Comparative 60Co total body irradiation (220 cm SAD) and 25 MV total body irradiation (370 cm SAD) dosimetry

Adults with acute leukemia and malignant lymphoma in relapse after conventional therapy are treated with cyclophosphamide and total body irradiation (TBI) followed by autologous bone marrow transplants. For cobalt TBI, patients seated in a stand angled 45° above the floor are treated in a single fraction with sequential right and left lateral 87 cm ×87 cm fields at 220 cm source-axis distance (SAD) using a 5000 Ci cobalt unit. Typical lateral diameters, mid-plane dose rates, mid-plane doses, and maximum doses are: Hips, 34 cm, 8 rad/min, 900 rad, and 1050 rad; and shoulders, 38 cm, 7.7 rad/min, 800 rad, 1080 rad. The estimated lung dose is 1000 to 1100 rad. A compensator limits the dose to the head to 1000 rad. Estimated organ doses are: small intestine, liver and kidneys-1100 rad, and heart-1200 rad. Phantom dosimetry and dosimetry on patients treated reveals that these doses are delivered within 5 % accuracy. Patient tolerance of treatment, and some biological considerations of low dose rate therapy are reviewed. Certain dosimetry features of an alternate treatment at 370 cm SAD, using 25 MV photons are also presented.     

Atenolol eye drops in glaucoma: a double-masked, controlled study.

Guttae atenolol 4% (Tenormin), a pure beta1-blocking (i.e., cardioselective) drug, produced a median overall fall of 5-6 mmHg (range 3-2 to 13-2 mmHg) in the first tonometrised eyes of 7 patients with open-angle glaucoma or ocular hypertension and 1 with closed-angle glaucoma (off any treatment for the whole of the day preceding each test day) after allowance for an 'effect' of guttae saline 0-9%, in a double-masked, cross-over trial. By a Wilcoxon matched pairs rank test this was significant at the P less than 0-05 level. The median overall fall of 3-5 mmHg (range 0-8 to 10-8 mmHg) in the second-tonometrised eyes of 7 patients (1 of the 8 contributed only 1 eye) was also significant (P less than 0-05). In 2 patients who had been treated with guttae atenolol 4% daily 3 X for 1 and 2 months there is evidence that, on replacing the atenolol 4% with saline 0-9%, a rise of pressure of around 3 mmHg occurred 2 and 3 and 5 days later, i.e., the drug still retained its effectivity (slightly reduced) after 1 and 2 months.     

Report of the Committee on Scientific Investigation of the American Academy of Restorative Dentistry.

The research for 1977, was extensive and meaningful. Selected articles related to the restorative disciplines and the general practitioner were presented for study. Use of the material will produce a better understanding of clinical problems and improved patient service, a lasting goal.     

Morphological,biochemical, ultrastructural,tissue culture and clinical observations of typical and aggressive craniopharyngiomas

Summary Craniopharyngiomas are tumors of the suprasellar area, which are often cystic, encapsulated and slow-growing. Certain of these tumors can behave in an aggressive manner and either invade surrounding structures or recur.In order to determine characteristics which may aid in distinguishing typical from atypical lesions, a study of biopsy and tissue culture specimens from 25 human craniopharyngiomas was undertaken. Tissue culture observations reveal two distinct cell populations.Typical lesions grew in culture in an orderly epithelial pattern and had desmosome-tonofibril aggregates and smooth surface topography demonstrable by electron microscopy.In the atypical tumors the cell growth was irregular, with mitotic activity, cholesterol crystals and features characteristic of neoplastic transformation, such as surface microvilli, an increase of cytoplasmic basophilia, size and number of nucleoli and retraction of cytoplasm.Correlation with the clinical status of the patients suggests that tumors of the four patients which exhibited atypical features in culture behaved more aggressively.     

Effect of metoclopramide and domperidone on aldosterone, 18-hydroxycorticosterone and prolactin secretion in the rhesus monkey

This study was designed to investigate dopaminergic mechanisms in the control of corticosteroid secretion. Eight rhesus monkeys received metoclopramide (200 μg/kg) or domperidone (200 and 400 μg/kg) with 5% dextrose (vehicle), or with dopamine (4 μg/kg/min) infusions begun 60 min before administration of the dopamine antagonist. Metoclopramide, in the presence of vehicle, increased plasma aldosterone concentrations from 4.8 ± 0.6 ng/dl to a maximum of 36 ± 4.7 ng/dl and PRL concentrations from 7.6 ± 1.1 ng/ml to a maximum of 120.5 ± 8.0 ng/ml. Administration of metoclopramide resulted in a rise in plasma 18-hydroxycorticosterone from 10.2 ± 1.3 ng/dl to a maximum concentration of 49.6 ± 4.5 ng/dl. Plasma concentrations of electrolytes, PRA, plasma cortisol, 11-deoxycorticosterone, corticosterone, 18-hydroxy-11-deoxycorticosterone, were not altered by metoclopramide. Domperidone, in both doses, markedly increased plasma PRL concentrations but had no effect on plasma 18-OHB or aldosterone concentrations. Dopamine infusion inhibited the aldosterone response to metoclopramide and the prolactin response to metoclopramide and domperidone. The results of this investigation demonstrate that aldosterone responses to metoclopramide and prolactin responses to metoclopramide and domperidone, are mediated by their antagonist activity at dopamine receptors.     

Cellular localization of immunoglobulin within human maglignant melanomata.

The presence of antibody in patients with malignant melanoma is well established if one examines the serum. In this report we have attempted to identify antibody within solid tumours showing that they are rarely present in any appreciable quantity on the surface of tumour cells but can be seen frequently on a number of different types of host cell within the tumours. This is discussed in the light of the role of antibody in the circulation and the possibility of antibody behaving as a blocking factor in vivo.     

Serum antibody to poliovirus in patients in a mental deficiency hospital, with particular reference to Down's syndrome.

Neutralization tests for poliovirus antibodies were carried out on 74 patients in an adult mental deficiency hospital: 37 patients with Down''s syndrome and 37 non-Down''s mental defectives. The distribution of antibody titres to poliovirus types 1, 2 and 3 did not differ significantly between the two groups. Most patients had antibody to at least one poliovirus type but less than a third had antibodies at a titre of 1/8 or greater to all three types. The low level of poliovirus immunity in this population may be of epidemiological importance.     

The velocity-strain relationship

Left-ventricular dimensions were measured during a complete cardiac cycle from one-plane cineangiograms and used to calculate the circumferential fiber velocity (V _CF) and circumferential fiber strain (ε). A velocity-strain (V _CF·ε) loop was then constructed for 39 patients. Characteristics of theV _CF·ε loop included: peak systolicV _CF(+V _CF), ε at +V _CF (ε_S), systolic time constant τ_S, absolute peak diastolicV _CF (|?V _CF|), ε at |?V _CF| (ε_D), diastolic time constant τ_D,V _CF≤|?V _CF|, ε_D≤ε_S, and τ_D≤τ_S. The first two inequalities combined provided the best criterion of cardiac decompensation. Only 2 of 15 normal patients, 2 of 6 compensated volume overload patients, and 1 of 3 compensated pressure overload patients satisfied the double inequality. However, 6 of 9 decompensated volume overload patients and 5 of 6 congestive cardiomyopathy patients satisfied the double inequality. Physically, this would imply that with depressed cardiac function: +V _CF≤|?V _CF| due to a reduced ability of the ventricle to actively contract, ε_D≤ε_S (and τ_D≤τ_S) due to an increased viscoelastic stiffness of the ventricle. TheV _CF·ε loop is independent of pressure, making it possible to acquire noninvasively.