Recurrence risk for the relatives of delusional depressed patients

The recurrence risks for major depression among the relatives of patients with delusional depression have been calculated using a computer program. The risk tables have been based on the data from the 454 first-degree relatives of 77 probands with delusional depression, the 503 first-degree relatives of 76 non-delusional probands and the 980 first-degree relatives of 153 controls. The results showed that: the familial aggregation of the delusional depression seem to follow the multifactorial pattern of inheritance (segregation analysis), the heritability of the delusional depression was found to be 62, the recurrence risk varies from 0.5% to 36.2% for the various relatives and tables for recurrence risks are provided.     

Serum creatine kinase B subunit levels in neurogenic atrophies

Summary This study is an attempt to determine the creatine kinase B (CK-B) subunit levels in neurogenic atrophies. A group of 69 patients was studied and the results were compared with those in a group of 32 patients with muscle disease. The results showed that the CK-B levels are considerably higher in patients with amyotrophic lateral sclerosis (P<0.001) and peroneal muscular atrophy (P<0.001). Further studies in the various subgroups of neurogenic atrophies showed that, regardless of the nosological entity, the CK-B activity is considerably higher: (1) in the widespread as opposed to limited forms (P<0.001); (2) in the chronic than in the acute neurogenic atrophies (P<0.001); and (3) in the active as opposed to residual forms (P<0.02). It is suggested that the increase of CK-B in neurogenic atrophies is a strong indication of an active regeneration process in the denervated muscle.     

Genotyping of presenilin-1 polymorphism in amyotrophic lateral sclerosis

The mechanisms underlying motor neuron degeneration in amyotrophic lateral sclerosis are not fully understood. Recent studies suggest that apoptosis is involved in the abnormal neural death that occurs in this devastating disease. Presenilin-1, a transmembrane protein, seems to be implicated in apoptosis. To determine whether presenilin-1 intron 8 polymorphism has an influence in the course of amyotrophic lateral sclerosis, we examined this polymorphism genotypes in a large group of patients (n=72) with amyotrophic lateral sclerosis and in a random sample of 213 healthy individuals. The results showed a significant difference in genotype (P < 0.04) and allele (P < 0.03) distribution between patients and controls. These results suggest a possible intervention of presenilin-1 in the pathogenesis of amyotrophic lateral sclerosis. Received: 14 February 2000 / Received in revised form: 20 April 2000 / Accepted: 4 June 2000     

Pulmonary blastoma presenting with massive hemothorax.

Pulmonary blastoma, a rare primary lung neoplasm occurring in both children and adults, is histologically distinct from other lung tumors. A patient is described who presented with massive and persistent hemothorax. Based on experience, it is possible that in advanced cases of this tumor, more vigorous chemotherapy is needed against both histologic elements.     

Successful surgical treatment of refractory amiodarone-induced thyrotoxicosis causing tachycardiomyopathy

Amiodarone is a well-established pharmacologic therapy used for several types of tachyarrhythmia. However, it is associated with potential adverse effects on thyroid function due to its high iodine concentration. Amiodaroneinduced thyrotoxicosis (AIT) is considered a difficult diagnostic problem that requires careful therapeutic strategy in order to balance the cardiologic and endocrine dysfunction associated with this condition. Herein, we report the case of a 52-year-old male patient who suffered from tachyarrhythmia due to paroxysmal atrial fibrillation. The patient had experienced recurring episodes of atrial fibrillation despite medical therapy with propafenone, sotalol and pulmonary vein isolation with catheter ablation. Amiodarone was subsequently administered, and temporary control of the arrhythmia was achieved. Six months after amiodarone treatment, the patient presented with uncontrollable tachycardia leading to heart failure, a condition known as tachycardiomyopathy. The thyroid function was assessed, and amiodarone-induced thyrotoxicosis was diagnosed. Unfortunately, AIT was refractory to treatment with carbimazole and cortisone and a surgical approach was decided. The patient eventually underwent a total thyroidectomy with complete control of the underlying arrhythmia, without the necessity for β-blockers. Heart failure was reversed and the patient has resumed his normal daily activities.     

Randomised trial of epirubicin versus fluorouracil in advanced gastric cancer: An International Collaborative Cancer Group (ICCG) study

Background: It is not yet established whether doses of epirubicinequitoxic to adriamycin are more effective in the treatmentof locally advanced or metastatic gastric cancer. Patients and methods: Seventy patients with advanced gastriccancer were randomised to receive fluorouracil (500 mg/m² days1–5 every three weeks) or epirubicin (100 mg/ m² everythree weeks), with doses escalating to a maximum dose of 700mg/m² of fluorouracil or 140 mg/m² of epirubic Results: No patients attained complete response. Partial responsewas seen in 3 patients in the epirubicin arm (8%) compared with2 patients in the fluorouracil arm (6%). No statistically significantdifference between the two treatments was seen in either responseor survival. Severe side effects, particularly alopecia, andnausea and vomiting were more common in the epirubicin arm (45%and 37%, respectively) compared with the fluorouracil arm (12%and 8%, respectively). Conclusions: Our trial demonstrates that fluorouracil and epirubicinas single agents have comparable but insufficient activity inadvanced gastric cancer. stomach cancer, chemotherapy, anthracycline     

Results of a prospective randomized study of hepatic artery infusion with 5-fluorouracil versus intravenous 5-fluorouracil in patients with hepatic metastases from colorectal cancer: A Central Oncology Group study.

In a controlled, prospectively randomized trial, 74 patients with hepatic metastases from colorectal cancer were randomized to either intra-arterial hepatic artery infusion with 5-fluorouracil (5-FU) or systemic chemotherapy with 5-FU. In 61 acceptable patients, there was no significant difference in terms of response rate, time to progression, duration of the response, and survival rate. Though the response rate for the intra-arterial infusion arm was slightly higher than for the systemic arm, the difference was not significant, and the intra-arterial infusion arm was associated with a greater incidence of nausea, vomiting, diarrhea, in addition to complications of femoral-arterial thrombosis, bleeding, and infection at the catheter site not seen in patients treated by systemic chemotherapy. Patients with an objective response to chemotherapy on either treatment arm survived twice as long as the nonresponders. Long-term survival in one patient, 77 months, can occasionally be achieved in patients with hepatic metastases.     

Karyometric changes in human muscle with age

Human muscle cell growth was studied to investigate the nucleo-cytoplasmic ratio during development and ageing. The mean muscle fibre size, as well as the number and size of myonuclei were estimated in human muscle biopsies from normal individuals whose ages ranged from 1 to 71 years. Changes in muscle fibre size were accompanied by similar changes in nuclear number, the size of which remained the same. This resulted in a constant nucleo-cytoplasmic ratio during the age range studied. The role of the satellite cell in the maintenance of this ratio was discussed.