The calpain system in human placenta.

The calpain system is involved in a number of human pathologies ranging from the muscular dystrophies to Alzheimer's disease. It is important, therefore, to be able to obtain and to characterize both mu-calpain and m-calpain from human tissue. Although human mu-calpain can be conveniently obtained from either erythrocytes or platelets, no readily available source of human m-calpain has been described.

Kupffer cells from halothane-exposed guinea pigs carry trifluoroacetylated protein adducts.

The anesthetic, halothane, is bioactivated by the liver cytochrome P450 system to trifluoroacetyl-chloride, which can readily acylate liver protein. Covalent binding of the trifluoroacetyl moiety may result in hapten formation leading to the induction of an immune response and ultimately halothane hepatitis. In this study the presence of trifluoroacetylated-protein adducts in Kupffer cells was investigated to learn how the immune system might come in contact with the proteins.

Demonstration of a cellular immune response in halothane-exposed guinea pigs.

Halothane hepatitis is considered to be a result of an idiosyncratic autoimmune reaction brought about by the formation of neoantigens that have been generated by covalent binding of halothane biotransformation intermediates. The guinea pig is being examined as an animal model to investigate an immune-mediated mechanism for halothane hepatotoxicity. Male Hartley guinea pigs were exposed to 1% halothane/40% oxygen for 4 hr, three times with 40-day intervals.

Randomized comparison of two combination regimens versus minimal chemotherapy in nonsmall-cell lung cancer: a Southeastern Cancer Study Group Trial.

Patients with advanced nonsmall-cell lung cancer (NSCLC), good performance status, and no prior chemotherapy were randomized to receive one of three regimens: intravenous vindesine (V) 3 mg/m2 every 2 weeks; V 3 mg/m2 weekly for 5 weeks, followed by a dose every 2 weeks plus mitomycin (VM) 20 mg/m2 day 1 and then 15 mg/m2 every 6 weeks; or V at the more intensive dose rate plus cisplatin (VC) 120 mg/m2 with forced diuresis on days 1 and 29 and then every 6 weeks. A total of 435 patients were enrolled in the trial, with 410 (94%) assessable for prognostic characteristics and survival. Among the 375 patients assessable for response, only 58 (15%) achieved objective response.

Etoposide combined with cyclophosphamide plus vincristine compared with doxorubicin plus cyclophosphamide plus vincristine and with high-dose cyclophosphamide plus vincristine in the treatment of small-cell carcinoma of the lung: a randomized trial of the Bristol Lung Cancer Study Group.

A total of 353 patients with previously untreated small-cell lung cancer (SCLC) were accrued in this multicenter trial. Patients were randomly assigned to receive one of the following three regimens: cyclophosphamide 1,000 mg/m2 intravenously (IV) day 1, vincristine 1.4 mg/m2 IV day 1, and etoposide 50 mg/m2 IV day 1, followed by etoposide 100 mg/m2/day orally days 2 through 5 (CEV); cyclophosphamide 1,000 mg/m2 IV day 1, vincristine 1.

Vindesine and mitomycin C in metastatic breast cancer. A Southeastern Cancer Study Group Trial.

64 eligible women with previously treated metastatic breast cancer received mitomycin C plus vindesine chemotherapy. Dosage was based on investigators' estimate of patients' bone marrow reserve. There were 19 evaluable patients in the good marrow reserve category, with two complete and three partial responses (26%).

An integrated oncology course for second year medical students.

A required course for second year medical students explores an integrated approach to the patient with cancer. Lectures detail the role of each medical discipline in the management of cancer. Panel discussions illustrate the cooperation necessary between clinical specialties in the diagnosis and treatment of these diseases.

Dose-response relationship to dacarbazine demonstrated in a patient with malignant melanoma.

Dacarbazine has shown the most consistent activity of any single chemotherapeutic agent in patients with metastatic melanoma. While the overall rate is 21%, responses fall to less than 10% when hepatic metastases are present. We report a patient with malignant melanoma metastatic to the liver in whom an apparent dose-response relationship to dacarbazine was demonstrated.

Vinblastine-associated pulmonary toxicity in patients receiving combination therapy with mitomycin and cisplatin.

Two of 33 patients entered in a local pilot study of mitomycin, vinblastine, and cisplatin for non-small cell lung cancer developed vinblastine-associated pulmonary toxicity. As with other reports of vinca alkaloid-related pulmonary toxicity, the regimen included mitomycin. Based on these cases and others previously reported, the incidence of abrupt pulmonary toxicity following vinca alkaloid administration as part of mitomycin/vinca alkaloid combination appears to be three to six percent.

Mitomycin C and vindesine associated pulmonary toxicity with variable clinical expression.

A patient receiving mitomycin and vindesine chemotherapy for lung cancer developed abrupt onset of shortness of breath following vindesine administration. Pulmonary function tests both before and after rechallenging him with vindesine showed an acute obstructive pattern, which resolved with bronchodilator therapy; persisting lung damage was evident by arterial blood gas analysis. A record review of the 126 patients placed on the same chemotherapy regimen uncovered an additional 6 patients with possible lung toxicity.

A prospective randomized trial of methotrexate versus cisplatin in the treatment of recurrent squamous cell carcinoma of the head and neck.

A prospective randomized study was conducted to determine the relative effectiveness, toxicity and tolerance of methotrexate (MTX) versus cisplatin (DDP) in patients with recurrent head and neck squamous cell carcinoma. Forty-four patients were randomized to receive either MTX, 40 mg escalated to 60 mg/m2 IV push weekly, or DDP, 50 mg/m2 6 hour infusion days 1 and 8 every 4 weeks. All patients had objectively measurable disease and a performance status greater than 60% (Karnofsky scale).

A randomized prospective study of vindesine versus doxorubicin and cyclophosphamide in the treatment of epidermoid lung cancer.

A randomized prospective study was conducted comparing vindesine (VDS) with doxorubicin and cyclophosphamide (D/C) in the treatment of advanced squamous cell carcinoma of the lung. No patient had a complete response. Seven of 28 (25%) patients had partial response (PR) to VDS while one of 19 (5%) had a PR to D/C (P less than 0.

Vindesine (VDS) monochemotherapy for non-small cell lung cancer: a report of 45 cases.

Fifty-three patients with non-small cell lung cancer were treated with vindesine. Of the 45 evaluable patients, 11 (24%) had a partial response. Responses were all evident within 6 weeks.

Head and neck involvement with malignant histiocytosis: case report and literature review.

Malignant Histiocytosis (MH) is a disease being recognized with greater frequency. A case is reported together with a literature review to determine the frequency of this occurrence. Of the 108 case reports of MH reviewed, 43 (39%) had head and neck involvement described, with 22 (20%) having extranodal disease.

A rational approach to the patient with cancer.

Acquisition of an adequate data base is essential to the management of the cancer patient. Staging systems currently in use are not applicable to the patient having either advanced disease or a complicating illness. We have found it useful to organize our approach to cancer patients by asking a series of eight questions.

Acute lymphocytic leukemia developing in a male with germ cell carcinoma: a case report.

A case of germ cell carcinoma (of presumed testicular origin) is described in which acute lymphocytic leukemia developed within nine months of the diagnosis. Possible relationships between the two neoplasms are discussed, as well as the need for continued observation of patients with germ cell tumors as they are living longer and may be at higher risk for developing a second cancer.

Antibody response to influenza immunization in adult patients with malignant disease.

Eight-two patients with solid tumors and lymphomas were immunized with New Jersey, Hong Kong, and Victoria influenza vaccines. Patients were divided into groups according to treatment: chemotherapy, radiotherapy, or no treatment. Four parameters were examined to assess the response to immunization: seroconversion, protective titer level, geometric mean titer, and response to multiple vaccines.

Histopathogenesis of skin and subcutaneous injury induced by adriamycin.

Extravasation of Adriamycin from an intravenous needle or catheter can produce a progressive skin necrosis and deep painful ulceration. The pathological changes which result in this ulceration were studied in a rabbit model. The earliest changes include vascular obliteration and necrobiosis of collagen.

Neutropenic enterocolitis: two case reports of long-term survival following surgery.

We report two cases of neutropenic enterocolitis with long-term survival following surgery. This favorable outcome was related to three major factors: recognition of the acute surgical abdomen, appropriately timed surgical intervention, and a prompt postoperative return of normal circulating white cells.

Adenocarcinoma of unknown origin. A rational approach to a diagnostic puzzle.

Determination of the tissue of origin of disseminated adenocarcinoma is often difficult. Careful clinical evaluation of the patient in light of known characteristics of certain primary tumors, followed by appropriate screening tests, may yield decisive information. If not, a decision for or against more specific tests must be made.