A view from the family: years after a loved one has died of ovarian cancer

BACKGROUND: Macrosclerotherapy in combination with compression has proven to be safe and effective in the treatment of varicose veins. Local compression is increased by pads, according to Laplace law. Firm rolls of cotton wool are fixed over the course of the entire vein to increase local compression and to reduce complications. Additional compression is given by a combination of a class I (daytime and nighttime) and class II (daytime only) medical compression hosiery. PURPOSE: To evaluate the effectiveness and side effects of sclerocompression therapy with cotton wool rolls in combination with medical compression hosiery. METHOD: Prospective study with 100 patients (120 legs) with primary varicose veins, which are treated with polidocanol as sclerosant with the empty vein technique. Immediately after the injection, a long cotton wool roll is placed over the entire vein and fixed. Additional compression is obtained with class I and class II medical compression hosiery. The interface pressure on the skin, just under the cotton wool roll, is measured on 12 legs with the aid of an interface pressure measuring instrument (Oxford Pressure Monitor). RESULTS: Good sclerosing results are obtained in all patients. Side effects are classified as early and late. In 16 patients, minor side effects which needed no treatment are observed. In only 3 cases (2.5%), intravascular blood clots (2) and phlebitis (1) needed incision and expression. The mean interface pressure of all measuring sensors under the cotton wool roll is 84 mm/Hg (68 to 122 mm/Hg). CONCLUSION: This study proves the high effectiveness of a cotton wool roll compression right at the place of treatment. By using these long cotton wool compression rolls, the compression part of sclerocompression therapy becomes more effective and much easier to perform.     

Entorhinal cortex of aged subjects with Down''s syndrome shows severe neuronal loss caused by neurofibrillary pathology

OBJECTIVE: To examine directly the extent to which ICD-10 hyperkinetic disorder and DSM-IV attention-deficit/hyperactivity disorder (ADHD) identify the same children with the same difficulties. METHOD: Participants were children referred for symptoms of overactivity, inattention, and impulsivity, and a normal control group. Diagnostic criteria for ICD-10 hyperkinetic disorder and DSM-IV ADHD were applied retrospectively. Four groups were identified: hyperkinetic disorder and ADHD (n = 21), ADHD only (n = 22), clinic control (n = 15), and normal control (n = 19). The groups were compared on measures reflecting the central characteristics of ADHD, neurodevelopmental functioning, academic and cognitive functioning, and the presence of conduct problems. RESULTS: There is some evidence of increased symptom severity in the combined diagnostic group. Few differences emerged on measures of neurodevelopmental, academic, and cognitive functioning. Rates of conduct disturbance were similar in both ADHD groups. CONCLUSIONS: DSM-IV criteria identify a broader group of children than those identified by ICD-10. However, there is substantial overlap between the groups formed with these different criteria.     

Bone marrow mononuclear cell count does not predict neutrophil and platelet recovery following autologous bone marrow transplant: value of the colony-forming unit granulocyte-macrophage (CFU-GM) assay

The common use of the marrow autograft mononuclear cell (MNC) count derives from positive correlative studies following allogeneic transplantation and from earlier conflicting data regarding the value of the bone marrow autograft colony-forming unit granulocyte-macrophage (CFU-GM) assay for prediction hematologic recovery after ABMT. We conducted a retrospective analysis at our institution to determine whether autograft CFU-GM levels predict engraftment of neutrophils and platelets after ABMT in heavily pretreated patients with hematologic malignancies. Between 1 January 1993 and 1 March 1995, 58 heavily pretreated patients received only marrow cells as the autograft product. Patients with Hodgkin's disease (n = 25), acute myeloid leukemia (n = 19), and non-Hodgkin's lymphoma (n = 14) underwent intensive therapy with etoposide and melphalan. Unpurged marrow containing a minimum of 1.5 x 10(8)/kg (range: 1.5-4.8) was infused. Median time to an absolute neutrophil count > or = 0.5 x 10(9)/L was 21 days (range 10-270) and median time to a platelet count > or = 20 x 10(9)/L independent of transfusions was 44 days (range 13-317). There was no correlation between autograft MNC count and neutrophil or platelet engraftment. However, a correlation between autograft CFU-GM and both platelet and neutrophil recovery was demonstrated with a threshold CFU-GM of 3 x 10(4)/kg; delayed neutrophil recovery was observed in 79% of patients below this threshold compared to only 9% in those with an autograft CFU-GM level of more than 3 x 10(4)/kg (p = 0.0001). Similarly, platelet recovery was delayed in 76% of patients below, and 20% of those above this threshold (p = 0.003). We conclude that marrow autograft CFU-GM is predictive of engraftment of both platelets and neutrophils in heavily pretreated patients after ABMT for hematological malignancies.     

Sequential bilateral isolated lung perfusion in the rat: an experimental model

BACKGROUND: A model of isolated single-lung perfusion in the rat has been established in our laboratory to study the chemotherapeutic treatment of pulmonary metastases. A sequential bilateral isolated lung perfusion model was designed to investigate the feasibility of staged perfusions in the rat. METHODS: Twenty-four Fischer rats were randomized into three experimental groups of 8 rats each. All rats underwent left isolated lung perfusion. One, 2, or 3 weeks later, the rats in groups I, II, and III, respectively, underwent contralateral (right) perfusion. Five control animals (group IV) underwent sequential bilateral sham thoracotomies 1 week apart. Arterial blood gas analysis was performed 1 week after the second operation in the rats in groups I and IV. RESULTS: All animals survived the first operation, with 100% (8/8), 75% (6/8), and 100% (8/8) of the animals in perfusion groups I, II, and III, respectively, surviving the second operation. All control animals (group IV) survived the second sham thoracotomy. Arterial blood gas analysis did not show a significant difference in the oxygen or carbon dioxide partial pressure or the pH between group I and IV (p = 0.32, 0.96, and 0.76, respectively). CONCLUSIONS: Our experiments demonstrate that sequential bilateral isolated lung perfusion is safe in and well tolerated by the rat. This model can be used to investigate the safety and efficacy of staged perfusions with chemotherapeutic agents in the treatment of bilateral pulmonary metastases in the rat.     

Clinical presentation of herpes zoster in a Singapore hospital

The purpose of the study was to give a histological picture of the different skin regions of the mammary gland in mares. Special emphasis on the dark coating in the sulcus intermammarius was given. As a result, the dark pigmented udder skin can be subdivided into the skin of the Corpus mammae, the sulcus intermammarius and the teat skin. In the sulcus intermammarius the whole epidermis was considerably thicker than usual, especially the stratum corneum (up to 70 layers of cornified layers) and the stratum spinosum. In general, the squamous keratinocytes were unusually large. The histological preparations of the coating revealed a stratum corneum instead of a supposed secretion of the sebaceous glands. The dermal papillae ended immediately below the stratum corneum.     

Enzymology of the reduction of the novel fused pyrazine mono-n-oxide bioreductive drug, RB90740 roles for P450 reductase and cytochrome b5 reductase

RB90740 is the lead compound in a series of fused pyrazine mono-N-oxide bioreductive drugs. Theses agents have potential application in cancer therapy, since they are more toxic to hypoxic than to aerobic cells as a consequence of their bioactivation by cellular reductase enzymes within the hypoxic regions of a tumour. In this study, mouse liver microsomes have been used to characterise the enzymology of the reductive activation of RB90740. Under hypoxic conditions, the reduction of RB90740 to its stable 2-electron reduced product RB92815 was supported by both NADH and NADPH, the former supporting a rate approximately 80% of the latter. Combining the two cofactors had no additive effect. Neither carbon monoxide nor metyrapone inhibited reduction of RB90740, indicating that P450 isozymes were not involved in the reduction of this compound. 2' AMP, and inhibitor of P450 reductase, did not inhibit formation of RB92815, whereas DPIC, another inhibitor but with a different mode of action, inhibited both the NADH, and NADPH-dependent reduction of RB90740. Similarly, two selective inhibitors of NADH: cytochrome b5 reductase, pHMB and PTU, completely inhibited both NADH and NADPH-dependent reduction of RB90740. Our findings implicate P450 reductase, cytochrome b5 reductase, and cytochrome b5 in the activation of the compound. However, there is no clear relationship between the intracellular levels of P450 reductase and cytochrome b5 reductase and the hypoxic toxicity of RB90740, which implies that other factors, in addition to drug activation, play a major role in controlling the toxicity of this particular bioreductive drug.