Arteriovenous malformation: a 22-year angiographic follow-up

A case is reported of an unoperated giant arteriovenous malformation with a progressive deterioration ending in a severe dementia and invalidism. Angiographic documentation is over a 22 year interval. The presentation, diagnosis and treatment of this disease are discussed. It is concluded that early surgical intervention should have a primary role in the management of giant arteriovenous malformation.     

Staging and surgery in testicular cancer

Both staging and surgery in testicular cancer are thoroughly analysed. Extensive experiences from various authors are reported and compared. The essentials for staging are suggested and a new detailed stage grouping is proposed. The role of surgery in diagnosis, staging and therapy is examined. It is stressed that in non-seminomas, retroperitoneal lymph node dissection is not only a staging procedure, but it may be also a curative operation in several cases of patients with lymph node metastases and a prospective randomized clinical trial is advocated in order to clarify the usefulness of adjunctive chemotherapy in these cases. Surgery is also useful as adjuvant to chemotherapy in several patients with advanced non-seminomas and it is underlined that it should be undertaken early, after only 2 or 3 cycles of chemotherapy, in order to avoid the strong fibrosis that often occurs after long-term chemotherapy and which makes surgical dissection very difficult or even impossible. Lastly, even if extensive, surgery seems to be a safe procedure in these young patients.     

Coproduction of Regan isoenzyme and carcinoembryonic antigen in HCT-8 cells

Five groups of adult Ss were submitted to free-recall learning of 24 objects presented as written nouns for the control group and as pictures for experimental groups, as follows: schematic black and white, schematic colored, detailed black and white, and detailed colored drawings. Pictures were better recalled than nouns. Recall was significantly inferior for schematic black and white than for detailed colored drawings, with schematic colored and detailed black and white drawings at an intermediate level. These results support the so-called incidental-cues hypothesis according to which the best recall of pictures in comparison with that of nouns is partially the result of pictures having more distinctive cues likely to be encoded than do verbal items.     

Lower esophageal sphincter function in children with and without gastroesophageal reflux

Resting lower esophageal sphincter (LES) pressure was assessed in infants and children 2 weeks to 12 years of age. There were 62 control subjects and 35 patients with reproducible gastroesophageal reflux (GER) determined radiologically. In control subjects without GER: (1) LES pressure was well developed by 2 weeks of age; (2) in children less than 1 year of age, mean LES pressure (43.3 +/- 2.4 mm Hg) was significantly greater than mean LES pressure (30.6 +/- 2.3 mm Hg) children older than 1 year of age; (3) LES sphincter length increased with age; and (4) bethanechol 0.1 mg per kg subcutaneously caused a rise in LES pressure that increased in magnitude as LES resting pressures increased. In patients with GER: (1) only 16 or 35 children had LES pressures below the normal range for their appropriate age group; (2) LES length was shorter than control values in children beyond 6 months of age; (3) GER usually occurred in the absence of hiatus hernia; (4) clinical improvement was common and in patients with low LES pressure was associated with a rise in LES pressures to normal, even in the presenece of hiatus hernia; and (5) bethanechol caused a change and an absolute rise in LES pressure that were not significantly different from those observed in controls. These results indicate that in infants and children low LES pressure is not the sole determinant of GER, and that pharmacological stimulation of the Les could prove to be a useful adjunct to the medical management of GER.     

Effect of vitamin A on the systemic and local antibody responses to intragastrically administered bovine serum albumin

The effects of vitamin A on the immune response to bovine serum albumin (BSA) were studied in adult mice. Treatment with vitamin A by the intragastric or parenteral routes markedly increased the local as well as the systemic antibody response to different concentrations of the antigen (BSA). In contrast, in animals given BSA alone, antigen concentrations above a certain dose resulted in a decreased or even absent anti-BSA response. These studies suggest that vitamin A may be an appropriate adjuvant in oral immunization.     

Alternate-day prednisone therapy in recipients of renal allografts. Risk and benefits

Forty-five patients receiving renal allografts were gradually converted from daily to alternate-day prednisone therapy. Indications for conversion included aseptic necrosis, growth retardation in children and adolescents, obesity, diabetes, cataract formation, and cosmetic appearance. Eight of the 45 patients developed acute or chronic rejection during or just after completion of alternate-day steroid therapy. The remaining 37 patients had a notable decrease in the degree of hypercorticism, with return of growth in children and adolescents. However, there was no improvement once aseptic necrosis or cataract formation had occurred. Although the use of alternate-day prednisone therapy is of benefit in reducing the untoward side effects of corticosteroids, the risk of precipitating allograft rejection is a significant threat and must be carefully considered whenever this form of treatment is undertaken.