Direct demonstration of transsynaptic degeneration in the human visual system: a comparison of retrograde and anterograde changes

Transneuronal degeneration of retinal ganglion cells was directly demonstrated in a patient who had unilateral removal of the striate cortex forty years prior to necropsy. For comparison, another case is presented showing anterograde transneuronal atrophy forty years after enucleation of one eye.     

A rapid agglutination assay to detect anti-streptokinase antibodies

Background Streptokinase resistance may cause suboptimal thrombolytic therapy. Aim To develop a rapid latex-bead assay to detect streptokinase antibodies. Methods Sera were obtained from 16 patients presenting with acute myocardial infarction (MI) before treatment with streptokinase and 1 and 6 months post treatment, and from 100 controls. Sera were assayed for anti-streptokinase antibodies using a functional streptokinase-neutralising assay. Results Streptokinase-neutralising activity was low in controls (54±5U/ml) and patients prior to treatment (101±18), increasing to 2,110±823 and 1,017±169 at 1 and 6 months (mean±SEM). The latex assay had a sensitivity of 94% and a specificity of 93% for detecting individuals with >350U/ml of streptokinase resistance, which is sufficient to neutralise the drug clinically. Conclusions Estimation of streptokinase resistance using an enzyme immunoassay and a latex bead assay correlated well with serum neutralising activity. This assay can rapidly identify patients who have a high level of streptokinase-neutralising activity.     

Is drug-induced toxicity a good predictor of response to neo-adjuvant chemotherapy in patients with breast cancer? -A prospective clinical study

Background  

Neo-adjuvant chemotherapy is an integral part of multi-modality approach in the management of locally advanced breast cancer and it is vital to predict the response in order to tailor the regime for a patient. The common final pathway in the tumor cell death is believed to be apoptosis or programmed cell death and chemotherapeutic drugs like other DNA-damaging agents act on rapidly multiplying cells including both the tumor and the normal cells by following the same common final pathway. This could account for both the toxic effects and the response. Absence or decreased apoptosis has been found to be associated with chemo resistance. The change in expression of apoptotic markers (Bcl-2 and Bax proteins) brought about by various chemotherapeutic regimens is being used to identify drug resistance in the tumor cells. A prospective clinical study was conducted to assess whether chemotherapy induced toxic effects could serve as reliable predictors of apoptosis or response to neo-adjuvant chemotherapy in patients with locally advanced breast cancer.     

Clinical manifestations,epidemiology, and laboratory diagnosis of human monocytotropic ehrlichiosis in a commercial laboratory setting

Clinical, epidemiological, and laboratory diagnostic issues of human monocytotropic ehrlichiosis (HME) were investigated in a retrospective case study conducted at a national reference laboratory (Focus Technologies, formerly MRL Reference Laboratory), and at the University of Texas Medical Branch at Galveston, Texas, during 1997 and 1998. Standard questionnaires were sent to physicians for each laboratory-diagnosed patient 2 days to 2 weeks after immunofluorescent antibody assay results were available. Among the 41 cases for which data were obtained, 32 (78%) were definite cases of HME, and 9 (22%) were probable cases of HME. Tick bite or exposure to ticks was recorded in more than 97% of cases. The most prominent clinical findings were fever, abdominal tenderness, and regional lymphadenopathy. There was an association between age and severity of illness. The main laboratory findings included leukopenia, thrombocytopenia, and elevated aspartate aminotransferase and alanine aminotransferase. Clinical and laboratory findings were nonspecific and were not good predictors of the severity of illness. The 90% of patients who received doxycycline treatment underwent rapid clinical improvement with a favorable outcome. The usual duration of effective treatment with doxycycline was 7 to 10 days. This retrospective study is unique because it was based in a commercial reference laboratory setting that receives specimens from different geographic locations. The clinical and laboratory information from 41 patients provides insight into the epidemiological, clinical, and laboratory characteristics of HME.     

Supervivencia a largo plazo con quimioterapia a altas dosis de rescate en pacientes con cáncer de células germinales metastásico. Análisis de los patrones de recidiva

Objective

To evaluate survival and relapse patterns in 13 patients with recurrent, or refractory, germ-cell tumours treated with high-dose chemotherapy (HDC) and with peripheral blood stem-cell support.

Material and methods

All patients were treated in a single centre and received a median of 9 cycles (range 3–13) of cisplatinum-based chemotherapy (CT). The protocol consisted of: a) induction with ifosfamide-based CT (EPI: VP16 120 mg/m², ifosfamide 1.3 g/m², cisplatinum 25 mg/m²×4 days); b) mobilisation of PBSC with of either G-CSF (10 ug/kg/day) in 2 patients or EPI plus G-CSF, and c) HDC (carboplatin 350 mg/m², cyclophosphamide 1500 mg/m², VP16 400 mg/m²×3 days). G-CSF (5 μg/kg) was administered until haematopoietic graft. Median age=32 years (range 20–52); tumours=10/11 testicular (1 seminoma), 2 mediastinal. HDC was administered 21 months (range 6–66) post-diagnosis. Inclusion criteria: failure to achieve CR with conventional CT (n=5 patients), poor-prognosis mediastinal tumour (n=1), first recurrence after cisplatinum and ifosfamide-based CT (n=2) and second or third relapse (n=5). At the conclusion of HDC, 9/13 patients were in CR, 1 patient did not receive HDC because CNS progression but was included for survival analysis.

Results

Median times to graft were 9 and 13 days for leukocytes and platelets, respectively. Non-haematological toxicity was low and no therapy-related deaths occurred. Median disease free and overall survival were 19 and 30 months, respectively. Currently, 2 patients have not relapsed at 36 and 80 months. Previously-affected sites of disease were the unique sites of relapse in 5/11 (50%), concomitant distant relapse in 4/11 patients, CNS metastases in 1 patient. Rescue CT consisted of either oral VP16 or CBDCA/Taxol, which induced a new response in 6/10 patients.

Conclusions

HDC achieves 20% improved survival in patients refractory to conventional chemotherapy and non-resectable tumours. No benefit was observed in HDC treatment in patients having only partial response to conventional chemotherapy. Relapse following HDC occurred mainly at previously affected sites.     

高效液相色谱法测定寒痹停片中士的宁含量

目的：建立用ＨＰＬＣ测定寒痹停片中士的含量的方法。方法：氰基柱;流动相－甲醇－水－三乙胺－乙酸（９８００：１５５：１５：３０）;紫外检测波长２５４ｎｍ。结果：在４～２０ｕｇ／ｍｌ范围内,标准曲线回归方程为：Ｙ＝－２８０３＋８９６７ｘ（ｒ＝０．９９９７）,ＲＳＤ＝１．６５％?加样回收率的平均值为９９．８２％。结论：实验表明,这是一个适用于生产控制和产品质量检验的简单、快速、准确的方法。