Med Clin North Research Articles

Thiotepa, Cutaneous Reactions, and Efficacy

To the Editor.— Allergic cutaneous reactions to systemic chemotherapeutic agents are well known, but the suggestion that such reactions might be beneficial has come only indirectly and from the topical use of alkylating agents and at least one cell-cycle-specific agent (fluorouracil) in the treatment of tumors in skin and soft tissues ( Med Clin North Am 60:389-418, 1976). In a retrospective review of our results of combination chemotherapy with thiotepa and methotrexate in 186 patients with stage III or IV ovarian cancer, ten survived free of disease more than three years after complete regression of previous advanced bulky metastases. Possible factors related to the clinical eradication of disease were sought. Seven patients had shown generalized cutaneous erythema, pruritus, and urticarial reactions of substantial proportions. These appeared one to three months after onset of the combination chemotherapy regimen and within one to 24 hours after thiotepa administration. Despite these reactions, treatment was

Chronic lymphocytic thyroiditis: Identification of rubella virus antigen in the thyroid of a child with congenital rubella

1. Mitchell SW, Morehouse GR, and Keen WW: Gunshot wounds and other injuries of nerves, Philadelphia, 1864, JB Lippencott & Co. 2. Kozin F, McCarty DJ, Sims J, and Genant HK: The reflex sympathetic dystrophy syndrome. I. Clinical and histologic studies: Evidence for bilaterality, response to corticosteroids, and articular involvement, Am J Med 60:321, 1976. 3. Steinbrocker O, and Argyros TG: The shoulder-hand syndrome: Present status as a diagnostic and therapeutic entity, Med Clin North Am 42:1533, 1958. 4. Matles A: Reflex sympathetic dystrophy in a child, Bull Hosp Joint Dis 32:193, 1971. 5. Carron H, and McCue F: Reflex sympathetic dystrophy syndrome in a 10-year-old, South Med J 65:631, 1972. 6. Guntheroth WG, Chakmajian S, et al: Post-traumatic sympathetic dystrophy, Am J Dis Child 121:511, 1971. 7. Patrnan RD, Thompson JE, and Perrson AV: Management of post-traumatic pain syndromes: Report of 113 cases, Ann Surg 177:780, 1973. 8. Barnett HL, and Ernhorn AH, editors: Pediatrics, ed 15, New York, 1972, Appleton-Century-Crofts, Inc. 9. Vaughan VC, and McKay R J: Nelson textbook of pediatrics, Philadelphia, 1975, WB Saunders Company. 10. Kozin F, Genant HK, Bekerman C, and McCarty D J: The reflex sympathetic dystrophy syndrome. 11. Roentgenographic and scintigraphic evidence of bilaterality and periarticular accentuation, Am J Med 60:332, 1976.

The Clinical Assessment of the Chemical Regulation of Ventilation

Adjustments in ventilation keep blood gas tensions and pH within relatively narrow limits despite variations in metabolic rate and environmental conditions. These adjustments depend (1) on signals from arterial and central-nervous-system (CNS) chemoreceptors which sense changes in their surroundings (as shown in Fig 1) and (2) on the proper functioning of the thoracic bellows. Most cases of hypercapnia and hypoxemia are probably caused by defective pulmonary and chest-wall performance, particularly by diseases which produce chronic airway obstruction or incoordination or weakness of the respiratory muscles; 1 Senior RM Fishman AP Disturbances of alveolar ventilation. Med Clin North Am. 1967; 51: 403-425 Crossref PubMed Scopus (7) Google Scholar , 2 Buchsbaum HW Martin WA Turino GM et al. Chronic alveolar hypoventilation due to muscular dystrophy. Neurology. 1968; 18: 319-327 Crossref PubMed Google Scholar however, it has been known for many years that respiratory failure can occur in patients with normal or nearly normal pulmonary function. 3 Mellins RB Failure of automatic control of ventilation (Ondine's curse). Medicine. 1970; 49: 487 Crossref PubMed Scopus (296) Google Scholar , 4 Fishman AP Goldring RM Turino GM General alveolar hypoventilation: A syndrome of respiratory and cardiac failure in patients with normal lungs. Q J Med. 1966; 35: 261-275 PubMed Google Scholar In these cases, defects in the respiratory chemoreceptors seem to play a significant role.

Letter: Tuberculosis and isoniazid in steroid-treated asthmatic patients.

Comments and Corrections1 July 1976Tuberculosis and Isoniazid in Steroid-Treated Asthmatic PatientsGARY R. EPLER, M.D., M. ANEES KHAN, M.D.GARY R. EPLER, M.D.Search for more papers by this author, M. ANEES KHAN, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-85-1-129 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: In the paper by Schatz and colleagues on the prevalence of tuberculosis in a steroid-treated asthmatic population (Ann Intern Med 84:261-265, 1976), they conclude that long-term use of corticosteroids in this clinical setting does not increase the risk of active tuberculosis and that such patients, therefore, should not receive isoniazid chemoprophylaxis.The authors seem to convey the impression that the risk of tuberculosis was ascertained in 132 patients over 620 corticosteroid years. In fact, only the intermediate-strength tuberculin reactors representing 185 patient years (37 patients with mean follow-up of 5.1 years) were actually subjected to this risk...Reference1. MOULDING T: Chemoprophylaxis of tuberculosis: when is the benefit worth the risk and cost? Ann Intern Med 74:761-770, 1971 LinkGoogle Scholar1. GABRIELSONGOOD AR: Chemical suppression of adoptive immunity. Adv Immunol 6:91-229, 1967 CrossrefMedlineGoogle Scholar2. MACGREGORSHEAGRENLIPSETT RJM: Alternate day prednisone therapy: evaluation of delayed hypersensitivity responses, control of disease, and steroid side effects. N Engl J Med 280:1427-1431, 1969 CrossrefMedlineGoogle Scholar1. Current trends: preventive therapy of tuberculosis infection. Morbid Mortal Weekly Rep 24:71-78, 1975 Google Scholar2. MAGBOOLASNESGREBIN SRB: Tine test compliance in a clinic setting. Pediatrics 55:338-391, 1975 Google Scholar1. FAUCIDALEBALOW ADJ: Glucocorticoid therapy: mechanisms of action and clinical considerations. Ann Intern Med 84: 304-315, 1976 LinkGoogle Scholar1. RICHERSON H: Symptomatic treatment of adults with bronchial asthma. Med Clin North Am 58:135, 1974 CrossrefMedlineGoogle Scholar2. PORTNERTHAYERHARTER MKJ: Successful initiation of alternate-day prednisone in chronic steroid dependent asthmatic patients. J Allergy Clin Immunol 49:16, 1972 CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Boston City Hospital 818 Harrison Avenue Boston, MA 02118 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byAdverse effects of inhaled corticosteroidsAsthma, Steroid Therapy, IsoniazidLEE B. REICHMAN, M.D., M.P.H., F.A.C.P., WAYMAN C. LATTIMORE, M.D., REYNARD J. MCDONALD, M.D. 1 July 1976Volume 85, Issue 1Page: 129-131KeywordsChemopreventionIsoniazidTuberculin Issue Published: 1 July 1976 PDF downloadLoading ...

Cancer immunotherapy.

Letters, Comments, and Corrections1 January 1973Cancer ImmunotherapyROBERT T. EAGAN, M.D.ROBERT T. EAGAN, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-78-1-153_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: After all the articles in the lay press and news media about "cures" of cancer with bacillus Calmette-Guérin (BCG) and other forms of immunotherapy and after receiving more than one phone call at the Cancer Information Center, Northern New England Cancer Project, about "curing" leukemia with active immunization rather than with chemotherapy, it is worth clarifying a paragraph in the recently published UCLA Conference "Recent Advances in Oncology," moderated by Dr. Donald L. Morton, (Ann Intern Med77:431-454, 1972). The paragraph is on page 435, and the four sentences that need clarifying are as follows: "Seven acute...Reference1. CLARKSONFRIED BJ: Changing concepts of treatment in acute leukemia. Med Clin North Am 55:561-600, 1971 CrossrefMedlineGoogle Scholar1. : Treatment of acute lymphoblastic leukemia. Comparison of immunotherapy (B.C.G.), intermittent methotrexate, and no therapy after a five-month intensive cytoxic regimen (Concord Trial). Br Med J 4:189-194, 1971 MedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Dartmouth Medical School Hanover, N.H. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByProlonged Survival of Patients Receiving Active Immunotherapy With Canvaxin Therapeutic Polyvalent Vaccine After Complete Resection of Melanoma Metastatic to Regional Lymph NodesIsatoic Anhydrides and Their Uses in Heterocyclic Synthesis 1 January 1973Volume 78, Issue 1Page: 153-154KeywordsBacille calmette guerinBacillusCancer chemotherapyCancer immunotherapyChemotherapyVaccination and immunization Issue Published: 1 January 1973 PDF DownloadLoading ...