Osmotic delivery systems for the beta-adrenoceptor antagonists metoprolol and oxprenolol: design and evaluation of systems for once-daily administration

The essential features and mode of action of oral osmotic drug delivery systems (Oros) for metoprolol fumarate and oxprenolol succinate are described. Critical aspects in the development of systems for once-daily administration of both drugs are discussed, and methods for evaluating in vitro release characteristics are presented. In vitro testing confirmed that drug delivery corresponded closely to the theoretical release behaviour predicted from the physicochemical and membrane permeability characteristics for both oxprenolol and metoprolol systems. In vitro release rates were also shown to be unaffected by pH, in vitro test procedures, dissolution media and long-term storage at different temperatures.

High-dose versus low-dose CMFP regimen in advanced breast cancer

Fifty cases of advanced breast cancer (stages III and IV) were treated by combination chemotherapy. The study compares the two different dose schedules and toxicities of a combination of cyclophosphamide, methotrexate, 5-flurouracil, and prednisone. Results are better with high-dose regimen, though the incidence of toxicity is much as compared to low-dose schedules, but, considering the beneficial response, the high-dose schedule is recommended.

Qualitative platelet dysfunction following cancer chemotherapy: a case report

A case of qualitative platelet dysfunction following cancer chemotherapy is documented. Besides the numerical reduction defect, there appear to be functional changes in the platelets leading to bleeding diathesis. The present case was thoroughly evaluated, and it was observed that there is suppression of the platelet functions in a patient receiving cancer chemotherapy, a combination of cyclophosphamide, methotrexate, and 5-fluorouracil.

Intensive combination chemotherapy for cancer of the oral cavity

Thirty advanced cases of cancer of the oral cavity were treated by intensive combination chemotherapy using bleomycin, methotrexate, 5-fluorouracil, cyclophosphamide, and Oncovin administered over a period of 48 hours. Bleomycin was given as a continuous infusion and Oncovin was administered six hours prior to the administration of other drugs. A clinical response was obtained in 73.3% of the cases, a complete response in 33.3%, and a partial response in 40%. The toxicity was within acceptable limits.

A reliable screening test for childhood celiac disease: fluorescent immunosorbent test for gliadin antibodies. A prospective multicenter study

The diagnostic value of gliadin antibody determination using the fluorescent immunosorbent test was examined in a prospective multicenter study comprising 251 children with malabsorptive disorders. Antibodies to gliadin were found in all 72 patients (100%) with active celiac disease (29 children with celiac disease proved by challenge, 43 with probable celiac disease). All children up to the age of 7 years had antibodies in high titers. By contrast, 96 (84%) of 114 children with other malabsorptive disorders and a normal mucosa or with partial villous atrophy had no gliadin antibodies, 14 (12%) had a low titer, and only four (3.5%) showed moderate to high titers. Four children with gastrointestinal tract symptoms of cow milk intolerance and a flat mucosa also showed no antibodies. In 24 of 29 children (83%) with cystic fibrosis and six of seven children with Crohn disease (biopsies not performed in either group), no antibodies could be detected. The others had low or elevated titers. In 25 children with acute gastroenteritis (not biopsied) antibodies were not found at hospital admission nor six weeks later after reintroduction of gluten. The determination of antibodies to gliadin with the fluorescent immunosorbent test is a reliable screening test for childhood celiac disease. In our series there were no false negative results in children with untreated celiac disease. A positive gliadin antibody titer is not proof of celiac disease. In each child the diagnosis must be confirmed by small intestinal biopsy even if the gliadin antibody titer is high. The detection of high titers of cow milk antibodies in 27% of patients with celiac disease is of no value.

Delayed hypersensitivity in squamous cell carcinoma of the oral cavity

Delayed hypersensitivity response to Dinitrochlorobenzine (DNCB), Purified Protein Derivative (PPD) and Candida albicans abstract (Dermatophytin 'O') was observed in 60 patients of squamous cell carcinoma of the oral cavity and 40 normal controls. The response to all these three antigens were significantly impaired in cancer patients as compared to normal controls. PPD and Dermatophytin 'O' response showed progressive decline with increasing tumour burden. Patients with well differentiated tumours responded well to all these three antigens as compared to those with poorly differentiated tumours.

Malignant hemangiopericytoma of the gallbladder

A rare case of malignant hemangiopericytoma in the gallbladder is described perhaps for the first time in the literature. Areas of necrosis, mitotic activity within the tumor, and the presence of metastases in the regional lymph nodes and right ovary suggest an aggressive behavior of the tumor and poor prognosis.

Bridging large bone defects with a xenograft composited with autologous bone marrow. An experimental study

We have investigated the role of defatted, decalcified xenogenic bone implants composited by impregnation with fresh autologous marrow in bridging large cortical defects. Diaphyseal cortical implants were obtained from orthopaedic operations on humans and from guinea pigs and prepared by treatment with acetone, 0.6 M HCl and ethanol. The composited graft was used to bridge a 3 cm defect in the diaphysis of the ulna of rabbits. Periodic investigations were made clinically, radiographically and histologically and by tetracycline, fluorescence studies up to 20 weeks. Abundant new bone formation was observed in 85.7% of composited human xeno-autografts and in 83.3% of composited guinea pig xeno-autografts. New bone formation was seen in 13.3% of noncomposited xeno-implants. No appreciable antigenicity was observed either clinically or histologically in the grafts. The high degree of success obtained justifies further studies on implants composited by fresh autologous marrow and offers hope for the enhancement of new bone formation clinically, particularly in reconstructive operations for significant skeletal defects. We feel that the osteo-inductive potential of autologous marrow was responsible for the healing of the defects aided by the better internal milieu provided by defatted decalcified xeno implant.

Desquamation of malignant cells in carcinoma of the uterine cervix: its role in prognosis

Percentage of malignant cell exfoliation in relation to that of benign epithelial cells was studied in pretreatment vaginal smears of 251 patients of squamous cell carcinoma of the cervix. The rate of exfoliation did not increase with increasing clinical severity. Also, the various cell types of squamous cell carcinoma and clinical radiation response were independent of number of malignant cells shed in the vagina. However, the group of patients having a fewer number of malignant cells in their vaginal smears had a statistically significantly better five-year survival.

Serum immunoglobulins in squamous cell carcinoma of the oral cavity

Serum immunoglobulins (IgG, IgA, and IgM) have been studied in 70 patients with squamous cell carcinoma of oral cavity and in 40 age-matched normal controls. The results were correlated with clinical stage, tumor size, lymph node status, tumor differentiation, and treatment modalities. There was a significant rise in serum IgM and IgA in oral cancer patients as compared to controls. It was further raised in advanced clinical stage, but tumor size and histological differentiation and treatment modalities (surgery and chemotherapy) do not seem to affect serum immunoglobulin levels. The observations implies that the extension and dissemination of tumor mass is the important factor for the change in serum immunoglobulin level in squamous cell carcinoma of the oral cavity.

Deficiency of suppressor T-cells in insulin-dependent diabetes mellitus: an analysis with monoclonal antibodies

Peripheral blood from 25 patients with insulin-dependent diabetes mellitus was examined for any alteration in the proportions and or functions of immunoregulatory T-cell subsets, defined with monoclonal antibodies. Ten of 25 (40%) patients demonstrated deficiency of OKT8+ (suppressor/cytotoxic) T-cells. Eight of these 10 patients had abnormally high ratios of OKT4+/OKT8+ T-cells. Nine of 10 patients with abnormally low proportion of OKT8+ T-cells had deficient concanavalin A-induced suppressor cell activity against the proliferative response of autologous or allogeneic lymphocytes to phytohemagglutinin. No correlation was observed between the deficiency of suppressor T-cells and the control of diabetes. Therefore, it is likely that the deficiency of suppressor cells is related to insulin-dependent diabetes mellitus itself and not to the metabolic changes that are associated with diabetes mellitus. This study demonstrates both quantitative and qualitative deficiency of suppressor T-cells in at least some patients with insulin-dependent diabetes, that might play an important role in the pathogenesis and autoimmune manifestations of a proportion of patients with insulin-dependent diabetes mellitus.