Continuous infusion cisplatin and etoposide chemotherapy for cancer of unknown primary site (CUPS) in Taiwan, a region with a high prevalence of endemic viral infections

BACKGROUND: To evaluate the efficacy and toxicity of cisplatin/etoposide continuous infusion chemotherapy for cancer of unknown primary site in Taiwan, a region with a high prevalence of endemic viral infections. METHOD: Between April 1994 and February 1996, 20 patients with a diagnosis of CUPS were treated, including 15 males and five females, of average age 63.3 years (range 41-83 years). Continuous intravenous infusion of etoposide 80 mg/m2 and cisplatin 25 mg/m2 was given for 3 days every 3 weeks. Pretreatment tumor marker and viral serology studies were performed for baseline evaluation. Nearly two-thirds of the patients had poorly differentiated carcinoma. The average number of metastatic sites was 2.65 (range 1-4), with liver and lymph node involvement predominating. RESULTS: The overall response rate was 25% (95% CI 17.7-32.3%); 30.7% for poorly differentiated cancers and 25% for well differentiated cancers. Median survival was 4 months (range 1-12 months), 4.8 months for patients attaining partial response. Toxicity was moderate, grade 3 and 4 neutropenia occurred in 55% and grade 3 and 4 thrombocytopenia in 40%; other toxicities were mild. CA125 and CA199 were elevated in more than 50% of patients. Viral serology studies were not significantly different from those of the indigenous population. CONCLUSION: Etoposide and cisplatin combination chemotherapy has modest activity in patients with extensive CUPS and, at the schedule and dosage given, it is associated with moderate toxicity.      

三叶鼠尾草中小红参醌丙的结构

从三叶鼠尾草(Salvia trijuga Diels)的干燥根中分得9种结晶性成分,经鉴定为铁锈醇(ferruginol)、柳杉酚(sugiol)及系列高级脂肪酸三十四酸、三十酸、二十八酸、十六酸,另两种酸分别为对羟苯甲酸及氨基酸(dl-homoserine),晶Ⅰ为一新化合物,定名为小红参醌丙(trijuganone C),经光谱分析及化学反应推定其结构为15,16-二氢丹参酸甲酯。     

Dopamine regulation in schizotypal personality disorder and psychosis

It has recently been proposed that reduced stimulation of prefrontal cortex DI receptors secondary to hypoactivity of mesocortical dopamine (DA) projections may explain the cognitive impairments experienced by patients with schizophrenia and the schizophrenia spectrum. Findings from studies done during the past two decades suggest that schizotypal personality disorder (SPD), the prototypic disorder of the schizophrenia spectrum, is associated with cognitive deficits and social deterioration that are qualitatively similar, although less severe, to those observed in schizophrenia. It generally is acknowledged that the psychotic symptoms of schizophrenia are associated with hyperactivity of mesolimbic DA projections resulting in excessive stimulation of striatal D2 receptors. In contrast with schizophrenia, dopaminergic interventions improved cognitive function in SPD without worsening psychotic-like symptoms, raising the possibility that patients with SPD are protected against increases in subcortical dopaminergic activity associated with psychosis. However, mounting evidence suggests that alterations in other neurotransmitter systems (eg, glutamate, γ-aminobutyric acid, opioid, serotonergic) may be involved in the pathophysiology of schizophrenia. This over view focuses on common DA-related neurobiological vulnerabilities shared by schizophrenia and the schizophrenia spectrum, in addition to factors that protect SPD from the overt psychotic symptoms and more severe social and cognitive deficits experienced by patients with chronic schizophrenia.     

头序木叶中三萜化学成分的研究

从头序木（ＡｒａｌｉａｄａｓｙｐｈｙｌａＭｉｑ）叶中分离到６个三萜化合物，用化学方法和波谱（ＵＶ，ＩＲ，ＭＳ，１ＨＮＭＲ，１３ＣＮＭＲ，１３ＣＤＥＰＴ，ＨＭＱＣ，ＨＭＢＣ）分析，确定其中４种化合物的结构，分别为齐墩果酸（Ｉ），１６β羟基１８βＨ齐墩果酸（Ｉ），齐墩果酸２８ＯβＤ吡喃葡萄糖甙（ＩＩ）和１６β羟基１８βＨ齐墩果酸２８ＯβＤ吡喃葡萄糖甙（ＩＶ）。用ＮＯＥＳＹ谱确定化合物Ｉ的立体构型。以上４个化合物均为首次从该植物中分离到，化合物ＩＶ为新化合物。     

Percutaneous aspiration of lumbar synovial cyst: CT and MRI considerations

This report describes image-guided percutaneous aspiration of a symptomatic lumbar synovial cyst, with prompt relief of symptoms. Received: 22 July 1997 Accepted: 13 October 1997