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Biomedical subjects

K C Calman

Publications and source records attributed to K C Calman.

At least 55 records · Page 3Linked to original sources
PubMed1986

Teaching in medicine.

This brief review has highlighted the important role of the clinician as a medical teacher. Indeed, it is difficult to be one without the other. The aims and challenges to medical education have been described, together with the various settings in which teaching can occur. The medical teacher has a range of functions, including the development of educational programmes for special groups, a knowledge of a wide range of techniques for medical education and the ability to identify informal teaching situations. Enthusiasm, commitment and motivation are essential as is clinical experience of a wide range of conditions and the ability to be flexible in approach. Teaching is an exciting and creative activity and is the responsibility of all doctors, not just a few 'medical educators'.

Education, Medical↗
PubMed1985

Malignant melanoma in Scotland 1979-1983.

1318 cases of primary malignant melanoma of the skin first presenting in Scotland in the years 1979-83 and registered with the Scottish Melanoma Group are described. The annual age-adjusted incidence rate is 4.75 per 100 000 for females and 2.77 per 100 000 for males. Incidence rose by an annual average of 2.5% over the five-year period. The female: male ratio was 2:1, and 48.5% of all cases were of the superficial spreading histogenetic variety. Five-year survival rates for the patients registered in 1979 confirm the prognostic value of the tumour-thickness (Breslow) measurement. They were 93% for patients with tumours less than 1.5 mm thick (39% of patients), 67% for those with tumours 1.5-3.49 mm thick (30%), and 37% for those with tumours thicker than 3.5 mm (31%). This study shows that methods for early recognition of thin tumours should be encouraged.

Adolescent↗
PubMed1985

Increased vascular permeability: a major cause of hypoalbuminaemia in disease and injury.

The rate of loss of albumin to the tissue spaces (measured as transcapillary escape rate) rose by more than 300% in patients with septic shock, and the average increase within 7 h of cardiac surgery was 100%. The transcapillary escape rate in cachectic cancer patients was twice that of a group of healthy individuals. The rate of loss of albumin to the tissue spaces is normally 5%/h, which is more than 10 times the rates of synthesis and catabolism, and these large rate increases indicate that increased vascular permeability is an important cause of the lowered concentration of albumin commonly seen in acute and chronic disease.

Capillary Permeability↗
PubMed1985

Failure of systemic ketosis to control cachexia and the growth rate of the Walker 256 carcinosarcoma in rats.

The Walker 256 carcinosarcoma was shown to lack the enzyme 3-ketoacid CoA transferase. This suggests that ketone bodies cannot be used as a major substrate for the energy metabolism of this tumour. Systemic ketosis (1-2 mM acetoacetate plus 3-hydroxybutyrate) was induced both in tumour-bearing and in non-tumour-bearing rats with a diet containing 70% medium chain triglyceride. However, in rats bearing the Walker 256 tumour, this dietary ketosis did not reduce the tumour growth rate nor did it prevent the subsequent decrease in host body weight. Host body nitrogen losses were similarly unaffected. The ketosis induced in tumour bearing rats was shown to be abnormal since the blood glucose concentration of ketotic, tumour-bearing rats was significantly higher compared with that of ketotic non-tumour bearing rats (5.2 +/- 0.4 mM cf 3.4 +/- 0.6 mM, P less than 0.01). These results may partly explain why systemic ketosis failed to alter the growth and cachexia induced by the Walker 256 carcinosarcoma.

Acetyl-CoA C-Acetyltransferase↗
PubMed1984

Determination of adriamycin, adriamycinol and their 7-deoxyaglycones in human serum by high-performance liquid chromatography.

A reversed-phase isocratic high-performance liquid chromatographic assay is described for the measurement of adriamycin, adriamycinol and their 7-deoxyaglycones in human serum. The lower limit of detection in serum is 3 ng/ml for adriamycin and 1 ng/ml for adriamycinol and the 7-deoxyaglycones with coefficients of variation for k' of less than 5% throughout the day. An extraction technique for serum is described which is capable of an almost equal recovery (greater than 77%) of adriamycin, metabolites and daunorubicin (the internal standard) without interference from endogenous components of serum. Serum concentrations of metabolites 15 min after intravenous bolus administration of 40 mg/m2 adriamycin in two different patients were 26.5 and 16.6 ng/ml for adriamycinol; 109.8 and 5.8 ng/ml for the adriamycinol 7-deoxyaglycone and 21.4 and 17.1 ng/ml for the adriamycin 7-deoxyaglycone. A total of six metabolites of adriamycin were detected in the two patients using this methodology.

Chemical Phenomena↗
PubMed1984

Low-density lipoprotein metabolism in mice with soft tissue tumours.

This study examines the potential value of low-density lipoprotein (LDL) as a vehicle for directing cytotoxic drugs to tumour cells in mouse model systems. Control and MAC 13 tumour-bearing NMRI mice were injected with tracer doses of 125I-labelled native and cyclohexanedione-modified 131I-labelled LDL. 18 h later the animals were killed and the radioactivities assimilated by various tissues were measured relative to plasma activity at the time of death. These values were used to calculate specific tissue receptor-mediated LDL uptake. All tissues expressed receptors but the liver and adrenal gland were particularly active. In tumour-inoculated animals, the neoplastic lesions were second only to liver in their net assimilation of LDL. CFLP mice bearing virus-induced parotid adenomata gave results similar to those obtained in NMRI animals. In order to improve the selectivity of LDL assimilation we attempted to downregulate LDL receptors in the liver and adrenal gland by administration of the bile acid sodium taurocholate or by subcutaneous injection of hydrocortisone sodium succinate. These manoeuvres together reduced uptake of the lipoprotein into both organs without affecting tumour activity.

Adenoma↗
PubMed1984

Advanced gastric cancer: experience in Scotland using 5-fluorouracil, adriamycin and mitomycin-C.

Eighty-four patients with advanced gastric cancer treated in four centres in Scotland between June 1980 and December 1982 were reviewed following treatment with 5-fluorouracil, adriamycin and mitomycin-C (FAM). Eighty-one patients were evaluable. Twenty-eight patients (35 per cent) responded (four complete) with a median duration of response of 10.5 months and median survival of 17 months. Ten are still alive. Response was associated with an improvement in performance status. Eight patients (10 per cent) had stable disease with a median survival of 10 months. Forty-five (55 per cent) had progressive disease with a median survival of 4.5 months; one patient remains alive. Analysis of prognostic variables indicated that the presence of hepatic metastases had a negative influence on response to FAM (P less than 0.001). Treatment was well tolerated on an outpatient basis. FAM offers good palliative therapy in a proportion of patients with this disease, especially those without overt liver metastases.

Adenocarcinoma↗
PubMed1984

The analysis and animal pharmacokinetics of 1,2,4, triglycidyl urazol using a high-pressure liquid chromatographic technique.

This article details a procedure for the analysis of TGU by a simple high-pressure liquid chromatographic (HPLC) method. Linearity is maintained over the range from zero to at least 30 micrograms 1,2,4, triglycidyl urazol (TGU). The sensitivity of the assay is 250 ng/ml. A second peak, as yet unidentified, was detected on the chromatogram and probably represents a metabolite of TGU. The pharmacokinetic profile of TGU in Porton mice shows a first-order elimination process with a half-life (t1/2 alpha) of 1.5 min for the distribution phase and a t1/2 beta of 5 min. The apparent volume of distribution is 0.75 ml and the clearance 0.10 ml/min with a elimination rate constant of 0.14 min.

Animals↗
PubMed1984

The effect of cytotoxic therapy on saliva and oral flora.

Oral complications of cytotoxic therapy result from direct mucosal damage and, indirectly, occur as a consequence of immunosuppression. Such problems are further exacerbated as a result of associated xerostomia and secondary infection. Therefore, the aims of this study were to examine the salivary volume and composition (amylase, IgA, and lysozyme) together with the oral carriage of potential pathogens in patients receiving cytotoxic therapy. A pilot study comparing healthy controls with patients on chemotherapy for malignant conditions indicated that there were differences between the two groups. Therefore, a longitudinal study was initiated and twelve patients were assessed prior to and 4 and 12 weeks after the start of cytotoxic therapy. The 10-minute forced-spitting salivary volume and amylase and IgA levels all declined significantly over the 12-week period. Lysozyme content did not change. A quantitative increase in the oral carriage of Candida species, coliforms, and Staphylococcus aureus was also observed during therapy. Hence, it is concluded that cytotoxic chemotherapy results in a decreased salivary flow, a reduction in salivary amylase and IgA, and an increase in the oral carriage of opportunistic pathogens.

Adult↗
PubMed1984

Vindesine and cisplatin combination chemotherapy compared with vindesine as a single agent in the management of non-small cell lung cancer: a randomized study.

One hundred and five patients with inoperable non-small cell lung cancer were included in a randomized trial comparing the activity of vindesine as a single agent with the combination of vindesine and cisplatin. All patients were previously untreated and the majority (70%) had squamous carcinoma. The overall partial response rates in 88 evaluable patients were 7% for vindesine alone and 33% for the combined regime. There were no complete responders in either arm. The median survival of patients treated with vindesine and cisplatin was 11 months, compared with 4 months in those treated with vindesine alone (P = 0.008). Patients showing a partial or complete response to vindesine and cisplatin survived a median duration of 13 months, compared with 7 months for non-responders (P = 0.03). This survival benefit associated with the combination was particularly apparent for patients with ECOG performance status 0 or 1 (median survival greater than 18 months and 13 months respectively), locoregional disease (median survival 14 months) and squamous cell histology (median survival 13 months). Myelo-suppression was greater with the combination but was not a major treatment problem. Neurotoxicity, which was frequently dose-limiting, was of similar severity in both treatment groups. The results indicate that the combination of vindesine and cisplatin is superior to vindesine alone for remission induction in non-small cell lung cancer and confers a significant survival advantage compared with vindesine alone in patients with favourable prognostic factors.

Adenocarcinoma↗
PubMed1984

The treatment of advanced bladder cancer with methotrexate and cis-platinum--a pharmacokinetic study.

As part of a phase III study in advanced bladder cancer, 5 patients received methotrexate (MTX) 50 mg/m2 as a single agent every 2 weeks, and with every alternate dose of MTX (i.e. every 4 weeks) cis-platinum (CDDP) 50 mg/m2 was given simultaneously, together with saline hydration and diuresis. The clearance of MTX was measured in a total of 12 courses by serial serum sampling for up to 72 hr following injection. In 4 patients (with a mean pretreatment creatinine clearance of 97 ml/min) there was no significant difference between the clearance of MTX when given alone [mean t1/2 (beta) 3.2 hr] and when given 2 weeks later with concurrent CDDP [mean t1/2 (beta) 2.9 hr]. In 1 patient with a pretreatment creatinine clearance of 52 ml/min the clearance of MTX when given alone (without hydration) was significantly delayed compared with the clearance of MTX when given 2 weeks later concurrently with CDDP and saline hydration [t1/2 (beta) 19 and 4.5 hr respectively]. Of the 5 patients so far treated with MTX-CDDP, 2 have had a partial objective response and 3 have had stable disease (including 2 with a marked subjective response). These data indicate that in patients with satisfactory renal function, low-dose MTX and CDDP may be given concurrently without risk of enhanced drug toxicity.

Aged↗
PubMed1984

The oral carriage of yeasts and coliforms in patients on cytotoxic therapy.

The oral carriage of yeasts and coliforms in a healthy adult population and a group of patients with malignancies, undergoing cytotoxic therapy was investigated. A quantitative increase in the intra-oral carriage of Candida species and coliforms was observed during cytotoxic therapy. The most frequent yeast and the coliform isolated were Candida albicans and Escherichia coli, respectively. Thus, the oral cavity may constitute a reservoir of potentially pathogenic flora in patients on cytotoxic therapy.

Adolescent↗