BACKGROUND: Interferon-gamma (IFN-gamma) gene/retroviral vector cell vaccinations have generated protective responses from unmodified tumor cell challenges as well as a regression of established tumors in animal models. The purpose of this trial was to determine the feasibility and safety of a direct intratumoral injection of IFN-gamma retroviral vector in advanced melanoma patients. METHODS: This was a phase I study, in which 13 patients received a single daily injection of a retroviral vector with the IFN-gamma gene for 5 consecutive days (1.5 x 10(8) colony-forming units total dose); patients subsequently underwent resection of the injected lesion to confirm DNA transduction in situ. RESULTS: No toxicity related to the injected vector was observed. Replication competent retrovirus was not observed in any prepared samples (n = 65). IFN-gamma expression was confirmed in 3 of 10 harvested tumor samples; one was equivocal, and DNA transduction was unable to be confirmed by enzyme-linked immunospot assay in six samples. CONCLUSIONS: An injection of IFN-gamma gene/retroviral vector is well tolerated. DNA transduction was demonstrated in human subjects, confirming the feasibility of the direct injection approach for the gene therapy of solid tumors. Further trials to determine optimal schedule and potential efficacy are indicated.

Adult↗

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Ebola fever: the African emergency.

The Ebola virus produces one of Africa's most lethal viral hemorrhagic fever (VHF) infections. Statistically, Ebola fever is at the bottom of Africa's list of infectious diseases, but the speed with which it induces agonizing death puts Ebola fever at the top of Africa's emergencies. Many aspects of the virus are unknown and have eluded medical scientists for 3 decades. Hence enormous difficulties may be encountered in treating, preventing, and controlling Ebola fever. In this article, the origin of the disease is traced, followed by a description of the Ebola fever triad, with some insights into the perspectives that may complicate treatment and control of the disease. The clinical manifestations are described in relation to the progression of the disease. Patients with the Ebola virus are admitted to the hospital as an emergency with the activation of a disaster-type plan of action.

Africa↗

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Determination of potentially toxic metals in human livers in New Zealand.

Ninety-six human liver samples from persons who died as a result of physical injuries in New Zealand have been analysed for arsenic, cadmium, chromium, cobalt, copper, mercury, lead, manganese, nickel, selenium, silver, and zinc. The levels found were generally lower than those found in similar studies outside New Zealand. Cadmium and lead levels showed a positive correlation with age and there did not appear to be any major regional variations within New Zealand.

Adolescent↗

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CT and MRI of pleomorphic xanthoastrocytoma: unusual biologic behavior.

OBJECTIVE: Our goal was to present three cases of pleomorphic xanthoastrocytoma (PXA) with unusual radiographic, clinical, and pathologic aspects. MATERIALS AND METHODS: The imaging findings in three patients with proven PXA were reviewed and correlated with clinical information and review of pathologic material. Two females and one male were studied, ranging in age from 8 to 42 years old. All patients underwent MRI with gadolinium (0.1 mmol/kg). Two of the patients had serial MR studies. CT scans with and without contrast agent were also available for two patients. The medical records for all three patients were reviewed. Radiographic findings were correlated with pathologic material obtained at surgery. RESULTS: Seizure disorder was the initial presentation in two patients. The third patient presented with a lytic lesion of the calvarium. Radiographic features showed rapid progression of disease over 3 months in one patient. Rapid tumor recurrence (within 7 months) without malignant transformation was proven in another patient. While typical pathological features of PXA were evident in two cases, a mixed tumor consisting of PXA and other tissue components was identified in the third case. CONCLUSION: Although generally regarded as a benign lesion in the literature, PXA has potential for aggressive behavior. Rapid tumor recurrence can occur without malignant transformation. Radiographic features may evolve over a short period of time. Dura and bony calvarium are not necessarily respected. PXA can occur as a separate entity or as a tumor of mixed components.

Adolescent↗

PubMedDate not supplied

A biomechanical analysis of posterior cervical fusions using polymethylmethacrylate as an instantaneous fusion mass.

Three posterior fusion reconstruction procedures for a canine experimental model of the C4-C5 bilateral facet dislocation are herein mechanically tested. The two procedures utilizing polymethylmethacrylate have increased angular stiffness as compared with the normal posterior soft tissue structures and the reconstruction procedure utilizing wire alone. Their ultimate moments are not significantly greater. These findings lead us to predict an increased incidence of fixation failure when polymethylmethacrylate acrylic cement preparations are used for instantaneous posterior "fusions" as compared with the more traditional wire and bone graft procedure.

Animals↗

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Pediatric oncology and hematology in Manchester, England.

The Manchester pediatric oncology unit is the third largest unit in the United Kingdom, with approximately 120 new referred cases per annum (10% of the U.K. total). Research activities include a gene therapy program, peripheral blood stem cell studies, the genetic epidemiology of childhood cancer, late-effects research (growth, body composition, pulmonary, quality of life), psychosocial studies, and clinical trial organization. Both the clinical oncology service and research activities involve close team coordination and collaboration with scientists both within and outside Manchester. A comprehensive pediatric hematology service is provided. The unit contains the second largest children's hemophilia service in the United Kingdom, serving 200 patients with congenital blood disorders. Twenty-five bone marrow transplants are performed each year (allogeneic, unrelated donor, autologous, and peripheral stem cell) for malignant and nonmalignant disorders. These activities are closely related to local, national, and international research groups.

Child↗

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Adrenal cortical tumors in childhood.

In a 41-year period, 18 children with a diagnosis of an adrenal cortical tumor were identified (14 carcinoma: 4 adenoma). The majority of patients had clinical signs of endocrine dysfunction at presentation, with virilization (11 patients) and a cushingoid appearance (8 patients) the commonest findings. Abnormal biochemical activity was identified in 16 tumors (94%). The primary treatment in 17 patients was surgical. In addition, 12 children, all with carcinomas, had radiotherapy. Of those children with a carcinoma, 12 are dead, with a median survival of 52 months (range 1-317 months). The three second primary tumors all developed at sites within the field of previous radiotherapy; and proved fatal at 127, 176, and 317 months (median 207 months). This series confirms the poor prognosis in adrenocortical carcinoma in childhood, but a complete resection is compatible with cure of the primary disease. The frequency of second, fatal, primary tumors is of particular concern and long-term follow-up is mandatory in survivors, especially if radiotherapy was part of the treatment protocol.

Adenoma↗

PubMedDate not supplied

An educational program for the prevention and management of disturbed behavior in psychiatric settings.

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Aggression↗