Polymorphic reticulosis: a reappraisal Strickler, J G; Meneses, M F; Habermann, T M ...
Human pathology,
07/1994, Letnik:
25, Številka:
7
Journal Article
Recenzirano
We studied 18 patients (15 men and three women) evaluated for a destructive sinonasal lesion that had been diagnosed as "polymorphic reticulosis." The histologic features of each lesion were those of ...angiocentric immunoproliferative lesions," characterized by atypical lymphoid infiltrates with polymorphous, angiocentric, and necrotic features; 13 were grade 2 and five were grade 3. The neoplastic cells in each patient had a T-cell phenotype. Epstein-Barr virus RNA was detected in the neoplastic cells of 17 of the 18 T-cell lesions. Initial treatment consisted of local radiation therapy in each patient, chemotherapy in two patients, and prednisone in another patient. Two patients were lost to follow-up and the other 16 had a median follow-up of 14 years, 2 months (range, 4 months to 32 years, 5 months). Four patients are alive and disease free, four patients died not of disease or complication of therapy, and eight patients died of disease. The Kaplan-Meier estimate of survival was 63% at 5 years and 50% at 15 years. Histologic progression of angiocentric immunoproliferative lesions from grade 2 to grade 3 was observed in two patients, and a correlation between angiocentric immunoproliferative grade and survival could not be detected. These data suggest that polymorphic reticulosis is an Epstein-Barr virus-related angiocentric T-cell lymphoma.
Terodiline, an anticholinergic/antispasmodic drug effective in the treatment of urinary incontinence, is presently restricted due to adverse side effects on cardiac function. To characterize its ...effects on cardiac L‐type Ca2+‐channel current carried by Ca2+ (ICa,L) and Ba2+ (IBa,L), concentrations ranging from 0.1 to 100 μM were applied to whole‐cell‐configured guinea‐pig ventricular myocytes.
Although sub‐micromolar concentrations of terodiline had no effect on ICa,L at 0 mV, 100 μM drug reduced its amplitude to ca. 10% of pre‐drug control. The estimated IC50 (15.2 μM in K+‐dialysed cells, 12.2 μM in Cs+‐dialysed cells; 0.1 Hz pulsing rate) is eight times higher than reported for ICa,L in bladder smooth muscle myocytes.
Terodiline affected ICa,L in a use‐dependent manner; block increased when the pulsing rate was increased from 0.1 to 2–3 Hz, and when holding potential was lowered from −43 mV. The drug accelerated the decay of ICa,L at 0 mV in a concentration‐dependent manner, and slowed the recovery of channels from inactivation.
Terodiline reduced peak IBa,L more effectively than peak ICa,L, and markedly accelerated the rate of inactivation of the current.
The results are discussed in terms of mechanisms of Ca2+ channel block and relation to the therapeutic and cardiotoxic effects of the drug.
British Journal of Pharmacology (1999) 127, 1837–1845; doi:10.1038/sj.bjp.0702713
Variable stars in the compact elliptical galaxy M32 are identified, using three epochs of photometry from the Spitzer Space Telescope at 3.6 and 4.5 \(\mu\)m, separated by 32 to 381 days. We present ...a high-fidelity catalogue of sources detected in multiple epochs at both 3.6 and 4.5 \(\mu\)m, which we analysed for stellar variability using a joint probability error-weighted flux difference. Of these, 83 stars are identified as candidate large-amplitude, long-period variables, with 28 considered high-confidence variables. The majority of the variable stars are classified as asymptotic giant branch star candidates using colour-magnitude diagrams. We find no evidence supporting a younger, infrared-bright stellar population in our M32 field.
We previously described a small group of renal transplant recipients considered to have successful allografts statistically, but who did not benefit clinically. These were patients in whom the grafts ...survived greater than 6 months but less than 3 years. This expanded study evaluates 179 consecutive renal transplant recipients divided into three groups. Group 1 (n = 18), group 2 (n = 41), and group 3 (n = 120) have patients with graft survival less than 6 months, between 6 months and 3 years, and greater than 3 years, respectively. Mean age, cause of renal failure, HLA match, and immunosuppressive regimen were not statistically different in any group. The number of acute rejection episodes, number of hospitalizations, and number and seriousness of complications were significantly greater in group 2 patients compared with the other groups. Patients in group 2 experienced five times the number of acute rejections (P < 0.0001), three times the number of hospitalizations (P < 0.0001), and two times the number of complications (P < 0.0001) compared with group 3 patients. In conclusion, those transplant recipients whose grafts survived longer than 6 months but less than 3 years were the most unfortunate. They experienced repeated and serious complications and spent many days in the hospital at great expense. A study with more sensitive methods of detecting presensitization might impact on graft performance in the future.
Calderon et al compare the Centers for Disease Control and Prevention (CDC) National Healthcare Safety Network catheter-associated urinary tract infection (CAUTI) metric and the Agency for Healthcare ...Research and Quality (AHRQ) CAUTI metric. CAUTIs are a major source of morbidity among US hospital patients, leading to unnecessary antibiotic use, secondary bacteremia, and increased length of stay. Many private and public sector organizations have led and continue to lead efforts aimed at preventing CAUTI, including initiatives spearheaded by federal agencies, including AHRQ, CDC, and the Centers for Medicare and Medicaid Services.
One hundred fifty-one patients with primary biliary cirrhosis (PBC) grouped into four strata based on entry serum bilirubin (<2 mg/dL vs. 2 mg/dL or greater) and liver histology (stages I, II vs. ...stages III, IV—Ludwig criteria) were randomized within each stratum to ursodiol or placebo given in a single dose of 10 to 12 mg/kg at bedtime for 2 years. Placebo- (n = 74) and ursodioltreated (n = 77) patients were well matched at baseline for demographic and prognostic factors. Ursodiol induced major improvements in biochemical tests of the liver in strata 1 and 2 (entry bilirubin <2), but had less effect on laboratory tests in patients with entry serum bilirubin of ≥2 (strata 3 and 4). Histology was favorably affected by ursodiol in patients in strata 1 and 2 but not in strata 3 and 4. Ursodiol enrichment in fasting bile obtained at the conclusion of the trial was approximately 40% and comparable in all strata. Thus, differences in ursodiol enrichment of the bile acid pool do not explain better responses of laboratory tests and histology found in patients with less advanced PBC. Patients treated with ursodiol tended to develop a treatment failure less frequently than those who received placebo, particularly in strata 1 and 2 (ursodiol 42%, placebo 60%,
P = .078). Development of severe symptoms (fatigue/pruritus) and doubling of serum bilirubin were reduced significantly in ursodiol-treated patients. Major complications of liver disease, progression to liver transplantation or death, occurred in 10.5% and 76.6%, respectively, in patients who had an entry serum bilirubin of <2 or ≥2 mg/dL. The incidence of these complications was comparable in ursodiol- and placebo-treated patients. Treatment failure occurred sooner in placebo than in ursodiol-treated patients in strata 1 and 2 but at the same rate in similarly treated patients in strata 3 and 4. Patients with advanced disease are unlikely to benefit from ursodiol. Trials longer than 2 years will likely be needed to determine whether ursodiol reduces major complications of liver disease in patients with milder disease.
Background Studies investigating lipid-lowering medication (LLM) use and LDL levels in coronary artery bypass grafting patients are limited. Study design The Veterans Affairs Randomized On/Off Bypass ...Trial's patient records were analyzed for LLM use and 1-year LDL levels. Mortality, acute MI (AMI), and repeat revascularization rates were compared at 1 year between patients with and without LLM at discharge. In addition, AMI, repeat revascularization, and graft patency were compared between patients that did and did not achieve a 1-year LDL target level of <100 mg/dL. Results The LLM data were available for 86.4% (1,904 of 2,203) of patients. Rates of LLM use were 83.4% (1,316 of 1,577) at discharge and 90.0% (1,713 of 1,904) at 1 year. Patients discharged after coronary artery bypass grafting on LLMs had a significantly lower 1-year mortality rate (1.9% vs 5.4%; p < 0.01) than those not discharged on LLM, and 1-year AMI and repeat revascularization rates were not significantly different. Of the patients with 1-year LDL measurements, 69.4% (1,200 of 1,729) achieved an LDL target level of <100 mg/dL. No differences were seen in AMI, revascularization, or graft occlusion rates between patients who achieved target LDL levels and those who did not. Conclusions Rates of LLM use among veterans post−coronary artery bypass grafting are high. Discharge on LLM might be associated with improved intermediate-term survival. Patients who achieved an LDL target of <100 mg/dL at 1-year did not experience improved 1-year clinical outcomes or graft patency. Longer-term follow-up might reveal differences in cardiac outcomes related to achievement of target LDL levels.
Clostridium difficile
is an important cause of hospital-associated diarrhea. In this report from the CDC, the U.S. burden of
C. difficile
infection is estimated at nearly 500,000 cases and 30,000 ...deaths in 2011, with an increasing burden among nonhospitalized persons.
Changes in the epidemiology of
Clostridium difficile
infections have occurred since the emergence of the North American pulsed-field gel electrophoresis type 1 (NAP1) strain, which has been responsible for geographically dispersed hospital-associated outbreaks.
1
–
3
In the United States, hospitalizations for
C. difficile
infection among nonpregnant adults doubled from 2000 through 2010 and were projected to continue to increase in 2011 and 2012, especially as laboratories transition to more sensitive
C. difficile
assays, such as the nucleic acid amplification test (NAAT).
4
–
6
On the basis of data from U.S. death certificates,
C. difficile
infection is the leading cause of gastroenteritis-associated death . . .
We introduce a simulation framework for the transport of high and low energy electrons in xenon-based gaseous optical time projection chambers (OTPCs). The simulation relies on elementary cross ...sections (electron-atom and electron-molecule) and incorporates, in order to compute the gas scintillation, the reaction/quenching rates (atom-atom and atom-molecule) of the first 41 excited states of xenon and the relevant associated excimers, together with their radiative cascade. The results compare positively with observations made in pure xenon and its mixtures with CO\(_2\) and CF\(_4\) in a range of pressures from 0.1 to 10~bar. This work sheds some light on the elementary processes responsible for the primary and secondary xenon-scintillation mechanisms in the presence of additives, that are of interest to the OTPC technology.
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