5-Fluorouracil, mitomycin, and doxorubicin (FAM) in carcinoma of the biliary tract.

A phase II trial of the regimen 5-fluorouracil, doxorubicin, and mitomycin C (FAM) was conducted in 17 patients with advanced or recurrent biliary tract cancer. Among 14 patients with measurable disease, 31% achieved a partial response. An additional seven patients evidenced stabilization of disease for periods of three to 18+ months. One patient with advanced but unmeasurable tumor has survived 72 months after 12 cycles of treatment. There was no serious life-threatening toxicity, and with appropriate dosage adjustment, the drug was administered to patients with mild hepatic insufficiency. We recommend the initiation of a larger controlled trial and a potential application with radiotherapy for patients with less advanced disease.

Photosensitive temporal lobe epilepsy.

Photic-induced seizures are usually generalized. There are several cases of focal seizures reported, and all have been shown to arise from the visual cortex. We report an unusual case of temporal lobe epilepsy, supported by electroclinical data and confirmed by a successful temporal lobectomy, with seizures induced by photic stimulation.

Deep scopulariopsosis: a case report and sensitivity studies.

A 36-year-old female was admitted to hospital for debridement of chronically inflamed tendon sheaths and adjacent tissues near the left ankle. Despite antibiotic therapy and initial surgical interventions, the inflammation had progressed slowly over 16 months. Histopathological examination of excised tissues in September 1973 revealed a chronic granulomatous inflammation of tendon sheaths and muscle. Many branched hyphal segments, intercalary swollen cells, and a few conidia-like bodies were seen in sections, and also in KOH- and PAS-stained slides prepared from homogenized tissues. Culture of homogenized tissues yielded pure colonies of Scopulariopsis brevicaulis. Sensitivity tests were initially begun with amphotericin B, potassium iodide, and potassium tartrate (0.05-15 mug/ml of the phytone-yeast extract agar), and no inhibitory effect was observed. Subsequently, amphotericin B, antimony, 5-fluorocytosine (5-FC), griseofulvin, hamycin, and mycostatin were tested (25-300 mug/ml of the phytone-yeast extract agar). Of these chemicals, griseofulvin and hamycin proved to be most effective. Antimony and 5-FC were ineffective, and mycostatin produced a negligible effect on growth. The four strains of Lysobacter antibioticus, the producer of myxin antibiotic, strongly inhibited the growth of the fungus.

Effects of housing relocation on immunocompetence and psychosocial functioning in older adults.

BACKGROUND: The psychological and physical response to moderate life stressors among older adults has not been well characterized. This research examines effects of voluntary housing relocation on distress and immune function in healthy older adults as a model for studying the effects of moderate life stress. METHODS: Thirty older adults moving to congregate living facilities were assessed 1 month premove, 2 weeks postmove, and 3 months postmove. Twenty-eight nonmoving control subjects were assessed at similar time points. Subjects completed psychosocial questionnaires and had early morning blood draws in their homes. Blood samples were assayed for natural killer cell cytotoxicity (NKCC), interleukin-6 (IL-6), and IgG antibody titers to the Epstein Barr virus (EBV) viral capsid antigen. RESULTS: Movers demonstrated decreased vigor and elevated thought intrusion 1 month premove and 2 weeks postmove. By the 3-month follow-up, vigor increased, and intrusion decreased to levels commensurate with the controls. Averaged across all time points, movers showed lower NKCC than controls; however, post-hoc analyses indicate that by the 3-month follow-up time point, these differences were no longer significant. There were no differences between groups in IL-6 or in EBV antibody titers. Independent of the effects of group, higher levels of vigor were associated with greater NKCC at all assessments and with lower EBV titers at 2 weeks postmove. CONCLUSIONS: Findings suggest that in general, healthy older adults recover well psychologically from moderate. temporary life stressors such as moving. Whereas movers showed generally lower NKCC than controls, IL-6 and EBV antibody titers appeared not to be strongly affected by the stress of moving.

Sense of coherence moderates the relationship between life stress and natural killer cell activity in healthy older adults.

A sense of coherence (SOC) has been found to be a strong predictor of health outcomes and life satisfaction in older adults. This study investigated mood and immune effects of anticipated voluntary housing relocation in 30 healthy older adults and 28 age-matched controls and examined whether SOC would buffer effects of relocation on natural killer (NK) cell activity. Movers completed assessments and had blood drawn 1 month before relocation to congregate living facilities; controls were assessed concurrently. Compared with the control group, movers showed decreased positive mood and NK activity and elevated thought intrusion. Positive mood mediated the relationship of moving with NK activity, whereas SOC moderated this relationship. Low SOC movers had the poorest NK activity; that of high SOC movers was less compromised. These findings are consistent with possible salutogenic contributions of SOC and positive mood to immune function in older adults facing stressful life transitions.

Attributions and adjustment to life-threatening illness.

An analysis of the role of attribution in major illness and serious injury is presented. Evidence reviewed includes the impact of illness variables on attributions, the association between attributions and adjustment to illness, and the proposed mechanisms of this association. Illness and injury characteristics such as severity and time since diagnosis appear to relate to attributional activity and content, but the association between attributions and psychological or physical adjustment is weak. Overall, it would appear that the attribution construct can describe individuals' reactions to life-threatening illness or injury. However, the utility of attribution in understanding the processes involved in adjustment to illness has not yet been demonstrated.

The interface of positive psychology with a psychology of loss: a brave new world?

In this paper, it is argued that a psychology of loss can help to illuminate one of the central themes of positive psychology: That is, showcasing those human skills that emphasize human strengths and optimal functioning. However, the interface of positive psychology and a psychology of loss also contains a definite paradox. Loss is not an intrinsically positive event that will necessarily build human strength. Yet, the experience of loss can become a profound means for showcasing human strengths and potential. We also caution that a positive psychology, in its quest to focus on the more uplifting qualities of the human experience, must also realize that suffering and loss is inherent to the human condition.

Minding the close relationship.

In this theoretical analysis, we argue that a process referred to as minding is essential for a couple to feel mutually close and satisfied in a close relationship over a long period Minding represents a package of mutual self-disclosure, other forms of goal-oriented behavior aimed at facilitating the relationship, and attributions about self's and other's motivations, intentions, and Mort in the relationship. Self-disclosure and attribution activities in minding are aimed at getting to know the other, trying to understand the other's motivations and deeper disposition as they pertain to the relationship, and showing respect and acceptance for knowledge gained about other. We link the concept of minding to other major ideas and literatures about how couples achieve closeness: self-disclosure and social penetration, intimacy, empathy and empathic accuracy, and love and self-expansion. We argue that the minding process articulated here has not previously been delineated and that it is a useful composite notion about essential steps in bonding among humans. We also argue that the minding concept stretches our understanding of the interface of attribution and close relationships. We present research possibilities and implications and consider possible alternative positions and counter arguments about the merits of the minding idea for close relationship satisfaction.

Determinants of perceived choice, number of options, and perceived time in making a selection.

An experiment was conducted to investigate the effects of number of choice options and perceived time taken to make a selection upon perceived choice. College students were asked to make a selection from a set of options which varied in numerosity; after making their selection, they were given information which varied their perception of time in making the selection. As predicted, perceived choice was found to be greater (1) the greater the number of options when a person perceived that he had taken a relatively short time; (2) if the selection involved a moderately large number of options than if it involved either a small or a very large number when a person perceived that he had taken a relatively long time; (3) the longer the time a person thought he had taken, except when the selection involved a very large number of options-in which case, perceived choice was greater the shorter the perceived time. The experiment also provided evidence about the relationship between perceived choice and perceived competence.

Personality and coping: three generations of research.

This article introduces the Journal of Personality's special issue on coping and personality. It first presents a historical overview of the psychological study of how people cope with stress and identifies three generations of theory and research: (a) the psychoanalysts and the ego development school, which tended to equate personality and coping strategies; (b) the transactional approach, which appeared in the 1960s and emphasized situational and cognitive influences on coping while downplaying the role of individual differences; and (c) the most recent, "third generation," whose work is represented in this special issue and focuses on the role of personality in coping while maintaining strong operational distinctions among coping, personality, appraisal, and adaptational outcomes. This introduction concludes with a discussion of unresolved conceptual and methodological issues and a brief orientation to the third-generation articles that follow in this special issue.

Pilot trial of prolonged continuous-infusion 5-fluorouracil and weekly cisplatin in advanced colorectal cancer.

Thirty-five patients with previously untreated, advanced, measurable metastatic colorectal carcinoma were treated with a 12-week course of continuous 5-fluorouracil (5-FU) and weekly cisplatin. Twenty of 32 evaluable patients responded (five complete and 15 partial responses), for an overall response rate of 63% (90% confidence limits, 43%-75%). Toxicity was generally mild and reversible and included mucositis (40%), painful erythema of the palmar and plantar skin (30%), diarrhea (21%), nausea and vomiting (15%), and leukopenia (6%). One patient died of sepsis secondary to mucositis and myelosuppression. This program is a well-tolerated outpatient regimen for metastatic colorectal carcinoma. The response rate is higher than expected for 5-FU and cisplatin and suggests clinical therapeutic synergism at this dose rate and schedule.

Cognitive tuning, encoding, and the attribution of causality.

Subjects were given a transmission or reception set before or after viewing a videotape of an event which involved an extreme outcome. The results indicated that transmitters made relatively extreme attributions to plausible causal agents when the set was given prior but not subsequent to viewing the event. The results also showed that subjects who had been given a transmission set before viewing the videotape exhibited relatively high recognition of aspects of the event they observed. It is suggested that the data provide support for an encoding interpretation of transmission-reception differences in the attribution of causality.

Phase I study of echinomycin administered on an intermittent bolus schedule.

We have conducted a phase I study of the cyclic peptide echinomycin (Quinomycin A) on a schedule of administration of once every 4 weeks. Ten dose levels between 20 and 1800 micrograms/m2 were studied. Acute gastrointestinal toxicity, thrombocytopenia, and transient elevations of serum transaminases occurred at doses of greater than or equal to 1000 micrograms/m2. Gastrointestinal toxicity was severe and dose-limiting in several patients at doses of 1800 micrograms/m2. Thrombocytopenia was erratic, but generally increased with drug doses. Platelet count nadirs occurred 5-10 days after administration. Hepatic toxicity was reflected in transient elevations of serum transaminases without hyperbilirubinemia. Three patients experienced apparent anaphylactic reactions to doses of 1500 micrograms/m2. The maximum tolerated single dose of echinomycin was 1800 micrograms/m2. A starting phase II dose of 1500 micrograms/m2 is recommended.

A comparison of efficacy of sargramostim (yeast-derived RhuGM-CSF) and filgrastim (bacteria-derived RhuG-CSF) in the therapeutic setting of chemotherapy-induced myelosuppression.

A randomized, double-blind, multicenter study in 181 afebrile cancer patients with ANC levels < 500/microL receiving myelosuppressive chemotherapy was undertaken to compare sargramostim (yeast-derived recombinant human granulocyte-macrophage colony-stimulating factor, RhuGM-CSF) and filgrastim (bacteria-derived recombinant human granulocyte colony-stimulating factor, RhuG-CSF) in the treatment of chemotherapy-induced myelosuppression. Patients received daily subcutaneous (SC) injections of either agent until ANC levels reached at least 1500/microL. There was no statistical difference between treatment groups in the mean number of days to reach an ANC of 500/microL, but the mean number of days to reach ANC levels of 1000/microL and 1500/microL was approximately one day less in patients receiving filgrastim. Fewer patients in the sargramostim arm were hospitalized, and they had a shorter mean length of hospitalization, mean duration of fever, and mean duration of i.v. antibiotic therapy compared with patients who received filgrastim. Both growth factors were well tolerated. No patient was readmitted to the hospital after growth factor was discontinued. Sargramostim and filgrastim have comparable efficacy and tolerability in the treatment of standard-dose chemotherapy-induced myelosuppression in community practice.