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Biomedical subjects

M Graham

Publications and source records attributed to M Graham.

156 records · Page 9Linked to original sources

Murine T lymphomas with retroviral inserts in the chromosomal 15 locus for plasmacytoma variant translocations.

The frequent trisomy of murine chromosome 15 in T lymphomas suggests that it bears one or more genes conducive to T-cell neoplasia. One such gene seems to be c-myc, the oncogene frequently activated in B-lymphoid tumours either by retroviral insertion, as in the avian bursal lymphomas, or by a translocation to the immunoglobulin heavy-chain locus, as in the predominant t(12; 15) of murine plasmacytomas and the analogous t(14; 8) of human Burkitt lymphomas. The c-myc gene was strongly implicated in T-cell neoplasia when 15-25% of T lymphomas arising in AKR mice, a strain prone to leukaemia, were found to have retroviral inserts near c-myc. Proviruses near c-myc were also found in several T lymphomas induced by murine leukaemia viruses (MuLV) in both mice and rats, but many of the rat thymomas bear an insert instead at one of several other common sites, at least two of which have murine homologues on chromosome 15. We show here that some murine T lymphomas contain proviral inserts in the recently identified chromosome 15 locus for plasmacytoma variant (6; 15) translocations, which we have denoted pvt-1. Although 6; 15 breakpoints map cytogenetically to the same chromosome band as c-myc, the alterations of pvt-1 in tumours occur at least 72 kilobases (kb) from the c-myc promoters. The insertions in T lymphomas suggest that an altered pvt-1 locus is conducive to neoplasia in T cells as well as B cells, possibly via long-range effects on c-myc expression.

Animals↗

Comparison of analytical methods in the determination of two venlafaxine fatalities.

Two venlafaxine (Effexor)-related deaths are reported with comparison of results from the analysis of specimens using capillary gas chromatography with a nitrogen-phosphorous detector (GC-NPD) and high-performance liquid chromatography (HPLC) using a UV-vis detector. Blood concentrations in Case 1 were 7.27 micrograms/mL venlafaxine and 5.03 micrograms/mL O-desmethylvenlafaxine, and Case 2 had 89.67 micrograms/mL venlafaxine with 3.44 micrograms/mL of the desmethyl metabolite. A comparison of analytical methods and specimen concentration is presented.

Adult↗

Disposition of cocaine in fatal poisoning in man.

A fatal case of intravenous (IV) cocaine administration is presented. Cocaine tissue concentrations (mg/kg) in descending order were: kidney, 26; spleen, 22; brain, 14; heart, 6.1; skeletal muscle, 6.1; lung, 3.4; liver, 1.6; and adipose, 1.0. Body fluid cocaine concentrations (mg/L) were: urine, 39; bile, 10; vitreous humor, 2.4; and blood, 1.8. These results are in excellent agreement with cocaine tissue distribution in the dog following IV administration and limited tissue data in previously reported cocaine fatalities in man.

Adult↗

Continuous infusion of epidural morphine in frostbite.

After frostbite injury, the phases of rewarming and progressive injury may cause intense pain for the patient. Although parenteral narcotic agents are the usual method of pain relief, they have well-described adverse effects such as heavy sedation, respiratory depression, and nausea and vomiting. In frostbite injury of the lower extremities, epidural blockade has the potential to provide good pain relief with fewer of those complications. However, the associated sympathetic blockade is believed by many clinicians to be of no benefit and by some to be potentially harmful. Epidural narcotics have the selective advantage of providing analgesia without sympathetic blockade. In this case report, the use of continuous epidural morphine during the first 24 hours after severe bilateral frostbite injury to the feet is described. The technique provided effective pain control, and no complications occurred. To our knowledge, use of continuous epidural morphine after frostbite injury has not been reported previously. Further use of this technique will be required to clarify its efficacy.

Adult↗

Tympanosclerosis. An electron microscopic study of matrix vesicles.

The ultrastructure of tympanosclerotic tissue has been studied and compared with other processes of fibrogenesis and calcification. Evidence is presented of the presence of large numbers of extracellular membrane-bound matrix vesicles and their role as the site of primary calcification in tympanosclerosis. Calcified spherular structures are formed and fuse into larger structures lined by a lamina limitans indicating the lines of arrested calcification in the collagenous matrix.

Adult↗

A tale of two tribes.

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Attitude of Health Personnel↗

Swallowing function and weight change observed in a phase I/II study of external-beam radiation, brachytherapy and concurrent chemotherapy in localized cancer of the esophagus (RTOG 9207).

BACKGROUND: A multi-institutional, prospective study was designed to determine the feasibility and tolerance of combined-modality chemotherapy, external-beam irradiation, and esophageal brachytherapy in a potentially curable group of patients with adenocarcinoma or squamous cell carcinoma of the esophagus. Swallowing function and weight were assessed before and after treatment. MATERIALS AND METHODS: Planned treatment was with 50 Gy of external-beam irradiation (25 fractions/5 weeks) followed 2 weeks later by esophageal brachytherapy (either a high dose rate of 5 Gy at weeks 8, 9, and 10 for a total of 15 Gy or a low dose rate of 20 Gy at week 8). Chemotherapy was given weeks 1, 5, 8, and 11 with cisplatinum, 75 mg/m2, and 5-fluorouracil, 1,000 mg/m2/24 hours in a 96-hour infusion. Swallowing was graded from 0 (no dysphagia) to 4 (complete obstruction for solids and liquids). Weight "loss" or weight gain was defined as a change in 3-month post- to pretherapy weight of < or = 5% or > 5%, respectively. RESULTS: The estimated survival rate at 1 and 2 years was 49% and 31%, respectively, and the estimated median survival was 11 months. Swallowing before treatment was graded as grade 1 in 14 patients, grade 2 in 22 patients, grade 3 in nine patients, and grade 4 in four patients. Swallowing grade after treatment was reported as improved in 29 patients (59%), unchanged in 12 patients (24.5%), and worse in eight patients (16.5%). The bestimproved dysphagia score after treatment in the 29 patients reporting improvement was grade 0 in 19 patients, grade 1 in five patients, grade 2 in four patients, and grade 3 in one patient. A posttreatment weight in 42 evaluable patients was categorized as a loss in 29 patients (69%), a gain in four patients (9.5%), and stable in nine patients (21.5%). Weight loss was significantly correlated with high swallowing grade, low performance status, and absence of a feeding tube. CONCLUSIONS: Swallowing function after brachytherapy and concurrent chemoradiation therapy is satisfactory in most surviving patients. Ninety-two percent of patients were able to swallow at least liquids at some point after therapy. Future plans are to compare this with other cooperative group studies that utilized chemoradiation or surgery, without brachytherapy.

Adenocarcinoma↗

Well differentiated astrocytoma occurring nine years after radiation therapy for medulloblastoma.

Conventional treatment for medulloblastoma includes surgical resection followed by craniospinal irradiation, with the potential risk of subsequent radiotherapy-induced secondary neoplasms. We report a 23-year-old woman previously irradiated nine years earlier for a cerebellar medulloblastoma who developed a new enhancing lesion in the primary radiation field four weeks following completion of high dose chemotherapy with bone marrow transplantation for recurrent disease. Resection of this lesion revealed a low grade glioma with no evidence of recurrent medulloblastoma.

Adult↗