G. O. Broun

Small cell undifferentiated carcinoma of the esophagus. Case report with hormonal studies.

This report details clinical and pathologic aspects of a case of small cell undifferentiated carcinoma of the esophagus. Transmission electron microscopic examination demonstrated neurosecretory granules, and indirect immunoperoxidase stain for adrenocorticotropic hormone (ACTH) was positive. However, the authors detected no abnormal hormone levels in urine or blood. The calculated tumor doubling time was approximately 2 days. The fulminant nature of this carcinoma was also evident from the rapid clinical progression in spite of surgical excision, radiotherapy, and chemotherapy.

T‐cell prolymphocytic leukemia with helper‐cell phenotype and a review of the literature

The majority of published cases of prolymphocytic leukemia (PLL) have been of B‐cell origin. Nineteen cases of PLL of T‐cell type have been described, as has a single case of PLL having a surface phenotype with features of both B‐cells and T‐cells. This report presents a review of these cases and comparison with one case of T‐cell PLL. By using specific monoclonal antibody technique, this case was subcategorized into helper‐cell phenotype: E‐rosette(+), SIG(−), Anti‐T(+), Anti‐B(−), Anti‐monocyte(−), OKT3(+), OKT4(+), OKT6(−), OKT8(−), Ia(+), and Tdt(−). Cytochemical studies showed paranuclear acid phosphatase granules. Postmortem examination revealed a predominant T‐cell zone infiltration by the leukemic cells in the spleen and lymph nodes, with involvement of multiple organs. The application of the monoclonal antibody technique, which can be standardized among different laboratories to subclassify lymphoproliferative disorders into functional subtypes, should lead to a better understanding and more effective treatment of this disease.

A randomized prospective study of vindesine versus doxorubicin and cyclophosphamide in the treatment of epidermoid lung cancer

A randomized prospective study was conducted comparing vindesine (VDS) with doxorubicin and cyclophosphamide (D/C) in the treatment of advanced squamous cell carcinoma of the lung. No patient had a complete response. Seven of 28 (25%) patients had partial response (PR) to VDS while one of 19 (5%) had a PR to D/C (P < 0.08). Adding PR plus minor response (MR), ten of 28 (36%) patients responded to VDS while two of 19 (11%) responded to D/C (P < 0.05). Median survival was improved among patients showing PR and MR over those not responding (P < 0.05). This study concludes, VDS is an active agent in the treatment of squamous cell carcinoma of the lung and should be considered for combination chemotherapy and adjuvant trials. VDS toxicity appears acceptable with six weekly doses of 3 mg/m2. The benefit of a maintenance schedule could not be demonstrated.

Effect of Guanethidine Therapy on Total Blood Volume in Patients With Essential Hypertension

Summary Total blood volume was determined in 5 female patients with essential arterial hypertension during and after treatment with guanethidine. Administration of the drug resulted in a decrease of arterial blood pressure and an increase in total blood volume. The increase in total blood volume was mainly due to an increase in plasma volume.

Transmission of St. Louis Encephalitis to the Hamster.

Summary The Syrian hamster is highly susceptible to intracerebral and intranasal inoculation with the virus of St. Louis encephalitis.

Phase II trial of piroxantrone in patients with recurrent and metastatic squamous cell carcinoma of the head and neck. A Southwest Oncology Group trial.

SummaryTwenty-two patients with recurrent or metastatic squamous cell carcinoma of the head and neck were treated with piroxantrone 150 mg/m2 intravenously every 21 days. There were no objective responses. The 95% upper confidence bound for response is 15%. Primary toxicity was hematologic.

Immunological Reaction of the Hamster to Inoculations with the Virus of St. Louis Encephalitis.

Summary Humoral antibodies against the virus of St. Louis encephalitis can be demonstrated in the sera of hamsters inoculated by subcutaneous, intracerebral, intranasal and oral routes provided the animals survive the infection 7 days or more. After subcutaneous inoculation, antibodies may appear in the serum within 48 hours after inoculation. They persist at high titer for many weeks. When inoculated intranasally or intracerebrally, some animals fail to develop antibodies prior to death and others which develop a high protective titer still succumb to the infection. Animals dying as long as 6 days after intracerebral or intranasal inoculation may fail to show neutralizing antibodies. No animal inoculated subcutaneously has failed to show humoral antibodies after the second day. The presence of humoral antibodies does not insure immunity against the disease.

Observations concerning Culex pipiens as a possible Carrier of St. Louis Encephalitis.

It has been shown by Casey and Broun that St Louis encephalitis cases appear to occur with higher incidence in those areas of the city and county which are adjacent to small streams and open ditches. 1 This suggests the possibility of a water breeding insect as a possible transmitting agent. Transmission of the equine types of encephalomyelitis by mosquitoes from animal to animal has been demonstrated by Kelser 2 , Simmons, Reynolds and Cornell 3 and Merrill, Lacaillade and Ten Broeck. 4 Webster, Clow and Bauer. 5 demonstrated the St. Louis encepha litis virus could be taken into the body of the Anoophles quadrimaculatus mosquito and retained for the duration of their lives. The virus containing mosquitoes, however, did not infect mice or monkeys by biting. Attempts were made subsequent to the 1933 epidemic to transmit encephalitis from human being to human being by the bite of the various species of mosquito without success. 6 Since Culex pipiens is the most common type of mosquito in the St. Louis area, we have studied the ability of this mosquito to become infected with the virus of St. Louis encephalitis. Mice infected with St. Louis encephalitis by intraperitoneal injection of heavy doses of virus have been shown By Webster and his co-workers to have a considerable concentration of the virus in the circulating blood for a period of five hours after the injection. In our experiments 1 cc of a 1/10 dilution of virus containing brain was injected intraperitoneally. The mouse was then placed in a specially built biting cage where he was exposed to a number of mosquitoes for a period of 5 hours after dark in a quiet room.

Intragastric and Intraintestinal Inoculations with St. Louis Encephalitis Virus

Summary Our studies indicate that it is difficult to secure cerebral infection when the virus of St. Louis encephalitis is introduced into the intestinal tract. Nevertheless one definite infection did occur after intraintestinal inoculation. We feel the experimental procedure ruled out the nasal route of infection. Some degree of humoral immunity was produced in mice both by intragastric and intraintestinal inoculation. Only two animals survived the subsequent intracerebral injection of 100 lethal doses of virus, showing that only rarely is adequate protection against infection provided by intragastric or intraintestinal virus inoculations.

Susceptibility of Field Mice and Meadow Mice to St. Louis Encephalitis.

In the vicinity of St. Louis the 3 most common species of wild mice are the field mouse, Reitkrodontomys megalotis, the house mouse Mus musculus and the meadow mouse, Microtus ochrogaster. As long ago as the epidemic of 1933 efforts were made to trap mice in the homes of encephalitic patients. Several field mice were captured but no representative of either of the other species were obtained in such homes. Beginning in 1934 we tested the susceptibility of field mice to the virus of St. Louis encephalitis and found that they can be infected both by intracerebral and intranasal inoculation. Harford, Sulkin and Bronfenbrenner 1 have reported that the house mouse, Mus musculus, is also susceptible to this infection. More recently we have captured a large number of field mice and also have been able to capture a number of meadow mice. Tests for the susceptibility of these strains of mice to the encephalitic virus have been carried out using simultaneous tests on white Swiss mice for comparison. The effect of the intracerebral injection of 0.030 cc of St. Louis encephalitic virus in dilutions of 10-1, 10-2, 10-3, 10-4, 10-5, 106 were tried in each species. In the case of the field mice some survivals were noted even in dilutions of 10-2 and the majority of the animals survived in dilutions of 10-4, 10-5, and 10-6, In the case of white Swiss mice controls, there were no survivals in less than 10-6. In meadow mice, no survivals were found in dilutions lower than 10-4. In one experiment using a number of resistant field mice, it was possible to show that animals inoculated intracerebrally with the virus showed no evidence of illness 10 days after the injection, yet were carriers of the virus in their brain tissue since the injection of this brain tissue into Swiss mice regularly resulted in the production of encephalitis.