Coronary artery diameter and coronary risk factors: a study with ultrafast computed tomography.

Coronary artery dilation has been described as an early effect of atherosclerosis. No noninvasive technique has been available to measure coronary size. In this study coronary diameters were measured in 100 asymptomatic subjects (89 men and 11 women, mean age 40 +/- 6 years) by means of ultrafast computed tomography (UFCT), with 3 mm thick ECG gated scans. Subjects without evidence of coronary calcium were studied. The diameter of the left main (LD) and right (RD) coronary arteries were measured. Total coronary diameter, TD = LD + RD, was determined, and univariate analysis was performed with respect to total, high-density lipoprotein and low-density lipoprotein cholesterol, mean blood pressure, age, body surface area, and triglycerides. Mean LD was 4.23 +/- 0.85 mm, and mean RD was 3.06 +/- 1.08 mm. TD increased with body surface area (p < 0.001). No other variable showed any significant effect on TD in this group without evidence of atherosclerosis. UFCT can be used to noninvasively measure coronary artery diameters and may be a useful technique to detect early changes of atherosclerosis in individual patients and in population studies.

COP-BLAM multidrug infusion chemotherapies for lymphoma: results in a community hospital setting.

Twenty-two patients with malignant lymphoma were treated with three different COP-BLAM infusional chemotherapy protocols at the Jersey Shore Medical Center. The treatment group included 18 patients with large-cell lymphoma, 3 patients with Hodgkin's disease, and 1 patient with composite lymphoma (large-cell lymphoma and Hodgkin's disease). Three patients were treated with COP-BLAM III, 9 with COP-BLAM IV, and 10 with COP-BLAM V. The age of the patients at diagnosis ranged from 18 to 74 years, with a median age of 64 years. One patient had stage I bulky disease, 4 had stage II bulky disease, 3 had stage III disease, and 14 had stage IV disease. Twenty patients were evaluable for response; 2 were too early to evaluate. Complete response (CR) was seen in 18 of the 20 evaluable patients (90%). Potential cure (excludes non-lymphoma-related deaths) at 24 months is projected at 78%. Eleven patients are presently without disease and off therapy (55%). Projected failure-free survival at 2 years is 71% (a failure being death from any cause). Eleven of 22 patients developed 15 febrile episodes. Vincristine neuropathy was seen in 6 patients. Subclinical pulmonary fibrosis was seen in 1 patient. There was one cardiotoxic death. The COP-BLAM infusional protocols are highly effective, tolerable regiments that are applicable in community hospitals and can yield good response rates, with a high percentage of disease-free survivors in all age groups. The treatment can be completed in a short period with acceptable toxicity.