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Biomedical subjects

G Ramirez

Publications and source records attributed to G Ramirez.

At least 181 records · Page 10Linked to original sources

Combination chemotherapy for soft-tissue sarcomas: a phase III study.

A total of 144 patients with advanced sarcomas were entered into a randomized prospective protocol with four treatment arms utilizing different combinations of chemotherapeutic agents. Of these, 120 patients (83%) were judged acceptable. Treatment 1: actinomycin-D (Act-D), 0.01 mg/kg IV, days 1--5; phenylalanine mustard (L-PAM), 4 mg PO, days 1--10 every six weeks. Treatment 2: Act-D, 0.01 mg/kg IV, days 1--5; L-PAM, 4 mg PO, days 1--10; vincristine, 1 mg IV, days 1, 8, 15, 22, 29, 36, repeat every six weeks. Treatment 3: Act-D, 0.01 mg/kg IV, days 1--5; L-PAM, 4 mg PO, DAYS 1--10; NSC-1026, 200 mg/kg IV, days 1--6. Treatment 4: Adriamycin, 0.4 mg/kg IV, days 1, 2, 3, 8, 9, 10, then 2XWK starting day 15 (max. 1,200 mg). There was a provision that upon progression of the disease in the first three treatment regimens, patients would be crossed over to Treatment 4. Responses were as follows: 1 - Partial Response (PR) 1/25; No Change (NC) 9/25 (36%). gF2 - NC 17/26 (65%). 3 - NC 13/25 (52%). 4 - Complete Response (CR) 1/41; PR 6/41; (15%); NC 27/41 (66%). Clearly Treatment 4 was the best arm, with a 17% response rate and an initial progression rate of 17%. The only other response was a partial in 1. The difference is statistically significant (H = 17.247, P = 0.0006). If the responders to Adriamycin were analyzed without crossovers, the response rate would be 22% (6/27). (H = 14.079, P = 0.003). Median times to progression were 12.5, 8.7 weeks for 1 and 2, and 5 weeks for 3 and 4. There was no significant difference in the median survival times among the four treatment arms. It appears that Adriamycin as a single drug is superior to the drug combinations and would probably be even more effective used in combination with known active agents.

Antineoplastic Agents↗

Travelers' diarrhea among U.S. Army troops in South Korea.

A prospective study of diarrhea was conducted among 98 U.S. Army soldiers during their first six weeks in South Korea. Diarrhea developed in 54 (55%) of 98 soldiers and had a mean duration of five days. Infections with Salmonella, Shigella, Vibrio, enterotoxigenic Escherichia coli, enteroviruses, and intestinal parasites were uncommon. Four (8%) of 50 soldiers with documented diarrhea, two (6%) or 32 with a history of diarrhea, and one (3%) of 29 who denied gastrointestinal symptoms had serologic evidence of a recent rotavirus infection. The etiology of diarrhea among U.S. soldiers who had recently arrived in South Korea differed from the etiology among travelers in warmer climates, where enterotoxigenic strains of E. coli were responsible for the majority of cases. Further efforts are needed to define other enteric pathogens in the etiology of diarrhea among new arrivals in different parts of the world.

Diarrhea↗

Treatment of carcinoma of base of tongue with radiation therapy and 5-fluorouracil. Potential for optimization with 18F-FU.

The treatment of advanced base of tongue carcinoma with concurrent radiation therapy and 5-fluorouracil versus radiation therapy alone is compared. Although the results are inconclusive, it is noteworthy that all the 5-year survivors were patients given combined treatment. Important questions regarding optimization of time-dose relationships with combined therapy were generated. Accordingly, 18F-5 fluorouracil was synthesized in an attempt to answer some of these questions.

Carcinoma, Squamous Cell↗

Carcinoma of the penis: analysis of 192 consecutive cases at the Instituto Nacional de Enfermedades Neoplasicas.

Between 1952 and 1976 192 consecutive cases of penile epidermoid carcinoma were seen at the Instituto Nacional de Enfermedades Neoplascias of Lima, Peru. The mean age when the disease developed was 60.5 years, with a peak incidence between 60 and 64 years (32 patients). No correlation was observed between extensive lesions of the shaft of the penis to high pathological staging. Clinical examination of the inguino-crural nodes is not a good criterion for staging. We wait six weeks after eradication of primary lesion before lymphadenectomy. No correlation exists between grade and pathological stage. When no lymph node was positive, the overall survival rate over five years was 90.69%; when lymph nodes were metastasized there was an overall survival rate over five years of only 9.39 percent. The coefficient of cancer versus noncancer cause of death was 1.25 for pathological stage I, 3.09 for pathological stage II, 4.83 for pathological stage III, and 10.000 for pathological stage IV. Our patients did have advanced disease, as 57.14% of deaths occurred at two years and 25.21% more at five years.

Adult↗

Serum C-peptide in renal failure patients following stimulation of pancreatic secretion.

We have demonstrated persistently elevated serum C-peptide concentrations in patients with chronic renal failure on chronic hemodialysis. A blunted serum C-peptide response to intravenous glucose, glucagon and tolbutamide was also found. However, the response to oral glucose stimulation was greater and more prolonged than in control subjects, probably related to the magnitude of hyperglycemia found in patients with chronic renal failure. These observations suggest the existence of a defect in the renal clearance of C-peptide although an abnormality in C-peptide secretion cannot be excluded.

Adult↗

Synovial sarcoma of the neck associated with previous head and neck radiation therapy.

Synovial sarcoma is a rare neoplasm that uncommonly arises in the neck. Fourteen years after facial and neck radiation therapy for acne, synovial sarcoma of the neck developed in a young man. Possible radiation-induced benign and malignant neoplasms that arise in the head and neck region, either of thyroid or extrathyroid origin, remain a continuing medical problem.

Acne Vulgaris↗

Hemangiopericytoma of the uterus: report of a case with a comprehensive review of the literature.

A case of locally recurrent and metastatic uterine hemangiopericytoma successfully treated with surgery, radiotherapy and chemotherapy is presented. The patient is alive without evidence of detectable tumor, 13 years after the initial diagnosis. Review of the literature revealed 64 reported cases of uterine hemangiopericytoma. The clinical features are not sufficiently characteristic to enable the diagnosis to be made preoperatively. However, with the help of histological and ultrastructural studies a definite diagnosis of hemangiopericytoma can be made. The primary treatment is radical surgery which usually involved total hysterectomy and bilateral salpingo-oophorectomy. The prognosis of uterine hemangiopericytoma is better than that of other sites. However, long follow-up of these patients is necessary because of the tendency to local and distant recurrence many years after the initial treatment. The recurrent tumor should be treated aggressively with surgery, radiotherapy, and chemotherapy as long-term survival is not unusual.

Adult↗

Yoshi 864 (1-propanol, 3,3'-iminodi-, dimethanesulfonate [ester], hydrochloride): a phase II study in solid tumors.

Two hundred and eight acceptable patients were treated with Yoshi 864 (2 mg/kg/day by iv push X 5 days repeated once every 6 weeks). Toxicity was minimal. There was an overall response rate of 11%. Cross resistance with other alkylating agents may not be present. Because of its lack of toxicity, Yoshi 864 should be further evaluated in chronic myelocytic leukemia, lymphomas, and carcinomas of the ovary and bladder where significant responses were seen. It should also be evaluated in combinations as a replacement for other alkylating agents which cause more nausea and vomiting.

Alkylating Agents↗

Abnormalities in the regulation of growth hormone in chronic renal failure.

Carbohydrate intolerance is a common abnormality in patients with chronic renal failure. In this group of patients we investigated the interrelation among glucose, insulin, and growth hormone and confirmed the presence of carbohydrate intolerance and hyperinsulinemia. In addition we demonstrated alterations in growth hormone regulation, characterized by (1) the lack of suppression of growth hormone by orally induced hyperglycemia and paradoxical increase in serum levels of growth hormone after the administration of intravenous glucose or glucagon; (2) lack of release of growth hormone with induced hypoglycemia and an exaggerated response to levodopa administration. Furthermore, thyrotrophin-releasing hormone stimulated growth hormone release, a phenomenon not observed in the control population. Our studies show an impaired hypothalamic regulation of growth hormones secretion in patients with renal failure undergoing long-term hemodialysis.

Adult↗

Cholesterol embolization: a complication of angiography.

Cholesterol embolization is not widely recognized as a complication of major arteriographic procedures. In a retrospective study of 71 autopsies of patients who underwent diagnostic arteriographic procedures (20 with aortograms, 51 with cardiac catheterization and coronary angiography), we found an incidence of cholesterol embolization of 30% and 25.5%, respectively, in comparison with 4.3% in an age and disease-matched control population. The organs most frequently affected are the kidney and spleen following aortogram, and the myocardium following cardiac catheterization. The clinical importance of these findings cannot be ascertained from this study, but our experience with a single case demonstrates that radiographic studies may produce substantial morbidity.

Adult↗

A phase III study comparing the clinical utility of four regimens of 5-fluorouracil: a preliminary report.

A clinical trial involving 462 colon, rectum, and breast cancer patients randomized among four different dosage regimens of 5-FU (an intravenous loading course, a weekly intravenous schedule, a nontoxic schedule, and an oral schedule) has shown a significantly better response among colon-rectum cancer patients for the intravenous loading course. In addition, duration of response and time to progression are also significantly better. Overall survival is approaching significance for the colon rectum group (p value .082). In contrast, breast cancer patients show little difference between treatments. Toxicity is somewhat higher for the loading course.

Administration, Oral↗

Review of local soft tissue recurrence of breast cancer irradiated with and without actinomycin-D.

Between 1962 and 1973, regionally recurrent breast cancer was treated in 156 patients by irradiation alone or irradiation with concurrent actinomycin-D. Thirty-two patients were entered into a randomized trial, and 124 patients were retrospectively reviewed. Local control with irradiation alone was achieved in 48 of 80 patients (60%) and in 60 of 76 patients (79%) treated with irradiation and actinomycin-D (p less than .05). Results were remarkably similar in the randomized and retrospective series.

Breast Neoplasms↗