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Biomedical subjects

L L Thomas

Publications and source records attributed to L L Thomas.

77 records · Page 5Linked to original sources
PubMedDate not supplied

Galactosamine hepatitis, endotoxemia, and lactulose.

Studies by Liehr et al. suggest that endotoxins are important in the pathogenesis of galactosamine hepatitis (Gal-N hepatitis) in rats. Lactulose (9.1 gm per kg per day) prevents hepatic lesions induced by Gal-N; an antiendotoxin effect of lactulose is postulated. However, commercial preparations of lactulose are contaminated with galactose, which shows a competitive action to Gal-N. To analyze the effect of galactose, male Wistar rats were pretreated with lactulose (Duphalac, 9.1 gm per kg per day) and given Gal-N (375 mg per kg i.p.). After 24 hr, serum was analyzed for glutamic pyruvate transaminase, glutamate dehydrogenase, and sorbitol dehydrogenase activities. Pretreatment with Duphalac, even 1 hr before Gal-N, abolished toxicity. Duphalac contains 10 gm galactose per 100 ml. Galactose was given in a similar concentration and similar inhibition occurred. Pretreatment with purified lactulose (9.1 gm per kg for 5 days) diminished the effects of Gal-N but did not normalize enzyme concentrations. Because small doses of galactose (80 and 300 mg per kg) showed similar inhibitory effects, we conclude that the protective effect of commercial lactulose preparations is mainly due to galactose contamination and not to an antiendotoxin effect.

Animals↗
PubMedDate not supplied

IMVP-16 followed by high dose chemotherapy and autologous bone marrow transplantation as salvage treatment for malignant lymphoma.

Thirty patients with high-grade malignant lymphoma were treated with ifosfamide-VP16213-methotrexate (IMVP-16) combination chemotherapy after failing to respond completely or after relapsing on CHOP-like therapy. Responders to the salvage therapy subsequently were treated with ablative chemotherapy (BCNU, VP16213, Ara-C and melphalan) and autografted. Of these 30 patients 11 were in relapse, 11 were partial responders and eight failed CHOP-like therapy. There were eight complete remissions and 12 partial responses to IMVP-16. These 20 patients were transplanted, together with one nonresponder. Ten of these 21 patients are disease-free survivors 16 to 76 months (median 32) after autografting. There were three treatment-related deaths: one before and two during the autografting procedure. Using one of the best salvage therapy combinations followed by high dose chemotherapy and autografting is feasible. The results of this study suggest that an appreciable number of patients may be cured by this procedure.

Adolescent↗
PubMedDate not supplied

Pneumocystis carinii pneumonia in HIV-negative patients with haematologic disease.

Since 1990, Pneumocystis carinii pneumonia (PCP) was diagnosed in 15 adult HIV-negative haematologic patients in our hospital. None of them had received PCP prophylaxis. All except one had been treated with prednisone. Symptoms usually started after stopping or tapering. In six patients the diagnosis of PCP was delayed because of confounding bacterial isolates from blood, sputum or urine leading to unsuccessful antibiotic treatment. PCP was diagnosed by demonstrating pneumocysts in bronchoalveolar lavage fluid. In four patients additional fungal or viral pathogens were identified. The infections were not clustered. The patients were treated with co-trimoxazole and, in case of a pO2 < 60 mmHg, with prednisone. Three patients died (20%); they all had a coinfection with cytomegalovirus and/or aspergillus. The others recovered completely. There were no relapses. Primary PCP prophylaxis should be considered in patients with lympho-proliferative disease and exposure to prednisone.

Adult↗
PubMedDate not supplied

Clinical management of cytotoxic drug overdose.

In this article the pharmacological management of accidental drug overdose is discussed, with various treatments for overdose proposed, as supported by clinical facts and speculation. Current knowledge is outlined concerning dacarbazine, nitrosourea compounds, melphalan, procarbazine, cyclophosphamide, VP-16.213, l-asparaginase (colaspase), 6-mercaptopurine, mustine (nitrogen mustard), intravenous or intrathecal methotrexate (amethopterin), cytarabine (cytosine arabinoside), fluorouracil and bleomycin.

Antineoplastic Agents↗