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Despite gains in chemotherapy for cancer, some fraction of patients will relapse or fail to respond to treatment. It would, of course, be useful to predict in advance which chemotherapeutic regimens would be unlikely to work and which would have the greatest chance of success. In the case of advanced ovarian cancer, only from 10 to 40 percent of patients may be expected to achieve a complete response, and the outlook for those who fail to respond or who relapse is grim. One method of potential usefulness in the prediction of response to chemotherapy is in vitro testing. This method involves culturing cells from a patient's tumor and then adding chemotherapeutic agents to these cells in the laboratory. It is far from certain, however, that chemotherapeutic agents which work in laboratory dishes will work in the patient as well. In order to evaluate the usefulness of tissue culture in the prediction of chemotherapeutic response, tumor cell cultures from 211 patients with epithelial ovarian cancer were cultured. In 168 patients, the cancers have proved refractory to prior chemotherapy, while in 43 patients no prior chemotherapy had been attempted. Of the 168 patients with prior chemotherapy, sensitivity of the cells to agents in tissue culture could be demonstrated in 23. These patients were treated with the same agents. For 101 patients, either cell cultures could not be successfully established or no sensitivity in culture could be demonstrated. These patients were treated with a chemotherapeutic agent of the physician's choice. The remaining patients were not treated due to either deterioration or death. Among the patients treated with the agents demonstrated to work in tissue culture, the response rate was 28 percent, in contrast to 11 percent for the remainder. However, this response rate did not translate into an improvement in survival, which was a median of 6.7 and 7.0 months for the two groups, respectively. For the patients who had never been treated, only seven cultures could be established, but among these the correlation between in vitro sensitivity and response to treatment was perfect. The results show that the technique shows some promise, but that it is at present severely limited by the difficulty in establishing successful cultures for the majority of patients. (Consumer Summary produced by Reliance Medical Information, Inc.)

When oxalated or resin-decalcified human plasma was adsorbed with barium sulfate, equilibrated with 0.0175M phosphate buffer (pH 6.3), and chromatographed through diethylaminoethyl (DEAE) cellulose, most of the plasma’s fibrinogen emerged from the column and factor XII was detected. No factor VIII was found. A second buffer phase, in which 0.04M phosphate buffer (pH 5.9) was used, removed more protein but not fibrinogen or factor VIII. A third phase, 0.10M phosphate buffer (pH 5.6), produced additional fibrinogen and, unlike the first fibrinogen fraction, factor XIII; but again, no factor VIII. A fourth and final phase, 0.40 to 0.50M phosphate buffer (pH 5.3), removed factors VIII and V, and the eluate contained no fibrinogen. Although separation of fibrinogen into two components required the four-buffer system, maximal yields of factor VIII were achieved by compressing the first three buffer phases into one. Specific activities of about 50-fold, from large volumes of plasma, and 200-fold, from small volumes, were obtained. Refined factor VIII was unstable unless citrate was added to a concentration of 0.4 per cent.

Acquired pure red blood cell aplasia (PRCA) in the adult is frequently associated with thymoma, and in these instances the anemia may respond to thymectomy.1 In about half the patients with PRCA, a thymoma is not present.2 In this latter group of patients, the cause of the anemia is often obscure and recovery is rare.3 The purpose of this communication is to report a patient with PRCA associated with chlorpropamide therapy in high dosage and to review the literature of PRCA associated with drugs. PATIENT SUMMARY A 63-year-old white man who was a heavy-equipment operator consulted his family physician in late July 1967, with complaints of excessive thirst, urinary frequency, and increased appetite. Diabetes mellitus was discovered, and the patient was treated with chlorpropamide, 250 mg daily. This dosage was increased over a three-week period to a level of 1,125 mg daily in late August. On Nov