Different types of renal dysfunction in patients with acute myocardial infarction treated with percutaneous coronary intervention

BACKGROUND: The prognostic significance of different types of renal dysfunction in patients with acute myocardial infarction (AMI) treated with percutaneous coronary intervention (PCI) has not been well characterized. METHODS: The single-center AMI registry encompassed 1,486 consecutive AMI patients treated with PCI, who were followed by mean 29.7 months. Subjects with an estimated glomerular filtration rate <60 mL/min per 1.73 m2 at baseline were selected (n = 283, 19.0%) and incorporated into the chronic kidney disease (CKD) group. The control group consisted of 1,203 subjects with normal renal function (81.0%). The CKD patients were divided into subgroups: with contrast-induced nephropathy - CKD + CIN (n = 68, 4.6%) and without - CKD-CIN (n = 215, 14.5%). RESULTS: Remote mortality rate was significantly higher in CKD group (34.6%) and in particular subgroups: CKD + CIN (47.0%), CKD-CIN (31.0%) than in controls (9.1%, P < 0.001 for all study groups vs controls). Multivariate analysis identified CKD as an independent predictor of any-cause death in the whole population (hazard ratio [HR] 1.77, 95% confidence interval [CI] 1.60-1.94, P < 0.001). Similarly, CKD + CIN contrary to CKD-CIN had significant and independent influence on remote survival in study population (HR 2.16, 95% CI 1.95-2.37, P < 0.001). CONCLUSIONS: CKD and its types have significant, negative influence on long-term survival in AMI patients treated with PCI. It is especially strongly expressed in those CKD patients who develop contrast-induced nephropathy, which occurrence is an independent risk factor of mortality associated with over twofold increase of death hazard.     

Cladribine in a weekly versus daily schedule for untreated active hairy cell leukemia: final report from the Polish Adult Leukemia Group (PALG) of a prospective, randomized, multicenter trial

Cladribine (2-chlorodeoxyadenosine, 2-CdA) treatment-associated infections may shorten potentially long-term survival in hairy cell leukemia (HCL). In search of the optimal mode of 2-CdA administration, 132 patients with untreated HCL were randomized to receive either standard 5-day 2-CdA protocol or a novel schedule of 6 weekly 2-CdA infusions suggested to be less toxic. Analysis of treatment response confirmed similar complete remission rates, overall response rates, progression-free survival, and overall survival in both 2-CdA protocols. However, we did not observe lower toxicity in the weekly schedule. Of special interest, no significant differences were found in the rate of grade 3/4 infections (18% for daily and 26% for weekly protocol, difference –8.2%; 95% confidence interval [CI] –23.2% to 6.9%; P = .28) and the rate of septic deaths (3% for daily and 2% for weekly protocol, difference 1.4%; 95% CI –4.3% to 7.0%; P = .64). In conclusion, HCL treatment with weekly 2-CdA infusions is equally effective but no safer than the standard 5-day 2-CdA protocol.      

Sialylation of intracellular proteins of thyroid lesions

Enhanced sialylation represents one of the most frequently occurring alterations of the sugar chain structure in various cancers. However, up to now, sialylation of intracellular proteins of thyroid carcinomas has never been investigated. The aim of this study was comparative analysis of cytoplasmic and nuclear sialoglycoproteins isolated from thyroid benign and malignant tumors as well as non-neoplastic lesions. The sialylation level and types of sialic acid linkages were analysed by lectin blotting and enzyme linked lectino-solid-phase assay (ELLSA) using Sambucus nigra (SNA) and Maakia amurensis (MAA) agglutinins. The presence of alpha2,6 and alpha2,3 linked sialic acid residues was detected in all types of thyroid lesion specimens but there were some differences in the banding and intensity patterns. Analysis of SNA and MAA binding by ELLSA method showed that in the majority of cancer samples the level of sialic acid residues was lower than in non-neoplastic lesions and adenomas. Our present results suggest that decrease in sialylation rather than increase is a characteristic feature of malignant transformation in the thyroid.     

Neuroendoscopic techniques in the treatment of arachnoid cysts in children and comparison with other operative methods

Objective: The authors intended to evaluate the application of neuroendoscopic techniques for the treatment of arachnoid cysts in children and compare it with other operative methods. Methods: The analysis covered the results of treatment of 44 children with arachnoid cysts who were subjected to neuroendoscopic procedures and 62 patients who underwent other operations. Results: The neuroendoscopic treatment of arachnoid cysts was very effective because of low rate of reoperative treatment (six out of 44 patients), no need to change the operative method (40 effective out of total 44 operative procedures), and low rate of persistent worsening (none of 44 patients worsened). Conclusions: Summing up all the mentioned aspects of neuroendoscopic techniques, the neuroendoscopic techniques were the most suitable operative procedures in the treatment of arachnoid cysts in the presented group of patients, providing that the connection between the lumen of the arachnoid cyst and the cerebrospinal fluid cisterns was of good quality.     

Determination of chloropromazine residues in animals kidney and urine using LC-MS/MS method

Chloropromazina (CP) is subjected to monitoring food animals products, with a minimum required performance limit (MPRL) set 5.0 microg/kg. Homogenized kidney and urine were extracted with acetonitrile. CP- d3 was used as internal standard. LC separation was done on Luna C18 150 x 2 mm, 5 microm column in mobile phase acetonitrile-acetic acid. CP was determination by LC-ESI-MS/MS negative mode. The method was validation according to the criteria of Decision Commission No 2002/657/EC. Recoveries for the level 5.0 ng/g were in the range 84-102%. The limit of decision (CCalpha) and detection capability (CCbeta) CP in kidney were 1.19; 2.87 ng/g and urine 1.08; 2.61 ng/g.     

Addressing relative motion of tumors and normal tissue during dynamic MLC tracking delivery

A general methodology for addressing relative motion of targets and normal tissue for dynamic-MLC (DMLC) tracking is discussed. The basic idea is to exploit the extra degrees of freedom that tissue motion introduces into DMLC delivery. This principle is illustrated through the use of a simple example which uses a moving rigid target whose projection in the beam's eye view intersects a stationary critical organ. DMLC delivery which tracks the target motion is simulated, and it is shown that the choice of leaf motion and the time of the onset of delivery can have a large impact on the exposure of the critical organ. Depending on the choice of these parameters, the integral MU delivered to the critical organ ranged from -75% to +250% relative to the delivery planned for static geometry. These results indicate that deliveries using DMLC tracking should accommodate any normal tissue that is moving with respect to the tumor. This should be done to (1) avoid deliveries which result in large over-exposures of critical organs, and (2) to seek out deliveries that result in critical organ exposures that are lower than what is possible with any static geometry (4D therapy).