Faculty Bibliography

PURPOSE/OBJECTIVE:There are few treatment options for patients with metastasized or inoperable endocrine gastroenteropancreatic (GEP) tumors. Chemotherapy can be effective, but the response is usually less than 1 year. Here, we present the results of treatment with a radiolabeled somatostatin analog, [177Lu-DOTA0,Tyr3]octreotate (177Lu-octreotate). PATIENTS AND METHODS/METHODS:One hundred thirty-one patients with somatostatin receptor-positive tumors were treated with up to a cumulative dose of 600 to 800 mCi (22.2 to 29.6 GBq) of 177Lu-octreotate. RESULTS:One patient developed renal insufficiency, and another patient developed hepatorenal syndrome. Creatinine clearance did not change significantly in the other patients. WHO hematologic toxicity grade 3 or 4 occurred after less than 2% of the administrations. We observed complete remission in three patients (2%), partial remission in 32 patients (26%), minor response (tumor diameter decrease of 25% to 50%) in 24 patients (19%), stable disease (SD) in 44 patients (35%), and progressive disease (PD) in 22 patients (18%). Higher remission rates were positively correlated with high uptake on pretherapy somatostatin receptor imaging and a limited number of liver metastases, whereas PD was significantly more frequent in patients with a low performance score and extensive disease. Median time to progression in 103 patients who either had SD or tumor regression was more than 36 months. CONCLUSION/CONCLUSIONS:Treatment with 177Lu-octreotate results in tumor remission in a high percentage of patients with GEP tumors. Serious side effects are rare. The median time to progression compares favorably with chemotherapy. Results are better in patients with a limited tumor load. Therefore, early treatment, even in patients who have no PD, may be better.

A series of novel ligands for the glucocorticoid receptor containing two heterocycles were synthesized. These compounds were investigated for a dissociative profile using transrepression and transactivation assays. Several compounds were tested in vivo and showed the ability to reduce inflammation in a mouse.

This parasitic infection usually is transmitted through the bite of the kissing bug (also known as the reduviid bug and the triatomine bug). The insect lives in cracks and holes in poor housing, where it bites people, often on the face, while they sleep. Occasionally, Chagas' is transmitted through blood transfusions, organ transplants, and from mother to child at birth. Recently, Brazilian health officials reported a widespread outbreak in which [Carlos Chagas]' apparently was transmitted orally through contaminated sugar cane juice. Brazil has banned the sale of the juice

Immediately, he said, investigators tracked down the woman to determine whether she was in fact infected with the strain. They asked her about her recent travels, contact with birds and when she first felt sick. They determined quickly that her respiratory symptoms were not from influenza. The origin of the 1957 strain remained mysterious. Dr. [Frank Plummer] said his team called the center in Atlanta on March 26. By April 8, Canadian epidemiologists had traced the strain to the specimens sent out by the College of American Pathologists in Northfield, Ill., which had ordered them from Meridian. Dr. Jared N. Schwartz, a microbiologist and official of the College of American Pathologists, said his group asked Meridian to include a type A influenza virus in the test kit, but did not specify which strain. When Meridian checked a United States government manual, he said, its team found that the A(H2N2) strain could be sent to laboratories as a biosafety Level 2 microbe, the second-lowest level of danger in a four-class rating. Dr. Plummer agreed, saying, ''Meridian made an error in choosing the A(H2N2) virus to send out.'' The strain was listed as A(H3N2), a common strain, on the permit forms for customs, Dr. Plummer said

[Maurice Hilleman] developed 8 of the 14 vaccines routinely recommended: measles, mumps, hepatitis A, hepatitis B, chickenpox, meningitis, pneumonia and Haemophilus influenzae bacteria (which brings on a variety of symptoms, including inflammation of the lining of the brain and deafness). He also developed the first generation of a vaccine against rubella, or German measles. The vaccines have virtually vanquished many of the once-common childhood diseases in developed countries. Hilleman overcame immunological obstacles to combine vaccines so that one shot could protect against several diseases, like the MMR vaccine for measles, mumps and rubella. One of Hilleman's goals was to develop the first licensed vaccine against any viral cancer. He achieved it in the early 1970s, developing a vaccine to prevent Marek's disease, a lymphoma cancer of chickens caused by a member of the herpes virus family. Preventing the disease helped revolutionize the economics of the poultry industry

[Maurice Hilleman], a microbiologist who developed vaccines for mumps, measles, chickenpox, pneumonia, meningitis and other diseases, saving tens of millions of lives, died on Monday at a hospital in Philadelphia. He was 85. Hilleman developed eight of the 14 vaccines routinely recommended: measles, mumps, hepatitis A, hepatitis B, chickenpox, meningitis, pneumonia and Haemophilus influenzae bacteria (which brings on a variety of symptoms, including inflammation of the lining of the brain and deafness). One of Hilleman's goals was to develop the first licensed vaccine against any viral cancer. He achieved it in the early 1970s, developing a vaccine to prevent Marek's disease, a lymphoma cancer of chickens caused by a member of the herpes virus family. Preventing the disease helped revolutionize the economics of the poultry industry

Dr. [Maurice Ralph Hilleman] developed eight of the 14 vaccines routinely recommended: measles, mumps, hepatitis A, hepatitis B, chickenpox, meningitis, pneumonia and Haemophilus influenzae bacteria (which brings on a variety of symptoms, including inflammation of the lining of the brain and deafness). He also produced the first generation of a vaccine against rubella, or German measles

The disease is named after Carlos Chagas, a Brazilian physician who first described it, in 1909. Chagas' usually spreads when someone is bitten by an insect, engorging itself with blood and passing the parasite in its feces onto the skin. The initial symptoms of Chagas' are usually mild or nonexistent. It generally takes decades for the Chagas parasite to cause death by slowly damaging heart muscle, the esophagus and the colon. By that time, drugs are ineffective in reversing the damage. The Santa Catarina outbreak is believed to be the largest known food-borne outbreak of Chagas' and the first that has led to an international warning, said Jennifer Marcone, a spokeswoman for the Centers for Disease Control and Prevention in Atlanta. She also said that the C.D.C. was not participating in the investigation because Brazil has many experts on Chagas' disease

Dr. Hilleman developed 8 of the 14 vaccines routinely recommended: measles, mumps, hepatitis A, hepatitis B, chickenpox, meningitis, pneumonia and Haemophilus influenzae bacteria (which brings on a variety of symptoms, including inflammation of the lining of the brain and deafness). He also developed the first generation of a vaccine against rubella or German measles. The vaccines have virtually vanquished many of the once common childhood diseases in developed countries. Luck played a major role in the discovery of adenoviruses. Dr. Hilleman flew a team to Missouri to collect specimens from troops suffering from influenza. But by the time his team arrived, influenza had died out. Dr. Hilleman, fearing that he would be fired for an expensive useless exercise, seized on his observation of the occurrence of a fresh outbreak of a different disease. His team discovered three new types of adenoviruses among the troops. Shifts can herald a large outbreak or pandemic of influenza, and Dr. Hilleman was the first to detect the shift that caused the 1957 Asian influenza pandemic. He read an article in The New York Times on April 17, 1957, about influenza among infants in Hong Kong -- cases that had escaped detection from the worldwide influenza surveillance systems

[Jonas Salk] favored a killed-virus vaccine, while [Albert Sabin] and most other researchers favored a live-virus version, which produced stronger immunity. But Salk's was safer and could be developed more quickly, giving it an edge in the vaccine competition. In 1949, in the prime of her career, the 38-year-old Morgan left Johns Hopkins to marry and become a homemaker. Had she remained, it's quite possible she would have beaten Jonas Salk to the killed-virus polio vaccine. The next step involved the testing of children, one she never got to take. In remembering the brilliance of Jonas Salk this week, it is wise to recall the help he received -- not the least from Morgan and [Dorothy Horstmann] -- in following his path to conquering polio