Basophilic blast crisis in chronic myeloid leukemia

Acute nonoliguric renal failure developed in a 13-year-old girl, 1 month after the institution of isoniazid therapy because of a positive tuberculin test at school screening. A renal biopsy demonstrated severe crescentic glomerulonephritis with focal interstitial changes. Discontinuation of isoniazid and a short course of steroids and cyclophosphamide therapy were followed by complete recovery. Whereas isoniazid has been shown to induce a lupus-like syndrome and antihistone antinuclear antibodies, our patient displayed none of the clinical or immunological features that are characteristic of drug-induced lupus. Furthermore, none of the identifiable causes for crescentic glomerulonephritis was evident in this girl. To the best of our knowledge this is the first report suggesting a possible association of crescentic glomerulonephritis to isoniazid treatment.     

Three cases of tuberculosis after heart transplantation in Spain

The fibrinolytic capacity of patients with acute myocardial infarction (AMI) is known to be impaired. The primary regulatory element of the fibrinolytic system is plasminogen activator inhibitor (PAI). It has been previously observed that there are 2 peaks in the plasma PAI level of AMI patients at 4h and 16h after thrombolytic therapy with recombinant tissue plasminogen activator (rtPA). Lanoteplase/SUN9216 is a mutant tPA with a biological half-life longer than that of rtPA. Thrombolytic therapy with mutant tPA or rtPA was carried out consecutively in 21 patients with AMI (8 patients as the mutant tPA group, and 13 patients as the rtPA group). The recanalization time of the mutant tPA group was significantly faster than that of the rtPA group (16.1 +/- 3.9 min vs 39.6 +/- 4.8 min, p<0.01). The PAI activity at 4h after the initiation of thrombolysis was significantly lower in the mutant tPA group than in the rtPA group (8.74 +/- 5.46IU/L vs 26.74 +/- 3.35 IU/L, p<0.01). There was a one mild peak in serial plasma PAI activity levels 24h after the initiation of thrombolysis. The results suggest that thrombolytic therapy with mutant tPA reduced the impairment of fibrinolytic capacity. The mutant tPA gives faster recanalization and lower PAI activity after successful thrombolysis, compared with rtPA.     

Liquid chromatographic determination of five benzoylurea insecticides in fruit and vegetables

A liquid chromatographic (LC) method was developed to determine 5 benzoylureas--diflubenzuron, hexaflumuron, teflubenzuron, flufenozuron, and lufenuron--in peppers, tomatoes, eggplants, cucumbers, and oranges. Preparation of samples involve extraction with acetone and partitioning into dichloromethane-petroleum ether. A portion of this extract is cleaned up with a solid-phase extraction aminopropyl disposable column. With LC analysis using an RP-8-DB microbore column, acetonitrile-water (70 + 30, v/v) as mobile phase, and photodiode array detection at 254 nm, recovery and repeatability data were collected for the 5 benzoylureas on 4 vegetables and citrus in the range 0.04-2.0 mg/kg. Validated limits of detection and quantitation were 0.01 and 0.04 mg/kg, respectively. The method is reliable for routine analysis of vegetables and fruits.     

The role of government in health insurance markets with adverse selection

This paper analyzes the welfare economics of three arrangements for purchasing health insurance: competitive markets in which consumers are free to choose among options with different levels of coverage and prices; systems with compulsory partial pooling which permit private firms to sell supplementary coverage; and government-run pools that purchase comprehensive coverage at a single price for all consumers. Competitive insurance markets are assumed to face the problem of 'adverse selection'. This refers to a situation in which the insurer cannot observe characteristics of individuals that affect the cost of insurance and that are known to the individuals. Competitive markets with adverse selection are not efficient because low risks cannot purchase comprehensive insurance coverage. However, government-run pools with comprehensive coverage are an inefficient solution to the problem of adverse selection. Compulsory partial coverage may represent an attractive alternative to both competitive markets and comprehensive pools. We discover two situations when government intervention of this type will succeed: when there are not many high risks in the population, and when the risk types are similar. We discuss the implications of these results for health insurance programs in several countries. Our results also have implications for the allocation of public funds for disease-prevention projects. A project targeted at high risks will produce external benefits for low risks, even though they are not directly affected by the program. However, a successful project might eliminate the market for private insurance; in this case the government should consider mandating partial insurance coverage.     

Clear lens extraction and implantation of negative-power posterior chamber intraocular lenses to correct extreme myopia

PURPOSE: To evaluate the effectiveness, predictability, and safety of clear lens extraction to correct extreme myopia. SETTING: Clinica de Nuestra Se?ora de la Concepción, Fundación Jiménez Díaz, Madrid, Spain. METHODS: This retrospective study comprised 26 eyes of 17 highly myopic patients who had clear lens extraction and implantation of a negative-power posterior chamber intraocular lens (IOL). The IOL power was calculated using the SRK/T formula. Analyzed were visual and refractive results and intraoperative and postoperative complications. Follow-up was at least 12 months in all cases. RESULTS: Uncorrected visual acuity improved in all cases, with 80.77% of eyes achieving 20/100 or better and 42.30%, 20/40 or better. Best spectacle-corrected visual acuity (BSCVA) improved in 23 eyes (88.46%). The percentage of eyes achieving a BSCVA of 20/100 or better increased from 73.07% preoperatively to 92.30% postoperatively and the percentage achieving 20/40 or better, from 23.07 to 73.07%. Of the 26 eyes, 76.91% were within 1.00 diopter (D) of refractive error and 96.16% were within 2.00 D. No intraoperative complications occurred. Although postoperatively 3 eyes (11.53%) developed choroidal detachment and 5 (19.23%) had an intraocular pressure greater than 25 mm Hg, all had a favorable outcome. Four eyes (15.38%) developed posterior capsule opacification and had a neodymium:YAG laser posterior capsulotomy 6 months postoperatively. No retinal detachments were observed. CONCLUSION: Clear lens extraction with negative-power IOL implantation using the SRK/T formula had good effectiveness, acceptable predictability, and a low morbidity in eyes with extreme myopia over a short follow-up. A longer follow-up with more cases is needed to assess the safety of the procedure.     

Congenital hypothyroidism

Congenital hypothyroidism (CH) occurs in 1/3 500 newborn infants. Interest in newborn screening for CH has been widely demonstrated in most countries. It was introduced in France in the last 70's; by the measurement of serum TSH level from an eluate of whole blood collected on filter paper on 3 days of life. It allows earlier diagnosis and treatment preventing most of the serious sequelae of the disease such as postnatal neurological damage. Their neuropsychological evaluation has shown normal mental development in most cases. Although CH with eutopic gland (15% of the cases) has recently been recognized as associated with different molecular defect, the cause of thyroid agenesis (85% of the cases with athyreosis or ectopic gland) remains unknown. These latter forms are usually sporadic but familial cases are described.     

Systemic and intracerebroventricular injections of vasotocin inhibit appetitive and consummatory components of male sexual behavior in Japanese quail.

The authors investigated the behavioral actions of vasotocin (VT) in castrated testosterone-treated male Japanese quail. The appetitive and consummatory components of sexual behavior as well as the occurrence frequency of crows were inhibited, in a dose-dependent manner, by injections of VT. The authors observed opposite effects after injection of the V1 receptor antagonist, dPTyr(Me)AVP. Lower doses of VT were more active after central than after systemic injection, and effects of systemic injections of VT were blocked by a central injection of dPTyr(Me)AVP. The behavioral inhibition was associated with a modified diuresis after systemic but not central injection. These results provide direct evidence that VT affects male sexual behavior in quail by a direct action on the brain independent of its peripheral action on diuresis. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Transporters for cationic amino acids in animal cells: discovery, structure, and function

The structure and function of the four cationic amino acid transporters identified in animal cells are discussed. The systems differ in specificity, cation dependence, and physiological role. One of them, system y+, is selective for cationic amino acids, whereas the others (B[0,+], b[0,+], and y+ L) also accept neutral amino acids. In recent years, cDNA clones related to these activities have been isolated. Thus two families of proteins have been identified: 1) CAT or cationic amino acid transporters and 2) BAT or broad-scope transport proteins. In the CAT family, three genes encode for four different isoforms [CAT-1, CAT-2A, CAT-2(B) and CAT-3]; these are approximately 70-kDa proteins with multiple transmembrane segments (12-14), and despite their structural similarity, they differ in tissue distribution, kinetics, and regulatory properties. System y+ is the expression of the activity of CAT transporters. The BAT family includes two isoforms (rBAT and 4F2hc); these are 59- to 78-kDa proteins with one to four membrane-spanning segments, and it has been proposed that these proteins act as transport regulators. The expression of rBAT and 4F2hc induces system b[0,+] and system y+ L activity in Xenopus laevis oocytes, respectively. The roles of these transporters in nutrition, endocrinology, nitric oxide biology, and immunology, as well as in the genetic diseases cystinuria and lysinuric protein intolerance, are reviewed. Experimental strategies, which can be used in the kinetic characterization of coexpressed transporters, are also discussed.