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Biomedical subjects

S Davis

Publications and source records attributed to S Davis.

At least 379 records · Page 21Linked to original sources

Prospective randomized clinical trial of teicoplanin for empiric combined antibiotic therapy in febrile, granulocytopenic acute leukemia patients.

The increasing prevalence of bacteremia caused by gram-positive bacteria in granulocytopenic acute leukemia patients prompted us to evaluate, in a prospective randomized trial, the role of teicoplanin, a new glycopeptide antibiotic, when it was added to amikacin plus ceftazidime, as an empiric therapy of fever in these patients. Of 47 evaluable episodes, 22 were treated with the teicoplanin regimen and 25 were treated with the combination of amikacin and ceftazidime. The overall response to therapy of patients treated with teicoplanin was slightly better (82% improvement) than that obtained with amikacin plus ceftazidime (52%). The response rate of patients with gram-positive bacteremias was 80% (4 of 5) to the regimen that included teicoplanin; 25% (1 of 4) of the patients treated with amikacin plus ceftazidime responded to treatment; and for patients with gram-negative bacteremias, the response rates were, respectively, 100% (4 of 4) and 70% (7 of 10). The better results obtained with amikacin-ceftazidime-teicoplanin treatment were most evident in patients with profound (less than 100/mm3) and persistent neutropenia (83 versus 30% improvement). Furthermore, a good response rate of patients with gram-positive bacteremias (seven of eight; 87% improvement) was achieved in a small group of bone marrow transplant patients who were all treated with amikacin-ceftazidime-teicoplanin. No severe side effects were documented in any patient. Teicoplanin, as a drug administered as a single daily dose, seems to be a safe and useful anti-gram-positive agent when used in combination with amikacin-ceftazidime as an empiric therapy of febrile episodes in granulocytopenic acute leukemia patients.

Acute Disease↗

Distinct alpha-L-fucosidase isoenzyme profiles in human leukemic cells.

alpha-L-Fucosidase (EC 3.2.1.51; FUS) activity and isoenzyme characteristics were analyzed in normal lymphocytes, normal (polymorphonuclear leukocytes, PMNs), and myeloid and lymphoid leukemic cells. Chronic lymphocytic leukemia (CLL) lymphocytes had a lower mean specific activity than normal lymphocytes (2.5 vs. 4.0, p less than 0.05). Acute lymphoblastic leukemia (ALL) blasts had a higher mean specific activity compared to normal lymphocytes (9.7 vs. 4.0; p less than 0.001), CLL lymphocytes (9.7 vs. 2.5; p less than 0.001), and acute myeloid leukemic (AML) blasts (9.7 vs. 7.6; p = NS). Normal PMNs had a higher mean specific activity than normal lymphocytes (7.0 vs. 4.0; p less than 0.05) but similar activity when compared to CML cells or AML blasts. Blasts from acute myelomonocytic leukemia (AMMoL) patients had higher activity than normal PMNs (9.0 vs. 7.0; p greater than 0.05). The isoenzyme patterns of normal and leukemic granulocytes and lymphocytes were obtained by automated chromatofocusing on PBE-94 microcolumns with normal and leukemic lymphocyte lysates. With normal and leukemic lymphoid lysates two major isoenzyme components (B and A) were isolated. The isoenzyme patterns of PMN, AML, CML, and AMMoL revealed three major peaks (B, A, I), totally different from those seen in lymphoid cells. The patterns of AML, CML, and PMN appeared to be similar to each other; however, the isoenzyme pattern obtained from AMMoL cells could be distinguished from the others by a prominent I peak. Thus, the FUS isoenzyme profile distinguishes the blasts of AMMoL from AML; and AMMol and AML from ALL.

Humans↗

Pachymeningitis cervicalis hypertrophica. Case report.

The authors present the case of a 25-year-old man with idiopathic pachymeningitis hypertrophica that caused cervical radiculopathy. Decompressive surgery produced significant neurological improvement. The etiology and management of the condition are discussed and the literature is reviewed.

Adult↗

Hodgkin's disease in the United States: a comparison of patient characteristics and survival in the Centralized Cancer Patient Data System and the Surveillance, Epidemiology, and End Results Program.

Demographic, pathologic, and clinical characteristics as well as subsequent survival were compared between 3,607 Hodgkin's disease (HD) patients registered by the Surveillance, Epidemiology, and End Results (SEER) Program of the National Cancer Institute and 2,278 HD patients registered by comprehensive cancer centers (CCCs) belonging to the Centralized Cancer Patient Data System (CCPDS). All patients were diagnosed with HD between July 1977 and December 1982. CCPDS cases were slightly younger, more often of the nodular sclerosing histologic type, and presented with Stage II disease at diagnosis more often than did SEER cases. CCPDS and SEER cases were similar regarding the lymph node region of origin, sex, and race. The mortality rate among SEER patients was approximately 1.5 times that among CCPDS patients. This significant survival difference was observed within all stages and within all histologic subtypes and remained after controlling for the effects of age. Late-stage, older age, non-Caucasian race, and a more diffuse histologic appearance were all independent and significant predictors of poor survival. These findings suggest that the management of HD in CCCs results in improved outcome relative to that in the general population. Possible explanations for such effects are explored, and additional lines of pursuit are suggested.

Adolescent↗

Formaldehyde and cancers of the pharynx, sinus and nasal cavity: I. Occupational exposures.

A population-based case-control study was undertaken in 13 counties of western Washington to determine if occupational formaldehyde exposure was related to cancer of the oro- and hypopharynx (OHPC, N = 205), nasopharynx (NPC, N = 27) or sinus and nasal cavity (SNC, N = 53). Controls were selected by random digit dialing (N = 552). A telephone interview inquired about lifetime occupational history as well as a number of potential confounding factors, including smoking and drinking. Approximately half (N = 143) of the case interviews were with next-of-kin. Occupational formaldehyde exposures were assessed by application of job-exposure matrix developed for this study which classified unique job codes into 4 categories based on judgement of likelihood and intensity of formaldehyde exposure. Exposure scores were calculated by weighing the number of years in a formaldehyde-associated job by the assigned exposure level. The effects assuming a 15-year induction period were also investigated. Logistic regression was used to estimate exposure odds ratios (OR) while taking into account multiple risk factors for each site. No significant associations were found between occupational formaldehyde exposure and any of the cancer sites under study. However, relative risk estimates associated with the highest exposure score categories were elevated for OHPC (OR = 1.3, 95% Confidence Interval = 0.6-3.1) and NPC (OR = 2.1, 95% CI = 0.4-10.0) when an induction period was accounted for. When only live interviews were considered, the odds ratios for OHPC and NPC increased to 1.7 and 3.1 respectively. Several limitations in the study tend to conservatively bias the results and must be taken into account in its interpretation.

Adenocarcinoma↗

Formaldehyde and cancers of the pharynx, sinus and nasal cavity: II. Residential exposures.

To investigate the possible association between residential formaldehyde exposures and risk of cancer of the oro- and hypopharynx (OHPC, N = 205), nasopharynx (NPC, N = 27) and sinus and nasal cavity (SNC, N = 53), a population-based case-control investigation was carried out in 13 counties of western Washington. Controls (N = 552) were selected by random digit dialing. Subjects' residential histories, including type of dwelling, were determined from a structured telephone interview which also collected smoking, alcohol and demographic information. Multiple logistic regression was used to estimate exposure odds ratios (OR) while adjusting for known risk factors. A strong association was found between a history of having lived in a mobile home and NPC, but not OHPC or SNC. The NPC risk increased with the number of years lived in a mobile home: for those with 1 to 9 years the OR = 2.1 (95% confidence interval = 0.7-6.6), and for those with 10 or more years, the OR = 5.5 (95% CI = 1.6-19.4). No associations were found between any of the cancers and a history of exposure to new constructions containing particle board and plywood, or to urea-formaldehyde foam insulation. The association found with living in a mobile home must be interpreted with caution since it is based on a small number of cases, and may be due to factors other than formaldehyde. This report emphasizes the need for additional studies focusing on potential associations between indoor air pollutants and respiratory cancers.

Adult↗

Cisplatin, etoposide, and mitomycin in the treatment of non-small cell carcinoma of the lung. A pilot study.

A total of 39 patients with non-small cell carcinoma of the lung (NSCL) were treated with cisplatin, etoposide, and mitomycin. A major response rate (complete response + partial response) was seen in 15 patients (39%). Median survival for all patients was 340 days; median survival of the responding group was 514 days. Toxic effects included moderate hematologic toxicity, nausea, and vomiting. There were no treatment-related deaths. This regimen clearly is effective in treating NSCL.

Adenocarcinoma↗

Case aggregation in young adult Hodgkin's disease. Etiologic evidence from a population experience.

There is evidence to suggest that young adult Hodgkin's Disease (HD) may be initiated by an infectious process and that age at exposure to the etiologic infection is an important modifier of risk. There is little evidence, however, to suggest that HD is transmissible through interpersonal contact. To evaluate this hypothesis, a population-based case-control study was conducted with 103 HD cases diagnosed between January 1, 1974 and June 30, 1979 in King County, Washington. Its purpose was to determine whether cases aggregate before clinical disease through interpersonal contact in either school or employment settings to a greater degree than would be expected in the general population. One control was randomly selected for each case of the same sex, approximate age, and general socioeconomic level. Results showed no indication of case aggregation in employment settings (observed/expected = 0.77; P = 0.77). Case contact was greater than would be expected in schools (observed/expected = 1.2; P = 0.07), particularly in grade schools (observed/expected = 1.94; P = 0.009). This finding is consistent with the possibility that HD is dependent on age at exposure, has an infectious origin, and can be transmitted horizontally in select circumstances. Additional research possibilities are recommended as suggested by these data.

Adolescent↗

Vindesine and mitomycin C in chemotherapy: refractory advanced breast cancer.

Thirty-five unselected postmenopausal women with metastatic breast carcinoma, refractory to hormonal manipulation and/or chemotherapy, were treated with vindesine (3 mg/m2 day 1, then weekly for 6 weeks, then every other week) and mitomycin (12 mg/m2 day 1, then every 6 weeks). Thirty-one patients were evaluable for response. Two patients obtained a complete response (CR), three patients a partial response. Duration of the response in the two patients with CR was 24 and 16 months, respectively. Toxicity was mild, consisting of leukopenia and neurologic toxicity. Thrombocytopenia was not a significant clinical problem. Vindesine with mitomycin C, as administered in this study, is a safe, but marginally effective regimen for previously treated patients with metastatic breast cancer.

Adult↗

Non-human primate (baboon) anti-carcinoembryonic antigen antibody infusion in patients with metastatic adenocarcinoma. A phase I study.

A total of 14 patients with advanced visceral carcinoma which produced carcinoembryonic antigen (CEA) were treated in a Phase I study with IV infusion of affinity purified baboon anti-CEA antibody (dosage range from 0.1 to 2 mg/kg body weight). In all 14 patients, the antibody infusion caused a decrease (26% to 97%) in the plasma level of CEA. The degree of decrease depended upon the patients initial CEA level and the amount of antibody given. In 12 of the 14 patients "free" circulating antibody was observed. The plasma half-life of the antibody ranged from 0.7 to 21 h and the duration of detectable free antibody ranged from 3 to 216 h postinfusion. No toxicity was observed for the dosage range of antibody tested. In 9 of the 14 patients a low titer anti-baboon antibody response occurred between 14 and 28 days postinfusion. No clinical regression of carcinoma was documented. In 7 of the 14 patients disease remained stable during the 28-day study period. By the end of the 28-day study period plasma CEA levels had returned to at least the preinfusion level in 11 of the 14 patients.

Adenocarcinoma↗

Non-human primate (baboon) anti-gross cystic disease fluid protein-15 antibody infusion in four women with metastatic breast carcinoma.

Four women with metastatic breast carcinoma and elevated plasma levels of human breast gross cystic disease fluid protein of 15,000 dalton monomer size (GCDFP-15) were treated IV with non-human primate (baboon) anti-GCDFP-15 antibody. Three patients were given a single IV infusion of antibody, while the fourth patient received four sequential IV infusions. Antibody dosage patients, after antibody infusion the plasma level of GCDFP-15 decreased to 0 ng/ml and remained there as long as "free" circulating anti-GCDFP-15 antibody was present. The plasma half-life of the antibody ranged between 1 and 40 h and the duration of detectable free antibody ranged from 6 to 240 h. No toxicity was observed for the dosage range of antibody tested. No anti-baboon antibody response was detected. In the patient who received four sequential infusions of antibody partial regression of subcutaneous metastatic nodules occurred. The other three patients showed no clinically detectable changes from the antibody infusion.

Animals↗

Immunologic studies of peripheral blood from patients with idiopathic dilated cardiomyopathy.

Immune function, T-lymphocyte subsets, serum quantitative immunoglobulin levels, serum lysozyme levels, and circulating immune complex levels were analyzed in patients with idiopathic dilated cardiomyopathy (IDCM). The percentage of helper/inducer T cells (OKT4) was higher and the percentage of suppressor/cytotoxic T cells (OKT8) was lower in IDCM patients than in healthy controls and in patients with ischemic heart disease. IDCM patients, in addition, have higher 5/9+ T cells, a T-cell subset known to give maximal helper activity in B-cell differentiation assays. Peripheral blood mononuclear cells (PBMC) from IDCM patients demonstrated a statistically greater ability to induce B-cell differentiation (helper T-cell function) into plasma cells and a hypofunctioning suppressor T-cell population in an in vitro pokeweed nitrogen (PWN)-driven B-cell differentiation assay. Serum immunoglobulin IgM levels were higher in IDCM patients, but serum lysozyme levels and serum immune complex levels in IDCM patients were normal. These data verify that an immunoregulatory defect exists in IDCM.

Adult↗

Alteration of beta-hexosaminidase activity and isoenzymes in human leukemic cells.

beta-Hexosaminidase (EC 3.2.1.20; Hex) activity and isoenzyme characteristics were analyzed in human normal and leukemic leukocytes. Unseparated CLL and CML cells had a specific activity that was lower, whereas ALL and AML blasts had a higher specific activity than normal lymphocytes and granulocytes. CLL B-cells had a lower specific activity compared with that in normal non-T-lymphocytes; CLL T-cells and normal T-cells had similar activity. Isoenzyme separation was performed by chromatofocusing on PBE-94 coupled with an automated enzyme assay. When using a single linear pH elution gradient, normal leukocytes and all leukemia cells contained two forms of isoenzyme (B and A). When a double pH elution gradient was performed, an extra distinct form of Hex (I) was recorded. Hex I was present in small amounts in normal granulocytes and PHA-stimulated normal lymphocytes; isoenzyme I was found in high amounts in all leukemias tested. The activity ratios I/B and I/A, as well as the I isoenzyme profile, may facilitate differentiation between normal and leukemic cells and between lymphoblastic and myeloblastic leukemias.

B-Lymphocytes↗

Responses of Adaxial and Abaxial Stomata of Normally Oriented and Inverted Leaves of Vicia faba L. to Light.

Stomatal conductances of normally oriented and inverted leaves were measured as light levels (photosynthetic photon flux densities) were increased to determine whether abaxial stomata of Vicia faba leaves were more sensitive to light than adaxial stomata. Light levels were increased over uniform populations of leaves of plants grown in an environmental chamber. Adaxial stomata of inverted leaves reached maximum water vapor conductances at a light level of 60 micromoles per square meter per second, the same light level at which abaxial stomata of normally oriented leaves reached maximum conductances. Abaxial stomata of inverted leaves reached maximum conductances at a light level of 500 micromoles per square meter per second, the same light level at which adaxial stomata of normally oriented leaves reached maximum conductances. Maximum conductances in both normally oriented and inverted leaves were about 200 millimoles per square meter per second for adaxial stomata and 330 millimoles per square meter per second for abaxial stomata. Regardless of whether leaves were normally oriented or inverted, when light levels were increased to values high enough that upper leaf surfaces reached maximum conductances (about 500 micromoles per square meter per second), light levels incident on lower, shaded leaf surfaces were just sufficient (about 60 micromoles per square meter per second) for stomata of those surfaces to reach maximum conductances. This ;coordinated' stomatal opening on the separate epidermes resulted in total leaf conductances for normally oriented and inverted leaves that were the same at any given light level. We conclude that stomata in abaxial epidermes of intact Vicia leaves are not more sensitive to light than those in adaxial epidermes, and that stomata in leaves of this plant do not respond to light alone. Additional factors in bulk leaf tissue probably produce coordinated stomatal opening on upper and lower leaf epidermes to optimally meet photosynthetic requirements of the whole leaf for CO(2).

Journal Article↗

Recombination aneusomy of chromosome 5 associated with multiple severe congenital malformations.

A male infant is described in whom congenital anomalies were recognized prenatally by ultrasound examination. The infant was delivered following spontaneous labor and died approximately 15 min after birth. An autopsy revealed major anomalies in the central nervous system (holoprosencephaly with premaxillary agenesis), the gastrointestinal system (esophageal atresia) and the heart (tetralogy of Fallot). Chromosomal studies revealed recombinant chromosome 5 [46,XY, rec(5), dup q, inv(5)(p15q32)], resulting in partial trisomy 5q and partial monosomy 5p. Cytogenetic investigation of the family revealed a pericentric inversion of chromosome 5 in the father and paternal grandmother, 46,XY (and XX, respectively,) inv(5)(p15q32). The congenital anomalies in this infant are more extensive and severe than previously reported in cases of recombination aneusomy involving chromosome 5.

Abnormalities, Multiple↗