No abstract

Apnea was elicited by the application of chemical stimuli to the laryngeal region of 25 piglets from 1 to 70 days of age. Animals were tested under normoxic and hypoxic (Flo2 10%) conditions with water and solutions of graded acid and salt concentration. The chemoreflex was found to diminish with postnatal age. Fatal apneic episodes were confined to animals less than 3 weeks of age. Hypoxia consistently augmented the reflex, and in some cases elicited fatal apnea in animals that had survived similar stimulation under normoxic conditions. A direct relationship was also found between the strength of stimulus and respiratory response. Apnea increased with diminishing NaCl concentration or pH. The reflex was abolished by bilateral section of the superior laryngeal nerves. Fatal apnea elicited by laryngeal chemo-stimulation under the circumstance of hypoxia may provide further insight into the enigma of sudden infant death.

No abstract

A prospective randomized study was conducted to determine the relative effectiveness, toxicity and tolerance of methotrexate (MTX) versus cisplatin (DDP) in patients with recurrent head and neck squamous cell carcinoma. Forty‐four patients were randomized to receive either MTX, 40 mg escalated to 60 mg/m2 IV push weekly, or DDP, 50 mg/m2 6 hour infusion days 1 and 8 every 4 weeks. All patients had objectively measurable disease and a performance status greater than 60% (Karnofsky scale). All had been treated with surgery and/or radiotherapy. No patients had prior chemotherapy. Prior treatment, performance status, and site of primary disease were comparable in both groups. Complete and partial objective responses were achieved in 23.5% of the MTX group and 28.6% of the DDP group (P = 0.51). Median duration of response was 84 days in the MTX group and 92 days in the DDP group. Median survival of patients was 6.1 months with MTX and 6.3 months with DDP. Mucositis was noted in 38% of patients in the MTX group (P = 0.001) compared to none in the DDP group. Vomiting occurred in 87% of patients in the DDP group (P < .0001) compared to 10% of patients in the MTX group. This study demonstrates that in the treatment of recurrent head and neck squamous cell carcinoma, MTX and DDP are equally effective, although MTX appears to be better tolerated. Cancer 52:206‐210, 1983.