c-myc oncoprotein in bronchial carcinoma: expression in all major morphological types.

We have studied the prevalence of a 62 kd protein product of the c-myc oncogene in tissue biopsies from 79 primary bronchial carcinomata using the monoclonal antibody Myc 1-9E10 and the avidin-biotin complex (ABC) technique. This oncoprotein was strongly expressed in 43% of 37 squamous lesions, 29% of 14 adenocarcinomata, 42% of 7 non-small cell lesions not further classifiable and 19% of 21 small cell neoplasms, all of classical morphology. There was no statistical difference between groups in the prevalence of its expression, nor was it related to survival. This oncoprotein is commonly expressed in non-small cell as well as small cell bronchial carcinomata and, in the latter, is not confined to those variant tumours which possess a "large cell" morphology and carry a poor prognosis.

Factors related to the problems of long-term catheterization.

A survey of 97 elderly catheterized patients revealed the catheter-related problems of leaking, blocking, need for irrigation, odour and irritation. Details were taken of factors thought to be related to the problems and the data were analysed by using stepwise forward multiple regression. Hospital and community patients were found to have different problems. Females in both groups had more problems than males. For hospital patients, larger catheters were found to be associated with most problems, particularly leaking and blocking. For community patients, immobility and daily changing of drainage bags were major problem causers. The common nursing practice of changing to wider-diameter catheters in an attempt to prevent bypassing is wrong.

The ageing game.

The ageing game is a teaching method for up to 30 students (in all medical and paramedical disciplines) which allows maximum student involvement. It consists essentially of 90 individual cards, each of which bears a statement relevant to ageing or the practice of medicine in old age. The statements may be true, false or doubtful. Students are dealt a proportion of the cards each and by discussion together and exchange between each other attempt to assemble a group in which all the statements are true. Students are subsequently combined in twos and fours and the final part of the game consists of an adjudication of the cards held by each group, allowing the teacher plenty of scope to comment on the various statements.

Moduretic-induced metabolic acidosis and hyperkalaemia.

A patient who developed significant metabolic acidosis and severe hyperkalaemia while taking Moduretic (amiloride and hydrochlorothiazide) is reported. During the period of hyperkalaemia (maximum potassium 7-6 mmol/l) the patient's whole body potassium content was normal. His acid-base balance and serum potassium returned to normal some 10 days after stopping the drug. The possible mechanism of acidosis and hyperkalaemia in this patient is discussed.

Long-term anabolic therapy in the elderly.

The anabolic agent stanozolol has been used to increase weight and activity in the elderly, but its long-term effect are largely unknown. A double-blind trial of stanozolol against placebo was continued for 12 months. Measuremtnes of weight, fat, fat-free mass, behaviour and activity were made at regular intervals, plus detailed biochemical and haematological profiles. There were no differences between the two groups in respect of weight, fat, fat-free mass and activity levels. There were significant increases in haemoglobin at six and 12 months and packed cell volume at 12 months in the active group. No androgenic side-effect were encountered.

The effect of potassium supplements on total-body-potassium levels in the elderly.

Weight, skinfold thickness, grip strength and the total-body-potassium content were measured in 13 healthy elderly subjects before and after a three-month course of potassium supplements given in a dose of 36 mmol per day. There were no significant changes in the total-body-potassium content or in the ratio of total body potassium to lean-body mass. An increase in the right-hand grip strength may well have been a placebo effect.

A double-blind trial of an anabolic steroid (stanozolol) in the disabled elderly.

Anabolic steroids have been widely recommended in the management of debility in association with the diseases of old age. Their action in promoting weight gain and in speeding rehabilitation is said to depend on nitrogen retention leading to increased muscle bulk reflected by increased fat-free mass (lean-body mass). In elderly patients undergoing rehabilitation a double-blind trial over 4 months of stanozolol, an orally active anabolic agent, is reported in which measurements of total body weight, body fat and fat-free mass were recorded. Physical activity and performance levels were also measured. Total body weight was found to have increased in both groups of patients, mainly due to increased body fat. There was no evidence of fluid retention due to the drug. Despite the absence of an anabolic effect, the group taking stanozolol increased their levels of physical activity significantly.