A cellular basis for growth hormone deficiency in the dwarf rat: analysis of growth hormone and prolactin release by reverse hemolytic plaque assay

The purpose of this study was to elucidate the cellular basis for growth hormone deficiency in Lewis-derived dwarf rats. To this end, we used reverse hemolytic plaque assays to evaluate hormone release. This allowed us to determine the proportional abundance of GH- and PRL- secreting cells and estimate the relative amount of hormone secreted by individual pituitary cells from dwarf rats and their somatically normal counterparts. The percentage of all pituitary cells that released GH (formed plaques) in pituitary dispersions was substantially lower for dwarfs when compared with normals in the absence (3.8 +/- 2.2% vs. 43.4 +/- 2.2%) or presence (6.6 +/- 3.8% vs. 45.7 +/- 1.4%; n = 3) of GRF. In addition, GH secretors from dwarfs released less hormone (formed smaller plaques) than their normal counterparts under both basal and stimulated conditions. An analysis of the relative number of GH cells that formed plaques of various sizes was accomplished by constructing a frequency distribution. Dwarf GH secretors formed more small plaques and proportionately fewer larger plaques than normals under both basal and stimulated conditions. For comparison, we also quantified the proportions of PRL secretors and found that they were actually more abundant in dwarfs than normals in the absence (52.4 +/- 4.6% vs. 33.7 +/- 3.7%) or presence (53.4 +/- 4.9% vs. 33.8 +/- 4.1%; n = 4) of TRH. Treatment with this secretagogue consistently increased mean PRL-plaque area for both groups. Our findings demonstrate that dwarf rats are severely deficient in the proportion of GH secretors. In addition, the few GH secretors present in the dwarf pituitary were less responsive to GRF than normals. In contrast, PRL cells in dwarfs appear to be functionally similar to those of their normal counterparts. The reciprocal relationship in the proportions of GH and PRL secretors in dwarfs provides a rather unique model for investigating the functional relationship between these cell types.

A review of methods for misclassified categorical data in epidemiology

Misclassification introduces errors in categorical variables. This paper presents a review of methods for misclassified categorical data in epidemiology. Different sampling schemes for a 2 x 2 x 2 table and methods of analyses will be discussed first. A misclassification matrix is defined, and the usual misclassification models will be shown to be a subclass of log-linear models. Well-known results on a 2 x 2 table with misclassification and recent results on a 2 x 2 x 2 table are then reviewed. Finally two methods of adjusting for misclassification will be given. The first method assumes a known misclassification matrix, and the second method uses subsampling to estimate the misclassification matrix. The analysis is based on a recursive system of log-linear models: first determine a misclassification model, then select a model for the correctly classified variables. The methods are illustrated by data from traffic safety research on the effectiveness of seatbelt use in reducing injuries.

Evolutionary implications of two rainbow trout growth hormone genes

The primary structures of two rainbow trout growth hormone mRNAs (GH1 and GH2) have been deduced by direct sequencing of their respective cDNA clones and portions of the mRNA. Both GH1 and GH2 mRNA contain open reading frames comprised of 630 nucleotides and encode 210 amino acid residues of which 11 are variant. The translated regions of both mRNA are flanked by a short but rather conserved 5'-end, and a relatively long but highly diverged 3'-end. The differences at translated and 3'-untranslated regions suggest that the GH1 and GH2 mRNA originate from different loci. The GH1 and GH2 mRNA are likely transcribed from two distinct loci which were duplicated during tetraploidization of salmonid genome between 50 to 100 million years ago.The GH2 gene has been isolated and sequenced from a rainbow trout genomic library. This gene spans a region of approximately 4 kilobases. The trout GH gene is comprised of 6 exons and 5 introns, in contrast to 5 exons and 4 introns in mammals. The additional intron in the trout gene interrupts the translated regions that are analogous to the last exon of the mammalian counterpart. The alleged internally repeating sequences in mammalian GH, prolactin (Pr1) and placental lactogen (PL) are not observed in the predicted polypeptide sequence of trout GH. In addition, direct repeats that flank exons I, III and V of mammalian GH, Pr1 and PL genes are absent in trout gene. These findings indicate that the rainbow trout GH gene structure does not support the current hypothesis that internally repeated regions in GH, Pr1 and PL arose from a small primordial gene.

Anterior ischemic optic neuropathy--recurrent attacks in one eye in a bilateral case

Subsequent involvement of the fellow eye is common in anterior ischemic optic neuropathy, but recurrent episodes in one eye are extremely rare. Our hypertensive patient had one eye attacked nine years before and two episodes in the second eye within ten days of each other. Visual-field examination revealed progressing field loss, and fluorescein angiography demonstrated an enlarged disc hypofluorescence area.

Structure of a fish (rainbow trout) growth hormone gene and its evolutionary implications

We have isolated and sequenced a clone from a rainbow trout (Salmo gairdneri) genomic library that carries a gene encoding a fish growth hormone (GH). This gene spans a region of approximately equal to 4 kilobases, nearly twice that of mammalian GH genes. The trout GH gene is comprised of six exons, in contrast with five exons in mammals. The additional intron in the fish gene interrupts translated regions that are analogous to the last exon of its mammalian counterpart. In addition, the alleged internally repeating sequence in mammalian GH, prolactin (Prl), or placental lactogen (PL) is not observed in the predicted polypeptide sequence of fish GH. Direct repeats that flank exons I, III, and V of the mammalian GH, Prl, and PL genes are absent in the fish GH gene. These findings indicate that the rainbow trout GH gene structure does not support the current hypothesis that internally repeated regions in GH, Prl, and PL arose from a small primordial gene.

Modelling the liver function data in diabetes

We have enrolled diabetic patients into a long-term follow-up study that entails visits to the eye clinic every six months at which time use of a classification scheme determines whether or not the patient is normal regarding liver function. Since the study is still in progress, not all patients have complete follow-up data. We fit models of complete symmetry to the multi-visit binary data with supplemental margins and also investigate the data as stationary Markov chains with testing for stationarity and determination of the order of chain. The final model, a synthesis of both approaches, has potential use in future clinical trials of new drugs for diabetic patients.

Molecular cloning and sequencing of coho salmon growth hormone cDNA

A cDNA library was constructed using mRNA isolated from coho salmon pituitaries. By employing rainbow trout growth hormone cDNA as a probe, the coho salmon cDNA was isolated and the complete nucleotide (nt) sequence determined. The coding region contains 630 nt while the 5'- and 3'-untranslated regions are 64 and 489 nt in length, respectively. Comparison of the noncoding regions of coho and chum salmon cDNAs reveal identity at the 5' end but significant variation in the 3' end. Chum salmon and rainbow trout have identical amino acid (aa) sequences, but coho salmon growth hormone has a sequence that differs by 6 of the 188 predicted aa. Since salmonids are tetraploid, this difference may be the result of either divergence of the same growth hormone locus or of variation between different loci. Comparisons of the cDNA restriction maps of these three fish species suggest the former possibility.

Outcome of prophylactic and therapeutic cranial irradiation in disseminated small cell lung carcinoma: a Southwest Oncology Group Study

The issue whether cranial radiotherapy (RT) should be used prophylactically (PCI) or therapeutically (TCI) in small cell lung carcinoma (SCLC) is considered controversial by some oncologists. Trying to clarify this issue we have performed a retrospective analysis of a Southwest Oncology Group (SWOG) protocol for disseminated SCLC. Three Hundred and seventy-seven cases had no evidence of metastases to the brain (MB). One hundred and forty four of those had PCI. Seventy one cases were diagnosed of MB, and 64 received TCI. We confirmed previous reports showing a low percentage of brain relapse with PCI (around 5%), with minimal immediate morbidity. We also confirmed a high percentage of objective response (90%) with TCI, (although we had no response information in 40% of them) with long duration of response of 33 weeks. Brain relapse after TCI was only 18%. Only long-term survivors had brain relapse as survival of relapsing patients was longer than those without brain relapse (45 weeks versus 33 weeks, p = 0.06). However, 20 (31%) of the 65 with initial MB died within 6 weeks of registration, some without completing RT to brain. In the majority, cause of death was considered related directly to brain damage, or indirectly as sepsis developed in patients whose poor performance status was considered to be caused by their brain symptoms. When comparing patients with and without MB, the former had (a) worse survival (24 versus 32 weeks, p = 0.02) and (b) higher proportion of patients with poor initial performance status (50% versus 34%, p = 0.04). Although the possibility of long-term morbidity with PCI is deterring some oncologists from recommending it, our data show that MB creates a real chance for immediate morbidity and this should not be ignored. The pros and cons of both approaches and some new recommendations for PCI are discussed.

Rainbow trout has two genes for growth hormone

We report the primary structures of two mRNA species (GH1 and GH2), each predicted from the cloned cDNA and genomic gene sequences, that encode growth hormone in rainbow trout (Salmo gairdneri). Both GH1 and GH2 mRNA contain open reading frames comprising 630 nucleotides and encode 210 amino acid residues, of which 11 are variant. The translated regions of mRNA are flanked by a short 5'-untranslated sequence, which is highly conserved, and a relatively long 3'-untranslated sequence, which is highly divergent. The differences at the 3'-untranslated regions suggest that the GH1 and GH2 mRNA originate from different loci. RNA blot analysis of trout pituitary RNA using an oligonucleotide probe specific for the GH2 sequence indicates that the cloned gene is expressed. The GH1 and GH2 mRNA likely are transcribed from two distinct loci, which were duplicated during tetraploidization of the salmonid genome between 50 and 100 million years ago.

Eating attitudes, dieting, and bulimia among junior high school students

Students in a western New England (U.S.) junior high school (ages 11-15) were surveyed in 1986 to identify attitudes and behaviors about eating and dieting which might foster disordered eating habits. Although few students met official criteria for disordered eating habits, at least 12 percent did practice dieting and 28 percent were frequently preoccupied with the desire to be thinner and/or were terrified of being overweight. One-quarter of girls (vs. only 3.2% of boys) mistakenly classified themselves overweight. Perception of one's own weight seems to be more highly correlated with measures of eating attitude and behavior than does actual weight. Differences also were found in how males and females viewed their own weight although both dieted to about the same extent. Females also were more interested in having school classes on eating and dieting. Recommendations were made for prevention and education regarding eating disorders among this age group.

Cataract and health status: a case-control study

Data from 97 cataract patients and 105 normal controls with ages less than 67 years were collected with respect to sex, age, disease status, drug intake, and blood chemistries. The statistical method of fitting log-linear models was used to determine the association between the case-control indicator variable and the other variables. The following variables were shown to be important and to associate independently with the risk of developing cataracts: age, allergy, diabetes, hypotension, hypertension, use of analgesics and coronary disease.

Cataract epidemiological study: correlation of cataract morphology with health status

Data on 288 cataract patients were collected with respect to sex, age, disease status, drug intake, and blood chemistry. Eight different types of lens opacities could be discriminated using slit-lamp examination, Scheimpflug photography of the anterior eye segment, and microdensitometric image analysis of the film negatives. The statistical method of fitting log linear models was used to investigate the association between cataract morphology and other variables. The following variables were shown to be important and to contribute independently to the differentiation of cataract types: cholelithiasis, pneumonia, heart insufficiency, allergy, and age.

Multimodal therapy for limited small-cell lung cancer: a randomized study of induction combination chemotherapy with or without thoracic radiation in complete responders; and with wide-field versus reduced-field radiation in partial responders: a Southwest Oncology Group Study

In 1979 we initiated a phase III study in the Southwest Oncology Group (SWOG) which was designed to determine the value of chest radiation in limited-stage small-cell lung cancer patients achieving complete response after induction chemotherapy, and to test the use of wide-field v more limited-volume radiation in patients with partial responses (PRs) and patients with stable disease (SD). The induction chemotherapy (VMV-VAC) consisted of vincristine, 2 mg intravenously (IV) every week for six doses; methotrexate, 60 mg/m2 IV days 1 and 43; VP-16, 50 mg/m2/d IV days 1 to 5 and 43 to 47; doxorubicin, 60 mg/m2 IV days 22 and 64; and cyclophosphamide, 1,000 mg/m2 IV days 22 and 64. Four hundred ninety-four patients were registered, of whom 473 were eligible. Of 466 response-evaluable patients, 153 (33%) achieved complete disease remission (CR) with chemotherapy. A total of 387 patients entered the consolidation phase of treatment after chemotherapy and response determination. CR patients were prospectively randomized to receive chest radiation, consisting of 4,800 rad administered in a split-course scheme, or to continue chemotherapy without interruption. The treatment volume was based on tumor extent before the induction chemotherapy. Maintenance chemotherapy consisted of cyclophosphamide and VP-16 administered for four cycles before a period of reinduction chemotherapy consisting of VMV-VAC as described above. Patients receiving chest radiation therapy were given the same maintenance and reinduction chemotherapy programs following completion of the chest radiation. One hundred ninety-one eligible patients achieving PR or SD status after induction chemotherapy were randomized to a preinduction treatment volume or to a postinduction reduced tumor volume, with treatment portals designed according to tumor extent before or after induction chemotherapy, respectively. After completion of the entire treatment plan, there were 218 (47%) CRs and 121 (26%) PRs. These figures represent the greatest response achieved at any point in the treatment program. The median survival for all eligible patients was 57 weeks (74 weeks for CRs). Overall survival for CR patients was not different for patients who did or did not receive chest radiation. However, patterns of tumor relapse were affected by the chest radiation, as 38 of 42 relapsing patients who did not receive radiation had intrathoracic recurrences in comparison to only 20 of 36 radiated patients.(ABSTRACT TRUNCATED AT 400 WORDS)

Clinical experience with soft intraocular lens implantation

A retrospective study of 205 consecutive, planned extracapsular cataract extractions with posterior chamber silicone elastomer lens implants inserted in the ciliary sulcus region were examined between six and 23 months postoperatively. When the patients with preexisting pathology were excluded, the percentage of patients seeing 20/40 or better was 94.1%. The postoperative complications included intraocular lens dislocation in two cases, cystoid macular edema in one case, and secondary glaucoma in one case.

Rainbow trout growth hormone: molecular cloning of cDNA and expression in Escherichia coli

We have isolated several recombinant clones carrying the complementary DNA (cDNA) sequence of the rainbow trout (rt) Salmo gairdneri growth hormone (GH) mRNA by immunoblot screening using an antiserum to chum salmon (Oncorhyncus keta) GH. The nucleotide sequence of one of the rtGH cDNA clones (pAF51) was determined. The rt cDNA sequence in pAF51 encodes a hybrid polypeptide of 199 amino acid residues containing 9 amino acid residues of the bacterial beta-galactosidase, one residue from the codon at the junction of the beta-galactosidase gene, and the rtGH cDNA sequence, an additional residue from the presumptive signal peptide of the pre-rtGH and the entire sequence of the mature rtGH (188 amino acid residues). Pairwise matrix comparisons of the hydropathy profiles of bovine, human, rat, and rainbow trout GH polypeptides indicate that regions of similarity exist between the rtGH and mammalian GH. In particular, there are two major regions of similarity found near the amino-terminal region and at the carboxy-terminal region. These regions correspond to hydrophilic domains of the GH molecules. The possible significance of these domains is discussed.

The porcine ovarian luteinizing hormone/human chorionic gonadotropin receptor II. Is the purified receptor an oligomer of identical subunits?

Purified porcine luteinizing hormone/human chorionic gonadotropin receptors were analyzed by sodium dodecyl sulfate/polyacrylamide gel electrophoresis following reduction and thermal denaturation and stained with Coomassie Brilliant Blue. A major protein of Mr = 77 +/- 4 X 10(3) and a minor protein of Mr = 66 +/- 4 X 10(3) were observed. Iodoreceptor proteins were resolved into a major component of Mr = 77 +/- 3 X 10(3) and a minor component of Mr = 62 +/- 5 X 10(3) after reduction and thermal denaturation. In the absence of reduction, the iodoreceptor had a major component of Mr 63 +/- 3 X 10(3). Purified human chorionic gonadotropin specifically transferred part of the iodoreceptor from the Mr = 63 X 10(3) species to an Mr = 110-120 X 10(3) species. Purified receptors were analyzed by nondenaturing polyacrylamide gel electrophoresis and identified by specific binding of iodo-human chorionic gonadotropin. Three binding species with approximate Mr = 60 X 10(3), 130 X 10(3), and 260 X 10(3) were identified. Iodoreceptors co-migrated with the Mr = 60 X 10(3) species under the same conditions. Similar results were obtained following renaturation of receptors separated by sodium dodecyl sulfate/polyacrylamide gel electrophoresis without reduction and thermal denaturation. These results suggest for the first time that the porcine corpus luteum luteinizing hormone/human chorionic gonadotropin receptor may be a hormone binding monomer of Mr = 60-65 X 10(3), and that the monomer may associate to form hormone binding polymeric receptor complexes.

Postsplenectomy sepsis and other complications following staging laparotomy for Hodgkin's disease in childhood

This is a survey of 234 pediatric patients in whom staging laparotomy/splenectomy was carried out (1975 to 1981) in the course of the Intergroup Hodgkin's Disease in Childhood Study (IHDCS). Relapse has occurred in 44 of these patients, and 12 have died, 7 secondary to extension of lymphoma, 2 with herpes or pneumocystis infections, 2 with leukemia, and 1 from an unrelated accident. During the period of surveillance (mean 5.5 yr), five episodes of bacterial sepsis (positive blood cultures) have occurred, including two due to Streptococcus pneumoniae; and three, to Hemophilus influenzae. The former occurred in the small group of patients in this series who had not received the prescribed pneumococcal vaccination. No fatalities were associated with these septic episodes. Intestinal obstruction secondary to adhesions (benign) occurred in eight patients and was managed without intestinal resection or mortality. One patient required operative release of an obstructed ureter following laparotomy, and one, oophorectomy for an infarcted (transposed) ovary.

Cellular myc (c-myc) in fish (rainbow trout): its relationship to other vertebrate myc genes and to the transforming genes of the MC29 family of viruses

We have isolated, cloned, and sequenced the rainbow trout (Salmo gairdneri) c-myc gene. The presumptive coding region of the trout c-myc gene shows extensive homology to the c-myc genes of chicken, mouse, and human. Comparison of nucleotide sequences reveals that human, mouse, chicken, and trout c-myc genes contain at least two coding exons, interrupted by introns of decreasing size of 1.38 kilobases (kb), 1.2 kb, 0.97 kb, and 0.33 kb, respectively. The exons are clearly delineated by donor-acceptor splice signals. The degree of nucleotide homology between trout, chicken, and human exon II is less than that observed for exon III. However, the greatest homology among these three genes is localized to two specific regions within exon II (myc boxes A and B). At the predicted amino acid level, fish c-myc shows considerable homology to vertebrate c-myc gene products. Trout c-myc is expressed in normal trout cells as a single 2.3-kb mRNA species, similar in size to other vertebrate transcripts.

Effect of alternating combination chemotherapy on survival of ambulatory patients with metastatic large-cell and adenocarcinoma of the lung. A Southwest Oncology Group Study

Using a randomized prospective trial design, chemotherapy with 5-fluorouracil, vincristine, and mitomycin C (FOMi) was compared with cyclophosphamide, doxorubicin, and cisplatin (CAP) and with FOMi alternating with CAP (FOMi/CAP) in 452 eligible patients with metastatic large-cell undifferentiated and adenocarcinoma of the lung. Objective responses were obtained in 26%, 17%, and 22% of patients treated with FOMi, CAP, and FOMi/CAP, respectively. The median survival was similar for FOMi, CAP, and FOMi/CAP therapies (20, 24, and 23 weeks, respectively), but the overall survival (log rank test), 1-year survival, and remission duration were longer for FOMi/CAP-treated patients. Survival was significantly longer for fully ambulatory FOMi/CAP-treated patients compared with either FOMi (P = .01) or CAP (P = .04). Younger patients treated with full doses of therapy responded more often than older patients receiving reduced drug doses (26% and 11%, respectively; P = .003). A prognostic factor regression analysis of all eligible patients indicates that sex, performance status, stage, and treatment assigned were important independent variables determining survival (P less than .05). Toxicity was comparable in each treatment group.

Receptor-mediated uptake of lipoproteins by cultured porcine granulosa cells

Receptor-mediated uptake of low density lipoprotein (LDL) has been shown to provide a major source of cholesterol for a variety of cell types, particularly steroidogenic cells. In this study, the functional significance of lipoproteins in porcine ovarian granulosa cells and their mechanism of uptake by the cell was examined. Porcine LDL and high density lipoprotein (HDL) were isolated using a KBr density gradient, and the purity of both lipoproteins was confirmed by single corresponding bands on agarose gel stained for lipid and protein. Purified LDL and HDL were radioiodinated and labelled with colloidal gold for binding and tracer studies respectively. Both lipoproteins bind to cell surface and are internalized within 30 min at 37 degrees C. The cultured granulosa cells possess more HDL binding sites than LDL binding sites and are more responsive in progesterone production when supplemented with HDL. These results suggest that granulosa cells may preferentially utilize HDL over LDL as a source of cholesterol for steroidogenesis.

Clinical results of pars plana vitrectomy in posterior-segment disorders

From June 1981 to August 1983, a total of 142 eyes with posterior-segment disorders were treated with a pars plana vitrectomy technique using the Ocutome II system. The patients were 45 years old on average, with an average follow-up of six months. Simple vitrectomy was performed in 108 eyes, and additional retinal reattachment surgery was performed in the remaining 34 eyes. The lens was removed in 56 eyes and untouched in 65 eyes; the remaining 21 eyes were either aphakic or pseudophakic. All of the cases were divided into six main groups: two diabetic groups, two nondiabetic groups, a penetrating trauma group, and an endophthalmitis group. The two diabetic groups included 16 eyes with vitreous opacity, six of them complicated by retinal detachment. The two nondiabetic groups included a total of 91 eyes, with 31 of them complicated by retinal detachment. The group with penetrating trauma included 24 eyes, seven of which had been injured by intraocular foreign bodies. The endophthalmitis group included 11 eyes, of which six were the result of penetrating trauma and five the result of cataract operation. In this series, vision was maintained or improved in 78.9% of cases and improved in 51.4%. Eyes with vitreous opacities in conjunction with retinal detachment were complicated by proliferative vitreoretinopathy of moderate or severe degree. The reattachment rate was 50.0% in the diabetic group and 51.6% in the nondiabetic group.(ABSTRACT TRUNCATED AT 250 WORDS)

Surgical results of second-attempt radial keratotomy

The safety, efficacy, and stability of second-attempt radial keratotomy were evaluated in 20 eyes of 12 patients from September 1, 1982, to August 31, 1983. The average amount of refractive error change was 1.89 diopters with 1.38 diopters of corneal curvature flattening. The effect of the second-attempt operation was about 60% that of the first-attempt operation. No significant surgical complications were observed in this study.

The porcine LH/hCG receptor. Characterization and purification

Porcine luteal LH/hCG receptor (LH/hCG R) was solubilized with 70-80% recovery from the crude plasma membrane fraction by Triton X-100 in the presence of 25% glycerol and protease inhibitors. The solubilized receptor maintained 90% of original activity at -60 degrees C for 90 days. Equilibrium association constant (Ka) values of 1.92, 2.22, and 2.03 X 10(10) M-1 were observed for the whole homogenate, plasma membrane fraction, and solubilized LH/hCG R preparations, respectively. The specific binding capacity for the same fractions were 49, 70, 55 fmol/mg protein, respectively. Complexes of LH/hCG R and Triton X-100 were resolved into two components with approximate Mr = 2.7 X 10(5) and 5.4 X 10(5) by gel filtration on Sepharose 6B and two glycoprotein components by chromatography on concanavalin A-Sepharose. Solubilized porcine LH/hCG R was purified by two cycles of affinity chromatography on highly purified hCG-Sepharose with an overall recovery of 30-35% of the initial activity in the Triton extract. Purified porcine LH/hCG R had a specific binding capacity of 2300 pmol/mg protein and a Ka = 1.5 X 10(10) M-1. Silver staining of sodium dodecyl sulfate-polyacrylamide gel electrophoresis gels demonstrated that the major protein in porcine LH/hCG R preparations has Mr = 68,000. A weakly staining band at Mr = 45,000 was also observed in the purified receptor preparation. Analysis of iodinated purified LH/hCG R by autoradiography has confirmed these results. Porcine LH/hCG R was purified 40,000-fold by this method.

Treatment of non-small cell bronchogenic carcinoma with vinblastine and mitomycin: a Southwest Oncology Group Study

Forty-five patients with stage III M1 non-small cell bronchogenic carcinoma were treated with vinblastine (1 mg/m2 by iv bolus twice a day on 2 consecutive days) plus mitomycin (10 mg/m2 on Day 1). This treatment was repeated at 3-week intervals for three courses. Consolidation therapy with doxorubicin and cisplatin at doses of 50 mg/m2 each was administered to responders every 4 weeks for two courses, with subsequent vinblastine and mitomycin maintenance therapy every 6 weeks. Eleven partial remissions (24%) were achieved, with a median duration of remission of 16 weeks (range, 8-32) and a median survival of 19 weeks. No differences were seen in median duration of remission or survival by cell type or performance status.

Analysis of intraocular lens power calculation

We performed an analysis of ocular biometry and intraocular lens (IOL) power calculation on 100 eyes that had anterior chamber IOL implantation during 1981 and 1982. Various methods of calculating the IOL power were used, including the standard lens power, presurgical basic refraction, Fyodorov's formula, Colenbrander's formula, Binkhorst's formula, and the SRK formula. In addition, we took the median value of these calculated results as the median power in selecting an appropriate IOL power. The postoperative refraction and actually implanted IOL power were used to determine the IOL power needed for emmetropia. Our regression analysis of the predicted IOL power and power actually needed for emmetropia showed that the methods of standard power and presurgical basic refraction were unreliable while the rest were of satisfactory accuracy. Among the latter, all the predicted IOL powers based on the biometric data had almost the same coefficient of determination and standard error of estimate. However, with the SRK formula and the median power the values of the regression line were closest to the ideal value. With the regression analysis, the accuracy of predicted IOL power from theoretical formulas was comparable to that of the SRK regression formula.

Response of chronic myelogenous leukemia patients to COAP-splenectomy. A Southwest Oncology Group study

Eighty-seven patients from 18 institutions with a confirmed diagnosis of chronic myelogenous leukemia were registered on a Southwest Oncology Group protocol for multiagent induction and single-agent maintenance chemotherapy, with randomization to an immunotherapy arm. Elective surgical splenectomy was performed for 42 patients at the completion of 3 months of induction therapy. Final analysis of the study revealed statistically significant survival advantages were correlated with age, splenectomy, the absence of hepatic leukemic infiltrate at the time of splenectomy, and race.

Role of elective brain irradiation during combined chemoradiotherapy for limited disease non-small cell lung cancer

We have studied the clinical impact of elective brain irradiation (EBI) in patients with locally advanced, non-small cell lung cancer (LA-NSC). All patients received combination chemotherapy (cyclophosphamide + doxorubicin (Adriamycin) + cisplatin = CAP) or CAP plus radiotherapy as the initial treatment for their active tumor or as an adjuvant therapy. Of 97 evaluable patients, 46 were randomized to receive EBI (3 000 rad in 10 fractions given over two weeks). The characteristics of both groups were comparable by sex, age, performance status, pretherapy weight loss, histologic cell type, clinical staging, and type of prior therapy. EBI significantly decreased the incidence of central nervous system (CNS) metastasis in the treated group compared to the control group (4% vs 27%, p = .002). CNS involvement occurred in the treated group after failure at other sites whereas 12 of 14 control patients had CNS metastases as the first site of relapse. EBI decreased the incidence of CNS metastasis in all prognostic categories. Using multivariate analysis, the beneficial effect was shown to be significant in females, patients with good performance status, weight loss less than 6%, squamous cell histology, state III disease or no prior therapy. EBI significantly increased CNS metastasis-free interval with a beneficial effect that was significant in males, patients with weight loss less than 6%, squamous cell histology or responders. Although no survival benefit was observed for the treated group because of the adverse effect from other relapses, EBI will become more important as better treatment programs are developed.(ABSTRACT TRUNCATED AT 250 WORDS)

Complications related to 234 staging laparotomies performed in the Intergroup Hodgkin's Disease in Childhood study

This is a study of 234 children and young adult patients entered in the Intergroup Hodgkin's Disease in Childhood (stage I-II) Study from November 1975 to June 1981 and followed for a mean of 3.8 years after laparotomy. All patients had a staging laparotomy with total splenectomy, liver biopsy, and sampling of abdominal lymph node groups. Four patients (1.7%) have had documented sepsis, and three have had possible sepsis. There has been no sepsis-related death. Intestinal obstruction requiring operation was noted in four patients (no intestinal resection required). Urgent operation was necessary in two patients, one with ureteral obstruction and one with ovarian torsion, following a repositioning procedure, neither of these patients died. Organisms in the four patients with positive blood cultures were Streptococcus pneumoniae (two) and Haemophilus influenzae (two). Of the 234 patients in the study, 194 (83%) had received polyvalent pneumococcal vaccine, and 174 (74%) were taking prophylactic antibiotics. One of the two patients with pneumococcal sepsis had not been vaccinated, and the second was vaccinated only during radiotherapy. Only one of the four patients with positive blood cultures was on a prophylactic antibiotic treatment regimen at the time of the septic episode. The liabilities in employing laparotomy-splenectomy for the evaluation of pediatric patients with Hodgkin's disease include both general surgical complications and an increase in the risk of hyperacute infection, specifically related to encapsulated species. The latter appears to be modified to a major degree by current prophylactic measures or therapy.

Combined modality treatment of extensive small cell lung cancer: a Southwest Oncology Group study

The Southwest Oncology Group entered 453 patients with extensive small cell carcinoma into a combined modality treatment program, involving a randomized comparison of three different chemotherapy regimens for remission induction, and of maintenance chemotherapy alone versus maintenance treatment with cycles of reinduction added at six and 12 months. In addition, there was systematic comparison of diagnosis by institutional pathologist versus review panel pathologist. No difference was observed among the three different induction arms with respect to the incidence of response to treatment (61%), complete response (16%), or survival duration (median, 31 weeks). Neither overall response rate nor survival are superior to previous results. However, patients who achieved a complete response demonstrated significant survival benefit if they were in the group who received reinduction chemotherapy, as opposed to maintenance alone. This observation may apply most importantly to patients with small cell lung cancer of limited extent, for whom complete response is achieved in a majority. Agreement of institutional and review panel pathologists on the diagnosis of small cell lung cancer was observed in 94% of reviewed cases. A final observation is that the omission of chest irradiation results in a dramatic increase in the incidence of initial relapse at the primary tumor site. This suggests that future studies will need to use better therapy for local control in responding patients.

Drug combinations in the treatment of gastric adenocarcinoma: a randomized Southwest Oncology Group study

The FAM combination with the simultaneous administration of 5-fluorouracil, doxorubicin, and mitomycin C is considered standard chemotherapy for gastric adenocarcinoma. This study was initiated to determine whether a kinetically designed sequential administration of these three drugs would be superior and whether the presence or absence of easily measurable tumor would imply differences in survival. To do so, the Southwest Oncology Group tested two schedules in a randomized study of 239 patients. Independent judgments of response were made by two authors with the same results. Equivalent response rates (23% of all eligible sequential and 30% simultaneous) and median survival durations (22 and 23 weeks, respectively) were seen. Patients with and without readily measurable tumors each lived a median of 22 weeks. Higher degrees of hematologic toxicity were associated with prolonged survival (median 27 weeks versus 20 weeks, p = 0.04). Patients treated by community oncologists were described as having higher response rates than those treated in major medical centers (64% versus 31%, p = 0.03). The meaning of this is questionable in that there were no statistical differences in survival or toxicity. Those with prior exposure to 5-fluorouracil had only a tendency, without statistical significance, for a slightly inferior response and survival.

The natural history of gastric cancer and prognostic factors influencing survival

This study of 783 patients with histologically confirmed gastric carcinoma has confirmed the importance of several previously recognized patient- and tumor-related characteristics related to prognosis and identified some new ones. Of the tumor-related factors, the ones that showed the strongest relationship to survival following curative gastric resection were tumor stage, histologic type, breach of lymph-node capsule, sinus histiocytosis, and gross appearance. Of the tumor- and patient-related factors, the ones that showed the strongest relationship to survival from time of diagnosis of surgically noncurable disease were status of primary, liver metastasis, serum bilirubin level, ascites, extent of tumor burden, and weight loss. The effect of treatment with 5-fluorouracil (5-FU) on survival duration was at best only minimal. Only those patients who received two or more cycles of 5-FU therapy had survival advantage over the remaining patients. The use of regression analysis has made it possible to make predictions of the prognosis of the patients. These predictions could be used in future studies to determine comparability of prognosis of various groups included in different studies and different arms of a randomized study.

Prognostic factors influencing survival of patients with advanced colorectal cancer: hepatic-artery infusion versus systemic intravenous chemotherapy for liver metastases

In this study of 232 patients with histologically confirmed large bowel carcinoma, patient- and tumor-related characteristics were examined and their effect on prognosis was determined. Serum alkaline phosphatase and albumin concentrations, symptom duration prior to diagnosis of the primary tumor, and the status of the primary tumor showed the strongest relationship to survival after diagnosis of surgically noncurable disease. Patients who had normal serum alkaline phosphatase and albumin concentrations, patients whose symptoms lasted over 12 months before diagnosis, and patients whose primary tumor had been resected before diagnosis of noncurable disease had a good prognosis. Performance status, weight loss, sex, presence of liver metastasis, hemoglobin concentration, and absolute lymphocyte or monocyte counts in the peripheral blood, at time of diagnosis of surgically noncurable disease, were significant factors when examined individually. One hundred seventy-nine patients with metastatic colorectal cancer confined to the liver were selected from 601 patients who received chemotherapy for advanced colorectal cancer over 10-year periods to compare the efficacy of hepatic-artery infusion therapy with that of intravenous 5-fluoropyrimidine--containing chemotherapy. The two groups were similar with respect to prognostic factors. The hepatic-artery infusion chemotherapy produced a higher response rate than intravenous chemotherapy, but did not result in significant prolongation of survival.

A survey of eating/dieting attitudes and bulimic behavior among university undergraduate women

A random sample of female undergraduates at a large New England state university was surveyed by mail in 1983 to determine their attitudes and behavior relating to eating, dieting, and body weight. Results indicated dissatisfaction with and negative attitudes about eating habits and body weight. Forty-five percent had ever experienced uncontrolled binge-eating; 18 percent had a combination of bulimia symptoms, and 10 percent had used self-induced vomiting for weight control. The health education needs and interests of these students also were assessed and recommendations for university programs were made.

Leukemia and preleukemia after adjuvant treatment of gastrointestinal cancer with semustine (methyl-CCNU)

We evaluated the risk of acute nonlymphocytic leukemia, acute myelodysplastic syndrome, and preleukemia in 3633 patients with gastrointestinal cancer who were treated in nine randomized clinical trials. Among 2067 patients given semustine (methyl-CCNU) as adjuvant therapy, leukemic disorders developed in 14, whereas only one leukemic disorder (acute nonlymphocytic leukemia) occurred among 1566 patients given other therapies (relative risk = 12.4; 95 per cent confidence interval = 1.7 to 250). The six-year cumulative mean risk (+/- S.E.) of acquiring a leukemic disorder after treatment with semustine was 4.0 +/- 2.2 per cent; the incidence rate was 2.3 cases per 1000 persons per year. Risk increased significantly with time after treatment. The risk of leukemic disorders did not differ according to sex, race, age at treatment, or initial tumor type, nor was it enhanced by concomitant radiotherapy or immunotherapy. In addition, no excess of acute nonlymphocytic leukemia was seen in 44,370 patients treated for gastrointestinal cancer in Connecticut during the period 1935 to 1974, before the advent of nitrosourea chemotherapy. This study provides quantitative evidence that nitrosoureas are leukemogenic in human beings and confirms previous observations that adjuvant chemotherapy with alkylating agents may increase the risk of leukemia.

Randomized trial of 5-fluorouracil and mitomycin C with or without streptozotocin for advanced pancreatic cancer. A Southwest Oncology Group study

A prospective randomized trial comparing streptozotocin, mitomycin C, and 5-FU (SMF) with mitomycin C and 5-FU (MF) in patients with advanced pancreatic cancer was performed. In patients with measurable disease the response rates were 34% (19/56) to SMF, and 8% (5/60) to MF (P = 0.009). Median survivals were similar, however, 18 versus 17 weeks (P = 0.356). Median survival of patients responding to chemotherapy was 33 weeks, and for nonresponders it was 17 weeks (P = 0.002). In patients with nonmeasurable disease, median survivals were 21 weeks (SMF) and 18 weeks (MF) (P = 0.797). Patients surviving greater than or equal to 48 weeks, however, appeared to be increased in the SMF arm (14 patients) compared to the MF (7 patients). Toxicity was moderate for both regimens, with SMF having greater gastrointestinal and renal toxicity. Chemotherapy with SMF appears to produce objective responses in patients with pancreatic cancer, but does not improve survival compared to MF.

Management of adult acute leukemia. A Southwest Oncology Group study

Five hundred forty three adult patients with acute leukemia were entered on the study designed to: (1) test efficacy of vincristine and prednisone used as primary drug therapy in patients with good prognosis as judged by a circulating blast cell count less than 30,000 cm2; (2) investigate the use of either simultaneously or sequentially administered Adriamycin plus cytosine arabinoside plus vincristine and prednisone; and (3) to assess the use of bacillus Calmette-Guerin (BCG) in the maintenance phase on both the response and duration of response. Complete remissions were seen in 21% of patients with the vincristine and prednisone arm. Complete remission rates were similar in both the simultaneously and sequentially administered chemotherapy with overall complete remission rates of 55%. Median durations of complete remission and survival were 35 and 62 weeks, respectively, for patients with AML; and 47 and 75, respectively, for patients with ALL. Toxicity was within acceptable limits. BCG administered during the maintenance phase of therapy caused no differences in duration of complete remission and survival. These results demonstrate an improved response and duration of response over previous studies done by this group.

Identification and characterization of estrogen-responsive gene products in the liver of rainbow trout

Injection of male rainbow trout with estradiol induced the production of a major serum protein, vitellogenin (VG), of molecular weight (MW) 170 000. This protein is immunoprecipitable by an antiserum raised against lipovitellin from the eggs. Labelling by incubation of liver cubes of estradiol-treated fish with [35S]methionine and analysis of immunospecific products showed incorporation into two polypeptides of MW 170 000 and 160 000. The peptide patterns generated from these two polypeptides by Staphylococcus aureus V8 protease digestion were identical. Cytoplasmic poly(A)+ RNA of estradiol-treated male liver directs the synthesis of a polypeptide of 160 000 daltons in the reticulocyte cell-free protein-synthesizing system or in Xenopus oocytes. This polypeptide is chemically, immunologically, and electrophoretically identical to the authentic VG polypeptide of 160 000 daltons. Changes in mRNA populations in the liver of male fish following estradiol treatment were detected on gels and by hybridization. On methylmercuric hydroxide gels, a polyadenylated RNA species of about 6300 nucleotides was found in estradiol-treated fish which was absent from the control fish. Data from R omicron t analysis revealed the presence of at least two mRNA sequences of the high frequency class in the RNA of hormone-induced fish and their sizes were determined by Northern blot analysis to be 6300 and 1800 nucleotides, respectively. These observations are consistent with the induction of vitellogenins and at least another estrogen-responsive gene product by estradiol as reported in other egg-laying vertebrates.

Surface effects on Raman scattering from Sb deposited on Ag-island films

Surface-enhanced Raman scattering from crystal vibrational modes of a Sb film rather than from vibrational modes of individual molecules has been observed for the first time to our knowledge. A ~20x enhancement of the longitudinal-optical mode (150 cm(-1)) in the Raman spectra of crystalline Sb films deposited on silver-island films was obtained. The excitation profiles, as well as the dependence of Raman intensity on the thickness of Ag films, were studied.