Monitoring central nervous system methotrexate levels via subcutaneous reservoir. Sources of errors in sampling and their avoidance.

The Ommaya reservoir allows for ready, well-tolerated direct access to the intraventricular cerebrospinal fluid (CSF). The toxicities associated with central nervous system (CNS) methotrexate (MTX) therapy have been attributed to prolonged high levels of the drug. When samples of CSF are removed from a reservoir for the monitoring of MTX levels, there may be sampling errors introduced by retention of high concentrations of drug in the reservoir.

Effect of intermittent-flow centrifugation leukapheresis on donor leukocyte counts.

Effects of intermittent-flow centrifugation leukapheresis (IFCL) on leukocyte counts in donor blood have not been reported. Accordingly, total and differential white blood cell counts were preformed serially during IFCL. A significant decrease (p less than 0.

Phase II study of cis-dischlorodiammineplatinum(II) in stage IVB Hodgkin's disease.

A broad phase II study of cis-dichlorodiammineplatinum(II) was conducted. Eight patients with stage IVB Hodgkin's disease were studied. Four of these patients attained an objective partial remission of 7--19+ weeks' duration.

Fertility and cancer therapy.

With increased survival of increasing numbers of cancer patients as a result of therapy, the consequences, early and late, of the therapies must be realized. It is the treating physician's duty to preserve as much reproductive potential as possible for patients, consistent with adequate care. With radiotherapy this means shielding the gonads as much as possible, optimal but not excessive doses and fields, oophoropexy, or sperm collection and storage prior to irradiation.

Combined platelet-leukapheresis: a technique for preparing separate platelet and granulocyte-platelet units from single donors.

One donor can provide separate platelet and granulocyte-platelet units that have the potential to fulfill the needs of two recipients. Combined platelet and leukapheresis were performed in the presence of hyddroxyethyl starch and citrate employing the Haemonetics Model 30 Blood Separator. Platelets and granulocytes were separated subsequently by centrifugation and two individual units were prepared for transfusion.

The effects of combined platelet and leukapheresis on the blood coagulation system.

Analysis of blood coagulation was done on samples of blood collected from ten donors undergoing combined platelet and leukapheresis using the Haemonetics Model 30 Blood Processor. Blood samples were obtained from the donors prior to, during, and following pheresis. Blood was also obtained from the blood-return line after the first collection of leukocytes and platelets, but before it was returned to the donor.

Properties of neutrophils collected by discontinuous-flow centrifugation leukapheresis employing hydroxyethyl starch.

The properties of neutrophils, collected by discontinuous-flow centrifugation leukapheresis in the presence of hydroxyethyl starch and citrate were studied in an attempt to insure that cells harvested in this fashion are suitable for transfusion. Neutrophils obtained from leukocyte units prepared for transfusion by leukapheresis were found to perform similarly to those isolated from the venous blood of corresponding donors prior to the pheresis procedures when assessed by morphology, viability, hexose monophosphate shunt activity, superoxide anion generation, nitroblue tetrazolium dye reduction, chemiluminescence, adherence to nylon fibers, random mobility, chemotaxis and staphylococcal killing. The results compared favorably with values previously established for healthy control subjects.

Glucose therapy of recurrent lactic acidosis.

Lactic acidosis not associated with hypoxic states has a high morbidity and mortality. Treatment of this condition has been supportive and the etiology poorly understood. We report a case of recurrent lactic acidosis in a patient with renal and hepatic insufficiency with hypoglycemia which was repeatedly reversed by restoring the glucose concentration to normal.

Peer review in community mental health.

The paper discusses the medical origins of the peer review legislation and its adaptation to community mental health. Three models of peer eview are presented which could be used in community mental health centers. They are the problem model, the sequential model, and the Psychiatric Utilization Review and Evaluation Project (PURE) model.