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Biomedical subjects

S J Soong

Publications and source records attributed to S J Soong.

15 recordsLinked to original sources
PubMed1992

Oral folic acid supplementation for cervical dysplasia: a clinical intervention trial.

OBJECTIVE: We attempted to evaluate the effect of oral folic acid supplementation on the course of cervical dysplasia. STUDY DESIGN: A total of 235 subjects with grade 1 or 2 cervical intraepithelial neoplasia were randomly assigned to receive either 10 mg of folic acid or a placebo daily for 6 months. Clinical status, human papillomavirus type 16 infection, and blood folate levels were monitored at 2-month intervals. Outcome data were subjected to chi 2 analysis. RESULTS: The prevalence of human papillomavirus type 16 infection initially was 16% among subjects in the upper tertile of red blood cell folate versus 37% in the lower tertile (trend p = 0.035). After 6 months no significant differences were observed between supplemented and unsupplemented subjects regarding dysplasia status, biopsy results, or prevalence of human papillomavirus type 16 infection. CONCLUSION: Folate deficiency may be involved as a cocarcinogen during the initiation of cervical dysplasia, but folic acid supplements do not alter the course of established disease.

Administration, Oral↗
PubMed1992

Second-look laparotomy and salvage therapy: a research modality only?

Two hundred twelve patients who underwent second-look laparotomy as part of their treatment for epithelial ovarian cancer were evaluated. Factors associated with positive second looks were initial stage, tumor grade, age, and residual disease (P less than 0.05). One factor not of significance was whether adjuvant therapy was platinum based. Initial stage only was associated with recurrence after a negative second look (P less than 0.001). When controlled for volume of disease no difference in survival between various salvage therapies could be demonstrated. Survival between patients with recurrence after negative second look and patients with microscopic residual disease was similar even though the former group was not treated until recurrence (P = 0.75). Second-look laparotomy does not improve survival with currently existing salvage modalities and should primarily be confined to those patients willing to participate in research protocols evaluating new second-line therapy.

Adult↗
PubMed1979

Sequential appearance of auto-erythrocyte antibody immunoglobulin classes with age.

The autoimmune, short-lived, NZB/BINJ mice were followed for the changes taking place in the number of thymic and splenic nucleated cells from day 1 up to 12 mo of age. The long-lived C57BL/6J mice were monitored in parallel with the NZB mice to see whether similar changes were reflected. Both strains of mice were investigated for the sequential appearance of anti-erythrocyte autoantibody classes by the direct Coombs' agglutination test. IgG1 was the first class of antibody detected on the erythrocytes and was followed by IgG3, IgG2 and IgA, simultaneously. IgM was the last antibody to react with erythrocytes. The C57BL strain had a very small number of mice with low levels of IgG1 antibody on erythrocytes throughout the study.

Aging↗
PubMed1979

A multifactorial analysis of melanoma. II. Prognostic factors in patients with stage I (localized) melanoma.

Stage I melanoma encompasses an extraordinary diversity of biologic behavior. In such a setting where numerous parameters appear to influence survival, a multifactorial analysis using Cox's regression model is a valuable statistical model. Using a computerized data base of 394 clinical stage I melanoma patients treated at this institution during the past 20 years, a multifactorial analysis was used to compare the relative prognostic strength of 11 parameters. Two pathological factors (tumor thickness and ulceration) and two clinial factors (initial surgical treatment and anatomic location) were identified as the dominant prognostic variables. Other factors examined simultaneously that did not provide additional predictive influence on survival included the level of invasion, pigmentation, growth pattern, lymphocyte infiltration, pathological state, sex, and age. Melanoma thickness was the most important factor for predicting survival in patients with stage I melanoma (P less than 10(-8). This parameter is easy to measure and provides a quantitative estimate of clinically occult regional and distant metastases. Contrary to other reports using single factor analysis, the type of initial surgical treatment, in fact, did influence survival after other variables were taken into consideration. Thus the multifactorial analysis supports the observation that patients with intermediate thickness melanoma thickness of 1.5 to 3.99 mm had a 78% 8-year survival rate with wide excision of the melanoma and elective node dissection, while none survived more than 8 years if a melanoma of the same thickness was only widely excised. Multifactorial analysis is a useful and important statistical method when comparing treatment alternatives and prognostic factors in patients with melanoma.

Adult↗
PubMed1978

Productive infection with cytomegalovirus and herpes simplex virus in renal transplant recipients: role of source of kidney.

Forty patients were prospectively studied for infection with cytomegalovirus (CMV) and herpes simplex virus (HSV) after renal transplantation. Although 85% had antibody to CMV and 95% had antibody to HSV prior to transplantation, excretion of CMV was found in 92.5%, usually as viruria, and HSV was recovered from 70%, most often from the oropharynx. Shedding of HSV reached a peak within the first month after transplantation when immunosuppression was most intense and then rapidly declined. In contrast, excretion of CMV was found in a greater proportion of patients during each interval up to about six months after transplantation and subsequently persisted in the majority of patients. Both serologic responses and viral isolation rates indicated more rapid activation of CMV but not of HSV in recipients of kidneys from cadavers than in patients who received kidneys from living related donors. At 60 days after transplantation, 76% of the recipients of kidneys from cadavers and only 33% of the recipients of kidneys from living, related donors had shed CMV (P = 0.003). These differences could not be accounted for by immunosuppressive treatment. Excretion of HSV was clearly associated with the time of most intense immunosuppression, but the major factor in initiation and maintenance of productive infection with CMV appeared to be the host vs. graft reaction.

Antibodies, Viral↗
PubMed1978

A multifactorial analysis of melanoma: prognostic histopathological features comparing Clark's and Breslow's staging methods.

A multifactorial analysis was used to identify the dominant prognostic variables affecting survival from a computerized data base of 339 melanoma patients treated at this institution during the past 17 years. Five of the 13 parameters examined simultaneously were found to independently influence five year survival rates: 1) pathological stage (I vs II, p = 0.0014), 2) lesion ulceration (present vs absent, p = 0.006), 3) surgical treatment (wide excision vs wide excision plus lymphadenectomy, p = 0.024), 4) melanoma thickness (p = 0.032), and 5) location (upper extremity vs lower extremity vs trunk vs head and neck, p = 0.038). Additional factors considered that had either indirect or no influence on survival rates were clinical stage of disease, age, sex, level of invasion, pigmentation, lymphocyte infiltration, growth pattern, and regression. Most of these latter variables derived their prognostic value from correlation with melanoma thickness, except sex which correlated with location (extremity lesions were more frequent on females, trunk lesions on males). This statistical analysis enabled us to derive a mathematical equation for predicting an individual patient's probability of five year survival. Three categories of risk were delineated by measuring tumor thickness (Breslow microstaging) in Stage I patients: 1) thin melanomas (<0.76 mm) were associated with localized disease and a 100% cure rate: 2) intermediate thickness melanomas (0.76-4.00 mm) had an increasing risk (up to 80%) of harboring regional and/or distant metastases and 3) thick melanomas (>/=4.00 mm) had a 80% risk of occult distant metastases at the time of initial presentation. The level of invasion (Clark's microstaging) correlated with survival, but was less predictive than measuring tumor thickness. Within each of Clark's Level II, III and IV groups, there were gradations of thickness with statistically different survival rates. Both microstaging methods (Breslow and Clark) were less predictive factors in patients with lymph node or distant metastases. Clinical trials evaluating alternative surgical treatments or adjunctive therapy modalities for melanoma patients should incorporate these parameters into their assessment, especially in Stage I (localized) disease where tumor thickness and the anatomical site of the primary melanoma are dominant prognostic factors.

Aged↗
PubMed1978

Southern Regional Trophoblastic Disease Center, 1972--1977.

The experience of the Southern Regional Trophoblastic Disease Center includes 222 patients who were referred from January 1972 to October 1977. The initial tissue diagnosis was hydatidiform mole in 212 patients and choriocarcinoma in ten. There was spontaneous remission of 142 (69%) of the moles and one of the choriocarcinomas, and 77 patients developed persistent trophoblastic disease. Of these, 58 had no evidence of metastasis, and all achieved remission with single-drug therapy. Nineteen patients developed metastases; 13 were in the "good prognosis" category, and all achieved remission with single-drug therapy. Five (83%) of the six patients with metastases in the "poor prognosis" group achieved remission with triple chemotherapy; one died of her disease.

Cancer Care Facilities↗
PubMed1977

Adenine arabinoside therapy of biopsy-proved herpes simplex encephalitis. National Institute of Allergy and Infectious Diseases collaborative antiviral study.

We evaluated adenine arabinoside (vidarabine) for treatment of herpes simplex encephalitis in a placebo-controlled study. In 28 cases proved by isolation of Type 1 virus from brain biopsy, treatment reduced mortality from 70 to 28 per cent (P = 0.03), and over 50 per cent of treated survivors had no or only moderately debilitating neurologic sequelae. This improvement was achieved without evidence of acute drug toxicity. Thus, adenine arabinoside has a good therapeutic index (efficacy/toxicity) for the treatment of Type 1 herpes simplex encephalitis. However, the drug must be given early in the course of infection before the advent of coma to have a beneficial effect. Moreover, it should be coupled with brain biopsy for specific diagnosis to avoid unnecessary treatment of nonresponsive encephalitides that can mimic herpes simplex.

Biopsy↗
PubMed1977

An experimental approach to relate a tumor-associated enzyme marker to tumor cell numbers.

Alkaline phosphatase was monitored in 17 mice with s.c.-implanted tumors to relate the total circulating alkaline phosphatase to the total number of tumor cells in each mouse. There was a semilogarithmic relationship between the alkaline phosphatase units and the number of tumor cells. A time-independent standard plot of alkaline phosphatase and the number of tumor cells was used to estimate the size of disseminated and localized tumors. In animals treated with cyclophosphamide, the alkaline phosphatase marker was used to monitor the regression and recurrence of the neoplasm in vivo.

Alkaline Phosphatase↗
PubMed1977

Gallbladder bile composition in different ethnic groups.

A total of 194 gallbladder biles from various ethnic groups were analyzed for their composition. The solubility of cholesterol in bile was determined mainly by its relative amounts of phospholipid and bile salt present. Bile from patients with gallstones was usually supersaturated with cholesterol above the boundary of the metastable state. Biles from normal white subjects of Finland, New Zealand, and the United States were already in the metastable state of supersaturation with cholesterol. The Masai of East Africa and black subjects of the Unites States had a bile level below the limit of maximum cholesterol solubility. This study indicates that the difference in the prevalence of cholesterol cholelithiasis in various ethnic groups was related to the difference in their bile compontified factors.

Black or African American↗
PubMed1976

Prognosis in adult acute myelogenous leukemia related to performance status and other factors.

Pretreatment factors of prognostic value were sought in 54 consecutively treated cases of adult acute myelogenous leukemia. Twenty of 37 patients with a good (greater than 50%) pretreatment Karnofsky performance status (P.S.) achieved complete remission (C.R.), while only 1/17 with a poor P.S. achieved C.R. This difference was highly significant (p=0.004). Complete remissions correlated with a median survival of 21 months. Patients with a good P.S. had a median survival of 8 months, while those with a poor P.S. had a median survival of only 1 month. This difference was also highly significant (p less than 0.002). Older patients with a good P.S. did as well as younger patients. The P.S., although imprecise, undoubtedly reflects the extent to which the disease, as well as intercurrent problems, have affected the patient. Attention to this aspect of patient selection for current drug regimens is indicated.

Adult↗
PubMedDate not supplied

Pharmacokinetics and tissue distribution of 2-fluoro-beta-alanine in rats. Potential relevance to toxicity pattern of 5-fluorouracil.

Clinical pharmacokinetic studies in our laboratory demonstrated that 2-fluoro-beta-alanine (FBAL), the major catabolite of fluorouracil (FUra), has a prolonged elimination with an approximately 150-fold longer half-life than that of the unchanged drug in humans [Heggie et al.: Cancer Res. 47, 2203-2206 (1987)]. Recent studies have suggested that FUra catabolites, such as FBAL, may have a role in neurotoxicity and cardiotoxicity that may occur during FUra chemotherapy [Okada et al.: Acta Neuropathol. 81, 66-73 (1990)]. This study was undertaken to determine the kinetics and tissue distribution of FBAL in rats following iv bolus administration of radiolabeled FBAL. Plasma disappearance curves for FBAL could be described by the sum of three exponentials, with half-lives of 0.26, 12.1, and 8426 min. Radioactivity, consisting mainly of FBAL-bile acid conjugates, was excreted in bile within 30 sec of iv bolus administration of FBAL and continued throughout the experimental period at concentrations 10-100-fold higher than that of the corresponding plasma level. Urinary excretion, consisting mainly of free FBAL, represented the major pathway of elimination of FBAL, with 40% of the administered dose excreted within 24 hr and approximately 70% over 192 hr. Fecal excretion was a minor pathway of elimination of FBAL, with approximately 10% of the administered dose excreted over 192 hr. During the initial 30 min, the highest levels of tissue radioactivity were found in the kidneys, liver, spleen, lungs, and heart. Radioactivity was retained over longer time periods in the enterohepatic circulation, central nervous system, heart, and skeletal muscle.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗