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1.  Neoadjuvant Paclitaxel Poliglumex (PPX), Cisplatin, and Radiation (RT) for Esophageal Cancer 
Background:
Paclitaxel poliglumex (PPX) is a drug conjugate that links paclitaxel to poly-L-glutamic acid thereby increasing its radiation enhancement factor to 4.0–8.0 compared to 1.5–2.0 for paclitaxel. In previous phase I studies, The Brown University Oncology Group evaluated PPX with concurrent radiation and PPX/cisplatin/RT. A phase II study was subsequently performed to evaluate the pathologic response rate of neoadjuvant PPX, cisplatin, and radiation for patients with esophageal cancer.
Methods:
Eligible patients had pathologically confirmed adenocarcinoma or squamous cell carcinoma of the esophagus or GE junction with no evidence of distant metastasis. Patients received weekly PPX 50 mg/m2 and cisplatin 25 mg/m2 for 6 weeks with concurrent 50.4 Gy of radiation. Six to eight weeks after completion of chemoradiotherapy, patients underwent surgical resection.
Results:
The study has completed accrual of 40 patients, 37 with adenocarcinoma and 3 with squamous cell cancer. The median age is 62 years. Toxicity data are available for the first 35 patients. Four of 35 patients experienced grade 4 non-hematologic toxicities, which included electrolyte abnormalities, glucose intolerance, hypersensitivity reaction, and thromboembolus. Eleven of 35 patients had grade 3 non-hematologic toxicities including electrolyte abnormalities (n=5), nausea (n=3), dysphagia (n=2), fatigue (n=2), glucose intolerance (n=2), and hypersensitivity reaction (n=1). Grade 3 anorexia was reported in only 1 patient who subsequently was given TPN. No patients required a feeding tube. There were no grade 4 hematologic toxicities; grade 3 hematologic toxicities included neutropenia (n=2) and anemia (n=1). Of the first 28 patients undergoing surgery, all with adenocarcinoma, 7 of 28 (25%) have had a pathologic complete response.
Conclusion:
PPX, cisplatin and concurrent radiation is a well tolerated, easily administered regimen for esophageal cancer with a very low incidence of significant esophagitis and a promising pathologic complete response rate consistent with the preclinical data of PPX and radiation.
PMCID: PMC3047047
2.  Biological warfare agents as threats to potable water. 
Environmental Health Perspectives  1999;107(12):975-984.
Nearly all known biological warfare agents are intended for aerosol application. Although less effective as potable water threats, many are potentially capable of inflicting heavy casualties when ingested. Significant loss of mission capability can be anticipated even when complete recovery is possible. Properly maintained field army water purification equipment can counter this threat, but personnel responsible for the operation and maintenance of the equipment may be most at risk of exposure. Municipal water treatment facilities would be measurably less effective. Some replicating (infectious) agents and a few biotoxins are inactivated by chlorine disinfection; for others chlorine is ineffective or of unknown efficacy. This report assesses the state of our knowledge of agents as potable water threats and contemplates the consequences of intentional or collateral contamination of potable water supplies by 18 replicating agents and 9 biotoxins known or likely to be weaponized or otherwise used as threats.
PMCID: PMC1566812  PMID: 10585901
3.  Reversible hypothyroidism after steroid replacement for Addison's disease. 
Postgraduate Medical Journal  1981;57(668):368-370.
An insulin-requiring diabetic patient who developed Addison's disease is described. At diagnosis, investigations revealed biochemical hypothyroidism and these abnormalities resolved after replacement therapy for the adrenal failure only. The possible mechanism of this change is discussed in relation to the presence of organ-specific antibodies.
PMCID: PMC2424895  PMID: 7301682
4.  Clonidine-induced dilutional hyponatraemia 
Postgraduate Medical Journal  1979;55(639):42-43.
A patient with a dilutional hyponatraemia induced by clonidine is decribed.
PMCID: PMC2425442  PMID: 432171
5.  Diabetic dimorphism according to acetylator status. 
British Medical Journal  1978;1(6107):208-210.
Two groups of diabetics and 19 normal controls had their rate of acetylation of sulphadimidine measured. Among 47 patients with maturity onset diabetes the 29 fast acetylators were older at diagnosis and, at a given glucose concentration, had a higher pretreatment fasting insulin concentration than slow acetylators. They also had a larger first-phase insulin secretion in response to intravenous glucose both before and after one month's dietary treatment. The greatest difference between fast and slow acetylators was in the first-phase secretion of insulin after a month's treatment. The proportion of fast acetylators among the second group of diabetics, who had been admitted to improve their glucose concentrations or for treatment of tissue damage, was similar to that among the normal controls (50% and 47% respectively). The data seem to indicate that diabetics are fast acetylators unexpectedly often, but it is not clear whether the dimorphism according to acetylator status produces a differential risk of neuropathy or of any other type of diabetic tissue damage.
PMCID: PMC1602542  PMID: 340001
6.  Radiation and growth hormone deficiency. 
British Medical Journal  1977;2(6091):893-894.
PMCID: PMC1631692  PMID: 922343
7.  Cyproheptadine and Cushing's disease. 
British Medical Journal  1977;1(6068):1084.
PMCID: PMC1606120  PMID: 858057
8.  Thyroid hormones in the elderly sick: "T4 euthyroidism". 
British Medical Journal  1975;4(5994):437-439.
Thyroid function and serum levels of triiodothyronine (T3) and thyroxine (T4) were investigated in 79 euthyroid geriatric patients. Of the 59 inpatients and 20 outpatients 35 (59%) and 2, respectively, had low T3 levels. In contrast, 7 (12%) and 6 (30%), respectively, had raised T4 levels. Two further patients were excluded from the study because of raised levels of thyroid-stimulating hormone. Thyroxine-binding globulin was greatly increased in both groups of patients, but low serum albumin levels were present in 31 (39%). Despite these changes free T3 and T4 indices closely followed total T3 and T4 levels. The difference between the two groups of patients did not correlate with body weight, diagnostic categories, age, drug treatment, or duration of stay in hospital.
PMCID: PMC1675395  PMID: 811313
9.  American consultants 
PMCID: PMC1941349  PMID: 20312100
11.  Abortion 
PMCID: PMC1930674  PMID: 20311734
12.  Chemical carcinogenesis. 
British Journal of Cancer  1969;23(4):751-754.
PMCID: PMC2008482  PMID: 5367334
13.  A Sea of Baffle-Gab 
PMCID: PMC1946083  PMID: 20311445
14.  The “Brain Drain” and Fellows 
PMCID: PMC1922836  PMID: 20328891

Results 1-16 (16)