Search PubMed⌕ Search

Biomedical subjects

J Kalra

Publications and source records attributed to J Kalra.

86 records · Page 5Linked to original sources

Effective multimodality treatment for advanced epidermoid carcinoma of the female genital tract.

Fifteen patients with advanced or recurrent squamous-cell carcinoma of the cervix, vulva, vagina, and urethra were treated with simultaneous combination chemotherapy (5-fluorouracil infusion and mitomycin C) and radiotherapy (3,000 rad for a period of three weeks). Three to four weeks after completion of radiotherapy, 13 of 15 patients achieved partial or complete tumor shrinkage. Nine of 15 patients are alive, eight of whom (at a median follow-up time of 24 months) have no evidence of disease. The longest survival time was 45 + months. There was minimal toxicity associated with this therapy. The results of this pilot study suggest that the simultaneous administration of radiation and chemotherapy is an effective method of treatment of advanced female genital tract carcinoma.

Adult↗

Digoxigenin biotransformation.

Two healthy subjects took 3H-digoxigenin-12 alpha and unlabeled digoxigenin. Metabolites were assayed by high-pressure liquid chromatography (HPLC) in serum and urine. Of the tritium activity in the serum at 30 min, less than 26% chromatographed with digoxigenin; the rest chromatographed as metabolites, most of which were polar. The main polar metabolites identified were glucuronides of 3-epidigoxigenin. An important route of biotransformation to polar metabolites appears to be from 3 beta-digoxigenin through 3-keto-digoxigenin to 3-epidigoxigenin. Several HPLC peaks remain unidentified. There was extensive cross reactivity between metabolites and antisera to digoxin. The digoxigenin route of digoxin biotransformation to polar metabolites may be important in some patients receiving digoxin and such metabolites could contribute an important fraction to the serum digoxin concentration measured by radioimmunoassay.

Biotransformation↗

Chemotherapy for head and neck cancer relapsing after radiotherapy.

Thirty-nine patients (28 men and 11 women, ages 43 to 83 years) with advanced head and neck epidermoid carcinoma (33 had relapsed from previous radiotherapy) were treated with a three-day bleomycin administration (30 by continuous intravenous infusion and nine by subcutaneous route) followed on the fifth day by intravenous administration of cyclophosphamide + methotrexate + 5-fluorouracil (Bleo-CMF). This drug schedule was based on the cell cycle synchrony principle. Twenty-one of 39 patients (54%) responded (seven complete, 14 partial remission) lasting from 4 to 20 months. The median duration of survival for complete remission, partial remission, and disease progression was 15, ten, and four months, respectively. The Bleo-CMF was well tolerated with minimal toxicity. The effectiveness of this regimen in previously irradiated patients compels us to pursue its application in a randomized study as an adjuvant for Stages III and IV head and neck cancer following maximum eradication of the local disease by surgery and/or radiotherapy.

Adult↗

Influence of gastric pH on digoxin biotransformation. II. Extractable urinary metabolites.

High-performance liquid chromatography (HPLC) analysis was performed on methylene chloride extracts of urine from six subjects after administration of 3H-digoxin-12 alpha and unlabeled digoxin by nasogastric tube under four conditions: pentagastrin and control saline infusions, each in the supine and ambulatory states. There were no differences with change in position. With pentagastrin stimulation of acid secretion, there was extensive intragastric hydrolysis, mainly to digoxigenin; there was further extensive biotransformation leading to an increase in both extractable and unextractable metabolites in urine, particularly the latter. In the first 5 hr mean digoxin was only 17% and unextractable metabolites were 54% of total urine radioactivity. Extractable radioactivity was found under HPLC peaks with retention times of digoxin, digoxigenin, and its mono- and bis-digitoxosides. There were also three other peaks that were not identified; two correlated with gastric H+ activity and with the peak for digoxigenin, which is probably their precursor since similar peaks were found after ingestion of digoxigenin. The third unidentified peak eluted immediately after the digoxin, with which it correlated; it may have a close structural relationship to digoxin. Gastric acid stimulation induced a major increase in the production of urinary metabolites and may prove a useful model for the study of digoxin biotransformation, which is not yet well defined.

Biotransformation↗

Comparison of infrared and wet chemical analysis of urinary tract calculi.

Infrared analysis of urinary tract calculi using the system of interpretation of spectra of Oliver and Sweet [1] was compared with qualitative wet chemical analysis. This method of interpretation could be learned quickly and gave reproducible results, but had some limitations. Advantages of the infrared procedure include greater reproducibility. 1-mg sample size, greater sensitivity for oxalate and more uniform sensitivities. Minimum detectable amounts of reference standards varied roughly within 1 order of magnitude, compared with a range of 10(5) for wet chemical procedures. The comparable sensitivity for oxalate and phosphate permits a semi-quantitative approach for infrared. The main problems relate to the detection of magnesium ammonium phosphate and carbonate apatite, and wet chemical tests are recommended in addition, when these compounds are suggested. Calculi from 308 patients were analyzed by infrared. With this system of interpretation of spectra, infrared is considered to be a major advance in methodology for analysis of urinary tract calculi in the clinical laboratory, compared with qualitative wet chemical procedures.

Calcium↗

Influence of gastric pH on digoxin biotransformation. I. Intragastric hydrolysis.

3H-digoxin-12 alpha and unlabeled digoxin were administered down a nasogastric tube and digoxin, digoxyigenin and its mono- and bis-digitoxosides, and pH were assayed in gastric fluid of 6 healthy subjects at intervals for 90 min each under 4 conditions: pentagastrin infusion 6 micrograms/kg/hr with the subjects ambulatory and supine, and saline infusion ambulatory and supine. Intragastric hydrolysis occurred at roughly the same rate as reported in vitro. At 90 min, an average of 12.5% of the radioactivity that remained in the gastric fluid was recovered as digoxin for the 2 conditions when pentagastrin was infused, compared with 52.5% for th 2 conditions when saline was infused. The main glycosidic metabolite was digoxigenin and the amount correlated closely with the hydrogen ion activity in gastric fluid at 90 min (r = 0.83, p less than 0.01). Only minor differences were found between the supine and ambulatory conditions. The clinical significance of these results remains to be determined.

Biotransformation↗

Loading dose of digoxin in renal failure.

1 Twenty-two dialysis dependent patients received an intravenous loading dose of digoxin of 10 microgram/kg and the mean +/- s.d. serum digoxin concentration 24 h later was 1.5 ng/ml +/- 0.4 (range 0.8--2.1 ng/ml). No evidence of toxicity was observed. 2 The average apparent volume of distribution of digoxin in dialysis dependent patients was found to be reduced by about one third compared with that reported for individuals with normal renal function, but there was great variation. 3 An appropriate intravenous loading dose of digoxin in most patients with advanced renal failure is 10 microgram/kg.

Acute Kidney Injury↗

Naked megakaryocyte nuclei revisited.

Bone marrow smears from 35 patients with various neoplasms and from 32 control patients were examined for the presence and percentage of naked megakaryocyte nuclei (NMN). The percentages of NMN in the two groups did not significantly differ. We conclude that the enumeration of NMN is of no value as a diagnostic test of malignancy.

Bone Marrow Examination↗