Combined method for evaluating fetal well-being by plasma estriol measurements and ultrasonography

Twenty-one patients classified as “high-risk” problems were observed to assess fetal well-being, size, and growth with repeated plasma estriol and ultrasonographic measurements. Estriol levels were of value in the estimation of the fetal condition if fetal size and age were known. When serial plasma estriol measurements and ultrasonographic cephalometry are used together, the fetal well-being, size, and growth may be more accurately assessed and the risk of prematurity greatly reduced. Further combined studies are needed to clarify the relative values of estriol levels and ultrasonography in the assessment of fetal status. The cirteria of normal fetal growth and welfare in high-risk situations must be established in an effort to decrease high perinatal loss rates.     

Imaging addiction with PET: is insight in sight?

Neurochemical imaging studies can identify molecular targets of abused drugs and link them to the underlying pathology associated with behaviors such as drug dependence, addiction and withdrawal. positron emission tomography (PET) is opening new avenues for the investigation of the neurochemical disturbances underlying drug abuse and addiction and the in vivo mechanisms by which medications might ameliorate these conditions. PET can identify vulnerable human populations, treatment strategies and monitor treatment efficacy. Thus, with this tool and the knowledge it provides, the potential for developing novel drugs and treatment strategies for drug addiction is now close at hand.     

Die Behandlung der diaphysären Klavikulafraktur

ZusammenfassungFragestellung. Das Ziel dieser prospektiven Untersuchung bestand in dem Vergleich der Frühergebnisse von 2 verschiedenen Behandlungsstrategien bei diaphysären Klavikulafrakturen des Typs A und B der OTA-Klassifikation.Methoden. In der 1. Gruppe wurden 27 Patienten konservativ im Rucksackverband behandelt, in der 2. Gruppe wurde die Fraktur bei 26 Patienten minimal-invasiv mit einem elastischen Titannagel intramedullär geschient. In einem Zeitraum von 6 Monaten wurden die Ergebnisse der Behandlung zu 7 Zeitpunkten evaluiert.Ergebnisse. Während des gesamten Untersuchungszeitraums konnten signifikant bessere Ergebnisse hinsichtlich der Schulterfunktion, des Constant-Score, des DASH-Score, der subjektiven Zufriedenheit, der subjektiven Schmerzempfindung und des kosmetischen Ergebnisses festgestellt werden. Die Dauer der Arbeitsunfähigkeit war in der Gruppe der operierten Patienten um mehr als die Hälfte kürzer.Schlussfolgerung. Die elastisch stabile intramedulläre Osteosynthese der diaphysären Klavikulafraktur ist ein sicheres, minimal-invasives Verfahren, das funktionell und kosmetisch in der Frühphase nicht zu schlechteren Ergebnissen führt als die konservative Therapie mit dem Rucksackverband.     

GFAP,FVIII/RAg,Laminin, and fibronectin in gliosarcomas: An immunohistochemical study

Summary GFAP, Factor VIII/RAg, laminin, and fibronectin were immunohistochemically investigated in 15 glioblastomas and 15 gliosarcomas. GFAP was found variably positive in the glial areas. F VIII/RAg characterizes the endothelial cells and in gliosarcomas suggests the origin of the sarcomatous component from the endothelial proliferations. Laminin separates the two components and characterizes the inner and the outer basement membranes in the vessels. It is multiplied and thickened in endothelial proliferations, while it is often fragmented in the larger vessel wall proliferations. Our observations confirm that gliosarcoma represents the last stage of a process which starts with the endothelial hyperplasia of glioblastoma.Partially supported by CNR, Special Project Center, Grant no. 82.00410.96     

Prognosis and clinical varieties of ALS disease

210 cases of ALS disease in the period 1955–1979 are considered. Different parameters such as sex, age, duration and clinical course have been correlated with four clinical types: conventional, pseudopolyneuritic, pyramidal and bulbar. The age distribution shows a peak in the fifth decade of life. The sex ratio is 2.08∶1. Considering together all the clinical types, the mean duration of the disease is 27.05 months. The bulbar variety has the poorest prognosis (19.6 months) and the pyramidal variety the best (37.59 months). Familiarity is evidenced in only 3 cases. All our data are discussed and compared with those of the literature.

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Sommario Sono stati considerati 210 casi di Sclerosi Laterale Amiotrofica nel periodo dal 1955 al 1979. Sono stati messi in relazione ai 4 tipi clinici della malattia: tipo convenzionale, pseudopolinevritico, piramidale e bulbare, vari parametri quali sesso, età, durata e decorso clinico. La distribuzione per età mostra un picco di incidenza nella 5^a decade di vita. Il rapporto maschi/femmine è di 2,08∶1. La durata mediana di malattia per tutti i 4 tipi è di 27,05 mesi. La varietà bulbare ha la prognosi peggiore (19,6 mesi) mentre quella piramidale ha la prognosi migliore (37,59 mesi). Solamente in 3 casi è stata messa in evidenza una storia familiare. Tutti i nostri dati sono discussi e confrontati con quelli della letteraura.

     

Normal excretory urography in patients with primary kidney neoplasms

The records of 65 consecutive patients discharged from the hospital with a diagnosis of primary parenchymal neoplasm of the kidney were reviewed. Four of the 65 patients had neoplasms which were not detected by excretory urography. The 4 undetected lesions included 3 renal cell carcinomas and 1 oncocytoma. All of these lesions projected from the anterior or posterior surface of the kidney, and all 4 were clearly demonstrated by computed tomography. Normal findings on an excretory urogram do not completely exclude a neoplasm of the kidney. When there is strong clinical suspicion of a renal neoplasm, computed tomography should be the initial examination or should be done even if the urogram has shown normal findings.     

Response rates to a questionnaire 26 years after baseline examination with minimal interim participant contact and baseline differences between respondents and nonrespondents

Research on response rates to surveys mailed to study participants decades after baseline examination, with minimal interim contact, is limited. This paper documents response rates to a 26-year follow-up survey of surviving participants from a large cohort in Illinois and compares baseline characteristics of nonrespondents and respondents. Mortality follow-up of the Chicago Heart Association Detection Project in Industry 1967-1973 cohort involved minimal or no participant contact since baseline. In 1996, a 26-year follow-up questionnaire was mailed to all surviving participants aged 65 years or older. Current addresses were obtained from the Health Care Financing Administration for 96.5 percent of 12,409 participants in our analyses. Total response rates were 59.8 percent and, for participants for whom Health Care Financing Administration addresses were available, 60.8 percent. A higher response rate was obtained for younger recipients, men, Whites, more-educated persons, nonsmokers, and those with a better cardiovascular risk profile at baseline. A graded negative relation was found between number of cardiovascular risk factors at baseline and response rates obtained in 1996. Use of Health Care Financing Administration records as an additional follow-up method and factors that influence response rates are discussed. In conclusion, long-term follow-up of older surviving participants is feasible if current addresses can be obtained from standardized sources.     

Intensive chemotherapy with and without cranial radiation for Burkitt leukemia and lymphoma: final results of Cancer and Leukemia Group B Study 9251

BACKGROUND: The objective of the current study was to evaluate the efficacy of intensive chemotherapy with and without cranial radiation for central nervous system (CNS) prophylaxis in adults with Burkitt leukemia or lymphoma. METHODS: Patients received 18 weeks of therapy. Prophylactic cranial radiation (2400 centigrays) and 12 doses of triple intrathecal chemotherapy were administered to the first cohort of patients. A subsequent cohort received the same therapy, with the exceptions that intrathecal therapy was reduced to six doses and radiotherapy was administered only to high-risk individuals. RESULTS: The median follow-up durations were 6.8 years in Cohort 1 and 4.1 years in Cohort 2. Three occurrences of transverse myelitis, 2 severe neuropathies, 3 cases of aphasia, and 1 case of blindness were documented in the first cohort of 52 patients (Cohort 1). In the subsequent cohort of 40 patients (Cohort 2), none of these occurrences were observed, and patients experienced less neurologic toxicity overall (61% vs. 26%; P=0.001). Responses were similar, and the 3-year event-free survival rate was 0.52 (95% confidence interval, 0.38-0.65) for Cohort 1 and 0.45 (0.29-0.60) for Cohort 2. CONCLUSIONS: Intensive, short-duration chemotherapy with less intensive CNS prophylaxis led to control at this sanctuary site with little neurotoxicity and may be curative for adults with Burkitt leukemia or lymphoma.