Unreliability of carcinoembryonic antigen (CEA) reverse transcriptase-polymerase chain reaction (RT-PCR) in detecting contaminating breast cancer cells in peripheral blood stem cells due to induction of CEA by growth factors.

RT-PCR is increasingly used for the detection of minimal residual disease in solid tumors. Carcinoembryonic antigen (CEA) RT-PCR seemed to be highly specific for detection of tumor cells when tested on PBMC. A very high frequency of RT-PCR amplification product for CEA in PBSC from breast cancer patients mobilized with G-CSF was found.

Retrovirus-mediated gene transfer of the human multidrug resistance-associated protein into hematopoietic cells protects mice from chemotherapy-induced leukopenia.

Utilization of chemotherapy for the treatment of tumors is mainly limited by its hematological toxicity. Because of the low-level expression of drug resistance genes, transduction of hematopoietic progenitors with multidrug resistance 1 (MDR1) or multidrug resistance-associated protein (MRP) genes should provide protection from chemotherapeutic agent toxicity. Successful transfer of drug resistance genes into hematopoietic cells may allow the administration of higher doses of chemotherapy and, thus, increase regression of chemosensitive tumors.

Reversible myocardial dysfunction in a patient with alcoholic ketoacidosis: a role for hypophosphatemia.

A 39-year-old woman had alcoholic ketoacidosis complicated by reversible life-threatening myocardial dysfunction. This complication occurred a few hours after correction of acidosis in association with severe hypophosphatemia. A marked improvement in clinical, echocardiographic, and hemodynamic features was associated with the normalization of the serum phosphorus level.

Unusual atrial pro-arrhythmic effect of flecainide: a contemporary review.

The authors report the case of a patient with drug-resistant atrial fibrillation, who developed, for more than 2 hours, a well-tolerated attack of palpitations, after taking 500 mg of flecainide acetate. The Holter monitoring demonstrated atrial flutter with 1:1 AV conduction and a ventricular rate at 220 bpm. This atrial pro-arrhythmic effect is rare and the mechanism is discussed.

[Carney's syndrome: 2 new cases].

The association of gastric leiomyoblastomas, pulmonary chondromas and extra-adrenal paragangliomas has been called "Carney's Triad" since 1977. It is incomplete when only two of these lesions are present. 42 cases has been published.

Prognosis of severely hypoxemic patients receiving long-term oxygen therapy.

Two hundred seventy severely hypoxemic (PaO2 < or = 55 mm Hg: mean +/- SD = 48 +/- 6) COPD patients (232 men) were selected for long-term oxygen therapy (LTOT). They were old (mean = 66 +/- 8 years), with severe airflow limitation (FEV1 = 30 +/- 12 percent of predicted), some CO2 retention (PaCO2 = 47 +/- 9 mm Hg), and compensated respiratory acidosis. Eighteen percent of the patients presented some complicating pleuropulmonary diseases (pleural thickening, sequelae of tuberculosis, etc).

Significant reduction of nonspecific bronchial reactivity in patients with Dermatophagoides pteronyssinus-sensitive allergic asthma under therapy with allergen-antibody complexes.

Thirty-nine asthmatic patients hypersensitive to Dermatophagoides pteronyssinus were treated for a total of 4 yr with injections of complexes made of allergen and autologous specific antibodies. The results obtained throughout the first 2 yr of a double-blind placebo-controlled trial have been published (1) and we now report the results of such therapy during an additional 2 yr. Three groups of patients had been defined: Groups A and B were comprised of patients treated with either "higher" doses of complexes (Group A) or "lower" doses (Group B), whereas Group C received the placebo preparation.

A prospective randomized study of two alternating, non cross-resistant chemotherapies for advanced Hodgkin's disease.

Fifty-four newly diagnosed patients with advanced Hodgkin's disease were randomized between two alternating non cross-resistant chemotherapies: MOPP-ABVD (MOPP: Mustine, Vincristine, Procarbazine, Prednisone-ABVD: Adriamycin, Bleomycin, Vinblastine, Dacarbazine) and MOPP-ABVD-CEM (CEM: Carmustine, Etoposide, methyl-GAG). There were no significant differences between the two therapies as far as complete remission, survival, relapse free survival and toxicity were concerned. This study does not support the use of MOPP-ABVD-CEM for improving the long-term outcome of patients with advanced Hodgkin's disease.

Allergen-antibody complexes can efficiently prevent seasonal rhinitis and asthma in grass pollen hypersensitive patients. Allergen-antibody complex immunotherapy.

We have prepared antigen-antibody complexes from grass pollen allergens and autologous specific antibodies isolated by immunoadsorption from the serum of allergic patients. These complexes were inoculated into patients in a double-blind trial to evaluate their effect on grass pollen-related rhinitis and bronchial asthma. Thirty-eight grass pollen-hypersensitive patients were allocated to three groups; patients in the first two groups were treated with antigen-antibody complexes at different ratios and dosages and were compared with the third group who received the placebo carrier buffer alone.

Complexes of grass pollen allergens and specific antibodies reduce allergic symptoms and inhibit the seasonal increase of IgE antibody.

Complexes made from antigen and specific antibodies have been used to suppress specific antibody production. This property is of potential therapeutic interest in immediate hypersensitivity states which are characterized by hyperproduction of IgE antibodies. We report here on the use of antigen-antibody complexes in patients with hypersensitivity to grass pollen.

CO transfer capacity as a determining factor of survival for severe hypoxaemic COPD patients under long-term oxygen therapy.

The transfer capacity for carbon monoxide is a commonly used method in clinical practice but is rarely considered as a prognostic factor for patients under long term oxygen therapy (LTOT). LTOT was applied to 217 stable, severely hypoxaemic (arterial oxygen tension (PaO2 less than 7.3 kPa or 55 mmHg) chronic obstructive pulmonary disease (COPD) patients, according to the usual recommendations.

Allergic bronchial asthma due to Dermatophagoides pteronyssinus hypersensitivity can be efficiently treated by inoculation of allergen-antibody complexes.

Antigen-antibody complexes were made from allergens of the common house dust mite, Dermatophagoides pteronyssinus (Dpt) and an excess of purified autologous specific antibodies. These complexes have been used to treat Dpt-hypersensitive patients who suffered from chronic bronchial asthma. Clinical symptoms and medication intake were followed by filling in diary cards.

Seasonal variation in specific IgE antibodies of grass-pollen hypersensitive patients depends on the steady state IgE concentration and is not related to clinical symptoms.

To evaluate parameters that determine the serum titer of specific antiallergen IgE antibodies, we graded the clinical symptoms of 78 grass-pollen hypersensitive patients during two consecutive seasons, while serum total and specific antigrass-pollen IgE antibodies were titrated every 2 weeks. Correlation studies of clinical symptoms, grass-pollen counts, and specific IgE antibodies demonstrated that (1) bronchial asthma and nasal symptoms cannot be predicted on the basis of preseasonal IgE titers, (2) clinical symptoms are not related to seasonal antigrass-pollen IgE antibodies, (3) antigrass pollen and total IgE antibodies are not directly dependent on the air pollen point concentration, (4) increase in specific IgE antibodies during the pollen season is strongly correlated to preseasonal specific IgE titers, and (5) individual fluctuations of specific IgE antibody titers during the pollen season are proportional to preseasonal specific IgE titers. These findings suggest that titration of serum-specific IgE antibodies is of little use in predicting or monitoring the clinical symptoms of grass-pollen hypersensitive patients, since IgE titers strongly depend on individual immune responsiveness.

Carboplatin in association with etoposide and either adriamycin or epirubicin for untreated small cell lung cancer: a dose escalation study of carboplatin. UCL Clinical Oncology Group.

A multi-center, open trial was conducted to determine the maximal tolerable dose of carboplatin in combination with conventional doses of both etoposide and an anthracycline for the treatment of previously untreated small cell lung cancer (SCLC) patients. Ninety-five patients [48 with limited disease (LD) and 47 with extensive disease (ED)] received a total of 376 courses of treatment. Carboplatin was given on day 1 at a dose of 250 mg m-2 in 60 courses, 300 mg m-2 in 69, 330 mg m-2 in 236 and 350 mg m-2 in 11, with 120 mg m-2 etoposide on days 1, 3 and 5 and either 40 mg m-2 adriamycin or 60 mg m-2 epirubicin on day 1.

Late intensification chemotherapy with autologous bone marrow transplantation in selected small-cell carcinoma of the lung: a randomized study.

A multicentric randomized prospective trial was conducted to test whether late intensification chemotherapy would increase the remission rate, the relapse-free survival, and the survival of small-cell lung cancer patients responding to induction chemotherapy. Autologous bone marrow transplantation was used as support to reduce the duration of the aplasia induced by very high-dose chemotherapy. As induction chemotherapy, 101 patients received, during a period of 5 months, a total dosage of 120 mg/m2 methotrexate, 4.

[Bronchial response to acetylcholine and Dermatophagoides pteronissimus in asymptomatic asthmatics].

Bronchial reactivity to increasing concentrations of acetylcholine (from 0.01 to 10 mg X ml-1) was studied in 84 asthmatic patients during a remission period. Three groups were identified based on decreasing reactivity : group 1 : 57 patients (68%) who exhibited a decrease equal or of more than 20% of forced expiratory volume per second (FEV1) and a decrease equal or of more than 35% of specific airway conductance (sGaw); group 2: 16 patients (19%) with a decrease in FEV1 of less than 20%, but a decrease in sGaw still equal or superior to 35%; group 3 : 11 patients (13%) with a less than 20% decrease in FEV1 and a less than 35% decrease of sGaw.