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Biomedical subjects

L Gaspar

Publications and source records attributed to L Gaspar.

At least 37 records · Page 2Linked to original sources

Permanent iodine-125 implants in the up-front treatment of malignant gliomas.

Between July 1989 and July 1992, 58 patients with newly diagnosed, histologically confirmed malignant gliomas (40 anaplastic astrocytomas, 18 glioblastoma multiforme) underwent implantation with low-activity iodine-125 sources. Patients were considered appropriate candidates for brachytherapy if their Karnofsky scores were > or = 70 and their contrast-enhancing tumors were < 6 cm in maximum diameter. Tumor volumes ranged from 0.1 to 90 ml. Ten patients had implants only. The other 48 patients received additional external beam radiation; 38 patients received radiation 1 to 2 weeks after the implant, and 10 patients received radiation preceding the implant. Median survival has not been reached but is currently greater than 31 months for patients with anaplastic astrocytoma and greater than 23 months for patients with glioblastoma. The rate of second operation for this group of patients was 45% (26 patients). Brain necrosis requiring resection occurred in 11 patients (19%). Although further follow-up is required, we conclude that low-activity permanent iodine-125 implants provide patients who have newly diagnosed malignant gliomas long-term survival with an acceptable risk of late complications.

Adolescent↗

A double-blind, randomized, prospective trial to evaluate topical vitamin C solution for the prevention of radiation dermatitis. CNS Cancer Consortium.

PURPOSE: The object of this study was to ascertain the value of topical ascorbic acid in the prevention of radiation dermatitis. METHODS AND MATERIALS: Patients with primary or metastatic brain tumors were eligible. Patients applied a topical solution, twice per day prior to and throughout the course of radiotherapy, to the left and right sides of the head. The radiotherapist and the patient were blinded as to the contents of the solutions. The bottle for one side of the head contained topical ascorbic acid solution. The bottle for the other side of the head contained only vehicle. During and after the course of treatment the radiotherapist scored the skin reaction on both the left and right sides of the irradiated head using a skin reaction scale. The data were analyzed with a matched pair analysis. Since each patient received both treatments (ascorbic acid and control solutions) the statistical analysis concentrated on the paired difference in scores based on the probability of a "preference" for the treatment or control. RESULTS: Eighty-four patients entered the study. Sixty-five were suitable for analysis. In 10 patients there was a preference for ascorbic acid solution (15%), in 20 patients there was a preference for placebo (31%), and there was a preference for neither in 35 patients (54%). Ascorbic acid solution could be considered to have an effect if the percentage of preferences favoring ascorbic acid over placebo, among those subjects with a preference, significantly exceeded the 50% expected by chance. The observed percentage of preferences for ascorbic acid was only 33% (10 of 30 with a preference; p = .10, two-sided sign test). Patient age, race, sex, and total dose of irradiation had no detectable influence on the comparative skin toxicity scores. CONCLUSION: There is no discernible benefit to ascorbic acid lotion, in the manner in which we used it in this trial, for the prevention of radiation dermatitis.

Adolescent↗

Predictors of survival following surgical resection of thymoma.

The aim of this study was to determine the predictors of long-term survival following surgical resection of thymoma. Forty-one patients with a histologically proven diagnosis of thymoma were evaluated and treated over a 30-year period (1961 to 1991) at our institution. Seven patients (Masaoka stage III or IV) were unresectable and were treated by radiotherapy and/or chemotherapy, with an overall 5 year survival of 50%. Thirty-four patients underwent primary surgical excision of the thymoma, most often through a median sternotomy, with 5- and 10-year survivals of 90%. Complete excision of the thymoma was achieved in 31 patients with a median survival of 54 months vs. 17 months if incomplete. Independent prognostic factors influencing survival were stage, histology, and patients judged to have a benign thymoma at surgery. Although the thymoma was associated with myasthenia gravis (8 patients) and second primary cancers (8 patients), neither factor was associated with overall survival. We conclude that the most significant predictors of long-term survival of thymoma include complete excision, Masaoka stage I disease, and lymphocytic histology. Multivariate analysis suggested that postoperative chemoradiotherapy may impact on survival.

Adolescent↗

Radiation therapy in the unresectable cavernous hemangioma of the liver.

Hemangioma is the most common benign neoplasm of the liver, for which a 'wait and see' policy has been advised when it is small or without symptoms. Surgery is the treatment of choice of these tumors when marked symptomatology is present. However, some of these lesions cannot be excised due to their size, multiplicity, location or medical conditions. In these patients, radiotherapy has been reported to give good results with minor morbidity, suspending the tumor growth and decreasing the symptomatology. Seven symptomatic patients were treated with radiotherapy with a dose of 15-30 Gray in 15-22 fractions. Improvement of the quality of life was observed in all patients and the regression of the tumor volume was confirmed by computed tomography in five, with a follow-up ranging from 40 to 67 months.

Adult↗

An analysis of radiotherapy data from the CNS cancer consortium's randomized prospective trial comparing AZQ to BCNU in the treatment of patients with primary malignant brain tumors. The CNS cancer consortium.

The CNS Cancer Consortium has conducted a phase III study comparing diaziquone (AZQ) with carmustine (BCNU) in the treatment of adults with primary anaplastic glial brain tumors. Patients eligible for this study were 18 years of age or older at the time of biopsy, subtotal resection, or gross total resection of an anaplastic glial brain tumor. Within 3 weeks of surgery, patients received whole brain radiotherapy at 1.7 to 2 Gy per fraction to a total whole brain dose of 42-48 Gy. This was followed by a boost to the tumor bed as ascertained by computed tomography (CT), angiography, and/or magnetic resonance imaging (MRI) of 1.7 to 2 Gy per fraction to a dose of 12-19 Gy. The recommended cumulative dose to the tumor bed was therefore 55-61 Gy. At 8 weeks following radiotherapy, patients were randomized to receive either AZQ at 15 mg/day for 3 days i.v. every 4 weeks or BCNU at 200 mg i.v. every 8 weeks. Chemotherapy was continued for at least 1 year unless death occurred, treatment failure was declared, or toxicity necessitated alteration of therapy. In the 249 randomized patients, there was no difference between the AZQ- and BCNU-treated patients in age, sex distribution, race, tumor histology, type of surgical resection, or Karnofsky performance status (KPS). Age and KPS at the initiation of therapy and tumor histology were the best overall predictors of survival. The type of chemotherapy (AZQ vs BCNU) was not predictive of survival. Two-year Kaplan-Meier survival was 22% in the AZQ-treated patients and 25% in BCNU-treated patients. In an analysis of radiotherapy administered we found that, within the range of doses required for this study, there was no influence of whole brain dose, boost dose, total dose, or size of the boost field on survival. The institution providing radiotherapy (teaching hospital vs nonteaching facility) did not influence survival.

Adult↗

Chromosomal assignments of the genes for neuroendocrine convertase PC1 (NEC1) to human 5q15-21, neuroendocrine convertase PC2 (NEC2) to human 20p11.1-11.2, and furin (mouse 7[D1-E2] region).

The chromosomal localization of the genes coding for the pro-protein and pro-hormone convertases PC1, PC2, and Furin has been achieved by in situ hybridization. The genes for PC1 and PC2 were located on human chromosomes 5q15-21 and 20p11.1-11.2, respectively. The gene for Furin was assigned to the mouse chromosome 7D1-7E2 region. These data complete the chromosomal localization of these three convertases in both human and mouse. The results confirm the regional correspondence of the human chromosomes 15 and mouse chromosomes 7, as well as between human chromosome 20 and mouse chromosome 2. Furthermore, the identification of the NEC1 locus on human chromosome 5 and mouse chromosome 13 suggests a conservation of synthenic regions between these regions of the human and mouse genomes.

Animals↗

Expression of endothelin-like peptide in the nervous system of the marine mollusk Aplysia.

The distribution of endothelin (ET)-like peptide immunoreactivity and mRNA in the nervous system of Aplysia californica was investigated by means of immunocytochemistry and in situ hybridization. Using specific antisera to human endothelin-1 (ET-1) and to the c-terminal peptide of human big endothelin-1 (22-38) (big ET-1), ET-like immunoreactivity was localized to various types of neurons. Immunoreactive nerve fibers for both antisera were prominent throughout the nervous system. Hybridization of radiolabeled complementary RNA probes for human ET-1 or rat endothelin (endothelin-3, ET-3) to paraformaldehyde-fixed, paraffin-embedded sections of various ganglia revealed the presence of a large number of labeled neurons. The number of labeled neurons was higher than those that were immunoreactive for the ET antisera. Preabsorption of the ET antisera with their respective synthetic peptide or hybridization of sections with the sense probes confirmed the specificity of the data. The present study shows that members of the endothelin family may be found in very distant phylogenetic organisms. This conservation suggests a possible role for this peptide as a neurotransmitter and/or neuromodulator in the central nervous systems of diverse species.

Animals↗

ANF mRNA is detected by the polymerase chain reaction technique in the chorioidea and bodies but not in the retina of the rat eye.

Specific proANF mRNA was demonstrated by the polymerase chain reaction (PCR) technique in ciliary body and chorioidea tissue extracts but not in the retina of the rat eye. However, immunoreactive (IR) ANF was detected in all of these tissues by a specific and sensitive radioimmunoassay (RIA). Since ANF seems to be involved in the maintenance of intraocular pressure, the regulation of ANF gene expression in these distinct eye tissues could be an important factor in the pathogenesis of glaucoma.

Animals↗

Cloning and primary sequence of a mouse candidate prohormone convertase PC1 homologous to PC2, Furin, and Kex2: distinct chromosomal localization and messenger RNA distribution in brain and pituitary compared to PC2.

Using a 796-basepair cDNA fragment obtained from a mouse pituitary library we have screened two mouse insulinoma libraries and isolated a full-length cDNA clone (2516 basepairs; 753 amino acids), designated mPC1. The cDNA sequence of mPC1 codes for a protein containing 753 amino acids and three potential N-glycosylation sites. This cDNA encodes a putative novel subtilisin-like proteinase, exhibiting within its presumed catalytic domain 64%, 55%, and 47% amino acid sequence identity to the recently characterized candidate prohormone convertases human Furin, mouse PC2, and yeast Kex2 gene products, respectively. An identical sequence to mPC1 was derived from a cDNA library of mouse corticotroph AtT-20 tumor cells. An ArgGlyAsp tripeptide identical to the recognition sequence of integrins was observed in the structures of the mammalian PC1, PC2, and Furin. In situ hybridization results demonstrated a distinct localization of the mPC1 and mPC2 transcripts in pituitary and brain. Thus, whereas both mPC1 and mPC2 are found in the intermediate lobe of the pituitary, only mPC1 is easily detected in the anterior lobe. In extrahypothalamic regions of the brain, including cortex, hippocampus, thalamus, and spinal cord, mPC2 transcripts predominate over mPC1. Both mRNAs are found in only a fraction of hypothalamic neurons, with greater abundance of mPC1 over mPC2 in the supraoptic nucleus. The genes coding for mPC1 and mPC2 map to the murine chromosomes 13 (band 13c) and 2 (2F3-2H2 region), respectively.

Amino Acid Sequence↗

[Suture of the meniscus in acute instability of the knee joint].

The authors describe a multiform function of the menisci and the causes of frequently occurring simultaneous injuries of the meniscus and of the ligament. In 26 cases of acute instability of the knee the authors put sutures over the meniscus. In all the cases the results were good, there were no complications and there was no need to make a repeated operation in any of the cases. Making use of the suture over the meniscus, it is possible to improve the results of the surgical treatment of instability of the knee to a greater extent.

Adolescent↗

Urinary levels of immunoreactive NH2-terminal of pro-opiomelanocortin in patients with malignant pulmonary disease.

Urinary levels of immunoreactive (IR) human NH2-terminal (hNT) of pro-opiomelanocortin were measured in 43 patients with various cell types of lung cancer (19 squamous cells, 12 oat cells, 2 large cells, and 10 adenocarcinoma), 32 patients with benign lung disease, two patients after hypophysectomy, and in 23 healthy volunteers. Lung cancer patients were divided into two subgroups according to the stage of the disease: 22 patients had "limited", and 21 patients "extensive" disease. Urinary and plasma levels were measured in 9 patients with lung cancer before and after radio- and chemotherapy or surgery. Urine samples were dialyzed and IR hNT material was extracted by Sep Pak C-18 cartridges using a propanol-2/TFA solvent system. The plasma and urinary IR hNT levels of the normal controls were 124 +/- 25 pg/ml and 47.8 +/- 14.5 pg/mg creatinine, respectively. The plasma levels of IR hNT were elevated (greater than mean + 2SD) in 65% of our patients with histologically proven lung cancer (422 +/- 775, mean +/- SD, pg/ml). The highest incidence of an elevated plasma level of IR hNT was found in oat cell carcinoma (83%). Elevated plasma IR hNT occurred in 66% of the patients with benign pulmonary disease (246 +/- 141 pg/ml, N.S.). In cancer patients with "limited" disease we found levels of 226 +/- 143 pg/ml and in patients with "extensive" disease 627 +/- 1074 pg/ml (N.S.). The urinary IR hNT level in lung cancer patients was 186 +/- 337 pg/mg creatinine and 81% of our patients had elevated levels.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Peptides related to the N-terminus of pro-opiomelanocortin in the human adrenal medulla.

The immunoreactive (IR) human N-terminal (hNT) of pro-opiomelanocortin (POMC) was measured by specific radioimmunoassay (RIA) and characterized by molecular sieving chromatography, concanavalin A-affinity chromatography and reversed-phase high-performance liquid chromatography (HPLC). The IR hNT levels were 380 +/- 144 ng/g wet wt (mean +/- SD) in the adrenal medulla (N:6), 21.6 +/- 6 ng/g wet wt in the adrenal cortex (N:6), and 45.6% ng/g wet wt in pheochromocytoma tissues (N:3). The IR hNT content of the adrenal medulla was found to be at least twice as high as that of the IR ACTH on a molar basis. Molecular sieving chromatography of IR hNT and IR gamma-3-melanotropin (MSH) showed two major molecular forms (apparent molecular weights of 14 and 12 kilodalton). These major forms were also separable using reversed-phase HPLC. In addition, a part of the IR ACTH material from the adrenal medulla extracts was eluted with an apparent molecular weight of 12 kilodalton. This latter form of IR ACTH was also separated from authentic human ACTH (1-39) by HPLC. Results obtained from concanavalin A-agarose chromatography suggest that one part of the IR gamma-3-MSH material from the adrenal medulla might be non-glycosylated. These results indicate the presence of IR hNT and IR gamma-3-MSH-like material in the human adrenal and also suggest a different processing pathway for POMC from that in the pituitary gland.

Adrenal Cortex↗