Retrograde ileography: value of glucagon

Many gastrointestinal diseases have a predilection for the terminal ileum. Retrograde ileography is a valuable technique for evaluating this region. However, this procedure necessitates reflux of barium (with or without air) into the terminal ileum. This does not often spontaneously occur during a barium enema study. The use of glucagon in double-contrast studies of the colon has been recommended for various reasons, one of which is to facilitate reflux of barium into the terminal ileum. This randomized, double-blind trial confirms that glucagon does promote reflux. Multiple regression analysis indicates that the independent variables of patient age, weight, and sex have little effect on the frequency of reflux. It is concluded that glucagon can facilitate examination of the distal small bowel during a double-contrast colon examination.     

Nonpalpable breast lesions: diagnosis with slightly overpenetrated screen-film mammography and hook wire-directed biopsy in 1,014 cases

Slightly overpenetrated screen-film mammography and hook wire-directed localization were used in 1,014 breast biopsies performed for nonpalpable, mammographically detected breast abnormalities. One lymphoma and 205 breast cancers (20%) were found; 115 breast cancers (56%) were noninvasive, and 90 (44%) were invasive. Mastectomy was performed in 69 breast cancers (34%); 136 (66%) were treated conservatively, 28 with biopsy only and 108 with lumpectomy, node dissection, and radiation therapy. All patients with noninvasive breast cancers treated with axillary dissection had uninvolved lymph nodes. Of the 90 invasive breast cancers, six (7%) had metastases to axillary nodes, which, to the authors' knowledge, is lower than percentages reported in other studies of wire-directed breast biopsies. The authors believe that the slightly overpenetrated technique is a valuable adjunct to screen-film mammography.     

Production of erythroid potentiating factor(s) by a human monocytic cell line

U-937 is a human monocytic cell line that has been to elaborate factors that affect normal human hematopoiesis in vitro. Studies on the effects of these factors demonstrated an erythroid potentiating factor (EPF) and a potent inhibitor of granulocyte-macrophage (CFU-GM) colony growth. The EPF was present in both serum-containing and serum-free U- 937 conditioned media, had a dose-dependent effect on erythroid colony formation and was remarkably heart stable. The CFU-GM inhibitory activity was also detected in serum-free conditioned medium, was dose- dependent, heart labile and its effect was reversed by Indomethacin. Indomethacin (Sigma, St. Louis, Mo.) did not alter the erythroid effects of the U-937 conditioned medium. No colony stimulating factor (CSF) or erythropoietin (Ep) could be detected in this medium. The existence of a human cell line capable of production EPF without simultaneous CSF production will permit further studies on the biochemical and biologic nature of these factors.     

In vitro tests for distinguishing possible immune-mediated aplastic anemia from transfusion-induced sensitization

Forty-two patients with aplastic anemia (AA) were studied to determine whether or not transfusion-induced sensitization is responsible for the in vitro inhibition by patient lymphocytes of HLA-identical erythroid burst-forming units (BFU-E). The results indicate that lymphocytes from 12 of 34 transfused patients inhibited normal colony growth. In contrast, lymphocytes from none of the 8 untransfused patients demonstrated inhibition. These data were interpreted to mean that coculture studies would not be useful for identifying immune-mediated AA in transfused patients. Therefore, in order to identify possible immune-related AA, we assayed BFU-E from patient blood before and after T-cell depletion. In all 32 patients studied, BFU-E failed to grow from peripheral blood cells before T-cell depletion, but in 8 cases, normal- appearing BFU-E grew after T cells had been removed. Growth of patient BFU-E colonies was inhibited in 6 cases when patient T cells were added back to the culture, indicating that in these 6 patients, an "autoimmune" mechanism may have been present.     

出生前母亲接受一疗程的倍他米松对早产儿心脏的影响

目的:研究母亲产前接受一疗程的倍他米松对早产儿心脏测量结果和心肌收缩功能的影响。方法:76例胎龄为25～33周的早产儿。根据胎龄进行最初分组:25～29周(n=28)和30～33周(n=48)两组。然后按照倍他米松阳性(母亲用过一疗程倍他米松)或阴性(母亲未用过任何糖皮质激素)再次分组。     

Marrow transplantation for children in first remission of acute nonlymphoblastic leukemia: an update

Thirty-eight children between the ages of 0.8 and 17 years with acute nonlymphoblastic leukemia in first remission induced by chemotherapy were given cyclophosphamide, total body irradiation, and bone marrow transplants from HLA-matched donors. Six patients died of pneumonia, one died of metabolic problems, and one died of chronic graft-v-host disease complications. Five patients relapsed between six months and 3.2 years after transplantation. Three of the five died of leukemia, one survives with leukemia three years after transplantation, and one survives in remission off treatment following chemotherapy for 22 months. Twenty-five survive in continuous remission from 1.7 to 8.4 years after transplantation, and the actuarial analysis shows a disease- free survival rate of 64%, with a plateau extending from 3.5 to 8.4 years. All lead normal lives.