RESUMEN
A 37-year-old woman with amyloidosis derived from light chain immunoglobulin had hepatosplenomegaly, elevated serum alkaline phosphatase values, and progressively destructive bony lesions. A 44-month intermittent course of chemotherapy with melphalan and prednisone resulted in regression, confirming the occasional efficacy of cytotoxic chemotherapy in this disease.
Asunto(s)
Amiloidosis/tratamiento farmacológico , Hepatopatías/tratamiento farmacológico , Melfalán/administración & dosificación , Prednisona/administración & dosificación , Enfermedades del Bazo/tratamiento farmacológico , Adulto , Esquema de Medicación , Quimioterapia Combinada , Femenino , Humanos , Melfalán/uso terapéutico , Prednisona/uso terapéuticoRESUMEN
The effect of 0.25 mg of terbutaline sulfate, a beta 2-adrenergic agent, on the right and left ventricular ejection fractions (RVEF and LVEF, respectively) was studied in 30 patients with severe stable chronic obstructive pulmonary disease (COPD) with a mean forced expiratory volume in 1 s of 0.79 +/- 0.06 L. All bronchodilator therapy was withdrawn 48 hours before the study. The ECG-synchronized gated equilibrium radionuclide ventriculography showed decreased RVEF in 27 patients and LVEF in 16 patients. Both the RVEF and LVEF significantly increased after the terbutaline injection; this increase was noted both in patients with normal and decreased ejection fractions. We conclude that the increase in ejection fractions after terbutaline injection may contribute to the good clinical response to this drug seen in patients with severe stable COPD even though the bronchodilator effect may be minimal.
Asunto(s)
Corazón/efectos de los fármacos , Hemodinámica/efectos de los fármacos , Enfermedades Pulmonares Obstructivas/fisiopatología , Terbutalina/farmacología , Adulto , Anciano , Volumen Espiratorio Forzado , Corazón/fisiopatología , Humanos , Masculino , Persona de Mediana Edad , Volumen Sistólico/efectos de los fármacosRESUMEN
An uncommon primary site for an American Burkitt's lymphoma in the nasopharyngeal region was demonstrated by radiogallium imaging in a 14-year-old white boy. Fifth cranial nerve involvement and cerebrospinal fluid cytology for Burkitt's responded initially to four drug chemotherapy with objective reduction in the tumor radiogallium uptake. Clinical relapse and recurrence of the tumor radiogallium uptake in less than three weeks following the completion of therapy was observed. Local irradiation and chemotherapy successfully reduced the symptoms and eliminated the radiogallium tumor uptake. Radiogallium imaging is advocated as a principal method for staging and monitoring the course of Burkitt's lymphoma.