P-glycoprotein expression in plasma-cell myeloma is associated with resistance to VAD

Tumor cell-associated expression of multidrug resistance (MDR) was quantitated in 22 patients with DNA-aneuploid myeloma using 2-parameter flow cytometry with monoclonal antibody (MoAb) C-219 for the detection of cytoplasmic p-170 and propidium iodide for nuclear DNA content. The proportion of cells expressing p-170 and the intensity of p-170-related fluorescence were determined for each patient. Among the 14 patients treated with vincristine-adriamycin-dexamethasone (VAD), the proportion of p-170-positive cells distinguished sensitive from resistant disease (P less than .01). Among a subgroup of seven patients with MDR analysis available prior to VAD therapy, two subsequent nonresponders had high proportions of C-219-reactive cells. The presence de novo of high proportions of p-170-expressing cells in another still untreated patient and in a further individual with resistance to dexamethasone and interferon (not associated with MDR) warrants systematic analysis of p-170 expression prior to therapy to determine its clinical implications for response to MDR-associated drugs as combined in the VAD regimen. Concurrent MDR expression by aneuploid tumor cells and cells in the diploid subcompartment may represent involvement of diploid cells in the myeloma disease process.     

Anaphylaxis to Pegylated Liposomal Doxorubicin: A Case Report

Liposomal doxorubicin is used for the treatment of various cancers like epithelial ovarian cancers, multiple myeloma and sarcomas. We report the first case of anaphylaxis to pegylated liposomal doxorubicin.     

Comparative Evaluation of the Therapeutic Efficacy and Safety of Injected Histaglobulin versus Autologous Serum Therapy in Chronic Urticaria

BACKGROUND: Urticaria affects 0.5 to 1 percent of the population at any given time. Treatments include nonsedative antihistamines, autologous serum therapy, and injected histaglobulin. OBJECTIVE: This study sought to compare the therapeutic efficacy and safety of injected histaglobulin with autologous serum therapy in chronic urticaria. METHODS: This was a hospital-based prospective study performed in the Department of Dermatology, Venereology, and Leprology at Guru Gobind Singh Medical College and Hospital in Faridkot, India. A total of 96 patients with chronic idiopathic urticaria were enrolled after applying inclusion and exclusion criteria and were divided into two groups of 48 patients each using an envelope method. Autologous serum skin tests were performed in each patient irrespective of their group assignment. Group A then received injected histaglobulin and Group B received autologous serum therapy (AST). Patient were evaluated using the Urticaria Activity Score (UAS) every week for six weeks, with follow-up conducted at three and six weeks after the completion of treatment. The Chronic Urticaria Quality of Life questionnaire was used to assess the quality of life of the study participants. RESULTS: Out of the 96 initially enrolled patients, 62 completed the six weeks of treatment and two follow-up visits. Twenty patients dropped out due to remission and 14 patients left the study for other reasons. Reductions in UAS values occurred in both the groups by the end of follow-up but were more significant in Group A. Improvement in quality of life scores was also greater in Group A. Recurrence occurred in both groups after treatment cessation but was less common in Group A. CONCLUSION: Both treatments were validated for treating chronic urticaria; however, injected histaglobulin showed statistically more consequential results than AST.     

Is the Bishop–Koop procedure useful in severe jejunoileal atresia?

Purpose

The aim of this study was to report our experience using the Bishop–Koop procedure for the treatment of various surgical problems of jejunoileal atresia including luminal discrepancy, complex meconium peritonitis, type IIIb and type IV atresia which we defined as severe jejunoileal atresia.

Intracellular acidification alters myogenic responsiveness and vasomotion of mouse middle cerebral arteries

Intracellular pH (pH_i) in the vascular wall modulates agonist-induced vasocontractile and vasorelaxant responses in mesenteric arteries, whereas effects on myogenic tone have been unsettled. We studied the role of Na⁺,HCO₃⁻ cotransporter NBCn1 in mouse isolated middle cerebral arteries and the influence of pH_i disturbances on myogenic tone. Na⁺,HCO₃⁻ cotransport was abolished in arteries from NBCn1 knockout mice and steady-state pH_i ∼0.3 units reduced compared with wild-type mice. Myogenic tone development was low under control conditions but increased on treatment with the NO-synthase inhibitor N-nitro-L-arginine methyl ester (L-NAME). This effect of L-NAME was smaller in arteries from NBCn1 knockout than wild-type mice. Myogenic tone with L-NAME present was significantly lower in arteries from NBCn1 knockout than wild-type mice and was abolished by rho-kinase inhibitor Y-27632. The arteries displayed vasomotion, and this rhythmic contractile pattern was also attenuated in arteries from NBCn1 knockout mice. No differences in membrane potential or intracellular [Ca²⁺] were seen between arteries from NBCn1 knockout and wild-type mice. We propose that NO production and rho-kinase-dependent Ca²⁺ sensitivity are reduced at low pH_i in pressurized mouse middle cerebral arteries. This likely impedes the ability to adjust to changes in perfusion pressure and regulate cerebral blood flow.