Regional hyperthermia in the treatment of recurrent deep-seated tumors: preliminary analysis of phase I trial

This is a preliminary report on a phase I pilot study of regional hyperthermia of advanced tumors, using annular phased array system (APAS) in combination with radiation therapy and/or chemotherapy. All patients were treated without anesthesia. In all hyperthermia sessions, physiological parameters such as blood pressure, cardiac rate, respiratory rate, and EKG were monitored throughout the treatment. Tumor temperature was monitored with intratumoral probe with an additional probe either in the esophagus or rectum for monitoring systemic temperature. Present reports are on analysis of the first 30 patients: a total of 139 treatment sessions were analyzed. The results indicate local discomfort, anxiety, systemic temperature elevation, and tachycardia were the predominant factors limiting the number of sessions, the duration of sessions, and the deposition of power, in 18, 6, 6, and 2 patients, respectively. The complications were rare. No injuries to visceral organs clearly attributed to the hyperthermia have been recorded.     

Inflammatory carcinoma of the breast: treatment results on 107 patients

From 1958 to 1985, 107 patients with a clinical and/or histopathologic diagnosis of non-metastatic inflammatory breast cancer received radiotherapy as all or part of initial treatment. Therapy included definitive irradiation alone in 31 patients, irradiation with mastectomy in 16 patients, irradiation and combination chemotherapy in 23 patients, and irradiation with chemotherapy and surgery in 37 patients. Survivors have a median follow-up of 30 months. Overall median relapse-free survival (RFS) was 12 months (12% at 5 years). Local control and relapse-free survival were significantly improved for patients receiving surgery as part of initial treatment: 19% (10/52) of operated patients experienced locoregional failure vs. 70% (37/53) not operated (p less than 0.0001). The median overall actuarial survival was 24 months (17% at 5 years). Patients who received surgery showed improved survival (44 months vs. 18 months median; 37% vs. 7% at 5 years; p = 0.0004). Chemotherapy also was associated with improved relapse-free survival (18 months vs. 8 months median; 20% vs. 5% at 5 years; p = 0.02) and actuarial survival (32 months vs. 17 months median; 23% vs. 3% at 5 years; p less than 0.02). Patients treated with initial chemotherapy (usually 2-3 cycles of CAF), surgery, and postoperative irradiation followed by maintenance chemotherapy showed a 34 month median relapse-free survival (37% at 5 years RFS) and a 47 month median survival (48% at 5 years). Moderate to severe complications were seen in 25% of patients, the most frequent complication being fibrosis of the breast or chest wall. There were two fatalities secondary to Adriamycin-induced cardiomyopathy. This study suggests better local control, with fewer complications, when surgery and irradiation are combined with multiagent chemotherapy. Further prospective clinical trials are strongly recommended.     

Quantitative analysis of short term deprivation and recovery of desynchronized sleep in cats

A quantitative analysis of desynchronized sleep (DS) deprivation (exposure to low ambient temperature) and recovery was carried out in unrestrained cats. The results show that: (1) the circadian obligate quota of DS is precisely regulated by a control mechanism paying by the 24th h the DS debt induced by up to 14 h of total DS deprivation, if recovery occurs during the rest phase of circadian photoperiodicity (CP); (2) during static rebound DS hourly duration is increased by 40 +/- 4 sec/h of total deprivation (mean and S.E.) and there is a statistically significant increase in the hourly frequency and in the duration of DS episodes, with respect to control values; (3) the hourly obligate and facultative quotas of DS amount to 409 +/- 82 and 229 +/- 140 sec/h (mean and S.D.), respectively. (4) preoptic heating during deprivation at low ambient temperature decreases the DS static rebound during recovery at control ambient temperature by an amount corresponding to the cumulative duration of DS episodes elicited by the preoptic treatment; (5) preoptic temperature decreases the more markedly the shorter the duration of exposure to low ambient temperature and regains control values the sooner the smaller the DS debt incurred during deprivation; (6) DS debt cumulation is a continuous process which develops at a steady rate during day and night, whereas DS debt payment is a discontinuous process (ultradian rhythm of DS) which develops at a variable rate depending on the DS debt and on the phase of CP.     

Les données épidémiologiques pour la lutte contre le paludisme dans une région de hauts plateaux du Cameroun occidental

International Journal of Public Health - A study carried out in March 1982 in three villages showed that malaria was meso-endemic, probabely due to relatively high altitude...     

Experience with Virocult as a viral collection and transportation system

Virocult was used as a supplemental viral collection and transportation system. It compared favorably with tryptose phosphate broth in maintaining clinically important viruses. Advantages of Virocult over tryptose phosphate broth are commercial availability; extended shelf life at ambient temperature; and ease of use.     

Pitfalls in the use of death certificates for assessing cause of death: a study of tonsil carcinoma patients

A study was undertaken to determine the accuracy of underlying cause of death as stated on the death certificate for patients treated at Mallinckrodt Institute of Radiology (MIR) for carcinoma of the tonsil. The sample consisted of 110 patients who were treated between 1953 and 1976 and who subsequently died; all patients were seen by a physician within 3 months of their death. Death certificate cause of death was compared with the cause of death as stated in the MIR patient record. Death certificates detected 42.5% of the deaths due to tonsil carcinoma recorded in the hospital record, and detection was found to correlate with time between treatment and death. Of the deaths reported on the death certificate as due to tonsil carcinoma, 91% were confirmed by the hospital record to be correctly reported. Overall agreement in assignment of cause of death between the hospital record and the death certificate was 59%, and was significantly affected by stage of disease at diagnosis. This review underscores the low reliability of death certificates and raises a serious question concerning the use of this information for patients who are registered in clinical trials without additional documentation of tumor extent and cause of death.     

Augmentation of donor-specific transfusion and cyclosporine effects with dietary linoleic acid

Increased prostaglandin production is a possible mechanism for the immunosuppressive effects of both cyclosporine and blood transfusions. Therefore, dietary supplementation with linoleic acid, a prostaglandin precursor, combined with either modality could act synergistically. Intraabdominal cardiac allografts were performed from Buffalo rat donors to Lewis recipients. Transplant recipients received a single donor-specific transfusion, low-dose cyclosporine (CsA, 1 mg/kd/d x 7 days), dietary supplementation with linoleic acid (LA, 16% of total calories) or a combination of the three modalities. CsA, DST or LA alone significantly prolonged allograft survival. Both CsA and LA acted synergistically with DST in further prolongation of survival--however, animals receiving all three modalities achieved 100% long-term survival. Augmentation of transfusion- and cyclosporine-induced immunosuppression with dietary prostaglandin precursor is possible.