Phaeochromocytoma in a coeliac ganglion in pregnancy

A case of a phaeochromocytoma is reported which presented as collapse in the postpartum period. The site of the tumour was in the coeliac ganglion.

Misonidazole and unconventional radiation in advanced squamous cell carcinoma of the esophagus: a phase II study of the Radiation Therapy Oncology Group

This is a report on Radiation Therapy Oncology Group (RTOG) Protocol No. 78-32, a Phase I/II prospective study aimed at determining tolerance, tumor response, and survival of squamous cell carcinoma of the esophagus treated with unorthodox fractionation radiotherapy combined with misonidazole. Misonidazole was administered by mouth 4 to 6 hr prior to radiation, at a dose of 1.0 to 1.25 Gm/.m2; blood levels were measured at about 4 hr after intake of the drug and reported in micrograms/ml. Radiotherapy was administered at 4 to 6 hr post-misonidazole dose and given with 400 rad fractions, alternating 2 or 3 times/week, up to 4,800 rad. A total of 43 patients were entered; 26 are evaluable for survival at 1 year post accession. Thirty patients (88%) received the planned radiation course. Twenty-eight patients (78%) received the planned misonidazole dosage. Tumor response, evaluable in 18 patients, showed a complete regression (C.R.) in only 2 patients (11%); and partial response (P.R.) in 6 patients (33%). Eight patients (44%) showed no tumor response to planned therapy. Toxicity was acceptable and in 38 evaluable patients only 4 reported (11%) nausea and vomiting, 7 reported mild paresthesias (18%). The median survival was only five months. In 26 patients evaluable for 1 year survival determination, only 1 survived (3.8%) this period. In view of the poor tumor response and low survival observed, we do not recommend that this particular fractionation regimen with misonidazole be used in a Phase III randomized trial in squamous cell carcinoma of the esophagus.

Effects of cyanate on the distribution of isotope-labeled H2O and extracellular markers in rat liver and tumors

Previous work has shown that administration of sodium cyanate inhibits the uptake of several metabolites in tumors under conditions in which there is generally no inhibition in normal tissues of the rat. In the present work, it was found that cyanate treatment inhibits the distribution of 3H2O, [3H]methoxyinulin, and [14C]sucrose in rats with greater effects in the tumors than the normal tissues examined. Tumor-bearing rats received i.p. injections of sodium cyanate (250 mg/kg body weight). After 60 min, the rats received s.c. injections of 3H2O. Treatment with cyanate decreased the radioactivity in blood and liver, but greater effects were seen in five transplanted tumors (LK1 colon tumor and Morris hepatomas 5123C, 7288CTC, 7777, and 9618A2). At 10 min after injection of 3H2O, the mean radioactivities in tumors of cyanate-treated rats were 11 to 23% of control values and in some tumors were still less than in controls at 60 min after isotope injection. Evidence was obtained that the action of cyanate was not due to osmotic effects or loss of water from the tissues. The distribution of the extracellular markers [3H]methoxyinulin and [14C]sucrose was also decreased in hepatomas in cyanate-treated rats. The data do not exclude effects on membrane permeability but suggested that cyanate decreased circulation in the tumors.

Combined pre- and postoperative adjuvant radiotherapy for bladder cancer: results of RTOG/Jefferson Study

This paper presents the results of adjuvant "sandwich" radiotherapy for bladder cancer in 65 patients treated in a Radiation Therapy Oncology Group (RTOG) phase II study and at Thomas Jefferson University Hospital. In this approach of adjuvant therapy, patients with clinical stages B or C bladder cancer were given low dose preoperative irradiation (500 rads) to the whole pelvis on the day before or on the day of surgery. Following cystectomy, patients were pathologically staged. Those with high grade (III or IV) stage B1 tumors or stages B2 or C were given 4500 rads in five weeks postoperative radiation. Thirty-four of these 65 patients were entered in the RTOG protocol and 31 in the Jefferson Study. TWenty patients had early lesions (stage 0, A or B1, grade I-II) and did not receive postoperative irradiation. Six patients had stage D cancer and were given palliative therapy. Of 39 patients eligible for postoperative irradiation, 29 received the full course of pre- and postoperative irradiation. Ten patients did not receive treatment. Follow-up ranged from six months to three years with a median of 18 months. Treatment was extremely well tolerated. Incidence of major complications was 6% (4/65). Local control of disease was excellent, with no failures in pelvis response. Actuarial survival at three years is 78%. At this preliminary analysis, these survival results appear to be better than those obtained with other approaches using preoperative irradiation and surgery.

Moxalactam (LY127935) in treatment of meningitis due to gram-negative bacilli

Moxalactam (LY127935; 6059S), a new broad-spectrum beta-lactam antibiotic, was used successfully with an aminoglycoside in a patient with Serratia marcescens meningitis complicating a neurosurgical procedure. With a bioassay method, peak and trough serum and cerebrospinal; fluid concentrations of moxalactam were determined during therapy. Mean peak and trough serum levels were 100.6 and 35.5 micrograms/ml, respectively. Corresponding mean peak and trough cerebrospinal fluid levels were 12.4 and 10.38 micrograms/ml. Cerebrospinal fluid levels of moxalactam exceeded the minimal bactericidal concentration for the infecting organism by more than 30-fold throughout therapy. No untoward effects of moxalactam were observed. Moxalactam may be a useful agent in the treatment of meningitis due to susceptible gram-negative bacilli.

Arbovirus isolations from ixodid ticks infesting livestock, Kano Plain, Kenya

In a study conducted on the Kano Plain, Kenya, virus isolation attempts were made on ixodid ticks collected, over a 14-month period, from livestock held in family enclosures (bomas) before releasing the animals for daily foraging. 8735 Amblyomma variegatum (Fabricius) were tested, 98.6% of which were taken from cattle, yielding 36 strains of Dugbe (DUG), four strains of Nairobi sheep disease (NSD), three strains of Bhanja (BHA), one strain of Thogoto (THO) and five strains of virus which could not be characterized. 6549 Rhipicephalus spp. ticks were collected (60.3% from cattle). NSD, DUG and BHA viruses were each isolated twice from ticks taken from cattle. One BHA virus strain was recovered from ticks from a sheep. One strain recovered from ticks on cattle could not be characterized.

Soluble factors from liver and hepatomas which inhibit [3H]thymidine incorporation into DNA of Novikoff hepatoma cells

The nature of soluble factors from liver and hepatomas which inhibit [3H]thymidine incorporation into DNA was studied in Novikoff hepatoma cells. The decreased activity in hepatoma preparations was due to loss of a high-molecular-weight heat-labile factor. Although this factor cochromatographed with arginase activity on Sephadex G-150, it does not appear to result from this activity as judged by the failure of arginine to prevent the inhibitory effect on [3H]thymidine incorporation. Both liver and hepatomas contained a heat-stable factor with inhibitory activity. Studies with ethanol-soluble material suggested that the action was not solely attributable to the presence of unlabeled thymidine, since the apparent molecular weight was too high and since the factor(s) inhibited [3H]leucine incorporation into protein in addition to inhibiting [3H]thymidine incorporation in DNA.

Pharmacology and efficacy of netilmicin

Twenty-six patients, 20 to 77 years of age, were treated with netilmicin, mean dose 2 mg/kg every 8 h intramuscularly or in a 20-min intravenous infusion. The mean serum half-lives in patients with creatinine clearances of >/=90 ml/min and 60 to 90 ml/min were 3.2 and 3.4 h, respectively. In patients with serum creatinines of </=1.4 mg/100 ml and creatinine clearances of >/=60 ml/min, mean serum levels were 9.0 and 1.2 mug/ml, respectively, 5 to 15 min and 7.5 h post-intravenous infusion, and 7.1 and 1.7 mug/ml, respectively, 1 and 8 h post-intramuscular injection. Twenty-five patients had acute pyelonephritis; 7 of the 25 had bacteremia. The infecting bacteria were Escherichia coli (15), Proteus mirabilis (5), Pseudomonas aeruginosa (2), Klebsiella pneumoniae (1), Enterobacter hafniae (1), and both Proteus rettgeri and Proteus morganii (1). All were inhibited by 6.3 mug of netilmicin per ml, except for the P. rettgeri, which required 25 mug/ml for inhibition. Of 23 patients who could be evaluated, 19 were bacteriologically and clinically cured at follow-up. Of the remaining four, one relapsed, two became reinfected, and one was lost to follow-up. Five patients developed nephrotoxicity; two of the five had previous renal insufficiency. Three patients, one with abnormal renal function, developed ototoxicity detected only with audiograms. These studies suggest that netilmicin is effective in serious gram-negative bacillary infections, but is nephrotoxic and ototoxic in humans.

Arbovirus isolations from, and serological studies on, wild and domestic vertebrates from Kano Plain, Kenya

Arbovirus infection and presence of haemagglutination-inhibiting antibodies in small mammals, birds and livestock were examined over a period of five years on the Kano Plain in western Kenya. Eleven isolations were made from mammals and birds. The viruses were identified as Arumowot and Germiston while three different agents could not be shown to be related to 188 African arboviruses. Prevalence of antibodies against arboviruses suspected of occurring in the area was generally low.

Effect of corticosteroids on the human monocyte IgG and complement receptors

A quantitative in vitro assay was employed to directly assess the effect of corticosteroids on the IgG and complement receptor function of human mononuclear phagocytic cells. In this system corticosteroids were solubilized with cholesterol-phospholipid sonicated dispersions before exposure to mononuclear cells. Solubilized corticosteroids at concentrations between 10(-4) and 10(-3) M inhibited both IgG and complement receptor activity in a dose-response fashion. Inhibition was dependent upon the time of interaction of the mononuclear cells with corticosteroids and was half-maximal by 15 min. The inhibitory effect at all concentrations of hydrocortisone was partially overcome by increasing the number of IgG molecules per erythrocyte. Hydrocortisone also inhibited the binding of erythrocytes coated with both IgG and C3, despite the fact that when both were on the erythrocyte surface a synergistic effect on binding to mononuclear cells was observed. At the steroid concentrations employed, the capacity of mononuclear cells to exclude trypan blue and to take up latex particles and neutral red was unaffected. Mineralocorticoids also inhibited receptor activity, but the sex hormones were less effective. These studies demonstrate an effect of steroid hormones on cell membrane receptor function, and they suggest that an inhibition of the recognition system for IgG and C3 in vivo may explain, in part, the effect of corticosteroids in man.