Ineffectiveness of chemotherapy in patients with metastatic ependymoma of the cauda equina

Six cases of intraspinal ependymoma metastasizing outside the central nervous system have been reported. This report documents a seventh case. This patient received multiple courses of combination and single-agent chemotherapy without evidence of tumor regression. All seven patients had four things in common: early onset of disease, numerous operations, massive local recurrence at the time distant metastases were noted, and a long time period from diagnosis to death.     

Combined therapeutic effects of an immunomodulator,PSK, and chemotherapy with carboquone on rat bladder carcinoma

Summary Responses of bladder cancer in ACI rats to combination therapy with an immunomodulator, PSK, and an alkylating agent, carboquone, are reported. PSK is a protein-bound polysaccharide isolated from Basidiomycetes, and carboquone is the alkylating agent 2,5-bis(1-aziridinyl)-3-(2-hydroxy-1-methanoxyethyl)-6-methyl-p-benzoquinone carbornate molecular weight 3,214.The immunomodulator, PSK, was shown to enhance the effectiveness of the chemotherapeutic agent, carboquone. The therapeutic effect of combination tratment was monitored by measuring growth rates of tumors transplanted SC and by measuring decreases in metastatic spread to lungs in tumor-bearing animals. Effects of PSK on host immunity were monitored by measuring serum levels of immunosuppressive substance.     

The effects of ototoxicity on the auditory brain stem response and the scalp-recorded cochlear microphonic in guinea pigs

“ldquo;ldquo;ldquo;he objective determination of hearing impairment with evoked response techniques may be of value in the early detection of ototoxic reactions, especially in infants and other “difficult” patient populations. In this study the auditory brain stem response to “clicks” at two intensities and two repetition rates were recorded from guinea pigs that had been given one of two dosage levels of kanamycin or no drug. The scalp-recorded cochlear microphonic to continuous tones was also recorded. Hearing loss was seen in one-third of the animals receiving kanamycin. The temporal course of the deficit varied considerably between animals. Auditory system change was most readily detected in response to low-intensity stimuli, while change in repetition rate of the clicks did not affect the results. The cochlear microphonic potentials correlated with the auditory brain stem response.     

Use of Value Clarification Methods In Venereal Disease Education

The use of values clarification methods offers a means of dealing with the social-emotional stigmas associated with venereal diseass. It has become apparent that the facts alone are not sufficient in motivating the individual to seek treatment and cooperate in the epidemiologic process. This article suggests techniques of educating students or patients in order to get them in touch with their own feelings, attitudes, and prejudices. It also fosters understanding of the prevalent social myths and misconceptions about venereal diseases.     

Sound-induced seizures during ethanol withdrawal in mice

An ethanol withdrawal syndrome, consisting of tremors and convulsions, was induced in C57BL/6J mice by feeding them a liquid diet containing 27% of ethanol-derived calories at an environmental temperature of +12 to 13° C for 6 days. Control groups were pair-fed with liquid diets containing isocaloric amounts of sucrose or Laboratory Chow. Seven and 24 h after the beginning of withdrawal, all mice were exposed to bell ringing for 90 sec. This sound induced convulsions in nearly one-half of ethanol-consuming mice at 7 h and in a few mice at 25 h. Only one mouse of the control groups had a convulsion. These findings support the concept that the ethanol withdrawal syndrome is a partially latent state of hyperexcitability of the brain following depression by ethanol.     

Management of symptomatic hypercalcemia and hypocalcemia

Symptomatic hypercalcemia is a medical emergency. Knowledge of the alteration in the factors that control normal calcium homeostasis permits selection of a plan of treatment, which includes general supportive measures along with therapeutic agents directed at the specific alteration in calcium homeostasis. The rationale for the selection of various modes of treatment and treatment schedules and the untoward side effects of the therapeutic agents are reviewed.Acutely developing hypocalcemia often requires emergency treatment. Relief of symptoms can be achieved with intravenous calcium preparations. Knowledge of the underlying cause permits selection of appropriate medications when long-term treatment is required. When vitamin D is needed, measurement of serum calcium and phosphate at regular intervals is essential. Hypoparathyroidism may be temporary after thyroid or parathyroid surgery, and efforts should be made 6 to 12 months after operation to determine whether the abnormality is permanent.

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Résumé L'hypercalcémie symptômatique représente une véritable urgence médicale. La connaissance exacte des modifications des facteurs qui contrô lent l'homéostase calcique permet de choisir un traitement adéquat comportant à la fois des mesures générales et des mesures spécifiques propres à traiter ces anomalies. Le choix des modalités thérapeutiques et du détoulement du traitement ainsi que les effets indésirables des agents thérapeutiques susceptibles d'être employés sont passés en revue par les auteurs.L'hypocalcémie a évolution aiguë nécessite également un traitement d'urgence. Elle peut être jugulée par l'injection intraveineuse de préparations calciques. La recherche de la cause de l'hypo calcémie permet de choisir la médication adéquate dès lors qu'un traitement à long terme est indispensable. L'emploi au long cours de la vitamine D impose le dosage de la calcémie et de la phosphorémie à intervalles réguliers. L'hypoparathyroïdie après chirurgie thyroïdienne ou parathyroïdienne est souvent provisoire mais il convient au 6ème et au 12ème moist après l'intervention de vérifier que l'hypocalcémie n'est pas permanente.

     

Formal carers: attitudes to working with the dementing elderly and their informal carers

This paper presents a discussion of some of the results arising from a study into the inter-relationships between the dementing elderly in the community, and their informal and formal carers. The results from one phase of the study, which gathered data from informal carers, were used in the development of an attitudinal questionnaire. The questionnaire was distributed to a sample of 60 formal carers drawn from a wide variety of health, social and voluntary services. The questionnaire sought to gather data about the formal carers’ responses to their work with dementing people and their co-resident informal carers. The results of the questionnaire indicated that most of the formal carers believed that it was part of their job to maintain the dementing person in their own home and that they were effective in doing this. However, many of the respondents were uncertain whether homecare was best for the dementing person. The results also suggested that the majority of respondents felt that maintaining the dementing person at home was not detrimental to the informal carers welfare and that their intervention was effective in supporting the informal carer. These findings are discussed within the context of the informal carer phase of the study and demonstrate some variance between the formal and informal carer perspectives of care control and the significance of formal carer input.     

A validity study of the St. Louis inventory of community living skills

Clinicians who work with the long term mentally ill often need an instrument which measures the level of community living skills. Independent raters scored 60 clients of the St. Louis Community Placement Program on the St. Louis Inventory of Community Living Skills (SLICLS), a 15-item instrument that requires little training and only a few minutes to complete. There was good inter-rater reliability and internal consistency. Construct validity was demonstrated for clients in three types of residences. Concurrent validity was demonstrated in relation to the longer Missouri Level of Care Instrument.     

Malaria: treatment efficacy of halofantrine (WR 171,669) in initial field trials in Thailand

Halofantrine (WR 171,669) hydrochloride was administered orally to 82 patients infected with Plasmodium falciparum malaria on the Thai—Kampuchean border between June 1982 and December 1983 in a randomized double-blind treatment trial which compared the efficacy of halofantrine with that of mefloquine. Halofantrine was curative with oral treatment on a single day in 65% of patients (13/20) who received 1000 mg followed 6 hours later by an additional 500 mg, and in 88% of patients (53/60) who received 500 mg every 6 hours for 3 doses. Mefloquine was curative in 88% of patients (22/25) given a single oral dose of 1000 mg and in 97% of patients (38/39) given a single oral dose of 1500 mg. The difference in cure rates between the 3-dose halofantrine regimen and either of the mefloquine regimens was not significant. The mean parasite clearance time for all regimens ranged from 75 to 84 hours. The mean fever clearance time for all four treatment groups was in the range 50-60 hours, with no significant differences between groups. Post-dosing side-effects in patients treated with halofantrine consisted of nausea, vomiting, abdominal pain and diarrhoea and were not significantly different from those treated with mefloquine. Halofantrine therefore appeared to be of comparable efficacy to mefloquine in the treatment of multidrug-resistant P. falciparum malaria.     

The relevance of psychoactive agents to psychotherapy

Summary It would appear that psychiatrists trained in psychodynamic and medical approaches are best equipped to evaluate the relevance of drugs to psychotherapy. Psychiatrists working in a general hospital setting should especially consider it their province to study and understand the uses and abuses of pharmacologic agents as they influence all patients, since their non-psychiatrist colleagues often turn to them for help in this area.His background includes a graduate degree in psychology, two years experience as a research psychiatrist with NIMH, and certification from the Boston Psychoanalytic Society and Institute. He is editor of the quarterlyPsychiatry in Medicine.