The interaction of thermal tolerance with drug cytotoxicity in vitro

The effect of preheating EMT6 cells in vitro on their response to cytotoxic agents of either 43 degrees C or 37 degrees C has been investigated. Preheating for 3 h at 40 degrees C produced measurable protection (thermal tolerance) to subsequent treatment for 1 h at 43 degrees C. This preheat treatment was further found to reduce cell killing by BLM and BCNU (drug tolerance) present during 1 h at 43 degrees C. In contrast, no such heat-induced drug tolerance was seen with ADR. An additional effect with ADR was the apparent elimination of heat-induced thermal tolerance at toxic drug doses. However, preheating under these conditions had no effect on the subsequent cytotoxicity of any of these drugs at 37 degrees C. Also, preheating for 1 h at 43 degrees C was found to sensitize cells to BLM and BCNU toxicity at 37 degrees C but to protect against ADR toxicity. The results are discussed in relation to known mechanisms of cell killing by heat and of thermal tolerance.

The hyperthermic potentiation of the cytotoxic effect of misonidazole on the EMT6 mouse tumour: relevance of in vitro measurement of in vivo effect

The effect of local hyperthermia combined with misonidazole and the influence of temperature monitoring on this effect in growth delay studies and in vitro colony assay are described.

Enhancement by hyperthermia of the effect of BCNU against the EMT6 mouse tumor

The combination of moderate hyperthermia (43 degrees C water bath for 1 hour) and BCNU against the EMT6 mouse tumor has been studied. The effect was found to be much greater than could have been predicted from the effects of the single modalities and this is true whether the endpoint is tumor cure, growth delay, or in vitro assay of clonogenic fraction. The results indicate that inhibition of "recovery from potentially lethal drug damage" is not the mechanism by which heating potentiates the action of BCNU.

The sloughed urethra syndrome

Sloughing of the urethra following obstetric trauma or pelvic surgery usually results in total urinary incontinence. Nine patients in a series of 2,000 investigated for incontinence presented with this syndrome. A technique of urethral reconstruction from the vaginal wall using a supporting bulbocavernosus graft and a Marlex sling is presented and results are discussed.

Liver biopsy in hemophilia A

Hepatitis is a significant complication of the treatment of hemophilia A with factor VIII concentrates. Chronic liver disease in these patients is infrequently documented in the literature. The results of percutaneous liver biopsy, under the coverage of glycine-precipitated factor VIII, in six patients with hemophilia A who had the persistence of abnormal liver-function tests for at least 6 months, are described. Three patients had chronic active hepatitis, and three had chronic persistent hepatitis. No complications were encountered as a result of the biopsy procedure. These results suggest that percutaneous liver biopsy should be considered in patients with hemophilia A with continuously abnormal liver-function tests to establish a histologic diagnosis and to guide further therapy.

Risk factors and early diagnosis in pancreatic carcinoma

A case is reported of pancreatic carcinoma recognized four years after bile peritonitis complicated cholecystectomy. The patient possessed all the known significant risk factors associated with pancreatic carcinoma. The wider recognition of risk factors for pancreatic adenocarcinoma might lead to closer follow-up of patients with multiple factors and possible earlier diagnosis and treatment leading to increased survival in patients with the disease.

Interaction of hyperthermia and the hypoxic cell sensitizer Ro-07-0582 on the EMT6 mouse tumour

The combination of hyperthermia and the hypoxic cell radiosensitizer Ro-07-0582 has been investigated on the EMT6 tumour implanted into the legs of BALB/c mice. Treatments at a drug dose of 1 mg/g over a range of waterbath temperatures from 37 to 45 degrees C are described. The surviving clonogenic fraction following treatment was assayed in vitro. Measurements of intra-tumour temperature have been made, and shown to be better correlated with the cytocidal effect on the tumour than the waterbath temperature. No significant effect of Ro-07-0582 was observed at 37 degrees C. However, marked cytotoxicity due to the drug was seen at intra-tumour temperatures above 42-5 degrees C for 1 h. These were in addition to the cytocidal effect of the hyperthermia. The results are discussed in relation to the distribution of temperatures and hypoxic cell populations throughout the tumour.

Recurrent stress urinary incontinence in the female

1,500 females presenting with recurrent urinary incontinence were investigated in depth. 27% required further surgery, 127 of whom were treated with a 2-team Marlex sling. Careful assessment is the key to treatment including cystoscopy and good radiological documentation. One must be aware of the capabilities and limitations of the various procedures employed for stress incontinence and select the correct procedure for the given problem. When dealing with recurrent stress incontinence the surgical procedure must take down all periurethral scar, anteriorly and posteriorly and adequately elevate the urethrovesical junction so it is not the dependent point at the base of the funnel. The Marlex sling procedure fulfills the above criteria, has been singularly effective, and remarkably free of complications.

Dermabrasion and limited excision of the fibrous papules of tuberous sclerosis: case report

We report a patient with tuberous sclerosis who had chronic bleeding from the fibrous papules on his face. Dermabrasion and local excision of these was a simple and effective treatment. Follow-up at one year is reported.

Total pancreatectomy for recurrent medullary fat necrosis

A patient had subcutaneous and medullary bone fat necrosis associated with chronic, recurrent pancreatitis. In the case, recurrent symptoms of pancreatitis as well as progressive bone destruction were correlated with an increase in serum lipase levels. Total pancreatectomy was followed by relief of all symptoms and healing of destroyed bone. Medullary fat necrosis may be associated with pancreatitis, pancreatic trauma, or cancer of the pancreas. Pancreatectomy may be useful if conservative treatment does not lead to healing of severe medullary fat necrosis associated with recurrent pancreatitis.

Experimental observations on the eosinopenia induced by acute infection

The effect of trichinosis on the number of eosinophils in the peripheral circulation and in the marrow has been determined in mice by accurate techniques. There is a sharp rise in number of eosinophils in the bone marrow and in the peripheral blood beginning about the 10th day, which persists for some weeks. The correlation between peripheral blood and evidence of bone marrow production is remarkably close.

When acute Escherichia coli pyelonephritis is induced during the height of eosinophilia due to trichinosis these cells rapidly disappear from peripheral blood and bone marrow, so that by the end of 24-48 hr the counts are in or near the normal range.