Treatment of small cell carcinoma of the lung using methyl-CCNU (NSC-95441) combined with cyclophosphamide (NSC-26271) and vincristine (NSC-67574) in a 3-week schedule

Twenty-six patients with small cell carcinoma of the lung were treated with a combination of methyl-CCNU (75 mg/m2 orally), cyclophosphamide (750 mg/m2iv), and vincristine (1.4 mg/m2iv) once every 3 weeks and followed for 2-56 weeks (mean, 24 weeks). An average of seven treatments were given per patient. Myelotoxicity was mild to moderate with no white blood cell count (wbc) less than 1000 cells/mm3 and no platelet count less than 25,000 cells/mm3. Six patients (23%) had a wbc of 1000-2000 cells/mm3 and two (8%) had a platelet count of 25,000-75,000 cells/mm3. Sixty-eight persons of the projected dose of methyl-CCNU was given. Fourteen of 22 patients with measurable disease (54%) responded. Of 14 patients who had received no prior treatment 64% responded with a median survival duration of 40 weeks. Complete responses occurred only in patients without prior radiation therapy or chemotherapy. We conclude that methyl-CCNU may be given with an acceptable level of toxicity in an every 3-week schedule and that the combination of cyclophosphamide, methyl-CCNU, and vincristine warrants further evaluation in the treatment of small cell carcinoma of the lung.     

Adapting the HCUP QIs for hospital use: the experience in New York State

BACKGROUND: The Agency for Healthcare Research and Quality developed the Healthcare Cost and Utilization Project (HCUP) quality indicators (QIs) in 1994. The Healthcare Association of New York State (HANYS; Albany), which represents more than 500 nonprofit and public hospitals, long-term care facilities, and home health care agencies, has adapted the HCUP QIs since 1997 to produce annual comparative reports for its member hospitals. Specifically designed for internal use, the reports have been well received and have drawn interest from other hospital associations and state health departments. METHODS: The HCUP QIs were applied to the New York State hospital discharge abstract. A risk adjustment model was constructed for each complication measure. Measures of utilization and access to care were adjusted for differences in patient demographics and payer status by indirect standardization. Data are presented in graphic format. Each hospital receives its own report (in both paper copy and CD-ROM) with comparisons to statewide norms, regional averages, and peer group averages. Report prepared for hospital systems include data for each affiliated hospital. CONCLUSIONS: When used appropriately, the HCUP QIs provide valuable information for individual hospitals to assess quality of care and target potential areas for improvement. The HCUP QIs also give hospitals a broad perspective to look beyond their own institutions and develop community-based quality improvement initiatives. Nevertheless, given the limitations that commonly exist with administrative databases and the lack of standard risk adjustment systems, the HCUP QIs are best used for internal purposes and not for public reporting.     

Social psychological factors in the genesis of posthypnotic source amnesia.

Three experiments assessed the role of social psychological variables in source amnesia. Experiment 1 found that low-hypnotizable subjects instructed to simulate partial amnesia were more likely to exhibit source amnesia than high-hypnotizable hypnotic or task-motivated subjects. Experiment 2 found equivalent rates of source amnesia in low-hypnotizable simulators and high-hypnotizable hypnotic subjects. In addition, the findings of Experiment 2 failed to support the idea that the instructions for partial amnesia given to simulators cued for the occurrence of source of amnesia as well as for the occurrence of partial amnesia. In Experiment 3, preliminary instructions that legitimated source amnesia as a role-appropriate response produced significantly more posthypnotic source amnesia than did neutral or no instructions. Together, the findings of the 3 experiments support the relation of source amnesia to experimental demands and subjects' expectations. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Wittig reaction of unprotected D-aldopentoses with stabilized ylides: metal-ion effects

Each of the four D-aldopentoses (1-4) reacts in the unprotected form with Ph3PCHCO2Me (5) in THF to give stereoselectively the corresponding trans-alpha,beta-unsaturated C7 Wittig adducts, isolated as the corresponding 4,5,6,7-tetraacetates (7-10) or 4,5:6,7-di-O-isopropylidene derivatives (11-14). Concurrently formed are also bicyclic, 1,4-lactone derivatives, isolated as their 5,7-diacetates (15-18) or 5,7-O-isopropylidene derivatives (19), arising through intramolecular Michael addition from the initial acyclic adducts. Formation of the cyclized products is suppressed by incorporation of Cu(OAc)2 in the reaction mixture, permitting preparative isolation of the hept-3-enonate derivatives 7-10, useful as dienophiles in Diels-Alder carbocyclizations with chirality transfer. Optimized yields were 25% (D-ribo), 50% (D-arabino), 49% (D-xylo), and 61% (D-lyxo). Under Cu(OAc)2-catalyzed conditions, the formation of small proportions of 3,7-anhydroheptonic acid esters (21 and 23) was observed in the D-arabino and D-xylo series, but not with the other two pentoses.     

Albendazole in human loiasis: results of a double-blind, placebo-controlled trial

To assess the filaricidal activity and clinical safety of albendazole in human loiasis, a double-blind, placebo-controlled study was conducted in an endemic area in Benin, Africa. Twenty-three men with microfilaremia (100-30,000/mL) were randomly assigned to receive albendazole (200 mg; n = 11) or placebo (n = 12) twice daily for 21 days; 1 patient from each group withdrew from the study. There were no clinical adverse effects and no observed hepatotoxicity, renal toxicity, or hematologic abnormalities attributable to the drug. In the albendazole group, microfilarial levels began to decrease at day 14 after treatment and by 6 months had fallen to a geometric mean of 20% of pretreatment levels (vs. 84.8% in the placebo group). Blood eosinophil levels and anti-filarial IgG and IgG4 also fell significantly in response to albendazole. Taken together, these data suggest that albendazole has a primary (possibly embryotoxic) effect on the adult parasite, resulting in a slow decrease in microfilaremia.     

Structural adhesive performance in marine environments

Durability of adhesively bonded aluminium joints was investigated for both stressed and unstressed joints exposed to environments of air, distilled water, 0.5% sodium chloride solution and 5% sodium chloride solution. Testing involved the use of marine grade aluminium, two acrylic adhesives and two epoxy resin adhesives. Surface preparation consisted of a solvent wipe degreasing procedure. The acrylic adhesives used in this study displayed greater bond durability than cpoxy resins. Results also reaffirmed that the combination of stress and environmental exposure is more detrimental to bond durability than environmental exposure alone. The combined effects of stress and dilute salt solution were found to be more detrimental to adhesive bond durability than stress combined with distilled water, or concentrated salt solution. Two possible causes of bond deterioration considered were corrosion of the aluminium adherend and instability of the interface. Either of these explanations could account for the observed results; however, more work is required to verify these theories.     

Plastic flow and microstructure of cast nickel aluminides at 1273 K

Chill-cast nickel aluminides based on Ni₃Al were compression-tested in vacuum at 1273 K at strain rates ranging from 10^-5 s^-1 to 10^-1 s^-1. As the strain rate increases, the propensity for intergranular cracking increases. The ductile-to-brittle transition strain rate (DBTS) of as-cast Ni-22.5Al-0.5Hf-0.1B (at. pct) is approximately 10^-1 s^-1. Homogenization lowers this value by three orders of magnitude, to 10^-4 s^-1 (a homogenized specimen disintegrated completely at a rate of 10^-3 s^-1). The fine-grained structure of the as-cast alloy plays an important role in its relatively high DBTS. A hafnium-free alloy, Ni-24A1-0.1B, on the other hand, shows only a weak dependence of the DBTS on prior homogenization, and possible reasons for this finding are discussed.     

Electrical modulation of diffractive structures

We present an experimental demonstration of two new methods for electronically modulating diffractive structures. The first involves the creation of periodic displacement of a liquid-air interface by application of a spatially modulated electric field produced by an array of electrodes. The second method also uses an electrode array but creates a diffraction grating by selectively attracting and repelling electrophoretic particles in a dielectric fluid. Potential areas of application of these techniques include controllable holography and wavelength division multiplexing.