Radioimmunoassay and chromatographic characterisation of CRF-41-like immunoreactivity in hypothalami from several species

We have developed a sensitive and specific radioimmunoassay (RIA) for the 41-residue ovine corticotropin releasing factor (CRF), employing direct radioiodination of the non-tyrosine containing synthetic peptide. Two different antisera are described, both raised against synthetic CRF conjugated to bovine thyroglobulin. With these RIA's, CRF-like immunoreactivity (CRF-LI) which eluted in the same position as synthetic ovine CRF on Sephadex G-50 was detected in ovine, bovine and rat stalk median eminence (SME). An additional, later-eluting peak of CRF-LI was found only in rat hypothalamic extracts. CRF-LI could also be detected in the void region of the chromatograms in all three species.     

Imipenem/cilastatin in the treatment of severe nosocomial pneumonia

Imipenem/cilastatin (Tienam 500; Logos) 1 g, administered intravenously every 8 hours, was evaluated in an open clinical trial in 35 patients with severe nosocomial pneumonia. In 84.4% of cases there was a favourable clinical response; microbiological success was achieved in 63.3% and partial success in 20% of patients. The majority of Gram-negative and Gram positive organisms were sensitive to imipenem, including those resistant to the aminoglycosides. Although colonisation was frequent, superinfection was uncommon. Imipenem was well tolerated in these critically ill patients, many of whom had renal and other organ failure. The wide spectrum of antimicrobial activity and minimal side-effects made it a useful agent in patients with severe nosocomial pneumonia.     

Posterior Rotator Cuff Strengthening Using Theraband® in a Functional Diagonal Pattern in Collegiate Baseball Pitchers

The deceleration phase of the pitching mechanism requires forceful eccentric contraction of the posterior rotator cuff. Because traditional isotonic strengthening may not be specific to this eccentric pattern, a more effective and functional means of strengthening the posterior rotator cuff is needed. Twelve collegiate baseball pitchers performed a moderate intensity isotonic dumbbell strengthening routine for 6 weeks. Six of the 12 subjects were randomly assigned to an experimental group and placed on a Theraband® Elastic Band strengthening routine in a functional-diagonal pattern to emphasize the eccentric contraction of the posterior rotator cuff, in addition to the isotonic routine. The control group (n = 6) performed only the isotonic exercises. Both groups were evaluated on a KIN-COM® isokinetic dynamometer in a functional diagonal pattern. Pretest and posttest average eccentric force production of the posterior rotator cuff was compared at two speeds, 60 and 180°/s. Data were analyzed with an analysis of covariance at the .05 level with significance at 60°/s. Values at 180°/s, however, were not significant. Eccentric force production at 60°/s increased more during training in the experimental group (+19.8%) than in the control group (-1.6%). There was no difference in the two groups at 180°/s; both decreased (8 to 15%). Theraband was effective at 60°/s in functional eccentric strengthening of the posterior rotator cuff in the pitching shoulder.     

Functional imaging in Lhermitte-Duclose disease.

PURPOSE: A comprehensive metabolic characterization of a patient with dysplastic gangliocytoma of the cerebellum or Lhermitte-Duclos Disease (LDD) is presented. PROCEDURES: Assessment using 2-deoxy-2-[18F]fluoro-D-glucose (FDG), carbon-11-labeled methionine (11C-MET), carbon-11-labeled choline (11C-Choline) positron emission tomography (PET), and 1H-proton magnetic resonance spectroscopy (MRS) was carried out in a 30-year-old Caucasian woman. RESULTS: FDG-PET revealed hypermetabolism of the tumor. 11C-MET-PET revealed moderate uptake and 11C-Choline showed no uptake. 1H-MRS demonstrated an elevated level of lactate and decreased levels of choline (Cho) and myoinositol. CONCLUSION: Functional imaging in LDD reflects the dual pathological features of neoplasm and hamartoma.     

Factor analytic study of the Children's Yale-Brown Obsessive-Compulsive Scale.

This study examined the psychometric properties of the Children's Yale-Brown Obsessive-Compulsive Scale (CY-BOCS; Scahill et al., 1997). Participants were 82 children and adolescents diagnosed with obsessive-compulsive disorder (OCD). Confirmatory factor analyses of 2 previously found models (Obsessions and Compulsions; Disturbance and Severity) yielded poor fit indexes. Exploratory factor analysis supported a model of severity and disturbance with slightly different item content than found by McKay et al. (2003). The internal consistency of the factors was acceptable, and the convergent and divergent validity was supported vis-a-vis correlations with clinician ratings of impairment, self-report measures of depression and anxiety, and parent ratings of Tourette's disorder (TD) symptoms. These findings suggest that the CY-BOCS Total Score may represent an inaccurate assessment of symptom severity and supports the use of the revised Severity and Disturbance factors in assessing illness severity.     

Role of radiotherapy in solitary bone plasmacytomas

Background: Solitary bone plasmacytoma (SBP) is a rare tumor for which the standard treatment remains local radiotherapy (RT). While this results in high rates of local control, the majority of patients ultimately develop multiple myeloma (MM). Here we present a 20‐year multi‐institutional review of our experience in an attempt to better understand the natural history of SBP and to identify possible prognostic factors. Methods: A total of 44 patients were identified. The inclusion criteria were the presence of a solitary bone lesion with histologic confirmation of plasma cells on biopsy, a normal bone marrow aspiration and trephine (<10% plasma cells), a negative radiographic skeletal survey, and no anemia, hypercalcemia or renal impairment secondary to plasma cell dyscrasia. Patient ages ranged from 25 to 83 years (median of 54 years) and 64% of patients had a monoclonal paraprotein in the serum and/or urine. All patients received local megavoltage RT with doses ranging from 30 to 54 Gy. Potential prognostic factors including age, gender, site of involvement, presence or absence of soft tissue extension, presence or absence of monoclonal paraprotein at diagnosis, persistence or disappearance of monoclonal paraprotein following RT, the time taken for monoclonal paraprotein to disappear following RT, and the use of magnetic resonance imaging (MRI) staging were evaluated to determine their impact on the likelihood of developing MM. Results: Median follow up was 6 years (range 0.1–15.2 years). Effective local control was achieved in 42 (95%) patients, but 30 (68%) patients subsequently progressed to MM at a median time to progression of 1.6 years. The median survival from initial diagnosis was 7.5 years. We were unable to define any prognostic factors that were associated with an increased risk of developing MM. Conclusion: Our series confirms the excellent local control achievable with RT. However, the majority of patients with SBP will ultimately progress to MM and strategies, such as adjuvant chemotherapy, should be explored in selected patients.     

Plasma exchange in thrombotic thrombocytopenic purpura

Three patients were recently treated for thrombotic thrombocytopenic purpura (TTP). One presented with toxic shock syndrome; TTP developed but promptly responded to a regimen of antiplatelet agents, steroids and plasma exchange. In another the manifestations of TTP developed after presentation with hypertension and abdominal pain. This patient responded to a similar regimen but required extended treatment before remission could be maintained with medications alone. In the third patient the full TTP syndrome appeared after several days of plasma exchange treatment for hemolyticuremic syndrome. He did not respond. It is suggested that TTP may present in many forms initially, that microangiopathic hemolysis may be a late manifestation and that the optimal therapy is not known.