A randomized, angiographically controlled trial of intracoronary streptokinase in acute myocardial infarction

Fifty-five patients with acute myocardial infarction evaluated within 4 hours of the onset of symptoms were entered into an angiographically controlled trial of intracoronary streptokinase (IC STK). Forty-three patients with total occlusion of their infarct artery were randomized to either IC STK or intracoronary nitroglycerin (IC NTG), and 12 patients with less-than-complete occlusion received only IC NTG. Reperfusion of a totally occluded vessel was achieved in 69% of STK patients and 17% of IC NTG patients. Time from onset of symptoms to peak CK activity was significantly shorter in reperfused patients and patients with subtotal occlusion on initial angiography than in patients with total occlusion who were not reperfused (p less than 0.0001). Comparison of radionuclide ejection fractions (EF) determined acutely and 10 to 14 days after infarction failed to show improvement in either the STK or IC NTG group (mean decrease of 2.8% and 0.4%, respectively). In contrast, patients with subtotal occlusion on baseline angiography demonstrated a significant (p = 0.05) spontaneous improvement in EF over 2 weeks (7.3% increase).     

The contribution of risk factors to the effect of early otitis media with effusion on later language, reading, and spelling

A cohort of 946 children who were screened for otitis media with effusion (OME) from the ages of 2 to 4 were studied for language, reading, and spelling at 7 years of age. The effects of OME in combination with single risk factors and with increasing numbers of risk factors were investigated. An interaction with an additional risk factor was found only for gender and OME, with boys' spelling influenced negatively by a history of OME. OME in combination with preterm birth and low birthweight also appears to put children at risk for later langauage and educational problems. Although a negative linear relation between the number of risk factors and later functioning was found, it is suggested that OME, even when combined with a number of other risk factors, produces only minor effects on later language, reading, and spelling.     

Gallbladder and bile duct stones: percutaneous therapy with primary MTBE dissolution and mechanical methods

The authors describe percutaneous treatment of gallbladder or bile duct stones in 18 patients who were poor surgical candidates or in whom conventional therapy failed. Dissolution was performed in most cases with methyl tert-butyl ether (MTBE) because of its potent dissolution properties; other solvents used included monooctanoin or chelating solutions. Gallbladder stones were eliminated in 11 of 13 patients (six of seven with dissolution alone, four of four with dissolution and basket extraction, one with basket removal alone). In five patients with stones in the common bile duct (n = 3), cystic duct remnant (n = 1), and intrahepatic bile ducts (n = 1), stones were eliminated with dissolution alone in two and with dissolution plus basket extraction in one. In two patients percutaneous therapy failed due to complications (vagal hypotension with bile peritonitis and transient respiratory arrest) that occurred during catheter placement. Preliminary results suggest that MTBE is effective for dissolution of many gallbladder stones and some bile duct stones. Noncholesterol solvents and adjuvant mechanical maneuvers are valuable adjuncts to achieve complete stone elimination.     

Control of Tetranychus urticae Koch by extracts of three essential oils of chamomile,marjoram and Eucalyptus

Objective

To evaluate the acaricidal activity of extracts of three essential oils of chamomile, marjoram and Eucalyptus against Tetranychus urticae (T. urticae) Koch.

Methods

Extracts of three essential oils of chamomile, marjoram and Eucalyptus with different concentrations (0.5%, 1.0%, 2.0%, 3.0% and 4.0%) were used to control T. urticae Koch.

Results

The results showed that chamomile (Chamomilla recutita) represented the most potent efficient acaricidal agent against Tetranychus followed by marjoram (Marjorana hortensis) and Eucalyptus. The LC₅₀ values of chamomile, marjoram and Eucalyptus for adults were 0.65, 1.84 and 2.18, respectively and for eggs 1.17, 6.26 and 7.33, respectively. Activities of enzymes including glutathione-S-transferase, esterase (α-esterase and β-esterase) and alkaline phosphatase in susceptible mites were determined and activities of enzymes involved in the resistance of acaricides were proved. Protease enzyme was significantly decreased at LC₅₀ of both chamomile and marjoram compared with positive control. Gas chromatography-mass spectrometer (GC-MS) proved that the major compositions of Chamomilla recutita are α-bisabolol oxide A (35.251%), and trans-β-farersene (7.758%), while the main components of Marjorana hortensis are terpinene-4-ol (23.860%), p-cymene (23.404%) and sabinene (10.904%).

Conclusions

It can be concluded that extracts of three essential oils of chamomile, marjoram and Eucalyptus possess acaricidal activity against T. urticae.     

Dialysis patients after kidney graft failure: Slovenian experience

Increased mortality has been reported in patients starting dialysis after kidney graft failure. In this study we analyzed this subgroup of dialysis patients based on the data from the Slovenian Renal Replacement Therapy Registry. Patients starting dialysis after graft failure in the period between 2004 and 2008 were identified from the registry. Demographic, clinical and treatment data, as well as survival were compared to incident dialysis patients, who were on the waiting list or preparing for enrollment. There were 49 patients starting dialysis after 7.9 ± 6.4 years spent with a functioning graft and a total of 13.7 ± 7.4 years on renal replacement therapy. Their mean age was 48.3 ± 11.0 years (vs. 48.2 ± 13.9 years in incident patients, P = 0.96), 53% were male, and all were on hemodialysis. By the end of 2008, 8 (16%) patients had been re-transplanted (after a median of 27.5 months) and 11 (23%) had died (after a median of 1.4 months of dialysis). The cause of death was infection in five patients, a cardiovascular event in three, malignancy in two, and a cerebrovascular event in one patient. Deceased patients were significantly older, but similar to survivors in other parameters. Unadjusted one- and three-year survival rates after graft failure were both 77%, which was significantly worse than in incident patients (P < 0.001). To conclude, patients after graft failure have increased mortality in the first year after starting dialysis, but patients surviving the first year have good survival thereafter. Studies focusing on the early period after graft failure are necessary to improve outcomes.     

Survey of Renal Transplantation in Slovenia

This brief survey presents data on renal transplantation in Slovenia, a country with a population of 2 million, which has one renal transplant center. The establishment of an appropriate national transplantation organization resulted in an increase in transplantations and the acceptance of Slovenia into Eurotransplant (ET) at the beginning of 2000. Current immunosuppression is composed of cyclosporine microemulsion (Neoral), mycophenolate mofetil, methylprednisolone, and anti‐interleukin‐2 receptor monoclonal antibodies. By the end of 2008, 766 renal transplantations had been performed, and from 1970 to 2007, 125 patients had been transplanted from living related donors. From 1986 to 1999, 239 patients received renal grafts from deceased donors. From 2000 to 2008, 402 patients were transplanted from deceased donors. In 2004, 55 renal transplantations were done. Two hundred and twenty‐eight (56.7%) renal grafts were shipped from other ET countries. The HLA‐antigen mismatch of 2.7 ± 1.1 was not significantly different to that before 2000. From 2000 to 2008, the one‐ and five‐year patient survival rates were 98.2% and 95.2%, respectively. The concomitant graft survival rates were 94.4% and 90.9%, respectively. In the ET era, the number of deceased donor renal transplants per year was 2.6 times higher than in the 14 years before. In 2004 we reached the average number of deceased donor renal transplants per million population of ET. Short‐ and medium‐term results of the last nine‐year period have been very good and entirely comparable to those in large reports.     

胸腺肽α1对转移性黑色素瘤患者有效

胸腺肽α1（Tα1）为一种免疫调节多肽,可增强效应T细胞反应。此项大型随机试验主要评价了Tα1与达卡巴嗪（DTIC）和干扰素α（IFN—α）对于转移性黑色素瘤患者的疗效和安全性。     

Severe Actinomyces israelii infection involving the entire spinal cord

A case of severe spinal infection with Actinomyces israelii is presented. A 38-y-old male was admitted with symptoms of infection and neurological symptoms. Magnetic resonance imaging showed extensive affection involving the entire spinal cord. Cultures of the cerebrospinal fluid revealed Actinomyces israelii. The patient was treated with long term penicillin G followed by amoxicillin. The patient recovered with severe neurological sequelae.