Thyroperoxidase: a tumor marker for post-therapeutic follow-up of differentiated thyroid carcinomas? Results of a time course study

Serum thyroperoxidase (TPO) and serum human thyroglobulin (hTg) were studied in 80 patients with differentiated thyroid carcinoma after thyroidectomy before and after the first therapeutic radioiodine application ("radioiodine thyroid ablation") and, in some cases, after the second radioiodine application. Eighteen patients with an autonomous adenoma were studied in the same manner. The values of TPO and hTg in 25 persons without thyroid impairment were used as controls. In 34 of 50 evaluable cases, TPO levels behaved as hTg during follow-up studies: The majority (n= 30) of these patients showed an increase in TPO and hTg serum levels immediately after radioiodine therapy, followed by a decrease approximately 3 days later. However, in 16 of 50 patients, the TPO and hTg serum levels showed different patterns of change both before and after radioiodine therapy. In six of seven patients with extensive postoperative residues and high anti-hTg levels, distinctly elevated TPO values were associated only by slightly elevated thyroglobulin values. There was no rise of TPO in autonomous adenoma except in patients treated with thyroid depressants. We assumed that TPO levels could serve as an "indicator" for destruction of thyroid cells or thyroid carcinoma cells and an aid in screening cases of false-negative hTg values.     

Endotoxaemia in severe burns

In an attempt to detect endotoxaemia the authors carried out the Limulus test in burned patients' plasma. The test was positive mainly in lethal cases, yet it was negative in many other cases where endotoxaemia could be presumed.The authors therefore carried out a series of experiments in rabbits, in which they proved that endotoxin entering the circulation is being accumulated in leucocytes and can be detected in platelet-leucocyte lysate, using Limulus test, even at low concentrations, when Limulus test in plasma is negative.It appears that endotoxin detection by Limulus test in plasma does not offer decisive results and that it should be supplemented by endotoxin detection in platelet-leucocyte lysate.     

Quality of margarine: fats selection and processing parameters

Optimum processing conditions on palm oil-based formulations are required to produce the desired quality margarine. As oils and fats contribute to the overall property of the margarine, this paper will review the importance of beta' tending oils and fats in margarine formulation, effects of the processing parameters -- emulsion temperature, flow-rate, product temperature and pin-worker speed -- on palm oil margarines produced and their subsequent behaviour in storage. Palm oil, which contributes the beta' crystal polymorph and the best alternative to hydrogenated liquid fats, and the processing conditions can affect the margarine consistency by influencing the solid fat content (SFC) and the types of crystal polymorph formed during production as well as in storage. Palm oil, or hydrogenated palm oil and olein, in mixture with oils of beta tending, can veer the product to the beta' crystal form. However, merely having beta' crystal tending oils is not sufficient as the processing conditions are also important. The emulsion temperature had no significant effect on the consistency and polymorphic changes of the product during storage, even though differences were observed during processing. The consistency of margarine during storage was high at low emulsion flow-rates and low at high flow rates. The temperature of the scraped-surface tube-cooler is the most important parameter in margarine processing. High temperature will produce a hardened product with formation of beta-crystals during storage. The speed of the pin-worker is responsible for inducing crystallization but, at the same time, destroys the crystal agglomerates, resulting in melting.     

Valve replacement surgery in patients with end-stage renal disease: long-term results

BACKGROUND: The life expectancy of patients with chronic renal failure who are dependent on dialysis is very poor. This study was undertaken to determine time-related outcomes in dialysis patients requiring cardiac valve replacement. METHODS: From 1994 to 2001, 29 end-stage renal disease (ESRD) patients on hemodialysis (HD) program underwent 30 valve replacement operations: 29 received mechanical valves (97%), and one received bioprosthetic valves. The sites of valve replacement were 11 aortic (36.7%), 18 mitral (60%), and one both aortic and mitral (3.3%). Mean age was 42.46 +/- 14.26 years (range 17-75 years). Follow-up was completed in 28 patients (96.5%). RESULTS: Early postoperative mortality (in the first 30 days) was 3.4% (n = 1). The overall estimated Kaplan-Meier survival was 56.7% at 36 months, 46.7% at 60 months, and 43.3% at 96 months. HD program was discontinued for two patients after renal transplantation in the follow-up period. All patients, except the one with bioprosthesis, used warfarin sodium for anticoagulation and none of them had bleeding. One of the patients had a major cerebrovascular accident (CVA) and another one had a minor CVA at the follow-up (6.7%). CONCLUSIONS: Life quality is better and life expectancy is longer after valve replacement in ESRD patients who have valvular disease. Also, longer life expectancy increases the probability for finding donors for kidney transplantation.     

Nasal angiomyolipoma

Angiomyolipomas (AMLs) are hamartomatous lesions containing smooth muscle, vasculature and mature adipose tissue. AML occurs most frequently in the kidneys, with the liver being the second commonest site of involvement. Other localizations for AML are extremely rare and, to our knowledge, only six cases of AML of the nasal cavity have been reported to date. Our case involved a 52-year-old male who presented with a history of snoring and obstruction of the left nasal cavity. Physical examination revealed a 3-cm polypoid mass in the left nasal cavity, which was excised surgically. Histopathologic examination revealed that the lesion was composed of smooth muscle bundles, mature adipose tissue and blood vessels of different sizes. No epitheloid smooth muscle cells were observed and HMB-45 staining was negative. In conclusion, although nasal AML is a rare lesion, it should be considered in the differential diagnosis of polypoid nasal masses, especially when the mass occurs unilaterally.