Robert C. Hartmann

The Impact of Current Staging Procedures in Assessing Disease Extent of Prostatic Adenocarcinoma

We studied 454 patients with prostatic adenocarcinoma who were assigned a preliminary clinical stage on the basis of serum acid phosphatase, routine bone survey and physical examination. Subsequently, they were assigned a final clinical stage after radioisotopic bone scanning, lymphangiography and staging pelvic lymph node dissection. Only 53, 54, 57 and 26 per cent, respectively, of patients initially assigned the preliminary clinical stage of IB, II, III or IVA remained at that stage after the additional studies.

The relationship of heparin activity to platelet concentration.

Conclusions Choline caused reabsorption of aortic atherosclerosis in the majority of rabbits whose lesion had been produced by cholesterol feeding.ConclusionsCholine caused reabsorption of aortic atherosclerosis in the majority of rabbits whose lesion had been produced by cholesterol feeding.

Prolonged treatment of pernicious anemia with vitamin B12

Abstract A large group of patients with pernicious anemia has been treated with vitamin B 12 for periods as long as forty months. Parenterally administered B 12 was as effective as refined liver extract in producing and maintaining clinical and hematologic remission. No evidence was found that patients with uncomplicated pernicious anemia need any therapy other than vitamin B 12 . Orally administered vitamin B 12 was effective in the treatment of pernicious anemia provided that the oral dose was about 100 times the amount which was adequate when given parenterally. Until the adequacy of oral dosage schedules has been demonstrated patients with pernicious anemia should receive parenteral therapy. An intramuscular injection of 45 μg. of vitamin B 12 given every six weeks appeared to be adequate for satisfactory maintenance therapy and protected against hematologic and neurologic relapse. Vitamin B 12 seems preferable to liver extract in the treatment of pernicious anemia because it causes less discomfort at the site of injection, does not give rise to untoward reactions and is less expensive than liver extract.

Lithium carbonate in patients with small cell lung cancer receiving combination chemotherapy.

Lithium administration has been shown to attenuate the leukopenia associated with systemic chemotherapy. The results of a randomized trial of lithium in 45 patients with small cell lung cancer who received combination chemotherapy and radiation therapy are reported. Patients randomized to receive lithium were started on 300 mg three times daily for 18 days of every 21 day chemotherapy cycle. Patients who received lithium experienced significantly less mid-cycle leukocyte and neutrophil count depression and spent fewer days with leukopenia and neutropenia than control patients regardless of age or extent of disease. Patients who received lithium spent fewer days hospitalized and fewer days with fever in the presence of severe neutropenia than control patients. The cumulative risk of fever with signs of infection was greater in control patients regardless of age, disease extent or the presence of marrow involvement. Patients who were given lithium received significantly more chemotherapy than control patients. Patient survival was greatest in those with limited disease, in complete responders and in those who received more than 75 percent of their induction chemotherapy although it did not differ between the two study groups. The majority of patients required either reduction or discontinuation of lithium. Those who received lithium continuously demonstrated a higher objective response rate and longer survival than either patients in whom the lithium had to be discontinued or those randomized to the control group. Infection was an important cause of death in the control group and cardiovascular event occurred frequently in the lithium group, but the major cause of death in this patient population remains progressive malignant disease.