Behaviour of the pertechnetate ion in humans.
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Biomedical subjects
Publications and source records attributed to S K Shukla.
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This is a retrospective study of 14 patients with lymphosarcoma with hypersplenism. Eight patients received radiation to the spleen followed by splenectomy for recurrence of hypersplenism. Six patients underwent primary splenectomy for hypersplenism. Radiation decreases the size of the spleen but recurrence of hypersplenism is seen in an average of 8 mo. Splenectomy in these cases improves the hematological picture. Average postsplenectomy survival is 27.6 mo. Splenectomy alone in hypersplenism also improves the hematological picture. Postsplenectomy survival in this group is 13 mo. One case of primary lymphosarcoma of the spleen is reported.
We treated 50 patients with stage D carcinoma of the prostate with 15 mg. per kg. per day oral estramustine phosphate for 3 to 24 months. We are able to evaluate 44 patients. Objective remissions were induced in 8 of the 44 patients (19 per cent) and subjective remission occurred in all objective responders and in 7 additional patients for a subjective response of 15 of 44 (36 per cent). No hematologic or renal toxicity was encountered. Transient nausea occurred early in half of the patients and was dose limiting in 3 patients. One case of hepatic toxicity was seen. Oral estramustine phosphate is well tolerated and long-term therapy is feasible.
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Seventy-two pathological fractures associated with tumors other than carcinoma of the breast in the long bones of the extremities of sixty patients were treated over a five-year period at Roswell Park Memorial Institute. Pain was relieved in 91 per cent of the patients treated by internal fixation, in 59 per cent of those treated by irradiation, and in 45 per cent of those treated by other means. Among patients with lower-extremity fractures, 61 per cent of those treated by internal fixation became ambulatory, whereas only 23 per cent of those treated by other methods were able to walk. Internal fixation of these pathological fractures appeared to be the best treatment.
The records of 12 patients with primary malignant neoplasms of the duodenum, excluding ampullary lesions, have been studied. There were eight adenocarcinomas and four leiomyosarcomas. The second portion of the duodenum was the most common site for these neoplasms. Common symptoms were epigastric pain; obstructive symptoms, such as nausea and vomiting; obstructive jaundice, and hematemesis. Hematemesis is the most common symptom in leiomyosarcoma of the duodenum. The mean duration of symptoms was six months for leiomyosarcoma and 3.2 months for adenocarcinoma. In five patients, excision of the tumor was carried out more frequently for those in the distal portion of the duodenum. More radical procedures, such as pancreaticoduodenectomy, are the treatment of choice in neoplasms of the second portion of the duodenum. A bypass procedure is done for palliation of intestinal obstruction. Three patients with leiomyosarcomas that were resected had a mean survival time of 51 months. On the other hand, patients with adenocarcinomas that were resected had a mean survival time of nine months, while patients with unresectable tumors had a mean survival time of 2.3 months.
Twenty-eight patients with inoperable or metastatic carcinoma of the lung who failed to respond to conventional chemotherapy and/or radiotherapy were entered in this study. All of them received repeated courses of multiple chemotherapy (cyclophosphamide, 5-fluorouracil, 6-thioguanine, methotrexate, and vincristine) with or without concurrent intravenous heparin anticoagulation. No tumor regression was noted in any of the 14 patients who received the multiple chemotherapy only. On the contrary, tumor progression was seen in all of them, and subsequently 12 died of their disease. The other 14 patients were anticoagulated with heparin, then received the same multiple chemotherapeutics while anticoagulated. Over 50% tumor regression was noted clinically and radiologically, and occasionally demonstrated histologically in 7 of them. Two patients in this group are alive and well for 1 1/2 years. No increase in toxicity or metastases was noted. The 2 patients who had progression of their disease while on the multiple chemotherapy program alone showed tumor regression when they received the same chemotherapy after heparinization.
Serum acid phosphatase activity, urinary total cholesterol, and ratio of deoxy to oxy urinary 17-ketosteroids were measured in a group of 42 patients with prostatic carcinoma and in a group of 14 age-matched normal healthy individuals. Our purpose was to evaluate whether or not the simultaneous determinations of these tests would increase the rate of detection obtained by the single assay alone. The results of single assay revealed for the following detection rate: 67 per cent (28 of 42 patients) for serum acid phosphatase, 62 per cent for urinary total cholesterol, and 22 per cent for ratio of 17-ketosteroids. A significant increase of detection rate was observed when simultaneous determinations of two assays were performed; 86 per cent for serum acid phosphatase activity and total urinary cholesterol; 74 per cent for serum acid phosphatase and ratio of 17-ketosteroids; and 74 per cent for total urinary cholesterol and ratio of 17-ketosteroids. A detection rate of 88 per cent (37 of 42 patients) was obtained as all three assays were analyzed, though it was not significantly different from a ratio of 86 per cent for simultaneous assays of acid phosphatase and total cholesterol. It was concluded that simultaneous determinations of serum acid phosphatase activity, urinary total cholesterol, and androgens are of values in diagnosis for patients with prostatic neoplasia.
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In the present work, we report conversion of fluoxetine (Prozac), a novel anti depressant to N-methyl fluoxetine in formalin fixed liver tissue. Earlier studies indicate that drugs containing secondary amino group will react with formalin to form corresponding N-methyl derivatives. Even though embalming cadavers is common, it may create problems for forensic toxicologists if a case was not previously suspected. In formalin solutions, fluoxetine is methylated producing N-methyl fluoxetine. N-Methyl fluoxetine standard was synthesized by treating fluoxetine in formaldehyde solution. The structure confirmed by (1)HNMR and gas chromatography-mass spectrometry in electron impact ionization mode. Randomly chosen rat liver pieces (200-250 mg) were injected with 100 microg of Fluoxetine. The liver pieces were covered with three different concentrations of formalin, 5%, 10%, and 20%, and at three different pHs, 3.0, 7.0, and 9.5. The reaction was studied for a total period of 30 days, and the reaction products were monitored on days 0, 4, 14, and 30 days. The study indicates that the rate of conversion of fluoxetine to its N-methyl derivative increased with increase in the concentration of formalin and pH of the solution. The conversion is rapid at higher pH values. Fluoxetine was totally converted to its N-methyl derivatives after 30 days in 20% formalin at pH 9.5. Therefore, analysis for parent drug or its N-methyl derivative in embalmed tissues may provide data that will reduce the likelihood of false negatives.
More than 90% of a breeding colony of clawed frogs (Xenopus tropicalis) imported to the United States from western Africa died in an epizootic of chlamydiosis. Chlamydial inclusions were observed by light and electron microscopy in the liver of an infected frog. Chlamydia pneumoniae was isolated in cell cultures from four frogs. A cutaneous infection by a chytridiomycete fungus observed in two frogs could have been a cofactor in the die-off.ous Diseases