TUBULAR PROTEINURIA AFTER PERINATAL HYPOXIA

ABSTRACT. Milt7eacute;nyi, M., Pohlandt, F., Bóka, G. and Kun, E. (2nd Department of Paediatrics, Semmelweis University, Medical School, Budapest, Hungary, and the Section of Neonatology, Centre of Paediatrics, University of Ulm, Federal Republic of Germany). Tubular proteinuria after perinatal hypoxia. Acta Paediatr Scand, 70:399, 1981.–Urinary total protein (UTP) and urinary protein pattern have been studied in 23 newborn infants with Apgar scores ±S3 at one minute or acidosis (pH ±7.15) on the first day. On the first and second day UTP excretion was increased in 13 out of 18 patients. At this time the excretion of low molecular weight microproteins (T-4 and T-5) was elevated in 12 patients without increased plasma urea concentration in any case. The increased excretion of the smallest microproteins T-4/T-5 is an early sign of an impaired tubular function.     

A fatality due to accidental PineSol ingestion

The case history and toxicological findings of a fatal PineSol intoxication are presented. An 89-year-old white female with Alzheimer's disease accidentally drank PineSol and was subsequently brought to the hospital where she was pronounced dead on arrival. Significant autopsy findings included acute erosive gastritis. There appeared to be no aspiration of PineSol into the lungs. Isopropanol along with 1-alpha-terpineol are the two major toxic ingredients of PineSol. The toxicological screening and quantitiation of 1-alpha-terpineol in postmortem fluids was performed by gas chromatography-mass spectrometry using a simple one-step extraction. Postmortem blood, urine, and gastric levels of 1-alpha-terpineol were 11.2 mg/L, 5.76 mg/L, and 15.3 g/L, respectively. Postmortem blood, vitreous humor, urine, and gastric acetone concentrations were 25, 31, 33, and 28 mg/dL. Postmortem concentrations of isopropanol were less than 10 mg/dL in the blood, vitreous humor, urine, and gastric contents. The cause of death was ruled acute 1-alpha-terpineol intoxication due to accidental ingestion of PineSol, presumably caused by confusion related to Alzheimer's disease.     

Subtle gastric abnormalities in a canine model: detection with low-dose imaging with storage phosphors and its equivalence to conventional radiography

The authors compared low-dose (32% of standard exposure) storage phosphor digital imaging (system resolution: 0.2-mm pixels, 10 bits) with isovoltage 75-kVp conventional radiography (standard exposure) in the detection of subtle simulated gastric abnormalities by using air contrast barium studies. Subtle simulated abnormalities (3-7-mm polyps, 4-15-mm ulcer craters, 4-11-mm-diameter edema, and 11-12-mm linear ulcers) were produced in resected canine stomachs. Receiver operating characteristic analysis of 1,800 observations by six readers indicated that the digital images with and without high-frequency edge enhancement were equivalent to conventional radiographs (mean receiver operating characteristic areas [+/- standard deviation]: 0.76 +/- 0.06, 0.78 +/- 0.04, and 0.77 +/- 0.04, respectively). The accuracy of the diagnosis was equivalent for all three modalities. The following mean accuracies of negative and positive responses, respectively, for unenhanced digital, edge-enhanced digital, and conventional images were determined: 0.71 +/- 0.05 and 0.41 +/- 0.07, 0.71 +/- 0.04 and 0.51 +/- 0.09, and 0.68 +/- 0.04 and 0.43 +/- 0.05. It was concluded that low-dose storage phosphor air-contrast barium studies were equivalent to conventional radiography in the detection of subtle gastric abnormalities.     

Stage migration and increasing proportion of favorable‐prognosis metastatic renal cell carcinoma patients

BACKGROUND:

The Memorial Sloan‐Kettering Cancer Center risk model classifies patients with metastatic renal cell carcinoma (RCC) by 5 pretreatment features as favorable, intermediate, and poor risk. The number of Memorial Sloan‐Kettering Cancer Center patients in each risk group was examined by year of treatment to analyze stage migration.

METHODS:

The distribution of risk groups was examined retrospectively in 789 Memorial Sloan‐Kettering Cancer Center patients with metastatic RCC treated in a first‐line therapy clinical trial from 1975 to 2007. Date of treatment onset was divided into 6 cohorts between 1975 and 2007 (1975‐1980, 1981‐1985, 1986‐1990, 1991‐1995, 1996‐2001, and 2001‐2007).

RESULTS:

The median age of the first‐line metastatic RCC clinical trial patients was 59 years (range, 20‐82 years). Most patients received cytokine therapy (55%), 37% received chemotherapy/other, and 8% received vascular endothelial growth factor‐targeted therapies. Overall survival increased with each consecutive cohort year group (P < .001). Median survival was 0.43 years (95% confidence interval [CI], 0.27‐0.68) in the 1973‐1980 cohort and 1.5 years in the 2001‐2007 cohort (95% CI, 1.15‐2.11). Memorial Sloan‐Kettering Cancer Center risk‐group distribution shifted between 1975 and 2007 (P < .0001). The poor‐risk group proportion became smaller (from 44% in 1975‐1980 to 13% in 2001‐2007), whereas the favorable‐risk group increased (from 0% in 1975‐1980 to 49% in 2001‐2007). The intermediate‐risk group remained stable at 50%. After adjusting for type of therapy, the shifts continue to be significant (P < .0001).

CONCLUSIONS:

The risk‐group distribution for metastatic RCC patients in clinical trials shifted from 1975 to 2007. These shifts have direct implications for data analysis, interpretation of metastatic RCC trends, and drug development. Cancer 2010. © 2010 American Cancer Society.     

Coarctation of the aorta

Coarctation of the aorta is a common cardiovascular disorder with an unknown etiology. In the preductal type, blood flows from a patent ductus into the distal aorta. When the coarctation is juxtaductal or postductal, blood flows to the lower extremities by way of the subclavian arteries and collaterals. Plain films may show the reverse sign in postductal coarctation. Arteriography is the gold standard for making the diagnosis. However, magnetic resonance imaging will probably become an increasingly important diagnostic tool. The treatment of choice is surgery, with complete resection of the stenosed segment.