Factor analysis in difficult tracheal intubation: laryngoscopy-induced airway obstruction.

We have studied eight patients with a history of difficult tracheal intubation, using x-ray laryngoscopy and local anaesthesia, a curved Macintosh blade and a standard intubating position. The view obtained was better than recorded previously during general anaesthesia in two patients, and in a third the x-ray showed that positioning the blade tip beneath the epiglottis would have improved vision, suggesting that reproducibility of the assessment may not be consistent. The "ease of intubation" and "complementary" angles may be helpful in the assessment of such patients.

A potential role for antisense oligonucleotide analogues in the development of oncogene targeted cancer chemotherapy.

The identification of activated oncogenes as the basic biochemical difference between tumour cells and normal cells has opened up the possibility for development of truly tumour specific chemotherapy. It may be hypothesized that malignant cells would revert to a more normal phenotype and might even be triggered into terminal differentiation if expression of the appropriate oncogenes were inhibited. Although, at present, it is not possible to anticipate what form future therapy based upon this approach would take, it is clear that the immediate priority must be to establish the general validity of the hypothesis with a variety of tumour cell types in vitro.

Melphalan resistant human ovarian tumour cells are cross-resistant to photons, but not to high LET neutrons.

High linear energy transfer (LET) fast neutrons for the local control of advanced head and neck tumours are currently being evaluated at several centres. Fast neutrons are believed to produce more direct, and less OH mediated damage than photons, and consequently be less affected by intracellular thiol levels. Chemoresistant tumours with elevated thiol levels may therefore be more effectively controlled by fast neutron therapy than by photons.

A comparison of two methods of in vivo dosimetry for a high energy neutron beam.

Two methods of in vivo dosimetry have been compared in a high energy neutron beam. These were activation dosimetry and thermoluminescence dosimetry (TLD). Their suitability was determined by comparison with estimates of total dose, obtained using a tissue equivalent ionization chamber.

Time trends in the outcome of lung cancer management: a study of 9,090 cases diagnosed in the Mersey Region, 1974-86.

The purpose of this paper is to describe temporal trends in the treatment of lung cancer in the Merseyside Region of England over the years 1974-86. A detailed analysis of 9,090 cases of histologically confirmed tumours showed that age at diagnosis and histological type were important prognostic factors, with the 5 year survival of adenocarcinoma, squamous carcinoma, undifferentiated carcinoma and small cell carcinoma after treatment being 22.5%, 18.

Dose intensity of carboplatin in combination with cyclophosphamide or ifosfamide.

In two separate studies of patients with ovarian cancer, subjects were treated on a protocol comprising 400 mg/m2 carboplatin in combination with 1 g/m2 cyclophosphamide (group A) or 5 g/m2 ifosfamide with mesna (group B). The dose intensities achieved in group A were 87.2 mg/m2 carboplatin per week and 245.

Comparative evaluation of cefotaxime and cephamandole in the prevention of post-operative infective complications following emergency abdominal surgery.

In previous published work we described 57 patients undergoing emergency abdominal surgery, prospectively randomised to receive either cefotaxime or cephamandole as a single-antibiotic, three-dose, peri-operative prophylaxis against post-operative infective complications. This earlier work suggested that cefotaxime might be more effective than cephamandole in preventing wound sepsis in emergency abdominal surgery. We describe here our findings in a further 63 patients undergoing emergency abdominal surgery who were similarly allocated into either a cefotaxime or cephamandole antibiotic group.

Disposition of cervical vertebrae, atlanto-axial joint, hyoid and mandible during x-ray laryngoscopy.

Ten healthy volunteers underwent direct laryngoscopy using topical anaesthesia and a curved Macintosh laryngoscope blade. A lateral x-ray was performed during laryngoscopy in a standard intubating position. In this position the lower neck was relatively straight and increasing curvature occurred from the mid cervical spine upwards.

Partial protection of oncogene, anti-sense oligodeoxynucleotides against serum nuclease degradation using terminal methylphosphonate groups.

Under certain circumstances sequence-specific inhibition of gene expression may be achieved in intact cells using exogenous anti-sense oligodeoxynucleotides. The efficacy of this approach to investigating gene function is limited in part by the rapid serum nuclease mediated degradation of oligodeoxynucleotides in culture media. In order to determine the relative contributions of 3'-exonuclease, 5'-exonuclease and endonuclease activity in fetal calf serum to oligodeoxynucleotide destruction, we have tested chimeric N-ras anti-sense sequence molecules protected against exonuclease attack with terminal methylphosphonate diester linkages.

Bronchoscopic "resection" of small cell carcinoma.

Small cell carcinoma of the bronchus frequently presents as a widely disseminated tumor with a large central primary lesion. A patient with peripheral shadowing on a chest radiograph is reported in whom bronchoscopy revealed endobronchial tumor of the small cell type. The patient underwent lobectomy, but residual carcinoma could not be identified in the operative specimen, and the patient has remained disease-free for 2.

Sequential combination chemotherapy and radiotherapy in locally advanced non-small cell carcinoma of the bronchus.

The feasibility, effectiveness and toxicity of a new four drug intensive combination chemotherapy regime has been assessed in 36 patients with inoperable non-small cell lung cancer. Three cycles of adriamycin, vindesine, ifosfamide and cisplatin were given to 36 patients followed by sequential radiotherapy to 25 patients. The overall response rate to chemotherapy was 33%, and median progression free interval was 6 months.

Radiation-induced cell death by chromatin loss. A model to explain the shape of low-linear-energy-transfer cell survival curves.

A model is proposed which relates reproductive death of cells caused by radiation to loss of chromatin at cell division. This loss of chromatin can occur through chromosomal deletions or through the formation of asymmetrical chromosomal exchanges. It is proposed that smaller doses of radiation produce fewer chromatin breaks, which are more likely to be accurately repaired, compared with larger doses.

A study of cis-platinum and ifosfamide in alkylating agent-resistant ovarian cancer.

Twenty patients with advanced epithelial ovarian carcinoma who had failed alkylating agent treatment were given cisplatin 60 mg/m2 together with ifosfamide 4 g/m2 and mesna 6 g/m2 every 4 weeks for 4-6 cycles. The overall response rate was 45% and the complete response rate 20%. The median time to disease progression was 9 months and 4 of the 9 responding patients are alive at more than 2 years.

Alternating six-drug combination chemotherapy induction for intermediate and high-grade non-Hodgkin's lymphoma.

31 patients with intermediate and high-grade non-Hodgkin lymphomas were treated by a six-drug alternating regime comprising four cycles of 200 mg/m2 i.v. methotrexate on days 8, 15, 28 and 35, 50 mg/m2 i.

Treatment of small cell lung cancer with induction chemotherapy followed by late intensification.

Seventy-seven patients with small cell lung cancer were entered on a protocol comprising induction chemotherapy with cyclophosphamide 1 g m-2, adriamycin 40 mg m-2 and vincristine 1.4 mg m-2 (CAV) every 21 days for four to six cycles. The overall response rate was 72.

The efficacy and safety of GR38032F in the prophylaxis of ifosfamide-induced nausea and vomiting.

The novel 5HT3 receptor antagonist GR38032F was evaluated in the control of emesis induced by the cyclophosphamide analogue ifosfamide. At a dose of 4 mg q 6 h, GR38032F was given to six patients receiving their first dose of ifosfamide infusion (4-6 g/m2 over 24 h); over the 42-h study period, major control of retching and vomiting was achieved in five patients. In the second phase of the study six further patients, in whom high-dose metoclopramide had failed to control emesis, were given 8 mg GR38032F q 6 h; major control of emesis was again observed in five patients.

Sequential cisplatin/cyclophosphamide chemotherapy and abdominopelvic radiotherapy in the management of advanced ovarian cancer.

Forty-six previously untreated patients with advanced ovarian cancer were treated with combination chemotherapy comprising cisplatin 80 mg m-2 i.v. and cyclophosphamide 1 gm-2 i.

Sequential chemotherapy, surgery and radiotherapy in locally advanced breast cancer.

Thirty-seven patients with locally advanced breast cancer, 86% of whom had skin involvement, were treated with three to six cycles of vincristine 1.4 mg m-2, doxorubicin 40 mg m-2 and cyclophosphamide 600 mg m-2. A complete response rate of 19%, and overall response rate of 61% were achieved.

The effect of combined therapy on the pharmacokinetics and pharmacodynamics of verapamil and propranolol in patients with angina pectoris.

1. The pharmacokinetics and pharmacodynamics of oral verapamil and propranolol were studied in patients with stable angina pectoris during chronic mono- and dual therapy. 2.

The Clatterbridge high-energy neutron therapy facility: measurements of beam parameters for clinical use.

Measurements have been performed on the 62 MeV proton cyclotron at the Douglas Cyclotron Centre, Clatterbridge Hospital, to determine the variation in beam parameters necessary for clinical use of the neutron therapy facility. These measurements are of total (neutron and gamma) doses, and include: depth doses for wedged and unwedged fields at various treatment distances; profile measurements and the production of associated isodose charts; calibration of the dosimetry system of the cyclotron; and determination of variations in calibration associated with changes in field size, wedge and focus-skin distance. Measurements have also been performed to estimate the degree of long-term stability of both calibration and field uniformity.