Pharmacokinetics of hyperimmune anti-human immunodeficiency virus immunoglobulin in persons with AIDS

Hyperimmune anti-human immunodeficiency virus immunoglobulin (HIVIG) is an intravenous immunoglobulin prepared from HIV-infected asymptomatic donors with a CD4 cell count greater than 400 cells/microl and a high titer of antibody to HIV-1 p24 protein. Twelve persons with AIDS received four doses of HMG (two at 50 mg/kg of body weight and then two at 200 mg/kg) every 28 days. Pharmacokinetics were evaluated by measurement of anti-p24 antibody. HIVIG was well tolerated, and all participants completed the study. Three subjects who were not receiving Pneumocystis carinii pneumonia (PCP) prophylaxis developed PCP. The mean value for HIVIG clearance was 3.02 ml/kg/day at 50 mg/kg and 3.65 ml/kg/day at 200 mg/kg (P = 0.027); the mean trough antibody titers (reciprocal units) were 1,442 and 4,428, respectively. This study indicates that high titers of anti-p24 antibody can be maintained with a monthly administration schedule of HIVIG and that short-term safety is acceptable. Comparisons to evaluate the therapeutic potential of HIVIG are justified.     

Laparoscopic surgery of adrenal glands: indications and limits

Over the last four years it has been demonstrated that laparoscopy can be used successfully for adrenalectomy, providing certain advantages over conventional open surgery. The aim of this study was to determine the indications for laparoscopic approach in adrenal surgery. From June 1994 to June 1996 laparoscopic transabdominal flank approaches were proposed in patients with a unilateral 8 cm or less, non-malignant tumors of the adrenal gland. For tumors under 4 cm in diameter only secreting tumors were removed. Among 77 patients requiring ablation of the adrenal gland, 50 (65%) underwent a laparoscopic procedure: 29 Conn adenomas, 10 Cushing adenomas, 6 Pheochromocytomas, 4 incidentalomas. One patient had Cushing's disease and underwent bilateral resection. Mean tumor size was 26 mm (7-75 mm). Malignancy was demonstrated in 2 tumors: one cortisone secreting tumor and one leiomyosarcoma. Conversion was required in 4 cases (8%). Mean operative time for unilateral adrenalectomies was 147 minutes (50-300'). There were no deaths. Morbidity included: one hemorrhage via the trocar orifice requiring reoperation, one infarction of the spleen which regressed spontaneously, one parietal hematoma, and one case of phebitis of the lower limb. The endocrinopathy was successfully cured in all patients with secreting tumors. The 27 other patients underwent open adrenalectomy. Laparoscopic approach was not proposed due to suspected malignancy in 13 cases, previous surgery in 8 cases and multiple, bilateral and/or extra adrenal tumors in 6 cases. Laparoscopic approach to the adrenal gland is the procedure of choice in patients with Conn adenomas, Cushing adenomas and in most cases of pheochromocytomas. It is not indicated for malignant and large tumor (> 8 cm). Currently two-thirds of our patients requiring and adrenalectomy are operated laparoscopically.     

AgNO<Subscript>3</Subscript> spray tests: advantages,weaknesses, and various applications to quantify chloride ingress into concrete. Part 1: Non-steady-state diffusion tests and exposure to natural conditions

Within the framework of the evaluation and the prediction of chloride-induced corrosion risks, simple and rapid AgNO₃ spray tests can be proposed for various issues. This paper forms the first part of a series. In this first part, the Maultzsch procedure (spraying of 0.1-N AgNO₃ solution + K₂CrO₄) as well as the procedure based on the use of a sole AgNO₃ solution have been investigated on a broad range of concretes. These procedures have also been compared to the Collepardi procedure (spraying of 0.1-N AgNO₃ + fluoresceine). The feasibility of these colorimetric techniques on saturated specimens cast in laboratory, after non-steady-state diffusion tests carried out in various conditions, is discussed. In addition, the results obtained from applying such spray tests in field conditions on cores drilled out from various RC test specimens exposed to a marine environment (tidal zone) and to a road and cold environment (freezing-thawing cycles and spraying of deicing salts) are presented. Colorimetric methods have in particular been applied here to the assessment of the average chloride penetration depth and of its evolution versus time (kinetics). Moreover, the detection threshold of these techniques has been investigated in various environments. The possible sources of discrepancy on the results have been analysed.     

Morphological responses in thermally conditioned linear low density polyethylene

An octene-modified linear low density polyethylene has been used to examine the mechanisms involved during thermal annealing. Annealing temperatures ranged from 60 to 100°C. Annealing results in crystallinity increments and these respond to two concurrent effects. One involves the segregation from crystalline regions of low molecular weight moieties in the polymer's molecular weight distribution; the other is lamellar thickening, leading to the formation of more highly perfected crystalline domains. In the present polymer, the two effects were found to be in balance at annealing temperatures near 80°C leading to the optimum distribution of crystalline regions in the amorphous portions of the polymer. The effect of thermal conditioning on mechanical properties of the polymer was illustrated in terms of the initial modulus and the polymer's yield strength. The twin mechanisms of molecular fractionation and lamellar thickening were found to influence both of the mechanical property parameters.     

Myeloma stem cells in autografting in multiple myeloma

Autologous transplantation has been used increasingly over the last 10 years for the treatment of multiple myeloma. As is the case in other cancers treated by high-dose therapy and stem cell rescue, the contribution of occult tumor cells in the graft to relapse posttransplant remains to be resolved. In this report, we review the biology and differentiation of plasma cells in the context of their significance as an origin of relapse in multiple myeloma.