5-Fluorouracil, epirubicin, and BCNU (FEB) in advanced measurable gastric cancer

Forty-eight patients with advanced measurable gastric cancer were treated with the three-drug combination of 5-fluorouracil, epirubicin, and BCNU (FEB). The response rate was 42% in 45 evaluable patients. There were five complete responders (11%). The median duration of response was 13 months, and the median survival of all patients was 9.2 months. Toxicity was generally mild to moderate. No instances of congestive heart failure were recorded. These results indicate that patients with metastatic gastric cancer can be effectively palliated with FEB chemotherapy.

Neonatal-onset panhypopituitarism in a girl with Brachmann-De Lange syndrome

We report on a girl with recurrent hypoglycemia since age 2 days and severe impairment of physical and neurological development. Panhypopituitarism was recognized at age 5 months. The diagnosis of Brachmann-De Lange syndrome (BDLS) was also made. Replacement therapy has avoided further episodes of hypoglycemia, improved growth, and allowed partial psychomotor catch-up. Though we are not aware of any other report of panhypopituitarism in patients with BDLS, we suggest that hormonal derangement may play a role in the manifestations of this syndrome.

[Aztreonam and oxacillin in the treatment of febrile neutropenic patients with solid tumors]

22 consecutive febrile episodes in 21 neutropenic (PMN less than 1000/mmc) cancer patients, were treated with aztreonam and oxacillin. Nineteen patients were severely neutropenic (PMN less than 500/mmc). Cure was obtained in 86% of the febrile episodes, including 6/7 bacteriologically documented gram negative infections. No major side effects were observed. These results seem to indicate that aztreonam is effective as empiric treatment of gram negative infections in neutropenic patients. However, it must be used in combination with another antibiotic to ensure gram positive coverage.

[Changes in the immunologic profile of newly-diagnosed diabetic patients during the first year of the disease]

Immunological markers including ICA-IgG, CF-ICA, other non organ specific autoantibodies, circulating immune complexes (CIC), IgG, IgA, IgM, C3, C4 and lymphocyte subpopulations (OKT3, OKT4, OKT8) were studied at onset in 32 insulin dependent diabetic patients (16 males, 16 females, aged 1-21 yr.). Other non organ specific autoantibodies, CIC, IgG, IgA, IgM, C3, C4 and OKT3, OKT4, OKT8 were also studied after a 6-12 months follow-up in the same group of patients. ICA-IgG and CF-ICA were also studied in a control group of 19 insulin dependent diabetic patients with an over 3 year history of diabetes. ICA IgC, CF-ICA, other autoantibodies and CIC were detected at diagnosis in 65%, 19%, 33%, and 50% of patients respectively. ICA-IgG and FC-ICA were detected respectively in 15% and zero of the control group of 19 long standing diabetes. No alterations in IgG, C3 and C4 levels and in T cells subsets have been found at onset. C4 levels significantly decreased at the successive observation. A significant elevation of IgG levels and helper/suppressor ratio were also observed at follow-up. Autoantibodies and CIC positive sera at diagnosis support the concept that a previous autoimmune disorder exists before clinical manifestations of diabetes. Other immunological abnormalities including relative hypogammaglobulinemie, lower C4 and higher helper/suppressor ratio, observed by other authors (Kanakoudi 1984, Vergani 1985, Lernmark 1985) represent an aspecific alteration due to metabolic imbalance or to an earlier immunological disorder.

Cisplatin, high dose folinic acid and 5-fluorouracil in squamous cell carcinoma of the esophagus. A pilot study

We treated 20 patients with squamous cell carcinoma of the esophagus with the following regimen: cisplatin = 100 mg/m2 i.v. day 1, HDFA = 200 mg/m2 i.v. day 1 to 5, 5-fluorouracil = 370 mg/m2 i.v. day 1 to 5 repeated every 28 days. Among the 17 evaluable patients, 4 (23%) had a partial remission, 6 had stable disease while 7 progressed. The median survival for all patients was 6+ months. Grade III or IV toxicity included 2 patients with grade III leukopenia, 1 with grade III thrombocytopenia, 1 patient with grade IV and 3 patients with grade III oral mucositis, 3 patients with grade III diarrhea. The regimen did not seem particularly active in the treatment of squamous cell carcinoma of the esophagus and had manageable but substantial toxicity.

[Insulin-dependent diabetes mellitus. Study and follow-up of 100 cases]

Clinical records of one hundred pediatric patients affected by IDDM have been analyzed. All the patients have been followed since the beginning of the disease and they have had a check up on average of four months (weight, height, blood pressure, HbA1, C peptide, Triglyceridemia, renal function were evaluated). The method of home-self-monitoring was applied. After four years, and periodically thereafter, microvascular abnormalities were evaluated in all the patients by fluorescein angiography. Neuropathy was evaluated only in symptomatic patients by peripheral nerve conduction. The average follow up period was 6.1 years (range 1-20).

RESULTS

the onset of the disease was expressed in 11% of the cases by coma, in 14% by ketoacidosis, in the remaining cases by hyperglycemia only. The severity of initial symptoms has progressively and significantly decreased in the last years. In 7% of the subjects diabetes affected more members of the same family (4 couples of siblings and 3 couples of parent-child). An infection preceding the onset of the disease was present in the history of 23% of the cases. Islet cell antibodies were found in 83% of the studied cases at the onset of the disease. In 80 out of the 100 patients a detailed history has been obtained about the occurrence of ketoacidosis episodes after the first admission and about the occurrence of severe hypoglycemic crises (seizures and/or coma). 17% of the patients presented at least one ketoacidosis episode after the first admission (the main cause was infection before 12 years of age, an emotional problem thereafter).(ABSTRACT TRUNCATED AT 250 WORDS)

Trisomy 20p from maternal t(3;20) translocation

A case of trisomy 20p resulting from a maternal translocation t(3;20) is described. QM and BUdR banding techniques were used for its identification. A round face with oblique palpebral fissures, strabismus, cardiac and vertebral abnormalities, mild psychomotor retardation, together with poor coordination and speech impediment, are the most typical features of the proband.