RESUMEN
The objectives of this study were to determine the nutrient composition of grass-fed beef in the United States for inclusion in the USDA National Nutrient Database for Standard Reference, and to compare the fatty acid composition of grass-fed and conventionally fed (control) beef. Ground beef (GB) and strip steaks (SS) were collected on 3 separate occasions from 15 grass-fed beef producers that represented 13 different states, whereas control beef samples were collected from 3 regions (Ohio, South Dakota, and Texas) of the United States on 3 separate occasions. Concentrations of minerals, choline, vitamin B(12), and thiamine were determined for grass-fed beef samples. Grass-fed GB samples had less Mg, P, and K (P < 0.05), and more Na, Zn, and vitamin B(12) (P < 0.05) than SS samples. Fat color, marbling, and pH were assessed for grass-fed and control SS. Subjective evaluation of the SS indicated that grass-fed beef had fat that was more yellow in color than control beef. Percentages of total fat, total cholesterol, and fatty acids along with trans fatty acids and CLA were determined for grass-fed and control SS and GB. Grass-fed SS had less total fat than control SS (P = 0.001), but both grass-fed and control SS were considered lean, because their total fat content was 4.3% or less. For both GB and SS, grass-fed beef had significantly less (P = 0.001 and P = 0.023, respectively) content of MUFA and a greater content of SFA, n-3 fatty acids, CLA, and trans-vaccenic acid than did the control samples. Concentrations of PUFA, trans fatty acids, n-6 fatty acids, and cholesterol did not differ between grass-fed and control ground beef. Trans-vaccenic acid (trans-11 18:1) made up the greatest concentration of the total trans fats in grass-fed beef, whereas CLA accounted for approximately 15% of the total trans fats. Although the fatty acid composition of grass-fed and conventionally fed beef was different, conclusions on the possible effects of these differences on human health cannot be made without further investigation.
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Composición Corporal/fisiología , Bovinos/fisiología , Métodos de Alimentación/veterinaria , Carne/análisis , Carne/normas , Tejido Adiposo/química , Animales , Peso Corporal/fisiología , Ácidos Grasos/análisis , Concentración de Iones de Hidrógeno , Minerales/análisis , Poaceae/metabolismo , Vitaminas/análisisRESUMEN
Prostate Specific Ets factor is a recently identified transcriptional activator that is overexpressed in prostate cancer. To determine whether this gene is overexpressed in breast cancer, we performed a virtual Northern blot using data available online at the Cancer Genome Anatomy Project website. Ninety-five SAGE libraries were probed with a unique sequence tag to the Prostate Specific Ets gene. The results indicate that Prostate Specific Ets is expressed in 14 out of 15 breast cancer libraries (93%), nine out of 10 prostate cancer libraries (90%), three out of 40 libraries from other cancers (7.5%), and four out of 30 normal tissue libraries (13%). To determine the possibility that the Prostate Specific Ets gene is a novel marker for detection of metastatic breast cancer in axillary lymph nodes, quantitative real-time RT-PCR analyses were performed. The mean level of Prostate Specific Ets expression in lymph nodes containing metastatic breast cancer (n=22) was 410-fold higher than in normal lymph node (n=51). A receiver operator characteristic curve analysis indicated that Prostate Specific Ets was overexpressed in 18 out of 22 lymph nodes containing metastatic breast cancer (82%). The receiver operator characteristic curve analysis also indicated that the diagnostic accuracy of the Prostate Specific Ets gene for detection of metastatic breast cancer in axillary lymph nodes was 0.949. These results provide evidence that Prostate Specific Ets is a potentially informative novel marker for detection of metastatic breast cancer in axillary lymph nodes, and should be included in any study that involves molecular profiling of breast cancer.
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Biomarcadores de Tumor/genética , Neoplasias de la Mama/diagnóstico , Metástasis Linfática/diagnóstico , Próstata/química , Proteínas Proto-Oncogénicas/genética , Factores de Transcripción/genética , Axila , Northern Blotting , Neoplasias de la Mama/patología , Femenino , Humanos , Masculino , Proteínas Proto-Oncogénicas c-ets , Reacción en Cadena de la Polimerasa de Transcriptasa InversaRESUMEN
A programmable ultra-low noise X-band exciter has been developed using commercial off-the-shelf components. Its phase noise is more than 10 dB below the best available microwave synthesizers. It covers a 7% frequency band with 0.1-Hz resolution. The X-band output at +23 dBm is a combination of signals from an X-band sapphire-loaded cavity oscillator (SLCO), a low noise UHF frequency synthesizer, and special-purpose frequency translation and up-conversion circuitry.
RESUMEN
In the present study, a national consumer evaluation was conducted for beef tenderness on USDA Select strip loin steaks of known Warner-Bratzler shear (WBS) force values, ranging from tough (> 5.7 kg) to tender (< 3.0 kg), and to assess the monetary value that consumers place on tenderness by determining the average price a consumer would pay for a steak in three tenderness categories. Three supermarkets in each of five metropolitan areas (Baltimore, MD/Washington D.C.; Chicago, IL; Dallas/Fort Worth, TX; Los Angeles, CA; and Lubbock, TX) were selected to represent a wide range of income, education, and ethnicity at each city. Five trained research teams traveled to the cities to collect data during the same 10-d period. Consumers (n = 734; minimum of 15 consumers/panel, three panels/store, three stores/city, five cities) were asked to evaluate samples from each tenderness classification (tender, intermediate, or tough) for overall and tenderness acceptability, overall quality, beef flavor, juiciness, tenderness, how much they would pay for the steak ($17.14, 14.28, or 10.98/kg), if they would pay more than current market price if guaranteed tender, and to estimate the number of meals in a 2-wk period that included beef. The consumers were 52% light beef users, consuming 0 to 8 meals containing beef in 2 wk, 41% heavy beef users (greater than 12 meals/2 wk), and 6% moderate beef users (9 to 12 meals/2 wk). Consumer tenderness acceptability increased as WBS values decreased (P < 0.05). The transition in consumer perception from tender to tough beef occurred between 4.3 and 4.9 kg of WBS based on > or = 86% consumer acceptability. Consumer acceptability for tenderness decreased from 86% at 4.3 kg for a "slightly tender" rating to 59% at 4.9 kg for a "slightly tough" rating. Data from the present study suggested that consumer WBS tenderness values of < 3.0, 3.4, 4.0, 4.3, and > 4.9 kg would result in 100, 99, 94, 86, and 25% customer satisfaction for beef tenderness, respectively. Seventy-eight percent of the consumers would purchase steaks if the retailer guaranteed them to be tender. The retail steak value differences found in this study would result in the opportunity for a premium to be paid for a guaranteed tender (< 3.0 kg WBS value) carcass of $76.26 vs the toughest (> 5.7 kg) classification. A premium of $66.96 could be paid to the tender classification carcasses vs the tough (> 4.9 kg) classification carcasses, and a premium of $36.58 could be paid for the tender classification carcasses vs the intermediate (> 3.0 to < 4.6 kg) classification carcasses. Results from the present study show that consumers can segregate differences in beef tenderness and that consumers are willing to pay more for more-tender beef.
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Comportamiento del Consumidor , Carne/economía , Carne/normas , Animales , Bovinos , Femenino , Tecnología de Alimentos/normas , Humanos , Masculino , Distribución Aleatoria , GustoRESUMEN
PURPOSE: The objective of this article is to evaluate our experience with sestamibi scanning in patients with primary and secondary hyperparathyroidism. PATIENTS AND METHODS: A retrospective review of patients referred to the radiology department at the University of Kansas Medical Center for parathyroid studies between January 1, 1993, and August 1, 1998, was done. Patients included in the study were those who underwent both dual-phase technetium (Tc-99m) sestamibi scanning and subsequent parathyroidectomy at our institution (n = 34). Twenty-six patients had primary hyperparathyroidism and 8 patients had secondary hyperparathyroidism. Fifteen had previous history of neck exploration. RESULTS: Sensitivity of sestamibi scans in detection of all abnormal pathology in cases of primary hyperparathyroidism was 60% overall. Among the subset of adenoma cases, sensitivity was 82% (14/17). Among cases of primary parathyroid hyperplasia, no scan correctly localized all abnormal glands; however 60% (3/5) showed localization of at least one hyperplastic gland. Of the 2 patients with parathyroid carcinoma, in only one case was there evidence of sestamibi retention in the correct thyroid lobe. In patients with secondary hyperparathyroidism, sestamibi scanning was successful in identifying all hyperplastic tissue in only one case (sensitivity 13%). In 7 of the 8 cases of secondary hyperparathyroidism, the scan localized at least one hyperplastic gland. CONCLUSION: Sestamibi scanning is useful in the localization of abnormal pathology in cases of primary hyperparathyroidism, especially adenomas. In cases of hyperplasia, whether attributable to primary or secondary hyperparathyroidism, sestamibi imaging is less successful.
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Hiperparatiroidismo/diagnóstico por imagen , Cuidados Preoperatorios , Radiofármacos , Tecnecio Tc 99m Sestamibi , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Hiperparatiroidismo/cirugía , Hiperparatiroidismo Secundario/diagnóstico por imagen , Hiperparatiroidismo Secundario/cirugía , Masculino , Persona de Mediana Edad , Paratiroidectomía , Cintigrafía , Estudios Retrospectivos , Sensibilidad y EspecificidadRESUMEN
Longitudinal changes in intra-abdominal (IA) fat and total body fat were assessed in three healthy postmenopausal Caucasian women receiving hormone replacement therapy (HRT) during a seven-year follow-up study. Measurements were made using dual-energy X-ray absorptiometry, anthropometry, and magnetic resonance images. Changes in intra-abdominal fat were examined in relation to different patterns of weight modification. The weight-stable women had the lowest percent body fat and IA fat at all examinations, with a slight decrease in IA fat at follow-up. The person with a gradual gain in weight of 1.9 kg experienced small increases in body fat and IA fat. The weight-cycling woman had the highest weight, percent body fat, and IA fat area at all examinations. The amounts of IA fat and percent body fat fluctuated with body weight fluctuations. Together with other findings, our results suggest that lean, weight-stable individuals receiving HRT can maintain a low level of IA fat, whereas those experiencing weight gains or regaining lost weight have increases in IA fat.
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Tejido Adiposo/anatomía & histología , Posmenopausia/fisiología , Abdomen , Absorciometría de Fotón , Antropometría , Peso Corporal , Femenino , Humanos , Estudios Longitudinales , Imagen por Resonancia Magnética , Persona de Mediana Edad , Missouri , Factores de Tiempo , Aumento de Peso , Población BlancaRESUMEN
Thoracic surgeons are involved in the diagnosis and management of patients with mediastinal emphysema because of the potentially life-threatening conditions that either must be treated emergently or excluded. Although the classic findings of pneumomediastinum have been described for nearly 60 years, an underappreciated finding is the presence of rhinolalia. Case reports of this finding are sporadic and absent from the thoracic surgical literature. The presence of rhinolalia in association with spontaneous pneumomediastinum is highlighted in the following case presentation and prior reports are reviewed.
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Enfisema Mediastínico/diagnóstico , Calidad de la Voz , Adulto , Humanos , Masculino , Enfisema Mediastínico/diagnóstico por imagen , Tomografía Computarizada por Rayos XRESUMEN
The role of human papillomavirus (HPV) in airway papillomas has been well defined in recent literature. The chronicity and recurrence of papillomas has been postulated to be a result of residual viral genome in tissue treated with standard laser techniques. Thirteen patients with airway papillomas were selected for study with polymerase chain reaction (PCR) methods to detect viral DNA. Specimens taken prior to laser therapy and specimens taken at laser margins were consistently positive for HPV DNA by PCR. The HPV DNA is apparently present in tissues after macroscopic disease has been ablated by laser techniques. Histologic analysis of laser biopsies demonstrated fragments of squamous epithelium with cytologic features of HPV infection. Laser treatment is ineffective in eradicating HPV-infected tissues from airway papillomas, and this finding supports the notion that recurrence is a product of HPV incorporated into tissue not ablated by laser irradiation. Specific methods, results, and clinical correlation will be discussed.
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Neoplasias Laríngeas/virología , Neoplasias Nasales/virología , Papiloma/virología , Papillomaviridae/aislamiento & purificación , Infecciones por Papillomavirus/virología , Infecciones Tumorales por Virus/virología , Adulto , Biopsia , Niño , Preescolar , ADN Viral/aislamiento & purificación , Femenino , Humanos , Neoplasias Laríngeas/patología , Neoplasias Laríngeas/cirugía , Terapia por Láser , Masculino , Neoplasias Nasales/patología , Neoplasias Nasales/cirugía , Papiloma/patología , Papiloma/cirugía , Infecciones por Papillomavirus/patología , Infecciones por Papillomavirus/cirugía , Reacción en Cadena de la Polimerasa , Recurrencia , Infecciones Tumorales por Virus/patología , Infecciones Tumorales por Virus/cirugíaRESUMEN
OBJECTIVES: Demonstrate the induction of cyclooxygenase-2 (COX-2) in laryngeal papilloma Discuss the possible causal role of COX-2 in papilloma formation. Consider the potential for treatment of papilloma using selective COX-2 inhibitors. STUDY DESIGN: Molecular biological analysis of COX-1 and COX-2 in laryngeal papilloma. METHODS: Tissue samples from five patients with recurrent respiratory papillomatosis (RRP) were analyzed by in situ hybridization, immunohistochemical staining, and reverse transcription polymerase chain reaction (RT-PCR) techniques. RESULTS: In situ hybridization to COX-2 mRNA showed strong autoradiographic signal surrounding fibrovascular cores. COX-1 autoradiographic signal was low intensity or nondetectable. Normal buccal mucosa biopsies showed low-density or nondetectable autoradiographic signal for both COX-1 and COX-2 mRNAs. In situ hybridization results were corroborated by RT-PCR studies. Levels of COX-2 mRNA were 13-fold more than those in normal mucosa. Immunohistochemical staining for COX-1 and COX-2 showed a similar pattern to that seen with in situ hybridization in both normal and papilloma tissues. CONCLUSIONS: There is an elevation of COX-2 expression in papilloma tissues. This may represent a causal role of COX-2 in the formation and proliferation of laryngeal papilloma. There may also be a role for selective COX-2 inhibition for the treatment of
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Neoplasias Laríngeas/enzimología , Papiloma/enzimología , Prostaglandina-Endoperóxido Sintasas/análisis , Autorradiografía , Southern Blotting , Ciclooxigenasa 1 , Ciclooxigenasa 2 , Inhibidores de la Ciclooxigenasa 2 , Inhibidores de la Ciclooxigenasa/uso terapéutico , Humanos , Inmunohistoquímica , Hibridación in Situ , Isoenzimas/análisis , Neoplasias Laríngeas/tratamiento farmacológico , Proteínas de la Membrana , Recurrencia Local de Neoplasia/enzimología , Papiloma/tratamiento farmacológico , Reacción en Cadena de la Polimerasa , ADN Polimerasa Dirigida por ARNRESUMEN
Removal of functional presynaptic input can result in a variety of changes in postsynaptic neurons in the central nervous system, including altered metabolism, changes in neuronal cell size, and even death of the postsynaptic cell. Age-dependent neuronal cell death and shrinkage has been documented in second order auditory neurons in the chick brainstem (nucleus magnocellularis, NM) following cochlea removal (Born and Rubel, 1985. J. Comp. Neurol. 231, 435-445). Here we examined whether the extent of neuronal cell death and shrinkage is also breed-dependent. We performed unilateral cochlea removal on both hatchling and adult birds of either a broiler breed (Arbor Acres Cross) or egg layer breed (Hy-Line, H and N) and killed birds one week later. Changes in neuronal cell number and cross sectional area were determined from Nissl-stained sections. We observed 25% neuronal cell loss and a 15-20% decrease in neuronal cross sectional area after cochlea removal in either broiler or egg layer hatchling birds. In adult birds, however, neuronal cell loss is breed-dependent. Adult egg layer birds lose an average of 37% of NM neurons after cochlea removal, while adult broiler birds show no cell loss. In both breeds of adult birds, cochlea removal results in a 20% decrease in neuronal cross sectional area. These results suggest that analysis of differences between breeds as well as ages of birds will prove fruitful in determining how afferent input controls neuronal survival and metabolism.
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Pollos/anatomía & histología , Núcleo Coclear/citología , Animales , Apoptosis/fisiología , Vías Auditivas/fisiología , Recuento de Células , Tamaño de la Célula , Núcleo Coclear/fisiología , Desnervación , Femenino , Masculino , Neuronas/citología , Especificidad de la EspecieAsunto(s)
Hipercalcemia/diagnóstico , Anciano , Anciano de 80 o más Años , Carcinoma/complicaciones , Carcinoma/patología , Diagnóstico Diferencial , Humanos , Hipercalcemia/complicaciones , Hiperparatiroidismo/complicaciones , Hiperparatiroidismo/diagnóstico , Masculino , Neoplasias de las Paratiroides/complicaciones , Neoplasias de las Paratiroides/patología , Glándula Tiroides/diagnóstico por imagen , UltrasonografíaRESUMEN
Managing postsurgical pain continues to be one of the nation's top clinical care priorities and concerns. Despite widely publicized national care guidelines, effective pain management for all patients is not a reality. This study explored how nurses in a community hospital documented the process of pain management for a group of postsurgical patients. The results have implications for all adult health nurses.
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Analgésicos/administración & dosificación , Registros de Enfermería , Dolor Postoperatorio/tratamiento farmacológico , Dolor Postoperatorio/enfermería , Enfermería Perioperatoria/normas , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Humanos , Persona de Mediana Edad , Auditoría de Enfermería , Investigación en Evaluación de Enfermería , Dimensión del DolorAsunto(s)
Conservación de los Recursos Naturales/métodos , Servicio de Alimentación en Hospital , Eliminación de Residuos/métodos , Servicio de Alimentación en Hospital/economía , Residuos de Alimentos , Eliminación de Residuos/economía , Estados Unidos , United States Environmental Protection Agency , Administración de Residuos/economíaRESUMEN
OBJECTIVE: To compare the survival rate and pregnancy rate (PR) of embryos from intracytoplasmic sperm injection (ICSI) or conventional IVF, which were cryopreserved at the pronuclear stage in cycles where fresh transfer was deferred. DESIGN: Comparative observational study. SETTING: University-associated IVF center. PATIENT(S): Ninety-nine patients who deferred ET and had all their embryos cryopreserved at the pronuclear stage after 153 oocyte retrievals. Thirty-nine patients had their oocytes inseminated by ICSI and 60 patients had conventional IVF insemination. INTERVENTION(S): All embryos were frozen-thawed at the two pronuclear stage and allowed to cleave for 2 days before transfer. MAIN OUTCOME MEASURE(S): Survival rate (morphologically intact after thaw), cleavage rate (cleaved by time of transfer), and the clinical PR after frozen ET. RESULT(S): In the ICSI group, 205 embryos were thawed for use in 57 frozen ETs; in the IVF group, there were 527 embryos thawed for use in 149 frozen ETs. There was no significant difference in any of the outcome measures by insemination method: survival rates (ICSI, 93.2%; IVF, 94.8%); cleavage rates (ICSI, 95.2%; IVF, 94.7%), and clinical PR (ICSI, 14.0%; IVF, 17.4%). CONCLUSION(S): Pronuclear embryos resulting from ICSI can be cryopreserved successfully, thawed, and the survival rate and PR are comparable to conventional IVF.
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Criopreservación , Fertilización In Vitro , Microinyecciones/métodos , Espermatozoides/fisiología , Transferencia Intrafalopiana del Cigoto , Adulto , Supervivencia Celular/fisiología , Citoplasma , Femenino , Congelación , Humanos , Masculino , Persona de Mediana Edad , Embarazo , Índice de EmbarazoRESUMEN
11 beta-Hydroxysteroid dehydrogenase (HSD) activity was measured in freshly frozen granulosa cells isolated from follicles of twenty-one infertility patients undergoing in vitro fertilization-embryo transfer (IVF-ET). A total of 213 follicles were analyzed for 11 beta-HSD activity. Both nicotinamide-adenine dinucleotide (NAD) and nicotinamide-adenine dinucleotide phosphate (NADP) dependent 11 beta-dehydrogenase activities were measured in granulosa cells. The activity in reductive direction (11-oxoreductase activity) was not measurable either with NADH or NADPH as cofactors. NAD- and NADP-dependent dehydrogenase activities are in comparable levels at 100 nmol/l and 1 mumol/l corticosteroid concentrations. For comparing enzyme activities of individual follicles, significant enzyme activity was considered to be a level of > 2 nmol/l/min/mg. 41.3% of the follicles demonstrated enzyme activity, 58.7% did not. The mean 11 beta-dehydrogenase (11 beta-DH) activity was calculated for each patient. Those patients with levels > 2 nmol/l/min/mg were considered enzyme positive; those with mean levels < 2 nmol/l/min/mg were considered negative. No significant association was noted between follicle size, oocyte maturity or fertilization rates and 11 beta-DH activity. This study noted the presence of 11 beta-DH activity in granulosa cells, however, no association with oocyte maturity and fertilization was found.
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Fertilización In Vitro , Células de la Granulosa/enzimología , Hidroxiesteroide Deshidrogenasas/metabolismo , Folículo Ovárico/enzimología , 11-beta-Hidroxiesteroide Deshidrogenasas , Adulto , Cromatografía en Capa Delgada , Corticosterona/química , Transferencia de Embrión , Ensayo de Inmunoadsorción Enzimática , Estradiol/sangre , Femenino , Hormona Folículo Estimulante/sangre , Líquido Folicular/enzimología , Humanos , Hidrocortisona/química , Hidroxiesteroide Deshidrogenasas/análisis , Hormona Luteinizante/sangre , NAD/química , NADP/química , Folículo Ovárico/crecimiento & desarrollo , Embarazo , Resultado del Embarazo , Progesterona/sangre , Conteo por CintilaciónRESUMEN
PURPOSE: Our purpose was to determine if pronuclear-stage embryos (2PN) could be thawed, then frozen again with subsequent survival and cleavage after thawing. METHODS: A simplified cryopreservation protocol was used in which a slow cooling program is started at the seeding temperature of -6 degrees C in an alcohol-bath controlled-rate freezer. 1,2-Propanediol (1.5 M) was added to embryos before cooling. A fast thawing technique at room temperature was used. The cryoprotectant was removed in one step using a 1 M sucrose solution. RESULTS: Three months after refreezing, the three 2PN embryos were thawed and all three cleaved after 24 hr in culture. Following embryo transfer a pregnancy was achieved and a healthy full-term baby girl was born. CONCLUSIONS: This is the third case reported of successful pregnancies after transfer of human embryos that were frozen twice before transfer and the first case where the second freeze occurred at the pronuclear stage. This is also the first successful refreezing of human embryos using a simplified freezing and thawing technique with one-step addition and removal of cryoprotectant.
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Criopreservación , Transferencia de Embrión , Embrión de Mamíferos , Fertilización In Vitro , Adulto , Femenino , Humanos , Ciclo Menstrual , Embarazo , Resultado del EmbarazoRESUMEN
OBJECTIVE: To compare clinical pregnancy and implantation rates after transfer of frozen-thawed embryos prepared according to an assisted hatching protocol or a nonassisted hatching protocol. DESIGN: A historical cohort study in which a cohort of patients who underwent an assisted hatching protocol was matched for clinical parameters to an external historical cohort treated before assisted hatching was available. SETTING: In vitro fertilization-ET facility of a university-based practice. PATIENTS: Seventy-nine matched pairs. INTERVENTIONS: Nonassisted hatching patients: embryos were thawed, cultured in human tubal fluid + 0.5% bovine serum albumin until 48 hours and transferred. Assisted hatching patients: embryos thawed, cultured in human tubal fluid + 10% synthetic serum substitute until 72 hours, had assisted hatching and transferred. MAIN OUTCOME MEASURES: Clinical pregnancy (gestational sac) and implantation rates. RESULTS: Twelve (15.2%) clinical pregnancies per transfer in nonhatched group versus 24 (30.4%) in hatched group. Nonhatched group: 284 embryos transferred; 15 (5.3%) implanted. Three pregnancies (25.0%) had two sacs. Hatched embryos: 269 were transferred; 37 (13.7%) implanted. Eleven pregnancies (45.8%) were multiple gestations (9 twins, 2 triplets). CONCLUSION: Clinical pregnancy and implantation rates were higher for group having assisted hatching protocol. It is not clear whether the improvement is due to the overall methodology change or to assisted hatching. Assisted hatching using the zona-drilling technique is not detrimental to frozen-thawed human embryos and may be beneficial.
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Criopreservación , Transferencia de Embrión/métodos , Embarazo/estadística & datos numéricos , Adulto , Estudios de Cohortes , Implantación del Embrión , Femenino , HumanosRESUMEN
This chapter reported the pharmacokinetics and the toxicities of mitomycin-c (MMC) when administered as a hyperthermic intraperitoneal lavage after surgical resection of advanced primary or recurrent gastrointestinal cancer. Pharmacologic studies were performed in 10 patients and all adverse reactions were recorded in 20 patients. These 20 patients had advanced gastrointestinal malignancies with peritoneal carcinomatosis and underwent cytoreductive surgery prior to intraperitoneal lavage. Heated (42 degrees C) intraperitoneal mitomycin C was used in a lavage technique with 30 mg/3 1 of drug for 2 hours. The fluid was distributed throughout the abdominal cavity by vigorous external massage of the abdominal wall. This resulted in approximately 70 percent (21 mg) drug absorption from the perfusate. Urine output of MMC averaged 2.5 mg during the 2 hour procedure. Median peak blood levels of 0.25 micrograms/ml (range 0.11-0.41 micrograms/ml) were observed at 45-60 minutes into the procedure. Morbidity was low and was mainly related to the surgical procedures (prolonged ileus, postoperative fistulas) with mild to moderate drug-related myelosuppression. This new method of delivery of MMC and 5-FU should be explored in phase II clinical trials.