Cytomegalovirus involving gastrointestinal tract in renal transplant recipients.

Infection due to cytomegalovirus (CMV) is a substantial cause of mortality and morbidity among renal transplant recipients but the prognosis of the disease has changed dramatically since the introduction of ganciclovir (GAN). During a period of 5 years we treated 54 patients who developed CMV disease. From this group of patients we identified 7 patients with primary gastrointestinal tract (GIT) CMV disease who received treatment with GAN. Tissue diagnosis was made by endoscopy of the upper GIT (6 patients) or sigmoidoscopy (one patient) and histological examination. All patients improved after treatment with GAN; three patients required additional treatment for recurrent CMV disease and recovered, and 1 patient relapsed without GIT involvement (P = 0.014). Recurrent CMV disease was more severe (mean score of 15 in relapse compared to 7 in the first episode). We believe relapse to be more common and the disease to be more severe in the presence of GIT involvement suggesting that a longer duration of treatment with GAN may be required in this clinical manifestation of CMV disease.

Intercalated radio-chemotherapy in small cell lung cancer: toxicity and implications for future regimens.

Thirty-six patients with small cell lung cancer have been treated using chemotherapy comprising carboplatin, ifosphamide and etoposide. A total of six cycles of chemotherapy were given. In 15 patients with limited disease intercalated radio-chemotherapy was used in which two 5-day courses of hyperfractionated radiotherapy were given to the thorax after the first and second cycles of chemotherapy. Each course of thoracic radiotherapy delivered 15 Gy in 15 fractions over 5 days. Oesophagitis occurred in 7 patients (40%), in 5 of whom this was severe (WHO grade 3). Radiological pneumonitis developed in 6 patients (40%) with subsequent fibrosis in 2 patients. These effects are greater than would be expected with this dose of radiation alone and reflect marked enhancement of normal tissue toxicity.

Clinical dosimetry for radiotherapy to the breast based on imaging with the prototype Royal Marsden Hospital CT simulator.

The result of conservative management of breast cancer is strongly dependent on the homogeneity of the dose delivered a schedule of post-surgical radiotherapy. In addition to improvements in local control, late normal-tissue effects should be minimised by achieving a good dose homogeneity. The Royal Marsden Hospital prototype CT simulator has been used to image patients in the treatment position. With the CT data incorporated into the planning process a quantitative measure of the dose homogeneity was made. There are strong indications that unless tissue compensators are used and/or conformation therapy is performed, the dose inhomogeneity in a widely used treatment geometry is too large to be clinically acceptable.

Learning of imitate in infancy.

Theories of imitation learning are examined regarding their account of how the infant acquires the ability to emit a response which resembles a response previously exhibited by another. Each theory suffers from 1 or more of the following problems: logical inconsistency, incompleteness, and lack of empirical support. 3 of the views (associative thesis, discriminative learning thesis, and acquired value of the relational stimulus of similarity) are not mutually exclusive, and, therefore, they could be included in a theory of learning to imitate. However, none of these learning theses deals with the fact that imitation requires the infant to consistently abstract similar features from stimuli which differ on various dimensions. Hence, consideration is given to the role of cognition in a theory of learning to imitate.

Protective action of sex hormones against mast cell depletion and other deleterious effects of magnesium deprivation.

Dietary magnesium deficiency has been more damaging to the mast cells in females than in males. Estradiol at a dose of 1.5 mg per week for 4 weeks and testosterone at a dose of 3 mg per week in the males have resulted in lesser mast cell depletion in the magnesium-deficient animals. Large doses of testosterone have also improved in the condition of the skin, decreased the severity of other magnesium deprivation symptoms such as nephrocalcinosis, bone hyperplasia and nervous manifestations in the males. Testosterone has had no beneficial effect on mast cells of the females but the large dose has protected the kidney against nephrocalcinosis. Estrogen administration has aggrevated the production of kidney stones in the females.