In the year 1976, 9614 outpatient throat cultures were received in the Babies Hospital Bacteriology Laboratory. Cultures were plated on sheep blood a ar with bacitracin disc f applied and incubated overnight at 35 C. in a GASPAK anaerobic jar. 60% had no beta hemolytic colonies. Of the 40% with beta hemolytic colonies, 16% requircd further identification. 7% by replate, 9% by fluorescent antibody (PA). 21% of all cultures and 52% of all cultures with beta hemolytic colonies were presumptive Group A Strep (group 3). The incidence of PCP at the University of Florida during the 12 months period 10175 to 10176 was 6.8%(10/147 children treated with intensive chemotherapy). Primary diagnoses included: 7 leukemia and 3 solid tumor patients. 417 ALL patients were in remission(median duration 91.5 days); 3 leukemia and 2 solid tumor patients were in relapse.Presenting symptoms: fever-10110; cough-9/10; tachypnea-6/10 and dyspnea-3/10. In 9/10 cases an interstitial pneumonitis was revealed on x-ray and a lung biopsy was performed within 24 hours following this finding. In one child, first in our series, an abnormal x-ray was present 4 weeks before biopsy.The method of diagnosis, thoracoscopy, was performed under intram! ~cular anesthesia, without endotracheal tube. It allowed for direct observation and intrathoracic biopsy. Equipment utilized for this procedure was the Karl Stolls peritoneoscope set employing the Hopkins fibroscope and biopsy forceps. The method proved safe even in seriously ill patients and complications were minimal. 1 case of pneumothorax was resolved by reposition of tubing and there was 1 case of mild subcutaneous emphysema.All patients were treated with TPM 20mglkgld and SMX 100mglkgId 7 patients recovered, symptoms improved within 4 days after therapy was begun. 3 patients died, 2 patients had progressive tumors. 1 was complicated by sepsis. The cure rate in this incidence was 70%. Analysis of the data demonstrated a small false positive (F.P.) but a marked false negative (F.N.) rate for Bac-U-Dip (BUD). The false negative rate for Bacturcult (B/C) was zero and the false positive rate, when compared to a no-growth culture (NG) was also low (1170).The combination of Bacturcult and Bac-U-Dip provides both low false positive and false negative rates. Previous studies have shown that latex particles coated with glucose oxidaae (GO) would partially correct the metabolic defects in CGD polymorphonuclear leukocytes (Pm). UTILIZATION OF LIPOSOIBS FOR CORRECTION OF THE W T A - BOLIC DEFICIENCIES IN CHRONIC GRANULOMATOUS DISEASE (CCDIn order to develop a technique with better therapeutic advantage, we studied the efficacy of preparing liposomes (LP) containing the hydrogen peroxide (11202) generating ?a. The activity of GO incorporated within the LP could only be demonstrated after treatment of the LP with Triton X-100. LP were coated with heataggregated human IgC, thereby increasing their cs ability to be phagocytized hp PMN. CCD PMN oxidized glucose-l-f4C upon phagocytosis of GO-containing LP at levels 4-f...
We examined the results of stopping therapy in children with acute lymphocytic leukemia. Of 639 patients in eight consecutive "total therapy" studies, 278 (44 per cent) had all treatment stopped, usually after 2 1/2 years of complete remission. About one fifth (55 of 278) of this group have relapsed, mainly in the bone marrow. The relapse rate for the first year off therapy was higher than that for the next three years (0.16 vs. 0.04, P less than 0.01). The life-table estimates of the four-year relapse rates were 0.24 for all patients and 0.22 for patients receiving adequate central-nervous system prophylaxis. Boys had a higher relapse rate than girls (0.33 vs. 0.15 P less than 0.01). None of the 79 patients who remained in complete remission for at least four years off therapy have yet relapsed. Acute lymphocytic leukemia appears curable in over one third of all newly diagnosed patients who receive treatment for approximately 2 1/2 years.
Children with acute lymphocytic leukemia in complete remission were randomized between 2 combination chemotherapy schedules for continuation of their remissions. One group received full dosage of 4 antileukemic drugs, and the other received half dosage of the same compounds. Median durations of complete remission and of hematologic remission were longer in the full‐dosage than half‐dosage group. Four out of 21 patients in the full‐dosage group continue in their initial complete remission for 40 to 48 months and have been off treatment for 3 months to 1 year. Nine in the full‐dosage group and 4 in the half‐dosage group remain in continuous hematologic remission for 40 to 55 months. Review of results of previous combination chemotherapy studies of childhood lymphocytic leukemia at this hospital indicated a 17 per cent 5‐year leukemia‐free survival rate.
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