CD34+ cell dose requirements for rapid engraftment in a sequential high-dose chemotherapy regimen of paclitaxel, melphalan, and cyclophosphamide, thiotepa, and carboplatin (CTCb) with PBPC support in metastatic breast cancer.

Sequential high-dose chemotherapy may increase the threshold dose of CD34+ cells necessary for rapid and successful hematologic recovery. There are limited data regarding the pharmacodynamics and threshold CD34+ cell dose required for engraftment following high-dose paclitaxel. To determine the dose of CD34+ PBPC sufficient for rapid engraftment, 65 women with metastatic breast cancer undergoing a sequential high-dose paclitaxel, melphalan, and cyclophosphamide, thiotepa, and carboplatin (CTCb) chemotherapy regimen were evaluated.

A phase I study of high-dose BCNU, etoposide and escalating-dose thiotepa (BTE) with hematopoietic progenitor cell support in adults with recurrent and high-risk brain tumors.

This phase I dose-escalation study was performed to determine the tolerability of three-drug combination high-dose BCNU (B) (450 mg/m2), escalating-dose thiotepa (500-800 mg/m2) and etoposide (1200 mg/m2) in divided doses over four days in 22 adults with malignant primary brain tumors. Patients received G-CSF and hematopoeitic support with peripheral blood progenitor cells (PBPC) (n = 18) or both PBPC and marrow (n = 4). The maximum tolerated dose of thiotepa with acceptable toxicity was determined as 800 mg/m2.

Epidemiology of Helicobacter pylori in chronic haemodialysis patients using the new RIBA H. pylori SIA.

Background: There are few data concerning the epidemiology of H. pylori in patients on chronic haemodialysis (HD) treatment. These surveys concerned small populations and were made with ELISA technique.

Stability and sulfur-reduction activity in non-aqueous phase liquids of the hydrogenase from the hyperthermophile Pyrococcus furiosus.

Hydrogenase from the hyperthermophilic archaeon, Pyrococcus furiosus, catalyzes the reversible activation of H(2) gas and the reduction of elemental sulfur (S degrees ) at 90 degrees C and above. The pure enzyme, modified with polyethylene glycol (PEG), was soluble (> 5 mg/mL) in toluene and benzene with t(1/2) values of more than 6 h at 25 degrees C. At 100 degrees C the PEG-modified enzyme was less stable in aqueous solution (t(1/2) approximately 10 min) than the native (unmodified) enzyme (t(1/2) approximately 1 h), but they exhibited comparable H(2) evolution, H(2) oxidation, and S degrees reduction activities at 80 degrees C.

Predictors of milk consumption in a population of 17- to 35-year-old military personnel.

Objective: The purpose of this investigation was to survey an entire population of Air Force recruits (N = 32,144) regarding milk consumption and demographic and health-related factors that may predict milk consumption.

Design: All subjects were required to fill out a 53-item health survey at the start of basic military training.

Subjects/setting: All recruits who entered the US Air Force from August 1995 to August 1996 participated in this study (N = 32,144).

Poly(ethylene glycol)-modified ligninase enhances pentachlorophenol biodegradation in water-solvent mixtures.

Polychlorinated hydrocarbons are prevalent environmental contaminants whose rates of biodegradation are limited by their minimal solubilities in aqueous solutions where the biological reactions take place. In this study, ligninase (LiP) from Phanerochaete chrysosporium was modified by poly(ethylene glycol) to enhance its activity and stability for the biodegradation of pentachlorophenol (PCP) in the presence of acetonitrile (MeCN), a water-miscible solvent. The modified enzyme retained 100% of its activity in aqueous solutions and showed enhanced tolerance against the organic solvent.

Side effects of triazolam in children.

Purpose: This study examined the incidence of side effects occurring with three doses of orally administered triazolam in children undergoing restorative dental procedures.

Methods: Thirty children, aged 39-81 months, participated in the study. The children were pretested for gait ataxia, amnesia, visual acuity, stereoscopic depth perception, and diplopia during a screening session.

Phase I trial of sequential high-dose chemotherapy with escalating dose paclitaxel, melphalan, and cyclophosphamide, thiotepa, and carboplatin with peripheral blood progenitor support in women with responding metastatic breast cancer.

A single high-dose cycle of chemotherapy with stem cell support can produce disease-free survival of 15-20% for at least 3 years in women with responding stage IV breast cancer. North American Autologous Bone Marrow Transplant Registry data suggest that a complete response (CR) is the single most important prognostic factor associated with prolonged disease-free survival. Therefore, if sequential high-dose chemotherapy can increase the CR rate, then perhaps an increased proportion of patients will remain disease free.

Evaluation of costs and benefits of advances in cytologic technology. International Academy of Cytology Task Force summary. Diagnostic Cytology Towards the 21st Century: An International Expert Conference and Tutorial.

Issues: Uterine cervical cytology smears are among the most cost-effective cancer prevention interventions available, but they are not infallible, and new or modified technologies have been and will be proposed to improve diagnostic accuracy. Before these new technologies are accepted, their performance attributes will be carefully studied and defined. Equally important in this era of fiscal constraints are cost/benefit analyses, for which we review certain guidelines.

Computerized screening devices and performance assessment: development of a policy towards automation. International Academy of Cytology Task Force summary. Diagnostic Cytology Towards the 21st Century: An International Expert Conference and Tutorial.

Issues: The extension of automation to the diagnostic assessment of clinical materials raises issues of professional responsibility, on the part of both the medical professional and designer of the device. The International Academy of Cytology (IAC) and other professional cytology societies should develop a policy towards automation in the diagnostic assessment of clinical cytologic materials.

Consensus Position: The following summarizes the discussion of the initial position statement at the International Expert Conference on Diagnostic Cytology Towards the 21st Century, Hawaii, June 1997.

Acute tolerance and reversal of the motor control effects of midazolam.

The purpose of this study was to determine whether acute tolerance develops to the motor control effects of the short-acting benzodiazepine, midazolam. Using a bolus and constant infusion scheme, 40 healthy adults received a 70-min intravenous infusion of either saline (n = 20) or 6.1 (SE = 0.

Automated RIBA hepatitis C virus (HCV) strip immunoblot assay for reproducible HCV diagnosis.

A comparison between the CHIRON RIBA hepatitis C virus (HCV) processor and manual systems was performed by using 88 specimens repeatedly reactive by the second-generation HCV enzyme-linked immunosorbent assay (ELISA) (HCV 2.0 ELISA) and 111 random specimens from volunteer donors. For the second-generation RIBA HCV strip immunoblot assay (SIA) (RIBA HCV 2.

Biodesulfurization of flue gases and other sulfate/sulfite waste streams using immobilized mixed sulfate-reducing bacteria.

Sulfur dioxide (SO2) is one of the major pollutants in the atmosphere that cause acid rain. Microbial processes for reducing SO2 to hydrogen sulfide (H2S) have previously been demonstrated by utilizing mixed cultures of sulfate-reducing bacteria (SRB) with municipal sewage digest as the carbon and energy source. To maximize the productivity of the bioreactor for SO2 reduction in this study, various immobilized cell bioreactors were investigated: a stirred tank with SRB flocs and columnar reactors with cells immobilized in either potassium-carrageenan gel matrix or polymeric porous BIO-SEP beads.

Use of human immunodeficiency virus (HIV) type 1 and 2 recombinant strip immunoblot assay to resolve enzyme immunoassay anti-HIV-2-repeatably reactive samples after anti-HIV-1/2 combination enzyme immunoassay screening.

Background: With the implementation of combination human immunodeficiency virus types 1 and 2 (HIV-1/2) antibody enzyme immunoassay (EIA) in donor screening in 1992, the supplemental testing algorithm changed to require the use of a Food and Drug Administration (FDA)-licensed HIV-1 Western blot (WB) or immunofluorescence assay, as well as an FDA-licensed HIV-2 EIA. When HIV-2 EIA-reactive specimens are identified, further testing to confirm HIV-2 infection is recommended. Currently, a licensed HIV-2 supplemental assay is not available.

Passive head-up tilt and actively standing up produce similar overall changes in autonomic balance.

The primary objective of this study was to compare, in normal subjects, the average change in autonomic balance during a 5-minute period by using two methods of changing posture: actively standing up and passive head-up tilt. We hypothesized that the average effect of these two methods of changing posture on autonomic balance would not significantly differ. After collecting supine baseline measurements, subjects were first tilted head up to 60 degrees for 15 minutes, then returned to the supine position for 5 minutes, before they stood up for 5 minutes.

A biological process for the reclamation of flue gas desulfurization gypsum using mixed sulfate-reducing bacteria with inexpensive carbon sources.

A combined chemical and biological process for the recycling of flue gas desulfurization (FGD) gypsum into calcium carbonate and elemental sulfur is demonstrated. In this process, a mixed culture of sulfate-reducing bacteria (SRB) utilizes inexpensive carbon sources, such as sewage digest or synthesis gas, to reduce FGD gypsum to hydrogen sulfide. The sulfide is then oxidized to elemental sulfur via reaction with ferric sulfate, and accumulating calcium ions are precipitated as calcium carbonate using carbon dioxide.

Enzymatic catalysis in organic solvents: Polyethylene glycol modified hydrogenase retains sulfhydrogenase activity in toluene.

Naturally occurring enzymes may be modified by covalently attaching hydrophobic groups that render the enzyme soluble and active in organic solvents, and have the potential to greatly expand applications of enzymatic catalysis. The reduction of elemental sulfur to hydrogen sulfide by a hydrogenase isolated from Pyrococcus furiosus has been investigated as a model system for organic biocatalysis. While the native hydrogenase catalyzed the reduction of sulfur to H(2)S in aqueous solution, no activity was observed when the aqueous solvent was replaced with anhydrous toluene.

Follow up on uncemented total knee arthroplasty.

Follow up data on 42 uncemented total knee arthroplasty patients were examined at an average follow-up period of 5 to 7 years. The prosthetic components were examined clinically using the modified Hospital for Special Surgery knee rating system and radiographically using fluoroscopically guided radiographs. When compared to the preliminary report, the knee rating score dropped from an average of 94 to 78, with most of the poor results due to patellar failure requiring revision.

Pulmonary edema: a complication following dental treatment under general anesthesia.

This article describes pulmonary edema in two young, physically healthy individuals following routine intensive dental treatment under general anesthesia. The etiology, diagnosis, prognosis, and treatment are discussed. This paper demonstrates that young, healthy patients may develop pulmonary edema in the perianesthesia period or even during anesthesia itself.

Diagnosis and treatment of drug and alcohol abuse in women.

The major reasons why women abuse drugs and alcohol are presented with a focus on societal and psychologic bases. A structured format is provided for eliciting a history while motivating the patient to obtain adequate treatment. A workable treatment contract is presented.

The relationship of autonomic function to age-related changes in left ventricular filling in normal subjects.

Heart rate and age are independent variables associated with the pattern of normal left ventricular filling. Since heart rate variability also varies with age, the relationship between these and left ventricular filling in normal subjects was assessed. In 31 subjects (age range 21 to 71 years), power spectral analysis of heart rate variability was determined from 24 h Holter tapes, and left ventricular filling was assessed by Doppler echocardiography.

Sedation for outpatient dental procedures.

Pain and anxiety in the dental setting prevent many patients from seeking needed treatment. As a result, various techniques of anesthesia or sedation have been developed over the last 150 years to overcome this problem. Both the historic evolution of sedation and the use of several currently popular techniques are described in this article.