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Biomedical subjects

S K Shukla

Publications and source records attributed to S K Shukla.

64 records · Page 4Linked to original sources
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Oral estramustine phosphate (NSC-89199) in the treatment of advanced (stage D) carcinoma of the prostate.

Thirty-two patients with stage D carcinoma of the prostate were treated with oral estramustine phosphate at a dose of 15 mg/kg/day from 3 to 15 months. Objective remissions, reduction of greater than 50 percent of measurable lesions such as soft tissue masses, lymph nodes, and prostatic masses, were seen in seven of 32 patients (22 percent response rate). Subjective response, ie, relief of pain, weight gain, sense of well being, snd improved performance status, occurred in all objective responders and in seven other patients with stable disease (15 of 32 patients = 47 percent). No hematologic, hepatic, or renal toxic effects were observed. Transient nausea occurred early in one half of the patients and nausea and vomiting was dose limiting in only two patients. Oral estramustine phosphate is well tolerated and worthy of further clinical use.

Acid Phosphatase↗
PubMedDate not supplied

Complete intraventricular dissociation. Electrocardiographic manifestation of a rare intracardiac complete dissociation.

Complete Intraventricular Dissociation manifesting as dual ventricular rhythm was observed on surface electrocardiography in two middle-aged males with acute myocardial infarction. The first patient had a dominant accelerated (AV) junctional rhythm, and there was a sudden emergence of an additional independent slow and regular idioventricular escape rhythm. These ventricular complexes were bizarre and markedly widened, waveform with prolonged undulating electric potentials. In the second case, the emergence of a dominant idioventricular rhythm was coexistent with an additional independent escape rhythm with monophasic wider agonal ventricular complexes. Terminal tracings recorded later were essentially the same, except that an ill sustained ventricular fibrillation had replaced the ectopic agonal beats, and there was an enhanced automaticity in the dominant ventricular part. The sites of ectopic ventricular rhythms were thought to be in the ischaemic damaged ventricular myocardium, with a surrounding zone of conduction block.

Adult↗
PubMedDate not supplied

Rhenium-186-HEDP palliative treatment in disseminated bone metastases due to prostate cancer.

Prostate carcinoma is the most commonly associated with osseous metastases malignancy in males. The lesions, being usually of a mixed sclerotic/lytic variety and less often of the pure sclerotic type, need to be treated by a bone seeking radioactive element with an as low as possible radiobiological burden on the surrounding (peritumoral) tissues. Rhenium-186-HEDP was used to treat these osseous metastatic lesions due to its bone seeking kinetics attractive radiochemical properties. Of a total of 16 prostate cancer patients. 3 experiment loss of pain, 8 experienced obvious and 2 some improvement. No change was observed in 3 patients. Ten patients manifested a flare syndrome increasing pain approximately 2 to 6 days, after Re-186-HEDP i.v. application. Six patients showed a definite and 9 a slight decrease in platelet levels and absolute number of polymorphonuclear white blood cells, up to fourth week following treatment. One patient underwent a whole blood transfusion and in 2 peripheral neuropathy was observed lasting about 9 to 12 days. Re-186-HEDP appears to be a promising new metal ion complex for the palliation of painful bone metastases in prostate cancer. Compared to Sr-89 therapy, it shows a longer analgetic efficacy and has the advantage of emitting gamma rays, a fact which facilitates dosimetric calculations.

Aged↗
PubMedDate not supplied

Renal cell carcinoma detection and systemic therapy with tumour-affine gallium-67 and with yttrium-90 citrate solutions.

BACKGROUND: There have been no major advances in the systemic detection of renal cell carcinoma (RCC) and its unpredictable metastases. Surgery, thus, remains the mainstay of the curative treatment for the localized disease. The propose of the present study has been to systemically detect and treat advanced RCC respectively with Ga-67 and Y-90 radiopharmaceuticals containing tumour-affine species. PATIENTS AND METHODS: Thirty-three RCC patients were imaged with Tc-99m-MDP and then with Ga-67 citrate solution in order to detect RCC and its metastases. Yttrium-90 citrate solution, containing the radionuclide species chromatographically and electrophoretically identical to those in RCC-affine Ga-67 solution, was administered i.v. for systemic therapy of advanced RCC. Total-body distribution of Y-90 was studied with a gamma-camera equipped with an ultra-high-sensitivity collimator. The efficacy of the therapy was studied by the clinical condition of the patient and by the total-body scintigraphic imaging with Tc-99m-MDP and with Ga-67 citrate solution. RESULTS: Ga-67 detects RCC bone metastases better than Tc-99m-MDP. Systemic therapy of RCC metastasized to bones, lung and brain was obtained with RCC-affine Y-90 citrate solution. CONCLUSIONS: Third group metal radionuclides, Ga-67 and Y-90, detect and treat advanced RCC.

Adult↗
PubMedDate not supplied

Advanced prostate cancer diagnosis and therapy with gallium-67 and yttrium-90, respectively.

BACKGROUND: Androgen deprivation therapy remains so far the mainstay of advanced prostate cancer treatment. Although it improves the quality of life of the patient for some time, the disease progresses and soon it becomes hormonally unresponsive. The object of our research has been to find a systemic therapy for prostate cancer patients whose disease no longer responds to hormone therapy, radiation therapy, chemotherapy and immunotherapy. PATIENTS AND METHODS: Thirty-one advanced prostate cancer patients with intense bone metastasis pain, bed ridden, and with permanent urinary catheter were first examined with Ga-67 and then treated with Y-90 solutions which were chromatographically and electrophoretically analysed for the presence of both cationic and anionic species of the radionuclide. The quality of life and prostate specific antigen (PSA values) values were followed for testing the success of the therapy. RESULTS: Prostate cancer-affine Y-90 cured the advanced prostate cancer patients who regained their normal life. The uptake of the radionuclide in the primary cancer and its metastases responsible for the treatment has been confirmed by scintigraphy. CONCLUSIONS: Prostate cancer-affine Y-90 solution, containing stable cationic and anionic species of the radionuclide, is effective in the cure of advanced prostate cancer patients.

Aged↗
PubMedDate not supplied

Palliative therapy using rhenium-186-HEDP in painful breast osseous metastases.

The efficacy and toxicity of treatment with 1400 +/- 100 MBq of Re-186-HEDP were evaluated in women with osseous metastatic breast cancer. The follow-up period was fourteen weeks. The efficacy of treatment was assessed by a) a pain and performance questionnaire that patients were asked to complete daily and b) a CT scan comparison of a randomly preselected osseous lesion before and 30 weeks after Re-186-HEDP i.v. application. The response to treatment was also evaluated by using the Kamofsky Index. Two out of fourteen women (14%) experienced loss of pain, 6 experienced obvious and 2 some improvement. No change was observed in 4 patients. Five patients manifested a flare response to treatment, with increase in pain within the first, 4 to 5 days after Re-186-HEDP administration. Five patients showed a decrease in platelet levels and absolute number of polymorphonuclear blood transfusion; no neurologic side effects were observed. Re-186-HEDP appears to be a useful new radiopharmaceutical for pain palliation induced by osseous metastases due to breast cancer. Compared to Sr-89 chloride efficacy, it provides longer-lasting analgesia, and when needed it can be reinjected with less risk due to its improved physico- and radiochemical properties.

Adult↗