Serial bronchoalveolar lavage of preterm infants is not associated with chest radiological changes

Concern has been raised that serial non-bronchoscopic bronchoalveolar lavage (NB-BAL) may constantly remove surfactant which may result in localised radiological changes. Radiological scores for the lavaged right lower lobe (RLL) were compared with (1) the scores for the unlavaged contra-lateral left lower lobe (LLL) in the NB-BAL group and (2) with the scores of the RLL of control infants not undergoing any formal lavage procedure. NB-BAL was performed daily for 2 weeks and twice weekly thereafter until 28 days of age or until extubation. Two paediatric radiologists obtained chest radiological scores at 1 (pre-lavage radiograph), 7 and 28 days of age. A total of 28 infants in the NB-BAL group (mean birth weight 1350 g and gestation 28.6 weeks) and 26 control infants (1450 g, 29.9 weeks) were studied. Radiological scores for the lavaged RLL and the unlavaged LLL in the NB-BAL group were similar at all time points studied. Although the RLL score in the NB-BAL group was higher on day 1 prior to NB-BAL when compared to control infants (3.2 versus 2.5, P<0.05), the subsequent scores at day 7 (2.6 versus 2.9) and 28 (2.7 versus 2.8) were similar in both groups. No differences were found between the two groups for any clinical parameter including ventilation, oxygen dependency, retinopathy of prematurity or intracranial haemorrhage.

CONCLUSION

repeated non-bronchoscopic bronchoalveolar lavage in newborn infants does not appear to be associated with radiological changes suggesting that surfactant is not constantly removed.

Entanglement, interference, and measurement in a degenerate parametric oscillator

Quantum dynamical equations of motion for homodyne detection of the degenerate optical parametric oscillator are solved exactly. Nonclassical photon statistics are shown to be a consequence of interference of probability amplitudes, entanglement of photon pairs from such an oscillator, and the role of measurement in quantum evolution.

Investigations in the transition metal catalyzed aziridination of olefins, amination, and other insertion reactions with Bromamine-T as the source of nitrene

Investigations into the transition metal catalyzed aziridination of olefins with Bromamine-T as a new source of nitrene is presented in this account. Comparison of Chloramine-T and Bromamine-T in this reaction indicates that the latter is superior as the source of nitrene. Systematic study with several transition metal based catalysts suggests that Cu-halides are the best catalysts. A first report of aziridination under microwave and ultrasound irradiation conditions is also presented. Copper-catalyzed aziridination of methyl cinnamate with Bromamine-T did not proceed at ambient temperature but was effected smoothly under ultrasound irradiation to furnish trans-aziridine selectively, while under microwave irradiation, a mixture of cis and trans isomers, was obtained. It has been demonstrated that aziridination of olefins proceeds smoothly with inexpensive bleaching powder. Preliminary results of Rh-catalyzed benzylic insertion reactions with Bromamine-T are included in this account.

Suppression of tumorigenicity in human ovarian cancer cell lines is controlled by a 2 cM fragment in chromosomal region 6q24-q25

Multiple distinct regions of chromosome 6 are frequently affected by losses of heterozygosity in primary human ovarian carcinomas. We introduced a normal human chromosome 6 into HEY and SKOV-3 ovarian carcinoma cell lines using microcell-mediated chromosome transfer techniques to further investigate the role of this chromosome in ovarian tumorigenesis. The exogenous chromosome was stably propagated in the recipient cells based on fluorescence in situ hybridization (FISH) analyses with a chromosome 6 painting probe. The tumorigenicity of HEY and SKOV-3 cells was completely suppressed after transfer of chromosome 6, but not after transfer of a chromosome 11q13-qter fragment used as control. Using 46 polymorphic microsatellite markers, the region bounded by D6S1649 and D6S1564 was found to be commonly deleted in HEY: chromosome 6 tumorigenic revertant clones. The boundaries of the commonly deleted region could be further narrowed down to a 2 cM (based on the Whitehead genetic map) or 0.36 megabase (based on gdb mapping data) region between D6S1637 and D6S1564 after transferring the exogenous chromosome from revertants into mouse L cells and performing allelic deletion mapping studies against this mouse background. We conclude that this region contains a tumor suppressor gene important for the control of ovarian tumor development.

Photothermal lensing detection: theory and experiment

Photothermal lensing signal shapes are experimentally investigated and compared with those predicted theoretically in our earlier paper. The investigation included flowing and stationary media and pulsed and cw excitations. Good qualitative agreement between theory and experiment is found. Since the lensing signal is almost always accompanied by a deflection signal, the influence of the deflection signal on the detection of lensing signal is investigated. For a perfectly aligned detection geometry the influence of the deflection signal on the lensing signal is negligible, but in the presence of misalignments a significant amount of deflection signal could be superimposed on the lensing signal. The effect of lensing on the deflection signal is also been considered. The effect of the finite size of the probe beam on the lensing signals is also investigated.

Clinical dysautonomia in diabetes mellitus--a study with seven autonomic reflex function tests

Thirty-eight patients of NIDDM, 12 of IDDM and 10 healthy age matched controls were subjected to seven standardised autonomic reflex function tests. A scoring criteria was utilised for diagnosing and grading the severity of dysautonomia. Eight patients of IDDM and 24 of NIDDM had dysautonomia. One-third of the patients in each group had grade IV autonomic dysfunction. Severity of autonomic dysfunction was directly related to the duration of disease in NIDDM whereas in IDDM this relation was not seen. Peripheral neuropathy was almost always associated with dysautonomia in NIDDM. On the contrary, in IDDM dysautonomia was independent of peripheral neuropathy. Charcot's arthopathy, dysphagia, constipation and nocturnal diarrhea were always associated with evidence of dysautonomia. Other symptoms viz. gustatory sweating, postural dizziness and impotence did not necessarily indicate dysautonomia.

Theory of photothermal spectroscopy in an optically dense fluid

The theory of photothermal spectroscopy in an optically dense fluid is presented. The general case is considered in which the fluid may be flowing or stationary, and the excitation could be cw (modulated or unmodulated) or pulsed (arbitrary pulse length). All three detection schemes, deflection, phase shift, and lensing, are considered. This is the most complete theory of photothermal spectroscopy in fluids to date.

Toxoplasmosis of the spinal cord in a patient with AIDS: case report and review

We present the case of a patient whose acute myelopathy almost completely resolved with empirical therapy for toxoplasmosis, and we review thirteen previously reported cases of myelopathy thought to have been caused by Toxoplasma gondii in patients with AIDS. The most common symptoms and abnormal physical findings were motor loss (usually paraparesis), bilateral sensory loss, urinary bladder dysfunction, and local pain. The majority of patients had magnetic resonance images that showed abnormalities of the spinal cord and brain in association with positive serology for Toxoplasma. Therapy for toxoplasmosis, when administered soon after the onset of symptoms, has resulted in clinical and radiographic improvement in the conditions of patients with toxoplasmosis.

Plasmacytoma of scalp

An interesting case of plasmacytoma of the scalp is described. Extramedullary plasmocytoma of scalp is rarely reported. This patient was treated with external radiotherapy dose of which was 40 Gy/20 fraction. Disease responded very well to radiotherapy.

Adenoid cystic carcinoma of the cervix

Adenoid cystic carcinoma constitute around 0.4 to 1.7% of all carcinomas of cervix. It generally presents in elderly age group, however few cases in younger age have also been reported. Majority of cases present in early stage. Though concluding statement regarding the results cannot be made from the cases accumulated from the various reported series, nonetheless this review shows that radiotherapy too is effective in early stage and even in stage I results with radiotherapy appear better than surgery. In advanced stage outcome is invariably poor. In early stage main pattern of failure is distant metastasis. Both local and distant failure are observed in stage III and IV. Though lung is the commonest site of metastases (51%), abdominal cavity and brain are also found to be involved in some cases. Limited experience shows effectiveness of high doses of cisplatin and multiagent chemotherapy. Cases of early stage disease having risk for metastases and local failure should be identified and managed with multimodality treatment using surgery for bulky disease with post-operative radiotherapy and chemotherapy. In advanced stages combination of chemotherapy and radiotherapy is required. Exenterative surgery for central failure has been used effectively. Overall no evidence of disease rate is found to be about 48%, with mean follow-up of 39 months.

Green's function solution to the tissue bioheat equation

A Green's function solution to the tissue bioheat equation including blood flow in cylindrical geometry is obtained. Numerical results for temperature variation in the bovine muscle are reported when the tissue is exposed to neodymium-yttrium-aluminum garnett (Nd:YAG) lasers with Gaussian profile and a comparison with recent measurements is made. A strong dependence of the tissue temperature on the beam radius and pulse time is found.

Treatment of promyelocytic blast crisis of chronic myelogenous leukemia with all trans-retinoic acid

Two recent reports have described major clinical benefits from all-trans-retinoic acid (tRA) therapy of patients with promyelocytic leukemia (APL). This paper describes the first patient with a blast crisis of chronic myelogenous leukemia (CML-BC) who responded to oral tRA therapy. In vitro marrow studies, including clonogenic assays, immunopheno-typing, cytogenetics and premature chromosome condensation together with chromosome painting provided evidence for the in vivo differentiation and maturation of the malignant cells. The patient achieved a partial remission with reversal of all clinical features of disease, including normalization of peripheral blood counts, complete resolution of fever, fatigue and splenomegaly, and marked maturation of the bone marrow. This response to tRA in CML-BC is unique, and broadens the spectrum of diseases which may respond to retinoids.

Differentiation therapy of acute promyelocytic leukemia with tretinoin (all-trans-retinoic acid)

BACKGROUND AND METHODS

Patients with acute promyelocytic leukemia have a characteristic (15;17) translocation, with a breakpoint on chromosome 17 in the region of the retinoic acid receptor-alpha (RAR-alpha). Since this receptor has been shown to be involved with growth and differentiation of myeloid cells in vitro, and since recent clinical studies have reported that tretinoin (all-trans-retinoic acid) induces complete remission in patients with acute promyelocytic leukemia we studied the effects of tretinoin on cellular maturation and molecular abnormalities in patients undergoing the induction of remission with this agent.

RESULTS

Eleven patients with acute promyelocytic leukemia were treated with tretinoin administered orally at a dose of 45 mg per square meter of body-surface area per day. Nine of the 11 patients entered complete remission. In two patients, complete remission was preceded by striking leukocytosis that then resolved despite continued drug treatment. Serial studies of cellular morphologic features, cell-surface immunophenotypic analysis, and fluorescence in situ hybridization with a chromosome 17 probe revealed that clinical response was associated with maturation of the leukemic clone. All patients who responded to treatment who were tested by Northern blot analysis had expression of aberrant RAR-alpha. As patients entered complete remission, the expression of the abnormal RAR-alpha message decreased markedly; however, it was still detectable in several patients after complete morphologic and cytogenetic remission had been achieved.

CONCLUSIONS

Tretinoin is a safe and highly effective agent for inducing complete remission in patients with acute promyelocytic leukemia. Clinical response to this agent is associated with leukemic-cell differentiation and is linked to the expression of an aberrant RAR-alpha nuclear receptor. Molecular detection of the aberrant receptor may serve as a useful marker for residual leukemia in patients with this disease.

A restriction fragment length polymorphism for human topoisomerase II: possible relationship to drug-resistance

In previous studies we used Southern blotting to examine the topoisomerase II locus (on chromosome 17) in human leukemia cell lines and noted a difference in the XmnI restriction endonuclease digestion pattern between an m-AMSA-resistant line and its m-AMSA-sensitive parent line (Zwelling, L. A.; Hinds, M,; Chan, D.; Mayes, J.; Sie, K. L.; Parker, E.; Silberman, L.; Radcliffe, A.; Beran, M.; Blick, M. Characterization of an amsacrine-resistant line of human leukemia cells. Evidence for a drug-resistant form of topoisomerase II. Journal of Biological Chemistry 264:16411-16420; 1989). We now demonstrate that the variable XmnI digestion pattern represents a normal restriction fragment length polymorphism (RFLP) which is observed in subjects without malignant disease and exhibits an autosomal pattern of inheritance. These data suggest that the previously described deviation in the genomic structure of topoisomerase II in the m-AMSA-resistant cell line did not reflect a new mutation, but rather a reduction to homozygosity at the topoisomerase II locus. This reduction to homozygosity is not due to chromosomal loss, as chromosome 17-specific gene probes clearly identify two chromosome 17's in the sensitive line and four in the resistant line, using chromosome painting with a chromosome 17-specific library. Some other genetic change must be the cause of the resistance of HL-60/AMSA and its topoisomerase II to the inhibiting actions of m-AMSA.