Transient hypertension after percutaneous transluminal renal artery angioplasty

A retrospective analysis of 128 technically successful percutaneous transluminal renal angioplasty (PTRA) procedures was performed. After the procedures, transient systemic hypertension (TSH) developed in 39 patients. The phenomenon usually occurred within 30 minutes of balloon dilation and always within 2 hours of PTRA. TSH lasted less than 5 hours in 35 patients and never persisted for more than 24 hours. TSH is a self-limiting process and should not be confused with the more sustained hypertension that arises from a complication of balloon angioplasty.     

Comparison of media for optimal recovery of<Emphasis Type="Italic">Candida albicans</Emphasis> and<Emphasis Type="Italic">Candida glabrata</Emphasis> from blood culture

Background Candida spp., mainlyCandida albicans, are frequently responsible for complications in immunocompromised patients. There are limited data comparing recovery efficiency using simple non-selective basal broth media. Aim To compare several commercially available basal growth media to determine the medium that gave highest yeast proliferation. Method Eight commercially available non-selective basal broth culture media were evaluated for optimum recovery of clinicalC. albicans andC. glabrata. They included nutrient broth (NB), nutrient broth no. 2 (NB2), Todd-Hewitt (TH) broth, tryptone soya broth (TSB), tryptone soya broth supplemented with yeast extract (0.5% w/v [TSBYE]), brain heart infusion broth supplemented with yeast extract (0.5% w/v [BHIYE]), salt meat broth (SMB) and 0.1% [w/v] peptone saline (PS). Differences in cell density were evaluated by spectrophotometrical analysis. Results TSBYE>BHIYE>TSB>TH>NB2>NB>SMB>PS for the optimum proliferation of cells in vitro. Either TSBYE or BHIYE broth may be employed as suitable basal broth media for growth ofC. albicans andC. glabrata. NB should be considered the least suitable medium for routine use when others are available. Conclusion These data may be of value to laboratories setting up simple blood culture systems to detectCandida spp., particularly in developing and underdeveloped countries.     

Improving access to pharmaceuticals in Brazil and Argentina

The population of many Latin American countries is having increasing difficulty in accessing needed medicines due to the rise in their unitary cost and the growing number of poor in most countries of the region. A number of countries have taken steps to increase access to pharmaceuticals and have had different levels of success. This article reports on two country-wide programmes: the AIDS programme in Brazil, which has been judged as being highly successful, and the Remediar programme that has been implemented recently in Argentina. Both programmes have significantly increased access to needed pharmaceuticals, and Argentina has done it in a record time. In the discussion, we suggest that pharmaceutical interventions are successful when there is a firm political commitment, they are comprehensive, include the participation of civil society, and use a combination of methods to control the rising cost of medicines, including centralized international competitive bidding processes for drug procurement and reliance on multi-source drugs.     

Clinically occult, noncalcified breast cancer: serial radiologic- pathologic correlation in 27 cases

A serial radiographic-pathologic correlation based on specimen radiography was performed on 27 consecutive, clinically occult, noncalcified breast cancers to determine the frequency of and correlation between appearances at mammography, pathologic diagnoses, and the features of the histologic margins. Twenty (74%) of the lesions were infiltrating ductal cancers, five (19%) were intraductal cancers, and two (7%) were medullary cancers. Forty-one percent of these malignancies contained microscopic calcifications. Lesions demonstrated at mammography in these 27 cases consisted of a well-defined round mass (n = 1); well-defined lobulated masses (n = 2); indistinct round, oval, or lobulated masses (n = 7); irregular or mixed lesions (n = 7); spiculated masses (n = 9); and architectural distortion (n = 1). Histologic margins of infiltrating and intraductal cancers, created by several types of tumor-fat interfaces and surrounding reactive fibrosis, correlated with these radiographic appearances. Serial specimen radiographic-pathologic correlation can improve our understanding of the appearance of early breast cancer at mammography.     

Lymphocyte depletion of donor bone marrow by counterflow centrifugal elutriation: results of a phase I clinical trial

We report here the results of a phase I clinical trial using counterflow centrifugal elutriation (CCE) for the removal of donor T lymphocytes before allogeneic bone marrow transplantation (BMT). Thirty- eight patients received lymphocyte-depleted allografts from HLA- identical, MLR-nonreactive sibling donors. The patients entered onto the study were either at high risk on the basis of age (median, 39 years) or disease status (acute leukemia in early relapse [ER], chronic myelogenous leukemia [CML] in accelerated phase [AP], or therapy resistant [RES] lymphoma). All patients received a standard lymphocyte dose of 1 x 10(6) morphologic lymphocytes per kilogram ideal body weight (BW) and were maintained on cyclosporine A (CsA) for 170 days after BMT. Prompt engraftment occurred in 37 of 38 patients with a median time to absolute neutrophil count (ANC) greater than 500/microL of 18 days. Although acute graft-v-host disease (GVHD; clinical stage I or greater) was observed in 45%, it was limited to the skin in all but five patients. Survival was related to disease status at the time of BMT. Among patients with acute leukemia in first or second remission, CML in chronic phase (CP) or lymphoma in partial remission (PR), 64% are currently alive, in contrast to 31% of patients with acute leukemia in third remission or early relapse, CML in second CP or AP, or RES lymphoma. Median follow-up for all patients was 351 days (range, 105 to 711 days). We conclude that this procedure is safe and warrants further evaluation in a randomized efficacy trial.     

吸收度线性组合法测定乳糖干扰下扑尔敏含量

本文通过乳糖干扰下扑尔敏的含量测定,主要探讨及考察了非专属的一般操作误差对方法的正确评价和比较的影响,提出了检查一般操作误差大小的方法,进一步确认了吸收度线性组合法的优越性。同时讨论了吸收度线性组合法的组合精度与组合点数之间的关系,以及主组分吸收度过小对测定精度的影响,考察了吸收度比值在确定组合方式中的重要性。     

The abnormal prostate: MR imaging at 1.5 T with histopathologic correlation

Thirteen patients with biopsy-proved adenocarcinoma were prospectively examined with magnetic resonance (MR) imaging with use of a 1.5-T superconducting magnet. All patients subsequently underwent radical prostatectomy and careful, axial, histologic mapping of prostatic disease. Histologic findings were recorded on serial, axial diagrams to ensure precise pathologic correlation with the MR images. MR permitted identification of eight of 12 (67%) adenocarcinomas as hypointense foci (relative to the surrounding, higher intensity, peripheral zone); but tumor volume was under-estimated with MR imaging in five of eight cases (63%). Nodules of prostatic hyperplasia were identified correctly in only one of nine patients (11%). These findings suggest that, despite that fact that high field strength MR imaging currently does not depict all pathologic foci within the prostate, it may be of predictive value in the differential diagnosis of prostatic abnormalities when their locations are demonstrable.