Release of urodilatin from perfused rat kidney and from cultured neonatal rat kidney cells

Release of rat urodilatin (rURO) from isolated perfused rat kidneys and neonatal rat kidney cells could be demonstrated by a specific competitive radioimmunoassay (rURO-RIA) using [¹²⁵I]rURO as the competitive antigen and an antiserum against the hypothetical rURO-N-terminus, Ala-Gly-Pro-Arg, as concluded from the amino acid sequence of the rat prohormone CDD/ANP-1-126. This antiserum did not react with synthetic rCDD/ANP-99-126, brain natriuretic peptide (BNP), C-type natriuretic peptide (CNP), or human URO (hURO). rURO could be demonstrated in the urine of the perfused rat kidney after an equilibration period of 20 min. After an initial slight decrease in the second 20 min, rURO production remained at almost the same level during the perfusion time of 100 min. A total of 470 fmol · 10 min^–1 · g^–1 kidney rURO was produced within 80 min. rURO was also produced by neonatal rat kidney cells kept in serum-free Dulbecco's modified Eagles medium. The production of rURO depended on the cultivation time of the cells. It increased up to 3 days reaching 239 ±7.5 fmol-h^–1 · g^–1 protein, afterwards it decreased rapidly. The results obtained indicate that the rat kidney produces a peptide of the type A family of natriuretic peptides, which very likely represents the putative rURO.     

Implementing telemonitoring in the daily routine of a GP practice in a rural setting in northern Germany

We conducted a two-month feasibility study of telemonitoring based on home visits by a specially trained nurse to 20 elderly patients who would otherwise have been receiving monitoring home visits from their general practitioner (GP). A specially-trained community medicine nurse was instructed to report important changes in the health status of a patient during her home visits immediately via telephone. In the case of 8 patients, various telecare devices were installed by the community medicine nurse according to the patients' needs. Patients were trained to use the devices independently in their homes. Three patients received a one lead ECG meter and made 100 successful transmissions in 101 patient-days. Three patients were supplied with an electric scale and successfully transferred 72 measurements in 73 patient-days. Two patients were equipped with a teletonometry system and used the blood pressure monitor and blood glucose meter successfully. The tonometer itself was used by only one of the patients as suggested by the GP (once per week; 5 successful transmissions in 39 days). The GP reported a positive effect on her work, with time saved because of less travelling for home visits. With the back-up of the measurements obtained by the telecare devices it was possible to delegate monitoring tasks to the community medicine nurse.     

Prognostic significance of activating FLT3 mutations in younger adults (16 to 60 years) with acute myeloid leukemia and normal cytogenetics: a study of the AML Study Group Ulm

To assess the prognostic relevance of activating mutations of the FLT3 gene in homogeneously treated adults 16 to 60 years of age with acute myeloid leukemia (AML) and normal cytogenetics, pretreatment samples from 224 patients entered into 2 consecutive multicenter treatment trials were analyzed for FLT3 internal tandem duplications (ITDs) and Asp835 mutations. Treatment included intensive double-induction therapy and postremission therapy with high cumulative doses of high-dose cytarabine. ITDs were detected in 32% of the patients and were related to de novo AML and to high white blood cell (WBC) counts, percentages of peripheral blood (PB) and bone marrow (BM) blasts, and serum lactate dehydrogenase levels. Asp835 mutations were present in 14% of the patients and were associated with WBC counts and percentages of PB and BM blasts that were higher than those of patients without FLT3 mutations. With a median follow-up of 34 months, remission duration and overall survival (OS) were significantly shorter for patients with Asp835 mutations or an ITD than for those without FLT3 mutations (P =.03 and P =.0004, respectively). These results were attributable mainly to the negative prognostic effect of FLT3 ITDs. On multivariate analysis, mutant FLT3 was an independent marker affecting remission duration and OS (hazard ratio, 2.35 and 2.11, respectively). Fluorescence in situ hybridization did not detect monoallelic FLT3 deletions in ITD-positive patients. FLT3 mutations identify a subset of young AML patients with normal cytogenetics who do not benefit from intensive chemotherapy, including double-induction and postremission therapy with high-dose cytarabine.     

Reduced-intensity conditioning followed by T-cell depleted allogeneic stem cell transplantation for patients with chronic myeloid leukaemia and minimal residual disease at the time of transplant: high risk of molecular relapse

A pilot trial was initiated for chronic myeloid leukaemia patients, which employed imatinib for remission induction, followed by reduced-intensity conditioning and an in vivo T-cell depleted graft. Out of nine patients, six experienced a molecular relapse and one patient had a haematological relapse at a median interval of 5 months after transplantation. Five relapsing patients achieved a 2nd molecular remission after treatment with either donor lymphocyte infusions (n = 4) or imatinib (n = 1). Two of nine patients died due to infectious complications. The probability of survival 2 years after transplant was 74% (95% CI 42-100%).