Ifosfamide treatment as a 10-day continuous intravenous infusion.

Experimental and clinical studies on ifosfamide indicate that fractionated treatment regimens have a higher efficacy compared to a single short-term infusion. In addition, protracted continuous infusion, in general, is often less toxic without loss of antitumour activity. To study the toxicity of a 10-day continuous infusion at increasing dosages of ifosfamide and mesna, 24 patients with a variety of advanced cancers (colon 10, pancreas 5, adenocarcinoma with unknown primary 5, and 4 others) received a total of 60 cycles (range 1-6 cycles, median 2) at 3 to 4 week intervals. The ifosfamide and mesna doses ranged from 654 mg m-2 day-1 to 1562 mg m-2 day-1 for a total of ten doses. Twenty-two patients were chemotherapy-naive. Pharmacia-Deltec CADD-1 pumps and Port-a-Cath implantable venous access devices were used. The dose-limiting toxicity was leucopenia without thrombocytopenia. At a dose of 1300 mg m-2 day-1 in 30% of the cycles in 7 patients leucopenia of WHO grades 3 and 4 was observed, while at higher dosages this percentage increased to 73%. Haemoglobin values usually decreased during the infusion with a mean of 1 mmol/l (range 0.3-2.5 mmol/l), frequently with partial or full recovery by the next cycle. The next most disturbing side-effect was fatigue (50% of patients WHO grades 2 and 3), and nausea and vomiting requiring drug treatment in 75% of patients. Renal failure and haematuria did not occur. There were two catheter-related complications: thrombosis (1 patient) and mechanical obstruction (1 patient). One patient developed severe encephalopathy at day 6 (total dose 18 g ifosfamide) with complete recovery after cessation of the infusion. In summary, a tolerable ifosfamide dose using this regimen in this previously largely untreated patient group appears to be 1200-1300 mg m-2 day-1 for 10 days. Fatigue is a frequent complaint and might be explained as a kind of neurotoxicity. The treatment can be administered to outpatients.

Body images of one's self and of others: developmental and clinical significance.

The author presents a new concept of the term "body image." He also introduces the term "extraneous body image," i.e., one's mental representation of others' appearance and behavior. The formation of one's own and extraneous body images and their role in the development of self-concept, concept of others, interpersonal relationships, and mind-body interactions, as well as their clinical implications, are discussed.

Rapid clinical effectiveness of MIF-I in the treatment of major depressive illness.

A double-blind 28 day study was conducted to compare the anti-depressant efficacy of MIF-I with that of imipramine. Twenty patients hospitalized with major depressive illness participated. Clinical responses were measured by using the Hamilton Depression Rating Scale, the Global Severity of Illness Scale, the Zung Self-Rating Depression Scale as well as the 100 mm line self-rating for depression. The results indicate that MIF-I was at least as effective as imipramine in this study, and that its anti-depressive effect was a rapid and often dramatic one.

Maprotiline versus imipramine and placebo in neurotic depression.

The antidepressant effect of maprotiline, a tetracyclic compound, was compared with that of imipramine in a four-week, double-blind, placebo controlled study with neurotic depressives. On all factors of the Hamilton Depression Rating Scale and on most items of the Zung Self-Rating Scales for Depression and Anxiety, maprotiline appeared slightly more effective than imipramine and showed a faster onset of action. In addition, it appeared to cause fewer anticholinergic side effects.

Monoacylcadaverines in schizophrenia.

Monoacetylcadaverine and monopropionylcadaverine were found in the blood of schizophrenic patients in higher concentrations than in the blood of nonschizophrenic subjects. The blood levels of both monoacylcadaverines in schizophrenics were relatively higher during exacerbation of the illness and were relatively lower during improvement.

Variability in schizophrenia. Reflection of a regulatory disease.

The clinical course, body weight, biological measurements, and responses to neuroleptic agents were examined in 92 chronic schizophrenics over a period of ten years. The individual occurrence of periodic exacerbations, shifts in symptoms, changes in drug responses, unusual fluctuations in body weight, and transient biological abnormalities led me to conclude that schizophrenia is characterized by an independent variability of clinical and biological features. This variability indicates that schizophrenia is a disease of regulation.

Lithium accumulation in some endocrine tissues.

Lithium levels were measured in several tissues of rats after oral lithium administration for various periods of time. The lithium levels in the brain approached those of the serum while there was a marked accumulation of lithium in the pituitary and thyroid glands. When lithium was stopped there was no noticeable lag in clearance for any of the tissues examined, with the pituitary maintaining a significant elevation of lithium over the serum levels. Animals receiving lithium had higher levels of adrenal corticosterone under quiescent conditions and higher levels of plasma corticosterone thirty minutes after a brief electric footshock.