Treatment of early breast cancer with adriamycin-cyclophosphamide with or without radiation therapy: initial results of a brief and effective adjuvant program.
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Biomedical subjects
Publications and source records attributed to R Jackson.
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Eighty-five patients with endospcopically confirmed duodenal or pyloric canal ulcers entered a double blind trial with 1200 mg of cimetidine per day or placebo for 6 weeks. Eighty-four per cent of patients treated with cimetidine and 38 percent of those receiving placebo healed their ulcers (P less than 0.001). Measurement of basal acid output and maximal acid output before and after treatment showed no significant change but patients who failed to heal their ulcers had a higher basal acid output and maximal acid output than those who healed. Patients who smoked or drank alcohol had the same healing rate as abstainers. Sity-seven patients with duodenal ulceration healed by a 6-week course of cimetidine were randomly allocated to 400 mg of cimetidine twice daily or placebo in the maintenance trial. Actuarial analysis of the number of relapses in each group demonstrates that cimetidine is highly effective in preventing relapse.
Human infection with blood parasites of the genus Babesia can result in a hemolytic disease very similar to malaria. Laboratory diagnosis of babesiosis is dependent upon the detection and identification of the parasite in blood films. The distinguishing criteria are: lack of pigment in infected red blood cells; no circulating schizonts or gametocytes; "atypical" malarialike organisms; tetrad groups, rods, or exclamation-mark forms; and persisting parasitemia after treatment for malaria.
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Over the years physicians have attempted to classify skin diseases. Plenck and Willan were the first to outline clearly the basic components of skin diseases and to devise classifications based on living gross pathologic features. With the development of molecular biology, etiologic classification--a system unrelated to that of clinical appearance--was begun. Most current textbooks present combinations of these two systems and those based on location or on other concepts.
Eczema is a specific clinical, morphologic and microscopic reaction pattern of the skin. It has many causes, including external and internal chemicals and the action of various microorganisms--bacteria, fungi, yeasts, viruses and mites--and their products. Peripheral vesicles with undermined borders are a feature of all eczemas caused by fungi, yeasts and bacteria and are thus a useful diagnostic finding.
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I present a bried review of Hutchinson's Archives of Surgery. I have listed most of his well-known and not-so-well-known early clinical descriptions. To this list can be added descriptions of Peutz-Jegher syndrome, lipomelanic reticulosis, telangiectatic lupus erythematosus, temporal arteritis, and recurrent herpes simplex on the thigh and buttocks. The characteristics of Hutchinson's writing are the use of catchy, descriptive terms, his use of patients' names for diseases, his belief in the effectiveness of illustrations, superb clinical observation but faulty conclusions, and a lack of humor. Seventy-two years after his death, there is still much that can be learned about clinical disease from Hutchinson.
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