Bronchoplastic methods in the resection treatment of malignant bronchial tumors

1548 patients who were hospitalized 1964--1975 for diagnosis and treatment of bronchogenic carcinoma, 779 underwent resection. 17 patients could be operated by lobectomy or bilobectomy and bronchial resection (sleeve resection). Postoperative complications were frequent (n = 8): 4 times bronchopleural fistula, 2 times empyema, once fatal pneumonia and once bronchial stenosis. The overalll mortality and the survival rates are comparable to those of patients with radical resections. Sleeve resection is therefore a suitable alternative to pneumonectomy in elderly patients with reduced pulmonary function, rarely indicated also by a favourable tumor size. Sleeve resection increases the resectability of malignant bronchogenic tumors by 2%. Methods to prevent or cure the postoperative complications consisted in the use of absorbable suture material and long lasting intrathoracic suction.     

Clostridium perfringens hip arthritis in a haemodialysis patient

Haemodialysis patients have acquired immunity disturbances, co-morbidities and a vascular access, factors predisposing them to infection and bacteraemia. Clostridium perfringens is an anaerobic bacterium potentially causing severe infections, including rarely septic arthritis. We report the first case of Clostridium perfringens septic arthritis in a haemodialysis patient and suggest a haematogenous spread. After rapid joint lavage combined with appropriate anti-microbial therapy, the patient recovered.     

Protocadherin 7–Associated Membranous Nephropathy

BackgroundMembranous nephropathy (MN) results from deposition of antigen-antibody complexes along the glomerular basement membrane (GBM). PLA2R, THSD7A, NELL1, and SEMA3B account for 80%–90% of target antigens in MN.MethodsWe performed laser microdissection and mass spectrometry (MS/MS) in kidney biopsies from 135 individuals with PLA2R-negative MN, and used immunohistochemistry/immunofluorescence and confocal microscopy to confirm the MS/MS finding, detect additional cases, and localize the novel protein. We also performed MS/MS and immunohistochemistry on 116 controls and used immunofluorescence microscopy to screen biopsy samples from two validation cohorts. Western blot and elution studies were performed to detect antibodies in serum and biopsy tissue.ResultsMS/MS studies detected a unique protein, protocadherin 7 (PCDH7), in glomeruli of ten (5.7%) PLA2R-negative MN cases, which also were negative for PLA2R, THSD7A, EXT1/EXT2, NELL1, and SEMA3B. Spectral counts ranged from six to 24 (average 13.2 [SD 6.6]). MS/MS did not detect PCDH7 in controls (which included 28 PLA2R-positive cases). In all ten PCDH7-positive cases, immunohistochemistry showed bright granular staining along the GBM, which was absent in the remaining cases of PLA2R-negative MN and control cases. Four of 69 (5.8%) cases in the validation cohorts (all of which were negative for PLA2R, THSD7A, EXT1, NELL1, and SEMA3B) were PCDH7-positive MN. Kidney biopsy showed minimal complement deposition in 12 of the 14 PCDH7-associated cases. Confocal microscopy showed colocalization of PCDH7 and IgG along the GBM. Western blot analysis using sera from six patients showed antibodies to nonreduced PCDH7. Elution of IgG from frozen tissue of PCDH7-associated MN showed reactivity against PCDH7.ConclusionsMN associated with the protocadherin PCDH7 appears to be a distinct, previously unidentified type of MN.     

Comparative dosimetry between 99mTc-MAA SPECT/CT and 90Y PET/CT in primary and metastatic liver tumors

European Journal of Nuclear Medicine and Molecular Imaging - The aim of this study is to determine whether 99mTc-MAA SPECT/CT-based dosimetry could predict the actual absorbed dose in...     

Dialysis‐related Amyloidosis: Is It Gone or Should It Be?

The prevalence and severity of dialysis‐related amyloidosis (DRA) appear to have decreased significantly over the last two decades, although recent, large‐scale epidemiological studies show that DRA continues to occur. Recent experimental findings have documented a direct cellular toxicity of β2microglobulin (β2m) fibrils but the mechanisms of β2m fibrillogenesis remain incompletely understood. Although a high plasma concentration of β2m is still considered as a prerequisite for developing DRA, other factors have been clearly incriminated such as older age at dialysis onset and longer dialysis vintage, or suspected effects such as proinflammatory effects of bioincompatible dialysis techniques. Improved dialysis technology has definitely played a role in delaying the onset of the disease, although the respective contributions of high‐flux biocompatible membranes, use of convective mode, and ultrapure dialysate remain imperfectly defined. Importantly, DRA still does exist and no current dialytic modality seems able to fully prevent it. Awaiting further progress in the understanding of DRA pathogenesis, the use of biocompatible high‐flux membranes and ultrapure dialysate is strongly recommended in order to minimize or delay its onset. Convective regimens may provide an additional benefit.     

Acute interstitial nephritis and fatal Stevens-Johnson syndrome after propylthiouracil therapy.

We report a case of acute interstitial nephritis and fatal Stevens-Johnson syndrome in a 90-year-old woman with amiodarone-induced hyperthyroidism, who had been treated for 5 weeks with propylthiouracil (PTU). On admission, the patient exhibited acute renal failure and generalized macular purpuric eruption. Acute interstitial nephritis and Stevens-Johnson syndrome were diagnosed and PTU withdrawn. Although renal function recovered after PTU withdrawal and corticosteroid therapy, the patient's condition worsened, and she died after developing multiple organ failure. Acute interstitial nephritis seems to be rarely associated with PTU therapy. Moreover, a literature review suggested that this could represent the first published report of a Stevens-Johnson syndrome developing during PTU therapy.     

Sevelamer and pharmacokinetics of cyclosporin A after kidney transplantation

Sir, In their interesting article, Pieper et al. analysed prospectivelythe effect of sevelamer on the pharmacokinetics of cyclosporin(CsA) and mycophenolate mofetil (MMF) in kidney     

Drug interaction between sevelamer and cyclosporin

Sir, Sevelamer hydrochloride is a calcium-free polymer licensed recentlyas a phosphate binder in haemodialysis (HD) patients. Its useis associated with a slower progression of coronary and aorticcalcifications than the use of calcium-based binders in suchpatients [1