Serial measurements of serum transaminases in renal transplant recipients with chronic hepatitis C: do they reflect disease severity?

Chronic hepatitis C infection is a common problem in renal allograft recipients, this study was designed to investigate the association of serum aminotransferase levels with liver histology, in renal transplant patients with chronic hepatitis C virus (HCV) infection, in the long term. METHODS: In this study, 82 HCV-infected renal allograft recipients, who were followed up with functioning grafts for at least 6 months, were analyzed. Patients were classified according to their transaminase values as persistently normal, intermittently abnormal, or continuously abnormal liver function tests. Serum transaminase levels exceeding at least 1.5 times the upper limit of normal (40 IU) for periods longer than 1 month were taken as abnormal. Patients with abnormal liver function tests owing to HCV unrelated causes (drugs, alcohol, or other toxic substances, other viruses, etc.) were excluded from the study. Forty-eight of these patients underwent at least one liver biopsy. RESULTS: Of the 82 patients, 34 (41.5%) had persistently normal (liver biopsy revealed normal or minimal changes in 77.0%, chronic persistent hepatitis in 15.3%, chronic active hepatitis in 7.7%; no patient had cirrhosis), 29 (35.3%) intermittently abnormal (liver histology was consistent with minimal changes in 50%, chronic persistent hepatitis in 27.8%, chronic active hepatitis in 16.7%, cirrhosis in 5.5%), 19 (23.2%) persistently abnormal (liver biopsy showed minimal changes in 41.1%, chronic persistent hepatitis in 17.6%, chronic active hepatitis in 35.3%, cirrhosis in 5.9%) transaminase values. CONCLUSION: Although continuously or intermittently elevated transaminases do not always indicate morphologically advanced disease, the normal course of serum transaminases is mostly accompanied by normal, or near-normal, liver histology, in HCV-infected renal transplant patients. Liver biopsy is not indicated in deciding disease severity in these patients unless clinical findings dictate otherwise.     

Left ventricular free wall rupture during coronary intervention after acute myocardial infarction: Report of two cases exhibiting fatal pseudocomplications

Two cases of left ventricular free wall rupture occurring in temporal relation to interventional coronary procedures are presented as autopsy-verified pseudocomplications. The possible impact of pseudocomplications on operator-specific registry data and credentialing is briefly discussed. Cathet. Cardiovasc. Intervent. 47:67–72, 1999. © 1999 Wiley-Liss, Inc.     

Prognostic factors in resected T3 non-small cell lung carcinoma: perineural invasion as a new prognostic factor

BACKGROUND: Currently the best prognostic indicator for resected non-small cell lung cancer (NSCLC) is the TNM stage. Moreover, certain histopathological properties of the tumor (such as lymphatic, vascular and perineural invasion) can help to predict the survival of the patients. PATIENTS AND METHODS: Between 1997 and 2004, the results of surgical treatment were retrospectively analyzed for 153 patients with T3 non-small cell lung cancer. One hundred and twenty-four of them had had complete (R0) resections, and 29 had had incomplete (R1) resections. The prognostic factors evaluated by univariate and multivariate analysis were: type of resection; N status; subgroup of pT3; effect of adjuvant therapy; tumor size; histological type; tumor differentiation; lymphatic invasion; vascular invasion; and perineural invasion. RESULTS: The overall 5-year survival rate was 32 % in R0 patients, and 8 % in R1 patients ( P = 0.0002). The presence of N2 disease, vascular invasion, and perineural invasion were found to be significant prognostic indicators in univariate analysis ( P = 0.0058, P = 0.033, and P = 0.0058, respectively). Among these indicators, N2 disease and perineural invasion were also found to be significant prognostic factors in multivariate analyses ( P = 0.013, and P = 0.003, respectively). CONCLUSIONS: Incomplete resection, N2 disease, vascular and perineural invasion were found to be prognostic indicators for the survival of T3 NSCLC patients. Of these indicators, perineural invasion was found to be the strongest predictor of poor prognosis and independently affected the patients' survival.     

Zur psychischen Verarbeitung der Ultraschalldiagnose einer schweren fetalen Mißbildung

Ohne Zusammenfassung     

Plasmacytoma of the hard palate

Multiple myeloma is a systemic malignant disease and is associated with a poor prognosis. It is characterized by neoplastic proliferation of plasma cells involved in the production and secretion of monoclonal immunoglobulins (M proteins). It is generally a disseminated disease involving many bones. Systemic symptoms include bone pain, pathologic fracture, renal failure, hypercalcemia, weight loss, anemia, thrombocytopenia, and neutropenia. This condition may occur as a solitary lesion (solitary plasmacytoma), which in some patients eventually progresses to plasma cell myeloma. Extramedullary plasmacytoma is defined as neoplastic proliferation of plasma cells in the soft tissue. It usually occurs in the upper respiratory tract, such as the nasal cavity or posterior oropharynx. The authors present a rare plasmacytoma case with maxilla involvement.     

A Case of Tubulointerstitial Nephritis and Uveitis in an Adult Male

We report a case of tubulointerstitial nephritis and uveitis (TINU) syndrome in an adult male. A 40-year-old man was found to have bilateral anterior uveitis and mild renal insufficiency with high urinary β-2 microglobulin. Work up for connective tissue and infectious diseases were negative. His kidney function normalized spontaneously and remained normal at 1 year without intervention. Uveitis responded completely to local corticosteroid treatment and has not recurred.     

Plasmapheresis in the treatment of hyperthyroidism associated with agranulocytosis: A case report

Plasmapheresis, also known as therapeutic plasma exchange, is used in the treatment of several disorders. Temporary improvement after plasmapheresis in cases with thyrotoxicosis has been reported. A 55-year-old woman presented with agranulocytosis induced by propylthiouracil and clinical signs of heart failure. Three sessions of plasmapheresis were performed. We observed an improvement of thyroid hormone levels and clinical findings as well. Plasmapheresis can be an option when drug treatment of thyrotoxicosis fails.     

Identification and characterization of an androgen-responsive gene encoding an aci-reductone dioxygenase-like protein in the rat prostate

The ALP1 [aci-reductone dioxygenase (ARD)-like protein 1] gene was identified in a comprehensive cDNA subtraction aimed at identifying genes regulated by androgens in the rat ventral prostate. ALP1 is homologous to the ARD/ARD' that were discovered in Klebsiella pneumoniae as enzymes that have the same polypeptide sequence and differ only in their metal content. This family of proteins is evolutionarily conserved from bacteria to humans and is involved in the methionine salvage pathway. Northern and Western blot confirmed the regulation of ALP1 by androgens in the rat ventral prostate. ALP1 mRNA is expressed in a variety of tissues; however, its regulation by androgens was specific to the prostate. ALP1 is expressed by the glandular epithelial cells of the rat prostate, with little or no expression in the stromal cells. ALP1 is down-regulated in the different rat Dunning tumor cell lines compared with the normal or castrated rat prostate. Expression studies showed that ALP1 overexpression is not tolerated by AT6.1 cells. Further studies demonstrated that ALP1 is also down-regulated in the human prostate cancer cell lines LNCaP, PC3, and DU145, and overexpression induces cell death in these cells. Taken together, our observations suggest that ALP1 may have an important role in androgen regulated prostate homeostasis as well as in prostate cancer progression by regulating cell death of prostate cancer cells.