Specular microscopy of hard contact lens wearers II

Specular microscopy was done on 65 long-term hard contact lens (CL) wearers and controls matched for age, sex, race, and refractive error. There was no difference in mean endothelial cell size between the two groups, although median cell area was slightly smaller in the CL group. Standard deviation and coefficient of variation increased as the duration of total wearing time increased and were greater in the CL group, as was skewness. In 15 long-term hard CL wearers who had discontinued their CL wear, there was a trend towards persistence of pleomorphism and polymegathism of cells compared with non-contact lens (NCL) wearers, but there was a suggestion of recovery compared with those continuing to wear CLs matched for duration of wear.     

Primary cutaneous carcinosarcoma: review and presentation of a case with emphasis on clinical characteristics and management

Carcinosarcomas are rare malignant biphasic tumours that contain intermingled carcinomatous and sarcomatous elements. Primary cutaneous carcinosarcomas (PCCS) are extremely rare. We present the 20th reported case and review the literature especially regarding histogenesis and clinical features such as diagnosis and management. PCCS resembles other non-melanocytic neoplasms of the skin. Diagnosis is obtained by primary excision with subsequent histologic and immunohistochemical examination. PCCS is a potentially lethal neoplasm, but radical surgery is successful in most cases.     

Die Wirkung langfristiger Tonephininjektionen auf den Hund

Ohne Zusammenfassung     

Disease-free survival after autologous bone marrow transplantation in patients with acute myelogenous leukemia

Autologous bone marrow transplantation (ABMT) makes it possible to escalate the dose of cytotoxic treatment to a lethal range. Disease- free survival (DFS) following myeloablative therapy and ABMT has been shown to be superior to conventional treatment in high risk patients with acute myelogenous leukemia (AML). It was the purpose of the present study to compare hematopoietic reconstitution, actuarial DFS, and relapse rate of patients transplanted in first complete remission (CR) of AML with those in second or subsequent CR, and to evaluate transplant related mortality. Fifty-two patients with AML, 22 in first CR (low risk) and 30 in second or subsequent CR (high risk), underwent total body irradiation (12.1 to 16.7 Gy) and cyclophosphamide (CY) treatment (200 mg/kg) followed by ABMT. The autograft was incubated with the active CY derivative Mafosfamide (ASTA Werke, Bielefeld, Federal Republic of Germany) to reduce the number of possibly contaminating clonogenic tumor cells. All patients showed three lineage engraftments with platelet recovery observed as being the slowest. The transplant related death rate was low at 5.8%. There was no significant difference in the kinetics of polymorphonuclear (PMN) cell or platelet reconstitution between the low and high risk patient subgroups. The estimated probability of DFS (relapse) after ABMT in first CR was 61% (36%) compared with 34% (65%) in second or subsequent CR, the longest follow-up being 55 months and 57 months, respectively (median follow-up 31 months and 19 months, respectively). ABMT offers a stable long-term DFS when performed in first CR with no relapses occurring in over a year after transplantation. Six later relapses, however, were seen after ABMT in second or subsequent CR, although DFS was not statistically different from that of first remission patients (P = .72).     

Pulmonary artery wedge pressure--when it's valid, when it's not

In this article, several technical and physiologic factors that might interfere with the accurate interpretation of the pulmonary artery wedge pressure as an indicator of LV preload and extravascular lung water have been reviewed. The purpose of this article is not to belittle the use of the wedge pressure value but, instead, to stress the importance of precise measurement and careful interpretation of this parameter. Every effort must be made by the critical care nurse at the bedside to minimize erroneous data and to optimize the validity of the wedge pressure value in order to prompt appropriate clinical decisions.     

Effect of opioid agonists selective for three subclasses of opioid receptors and one sigma receptor agonist on dopamine stimulated adenylate cyclase in rat caudate nucleus.

The adenylate cyclase in rat caudate nucleus homogenate could be stimulated by dopamine and less potently by the dopamine D1 receptor specific agonist SKF38393. Agonists selective for mu[D-Ala2, MePhe4Gly(ol)5]enkephalin (DAGO) and delta opioid receptors [D-Pen2, D-Pen5]enkephalin (dPen-dPen), inhibited the dopamine but not the dopamine D1 stimulated adenylate cyclase. The kappa opioid agonist, U69593, had no effect, probably due to low kappa receptor contents in rat caudate nucleus. 10(-4) M of the sigma receptor specific agonist, 1,3-di-o-tolylguanidine (DTG), potentiated the dopamine as well as the dopamine D1 stimulated adenylate cyclase while lower concentrations of DTG had no effect.     

Die Wirkung quantitativ abgestufter Drosselung der Nierendurchblutung auf den Blutdruck

Ohne Zusammenfassung Mit 8 Textabbildungen.     

EMPHYSEMATOUS PYELONEPHRITIS RESPONDING TO MEDICAL THERAPY

We describe two type 2 diabetic patients with unilateral emphysematous pyelonephritis who responded to medical treatment alone. Escherichia coli was isolated in both patients. The presence of gas was confirmed early by ultrasound and CT scan of abdomen. Following treatment, good functional recovery was demonstrable in the affected kidneys by isotope renogram. We stress the need for early diagnosis of this condition and aggressive treatment with broad spectrum antibiotics.