Use of octreotide acetate for control of symptoms in patients with islet cell tumors

Gut tumor syndromes are rare, occurring in less than two cases per million population per year: Insulinomas are most common and gastrinomas are less common; all the others are extremely rare. Conventional treatment of the symptoms caused by these tumors has included surgery, hepatic arterial embolization, and chemotherapy; some patients with Zollinger-Ellison syndrome (ZES) have been treated with specific agents such as gastric antisecretory drugs. The development of octreotide, a synthetic, long-acting analogue of the natural peptide somatostatin, has offered an alternative to such therapies. Octreotide has a half life of > 100 minutes and inhibits both physiological- and tumor release of many peptides. It also has direct effects on the gut that modify secretion and motility. Octreotide has been shown to be particularly useful for the symptoms of tumors producing vasoactive intestinal peptide (VIP), and of the carcinoid syndrome. It is also useful in patients with glucagonomas, with growth hormone-releasing hormone producing tumors, and in some patients with Cushing's syndrome and unresectable insulinomas. Octreotide is effective in patients with ZES, but alternative therapies such as omeprazole are more effective, safer, and more convenient for those patients. Side effects of octreotide have not been troublesome in these patients, but the incidence of long term effects is still not entirely clear. Octreotide has proved to be a significant advance in the treatment of patients with islet cell tumors.     

Identification of a novel actin binding site within the Dp71 dystrophin isoform

A method is described by which the diffusion coefficients of electrically charged micelles can be determined using micellar electrokinetic chromatography (MEKC). The determination is based on a theory for the dispersion, at low electric field strengths, of analytes that are solubilized by only the micellar phase. The dispersion is represented by contributions from instrumental sources and from longitudinal diffusion. The latter depends on the micellar diffusion coefficient. The theory is used to determine the micellar diffusion coefficients of the surfactant sodium dodecyl sulfate in three solutions having different surfactant concentrations. These diffusion coefficients compare very favorably with those determined by diffusion-ordered two-dimensional NMR spectroscopy. An argument is presented justifying that the diffusion coefficients determined by MEKC are self-diffusion coefficients.     

Apolipoprotein E polymorphism influences lipid phenotypic expression, but not the low density lipoprotein subfraction distribution in familial combined hyperlipidemia

The impact of apo E polymorphism on interindividual variation in plasma lipid, lipoprotein concentrations, and LDL subfraction profiles was studied in 201 well-defined patients (88 men and 103 women) with familial combined hyperlipidemia (FCH). When corrected for the concomitant influences of age, gender and obesity, the allelic variation in the apo E gene was shown to explain a statistically significant portion of the variability in lipid and (apo)lipoprotein concentrations. Carriers of the apo epsilon 2 allele exhibited a substantially higher plasma triglyceride concentration and a lower low density lipoprotein (LDL) cholesterol level, while subjects with the apo epsilon 4 allele had significant higher total plasma cholesterol and LDL cholesterol levels. In line with this observation, our FCH population was characterized by an over-representation of the apo E4 allele as compared with a Dutch standard population (chi 2 = 55.2, P < 0.0001). The contribution of apo E polymorphism to trait variability was different between sexes for plasma triglyceride, VLDL cholesterol, VLDL triglycerides, and high density lipoprotein (HDL) cholesterol levels. Apo E polymorphism had no impact on chemical composition of VLDL; for LDL particles the apo epsilon 2 allele was associated with a lower cholesterol to protein (C/P) ratio, whereas the opposite was true for the apo epsilon 4 allele. Despite the demonstrated impact of apo E polymorphism on plasma lipids and LDL chemical composition, in all phenotypic groups a dense LDL subfraction profile predominated. Thus, apo E polymorphism contributes to the lipid phenotypic expression in FCH, whereas further evidence was obtained that a dense LDL subfraction profile is an integral feature of FCH.     

Osteonecrosis of the femoral head. Hip salvaging with implantation of a vascularized fibular graft

The authors tried to save the hip joint by implanting a vascularized fibular graft, augmented with cancellous bone, into the curetted core of the femoral head that was affected by aseptic necrosis. Forty of 66 hips were observed for a minimum of 20 months and for as long as 66 months (average, 32 months). Clinical assessment according to the cause and severity of the disease was done using the Harris Hip Score. Twenty-eight hips (70%) were rated excellent, 7 (17.5%) were good, 2 (5%) were fair, and 3 (7.5%) failed and were replaced with an artificial joint. Clinically satisfactory results, including good and excellent, were obtained in 35 hips (87.5%). Radiographic evaluation showed improved appearance of the femoral head core in all 15 patients (37.5%) operated on at a precollapse stage of the disease. In 20 hips, the deformity of the femoral head was unchanged (50%), 2 (5%) became worse, and 3 (7.5%) failed. The number of hips with improved appearance as shown on radiographs and those in which the process was unchanged equaled the number of hips with satisfactory clinical results. These data show that the procedure can induce new bone formation that fuses with the affected subchondral bone, thus preventing the articular surface from collapse. This suggests that vascularized fibular grafting is an excellent alternative for hip salvaging when treating femoral head osteonecrosis.     

Individual and structural solutions to resource dilemmas in two cultures.

Administered a resource management task to 86 US and 97 Dutch undergraduates. Ss were divided into groups of 6 and instructed to harvest points from a regenerating resource pool. Their objective was to maximize individual harvests while maintaining the resource pool. The factorial design crossed 3 levels of resource use (overuse, underuse, and optimal use) with 2 levels of variance of others' purported harvests (low and high). Both variables were manipulated through false feedback to Ss regarding the pool size and the other Ss' harvests. The primary dependent measures were Ss' individual harvests and whether Ss voted for or against elimination of free access to the resource in favor of electing a leader who would make harvest decisions for the group. Results indicate that harvest size increased over time only in the under- and optimal-use conditions. As predicted, overuse Ss voted to give up free access to the resource and to elect a leader more frequently than Ss in the other conditions. Differences between American and Dutch Ss were found only for the variance manipulation. (20 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Platelet coagulant activities and serum lipids in transient cerebral ischemia

To determine whether platelets play a part in the pathogenesis of transient cerebrovascular ischemia, we studied 22 patients with transient ischemia, 18 control patients and 38 normal subjects. Platelet aggregation and [14C]-serotonin release by ADP, epinephrine and collagen were normal in all patients, as were plasma coagulation assays, except for shortened partial thromboplastin times in the patients with transient ischemia. Platelet coagulant activities concerned with initiation and early stages of intrinsic coagulation were increased two to three times in 12 patients with transient ischemic attacks with normal serum lipids and normal in the 10 others with Type IV hyperlipoproteinemia. These results indicate an association between platelet coagulant hyperactivity and transient ischemic attacks in a group of patients with normal serum lipids.     

Acute penetrating tracheal trauma

Four hundred seventy blood access procedures performed on 170 dialysis patients during the period 1962-1975 have been analyzed according to survival of access with respect to age, sex and cause of failure. Subcutaneous forms of blood access have a significantly longer life and are more free of complications than external shunts. Although the mode of access can now be tailored to the individual patient, the arterio-venous fistula remains the least expensive and simplest surgical procedure. It should therefore remain as the first choice of access for most patients.