Vagal hyperreactivity and sudden infant death. Study of 15 families

Prone sleep position is obviously the main risk factor for sudden infant death. Other risk factors, such as vagal overactivity particularly in the familial form, are still discussed. We here report 15 families characterized by the coexistence of vagal overactivity and sudden infant death. At least, 1 child for each family had documented [Holter or occulo-cardiac reflex (OCR)] vagal overactivity. In 5 families 2 children were affected; in 2 families 3 children were affected and in 1 family 4 children were affected. Sudden death occurred in the elderly of the family in 8 cases, in the twin in 3 cases, in the 2nd in 3 cases and in the 5th child in 1 case. Within the 15 families, at least 1 parent had experienced vagally-induced fainting or syncope in 10 cases. Familial pattern of vagal overactivity is underlined. Possible links between vagal overactivity, risk factor for suddden death and sudden death are discussed. We suggest an Holter-ECG and OCR follow-up for sudden infant death siblings with history of familial vagal overactivity (3 examinations during the 1st year of life, at 1, 3 and 9 months).     

The prevalence of reproductive tract infections in Hue,Vietnam

A study was conducted in central Vietnam to measure the prevalence of reproductive tract infections among clients of a family planning clinic, and to determine the usefulness of simple, clinic-based diagnostic tests. The prevalence of such infections was moderate, with the majority being endogenous. Few cases of cervical infection were identified, and no clinical or sociodemographic variables proved to be good predictors of such infection. Most vaginal infections could be identified through simple, clinic-based diagnostic tests, although further research into the cost-effectiveness of establishing and maintaining these services would be useful. Comparison of the results from laboratory tests and the presumptive diagnosis of the clinician indicate that the current practice of presumptive treatment is leading to significant overtreatment. Use of the World Health Organization flowcharts would reduce the overtreatment of vaginal infection but not of cervical infection. The importance of adapting the flowcharts to local epidemiology is highlighted.     

Toxicity evaluation of petroleum blending streams: reproductive and developmental effects of light catalytic cracked naphtha distillate in rats

A distillate of light catalytic cracked naphtha (CAS number 64741-55-5, LCCN-D), administered by inhalation, was tested for reproductive and developmental toxicity in Sprague-Dawley rats, following a modified OECD Guideline 421, Reproductive/Developmental Toxicity Screening Protocol. LCCN-D was administered as a vapor, 6 h/d, 7 d/wk at target concentrations of 0, 750, 2500 or 7500 ppm to female rats for approximately 7 wk from 2 wk prior to mating, during mating through gestational d 19, and to males beginning 2 wk prior to mating for 8 consecutive weeks. Dams and litters were sacrificed on postnatal d 4, and males were sacrificed within the following week. Parental systemic effects observed at the 7500 ppm exposure level were increased kidney weights and relative liver weights in males and increased spleen weights in high-dose females. Livers and spleens from rats in the high-dose group were normal in appearance at necropsy. IncreaSed kidney weights in high-dose males were indicative of male-rat-specific light hydrocarbon nephropathy. No test-related microscopic changes were observed in the reproductive organs or nasal turbinate tissues of either sex. Reproductive performance was unaffected by treatment with LCCN-D. Fertility index was > or =90% in all dose groups. There were no exposure-related differences in implantation sites and live pups per litter, and no gross abnormalities were observed. Pups born from treated dams showed comparable body weights and weight gains to controls. The viability index on postpartum d 4 was > or =97%; the high-dose group had more male than female pups at birth and at d 4 postpartum. Under the conditions of this study, the no-observable-adverse-effect level (NOAEL) for exposure to light catalytic cracked naphtha distillate for parental toxicity was 2500 ppm and the NOAEL for reproductive performance and developmental toxicity was 7500 ppm.     

Phase I-II trial of intensification of the MAID regimen with support of lenograstim (rHuG-CSF) in patients with advanced soft-tissue sarcoma (STS).

This study was conducted to determine the maximum tolerated dose of an intensified MAID (mesna, adriamycin, ifosfamide, dacarbazine) regimen with the support of lenograstim in patients with advanced soft tissue sarcomas. Following 1 cycle of MAID at the standard dose, four patients were to be treated at each of five dosage levels: +25%, +45%, +65%, +85%, +100%. Sixteen patients were treated. Because there were no significant differences in hematologic toxicity between patients receiving lenograstim 5 or 10 microg/kg/day (levels 1-5 and 1-10), the data were pooled for comparison with level 2. The median duration of absolute neutrophil count < 0.5 x 10(9)/l was 3 days at level 1 and 7 days at level 2 (p < 0.01). The median platelet nadir was 25 x 10(9)/l at level 1 and 10 x 10(9)/l at level 2 (p < 0.01). The median duration of toxicity-related hospitalization was 3.5 days and 11 days at levels 1 and 2, respectively, (p < 0.001). Mucositis > or = grade III occurred after 3/29 cycles at level 1 and 10/15 cycles at level 2 (p < 0.001). After 4 cycles at level 1, 8/8 patients still had performance status scores < or = 2, and only 4/8 had performance status scores < or = 2 after the second cycle at level 2. Lenograstim enabled an increase of 25% of the MAID regimen. At higher dose levels, severe mucositis and deterioration in performance status were dose limiting.     

Postoperative radiotherapy of a benign tumor of the ankle]

Pigmented villonodular synovitis is a rare benign tumor. The high rate or recurrence after surgery exposes the risk of non-conservative or non-functional treatment. External irradiation of post-surgical residual disease seems to be useful for the prevention of relapse and conservation with a good functional result. We report a clinical observation of a case with a diffuse type of pigmented villonodular synovitis of the ankle, operated on three times, and then treated by external irradiation. The published results in terms of response and functional prognosis of 14 cases of multi-recurrent villonodular synovitis treated by irradiation seem to confirm this therapeutic option.     

Nucleotide Sequence Variation of Human T-Lymphotropic Virus Type II in Vietnam

A high rate of human T-lymphotropic virus type II (HTLV-II) infection has been documented in intravenous drug abusers (IVDAs) in South Vietnam. We have investigated the molecular characteristics of the virus and have shown that one HTLV-II subtype is predominant in Ho Chi Minh City. This molecular subtype, HTLV-IIb, was identified in a number of South Vietnamese by nucleotide sequence analysis of the long terminal repeat (LTR) region. HTLV-IIa was not found. These findings suggest that HTLV-IIb is endemic in IVDAs in South Vietnam, although IVDAs in urban areas in North America are predominantly infected with HTLV-IIa.     

Therapeutic potential of recombinant p53 overexpression in breast cancer cells expressing endogenous wild-type p53

Reconstitution of the p53-dependent apoptotic pathway by gene transfer of a recombinant wild-type p53 minigene leads to rapid apoptotic cell death in breast and other cancer cell types expressing null or mutant p53. Tumour cells expressing wild-type p53 have been reported to be more resistant to this treatment strategy, presumably as a result of mutations in downstream regulators of p53-dependent apoptotic signalling. The MCF-7 breast cancer cell line is representative of this class of tumour cell. Our recent observation of a p53-dependent apoptotic response following adenovirus-mediated HSV thymidine kinase gene transfer and gancyclovir treatment led us to reexamine recombinant p53 cytotoxicity in MCF-7 cells. Infection with a recombinant adenovirus expressing wild-type p53 resulted in a dramatic increase in p53 protein levels and was accompanied by an increase in p21^{WAF 1/CIP1} protein levels and G1 arrest within 24 hours post-infection. A significant decrease in MCF-7 cell viability was first observed at 5 days post-infection and coincided with the appearance of morphological and biochemical changes consistent with apoptotic cell death. By day 7 post-treatment, cell viability decreased to 45% and clonogenic survival was reduced to 12% of controls. The results demonstrate that persistent, high level expression of recombinant p53 can induce programmed cell death in MCF-7 cells. While the mechanism by which p53 overexpression overcomes the defect in downstream apoptotic signalling is not clear, our data suggests that this treatment strategy may be beneficial for the class of tumour cells represented by the MCF-7 cell line.     

Mycobacterium tuberculosis Beijing genotype emerging in Vietnam

To assess whether the Mycobacterium tuberculosis Beijing genotype is emerging in Vietnam, we analyzed 563 isolates from new cases by spoligotyping and examined the association between the genotype and age, resistance, and BCG vaccination status. Three hundred one (54%) patients were infected with Beijing genotype strains. The genotype was associated with younger age (and hence with active transmission) and with isoniazid and streptomycin resistance, but not with BCG vaccination.     

The disability assessment database model

Collecting disability-related information in order to prevent and treat specific disabilities is important and necessary, but does it meet the major needs of individuals with disabilities? This article presents preliminary research performed to assess those needs as well as a Disability-service Assessment Database (DAD) model. This model provides local disability service data and surveys users so that their input is used to modify existing data. The content of the database and Web site are discussed and diagramed. A major goal of the DAD is to serve as a model to other communities.     

Chemotherapy associating mitomycin C, thiotepa and vindesine in advanced breast cancers. Study of 100 cases (author's transl)

One hundred patients suffering from advanced breast cancers and resisting to one (15) or several (85) drugs previously administered have been treated by an association of mitomycin C, thiotepa and vindesine, given every 3 weeks. Toxic effects were frequently observed and it was necessary to stop the treatment in more than 25 p. cent of the patients. Hemorrhagic complications due to thrombopenia (50 p. cent of cases) were severe in few cases and were responsible for the death of 2 patients. An overall objective response has been obtained in 41 cases and a regression in more than 50 p. cent of the lesions with a median duration of 7.5 months has been observed in 15 cases. The most striking effects have been noted in lymph nodes and skin involvement with an appreciable effect on the functional (subjective) and painful syndrome in 60 p. cent of cases. Difficulties in applying this chemotherapy to patients who had already been heavily treated explain a toxicity which would probably be reduced by an earlier application of the treatment. The quality of the results obtained (here) with these patients incite to study the effect of this association primarily to improve the long-term prognosis of localized or already disseminated breast cancers.