Effects of therapy with T101 ricin A-chain immunotoxin in two leukemia patients

Two leukemia patients, refractory to chemotherapy, were treated with T101-ricin A-chain immunotoxin (T101 IT). Patient 1 (T-ALL) received a single 13.5 mg dose of T101 IT IV (12-hour infusion). Patient 2 (B-CLL) was treated with a daily 25 mg dose of T101 IT IV (two-hour infusion) over three consecutive days. Patient 2 also received 300 mg of chloroquine IM on days two and three as enhancer. In vivo binding of T101 IT was demonstrated by FACS analysis using either an antimouse Ig- FITC or anti-A-chain-FITC antibodies. Following IT therapy, the expression of T65 antigen on target cells dropped to 50% and 20% of pretreatment levels, respectively. In patient 1, circulating blast cells remained unsaturated during therapy while in patient 2, cells were fully saturated for four to six hours following each infusion. Pharmacokinetic studies showed a rapid clearance of T101 IT after IV administration. Antimouse and anti-A-chain antibodies could not be detected. There were no treatment-related adverse effects. In patient 1 a rapid but transient decrease of target cells was observed, possibly related to the administration of the antibody part of T101 IT. In contrast, patient 2 showed a 40% reduction of the lymphocyte count, which remained stable over a period of 2 weeks. Such a clinical benefit following IT therapy in patient 2 could be ascribed to the absence of circulating free antigen and the complete saturation of target cells.     

Clinical study of FK506 in patients with myasthenia gravis

Focal demyelinating lesions typically occur within a 1-cm segment of a nerve. In electrodiagnostic studies, measurements over longer distances decrease the chance of detecting such lesions, but measurements over shorter distances result in greater experimental error. Our objective was therefore to determine the optimal screening distance for ulnar neuropathy at the elbow (UNE) incorporating previously derived experimental errors for calculating nerve conduction velocity (NCV). Using a lesion model wherein prolongation of 0.4 ms was added to the expected latency of a 1-cm nerve segment, new NCVs were derived for distances between 1 and 10 cm for nerves normally conducting between 40 and 65 m/s. Lesion detection, or sensitivity, was defined as the likelihood of calculating a decrease of 10 m/s from the normal NCV while including the experimental error. Specificity was related to the likelihood of an inadvertent calculation of such a decrease in NCV in a segment without a lesion. Sensitivity and specificity were derived at multiple distances with varying NCVs. The total percentage error was the sum of the false-negative and false-positive percentages. The least total percentage error occurred at 3-4 cm, 4-6 cm, and 6-8 cm for nerves normally conducting at 40-50 m/s, 50-60 m/s, and 60-65 m/s, respectively. We conclude that the optimal distance for screening UNE, considering both sensitivity and specificity, is significantly less than 10 cm, perhaps as low as 4-6 cm; considering in addition the likely locations of focal lesions, the best distance is 6-8 cm.     

Multi-institutional validation of a new renal cancer-specific survival nomogram

PURPOSE: We tested the hypothesis that the prediction of renal cancer-specific survival can be improved if traditional predictor variables are used within a prognostic nomogram. PATIENTS AND METHODS: Two cohorts of patients treated with either radical or partial nephrectomy for renal cortical tumors were used: one (n = 2,530) for nomogram development and for internal validation (200 bootstrap resamples), and a second (n = 1,422) for external validation. Cox proportional hazards regression analyses modeled the 2002 TNM stages, tumor size, Fuhrman grade, histologic subtype, local symptoms, age, and sex. The accuracy of the nomogram was compared with an established staging scheme. RESULTS: Cancer-specific mortality was observed in 598 (23.6%) patients, whereas 200 (7.9%) died as a result of other causes. Follow-up ranged from 0.1 to 286 months (median, 38.8 months). External validation of the nomogram at 1, 2, 5, and 10 years after nephrectomy revealed predictive accuracy of 87.8%, 89.2%, 86.7%, and 88.8%, respectively. Conversely, the alternative staging scheme predicting at 2 and 5 years was less accurate, as evidenced by 86.1% (P = .006) and 83.9% (P = .02) estimates. CONCLUSION: The new nomogram is more contemporary, provides predictions that reach further in time and, compared with its alternative, which predicts at 2 and 5 years, generates 3.1% and 2.8% more accurate predictions, respectively.     

牛黄解毒片的三维高效液相色谱法鉴定和指标成分的定量

用三维高效液相色谱(three dimensional HPLC)法对中成药牛黄解毒片进行了分析。结果表明该法用于牛黄解毒片中单味中药鉴定及指标成分(marker substance)含量测定均得到较满意结果。     

牛黄解毒片的三维高效液相色谱法鉴定和指标成分的定量

用三维高效液相色谱(three dimensional HPLC)法对中成药牛黄解毒片进行了分析。结果表明该法用于牛黄解毒片中单味中药鉴定及指标成分(marker substance)含量测定均得到较满意结果。     

弱视的双眼视功能重建

目的：评价不同年龄、不同类型弱视的双眼视功能的训练效果。方法：观察各年龄组不同类型弱视62例94例,给予综合治疗及双眼视功能训练。治疗前及治疗后分别用同视机和《Randot Sterrotesis》图谱检查融合范围和立体视锐度。结果：随访12～30个月,视力进步82眼（占87.2%）,融合范围扩大39例（占62.9%）,立体视锐度提高37例（占59.7%）,双眼视功能训练的效果,各年龄组之间差异无显著性意义,但不同类型弱视之间差异有显著性意义,屈光不正性弱视疗效最好,形觉剥夺性弱视疗效最差。结论：不同年龄、不同类型的弱视患者经过综合治疗和双眼视功能训练后,大多有不同程度的视力进步,融合范围扩大及立体视锐度的提高。     

多巴胺和维生素B12球后注射治疗儿童弱视

目的：探讨多巴胺和维生素B12球后注射治疗儿童弱视的疗效。方法：80例屈光参差性和斜视性弱视儿童随机分为两组：治疗组,应用小剂量（2～4mg）多巴胺和维生素B12进行球后注射;对照组,采用综合疗法如光栅、后像及精细作业等训练。两组均遮盖主导眼,观察3～24个月,平均15.8个月。结果：治疗组基本治愈率为72.5%,47.5%恢复完善的立体视觉,27人P-VFP潜时缩短。对照组基本治愈率为27.5%。立体视觉恢复率为15%,8人P-VFP潜时缩短,两级差异具有非常显著性意义。结论：多巴胺和维生素B12治疗儿童弱视安全有效。     

Angiographic assessment of atherosclerotic load at the lower extremity in patients with diabetic foot and charcot neuro-arthropathy

Background

The aim of this study was to investigate atherosclerotic load at the lower extremity in patients with diabetic foot and charcot neuro-arthropathy and compare them with patients with diabetic foot without charcot neuro-arthropathy.