PURPOSE: We conducted a phase II study in previously untreated patients with unresectable stage IIIB or IV non-small cell lung cancer to evaluate the response rate and toxicity of the combination chemotherapy regimen of etoposide, ifosfamide and cisplatin. MATERIALS AND METHODS: From September 1993 to December 1996, twenty patients with advanced non-small cell lung cancer (stage IIIB 5 and IV 15) (squamous cell 8, adeno- carcinoma 12), were enrolled in this study. There were 13 (65%) males and 7 (35%) females, and median age of patients were 56 years (range: 34~66). Eighteen patients had performance status (ECOG) 0~1, two patients had performance status 2. Treatment was consisted of cisplatin (20 mg/m2 i.v., day 1~4), VP-16 (etoposide) (75 mg/m2 i.v., day 1~4), ifosfamide (1000 mg/m2 i.v., day 1~4) with mesna. This treatment was repeated every four weeks. RESULTS: The overall response rate was 25%. Complete response rate was 5% (1/20) and partial response rate was 20% (4/20). The median cycle of response was 4 (2~6) cycles. The median overall survival time was 28 weeks (9~98 weeks). The median time to progression was 10 weeks (3~50 weeks). Toxicities were evaluated by WHO criteria. Toxicity > GradeIII included: leukopenia 1.6%, thrombocytopenia 3.2%, nausea and vomiting 15%, alopecia 30%, stomatitis 10%. These toxicities were tolerable and reversible. CONCLUSION: VIP regimen was not superior to previous regimens for advanced non-small all lung cancer, and the toxicities were tolerable.
Alopecia ; Carcinoma, Non-Small-Cell Lung ; Cisplatin* ; Drug Therapy, Combination* ; Etoposide ; Female ; Humans ; Ifosfamide* ; Leukopenia ; Lung Neoplasms ; Male ; Mesna ; Nausea ; Small Cell Lung Carcinoma* ; Stomatitis ; Thrombocytopenia ; Vomiting

The purpose of this study was to investigate the morphologic changes of the bile canaliculi and its associated structures of the liver induced by common bile duct ligation(CBDL) in the rat. The canalicular surface and lateral surface of the dry-fractured hepatocytes was studied with scanning electron microscopy at 1~6 weeks post ligation. The first week after CBDL, the bile canaliculi were dilated. The microvilli were increased in number and the lumens contained granular materials After 2 weeks or more, the bile canaliculi were dilated to a variable degree, and with irregularity, measuring from 1.5 to 5 micrometer in diameter, and in the advanced stage, the canaliculi showed blunting and the disappearance of microvilli. Some canaliculi had sprouting side branches. At 4~6 weeks post-ligation, the lateral surface of the hepatocytes also showed some irregularity and a tortuous appearance, and numerous small sized microvillous projections were formed. The tubular structures of the proliferated SER distributed adjacent to the lateral surface of the hepatocytes, and the direct connection of a tubular structure and the cytoplasmic membrane was observed. These results suggest that the deformity and loss of microvilli of bile canaliculi reflect the disturbance of bile secretion from the hepatocytes. And prolonged obstruction of bile flow may result in bile excretion via the lateral surface of hepatocytes.
Rats ; Animals

Chronic sclerosing sialadenitis, Mikulicz disease or Kuttner tumor has been recently recognized as a spectrum of IgG4-related sclerosing disease. IgG4-related disease is characterized by a high serum IgG4 level and tissue infiltration of IgG4-positive plasmacytes. We report three cases of chronic sclerosing sialadenitis with variably associated systemic involvement. All patients presented with a submandibular mass or swelling, and all the resected submandibular glands showed diffuse lymphocytic infiltration, lymphoid follicles, and septal fibrosis. Two of the specimens revealed numerous IgG-positive plasma cells, most of which were IgG4-positive on immunohistochemical staining. One of them was associated with dacryoadenitis and hypophysitis. The other patient had ureterorenal lesions. Immunohistochemical study was unavailable in remaining one case, but the histologic features along with elevated IgG level and associated pancreatitis supported the diagnosis. All patients received steroid therapy postoperatively and are doing well. Salivary gland involvement in IgG4-related fibrosclerosis should be recognized in systemic medical pathology.
Dacryocystitis ; Fibrosis ; Humans ; Immunoglobulin G ; Mikulicz' Disease ; Pancreatitis ; Plasma Cells ; Salivary Glands ; Sialadenitis ; Submandibular Gland

No abstract available.
Humans ; Infant*

No abstract available.
Pneumothorax, Artificial* ; Treatment Failure* ; Tuberculosis, Pulmonary*

To determine the perinatal mortality and morbidity of fetuses with absent end-diastolic velocities (AEDV) of the umbilical artery in severe pre-eclampsia and eclampsia, the outcome of 5 fetuses with AEDV was compared with that of 35 fetuses with positive end-diastolic velocities (PEDV). The study population comprised 38 cases of severe pre-eclampsia and 2 cases of eclampsia with structurally normal singletons, who had had umbilical artery Doppler velocimetry weekly from admission to delivery. The Doppler velocimetry result was not used for the clinical management. Perinatal death and neonatal morbidity from both groups were further examined in gestational age category to control the influence of preterm births. The incidence of AEDV of the umbilical artery Doppler velocimetry in severe pre-eclampsia and eclampsia was 12.5% (5/40). The AEDV group had a significantly higher incidence than the PEDV group in terms of ceasarean section due to fetal distress (60% : 17%), Apgar score < 7 at 5 minutes (60% : 14%), perinatal death (25% : 0%) and assisted mechanical ventilation (67% : 9%) both at 32-36 weeks. Time intervals from the detection of AEDV to delivery of live neonates varied from the day to 15 days. In conclusion, AEDV in the umbilical artery might be of clinical value in routine surveillance of pregnancies complicated by severe pre-eclampsia and eclampsia, and predict hypoxic fetal condition which needs operative interventions before or during labor and mechanical ventilation after birth.
Apgar Score ; Cesarean Section ; Dystocia ; Eclampsia* ; Female ; Fetal Distress ; Fetus ; Gestational Age ; Humans ; Incidence ; Infant, Newborn ; Maternal Death ; Mortality ; Parturition ; Parturition* ; Perinatal Mortality ; Pre-Eclampsia* ; Pregnancy ; Premature Birth ; Respiration, Artificial ; Rheology ; Trial of Labor ; Umbilical Arteries* ; Uterine Rupture

No abstract available.
Mediastinitis*

No abstract available.
Mediastinitis*

No abstract available.

The extracellular PH has been known to be lowered under the condition of chronic inflammation, and the tetrodotoxin-resistant sodium currents(TTX-r INa ) is thought to responsible for the inflammatory pain. We investigated the effects of PH and lidocaine on the TTX-r INa in sensory neurons derived from abolt rat trigeminal root ganglion(TRG) using whole-cell patch clamp technique to evaluate the underlying mechanisms of the poor analgesia following the administration of local anesthetic solutions into or around the area of the of inflammation. The results are as follows: 1. Two types of INa showing different sensitivity to TTX, TTX-sensitive and TTX-resistant INa , were expressed in the rat TRG neurons. 2. The amplitude and the current-voltage(I-V) relationship of TTX-r INa were significantly affected by the changes of extracellular pH. The acidification of external pH reduced the current amplitude and shifted the I-V relation to the depolarizing directions. 3. The change of extracellular PH also affected the voltage-dependence of activation and steady-state inactivation of TTX-r sodium channels. The voltage-dependence of the channel shifted to a depolarizing direction by the elevated concentration of external hydrogen ion. 4. Lidocaine suppressed TTX-r INa in a dose-dependent manner, and inhibitory effect of lidocaine decresed as the external PH lowered. 5. Lidocaine significantly shifted the activation and steady-state inactivation curves of TTX-r sodium channel to a hyperpolarizing direction by about -20 mV. 6. The effects of lidiocaine on TTX-r sodium channel producing an increase in the probability of channel inactivation greatiy decreased when the external pH was changed to 6.3 or 8.3 7. The 0.1mM lidocaine applied at PH 8.3 shifted the steady-state curve to a hyperpolazizing direction by -20mV compared to that obtained at lidocaine-free pH 7.3 condition. In contrast, the steady-state inactivation curve obtained in the presence of 0.1 mM lidocaine at pH 6.3 614 not showed any significant difference to that obtained at lldocaine-free pH 7.3 condition. These results suggest that the inhibitory action of lidocaine on the TTX-r sodium channel may be derived from the modificition of channel gating as well as blockade of channel pore. The reduced extracellular PH may reduce the TTX-rINa and increase the threshold for activation of TTX-r sodium channels. which may be responsible for the decresed neuronal excitability in the acidified environment. In the presence of lidocaine, however, the sensory neuron is thought to be more excitable in the acidic condition than in physiological PH, which may be due to the decreased lidocaine-induced inactivation of TTX-r sodoum channel as well as reduced amount of hydrophobic neutral from of lidocaine in acidosis.
Acidosis ; Analgesia ; Animals ; Ganglion Cysts* ; Hydrogen-Ion Concentration* ; Inflammation ; Lidocaine* ; Neurons* ; Protons ; Rats* ; Sensory Receptor Cells ; Sodium Channels ; Sodium*