Marrow purging in autologous bone marrow transplantation for T-lineage acute lymphoblastic leukemia: efficacy of ex vivo treatment with immunotoxins and 4-hydroperoxycyclophosphamide against fresh leukemic marrow progenitor cells

A lymphoblast progenitor cell assay was used to evaluate the antileukemic efficacy of marrow-purging protocols that employed intact ricin immunotoxins (IT) and 4-hydroperoxycyclophosphamide (4-HC) against clonogenic primary T-lineage marrow blasts freshly obtained from 12 T-lineage acute lymphoblastic leukemia (ALL) patients. Residual T-lineage blast colonies were observed after treatment with 1 micrograms/mL T101 (anti-CD5)-Ricin (R) + G3.7 (anti-CD7)-R in eight of 12 cases and after 100 micrograms/mL 4-HC in six of nine cases. By comparison, a combination of IT and 4-HC proved very effective against T-lineage leukemic progenitor cells, and no residual blast colonies were observed in any of the eight cases studied. We conclude that future trials should consider combined treatment protocols such as IT + 4-HC for more effective purging of autologous marrow grafts.     

蒽环类药对白血病及淋巴瘤患儿的心脏毒性

蒽环类药对白血病及淋巴瘤患儿的心脏毒性翟力平吴吴长根马伴吟陈伟达蒽环类化疗药（包括阿霉素、柔红霉素）引起心脏毒性已经是众所周知，但由于在肿瘤治疗中的重要作用，至今尚无满意的药物可以替代。据认为对儿童心毒性更敏感。如何掌握儿童治疗与心毒性之间的关系，...     

A portable target controlled propofol infusion system

A portable target controlled infusion system for propofol has been developed based on a Psion hand-held microcomputer and the Ohmeda 9000 syringe pump. The system uses a pharmacokinetic model which describes the distribution and elimination of propofol to achieve and maintain any selected target blood concentration. Target blood concentrations of 1 g/ml, 3 g/ml and 5 g/ml were selected in laboratory trials and the cumulative volumes delivered by the Psion system each minute were compared with the theoretical output calculated by the pharmacokinetic model. The results obtained showed that the computer system delivered volumes which were always within 2% of the theoretical values. This system offers a convenient and simple method of maintaining anaesthesia using propofol.     

ON WHICH DAY IS PAIN WORST FOLLOWING ADULT TONSILLECTOMY?

SUMMARY Anecdotal evidence from several ENT departments suggests that pain following tonsillectomy is worst on the second and/or third days after surgery. This study tests this hypothesis. A pilot study with 19 subjects suggested this theory might well be true. A fuller study was then carried out on 91 subjects with standardised surgical and anaesthetic techniques, and standardised analgesia for five days postoperatively. Pain on the second and third postoperative days was compared with that eight hours after the operation and on the first, fourth and fifth postoperative days. No statistically significant difference was found. There is increasing pressure for early discharge from hospital after surgery. If pain following tonsillectomy is not going to become worse at home, this will tend to make early discharge more acceptable to patients.     

A comparison of frequency and sources of nursing job stress perceived by intensive care, hospice and medical-surgical nurses

This study compared the frequency and sources of nursing job stress perceived by 35 intensive care (ICU), 30 hospice and 73 medical-surgical nurses. Analysis of variance revealed no significant differences among the three groups of nurses on the overall frequency of job stress. Post-hoc Tukey tests demonstrated a significant difference in three stress subscales among the three groups. ICU and hospice nurses perceived significantly more stress than medical-surgical nurses related to death and dying; ICU and medical-surgical nurses perceived significantly more stress than hospice nurses related to floating; and medical-surgical nurses perceived significantly more stress than ICU and hospice nurses related to work-overload/staffing. Spearman-Rank Correlation revealed no significant correlations among the three groups in their rank-ordering of the eight stress subscales. Death and dying situations were the most stressful to ICU and hospice nurses, while work-overload/staffing situations were the most stressful to medical-surgical nurses. Results of the study, although not generalizable, have implications for nurse managers.     

DRUGS AFFECTING THE LEUKOTRIENE PATHWAY IN ASTHMA

SUMMARY Drugs affecting the leukotriene pathway are emerging as a new class of asthma treatment — the first for more than 20 years. Development of these leukotriene antagonists should lead to greater understanding of the underlying processes in asthma and may result in a safe, oral, anti-asthmatic drug to benefit particular groups of asthmatic patients.