Revisiting the prognostic role of gallium scintigraphy in low-grade Non-Hodgkin’s lymphoma

The purpose of this study was threefold: to evaluate the role of gallium-67 scintigraphy in the staging of low-grade non-Hodgkin’s lymphomas (LGNHL), to assess the relationship between the expression of CD71 on the surface of the neoplastic cells and the ⁶⁷Ga uptake by the tumour, and to establish the contribution of ⁶⁷Ga scan in defining the prognosis of LGNHL. Forty-eight patients with untreated LGNHL diagnosed in a single institution over a decade were reviewed. The end point of the study was survival of the patients according to the scintigraphic ⁶⁷Ga score at diagnosis. In addition to ⁶⁷Ga scan, other prognostic variables were studied, relating to the neoplastic burden, the biology of the tumour and the host. Univariate and multivariate analyses were used. ⁶⁷Ga scan identified only 116/286 (41%) nodes involved by lymphoma that were detected by clinical examination or computed tomography scan. A scintigraphic scoring system with an arbitrary cut-off value of 3 (high scan score) was able to predict patients with a dismal prognosis: with a mean follow-up of 47 months (range: 1–146 months) the median survival time was 28 months in patients with a high scan score and 74 months in patients with a low scan score (P=0.002). CD71 values were 27.4%±14.9% (mean ±SD) in the former and 8.9%±7.2% in the latter (P=0.0001). Only performance status and extranodal sites were significant variables for prognosis in multivariate analysis. It is concluded that ⁶⁷Ga scan is inaccurate in staging but might be very important in defining the prognosis in LGNHL, in association with other prognostic variables. Received 1 May and in revised form 6 August 1997     

Effect of testosterone on bone in hypogonadal males.

Bone mineral content (BMC) and testosterone levels were evaluated and compared in 10 hypogonadal males and 10 normal, age-matched controls. In 6 of the subjects an investigation was also carried out into the effects of testosterone administration on lumbar BMC, calcitonin (CT) response to hypercalcaemia, osteocalcin (BGP) and the fasting urinary calcium/creatinine and hydroxyproline/creatinine ratios. Our results confirm that male hypogonadism is characterized by a low BMC and that testosterone administration is able to improve this parameter and to increase both basal BGP and CT response to hypercalcaemia. Testosterone therefore probably acts on bone tissue through both a direct action on osteoblast cells and an improvement in CT secretion.     

Hypermetabolic response after hypothermic cardiopulmonary bypass

Sixteen patients undergoing hypothermic cardiopulmonary bypass for open heart surgery were studied prospectively. Oxygen consumption and CO2 production showed a marked increase during the first 6 h postoperatively. Consequently, the measured resting energy expenditure was markedly elevated compared to the predicted energy expenditure. This hypermetabolic response occurred simultaneously with maximum spontaneous rewarming after the end of surgical procedures. Ventricular function was low throughout the postoperative period, and no cardiac response to increased energy requirements was recorded. On the contrary, marked increases in arteriovenous oxygen and CO2 difference were observed during the period of highest resting energy expenditure. We conclude that the first hours after hypothermic cardiopulmonary bypass represent the period of highest risk for decompensation. The continuous monitoring of CO2 production is suggested as a useful clinical method to detect postoperative changes in metabolic rate.     

Non-invasive treatment for retained common bile duct stones in patients with T tube in situ: saline washout after intravenous ceruletide

The combination of ceruletide-induced relaxation of the sphincter of Oddi plus flushing with saline has recently been proposed as a novel procedure for the treatment of residual common bile duct (CBD) stones. In this study we have administered intravenous ceruletide (2 ng kg-1 body weight min-1 for 1 h) plus intraductal saline (800-3000 ml, infused at a rate that kept biliary pressure below 30 cmH2O) to a group of 14 patients. The treatment induced the passage of residual stones in 11 subjects (79 per cent) with complete clearance in 7 (50 per cent). The majority of the cleared concretions (11/15) had a diameter less than 10 mm. No severe side-effects were recorded during the treatment. Four of the seven subjects who exhibited incomplete CBD clearance underwent a short cycle of mono-octanoin administration in order to reduce the size of residual radiolucent stones. This course of treatment was followed by another attempt with intravenous ceruletide and saline washout which gave a successful response in an additional three cases. These data indicate that the combination of ceruletide and flushing is a safe and inexpensive method for treatment of residual stones. The procedure is feasible for both radiolucent and radio-opaque stones and is mainly eligible for small concretions of diameter less than 10 mm. Larger (greater than 10 mm) radiolucent stones may be partially dissolved with mono-octanoin and then eliminated by the washout technique.     

肝脏缺血再灌注损伤大鼠嘌呤核苷磷酸酶活性的研究

目的:探讨大鼠肝脏低温保存及常温缺血再灌注过程中,不同保存液中嘌呤核苷磷酸酶(PNP)活性的变化.方法:将大鼠肝脏在3种不同保存液中低温保存不同时限后,用37℃Krebs-Henseleit液连续循环灌注90min,分别于不同灌注时间检测灌洗液中PNP活性的变化.结果:经过8 h的低温保存,再灌注90min后,HTK保存的肝脏中PNP明显高于UW和Celsior;经过16 h的低温保存后,再灌注60min前,HTK保存的肝脏中PNP明显高于UW和Celsior;60min后HTK和Celsior保存的肝脏中PNP明显高于UW;经过24 h的低温保存后,再灌注15min后,HTK保存的肝脏中PNP明显高于Celsior,而Celsior又明显高于UW.结论:随着低温保存和再灌注时间的延长,大鼠肝脏中PNP逐渐增高且UW液的保存效果明显优于HTK和Celsior     

快速杂交法定量检测HBV DNA及临床应用

目的：介绍一种快速定量检测HBV DNA的方法及临床初步应用。方法：对40例乙型肝炎病毒表面抗原阳性的慢性乙型肝炎患者共79份血清标本，采用Digene第二代杂交捕获试验(Hybrid Capture Ⅱ,HCⅡ,v2.0)定量检测HBV DNA，并与分枝链DNA信号扩增试验(bDNA，v1.0)作比较。结果：79份HBsAg阳性血清中，HCⅡ检出HBV DNA57份(72．2％)，bDNA法为45份(57％)，HCⅡ敏感性略高于bDNA法；2种方法定量检测HBV DNA的符合率为85.9％，相关性良好(r＝0．95)；19例抗病毒治疗乙肝患者，治疗后平均HBV DNA载量下降2(Log10)数量级，6例发生e抗原血清转换的患者平均HBV DNA载量下降3(Log10)数量级以上，且HBV DNA阴转早于e抗原血清转换。结论：HCⅡ比bDNA更为简便、经济、快速，可用于临床HBV DNA水平的定量检测、监控及抗病毒药物的筛选、考核。     

Inhibitory action of quercetin on intestinal transit in mice

The effects of quercetin have been investigated on the gastrointestinal propulsion of charcoal meal in mice. Quercetin reduced the rate of intestinal transit and this effect was potentiated by verapamil.