Relation to restenosis after percutaneous transluminal coronary angioplasty to vasomotion of the dilated coronary arterial segment

Among 868 patients with successful percutaneous transluminal coronary angioplasty (PTCA), 437 were restudied angiographically and had a provocative test with ergonovine during coronary angiography performed before and 6 months after the procedure. The relation between provoked coronary artery spasm and restenosis was studied and 4 groups of patients were analyzed. Those in group 1 (n = 63) had spasm before and after PTCA and their rate of restenosis was high (55%), especially when spasm after PTCA was observed on the dilated coronary segment (restenosis rate 58%). Patients in group 2 (n = 78) had spasm before PTCA but without abnormal vasoconstriction at 6 months and their incidence of restenosis was 19%. Sixty-one patients in group 3 had no spasm before PTCA but developed spasm at restudy. The rate of restenosis was high (38%) in this group, especially when the spasm after PTCA was located on the dilated segment (43%). In group 4 (n = 235), patients had no spasm before or after PTCA and the restenosis rate was 20%. Thus, the presence of coronary artery spasm on the dilated coronary segment, 6 months after a successful PTCA, is frequently accompanied (43% in group 3 and 58% in group 1) by restenosis.     

Human parvovirus and aplastic crisis in chronic hemolytic anemias: a study of 24 observations

From March 1984 through November 1985, 24 children and adults with aplastic crises were admitted in several Parisian hospitals. Twelve patients had known hemolytic anemia. Aplastic crisis revealed hemolytic anemia in the remaining patients. The detection of human parvovirus antigen was performed by counter-immunoelectrophoresis, and specific IgM antibodies were detected by IgM-antibody-capture-radioimmunoassay, in order to establish the incidence of human parvovirus infection in the genesis of the aplastic crisis. Twenty-one patients had acute infection with human parvovirus. In the three remaining patients, no marker of human parvovirus infection was found. The features of the human parvovirus linked aplastic crisis are described. We consider that human parvovirus infection, and unknown hemolytic anemia, must be systematically researched in any case of unexplained acute aplastic anemia.     

Radio-immunotherapy in low-grade non-Hodgkin's lymphoma

Radiolabelled monoclonal antibodies (MAbs) differ from naked MAbs because they usually use murine antibodies, however, the next generation will use humanised MAb. Currently two compounds have been widely tested and both have been registered in the USA (yttrium-90 ibritumomab tiuxetan (Zevalin; Idec Pharmaceuticals) and iodine-131 tositumomab formerly known as (131)I-anti-B1 (Bexxar; Corixa Corp.)). The first one has recently been registered in Europe. Both MAbs have activity for the treatment of follicular lymphoma (FL) but few studies have been done outside this indication. In FL, they are associated with a higher response rate than rituximab. Their best indication is currently for patients who are refractory to rituximab but studies are running to define other indications.     

CBV-N大剂量化疗和自体外周血干细胞移植治疗复发性霍奇金病1例

患者,女,58岁.因发现右腋下肿块1年余,于1998年10月15日入院.体检:右腋下淋巴结4 cm×4 cm,右锁骨上淋巴结3 cm×4 cm.一般状态分级(PS)0级,无B症状,病理活检为霍奇金病,混合细胞型,CD20+,LCA+.诊断为霍奇金病(混合细胞型).Ann Arbor分期为Ⅱ期,PS为0.当时给予CTOP方案(环磷酰胺加吡南阿霉素加长春新碱加泼尼松)常规化疗6个疗程后缓解.至1999年7月,右腋下淋巴结及右锁骨上淋巴结再次肿大,3 cm×3 cm及2.5 cm×1.5 cm, 诊断为霍奇金病(混合细胞型)复发,Ⅱ期,PS为0.给予CTVP方案(V:长春碱酰胺)常规化疗4个疗程后,淋巴结缩小不明显,遂局部加用放疗3cGY, 此后达第2次缓解.重复上述方案2个疗程后结束.然而至2000年9月发现左腋下淋巴结肿大,诊断为霍奇金病(混合细胞型)第2次复发,Ⅱ期,PS为0.遂决定行大剂量化疗和自体外周血干细胞移植.     

Assessment of a simplified method for counting leukocytic malaria pigment

Severe and fatal malaria is associated with the increased presence of malaria hemozoin in peripheral phagocytes. Large studies of this relationship are hampered by the fact that identifying and counting phagocytes on thick blood smears is time consuming. Distinguishing which mononuclear cells are monocytes and which granulocytes are neutrophils requires time and careful training. In this study, we evaluated a simplified method in which only the proportions of hemozoin-containing mononuclear cells and granulocytes are counted. Thick blood films from 471 Gabonese children with malaria were evaluated. We found a linear relationship and a strong correlation between the proportions of hemozoin-containing monocytes versus mononuclear cells (r = 0.85) and neutrophils versus polymorphonuclear cells (r = 0.93), respectively. The two methods had similar predictive values, as estimated by receiver operating characteristics curves. This simplified method can be used to estimate the amount of extra-erythrocytic pigment in peripheral blood, and we suggest that it may be particularly suitable for very large studies.     

Age, hormones, and cognitive functioning among middle-aged and elderly men: cross-sectional evidence from the Massachusetts Male Aging Study

BACKGROUND: This study examines interrelationships among age, hormones, and cognition for middle-aged and elderly men, and tests whether hormones predict lower cognitive functioning and mediate the age-cognition relationship. METHODS: We analyzed Time 2 data from the Massachusetts Male Aging Study, a population-based cohort study. Selection criteria included complete information on cognition and hormones (n = 981). Cognitive measures included working memory (Backward Digit Span test), speed/attention (Digit Symbol Substitution test), and spatial ability (Figural Relations test). Hormones included free testosterone, total testosterone, dehydroepiandrosterone (DHEA), dehydroepiandrosterone sulfate (DHEAS), androstanediol glucuronide (3 alpha-A-diol-gluc), luteinizing hormone (LH), follicle-stimulating hormone (FSH), sex hormone-binding globulin (alternatively known as a "binding protein") (SHBG), prolactin (PRL), estrone (E1), and cortisol (CRT). Age was measured in years. Adjusted analyses added educational attainment, health conditions and behaviors, body mass index, and depression. RESULTS: Older age was associated with lower cognitive functioning. In unadjusted models, logged free and total testosterone, DHEA, and DHEAS related to higher functioning in at least one cognitive domain; logged FSH, SHBG, and LH related to lower functioning in at least one cognitive domain; and logged E1, CRT, and PRL were not significant. In adjusted models, logged hormones did not relate to cognitive function except for logged E1 and CRT, which had negative effects. Logged hormones did not mediate the age-cognition relationship. CONCLUSIONS: The direct effects of hormones on cognition are not significant when salient factors are considered. Further, hormones do not mediate the age-cognition relationship; it is necessary to look to other explanatory pathways.