A single nocturnal dose of famotidine for the treatment of duodenal ulcer: evaluation of efficacy and safety

The efficacy and safety of a single nocturnal dose of famotidine (40 mg) was evaluated in 30 consecutive patients of duodenal ulcer (DU). Three patients were lost for follow-up and therefore were excluded. The mean age of remaining 27 patients was 34.3 (+/- 9.9) years and male to female ratio was 8:1. The mean size of the DU was 1.21 (+/- 0.79) cm. After a 4-week therapy all patients showed significant improvement and repeat endoscopy in 24 out of 27 patients (89%, 95% confidence interval; 78% to 100%) showed healed ulcer. Clinical assessment of pain relief at 4-week showed significant drop in the mean score of baseline daytime (from 1.85 to 0.13) and baseline nocturnal pain (from 1.70 to 0.10) (p less than 0.0001 and less than 0.0001, respectively). Also shown was the significant decrease in the mean gastrointestinal symptoms score from 5.89 at baseline to only 0.89 at 4-week (p less than 0.0001). Despite that all those who failed to show ulcer healing at 4-week were smokers, logistic regression analysis could not identify smoking or any other risk factors as adverse predictors of ulcer healing. None of the patients experienced significant side effects or adverse reactions. We conclude, that a single nocturnal dose of famotidine is a practical, highly effective and safe approach for the management of DU.     

Purification of B16-F1 melanoma autocrine motility factor and its receptor.

Tumor autocrine motility factor (AMF) is a cytokine which stimulates both random and directed cell migration by self-producing cells. AMF has been detected in and purified from serum-free conditioned medium of murine B16-F1 melanoma cells. Under nonreducing conditions AMF migrates in sodium dodecyl sulfate-polyacrylamide gel electrophoresis as a single band of Mr 55,000, whereas under reducing conditions it migrates as a single polypeptide of Mr 64,000. Two-dimensional polyacrylamide gel electrophoresis of the purified AMF resolved two polypeptides with isoelectric points of 6.35 (major) and 6.4 (minor). No carbohydrate side chains were detected in the B16-F1 AMF. Purified AMF stimulated B16-F1 cell migration in a dose-dependent fashion and bound directly in a protein-protein-binding assay to the AMF receptor, a cell surface glycoprotein of Mr 78,000 [glycoprotein (gp) 78]. The involvement of gp78 in AMF-stimulated function was demonstrated by motility assays. These results suggest that AMF is the natural ligand for the gp78-AMF receptor.     

Radiolabeled monoclonal antibody imaging (immunoscintigraphy) of colorectal cancers: current status and future perspectives.

Over the past two decades, the role of radiolabeled monoclonal antibodies has been steadily growing in clinical practice, particularly for staging and locating a variety of neoplasms. This is due largely to the availability of these products in pharmaceutical quantities as well as the relatively low incidence of adverse reactions following the intravenous administration of antibodies to patients. One particular area of oncology where radiolabeled monoclonal antibodies are most likely to play an extremely important clinical role is in the evaluation of patients with colon and rectal carcinomas. In this report, we review the current utilization of tumor-associated monoclonal antibodies in the preoperative as well as postoperative screening of patients with colorectal carcinoma.     

Marjolin's ulcer of the suprapubic cystostomy site infiltrating the urinary bladder: a rare occurrence

We report a case of a 40-year-old man who had presented with a spontaneous suprapubic urinary leak from a well-healed suprapubic cystostomy tract scar, 20 years following a successful scrotal tube substitution urethroplasty done for a post-traumatic urethral stricture. Preoperative contrast studies suggested a recurrent bulbomembranous urethral stricture. Excision biopsy of the suprapubic fistulous tract revealed scar cancer infiltrating the bladder wall. Of 3 similar cases reported in the past, only 1 had bladder involvement. Ours is the second such case with bladder involvement.     

12. Patterns of Adrenal Gland Involvement from Lung Cancer Shown by 18F-Fluorodeoxyglucose Positron Emission Tomography Compared to Computed Tomography and Magnetic Resonance Imaging

Purpose: The frequency of adrenal metastases from non-small cell lung cancer (NSCLC) varies between 4 to 25%. Adrenal metastases are frequently missed (78%) by Computed Tomography (CT) and Magnetic Resonance Imaging (MRI). The purpose of this study was to characterize the patterns of adrenal gland involvement from lung cancer by 18-F-Fluorodeoxyglucose Positron Emission Tomography (18FDG-PET).Methods: Retrospective review of patients evaluated for known or suspected lung carcinoma. Results of 18FDG-PET, CT, MRI, and scans were compared.Results: From February 1996 to May 2000, 91 patients with known (85 patients) or suspected (6 patients) lung cancer were evaluated with 18FDG-PET scan. Twenty-two patients (mean age 63, range 38-88 years) had abnormal adrenal glands by either 18FDG-PET (16 patients), CT (12 patients) or MRI (1 patient). In 13 cases 18FDG-PET scan was ordered to clarify CT or MRI findings. Only 7 patients showed adrenal gland involvement: 5 patients (5.5%) with unilateral disease and 2 patients (2.2%) with bilateral disease. PET depicted unsuspected findings in 9 patients: 8 patients (8.8%) with unilateral disease and 1 patient (1.1%) with bilateral disease.(18)FDG-PET upstaged 9 patients from limited (N1M0) to widespread disease (M1), thus obviating surgical intervention.Conclusion: This study demonstrates the potential of 18FDG-PET scanning in revealing unsuspected adrenal metastases in patients with early stages of NSCLC as well as characterizing CT or MRI equivocal adrenal masses.     

Sleep duration and sleep disturbances partly explain the association between depressive symptoms and cardiovascular mortality: the Whitehall II cohort study

Depressive symptoms are associated with an increased risk of death, but most of this association remains unexplained. Our aim was to explore the contribution of sleep duration and disturbances to the association between depressive symptoms, all‐cause and cardiovascular disease mortality. A total of 5813 (4220 men and 1593 women) aged 50–74 years at baseline, participants of the British Whitehall II prospective cohort study, were included. Depressive symptoms, sleep duration and disturbances were assessed in 2003–04. Mortality was ascertained through linkage to the national mortality register until August 2012, with a mean follow‐up of 8.8 years. Depressive symptoms were associated with an increased risk of mortality from all causes [hazard ratio (HR) = 1.51; 95% confidence interval (CI): 1.16–1.97)] and cardiovascular diseases (HR = 1.63; 95% CI: 1.01–2.64) after adjustment for sociodemographic characteristics. Further adjustment for sleep duration and disturbances reduced the association between depressive symptoms and cardiovascular mortality by 21% (HR = 1.53; 95% CI: 0.91–2.57). Sleep seems to have a role, as a mediator or confounder, in explaining the association between depressive symptoms and cardiovascular mortality. These findings need replication in larger studies with longer follow‐up.     

Effect of bed head elevation during sleep in symptomatic patients of nocturnal gastroesophageal reflux

Background and Aim: Nocturnal gastro‐esophageal reflux causes heartburn and sleep disturbances impairing quality of life. Lifestyle modifications, like bed head elevation during sleep, are thought to alleviate the symptoms of gastroesophageal reflux. We tested the hypothesis that bed head elevation might decrease recumbent acid exposure compared to sleeping in a flat bed. Methods: Patients of symptomatic nocturnal reflux and documented recumbent (supine) reflux verified by esophageal pH test entered the trial. On day 1, baseline pH was measured while the patient slept on a flat bed. Then patients slept on a bed with the head end elevated by a 20‐cm block for the next 6 consecutive days from day 2 to day 7. The pH test was repeated on day 2 and day 7. Each patient acted as his own control. Results: Twenty of 24 (83.3%) patients with mean age of 36 ± 5.5 years completed the trial. The mean (± SD) supine reflux time %, acid clearance time, number of refluxes 5 min longer and symptom score on day 1 and day 7 were 15.0 ± 8.4 and 13.7 ± 7.2; P = 0.001, 3.8 ± 2.0 and 3.0 ± 1.6; P = 0.001, 3.3 ± 2.2 and 1.0 ± 1.2; P = 0.001, and 2.3 ± 0.6 and 1.5 ± 0.6; P = 0.04, respectively. The sleep disturbances improved in 13 (65%) patients. Conclusions: Bed head elevation reduced esophageal acid exposure and acid clearance time in nocturnal (supine) refluxers and led to some relief from heartburn and sleep disturbance.