Brain-stem tumors in childhood: a prospective randomized trial of irradiation with and without adjuvant CCNU, VCR, and prednisone. A report of the Childrens Cancer Study Group

Seventy-four children with a brain-stem tumor diagnosed between 1977 and 1980 were entered into a prospective study in which exploration and assessment for resection were optional, radiation treatment using standard methods was required, and randomization occurred with regard to the use of adjuvant chemotherapy (1-(2-chloroethyl)-1-nitrosourea, vincristine, and prednisone) or no further treatment. The overall 5-year survival rate was 20% and was not improved by the adjuvant chemotherapy program. An increased risk of infection was associated with the adjuvant therapy.

Excess Molar Volumes of Binary Mixtures of Ethyl Acetate and Propyl Acetate With Normal Alkanols

This article reports measurements of VE/m at 298.15 K for binary mixtures of n- alkanols CnH2n+1OH (from n = 2 to n = 10) with ethyl and propyl acetates. All the excess volumes are positive over the entire concentration range, with VE/m increasing with the length of the alkanol chain. Suitable equations have been fitted to the data for each mixture. The results are compared with data previously published.

Study of the main extracted species of cobalt(II) ion with dodecylthioglycolic acid as extractor

The distribution of cobalt(II) between water and an organic extractant (dodecylthioglycolic acid) dissolved in kerosene has been studied using a tracer of 60Co. The aqueous media wee always constituted by buffer solutions (acetic acid – sodium acetate) and the ionic strength was adjusted with sodium nitrate to 1 mol dm−3. The main species of cobalt(II) originating in the organic phase has been isolated and characterized on the basis of elemental analysis, thermal gravimetric analysis, and ir spectra.

Computed tomography in stage III neuroblastoma

This multicenter study was designed to determine if CT can assess operability in stage III neuroblastoma. Nineteen children (11 boys, eight girls), aged 2-51 months, considered to have, by conventional clinical and radiographic examinations, localized neuroblastoma that crossed the midline were examined by CT. After intravenous and oral contrast media enhancements, CT was able to show the relation of the tumor to the adjacent vital vessels: aorta, celiac axis, and superior mesenteric artery. In all 15 patients, tumors that encased the aorta or its major branches were unresectable. However, three of four tumors crossing the midline but not coming into contact with the aorta or adherent only to one side of the vessel could be resected. Because surgery currently plays the major role in the treatment of neuroblastoma, the relation of the tumor to the aorta and great vessels is a more reliable and important factor in predicting the outcome of these children than the extension and location of the tumor with reference to the midline. CT after intravenous contrast enhancement can establish this relation and assess resectability.

Excess molar volumes of binary mixtures of 2-hexanone with n-alkane at 298.15 K

The excess molar volumes, [Formula: see text], of 2-hexanone (MBK) with n-hexane, n-heptane, n-octane, n-nonane, n-decane, n-undecane, n-dodecane, and n-tridecane have been obtained at 298.15 K from densities measured with a vibrating tube densimeter. The [Formula: see text] are positive over the entire composition range in all mixtures, with the exception of the MBK + n-hexane system, where an inversion of the sign of [Formula: see text] is observed. In other systems, [Formula: see text] increases with increasing size of the alkyl group in n-alkane.

[Intestinal invagination caused by a lymphangiolipoma]

We report a 11 year-old boy with ileo-ileal intussusception due to a pediculated tumor of the bowel wall. This lesion was found to be a lymphangiolipoma in which mature adipose cells were interspersed with dilated lymphatic ressels. Tumorectomy by enterotomy was curative. The ranty of this hamartomatous lesion is pointed out.

Excess Molar Volumes of Butyl Acetate+an n-Alkanol at 298.15 K

Excess molar volumes VEm at 298.15 K and atmospheric pressure were calculated over the entire composition range from densities measured with a vibrating-tube digital densimeter for the binary mixtures butyl acetate + methanol, + ethanol, + propan-1-ol, + butan-1-ol, + pentan-1- ol, + hexan-1-ol, + heptan-1-ol, + octan-1-ol, + nonan-1-ol and + decan-1-ol. The excess volumes are positive over the entire composition range for these mixtures except the system butyl acetate + methanol, for which all VEm values are negative. The excess volumes show a consistent trend towards more positive values as the length of the hydrocarbon chain of the alkanol increases. The results suggest the presence of specific interactions.

5-Fluorouracil and 1-(2-chloroethyl)-3-cyclohexyl-1-nitrosourea (CCNU) followed by hydroxyurea, misonidazole, and irradiation for brain stem gliomas: a pilot study of the Brain Tumor Research Center and the Childrens Cancer Group

Twenty-eight evaluable children with the diagnosis of brain stem glioma were treated with 5-fluorouracil and CCNU before posterior fossa irradiation (5500 rads); during irradiation, the children received hydroxyurea and misonidazole. The treatment was well tolerated, and minimal toxicity was produced. The median relapse-free survival was 32 weeks, and the median survival was 44 weeks. Analysis of covariates showed that, in patients between the ages of 2 and 19 years, survival was longest in the older children (P less than 0.02). Tumor histology, sex, extent of operation (if any), Karnofsky score, and radiation dose did not correlate with survival.

Neonatal neuroblastoma metastatic to the iris

A newborn infant was found to have Stage IVS retroperitoneal neuroblastoma. Multiple iris nodules were present at birth and regressed in synchrony with the primary tumor mass as chemotherapy was administered. A summary of the ocular manifestations of neuroblastoma is presented. A discussion of the possible significance of the iris lesions in this case is given. As far as we are aware, this is the first case report of neuroblastoma metastatic to the iris.

Presymptomatic central nervous system therapy in previously untreated childhood acute lymphoblastic leukaemia: comparison of 1800 rad and 2400 rad. A report for Children's Cancer Study Group

The Children's Cancer Study Group has organised two therapeutic clinical trials designed to evaluate the efficacy of various types and doses of CNS prophylaxis in the treatment of childhood acute lymphoblastic leukaemia. Of 478 previously untreated patients who subsequently achieved an initial marrow remission, 299 were randomised to receive 2400 rad craniospinal radiation therapy (RT) or 2400 rad cranial RT plus intrathecal methotrexate (i.t. MTX) while the remaining 179 patients were randomised between the same two regimens using a radiation dose of 1800 rad. All patients received identical induction and maintenance chemotherapy. Comparison of the two studies indicated that reduction of the dose of CNS radiation from 2400 rad to 1800 rad did not result in a significant increase in the frequency of CNS relapse, bone marrow relapse, or death. Moreover, no significant differences were observed when analyses were done within prognostic risk groups. Randomised trials with RT doses lower than 1800 rad or with i.t. chemotherapy alone should be considered to determine the most effective and least toxic forms of CNS prophylaxis.

Active components in Perezia roots

The effects produced by perezone, which was isolated from Perezia cuernavacana Rob. et Greenm., and hydroxyperezone monoangelate, from Perezia hebeclada (D.C.) A.Gray, on intestinal motility in vivo and in vitro in animal experiments are reported. It is suggested that hydroxyperezone monoangelate is a laxative principle present in certain species of the Perezia genus, with use in Mexican folk medicine.

Effect of the septal lesion on the non-learned responses of the rat

Effect of septal lesions has been studied in rats to find if they alter aspects of its SSDR. Results may be summarized as follows: 1. Animals with the septal syndrome tried to attack only when about to be caught, while they showed exaggerate freezing and submissive responses once caught. 2. A shock associated situation caused an increase in the freezing behavior and a decrease in the number of boluses excreted. 3. The septal animals never left walls of the open field, and did not explored its internal areas, showed in increase in thigmotaxis. 4. They showed an increase in the emergence time. The results are interpreted as due to an enhancement of the species-specific defence reactions.

Tumors of the pineal and suprasellar region: Childrens Cancer Study Group treatment results 1960--1975: a report from Childrens Cancer Study Group

Tumors of the pineal and suprasellar region form a rare and interesting group of lesions with germinomas accounting for over 50% of all lesions in this anatomic region. The Brain Tumor Committee of Childrens Cancer Study Group (CCSG) recently surveyed all CCSG member institutions to determine treatment parameters and assess the techniques. A total of 140 patients were seen during the period from 1960 to 1975; 118 patients were evaluable, having adequate treatment records. One hundred and one patients were less than 30 years of age with a 2:1 male predominance. Thirty-six of the 57 biopsied patients (63%) were found to have germinomas. The survival of patients in the germinoma group (72%) was comparable to that of the patients without biopsy (71%). The overall survival rate for all patients (biopsied and unbiopsied) was 65% with follow-up times ranging from 2 to 15 years. Nine patients developed spinal cord metastases (8%), two of whom also had simultaneous primary recurrence; none of these patients had received adjunctive spinal irradiation.

Multiple agent chemotherapy including bleomycin of non-Hodgkin's lymphoma during pregnancy

The association of non-Hodgkin's lymphoma and pregnancy is a rarely reported occurrence. We describe the case of a female patient in which a wide-spread lymphoma of mixed lymphohistiocytic diffuse type was diagnosed in the second trimester of the pregnancy. Combination chemotherapy (cyclophosphamide, vincristine, prednisone and bleomycin) was started at approximately the twenty-first week of fetal life. A prompt remission was obtained and a normal full term infant was born. Chemotherapy of progressive lymphoma in women late in pregnancy appears to be rational with little risk of fetal malformation or morbidity.

Multiple agent chemotherapy including bleomycin of non-Hodgkin's lymphoma during pregnancy

The association of non-Hodgkin's lymphoma and pregnancy is a rarely reported occurrence. We describe the case of a female patient in which a wide-spread lymphoma of mixed lymphohistiocytic diffuse type was diagnosed in the second trimester of the pregnancy. Combination chemotherapy (cyclophosphamide, vincristine, prednisone and bleomycin) was started at approximately the twenty-first week of fetal life. A prompt remission was obtained and a normal full term infant was born. Chemotherapy of progressive lymphoma in women late in pregnancy appears to be rational with little risk of fetal malformation or morbidity.

Gonadal function abnormalities in sickle cell anemia. Studies in adult male patients

Thirty-two adult patients with sickle cell anemia were evaluated endocrinologically. Secondary sex characteristics were abnormal in 29, and eunuchoidal skeletal proportions were present in all except one. The age at which different stages of pubic hair growth were attained in these patients was delayed in comparison to normals (P less than 0.005). Hormonal assays were carried out in 14 patients. Basal serum testosterone, dihydrotestosterone, and androstenedione values were lower (P less than 0.02) in patients than controls. Serum LH and FSH levels before and after stimulation with gonadotropin-releasing hormone were consistent with primary testicular failure. Erythrocyte and hair zinc concentrations were significantly decreased, and there was positive correlation between erythrocyte zinc and serum testosterone (r = 0.61, P less than 0.01) in sickle cell anemia. Our study shows that androgen deficiency in this disease is a result of primary rather than secondary hypogondadism. Further studies are required to establish the role of zinc in the pathogenesis of testicular failure in sickle cell anemia.

Trace elements in sickle cell disease

Trace elements in 84 adult patients (38 men and 46 women) with sickle cell disease (SCD) were reflected in clinical and biochemical data. Height was retarded in six men and five women. Eighty percent of the SCD patients in this sample were below the 50th percentile from the normal mean for weight. Twenty-eight men showed a lack of facial and body hair, and five additional subjects showed only scanty facial hair. Whereas zinc in plasma, red blood cells, and hair was decreased, the excretion of zinc in urine was increased in SCD patients as compared to the controls. We believe that one of the mechanisms accounting for zinc deficiency in SCD may be hyperzincuria and that growth retardation and hypogonadism in men so commonly seen in SCD may be related to zinc deficiency.

L-asparaginase reinduction and maintenance therapy in previously treated acute lymphocytic leukemia

Four patients with acute lymphocytic leukemia previously treated with conventional chemotherapy received intramuscular L-asparaginase in combination with other chemotherapy for reinduction and maintenance therapy. These patients received the L-asparaginase for 8, 14, 27, and 34+ months without demonstrating any significant adverse effects. Only 1 of the 4 was clearly resistant to the other chemo-therapy, and 3 of 4 had recurrence of their disease while receiving L-asparaginase. L-asparaginase can be added to reinduction and maintenance regimens of patients resistant to other chemotherapy and is well tolerated for long periods when given intramuscularly weekly with other immunosuppressant agents.

Intensive chemotherapy as primary treatment for rhabdomyosarcoma of the pelvis

Twenty-six cases of childhood rhabdomyosarcoma involving the pelvis were treated at Childrens Hospital of Los Angeles between 1950 and 1972. The median survival of 17 patients treated up to 1970 was 6 months. Of a group of 9 patients treated with intensive chemotherapy (ICG) prior to surgery and/or x-ray therapy, 5 are surviving from 12 to 60 months and have a relative survival rate of 4.5 times that of the mixed therapy group (MTG) (p = 0.01). Deaths have occurred only in patients with Stage IV disease. The use of preoperative chemotherapy with or without x-ray therapy followed by local surgical excision when necessary can be as effective in prolonging the survival of children with pelvic rhabdomyosarcoma as those obtained with more traditional approaches; this limitation in use of surgery is likely to preserve the quality of life, should the child live to adulthood.

Zinc deficiency in sickle cell disease

Clinical similarities between patients with sickle cell anemia and zinc-deficient subjects suggested a secondary zinc deficiency in sickle cell anemia. Zinc was assayed in various biological fluids and tissues by atomic absorption spectrophotometry. Zinc in the plasma, erythrocytes, and hair was decreased and urinary zinc excretion was increased in anemia patients as compared to controls. Erythrocyte zinc and daily urinary zinc excretion were inversely correlated in the anemia patients (r equal to minus .63, P smaller than 0.05), suggesting that hyperzincuria may have caused zinc deficiency in these patients. Carbonic anhydrase, a zinc metalloenzyme, correlated significantly with erythrocyte zinc (r equal to plus 0.94, P smaller than 0.001). Plasma RNase activity was significantly greater in anemia subjects than in controls. We administered zinc sulfate, 660 mg per day, orally, to seven men and two women with sickle cell anemia. Two 17-year-old males gained 5 cm and 7 cm in height during 49 and 42 weeks of zinc therapy, respectively. All but one patient gained weight (0.5 kg to 4.1 kg). Five of the males showed increased growth of pubic, axillary, facial, and body hair, and in one a leg ulcer healed in six weeks on zinc and in two others some benefit of zinc therapy on healing of ulcers was noted.

[Left atrio-ventricular parachute valve. Clinical, angiocardiographic and anatomic study, presentation of 6 cases]

Report of 6 cases of parachute left atrio-ventricular valve, combined with complex malformations in 4. Age ranged from 24 hours to 9 years, five of them being less than 3 months old. Four girsl and two boys. All were examined post-mortem and two had angiography and chateterization. This series was compared with those described in the world literature.

An unusual hemoglobin anomaly and its relation to alpha-thalassemia and hemoglobin-H disease

A Chinese family with hemoglobin H in the propositus has been reinvestigated. Although the original propositus is now deceased, a sister has the same hematological manifestations. Her hemoglobin, like that of the deceased sister, contains hemoglobins A, H, and Bart's. In addition, however, two minor components have been detected. These minor components appear to have abnormal alpha-chains and are also present in the maternal grandmother, the mother, a maternal aunt, and three other siblings but only in about one-tenth the amount. One of the minor components may be the same as Hb-Thai (25). The father has the characteristics of classical alpha-thalassemia. These results are discussed in relation to current concepts of alpha-thalassemia as they relate to "silent" and "classical" alpha-thalassemia and to possible multiple alpha-chain loci.

Studies of tubular alterations in diffuse renal disease. II. Quantitative evaluation of cellularity and length of proximal convoluted tubules in the kidney of lupus nephritis

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