found to be more sensitive in detecting small CBD stones when compared with intraoperative cholangiogram.
Animals↗
Alloantibody responses in multiply transfused sickle cell patients.
Fifty-six adult and 15 pediatric black patients with sickle cell disease were studied to determine their antibody responses to repeated transfusions of red cells. Red cell antibodies were determined retrospectively; anti-lymphocyte antibodies (class I and II) were determined on the single, most recently drawn blood sample. All adults were HLA-A, B, C, DR and DQ typed. Ten percent of the individuals with less than 50 transfusions, but greater than 50% with 100 transfusions or more, had red cell antibodies. The percentage of patients producing anti-red cell antibodies increased consistently with the number of transfusions (p = 0.0062). Women were more likely to become sensitized to red cell antigens than men (p = 0.008), and nulliparous women more likely than multiparous women. Children were also sensitized to red cell antigens (20%), and to a high degree to lymphocyte antigens (73%). No HLA association was found with increased propensity to red cell sensitization. A weak association of HLA DR5 and DR7 with failure to become sensitized to lymphocyte alloantigens was observed, but did not reach statistical significance. Our results suggest that, while genetic factors influencing transfusion response almost certainly exist, other factors such as number of transfusions, age, sex and parity need to be examined to provide accurate projections of risk in chronic transfusion.
Age Factors↗
Recurrent stroke and multi-infarct dementia in systemic lupus erythematosus: association with antiphospholipid antibodies.
Four patients with recurrent stroke and multi-infarct dementia are presented in whom the dementia was progressive and severe. Three of the patients developed the dementia during the course of an illness which was punctuated by repeated episodes of cerebral infarction demonstrated by computed tomographic (CT) scans. The fourth patient presented with an illness dominated by progressive and deteriorating higher mental functions, which culminated in a major stroke 18 months later. Three patients fulfilled the American Rheumatism Association (ARA) criteria for the classification of systemic lupus erythematosus, the fourth had a 'lupus-like' disease. All had livedo reticularis, severe migraines, and also demonstrated antibodies to phospholipids. All four patients suffered deep vein thromboses.
Adult↗
Comparison of sustained-release with standard tiaprofenic acid in the treatment of rheumatic diseases in general practice.
An open, parallel-group study was carried out to compare the efficacy and tolerance of a sustained-release capsule formulation of tiaprofenic acid at a dosage of 600 mg once daily with standard 300 mg tiaprofenic acid tablets given twice daily. Four hundred and eighty-five general practice patients with rheumatic disease requiring long-term non-steroidal anti-inflammatory drug therapy were included in the analysis. Patients were randomly allocated to receive, in a ratio of 3:1, either 2 X 300 mg sustained-release capsules at night or standard 300 mg tablets twice daily for a treatment period of 3 months. Pain, impairment of function and duration of morning stiffness were assessed at Week 0 (after a 3-day washout period) and at the end of Weeks 4, 8 and 12. Side-effects and compliance were also recorded at the end of Weeks 4, 8 and 12. Eighty-one (16.7%) patients withdrew from the study, with no significant difference in the withdrawal rates for the two treatment groups. Both treatment groups showed significant improvements clinically during tiaprofenic acid treatment; there were no significant differences between the two groups at Weeks 4, 8 or 12, nor were there any significant differences between the two treatment groups in the number of patients reporting side-effects at any of the assessments. In total, 36% of patients reported side-effects during the trial. The results indicate that both formulations are effective, well-tolerated treatments for rheumatic disease in general practice.
Adult↗
Cooperative phenomena in the perception of motion direction.
A percept of global coherent motion can result from the combination of many different localized motion vectors. We report here evidence of hysteresis in the perception of this global motion, obtained with random-dot cinematograms. The hysteresis characteristics are relatively robust with respect to changes in dot density, display area, and location. Changing the directional content of the stimulus, however, did alter the hysteresis profile in a manner consistent with a model incorporating cooperative interactions among direction-selective motion mechanisms. Our results lend further support to a cooperative interpretation of motion results lend further support to a cooperative interpretation of motion perception in random-dot cinematograms.
Humans↗
Ultrasonic evaluation of the scrotum in lymphoproliferative disease.
Scrotal ultrasound examinations of 23 male adults and children with the diagnosis of lymphoproliferative disease (LPD) were performed. Diagnoses included acute lymphoblastic leukemia (ALL) (six patients); acute myelogenous leukemia (AML) (one patient); chronic lymphocytic leukemia (CLL) (nine patients); non-Hodgkin's lymphoma (four patients); Hodgkin's lymphoma (three patients). Sonography-biopsy correlation was 100% in identifying testicular infiltrates. Nine of ten patients with testicular involvement had bilateral disease. Six patients had nonpalpable disease correctly identified by sonography. Ultrasound has great potential value as a screening modality for testicular biopsy in ALL and for detecting subclinical or nonpalpable disease in adults with LPD.
Adolescent↗
The measurement of opiate dependence.
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Adult↗
Ultrasonically guided percutaneous aspiration biopsy of the pancreas.
One hundred and twenty-six patients had fine needle aspiration of the pancreas under ultrasonic guidance. The aspirates of 66 patients contained malignant cells. Two of 38 patients who had negative cytology subsequently were diagnosed at laparotomy as having carcinoma of the pancreas. The results of this study show that the sensitivity of the cytologic method was 97%, and the specificity and predictive value were 100%.
Adenocarcinoma↗
Potential of SeHCAT retention as an indicator of terminal ileal involvement in inflammatory bowel disease.
The absorption of 75Se-23-selena-25-homotaurocholate (SeHCAT) was compared with vitamin-B12 absorption and conventional radiography in 44 patients with inflammatory bowel disease. The retention of SeHCAT was normal in 11 patients with ulcerative colitis but was abnormally low in 9 patients with terminal-ileal resection, 9 out of 14 patients with small-bowel Crohn's disease and in 2 out of 10 patients with Crohn's colitis. The 5 patients with small-bowel Crohn's disease and normal retention had either inactive disease or no radiological evidence of terminal ileal involvement. Measurements of the absorption of vitamin B12 did not discriminate between these groups, and there was very poor correlation between B12 and SeHCAT absorption (r = 0.506, P less than 0.05). There was extremely good correlation of SeHCAT retention measured using a wholebody counter with that measured using an uncollimated gamma camera (r = 0.96, P less than 0.001). The results suggest that SeHCAT retention may prove complementary to conventional methods of assessing small-bowel disease in patients with inflammatory bowel disease. As measurement by gamma camera is feasible, this test can be used in most departments of nuclear medicine.
Colitis, Ulcerative↗
Indium 111 autologous leucocyte scanning in lobar pneumonia and lung abscesses.
Indium 111 leucocyte scanning was used to examine the kinetics of granulocyte localisation in five patients with lobar pneumonia and four patients with lung abscess. Lung abscesses showed dense accumulation of labelled granulocytes within four hours of injection. In contrast, in all cases of lobar pneumonia granulocytes failed to accumulate over a period of up to 24 hours despite evidence of adequate perfusion and of uptake in inflammation elsewhere. These results suggest that the recruitment of granulocytes to lobar pneumonia may be terminated early in its clinical course.
Cell Movement↗
Heterogeneity in the specific activity and methotrexate sensitivity of dihydrofolate reductase from blast cells of acute myelogenous leukemia patients.
Dihydrofolate reductase activity was found to be highly heterogeneous in terms of its specific activity and methotrexate sensitivity in the blast cells of patients with acute myelogenous leukemia. None of the patients had previously been treated with methotrexate (MTX). The blast cells of four of 12 patients studied contained methotrexate-insensitive forms of dihydrofolate reductase, and the blast cells of three (distinct from the four mentioned previously) of the 12 had significantly higher dihydrofolate reductase activities than the rest. The presence of MTX-insensitive dihydrofolate reductases and high levels of enzyme activity represent intrinsic mechanisms of resistance and may explain the apparent clinical resistance of acute myelogenous leukemia to methotrexate.
Cells, Cultured↗