Purging murine leukemic marrow with alkyl-lysophospholipids

Autologous bone marrow transplantation is potentially curative in the treatment of acute leukemia if residual leukemic cells in the marrow can be eliminated prior to transplantation. We studied the purging effects of a synthetic alkyl-lysophospholipid (ALP) on marrow containing leukemic cells from a transplantable myelomonocytic leukemia (WEHI-3B) in BALB/c mice. Simulated remission bone marrow containing 2% leukemic cells treated in vitro with 20 and 100 micrograms/mL of ET-18- OCH3 (1-octadecyl-2-methyl-sn-glycerol-3-phosphocholine) significantly prolonged survival of lethally irradiated transplanted recipients. At a dose of 100 micrograms/mL, 88% of the mice survived for the duration of the experiment (approximately five months). Autopsies showed that 25% of these survivors had microscopic evidence of leukemia. Thus, in vitro treatment of marrow eliminated leukemic blasts and spared sufficient normal stem cells to allow hematologic reconstitution. The effect of ET- 18-OCH3 is not entirely selective for leukemic cells. A spleen colony assay showed that ALP has some cytotoxic effect on normal hematopoietic stem cells.     

亮菌甲素速溶片剂的研制及其利胆作用研究

试制出亮菌甲素速溶片剂(A),并以市售品亮菌甲素片剂(B)、亮菌甲素粉针(C)等作对照,考察了它们对大鼠体内胆汁分泌作用的影响,并测定了A和B的体外溶出速率。结果表明,A片剂比B片剂明显地增强了利胆作用,A片的体外溶出速率也较B片为快。     

Musculoskeletal tumors: improved depiction with linear combinations of MR images

With postprocessing, the authors produced a single hybrid image that combines the complementary information in conventional T1- and T2-weighted magnetic resonance (MR) images. A 1-T MR imager was used to produce T1- and T2-weighted images (repetition time, msec/echo time, msec: 500/30, 1,500/120) of patients with various primary bone tumors. Various weighted sums and differences of these images were then formed. Weighted subtraction allowed formation of hybrid images with high contrast between tumor and all adjacent normal tissues (muscle, fat, bone marrow), unlike the original T1- and T2-weighted images. Certain weighted sums of the acquired images simultaneously display the high signal-to-noise and clear anatomic detail of the T1-weighted technique along with the high contrast between extraosseous tumor and muscle of the T2-weighted image. A single hybrid MR image can contain useful characteristics both of T1- and T2-weighted images, making it easier for one to detect the extent of an abnormality.     

Regression of mediastinal Hodgkin disease after therapy: evaluation of time interval

Ninety-one patients with Hodgkin disease of the upper torso who had mediastinal masses were studied to determine the frequency of residual mass and the time required for resolution or stabilization of the mass. In 72 of these patients, radiographs from sufficient intervals were available for determination of the rate of regression. In 62 patients (86%), the mediastinum returned to normal width within 11 months, regardless of the size of the mass. The mediastinum returned to normal in all but one patient with small masses. The intrathoracic relapse rate did not correlate with the regression time of the masses, but relapse occurred more than twice as often in patients with residual mediastinal widening.     

卒中一级预防指南的执行摘要

卒中仍然是一个重要的医疗问题,所带来的人力和经济代价是惊人的。美国每年约79．5万人发生卒中,其中约61万为首次发作,现在美国有640万卒中后存活患者。     

Hemoglobin M equon beta 41 (C7) phenylalanine leads to tyrosine

A severe hemolytic crisis was observed in a 34-yr-old female of English- Irish extraction following a viral illness treated with acetaminophen. Heinz bodies and heat instability were present only during a transient hemolytic event. A challenge dose of acetaminophen caused no detectable hematologic abnormality. Structural studies of the hemoglobin during hemolysis and again after complete recovery localized the abnormality to tryptic peptide beta Tp-5, and automated sequencing of I 125-labeled beta chains indicated a replacement of phenylalanine (C7) beta 41 by tyrosine. Substitution of the next residue, phenylalanine (CD1) beta 42 by serine (Hb Hammersmith), has resulted in chronic severe Heinz body hemolytic anemia. The lack of chronic anemia in the present disorder may reflect the different relationships of beta41 and beta 42 and/or the similarities in volume and hydrophobicity of tyrosine and phenylalanine. It is suggested that substitution of tyrosine for phenylalanine in Hb Mequon may disturb the critical environment around the heme group and render it susceptible to oxidative denaturation in the presence of infections and/or drugs.     

Salmonella enteritidis orchitis in a 10–week-old boy

Extraintestinal manifestations of salmonellosis in paediatric patients are found predominantly in infants less than three months of age. Genital involvement is a rare complication. We present a short review of the literature and describe the case of a 10–week-old boy suffering from severe diarrhoea, who presented with a swelling of the right testicle after six days of illness. He underwent surgery on suspicion of testicular torsion, whereby orchitis was diagnosed. Salmonella enteritidis was cultured from the intraoperative swab. All cultures from blood, CSF and urine remained sterile. We conclude that orchitis must be taken into consideration as an extraintestinal complication of enteric salmonellosis and as a differential diagnosis of tcsticular torsion. In addition, we wish to emphasize that any infant less than three months of age with suspected or proven salmonellosis, should receive early antibiotic treatment.     

Postoperative pain treatment on wards – USA experience

A large variety of treatment options are now available to experienced pain therapists. Effective doses of opioids can be administered by the oral, rectal, transdermal, or sublingual route, or by subcutaneous, intramuscular, or intravenous injection or infusion. Patient–controlled analgesia (PCA) is now familiar and commonly available. Most PCA pumps also offer the option to add a continuous background infusion to the basic patinet–controlled mode with the possibility of therapeutic benefits and new problems. Alternative delivery routes and PCA drugs have been reported.
A variety of neural blockade techniques can provide effective and safe analgesia. These include topical application, local infiltration of incicions, and blockade of peripheral nerves or plexuses. Intrathecal and epidural opioids are now commonly used to control pain following a wide variety of surgical procedures, but many questions remain to be answered.
The concept of postoperative pain management by anesthesiologists is growing in popularity in North America. It is not surprising that such a revolutionaryidea involving basic changes in long–established practices is receiving attention not only from clinicians, but also from economists and politicians. One manifestation of this attention in the United States is a clinical practice guideline entitled Acute Pain Management: Operative or Medical Procedures and Trauma. Important elements of the guideline include recognition of historic inadequacies in postoperative pain management and acknowledgement of the importance of effective pain control.