A phase I-II study of paclitaxel, ifosfamide, and vinorelbine with filgrastim (rhG-CSF) support in advanced non-small-cell lung cancer

PURPOSE: We designed a phase I-II trial of three active agents, paclitaxel, ifosfamide, and vinorelbine, in advanced non-small-cell lung cancer (NSCLC) to: 1) define the dose-limiting toxicities (DLT) and maximum tolerated dose (MTD) of paclitaxel with filgrastim (G-CSF) support; and 2) determine the overall response rate and median survival of patients treated on this regimen. PATIENTS AND METHODS: We treated cohorts of patients with stage IIIB or IV NSCLC with ifosfamide 1.2-1.6 g/m2/day x 3 and vinorelbine 20-25 mg/m2/day x 3 and escalating doses of paclitaxel at 100-175 mg/m2 on day 2 with G-CSF support on a 21-day cycle. One prior experimental single-agent chemotherapy regimen was allowed. RESULTS: Fifty-six patients, were enrolled on this trial: 27 on the phase I portion of the study and an additional 29 at the recommended phase II dose (RPTD). Thirteen patients had received prior chemotherapy. Paclitaxel doses of 175 mg/m2 and 150 mg/m2 produced dose-limiting myelosuppression, and the RPTD was determined to be paclitaxel 135 mg/m2 with ifosfamide 1.2 g/m2/day on days 1-3 and vinorelbine 20 mg/m2/ day on days 1-3 with G-CSF support. The overall response rate was 18%, with a median survival of 6.1 months. Six of 35 patients (17%) treated at the RPTD achieved a partial response to therapy. Grade IV neutropenia was observed in 19 of 35 patients at this dose, with eight patients suffering febrile neutropenia. CONCLUSIONS: This non-cisplatin-containing three-drug regimen has substantial toxicity and low activity in advanced NSCLC, and does not seem to improve on prior regimens. It is unclear whether the lack of efficacy relates to an antagonistic reaction between the specific drugs, administration schedule, or to subtherapeutic doses of the individual agents.     

Trends in low-cost, high-performance substrate technology

The trends in high density interconnection (HDI) multichip module (MCM) techniques that have the potential to reduce interconnection cost and production time are described. The implementation in laminated dielectric (MCM-L) technology of a workstation processor core illustrates current substrate technology capabilities. The design, routing, layout and thermal management of the processor core are described. Thin-film deposited dielectric (MCM-D) technology is discussed as a cost-effective method for future interconnection applications     

The virtual reality modeling language explained

VRML stands for Virtual Reality Modeling Language. Technically, VRML is neither virtual reality nor a modeling language. Virtual reality generally implies an immersive 3D experience, which typically requires a head mounted display (HMD) and 3D input devices, such as digital gloves. VRML neither requires nor imposes immersion. Furthermore, a true modeling language would contain richer geometric modeling primitives and mechanisms. VRML provides a bare minimum of geometric modeling features but contains numerous features unavailable in a modeling language. If VRML is not virtual reality or a modeling language, what is it? This question has several answers. At its core, VRML serves as a 3D interchange format. It defines most of the commonly used semantics found in today's 3D applications such as hierarchical transformations, light sources, viewpoints, geometry, animation, fog, material properties, and texture mapping. Here's a second answer to: what is VRML? It's a 3D analog to HTML. This means that VRML serves as a simple, multiplatform language for publishing 3D Web pages. The fact that some information, including games, engineering models, scientific visualizations, educational experiences, and architecture, can best be experienced in 3D has motivated this language. Typically, these types of projects require intensive interaction, animation, and user participation and exploration beyond what a page, text, or image based format can handle. Another answer is that VRML provides the technology to integrate 3D, 2D, text, and multimedia into a coherent model     

Psoralen photochemotherapy

Psoralens and sunlight have been used by the Egyptians and Indians for hundreds of years for treating vitiligo. The combination of oral psoralens and artificial ultraviolet A (PUVA) therapy was approved for managing severe psoriasis by the Food and Drug Administration in 1982. Since then, PUVA therapy has been an effective modality for treating many cutaneous conditions (psoriasis, atopic dermatitis, vitiligo, and mycosis fungoides). However, proper knowledge and administration of PUVA therapy are vital to treatment success and reducing side effects.     

Seeking the truth about ad hoc join costs

In this paper, we re-examine the results of prior work on methods for computing ad hoc joins. We develop a detailed cost model for predicting join algorithm performance, and we use the model to develop cost formulas for the major ad hoc join methods found in the relational database literature. We show that various pieces of “common wisdom” about join algorithm performance fail to hold up when analyzed carefully, and we use our detailed cost model to derive op timal buffer allocation schemes for each of the join methods examined here. We show that optimizing their buffer allocations can lead to large performance improvements, e.g., as much as a 400% improvement in some cases. We also validate our cost model's predictions by measuring an actual implementation of each join algorithm considered. The results of this work should be directly useful to implementors of relational query optimizers and query processing systems. Edited by M. Adiba. Received May 1993 / Accepted April 1996     

Primary sternal osteomyelitis presenting as a pleural-based mass

Osteomyelitis in uncommon locations can present unusual diagnostic difficulties. A patient with primary sternal osteomyelitis who presented with pain over the right supraclavicular area and a radiologic picture of a pleural-based right upper lung mass is discussed. A triple-phase bone scan was consistent with the diagnosis, and a needle aspiration of the mass revealed a staphylococcal abscess. Percutaneous drainage of the contiguous abscess and a prolonged course of antibiotic therapy cured the infection.