Transluminal angioplasty of the iliac and femoral arteries: follow-up results without anticoagulation

With the advent of the angiographic balloon catheter, transluminal angioplasty has become a more effective procedure for the alleviation of symptoms of peripheral ischemia. In the past two and a half years we have performed this procedure on over 208 iliac and femoral arteries. One hundred twenty iliac arteries were dilated. Of these, 86% remained patent at one year and 83% at two years. Eighty-eight femoral arteries were dilated. Of these, 75% remained patent at one year and 67% at two years. These vessel survival rates are slightly less than those following surgery. However, the morbidity from transluminal angioplasty is very low and the mortality is essentially zero.     

Educational progress, behaviour, and motor skills at 10 years in early treated congenital hypothyroidism

AIM: To assess educational attainments, behaviour, and motor skills at 10 years of age in a group of children with congenital hypothyroidism identified by neonatal screening. SUBJECTS: 59 children with congenital hypothyroidism born in 1978-81, 31 cases with pretreatment thyroxine (T4) values of 40 nmol/l or below (group I) and 28 less severe cases with T4 values over 40 nmol/l (group II), together with 59 classroom control children matched for age, sex, social class, and main language spoken at home. METHODS: The Neale analysis of reading ability; the child health and education study written test of mathematics; Rutter behaviour questionnaires for parents and teachers; the Oseretsky test of motor proficiency (short form). RESULTS: On all measures the congenital hypothyroidism children in group I had less satisfactory scores for educational attainments, behaviour, and motor skills than those in group II and controls. For reading the differences were small and did not reach statistical significance, but the deficits in mathematics and total motor skills were statistically significant (p < 0.01). There were more striking and statistically significant differences in behaviour scores, particularly with respect to attentional difficulties. Although less striking, these were also apparent in the group II children with mild hypothyroidism. CONCLUSIONS: At the age of 10 years severe congenital hypothyroidism is associated with some mild impairment in educational and motor attainments. Behaviour problems are also common, even in some children with less severe congenital hypothyroidism.     

The angiogenic switch in hamster buccal pouch keratinocytes is dependent on TGFbeta-1 and is unaffected by ras activation

This study was undertaken to investigate the mechanisms by which Syrian hamster buccal pouch keratinocytes treated in vivo with 7,12- dimethylbenz[a]anthracene (DMBA), switch from an angio-inhibitory to an angiogenic phenotype. Cells were cultured from pouches at various times after exposure to carcinogen and their angiogenic activity assessed. The angio-inhibitory activity present in conditioned media from normal cells was lost as early as 3 weeks after carcinogen treatment, resulting in weak expression of angiogenic activity. By 5 weeks, cells had become strongly angiogenic due to the secretion of high levels of TGFbeta-1, a potent angiogenic factor. Because the switch to high levels of secreted TGFbeta-1 occurred at the same time as the activation of the H-ras oncogene, non-angiogenic cell lines lacking an activated H-ras oncogene were stably transfected with mutant H-ras and their transformed and angiogenic phenotypes were evaluated. Although ras transfection drove two of the three cultured cell lines to anchorage independence and modestly increased their ability to clone in low serum, it had no effect on the angiogenic phenotype or on the level of secreted active TGFbeta-1. These results demonstrate that the angiogenic phenotype in the hamster buccal pouch model of oral carcinogenesis develops in a step-wise fashion with an early decrease in the production of an inhibitor of angiogenesis and a subsequent marked increase in the secretion of the inducer TGFbeta-1. Although the activation of the H-ras oncogene contributed to anchorage independence, it did not affect the expression of the angiogenic phenotype in this model system.      

Specific Interferon-Gamma Producing CD4+ and CD8+ T Cells After Autologous EBV-B Stimulation: The Necessity of Restimulation

The response of T cells to produce interferon-γ, to proliferate and to become cytotoxic after specific stimulation with low dose (2%) autologous EBV-B cells was investigated in 15 EBV seropositive and five seronegative patients. A significantly higher number of interferon-γ producing cells (56 ± 24 per 10⁵ T cells) were found in a spot ELISA in EBV positive than in EBV negative patients (7 ± 2 spots, P<0.01) and it was only found with restimulation after 5–12 days of primary culture. No correlation was found between the extent of interferon-γ production, cytotoxicity or profileration. Specificity of EBV-induced interferon-γ production was demonstrated by comparison of the response to allogeneic EBV-B cells or IL-2 in the reslimulation phase. The response was stronger in CDS⁺ T cells than in CD4⁺ T cells and could be blocked in the restimulation phase with HLA class I and class II antiserum, respectively.     

Multicenter, crossover study of the efficacy and tolerability of terfenadine, 120 mg, versus cetirizine, 10 mg, in perennial allergic rhinitis.

In this 3-week randomized, double-blind, double-dummy multicenter, crossover study terfenadine, 120 mg, was compared with cetirizine, 10 mg, both given once daily in the treatment of perennial allergic rhinitis in sixty patients. Compared with the investigators' pretreatment assessment, both terfenadine and cetirizine significantly reduced the severity of all five symptoms (P less than .001). The two treatments were equally effective in controlling eye irritation, sneezing, nasal congestion and itchy nose, throat and palate, but cetirizine improved rhinorrhea more than terfenadine (P less than .05). Daily symptom assessments by the patients for the last 14 days of each treatment period showed no difference in efficacy between the two drugs for any of the symptoms. There were also no differences between the two drugs for overall assessments of efficacy or patient preference. Adverse events were recorded more frequently while taking cetirizine, with 14 attributable events compared with only five with terfenadine. Four of the cetirizine-related events were drowsiness or tiredness, but none was reported while patients were taking terfenadine. There was a tendency to increased weight (greater than 1 kg) with both treatments.     

Injecting equipment sharing among injecting drug users in Togliatti City, Russian Federation: maximizing the protective effects of syringe distribution

OBJECTIVE: To compare risk factors for injecting equipment sharing among injecting drug users (IDUs) in Togliatti City, Russia. DESIGN: Unlinked, anonymous, cross-sectional community-recruited survey with oral fluid sample collection. METHODS: Between September and October 2001, 426 IDUs completed an interviewer-administered questionnaire and oral fluid samples were tested for HIV. Univariate and multivariate analyses compared potential risk factors for injecting equipment sharing. RESULTS: More than half (56% [234/418]) of the sample were positive for antibodies to HIV. A third (36%) had injected with used needles and syringes in the last 4 weeks. IDUs who reported syringe exchanges or outreach workers as their main sources of new needles and syringes in the last 4 weeks had 0.3 times the odds of sharing compared with those obtaining them from a pharmacy or shop, whereas those whose main source was buying them from the streets or obtaining them from friends, sexual partners, or other drug users had 12 times the odds of receptive needle and syringe sharing. IDUs who reported being last arrested or detained by the police for a drug-related offense had higher odds of sharing. CONCLUSIONS: Findings highlight the delicate balance in HIV prevention between potentially competing strategies of law enforcement and syringe distribution.     

Plasmacytoid dendritic cells (PDC) are the major DC subset innately producing cytokines in human lymph nodes

Plasmacytoid dendritic cells (PDC) constitute a distinct subset of DC found in human peripheral lymph nodes (LN), but little is known about their function. Cell suspensions were prepared from tumor draining LN (n=20) and control LN (n=11) of women undergoing surgical resection for primary breast cancer and elective surgery for benign conditions, respectively. Using four-color flow cytometry, human leukocyte antigen-DR+ DC subsets were identified phenotypically. The proportions and numbers of cells innately producing interleukin (IL)-4, IL-10, IL-12, and interferon-gamma (IFN-gamma) were also measured from intracellular accumulation of cytokine after blocking with monensin. All flow cytometry data were collected without compensation and were compensated off-line using the Winlist algorithm (Verity software). This package also provided the subtraction program to calculate percentage positive cells and intensity of staining. PDC (CD11c-, CD123+) expressed more cytokines than did myeloid DC (CD11c+) or CD1a+ putative "migratory" DC (P<0.001). LN PDC from patients with a good prognosis (px; n=11) demonstrated a relative increase in IL-12 and IFN-gamma expression (median IL-10:IL-12 ratio=0.78 and median IL-4:IFN-gamma ratio=0.7), and PDC from LN draining poor px cancer (n=9) showed a relative increase in IL-10 and IL-4 expression (median IL-10:IL-12 ratio=1.31 and median IL-4:IFN-gamma ratio=2.6). The difference in IL-4:IFN-gamma expression between good and poor px cancer groups was significant (P<0.05). Thus, PDC innately producing cytokines were identified in cell suspensions from human LN, and the character of PDC cytokine secretion may differ between two breast cancer prognostic groups. We speculate that a shift towards PDC IL-10 and IL-4 expression could promote tumor tolerance in LN draining poor px breast cancer.