MHC5 The EuroQol in Parkinson''s Disease Research: Rated Current Health vs. Population-Derived Health State Preferences

The EuroQoL EQ-5D and MOS SF-36 are two generic quality of life measures that differ significantly in their design (the former being an index and the latter a profile). Both have been extensively used in evaluating interventions in acute disease. This study tested their comparative performance in a survey of patients with relapsing-remitting multiple sclerosis (MS).
METHODS: 309 patients with diagnosed relapsing-remitting MS were identified through the records of 5 specialist centers in North West England. Patients were contacted by telephone by a specialist MS nurse and asked to complete a set of questionnaires distributed by mail. The questionnaire booklet reproduced the English version of SF-36, together with the EQ-5D and a self completion form of the Barthel. Minimal additional background information was obtained from all respondents; 4 weeks following their completion of the initial booklet, a second identical booklet was sent to the first 200 initial respondents. Patients in this re-test sub-group were asked whether their health status had improved, deteriorated, or remained unchanged over the intervening period.
RESULTS: Of the 200 patients in the test/re-test subgroup, 144 (72%) replied on both occasions. Paired t-tests for the PCS, MCS, and general health perception scores on the SF-36 failed to generate comprehensive evidence of reliability. The weighted index form of the EQ-5D and the visual analogue scale self-ratings provided superior evidence of reliability. Standardized response means for both measures confirmed this general pattern.
CONCLUSION: EQ-5D performs satisfactorily as a generic measure of health-related quality of life in patients with MS.     

Excretory urography with iohexol: evaluation in children

A multicenter clinical study was conducted using iohexol, a second-generation nonionic contrast medium, for excretory urography performed in 130 children. Doses of iohexol (300 mg iodine/ml) ranged between 150 and 660 mgI/kg (0.5 and 2.2 ml/kg). Iohexol was tolerated well, and no significant adverse reactions occurred. Sixty-five iohexol urograms were evaluated to determine the minimum dose for adequate visualization of the kidneys and collecting systems. A dose greater than 300 mgI/kg (1.0 ml/kg) always resulted in a urogram of diagnostic quality, while visualization was insufficient for diagnosis in 10% of studies done with doses of 150-300 mgI/kg (0.5-1.0 ml/kg). Another 65 iohexol urograms were compared in a blinded manner with a similar number of studies performed using iothalamate meglumine at comparable iodine concentration and dose. Visualization of calyces and pelvoinfundibular structures achieved with iohexol was rated better with statistical significance, but there was no difference in visualization of the renal parenchyma or ureters. Use of iohexol in excretory urography may be advantageous in children who are at greatest risk for an adverse reaction to contrast media or in those most likely to benefit from use of a low osmolality contrast agent.     

Use of combined radionuclide tests in the differential diagnosis of different forms of thyroid cancer

The levels of TSH, T4, T3, calcitonin (CT), PTH, TGA and TG were determined in 96 persons (87 patients and 9 healthy persons) before and after operation; 46 patients had papillary carcinoma, 15 follicular cancer, 24 medullary carcinoma, 2 undifferentiated cancer. There was no common clinicomorphological approach to the studied problem therefore it was impossible to compare the data of different researchers. Radionuclide tests were employed to specify the importance of different methods in clinical practice. Elevated levels of TG, TSH, PTH, T4 and a lowered level of CT were revealed in differentiated thyroid carcinomas; elevated levels of CT, TSH, PTH, T4 and a lowered level of TG were revealed in medullary carcinoma. A decrease in T4 and T3 levels was noted after operations in patients with differentiated thyroid cancers necessitating the use of substitution therapy and thyroid hormones.     

Myocardial tagging in polar coordinates with use of striped tags

Regional deformation abnormalities in the heart wall provide a good indicator of ischemia. Myocardial tagging with magnetic resonance imaging is a new method of assessing heart wall motion during contraction. Current methods of myocardial tagging either do not provide two-dimensional information or lack a coordinate system well adapted to the morphology of the heart. In this article, the authors describe a new tagging method that provides a true polar coordinate system, with both radial and angular dimensions. This is accomplished with use of a section-selective version of spatially modulated magnetization resulting in striped tags (STAGs). These STAG planes are placed in the myocardium in a star pattern so that they intersect on the long axis of the heart and stripes appear through the width of the heart wall. In the short-axis view during contraction, rotation around the long axis yields angular information such as shear and twist, while separation of the stripes within the myocardium permits measurement of radial thickening. Therefore, this method provides a coordinate system for calculating two-dimensional strain that is adapted to the morphology of the left ventricle.     

The ts phenotype of reisolates from children inoculated with live cold-adapted influenza vaccine type A]

Using mutants of fowl plague virus (FRV) which have single temperature-sensitive (ts) mutations in some genes, an analysis was carried out on reisolates from children of 3-6 years, vaccinated with a monovaccine from recombinant strains of influenza type A virus. The recombinants were obtained by crossing of current epidemic strains of subtypes A (HINI) and a (H3N2) with the cold-adapted (XA) ts-donor of attenuation A/Leningrad/134/47/57 (H2N2) from which they, as a rule, inherited 5 ts-mutations in genes 1 (PB2), 2 (PB1), 5 (NP), 7 (M), and 8 (NS). All the reisolates were shown to retain the ts-phenotype. However, in the recombination test some reisolates (most frequently those isolated at late periods of vaccination infection) no ts-mutations could be found in 1-3 genes coding for proteins of the polymerase complex, less frequently for NP and NS proteins but not for M proteins.     

Combination of pulmonary lymphangioleiomyomatosis with skin leiomyomatosis and uterine leiomyoma]

Clinical observation with morphological verification of the above combination in a 48-year-old patient is presented. Large cysts, dystelectasia, fibrosis and smooth muscle proliferation were found in the lungs. The characteristic feature of smooth muscle cells was their differentiation in the direction of myofibroblasts and expression of antigen interacting with HMB-45 antibodies as well as protein products involved in catecholamine metabolism and estrogen receptors.     

The effect of a peptide-containing extract of the right hemispheric cortex on the recovery of conditioned reflex activity and on the level of neuromediators in the brain structures of rats after a unilateral frontal lobectomy

Experiments were conducted on 97 non-inbred [correction of unbred] male rats to study the effect of a peptide-containing extract of the cortex of the right hemisphere of donor rats, who underwent left lobectomy 9 days before the experiment, on restoration of conditioned reflexes of bilateral avoidance and level of neuromediators in the brain structures of recipient rats with a similar damage to the cerebral cortex. It is shown that the brain extract from the right hemisphere of operated on donors has a much higher effect on the restoration of reflexes. At the same time it was found that in left frontal lobectomy this extract produces a most manifest effect on monoamine metabolism in the structures of the right intact hemisphere. It is suggested that a directed effect may possibly be produced on the development of compensatory-restorative process in the central nervous system by endogenous substances of peptide origin which are isolated from brain structures actively contributing to the restoration of disturbed functions.     

The sensitivity and specificity of the immediate-spin crossmatch

The immediate-spin (IS) crossmatch is used to detect ABO incompatibility between donor red cells (RBCs) and the serum of the intended recipient. However, this test may be positive in the absence of ABO incompatibility (false positive) or it may be negative when ABO incompatibility exists (false negative). During a 25-month study, the rates of both false-positive and false-negative IS crossmatch results were evaluated, and the sensitivity and specificity of the IS crossmatch were determined. During the study period, 53,656 IS crossmatches were performed for patients without significant RBC antibodies. Fifty-five patients had positive IS crossmatches, and no false-negative reactions were found. In tests of 55 patients with positive IS crossmatches, 77 false-positive and 5 true-positive reactions were noted. The causes of the false-positive reactions were rouleaux (36 patients), cold-reactive antibodies (8 patients), a combination of rouleaux and cold-reactive antibodies (2 patients), fibrin clot (1 patient), and undetermined (3 patients). The sensitivity and specificity of the IS crossmatch were 100 and 99.86 percent, respectively. Laboratory personnel should be aware that the IS crossmatch may have false-positive or false-negative results, and they should develop written protocols to distinguish quickly between true-positive and false-positive reactions.