The accuracy of 111InCl3 as a bone marrow scanning agent.

The number of normal cellular elements present in bone marrow biopsies was compared to the extent of uptake at corresponding sites on 111InCl3 bone marrow scans in 87 patients with malignant lymphoma. Of the biopsies free of tumor, 49/54 interpreted as normocellular and 16/17 hypocellular or aplastic confirmed the scan interpretation. Of the biopsies demonstrating tumor, 10/11 of those interpreted as normocellular and 14/15 hypocellular or aplastic confirmed the scan interpretation. The 111InCl3 bone marrow scan is accurate in depicting the presence or absence of normal marrow elements, but is of value in detecting tumor only when the normal elements are extensively replaced.     

Prostaglandins and angioplasty. An experimental study in canine arteries

To prevent platelet aggregation following percutaneous transluminal angioplasty (PTA), cyclooxygenase inhibitors such as acetylsalicylic acid (ASA) and indomethacin are recommended. However, ASA blocks both the proaggregating effects of thromboxane (TXA2) and the antiaggregating and vasodilating effects of prostacyclin (PGI2). The authors measured the contractile response of dilated canine carotid arteries in situ and in vitro using an isometric force transducer. Following PTA, contraction of the arterial wall was significantly reduced (p less than 0.01). By blocking cyclooxygenase with indomethacin (3 micrograms/ml), contraction was greatly improved (p less than 0.001). These results suggest that PTA may result in marked release of prostacyclin by the damaged arterial wall, which could account for the decreased responsiveness of the artery to exogenous norepinephrine.     

Neutrophil function and lipid peroxidation in a rat model of multiple organ failure

Multiple organ failure (MOF) was induced by sterile intraperitoneal inoculation of zymosan in the rat. This results in a typical triphasic illness with maximal clinical signs at Days 2 and 14. In this study, granulocyte superoxide production (unstimulated and phorbol myristic acid stimulated) was studied as well as lipid peroxidation (TBAR) in plasma, liver, and lung tissue. Mainly TBAR levels in liver and lung tissue closely correlated with the triphasic clinical illness, while bacteriological data did not. It is concluded that the severe inflammatory response in this experimental model probably is the result of excessive toxic oxygen radical production. The first phase of illness may mainly be due to oxygen radical formation by activated PMN, the third phase of illness to the production of lysosomal enzymes (proteinases) from PMN, and activated macrophages as indicated by elevated N-acetylglucosaminidase levels.     

Hemopoiesis during thiamphenicol treatment. I. Stimulation of stem cells during eradication of intermediate cell stages

Continuous treatment of C57bl/6 mice for 4 days with the cytostatic antibiotic thiamphenicol revealed a dual response of hemopoietic cells. On one hand, morphologically recognizable erythroid precursors and late progenitors (erythroid colony-forming units; CFU-E) and, to a lesser extent, granuloid precursors were found substantially reduced. On the other hand, early granuloid (granulocyte-macrophage colony-forming units; CFU-GM) and erythroid (erythroid burst-forming units; BFU-E) progenitors increased on day 3 to 220%-240% and 120%-130% of the control value, respectively. This was accompanied by a decline of the initial spleen colony-forming units (CFU-S) (day 8) pool size to approximately 60%. These patterns were similar in the bone marrow and the spleen. In addition, the tritiated thymidine kill of femoral and splenic CFU-S rose significantly (p less than 0.05) from 16% +/- 3% to 38% +/- 2% and from 3% +/- 1% to 17% +/- 2%, respectively. A sudden decline of peripheral reticulocytes between days 2 and 3 from 2.8% +/- 0.3% to 0.6% +/- 0.2% was observed, whereas the hematocrit gradually decreased from day 1 to day 4 from 45.2% +/- 0.1% to 39.3% +/- 0.3%. The white blood cells were not affected. From these results we conclude that stem cells were stimulated as a consequence of the suppression of the intermediate cell stages. As analyzed in the accompanying paper, this confirms a prediction stated by a quantitative theoretical concept of in vivo stem cell regulation.     

Renal injury management: no longer controversial

Optimal management of renal injuries used to be a subject of controversy between the advocates of 'early intervention' and 'expectant' approach. Nowadays, most opinions have blended into a consensus for all but a small number and type of renal injuries. The purpose of this study was to investigate if the therapeutic approach in renal injuries is no longer controversial. We report the long-term results in 622 consecutive patients with renal injury, admitted to the University Hospital St Radboud in Nijmegen, The Netherlands, between 1972 and 1983. During this 11-year period a middle-course management was followed relative to indication and timing of operative intervention. This type of approach proved quite successful not only in reducing the nephrectomy rate but at the same time in lowering the incidence of early and late complications. It is concluded that choice and timing of therapy in renal injuries should depend on: 1. Accurate diagnosis of the extent of the renal injury, 2. Associated major injuries and 3. Clinical condition of the patient. Such an individualized approach most benefits the patient.     

Pedigree analysis and epidemiological features of idiopathic congenital talipes equinovarus in the United Kingdom: a case-control study

Background  

Congenital talipes equinovarus (CTEV) is a common developmental disorder of the foot, affecting between 1 and 4.5 per 1000 live births. The aetiology is not well elucidated. While both genetic and environmental factors are implicated, no specific genes have been identified and little is known about environmental risk factors.     

A stochastic interpretation of thallium myocardial perfusion scintigraphy

A method is presented for the quantitative interpretation of thallium-201 myocardial perfusion studies. The data are planar images collected immediately following the stress injection, and 4 to 6 hours later. Data analysis consists of preprocessing, including thresholding of the original data, and data reduction using a variant of the circumferential profile methods. The profiles are subdivided into segments, and for each segment the difference between the norm and the actual data is computed. This difference is a quantitative symptom, whose size is assumed to be related to the probability of having the disease. The relationship between the size of the symptom in each of nine segments (three segments/view in three views) and the probability of disease is expressed in a table in which for 30 diseases (combinations of vascular lesions) the sensitivity for each of the nine symptoms is described as a Gaussian function whose average and standard deviation are computed from previous validated cases. Using an arbitrary prevalence, the post-testing probability can then be computed using Bayes' formula sequentially. The sensitivities, however, are not expressed as a binary function of the presence or absence of a symptom, but as a distribution function defined by experience. The method is sensitive for the detection of isolated left anterior descending disease (100%) and triple vessel disease (96%). When specific combinations of vascular lesions are recognized the specificity increases from 79% (when unspecified abnormalities are recognized) to 87% when left anterior descending disease or triple vessel disease is recognized.(ABSTRACT TRUNCATED AT 250 WORDS)