Neurologic complications after bone marrow transplantation]

The retrospective study presented here reports clinical, electrophysiological and CT-data from 21 patients who underwent bone marrow transplantation for leukemia or aplastic anemia between 1980 and 1985. The aim of the investigation, which was performed at the end of 1986, was to elucidate whether antineoplastic drugs and radiation can result in long-term damage of the central nervous system. In 9 patients we observed neurological signs (1 leukencephalopathy, 5 cerebellar symptoms). Seven patients revealed dysrhythmia in the EEG and five had delayed latencies of visual evoked potentials. Eight patients exhibited pathological changes in CT (3 atrophy of supratentorial structures, 3 periventricular lucencies, 2 a combination of both). The results indicate that long-term damage to the CNS may be encountered after successful bone marrow transplantation.     

Thermal inactivation of32P-poliovirus at 37°C and 50°C in the presence of NaCl with high molarity

Summary Poliovirus labeled with³²P was heated at 37° C and 50° C. At 50° C, inactivation of infectivity is accompanied by an alteration of density and a release of RNA. By heating in the presence of 2 M NaCl, infectivity and physical structure are stabilized, but prolonging the time of incubation infectivity is lost more rapidly than normal density. At 37° C infectivity is inactivated more rapidly than physical integrity is destroyed in the absence of NaCl. In the presence of NaCl physical integrity is stabilized but infectivity is more rapidly inactivated. There seems to be no difference in the action of NaCl per se at both temperatures. Stabilization of infectivity at 50° C and enhancement of inactivation at 37° C by NaCl seem to reflect rather two different mechanisms of thermal inactivation, one operating by physical destruction and another not being dependend on it.Supported by Deutsche Forschungsgemeinschaft (Unit Medizinische Virologie).     

Digital bone densitometry. A routine method for evaluating and monitoring bone mineralization

Digitalized bone densitometry is a simple technique for studying bone mineralization which can be performed during the radiological examination. Digitalized bone densitometry was used to estimate the bone mineral content of the third lumbar vertebra in 30 women and 16 men, the neck of the femur in 27 women and 20 men and the second metacarpal in 27 women and 17 men. The results were compared to the data provided by conventional methods. The appearance of the curves, the index of accuracy and reproducibility of the method suggest that it can be used to detect and monitor bone mineralization of patients for a moderate cost.     

Multidisciplinary treatment of brain metastases derived from clear cell renal cancer incorporating stereotactic radiosurgery

BACKGROUND

Brain metastases are a frequent complication in patients with metastatic clear cell renal cancer. Survival after whole‐brain radiotherapy (WBRT) is disappointing. A retrospective analysis of multimodality treatment was performed in patients who had received linear accelerator (LINAC)‐based stereotactic radiosurgery (SRS).

METHODS

Thirty‐two patients underwent SRS‐based treatment for 71 metastatic foci between 2000 and 2006. All patients had a Karnofsky performance status ≥70 and all 32 patients had extracranial metastatic disease (Radiation Therapy Oncology Group recursive partitioning analysis [RPA] Class 2). Survival was calculated from the time of diagnosis of brain metastases. The minimum potential follow‐up was 1 year after SRS. Univariate and multivariate analysis of potential prognostic factors affecting survival was performed.

RESULTS

Twenty‐six patients required only 1 SRS treatment (84%) to achieve central nervous system (CNS) control, whereas 5 patients received 2 to 3 treatments (16%). The median survival of renal cancer patients from the diagnosis of brain metastases was 10.1 months (95% confidence interval, 6.4‐14.8 months). One‐year and 3‐year survival rates were 43% and 16%, respectively. The addition of surgery or WBRT did not appear to prolong survival. Immunotherapy after control of brain metastases with SRS appeared to result in significantly improved survival. Survival was also found to be strongly influenced by prognostic stratification of metastatic disease using Motzer or modified risk criteria.

CONCLUSIONS

The results of the current study demonstrated that SRS‐based treatment of patients with up to 5 brain metastases from clear cell renal cancer is feasible and results in excellent CNS control. Survival beyond 3 years from the time of diagnosis of brain metastases was achievable in 16% of patients and was associated with the use of systemic immunotherapy with interleukin‐2 and interferon but not antiangiogenic agents. Cancer 2008. © 2008 American Cancer Society.     

Molecular identification and classification of Trichophyton mentagrophytes complex strains isolated from humans and selected animal species

Species differentiation within Trichophyton mentagrophytes complex group currently poses a major diagnostic challenge, with molecular methods increasingly supplementing classical identification based on the morphological and physiological properties of the fungi. Diagnostic and epidemiological research aimed at determining the source and means of transmission of dermatophytoses in both humans and animals requires not only species differentiation of isolates but also differentiation within species. The study was conducted on 24 isolates originating in humans and various animal species with clinical symptoms of dermatophytosis. The analysis included phenotypical identification methods and molecular methods: internal transcribed spacer sequencing and ITS‐restriction fragment length polymorphism (RFLP) with multi‐enzyme restriction. ITS sequence analysis identified the isolates to species – Trichophyton interdigitale, Arthroderma benhamiae and A. vanbreuseghemii, and ITS‐RFLP detected six different genotypes. Genotypes I, II and III characterised strains belonging to A. benhamiae, genotype IV characterised the A. vanbreuseghemii strain, and genotypes V and VI occurred only within the species T. interdigitale. Strains isolated from guinea pigs were dominant within genotype I, while genotype II was found mainly in strains from foxes. Multi‐enzyme restriction analysis of this region enables intraspecific differentiation, which may be useful in epidemiological research, particularly in determining the source of infections.