Manidipine: A different dihydropyridine

Blood pressure (BP) plays an important role in the development and progression of cardiovascular disease. Moreover, hypertensive patients often have additional cardiovascular risk factors. Despite the abundance of antihypertensive drug categories, satisfactory BP regulation is often difficult to achieve. A major cause of this difficulty to properly manage BP is the less than optimal adherence of subjects to treatment. This is often due to the various adverse effects of the antihypertensive drugs. Calcium channel blockers (CCB) have an established efficacy for reducing BP. However, their side effect of peripheral edema is often a cause for the discontinuation of treatment. Manidipine holds some unique properties differentiating it from the rest of the CCB class. It has a better safety profile with a lower incidence of peripheral edema. Moreover, there are indications that manidipine holds additional beneficial attributes, such as improvement of renal function and decrease of insulin resistance.     

A comparison of four different HRQoL generic questionnaire in five different patient groups

Most of musculoskeletal diseases involve pain and reduced physical functioning. Recognition of the coexistence of more than one musculoskeletal disease is important because they are relatively common and has a substantial impact on health-related quality of life (HRQoL). Our aim was to compare the results of four generic QoL questionnaires—QoL-5, Nottingham Health Profile (NHP), Short Form (SF)-6D, and Visual Analogue Scale (VAS)—in five different patient groups. Two hundred and one patients representing five different disease groups (knee osteoarthritis, osteoporosis, back pain, rheumatoid arthritis and ankylosing spondylitis), randomly selected through the Ankara Numune Education and Research Hospital Physical Medicine and Rehabilitation Outpatient Clinic, were included in the study. Scores indicating low QoL for each of the five diseases compared are reported. Patients in each disease group stated high disability. No strong correlation between any of the scales could be determined, and NHP was identified as the only scale able to differentiate between the diseases. Many instruments are available for measuring HRQoL. The QoL-5, NHP, SF-6D, and VAS are four commonly used generic (i.e., not disease-specific) measures for quantifying HRQoL in patients with musculoskeletal disorders. Most studies have focused on only one musculoskeletal disease, but comorbidity of musculoskeletal disorders is common. We emphasize in this study the effect of multiple musculoskeletal diseases on HRQoL.     

A different sort of Mott cell.

NYC is a B lymphoma cell line derived from B/W mice. Upon fusion of NYC cells with a plasmacytoma, which itself produces no immunoglobulin, the resulting NYCH hybridoma cells are Mott cells; i.e., they contain large intracellular vesicles filled with immunoglobulin, the so-called Russell bodies. When NYCH.kappa, a variant of NYCH that had lost the ability to produce heavy chain, was transfected with a heavy-chain construct, this concentration of immunoglobulin in the intracellular vesicles occurred only when the transfected immunoglobulin heavy chain had the same variable region as NYC. Moreover, unlike conventional Mott cells, the hybrid cells secrete immunoglobulin at a normal rate.     

A different intracardiac mass: retained sponge

We report a case involving a surgical sponge retained following an aortic valve replacement. The surgical sponge was placed into the left ventricle to protect calcified debris from falling down into the left ventricular cavity. However, the sponge was forgotten and left inside the patient. We identified the retained surgical sponge by transesophageal echocardiography, which was performed because of a difficulty in weaning the patient from the cardiopulmonary bypass.     

Supraventricular aortic stenosis. A different surgical approach

A 15-year old female with William's syndrome became symptomatic for congenital supravalvular aortic stenosis. Surgery was carried out using an unpublished technique which consisted in a symmetrical enlargement of the aortic root by inserting three triangular patches of autologous pericardium. This method has the advantage of restoring normal valvular competence while respecting coronary orifices .     

A comparison of different methods for diagnosing acromegaly

OBJECTIVEThe present study was designed to assess the diagnostic value of different single measurements in comparison to the classic time-consuming method, the oral glucose tolerance test (OGTT), in acromegaly. DESIGN, PATIENTS AND MEASUREMENTS IGF-I, free IGF-I, 24-hour-urinary GH (uGH), serum IGFBP-3 and 24-hour-urinary IGFBP-3 (uIGFBP-3) were measured in 12 patients with untreated active acromegaly, in 29 patients who had been treated but were not cured, in 13 patients with cured acromegaly and in 14 healthy control subjects, and compared with the results of the OGTT. RESULTSIn all patients with active acromegaly, whether they had been treated or not, nadir GH in OGTT was >3 mU/I, whereas nadir GH was <1.88 mU/I in the cured patients and the control subjects. In patients with untreated active acromegaly IGF-I, free IGF-I, uGH and IGFBP-3, but not uIGFBP-3, were significantly higher than in healthy individuals (P<0.0001). Only IGF-I values did not overlap with the control group. In those patients with acromegaly who had been treated but not cured these parameters overlapped with the control group. In patients with acromegaly there was a significant correlation between nadir GH levels in OGTT and IGF-I (r=0.71), free IGF-I (r=0.76, IGFBP-3 (t=0.73) and uGH (r=0.81) (P<0.0001), but no correlation with uIGFBP-3. CONCLUSIONSOnly be means of the OGTT could patients with active acromegaly be completely distinguished from the control subjects and from cured patients. IGF-I, free IGF-I, IGFBP-3 and uGH were useful in the diagnosis of acromegaly, but of limited value in the follow-up of acromegalic patients after treatment. The determination of free IGF-I, which has yet not been investigated in acromegaly, offered no advantage over that of total IGF-I and IGFBP-3; uIGFBP-3 was not useful in the diagnosis of acromegaly.     

Collateralized chronic total occlusion: A different animal

This report describes a patient with a chronically occluded proximal LAD in whom antegrade flow was not re-established by successful dilatation alone. Obliteration of retrograde collateral flow restored antegrade flow. This case demonstrates the potential detrimental effect of vigorous collateral flow on the patency of chronic occlusions after successful PTCA. © 1993 Wiley-Liss, Inc.     

不同基因型地中海贫血患儿伴铁缺乏的研究

目的 :了解不同基因型地中海贫血 (地贫 )患儿并发铁缺乏的发生率。方法 :对 2 33例临床诊断为地中海贫血的患儿进行点阵列杂交技术基因分析和铁指标检测。结果 :2 33例患儿中并发缺铁的有 5 9例(2 5 .3% ) ;30例α 地贫并发缺铁 9例 (30 % ) ,2 0 3例 β 地贫并发缺铁 5 0例 (2 4 .6 % ) ,差异无统计学意义 (P >0 .2 5 )。HbH病患儿中 ,基因缺失型的缺铁发生率为 33.3% (5 / 15 ) ,非缺失型的缺铁发生率为 12 .5 % (1/ 8) ,前者高于后者 ,但差异无统计学意义 (P >0 .10 )。双重杂合子 β 地贫无缺铁病例 ,而杂合子 β 地贫铁缺乏率为2 6 .7% (5 0 / 16 5 ) ,两者差异有统计学意义 (P <0 .0 1)。结论 :本文发现地贫患儿可并发铁缺乏 ,尤其是杂合子 β 地贫及除非缺失型HbH病外的α 地贫患儿的铁缺乏发生率较高。因此有必要对其进行适当治疗。     

A family inheriting different subtypes of acute myelogenous leukemia

Rare inherited cancer syndromes have proven invaluable for the identification of genes involved in the more frequent corresponding noninherited cases. We report on a family with an adult onset, incompletely penetrant, autosomal dominant syndrome of myelodysplasia and acute myelogenous leukemia, affecting at least eight, and probably ten, individuals from three generations. The patients have developed leukemias differing in morphologic subtype, tumor cytogenetics, and abruptness of presentation. Some have presented with acute onset and others with protracted myelodysplasia. This family does not have an unusual incidence of other malignancies; however, one person at 50% risk of inheriting this gene developed atypical mycobacterium infection in the absence of leukemia, but also without appreciable risk factors for acquired deficiencies in cellular immunity. Features common to affected family members, including the individual with mycobacterium infection, are the early presence in the bone marrow of red cell and platelet maturation defects. A search for mutations in diseased marrows fails to detect abnormalities of p53 or N-ras. Two of the affected family members, third degree relatives, have co-inherited a constitutional chromosomal banding variation of 9p21–22, potentially suggesting linkage to this locus. The variable penetrance and expressivity of this syndrome support a multistep model of leukemia evolution, in which the gene defined by this family's syndrome is the signal step. © 1996 Wiley-Liss, Inc.