A total of 56 consecutive patients with metastatic colorectal cancer received treatment with 5-fluorouracil (5-FU) given at 425 mg/m2 by rapid intravenous infusion, immediately preceded by leucovorin ...(LV) given at 20 mg/m2, with cycles being repeated every 4 weeks. Of 48 evaluable patients undergoing this treatment, a tumor response was observed in 16 (33%); a complete response, in 2 (4%); and a partial response, in 14 (29%). The median survival was 8.5 months for all patients and 16.5 months for responders. An improvement in symptoms was seen in 9 (26%) of 34 symptomatic patients. In all 15 (27%) of 44 evaluable patients showed an improvement in performance status. The most significant toxicity attributable to the treatment was mucositis of grade 3 or 4, seen in 27% of the patients. Altogether, 2 patients (3.5%) were hospitalized for treatment-related toxicity. We conclude that the combination of 5-FU and low-dose LV is active in advanced colorectal cancer and is associated with acceptable toxicity.
Neuropeptide Y (NPY) coexists with noradrenaline (NA) in many peripheral sympathetic nerves. Since it has been found that patients with preeclampsia have elevated myometrial levels of both NPY and ...NA, we have examined the effects of NPY and NA on blood pressure and blood flow velocity in the uterine artery of the term pregnant guinea-pig (n = 7). We found that NPY (10-1000 pmol) significantly increased local blood pressure, with increases ranging from 15.4% (P less than 0.05) to 46.4% (P less than 0.001) as compared to control. NA (10-1000 pmol) had similar effects, increasing local blood pressure (5%-57.5% (P less than 0.01. NPY had no significant effect on uterine blood flow velocity as measured by pulsed Doppler ultrasound, whereas NA (10-1000 pmol) decreased local uterine blood flow velocity (5.9%-30.2% (P less than 0.05. The effect of NPY on blood pressure was phentolamine-resistant, indicating that it is not alpha-adrenoceptor-mediated. The results indicate that NPY and NA have significant pressor effects in the local uterine circulation during pregnancy in the guinea-pig.
The presence of several neuropeptides (neuropeptide Y (NPY), vasoactive intestinal polypeptide (VIP), calcitonin gene-related peptide (CGRP), substance P (SP), galanin (GAL), enkephalin (ENK), ...somatostatin (SOM) was established in the early pregnant human cervix using indirect immunofluorescence immunohistochemistry. Several peptides (VIP, NPY, CGRP, GAL) were present both in free nerves among smooth muscle cells and around blood vessels. Others (SP, SOM) were only seen as single varicosities among smooth muscle cells. Randomized treatment of patients with RU 486 (mifepristone) prior to surgical sampling revealed no clearcut differences in peptide immunoreactivities. After RU 486 treatment, however, there was a tendency towards a decrease of NPY- and VIP-immunoreactivity, and an increase of CGRP-immunoreactivity.
We have examined the subcellular distribution of synapsins and synaptophysin in density gradients from synapsin- and vector-transfected NG108-15 cells, since we recently found that transfection of ...synapsin IIb cDNA into neuroblastoma x glioma hybrid cells (NG108-15) resulted in cell lines that had a more neuronal phenotype than controls. The increase in synapsins and synaptophysin in the transfected cells was maximal in the region of the gradient containing small synaptic vesicles. The transferrin receptor, a marker for early endosomes, did not increase in the synapsin-containing fractions in the transfected cells. Secretogranin I, a soluble protein stored in and secreted from large dense cored vesicles, showed a very pronounced increase in the dense regions of gradients from transfected cells. These subcellular fractionation data suggest a possible role for the synapsins in the regulation of synaptic vesicle function.
Between 1981-1993 581 women with primary breast cancer were treated by breast conservation. Their mean age was 56 +/- 12 years and 63% were postmenopausal and 37% pre- or perimenopausal. The median ...follow-up time was 56 months. 45% had pathological Stage I disease, 49% Stage II, 2.5% Stage III and 3.5% clinical Stage I-II disease. 54% of lesions were excised with good margins, 10% with close margins (< 0.5 cm), 9% with microscopic residual, 3% with macroscopic residual, and in 24% margins were not reported. Adjuvant therapy, consisting of combination chemotherapy and/or hormones, was given to 69%. Radiotherapy, usually 50 Gy tangential photon irradiation to the whole breast, was given to 564 (97%); an electron or photon "boost" to the tumor with a median dose of 17.5 Gy was given to 378 (65%). Most of those with positive nodes received 50 Gy to the lymphatic drainage system. 1 year after radiotherapy cosmetic results were rated as "good" or "excellent" in 80%, "moderate" in 17% and "poor" in 3%. The 5-year actuarial survival was 97% in Stage I and 88% in Stage II. 37 patients (6.5%) developed breast recurrence; 11 of these (2%) had simultaneous distant metastases. 5 (< 1%) developed axillary or supraclavicular lymph node metastases, and 81 (14%) developed distant metastases. Most local recurrences were in those younger than 40, and in those with primary tumors > 1.75 cm. The satisfactory level of local control achieved is attributed to the high doses of radiation (up to 75 Gy) administered to those with high risk lesions.
The management of bile leaks has evolved in the laparoscopic era. This study characterizes risk factors for their developmental and their clinical course and management.
Data on a cohort of patients ...who developed bile leaks after cholecystectomy in the laparoscopic era were gathered prospectively and retrospectively from an ongoing surgical database and following a review of hospital charts.
Sixty-four patients (mean age 56 +/- 17.1 years, 72% women) were included over a 5-year study period. The incidence of leaks was 1.1% among patients entered in a laparoscopic cholecystectomy database. Intraoperative complications were encountered in 36%. Rates of intraoperative complication and conversion to open surgery were greater among patients who developed leaks (5.2% vs 0.6% and 33% vs 6.3%, respectively, p < 0.00001). Patients presented 5.3 +/- 4.2 days following surgery with abdominal pain (89%), fever (74%), and tenderness (81%). Ultrasound diagnosed a suspected leak in 73%, which ERCP showed as originating from the cystic duct stump in 77%. Biliary obstruction was noted in 20 (31%) patients (14 with stones). Treatments included percutaneous (13%), endoscopic (28%), primary or secondary operative procedures (14%), or a combination thereof (45%).
A complication at laparoscopic cholecystectomy increases the likelihood of a subsequent bile leak. Most patients present early with a patent cystic duct stump in the absence of biliary obstruction. Endoscopic therapy is successful in the majority of cases, but otherwise percutaneous or operative procedures may be needed.
The dilemmas of German youth Fried, Edrita G; Lissance, Marjorie Fiske
Journal of abnormal and social psychology,
01/1949, Letnik:
44, Številka:
1
Journal Article
Prospects of democratizing German youth were appraised by interviewing 225 young men and women, aged 18 to 28, of a town in the American zone. Questions dealt with social attitudes and personal ...outlook. Despite economic scarcity, laborers and professionals are equally interested in marriage and raising a family. Men want to be master of the household, with wives who are good housekeepers. Women want husbands to "understand" them and be good providers. Both sexes want partners who feel just like themselves about everything. Case studies illustrate the common inability to compromise or to adjust to differences of opinion. 68% believe in training children by punishment, shaming, or contempt. Although half of the respondents professed to favor democratic government, they had no conception of grass-roots democracy. They want to be governed from afar by strong leaders. Strong ties are with the "Fatherland," not with their neighbors. Nearly half of the sample desired to emigrate; and only the veterans wanted to see Germany involved in another war. Responsibility for War II is evaded, but there is willingness to admit their political immaturity, deference to authority, and inability of compromise.
