Response of lymph node metastasis to sequential estrogen and radiation therapy in prostate carcinoma

Increasingly sophisticated diagnostic studies have shown a high incidence of tumor spread to the regional lymph nodes. The status of the lymph nodes has been evaluated by noninvasive diagnostic procedures such as lymphangiography and computerized axial tomography. The applicability of these procedures has been enhanced by the use of stringent criteria. Gross lymph node metastasis can be diagnosed with considerable confidence. Serial observations of lymphangiograms and computerized axial tomograms before and two months after the administration of estrogens provide an added dimension to the interpretation of lymph node metastasis. The nature and range of the response of lymph node metastasis were observed. Survival of patients with gross lymph node metastasis treated by sequential estrogen and radiation therapy was evaluated. A total of 11/18 (61 per cent) of patients remained free of symptoms, 8/11 (74 per cent) with a favorable lymph node metastasis responsive to estrogen therapy, and 3/7 (42 per cent) with lymph node metastasis refractory to estrogen therapy. Follow-up computerized axial tomograms of the lymph nodes done at one and two years after irradiation showed a persistent favorable response. Five patients are alive with disease, and 2 patients died of the disease.

Naltrexone treatment of heroin addiction: efficacy and safety in a double-blind dosage comparison

The goals of this study were two-fold: (1) to test the hypothesis that retention of patients in naltrexone treatment could be improved by educating and preparing them for it while enrolled in a LAAM (l-alpha-acetylmethadol) detoxification program; and (2) to compare the safety and efficacy of 60 mg vs. 120 mg administered thrice weekly in a double-blind, sequential trial design. Patients were allowed a maximum of 365 days on naltrexone, and a maximum of four admissions; 119 patients received at least one dose of naltrexone. We found no clinically important differences between the two dosages, and retention in treatment was similar to that reported in earlier clinical trials. Slightly more than half the patients ever used heroin while receiving naltrexone, and only 9% of all urine tests were positive for opiates. Craving for heroin decreased dramatically by the end of the first week. We found no side-effect or toxicity due to naltrexone.

Diurnal rhythm of plasma immunoreactive beta-endorphin and its relationship to sleep stages and plasma rhythms of cortisol and prolactin

To determine the diurnal rhythm of plasma beta-endorphin (beta-End), 10 healthy male volunteers between the ages of 20 and 32 yr were studied in a sleep laboratory setting for a 24-h period. Blood samples were taken through an indwelling catheter at 0800, 1000, 1400, 1800, 2200, 2300, and 2400 h and then half-hourly until 0730 h, and they were then assayed for total beta-End-like immunoreactivity (ir beta-End), PRL, and cortisol. Subjects were habituated by spending the night before the study in the sleep laboratory with an indwelling catheter and electrodes for sleep recording in place. There was a clear diurnal variation of ir beta-End, with lowest levels between 2200 and 0330 h and highest levels between 0400 and 1000 h. There was no evidence for direct entrainment with sleep stage. There was a close correlation with cortisol levels, suggesting a similar secretory pattern for beta-End and PRL in only 5 of the subjects. Because the beta-End antiserum used has a cross-reactivity of 30% with beta-lipotropin gel permeation chromatography was done on extracts of plasma taken at 1400, 2400, 0400, and 0730 h for each subject. The peak in the beta-End elution position showed a clear diurnal variation similar to that of ir beta-End.

Mycosis fungoides. Small-bowel involvement complicated by perforation and peritonitis

Mycosis fungoides (MF) is a malignant lymphoma that arises in the skin and subsequently may involve lymph nodes and viscera as part of the natural course of the disease. The disease has distinct histologic characteristics that may be recognized in extracutaneous tissues. A patient who had MF with ulcerating cutaneous nodules is presented herein. Death resulted from perforation of the small bowel involved by the disease and consequent peritonitis.

Resonance by rod-shaped reflectors in ultrasound test objects

Rod-shaped reflectors such as those used in the AIUM test object resonate at medical ultrasound frequencies, producing artifacts posterior to the reflector. Rods of various diameters and materials were examined to determine their resonant properties, and the effect of the Plexiglas scanning surface of the enclosure on image quality was studied. A theory predicting the resonant frequencies of rods is proposed, and methods of eliminating resonance artifacts are discussed.

Range ambiguities in real-time ultrasound

The frequent occurrence of low-level artifactual echoes in normally echo-free areas of real-time images is shown to be due to a range-ambiguity effect caused by the fast frame rate of real-time equipment. The experimental data demonstrates the range-ambiguous echoes to be present in linear array and mechanical sector scanner real-time images. Several suggestions are made to reduce the effect of the artifact in real-time images. A set of real-time acceptance tests that utilize this artifact are proposed.

The use of the multiplicity survey to identify migrants

New approaches must be developed and tested to meet the needs for current data on population movement. One such approach is the survey with multiplicity (social networks). It allows respondents to report events (in this case, migration) that occurred to specified relatives living elsewhere. In order to test the value of the approach on a limited, exploratory basis, a two-stage research design was employed. A sample of persons resident in Cranston, Rhode Island who had changed address in the three years preceding the survey, was first identified and information was gathered in Round I on their mobility and on their relatives living in the State. In turn, these relatives (Round II) were asked about the mobility of their parents, siblings, and children. (The responses from Round II should have included the migrants in Round I.) Evaluation of the accuracy of Round II responses in comparison to those obtained in Round I was undertaken in terms of kin relationships, recency of move, and type of move. The results indicate that respondents had a low awareness of their relatives' movements, that moves of females were more likely to be reported than those of males, that recent moves were more frequently cited and that moves between communities were more likely to be reported than intracity mobility.

Dynorphin immunocytochemical localization in brain and peripheral nervous system: preliminary studies

Using antisera specific for the opioid peptide dynorphin, we have carried out immunocytochemical studies of the distribution in rat brain and periphery. In the central nervous system, cells that stain positively for dynorphin are found in the supraoptic nucleus, with less-well-stained cells in the paraventricular nucleus of the hypothalamus. Few positive fibers were detected in brain, suggesting problems with fixation and preservation of antigenicity. In pituitary no staining was seen in the anterior and intermediate lobes but heavy staining was detected in the posterior lobe. In the guinea pig, adrenal chromaffin cells stained with dynorphin antisera. Staining of these cells could be blocked with excess of dynorphin-(1-13) or either enkephalin. Radioimmunoassays revealed a great excess of the enkephalins in the adrenal, suggesting cross competition between dynorphin antiserum and adrenal medullary enkephalin. Finally, the dynorphin antiserum stained a complex of fibers in guinea pig ileum. Staining of these fibers could be blocked by moderate amounts of enkephalin as well as by smaller amounts of dynorphin-(1-13). We conclude that in some places (brain and pituitary) dynorphin exists separately from leucine-enkephalin. In other parts of brain and in the periphery the relationship between dynorphin and the enkephalins is very complex and requires further study and improved antisera.

Registration errors in compound B-scans

The effect of B-scanner articulated arm angle measurement errors on B-mode registration is considered. For a single-angle articulated arm model, a mathematical equation predicting B-mode misregistration as a function of angular errors and compound scan angle is derived and discussed. This model accurately predicts registration errors for transducer connector/acoustic axis misalignment or third arm angle errors.

Characterization of the receptor mediating the nicotine discriminative stimulus

The discriminative stimulus (cue) property of nicotine was studied in a T-maze paradigm, and the results were analyzed by a new statistical method. For rats trained on 0.4 mg/kg, the ED50 was 0.11 mg/kg. The enantinomer of natural nicotine (+)nicotine was much less potent, and both position isomers of nicotine were inactive. Anabasine, which is active at nicotinic cholinergic receptors, provided the nicotine cue. Cytisine, a potent nicotinic agonist in vitro, was ineffective after SC administration and this was shown to be due to its inability to enter the brain in adequate amounts. High doses of cytisine by the intracerebroventricular route partially provided the cue. The cue was blocked by low doses of mecamylamine and pempidine and by high doses of hexamethonium. The data indicate that the cue receptor is pharmacologically similar to the nicotinic cholinergic receptor in autonomic ganglia.

Human leukocyte A and B antigens in patients with prostatic adenocarcinoma

An increasing number of diseases has been associated with specific human leukocyte antigens. A total of 100 white men with adenocarcinoma of the prostate was serotyped for 32 A and B antigens. Compared to a control population of 169 white subjects relative risks of 2 or more were associated with the antigens A11 and A29. Relative risks of 0.20 or less were associated with the antigens AW23, BW21 and BW22. None of these relative risks was significant statistically. We were unable to demonstrate a significant human leukocyte A or B antigen association with adenocarcinoma of the prostate.

Stereospecific nicotine receptors on rat brain membranes

A stereospecific binding site for nicotine has been detected on rat brain membranes. Competition studies with cholinergic agonists suggest that this site is a nicotinic cholinergic receptor.

A follow-up study of heroin addicts five years after first admission to a methadone treatment program

A random sample (n = 260) of the first 799 admissions to the Santa Clara County Methadone Treatment Program was sought for interview five years after the date of their first dose; 80% were successfully located. Data from the year prior to entering methadone treatment were compared to data from the year prior to the follow-up interview. The two specific areas showing the most dramatic improvement were in heroin use and employment. During the year prior to the follow-up interview, 24% of the subjects with known outcome had no heroin use; 19% were abstinent from both heroin and methadone and at risk (not in jail or other treatment) for the entire year. Unemployment dropped from 51% to 19%. Subjects drank significantly more alcohol during the year prior to interview, with a 48% increase in the number of daily drinkers. Little or no change was seen in the use of other drugs, in the percentage of subjects with an arrest or jail time, or in the number living with an addicted person. Time in treatment was not a predictor of successful outcome and subjects who had left methadone treatment were doing at least as well as those continuously in methadone treatment.

A low-cost gate for ultrasound pulse-echo studies

Selective gating of ultrasounds echoes usually requires an expensive piece of electronics, a stepless gate. This note presents a simple circuit utilizing low-cost components which is easily built, and gives satisfactory performance as a gate for the study of individual ultrasound echoes. The gate has been measured to have a transmission loss of - 2 dB and an isolation of - 50dB.

B-mode registration: a new procedure for analyzing errors

The theory of a new B-mode registration test procedure is presented along with experimental verification of the detailed theoretical predictions. The new procedure separately tests the B-scan articulated arm calibration and the equipment acoustic velocity calibration. Readily verifiable secondary standards are incorporated into the procedure for self-calibration purposes. The procedure provides a specific and reproducible analysis of angular misregistration errors while maintaining an acceptable level of sensitivity. No coupling gels or oils operator skill is required. A special test has been found which permits the service person to verify that the equipment is capable of attaining proper B-mode registration before beginning the recalibration procedure.

Synthesis of 3-O-demethylfortimicins

Treatment of fortimicin B with lithium in ethylamine gave 3-O-demethylfortimicin B. The latter was converted by methodology developed with fortimicin B to 3-O-demethylfortimicin A, 4-N-sarcosyl-3-O-demethylfortimicin B, 4-N-beta-alanyl-3-O-demethylfortimicin B, and 4-N-(beta-aminoethyl)-3-O-demethylfortimicin B. 3-O-demethylfortimicin A and the 4-N-acyl-3-O-demethylfortimicins B had appreciably higher antibacterial activities than the corresponding parent fortimicins. Most significant was the increased activity of 3-O-demethylfortimicin A relative to fortimicin A against a variety of strains of Pseudomonas aeruginosa.

Levels of immunoreactive dynorphin in brain and pituitary of Brattleboro rats

The very potent opioid peptide, dynorphin, has recently been shown by radioimmunoassay and immunocytochemical techniques to be selectively concentrated in the pars nervosa of pituitary, suggesting a possible association of dynorphin with the neurohypophyseal hormones, vasopressin and oxytocin. In this study, we report that pituitary and brain contents of immunoreactive dynorphin in homozygote Brattleboro rats (unable to synthesize vasopressin) are similar to those in heterozygote animals and in normal Long-Evans rats. Thus, the syntheses of immunoreactive dynorphin and vasopressin in the hypothalamo-hypophyseal tract appear to be independently regulated.

Immunoreactive dynorphin in pituitary and brain

Distribution of the potent opioid peptide dynorphin has been determined in pituitary gland (pig, beef, rat), in the various regions of rat brain, and in rat spinal cord, by using a highly specific antiserum. By gel permeation chromatography in 4 M guanidine, the porcine pituitary immunoreactivity is found in a major peak of apparent molecular weight about 1700 and a minor peak of about 3400. Similar peaks are found in rat pituitary extracts, whereas rat brain contains, in addition, two peaks of larger apparent molecular weight. In the pituitary, immunoreactive dynorphin is found predominantly in pars nervosa. In the central nervous system, it is distributed widely, with highest concentrations in hypothalamus, medulla-pons, midbrain, and spinal cord. Although dynorphin contains leucine-enkephalin, the regional distribution of dynorphin is different from that of enkephalin or of any other known opioid peptide.

Epidural analgesia and cardiac output in severe pre-eclamptics

Labour and delivery cardiac output was assessed by thermal dilution in ten severe pre-eclamptics who received lumbar epidural analgesia. Control cardiac output was 8.8 litres/min which remained statistically unchanged following administration of lumbar epidural analgesia. At birth and delivery of the placenta, there was a moderate increase in cardiac output which increased significantly (28%) by 15 min after delivery of the placenta. Subsequently over the next hour, cardiac output returned toward baseline levels. Mother and fetus were stable throughout and infant Apgar scores were good. These results emphasise that lumbar epidural analgesia has little effect on cardiac output in severe pre-eclamptics.

The naloxone test for opiate dependence

Naloxone tests for opiate dependence were given to 296 applicants for treatment with the surrogate opiate levomethadyl acetate (LAAM, levo-alpha-acetylmethadol) and to 103 applicants for treatment with the opiate antagonist naltrexone. Thirty-five of the 296 LAAM applicants applied first for LAAM, then following detoxification, for naltrexone. There was a dramatic decrease in withdrawal signs and symptoms when the subject went from opiate-dependent to a nondependent state. From our experience, we devised a scoring guide and testing procedure based on objective signs. We propose a 2-step test, with an initial intramuscular dose, then (if necessary) an intravenous dose, to determine an applicant's eligibility for surrogate opiate or narcotic antagonist treatment.