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.     

Sacrospinous colpopexy in the management of uterovaginal prolapse

The tet(M) genes were characterized from 84 isolates of 10 different bacterial species isolated from the periodontal pockets of 16 patients with periodontal disease. A 740 bp polymerase chain reaction product from the hypervariable region of the tet(M) structural gene was cleaved with the restriction enzymes AluI and HinfI. Three different restriction patterns were identified for each of the two enzymes. By DNA sequencing, using a direct solid-phase automated sequencing method, the isolates could be grouped into 3 different clusters of tet(M) subtypes. The internal DNA homology within each subtype was 98-100%; the homology between clusters was 89-94%. Two different subtypes were identified in 9 of 10 bacterial species, and the remaining species had 3 different subtypes. One of the subtypes (M3) was seen mainly in the anaerobic isolates. This subtype was different from all earlier sequenced structural tet(M) genes present in the Genbank. Most patients had two different subtypes of tet(M), and a third subtype was seen in the 3 patients who exhibited the greatest variety of tetracycline-resistant bacterial species. It appears that the presence of one subtype of the tet(M) gene within a patient or bacterial species does not prevent the acquisition of another subtype of the same gene. This study identified a new subtype of the tet(M) gene and grouped it into 3 distinct yet highly homologous genetic subtypes.     

Characterization and modeling of a noncollinearly phase-matchedfemtosecond optical parametric oscillator based on KTA and operating tobeyond 4 μm

We describe the design and operation of a critically phase-matched femtosecond optical parametric oscillator based on KTA. By employing a small pump-signal noncollinear angle, tuning of the idler to beyond 4 μm is achieved using a Ti:sapphire pump laser. A Gaussian-beam model is described which can be used to identify the optimal noncollinear phase-matching geometry. Idler and signal pulses are characterized fully both temporally and spectrally and interferometric autocorrelation data at 3.5 μm showing idler pulses of only eight optical cycles duration are presented     

Concordant but different: Cognitive function, cerebral anatomy, and metabolism in monozygotic twins with Alzheimer's disease.

To illustrate the utility of the twin method in Alzheimer's disease (AD) research, a pair of monozygotic twins, concordant for the disease but markedly different in their clinical presentations, was studied in detail. Neuropsychological evaluation, magnetic resonance imaging (MRI), and cerebral glucose metabolic studies revealed a typical behavioral presentation for AD in Twin A. In contrast, Twin B showed prominent visuospatial impairments. Although there was no identified cause for the disparate presentations, a close correspondence was observed between the neuropsychological findings and the regional brain measures. The results suggest that the trajectory of AD may vary widely even in genetically identical individuals. Factors accounting for the variability include potential intrauterine, early developmental, and environmental differences. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The Tenckhoff catheter in acute renal failure

The results of a retrospective study of routine measurement of haemoglobin at the examination of one-year-old children at Gr?land mother and child clinic during 1989-91 showed that 37% of the children had anaemia. There was no difference between immigrants and the European population. There was no correlation between anaemia and sex in either of the population groups. This may imply that routine haemoglobin measurement should be generally introduced as part of the regular control of one-year-old children.     

Granulation tissue polyposis associated with carcinoid tumours of the small intestine

We report two patients with ileal carcinoid tumours which were associated with polyps due to mucosal granulation tissue proliferation. In both cases the tumours had extensively infiltrated the small bowel wall and mesentery, and one had hepatic metastases. The mucosal surface of each specimen showed numerous, pale brown, sessile polyps which were restricted to the intestinal segment involved by carcinoid tumour, although not always closely related to neoplastic cells. The polyps were formed by the proliferation of capillaries, smooth muscle cells and myofibroblasts as demonstrated by immunohistochemistry and electronmicroscopy.     

Dissolved organic carbon of coal slurry transport water

The qualitative and quantitative occurrence and fate of dissolved organic carbon (DOC) leaching into coal slurry transport water was examined in laboratory-generated coal slurries and wastewaters from the Black Mesa coal slurry pipeline. Laboratory slurries were formulated for both western coals (Wyodak, Montana Rosebud and Black Mesa) and eastern coals (Illinois No. 6 and Pittsburgh No. 8). Sephadex G-25 elution profiles and ultrafiltration studies indicate that the majority of the organic compounds in western coal slurry wastewaters were lower (less than 1000) molecular weight species (62% for Wyodak and 74% for Montana Rosebud). Biochemical Oxygen Demand (BOD) for these particular wastewaters ranged from 50 to 150 mg l⁻¹ as determined through the use of an electrolytic respirometer. Also, there was a concomitant 51–74% reduction in the DOC levels in the wastewaters. This removal was primarily due to the removal of the lower (< 1000) molecular weight compounds by the seed inoculum. There was no evidence for the presence of mutagenic organics in the raw wastewater.     

Differentiation of apple juice samples on the basis of heat treatment and variety using chemometric analysis of MIR and NIR data

The potential of mid-infrared (MIR) and near-infrared (NIR) spectroscopy for their ability to differentiate between apple juice samples on the basis of apple variety and applied heat-treatment was evaluated. The heat-treatment involved exposure of juice samples (15 ml) for 30 s in a 900 W microwave oven and the apple varieties used to produce the juice samples were Bramley, Elstar, Golden Delicious and Jonagold. The chemometric procedures applied to the MIR and NIR data were partial least squares regression (PLS1 for differentiation on the basis of heat-treatment, PLS2 for varietal differentiation) and linear discriminant analysis (LDA) applied to principal component (PC) scores. PLS1 and PLS2 gave the highest level of correct classification of the apple juice samples according to heat-treatment (77.2% for both MIR and NIR data) and variety (78.3–100% for MIR data; 82.4–100% for NIR data), respectively.