A 31P nuclear magnetic resonance study in vivo of metabolic abnormalities in rats with acute liver failure.

31P NMR spectroscopy was used in conjunction with conventional biochemical techniques to study metabolic abnormalities in normal rats, in rats with CCl4-induced acute liver failure and in rats with paracetamol-induced acute liver failure. Studies were carried out before and after a metabolic challenge in the form of a fructose infusion. Prior to fructose infusion the ATP levels in the groups with acute liver failure were significantly lower than in control rats, despite their having a similar ATP/Pi ratio.

Determination of plutonium in urine by radiochemical separation and use of etched CR-39 track analysis.

Well-validated preparative and radiochemical procedures for separating plutonium from urine by wet-oxidation, ion-exchange and electrodeposition are outlined. Recently developed application of etched alpha track analysis using an automated image analyser is described. Experiences with this sensitive radiometric technique are reported and discussed.

Simplifying infusion chemotherapy: preliminary communication.

A low-intervention policy for Hickman catheter maintenance has been evaluated and found to be safe and cost effective. A simple, lightweight, disposable device has been used for 24-hour ambulatory home infusion. Implementation of this policy as part of a prospective randomized trial of single-agent chemotherapy in advanced breast cancer has demonstrated that slow intravenous infusion reduces the acute toxicity of epirubicin when compared with bolus injection.

Failure of kindling to alter susceptibility to kainic acid.

In this study, the interaction between electrical kindling and kainic acid seizures was investigated. Prepubescent male rats were kindled using hourly, suprathreshold stimulations. Two days later the kindled rats and their non-kindled controls received systemic injections of either 6, 10, or 17 mg/kg of kainic acid.

Primary adenocarcinoma of the cervix: treatment and results.

Between 1972 and 1983, 49 patients with adenocarcinoma of the cervix were treated in four ways: (i) radiotherapy alone, (ii) pre- or postoperative radiotherapy and a total abdominal hysterectomy and bilateral salpingo-oophorectomy, (iii) Wertheim's hysterectomy, and (iv) pre- or postoperative pelvic radiotherapy and Wertheim's hysterectomy. The 5-year survival results for patients with FIGO Stage I disease was 90%; with Stage II disease 60%; with Stage III disease 11% and none survived with Stage IV disease. All the patients, except one (Stage III), with well-differentiated tumours are alive and disease-free, irrespective of the type of treatment they received whereas only one patient out of the 13 who had poorly differentiated tumour is alive and disease-free.

Spectral resolution in clinical magnetic resonance spectroscopy.

We observe linewidths of 0.1-0.4 ppm in 31P spectra of human muscle, liver, and brain.

A randomized, prospective, comparative, multicentre trial of a single combination versus alternating combinations of antitumour drugs in advanced breast cancer.

A prospective, multicentre trial was conducted in 262 patients with advanced breast cancer randomized to receive every 3 weeks either: (i) a single five-drug combination of adriamycin (50 mg), vincristine (1.5 mg) and 5-fluorouracil (750 mg) given intravenously; with methotrexate (50 mg) intramuscularly and chlorambucil (10 mg) orally all at time zero, followed by three further doses of chlorambucil (10 mg) at 6-h intervals, or (ii) one course of two alternating three-drug combinations consisting of regimen A--vincristine (1.5 mg), adriamycin (70 mg) and methotrexate (50 mg) and regimen B--5-fluorouracil (750 mg) and vindesine (5 mg) intravenously with cyclophosphamide (50 mg) orally at time zero, followed by three further doses of cyclophosphamide (50 mg) at 6-h intervals.

A preliminary study of low-dose splenic irradiation for the treatment of chronic lymphocytic and prolymphocytic leukaemias.

21 patients, 18 with chronic lymphocytic leukaemia (CLL) and 3 with prolymphocytic leukaemia (PLL), all B-lymphocyte origin and with progressive disease, were treated with a regime of low-dose splenic irradiation (SI). All patients experienced a rapid relief of disease-related symptoms. Following SI the total lymphocyte count (TLC) was markedly reduced in 18 patients.

Adjuvant chemotherapy in the treatment of breast cancer: results of a multicentre study.

248 patients with locally radically treated early breast cancer (196 node-positive) were randomized post-operatively between 6 courses of a 'CMF like' chemotherapy and no further treatment. Results (with a minimum of 5 years follow-up on every patient) favour chemotherapy with a significant increase in the median time to recurrence from 31 to 50 months for all patients (P = 0.04) and from 26 to 49 months for node-positive patients (P = 0.

Interpretation of the breath hydrogen profile obtained after ingesting a solid meal containing unabsorbable carbohydrate.

The extent to which monitoring breath hydrogen excretion provides information concerning the entry of the residues of a solid test meal into the colon was investigated in 89 normal subjects, and 11 patients with the irritable bowel syndrome. The profile of breath hydrogen concentration showed an early peak, that occurred soon after ingesting the test meal in 89% subjects. This was followed by a later more prolonged rise in breath hydrogen concentration.

Oral pemoline kinetics in hyperactive children.

The time course of pemoline in plasma was investigated in seven prepubescent boys with attention-deficit disorders who were hyperactive. Maximum plasma concentrations of 4.3 +/- 1.

Liquid chromatographic determination of propoxyphene and norpropoxyphene in plasma and breast milk.

A sensitive and specific high-performance liquid chromatographic (HPLC) procedure was developed for determination of propoxyphene and norpropoxyphene in plasma and breast milk. The compounds were isolated from the biological specimen by extraction, the organic phase was evaporated to dryness, and the residue was redissolved in mobile phase [acetonitrile: 0.002 M H2SO4 (1:1)].

A clinician's view on palliative care, terminal care and quality of life.

No more than 20-25% of cancer patients are cured and 55% need palliative treatment from the time of diagnosis. Medical and nurse training in palliative care, and pain control in particular, is poor and there is a great shortage of doctors trained in terminal care. Palliative care is detailed, complex care and includes many services both in the hospital and in the community.

Gall stones and mortality: a study of all gall stone related deaths in a single health district.

In a prospective study of gall stone related deaths in a single Health District, the biliary tract was examined at necropsy in 1701 cases and 8078 death certificates were searched. Gall stones were identified as the cause of death in only 21 cases (0.26%) but in 291 subjects found to have gall stones or cholecystectomy at necropsy, the mortality was 3.

Obstructing/perforated carcinoma of the left colon treated by resection and the formation of a double colostomy.

Forty patients presenting with obstructing left colon tumours between 1975 and 1980 were treated by a modified Paul-Mikulicz resection. The hospital mortality was 5 per cent. Subsequent mortality was largely related to the stage of the tumour at presentation and was not higher than that to be expected after an elective resection.

Effect of infusion of nutrient solutions into the ileum on gastrointestinal transit and plasma levels of neurotensin and enteroglucagon.

The small bowel transit time of 100 ml of lactulose solution infused at the ligament of Treitz was measured by breath hydrogen excretion in paired studies carried out in 43 healthy volunteers during infusion (1.2 ml/min) of equal volumes (100 ml) of isotonic solutions of either fat emulsion (Intralipid, Prosparol, or Calogen), protein hydrolysate, glucose, or saline into either the jejunum (90 cm from the teeth), ileum (205 cm from the teeth), or colon (350 or 400 cm from the teeth). Ileal infusion of Intralipid or protein hydrolysate resulted in significant delays in small bowel transit time (125 +/- 21 min and 71 +/- 11 min, respectively) compared with infusion of saline (50 +/- 3 min; p less than 0.

Antimetastatic effect of cimetidine on mice bearing a C3H mouse mammary adenocarcinoma: survival and lymphocyte function studies.

It has been reported that treatment with cimetidine, a histamine H2-receptor antagonist, increased survival and decreased the number of lung metastases in mice bearing the Lewis Lung carcinoma [29]. It was suggested that this effect was due to the ability of cimetidine to block histamine activation of suppressor lymphocytes and hence allow host defence mechanisms to inhibit tumour growth. In the present studies, C3H/He mice were implanted with a C3H mouse mammary adenocarcinoma on Day 0.

Metronidazole v. cefoxitin in severe appendicitis--a trial to compare a single intraoperative dose of two antibiotics given intravenously.

In severe appendicitis, the effect of a single intravenous dose of metronidazole (500 mg) was compared with cefoxitin (1 g). The antibiotics were given by random allocation once the diagnosis had been established at operation. In the metronidazole group, 5 out of 48 patients developed a wound infection whilst in hospital compared with 13 out of 48 in the cefoxitin group (P = 0.

Effect of gastrointestinal intubation on the passage of a solid meal through the stomach and small intestine in humans.

The effect of a gastrointestinal tube on the passage of a radiolabeled solid meal through the stomach and small intestine was investigated in 22 healthy volunteers using the gamma camera and breath hydrogen analysis. Gastric emptying was significantly retarded in 12 subjects, who had an intestinal tube in situ compared with 10 control subjects, who were not intubated (t 1/2 = 1.5 +/- 0.

Seventh interim progress report of the british institute of radiology fractionation study of 3F/week versus 5F/week in radiotherapy of the laryngo-pharynx.

A fresh analysis of the data entered into the multicentre BIR fractionation trial of 3F/week versus 5F/week in radiotherapy of the laryngopharynx has been undertaken. Completed records of the 732 patients initially entered into the trial have now risen from 687 at the last report to 706. The data have been analysed in a manner similar to that adopted previously so as to measure the effects of the two regimes on both tumour and normal tissues, and some additional analyses have now also been made.