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Biomedical subjects

R Lee

Publications and source records attributed to R Lee.

At least 307 records · Page 17Linked to original sources

A study of 31 cases of gastric carcinoma in dogs.

Over a five year period 31 dogs were diagnosed as having advanced gastric carcinoma. The most frequent clinical features were vomiting, polydipsia and weight loss. A predisposition to the tumour was found in the rough collie and Staffordshire bull terrier. In 18 dogs the main finding endoscopically was a large deep ulcer with thickened, irregular rims and walls. Fluoroscopically a marked irregularity of the mucosal surface was noted in 10 dogs. Pathologically, large ulcers with thickening of the stomach wall and involvement of the serosal lymphatics were evident in 17 dogs, and similar ulcers with involvement of the gastric lymph nodes were evident in 18 dogs.

Adenocarcinoma↗

Chemotherapy for carcinomatous peritonitis and pleuritis with MMC-CH, mitomycin C adsorbed on activated carbon particles. Clinical trials.

A new drug dosage form comprising activated carbon particles adsorbing mitomycin C (MMC-CH) is designed to slowly release its components, and has affinity for the tumor surface and lymph nodes and a tendency to stay long in the local portion. The therapeutic index of MMC-CH in experimental carcinomatous peritonitis is 3.1 times as high as that of MMC-solution. In clinical experiments 81 patients with carcinomatous effusions were administered with MMC-CH (2.0-2.4 mg/kg in terms of MMC) in bolus intracavitarily. Fifty-one patients responded well to the MMC-CH therapy. Nineteen patients were alive for more than 6 months. The responders showed marked improvement in subjective symptoms, and 26 patients became dischargeable from hospital. Bone marrow suppression and peritoneal irritation were main adverse effects, but the symptoms were temporary and not so serious in spite of a high dose of MMC.

Charcoal↗

Granulocytic sarcoma of the prostate. Two cases causing urinary obstruction.

Two cases of patients with prostatic granulocytic sarcoma in whom urinary obstruction occurred are presented. The diagnosis was made by tissue examination with hematoxylin and eosin and specific esterase stains. One patient had a myelodysplastic syndrome and the other patient had acute myeloblastic leukemia. In both cases the diagnosis of prostatic granulocytic sarcoma was unexpected. Granulocytic sarcomas should be considered in the differential diagnosis of urinary obstruction in patients with myeloproliferative or myelodysplastic syndromes.

Aged↗

Esmolol: a titratable short-acting intravenous beta blocker for acute critical care settings.

Esmolol (Brevibloc) is an intravenous, short-acting, titratable, cardioselective beta blocker with a very rapid onset and offset of action (t1/2 = 9.2 minutes). Esmolol-induced beta blockade can be maintained as long as infusion is continued. It exhibits neither intrinsic sympathomimetic activity nor significant membrane-stabilizing activity. It is rapidly metabolized by an esterase in the erythrocyte cytosol to an inactive acid metabolite. Its hemodynamic and electrophysiologic effects are similar to those of other beta blockers. Unlike the effects of other beta blockers, however, the effects of esmolol dissipate rapidly to baseline within 30 minutes after its discontinuation. Evidence obtained from clinical studies indicates that esmolol is effective and safe in reducing the ventricular rate in patients with supraventricular tachyarrhythmias, and in reducing the heart rate in patients with acute myocardial infarction and/or unstable angina. Esmolol has also been shown to be effective and safe in attenuating the tachycardia and hypertension seen during the intraoperative period. Data from postoperative patients indicate that esmolol is ideal as sole-agent therapy for the treatment of moderate postoperative hypertension associated with a hyperdynamic state. The short duration of action and titratability of esmolol make it an ideal drug for use in patients in whom the clinical need for beta blockade is limited in duration, and it offers additional safety in patients in whom beta blockade is beneficial; however, it might be precluded because of coexisting contraindications. To date, experience with esmolol in over 1200 patients has been gathered, and the adverse effect profile is basically similar to that reported here.

Adrenergic beta-Antagonists↗

Cross-reactive antibody in immunity to colisepticemia in calves.

Cattle were immunized with a uridine diphosphate galactose epimerase deficient mutant of Escherichia coli to prepare antiserum cross-reactive with different serotypes of E. coli. Hypogammaglobulinemic calves were given bovine anti-J5 serum before oral challenge with virulent E. coli derived from a septicemic calf. Passively immunized calves had delayed and decreased bacteremia compared with calves given saline before challenge. Calves given antiserum also lived longer than control calves. A second experiment using ampicillin and antibody to treat colisepticemia also showed increased survival in anti-serum-treated calves. Decreased bacteremia was probably not due to the killing of the challenge strain by antibody and complement, as the strain was serum-resistant. However, anti-J5 serum did increase phagocytosis of the challenge strain of E. coli (JL9) by bovine neutrophils. Thus, partial protection by antiserum was probably due to increased clearance of bacteria as well as neutralization of endotoxin.

Ampicillin↗

A new IVIgG preparation (IVIgG pH 4.25): preliminary results for the treatment of immune thrombocytopenia.

Fifteen patients comprising ten with chronic idiopathic autoimmune thrombocytopenic purpura, three with acute autoimmune thrombocytopenic purpura, and two with secondary chronic autoimmune thrombocytopenic purpura were treated. All patients received 5-day courses of intravenous immunoglobulin (pH 4.25) at a dose of 400 mg kg body weight daily and five patients received maintenance treatment with double dose single infusions. Responses were seen in 12 patients which were in general of brief duration although one patient had a sustained remission. Five patients were treated with maintenance therapy of 800 mg/kg given at approximately 3-weekly intervals and maintained satisfactory platelet counts.

Autoimmune Diseases↗

The glycemic index: similarity of values derived in insulin-dependent and non-insulin-dependent diabetic patients.

To see whether relative differences in the glycemic responses to different foods were similar in insulin-dependent (IDDM) and non-insulin-dependent diabetic patients (NIDDM) we determined the glycemic index (GI) of a total of 20 foods and mixed test meals in groups of IDDM and NIDDM volunteers. The mean GI values ranged from 32 in NIDDM and 41 in IDDM (pearled barley) to 105 in NIDDM and 111 in IDDM (bread with cheese and tomato). The correlation between the mean GI values in IDDM and NIDDM was highly significant (r = 0.927, p less than 0.001). The mean GI values for 15 of the 20 test meals was greater in IDDM than in NIDDM (mean of GI for all 20 foods, 76 in IDDM compared with 68 in NIDDM, p less than 0.005). However, the difference in GI between IDDM and NIDDM was t statistically significant for 19 of the 20 individual test meals. Greater within-individual variability of glycemic responses in IDDM probably accounts for the slightly greater mean GI value seen in IDDM compared with NIDDM. The addition of 32 g cheddar cheese to four foods which were also fed without cheese had no significant effect on the GI in NIDDM (mean GI of 68 without cheese compared with 72 for the meals with cheese), but had a small effect in IDDM where the mean GI was increased from 72 to 87 (p less than 0.05). However, despite small increases in glycemic response to foods with added cheese, the relative differences between foods were unaffected by the addition of cheese in both IDDM and NIDDM. It is concluded that mean GI values for foods are very similar in IDDM and NIDDM patients.

Adult↗

Imaging studies of patients with malignant fibrous histiocytoma using C-11-alpha-aminoisobutyric acid (AIB).

Alpha-aminoisobutyric acid (AIB), a synthetic, nonmetabolized amino acid which is rapidly transported into viable cells by the A-type or alanine-preferring amino acid transport system, has been labeled with the short-lived, positron-emitting radionuclide carbon-11. Carbon-11 labeled AIB is currently being evaluated as a tumor imaging agent for in vivo amino acid transport studies in patients with cancer. In this study, C-11 AIB was used to image two patients with malignant fibrous histiocytoma (MFH), a pleomorphic sarcoma. Following intravenous administration of C-11 AIB, tumors in the distal femur of one patient and in the anterior chest wall of another patient were well visualized using high energy gamma scintigraphy. Since therapy may alter the accumulation of amino acids in tumor tissue, studies using C-11 AIB in patients with MFH before and after chemotherapy are in progress.

Adult↗

Protein factor(s) binding independently to two different regions of the adenovirus 2 major late promoter.

The protein factor(s) in a fraction from the HeLa cell nuclear extract required for specific in vitro transcription can specifically bind to adenovirus 2 major late promoter (Ad 2 MLP) DNA. We demonstrate by in vitro footprinting assay that there are two asymmetric protected regions covering the TATA box and the nucleotides upstream from the TATA box. In the coding strand, the DNAse I protected regions span from nucleotides -10 to -50 and from -52 to -68. In the noncoding strand, the protected regions span from nucleotides -10 to -32 and from -45 to -65. Using different Ad 2 MLP point mutants in this assay, we show that the transcriptional down mutants of the TATA box (AC-30 and AC-28) abolish the binding of protein factor(s) to the TATA box but do not affect binding in the upstream region. The new upstream transcriptional down mutant (TA-56) abolishes the binding of protein factor(s) in the upstream region but does not affect binding to the TATA box. The mutants which do not affect transcription efficiency (GA-51 and CG-61) do not modify the binding to either the TATA box or the upstream region. Methylation protection experiments show that the guanosines at -58 and -60 in the coding strand and at -57 (probably also -55) in the noncoding strand are in close contact with protein factor(s). The results indicate that the TATA box and its upstream region of Ad 2 MLP are independently bound by at least two different factors in vitro.

Adenoviruses, Human↗

Comparison of the efficacy and safety of esmolol, a short-acting beta blocker, with placebo in the treatment of supraventricular tachyarrhythmias. The Esmolol vs Placebo Multicenter Study Group.

The efficacy and safety of esmolol, a short-acting intravenous beta-adrenergic-blocking agent, and placebo were compared in patients with supraventricular tachyarrhythmias (heart rate greater than 120 bpm) in a multicenter, double-blind, partial-crossover study. Seventy-one patients were randomized to receive either esmolol (n = 36) or placebo (n = 35) as initial treatment. Therapeutic failures were crossed over to the other study medication. Therapeutic response was defined as greater than or equal to 20% reduction in heart rate, heart rate less than 100 bpm, or conversion to normal sinus rhythm. The therapeutic response to esmolol during the initial treatment period (72%) was similar to that obtained when esmolol was given as a second agent. The average esmolol dosage producing a therapeutic response was 97.5 micrograms/kg/min. Four patients (6%) converted to normal sinus rhythm during esmolol infusion. In the majority of patients (80%), therapeutic response was lost within 30 minutes following discontinuation of esmolol infusion, a finding indicative of rapid reversal of beta-adrenoceptor blockade. The most prevalent adverse effect during esmolol infusion was hypotension which occurred in eight patients (12%). Hypotension and associated symptoms resolved within 30 minutes after discontinuation of esmolol infusion, which is consistent with the short duration of action of esmolol (elimination half-life of 9.2 minutes).

Adrenergic beta-Antagonists↗

Collagen tubes: role in subperiosteal contour augmentation.

Collagen-contained implants of particulate hydroxylapatite (C-HA) were compared to implants of hydroxylapatite alone (HA). The collagen-contained implant was more rapidly and more firmly attached to the recipient site and demonstrated more consistent particle consolidation than implants of HA alone. Additionally, the collagen did not interfere with the favorable properties of the particulate hydroxylapatite. Results are excellent for the (C-HA) implant and warrant further investigation in both animals and in man.

Animals↗

Treatment of verapamil toxicity in intact dogs.

The treatment of verapamil toxicity was examined in lightly sedated dogs. Verapamil, administered as a bolus (0.72 mg/kg) followed by a continuous infusion (0.11 mg/kg per min), decreased cardiac output (CO) from 3.1 +/- 0.1 to 1.7 +/- 0.1 liter/min (P less than 0.001), heart rate (HR) from 85 +/- 4 to 57 +/- 3 beats/min (P less than 0.001), left ventricular derivative of pressure with respect to time (LV dP/dt) from 2,085 +/- 828 to 783 +/- 78 mm Hg/s (P less than 0.001), mean aortic pressure (AO) from 77 +/- 4 to 38 +/- 2 mm Hg (P less than 0.001) and stroke volume from 39 +/- 3 to 28 +/- 2 ml/beat (P less than 0.01). In verapamil-toxic animals isoproterenol increased HR, CO, LV dP/dt, and AO; calcium chloride increased LV dP/dt and AO; norepinephrine, epinephrine, and dopamine increased CO, AO, and LV dP/dt, atropine increased HR, CO, and AO. Phenylephrine (13-55 micrograms/kg per min) produced no changes except a small increase in AO while very high dose phenylephrine (300 micrograms/kg per min) increased AO, CO, and LV dP/dt. 4-Aminopyridine (4-AP) increased HR, CO, LV dP/dt, and AO. When administered prior to verapamil, 4-AP prevented the development of verapamil toxicity as shown by the significantly higher AO (P less than 0.001), CO (P less than 0.01), and LV dP/dt (P less than 0.01) when 4-AP followed by verapamil was compared to verapamil alone. In conclusion, there does not appear to be a single specific therapy for verapamil toxicity, however it can be partially corrected by presently available pharmacologic therapy and 4-AP.

4-Aminopyridine↗

A 10-year update of CHOP-Bleo in the treatment of diffuse large-cell lymphoma.

Long-term follow-up results of two studies using cyclophosphamide, doxorubicin, vincristine, and prednisone plus bleomycin (CHOP-Bleo) for the treatment of diffuse large-cell lymphoma are presented. Twenty-eight patients were treated with conventional-dose CHOP-Bleo and 36 patients with maximally tolerated doses of CHOP-Bleo. The maximal duration of follow-up was 10.5 years. The minimum follow-up was 5.7 years. Seventy-five percent of the conventional-dose group achieved a complete remission (CR) with a 10-year actuarial survival of 53% and a corresponding relapse-free survival (RFS) of 69% for CRs. Eighty-one percent of the high-dose group achieved CR, and the 10-year actuarial survival for all patients and RFS for CRs were 48% and 63%, respectively. The combined actuarial survival and RFS for both groups were 51% and 66%, respectively, at 10 years. For 11 patients with stage III disease, 91% achieved CR, 52% survived at 10 years, and the RFS was 67% for CRs. Seventy-five percent of 44 patients with stage IV disease achieved CR, 50% survived at 10 years, and the RFS was 67% for CRs. Three of the 16 relapses occurred late, between 30 to 65 months after initiation of therapy. Neuropathy occurred in 14 patients (22%). Five patients (8%) died of complications related to treatment. Five (8%) had clinically apparent, but nonfatal cardiopulmonary complications. The CHOP-Bleo regimen is an effective treatment for diffuse large-cell lymphoma, and is moderately well tolerated. The use of high-dose CHOP-Bleo for induction therapy did not result in any advantage after long-term follow-up.

Adolescent↗