.I 274229
.U
91000001
.S
Am J Emerg Med 9101; 8(5):373-8
.M
Abdominal Pain/ET; Adolescence; Adult; Aged; Aged, 80 and over; Appendicitis/CO/*RI/US; Child; Female; Human; Leukocytes/*; Middle Age; Predictive Value of Tests; Support, Non-U.S. Gov't; Technetium Tc 99m Aggregated Albumin/*DU.
.T
Evaluation of women with possible appendicitis using technetium-99m leukocyte scan.
.P
JOURNAL ARTICLE.
.W
The authors evaluated the use of technetium-99m albumin colloid white blood cell (TAC-WBC) scan in women with possible appendicitis. One hundred and nine women underwent 110 TAC-WBC scans. One woman had a second scan on a separate admission and was considered two individual patients in the analysis. Twenty-six women had appendicitis, 10 of whom had a perforated appendix at surgery. The TAC-WBC scan was indeterminate (abnormal but nondiagnostic for appendicitis) in 52 women (47%), nine of whom had appendicitis. Fifty-eight scans were read as positive or negative for appendiceal pathology. There were 16 true positives, 5 false positives, 36 true negatives, and 1 false negative. The predictive value of a positive scan was 76%, and the predictive value of a negative scan was 97%. The TAC-WBC scan was positive in 62% of patients with appendicitis and negative in 43% of the patients without appendicitis resulting in an overall accuracy of 47% in the 109 women. The main value of TAC-WBC scan in women with possible appendicitis is its high negative predictive value and the main problem with the TAC-WBC scan is its high indeterminate rate.
.A
Henneman PL; Marcus CS; Butler JA; Hall TA; Koci TM; Worthen N; Wilson SE.
.I 274230
.U
91000002
.S
Am J Emerg Med 9101; 8(5):379-84
.M
Accidents/SN; Adolescence; Adult; Aged; California; Case Report; Cause of Death/*; Child; Child, Preschool; Coronary Disease/MO; Emergency Service, Hospital/*SN; Female; Heart Diseases/MO; Homicide/SN; Human; Infant; Male; Middle Age; Retrospective Studies; Suicide/SN; Survival Rate.
.T
Cause of death in an emergency department [see comments]
.P
JOURNAL ARTICLE.
.W
A retrospective review was done of 601 consecutive emergency department deaths. Nontrauma causes accounted for 77% of the deaths and this group had an average age of 64 years and a male to female ratio of 1.9:1. Trauma caused 23% of the fatalities and this group had a younger average age of 29 years and a male to female ratio of 4.6:1. The most common causes of nontrauma death were sudden death of uncertain cause (34%), coronary artery disease (34%), cancer (5%), other heart disease (4%), chronic obstructive lung disease (3%), drug overdose (3%), and sudden infant death syndrome (2%). The most common causes of trauma death were motor vehicle accidents (61%) and gunshot wounds (16%). The overall autopsy rate was 40%. Death certificates were often in error.
.A
Cummings P.
.I 274231
.U
91000003
.S
Am J Emerg Med 9101; 8(5):385-7
.M
Case Report; Gangrene/TH; Genital Diseases, Male/PA/TH; Human; Hyperbaric Oxygenation/*; Male; Middle Age; Scrotum/*PA.
.T
Treatment of Fournier's gangrene with adjunctive hyperbaric oxygen therapy.
.P
JOURNAL ARTICLE.
.W
Fournier's gangrene is a devastating infection and often is associated with a high morbidity and mortality. Surgical debridement and antibiotics are the cornerstones of therapy. This case describes the use of hyperbaric oxygen as an adjunct in the treatment of Fournier's gangrene.
.A
Lucca M; Unger HD; Devenny AM.
.I 274232
.U
91000004
.S
Am J Emerg Med 9101; 8(5):388-90
.M
Aged; Case Report; Female; Hernia, Hiatal/*CO/RA; Human; Intestinal Obstruction/*CO/RA; Stomach/*RA.
.T
Intermittent obstruction of an incarcerated hiatal hernia with a total thoracic stomach.
.P
JOURNAL ARTICLE.
.W
A case of intermittent obstruction of a sliding hiatal hernia is presented. The obstruction occurred when the patient's stomach was totally above the diaphragm. The anatomy of sliding hiatal hernias is discussed, as well as the presenting signs and symptoms of obstruction in sliding hiatal hernias.
.A
Bozzuto TM.
.I 274233
.U
91000005
.S
Am J Emerg Med 9101; 8(5):391-3
.M
Aged; Aged, 80 and over; Arrhythmia/*DI/TH; Case Report; Electrocardiography/*MT; Emergency Service, Hospital; Female; Human; Male; Middle Age; Monitoring, Physiologic/MT.
.T
Cases in electrocardiography.
.P
JOURNAL ARTICLE.
.A
Zimmers T; Geninatti M.
.I 274234
.U
91000006
.S
Am J Emerg Med 9101; 8(5):394-442
.M
Adolescence; Adult; Aged; Aged, 80 and over; Case Report; Child; Child, Preschool; Female; Human; Infant; Male; Middle Age; Poison Control Centers/*; Poisoning/*EP/MO; Population Surveillance; Prevalence; Suicide, Attempted/SN; Survival Rate; United States/EP.
.T
1989 annual report of the American Association of Poison Control Centers National Data Collection System.
.P
JOURNAL ARTICLE.
.A
Litovitz TL; Schmitz BF; Bailey KM.
.I 274235
.U
91000007
.S
Am J Emerg Med 9101; 8(5):443-5
.M
Adolescence; Adult; Aged; Aged, 80 and over; Child; Child, Preschool; Emergency Service, Hospital/*; Female; Human; Infant; Japan; Male; Middle Age; Reproducibility of Results; Ultrasonography/*MT.
.T
Ultrasonography in Japanese emergency departments.
.P
JOURNAL ARTICLE.
.W
This is a review of 50 consecutive cases where ultrasound was performed in the emergency department of a general hospital demonstrating the efficacy of its usage by "nonspecialists." This study demonstrates that in the Japanese model of emergency care delivery, abdominal ultrasound has been shown to be used in the emergency department with accuracy and safety.
.A
Shapiro RA; Nakamoto M.
.I 274236
.U
91000008
.S
Am J Emerg Med 9101; 8(5):446-62
.M
Wounds and Injuries/*.
.T
Trauma: an annotated bibliography of the recent literature.
.P
BIBLIOGRAPHY; JOURNAL ARTICLE.
.A
McCabe CJ.
.I 274237
.U
91000009
.S
Am J Emerg Med 9101; 8(5):466-7
.M
Administration, Inhalation; Adult; Case Report; Cocaine/*; Human; Male; Pneumothorax/*ET/TH; Substance Abuse/*CO.
.T
Bilateral spontaneous pneumothorax after cocaine inhalation [letter]
.P
LETTER.
.A
Lieberman ME; Shepard H; Reynolds F; Christopher T.
.I 274238
.U
91000010
.S
Am J Emerg Med 9101; 8(5):467-8
.M
Adolescence; Case Report; Ethchlorvynol/*PO; Human; Male; Necrosis/ET; Overdose/PA; Pressure/AE; Skin Diseases, Vesiculobullous/*ET/PA.
.T
Pressure necrosis following ethchlorvynol overdose [letter]
.P
LETTER.
.A
Chamberlain JM; Klein-Schwartz W; Gorman R.
.I 274239
.U
91000011
.S
Am J Emerg Med 9101; 8(5):468-9
.M
Aged; Case Report; Cervical Vertebrae/*IN; Human; Male; Resuscitation/*MT; Wounds, Nonpenetrating/*DI.
.T
Mismanagement of a potential cervical spine injury [letter; comment]
.P
COMMENT; LETTER.
.A
Abarbanell NR.
.I 274240
.U
91000012
.S
Am J Emerg Med 9101; 8(5):469-70
.M
Emergency Service, Hospital/*; Female; Gallbladder Diseases/US; Human; Predictive Value of Tests; Pregnancy; Pregnancy, Ectopic/US; Retrospective Studies; Ultrasonography/*MT.
.T
Emergency department sonography by emergency physicians [letter; comment]
.P
COMMENT; LETTER.
.A
Kellermann AL; Holley J.
.I 274241
.U
91000013
.S
Am J Emerg Med 9101; 8(5):470-1
.M
Amputation/*; Case Report; Compartment Syndromes/*ET/SU; Human; Infant; Infusions, Parenteral/*AE/MT; Ischemia/*ET/SU; Male; Tibia/*BS/SU.
.T
Compartment syndrome with resultant amputation following intraosseous infusion [letter]
.P
LETTER.
.A
Moscati R; Moore GP.
.I 274242
.U
91000014
.S
Am J Emerg Med 9101; 8(5):472-3
.M
Emergencies; Female; Human; Hypertension/*DT; Labetalol/*TU; Male; Middle Age; Pilot Projects; Prospective Studies.
.T
Ineffectiveness of oral labetalol for hypertensive urgency [letter]
.P
LETTER.
.A
Wright SW; Hedges JR; Wright MB; Chudnofsky CR; MacCarthy EP.
.I 274243
.U
91000015
.S
Pediatr Neurol 9101; 6(4):219-28
.M
Age Factors; Amino Acids/*PH; Animal; Brain/*PP; Brain Damage, Chronic/*PP; Cerebral Anoxia/PP; Female; Human; Infant, Newborn; Nerve Regeneration/*PH; Neural Transmission/*PH; Neuronal Plasticity/*PH; Pregnancy; Rats; Receptor, N-Methyl-D-Aspartate/PH; Receptors, Endogenous Substances/*PH; Support, U.S. Gov't, Non-P.H.S.; Support, U.S. Gov't, P.H.S..
.T
Excitatory amino acids in the developing brain: ontogeny, plasticity, and excitotoxicity.
.P
JOURNAL ARTICLE; REVIEW; REVIEW, TUTORIAL.
.W
Besides their role as neurotransmitters, excitatory amino acids (EAAs) in the developing brain are crucially involved in plasticity and excitotoxicity which are modified by their distinct ontogeny. Along with incomplete neuritogenesis and synaptogenesis, presynaptic markers of the EAA system are immature in the developing brain; however, postsynaptic EAA system activities, particularly of the N-methyl-D-aspartate and quisqualate receptors, are transiently enhanced early in life. This transient enhancement is presumably beneficial to the immature brain because physiologic activation of the EAA system plays a critical role in plasticity of early learning and morphogenesis. At the same time, this transient hypersensitivity renders the immature brain vulnerable to pathologic excitation of the EAA system (excitotoxicity) as observed during neonatal hypoxia-ischemia.
.A
Hattori H; Wasterlain CG.
.I 274244
.U
91000016
.S
Pediatr Neurol 9101; 6(4):229-32
.M
Asphyxia Neonatorum/DI; Cerebral Hemorrhage/DI; Cerebral Palsy/DI; Cerebral Ventricles/*PA; Follow-Up Studies; Human; Infant; Infant, Newborn; Leukomalacia, Periventricular/*DI; Magnetic Resonance Imaging/*; Meningitis/DI; Sleep Apnea Syndromes/DI; Tomography, X-Ray Computed.
.T
Periventricular hyperintensity detected by magnetic resonance imaging in infancy.
.P
JOURNAL ARTICLE.
.W
Twenty-one infants younger than 12 months of age were diagnosed as having periventricular hyperintensity (PVH) on T2-weighted magnetic resonance imaging. Ten infants had experienced neonatal asphyxia, 6 intracranial hemorrhage, 2 bacterial meningitis, and 3 apnea. PVH was classified according to its extent. Round foci of PVH surrounding the frontal and occipital horns of the lateral ventricles were observed in 4 infants (PVH pattern I). Continuous PVH was observed in 17 infants (PVH patterns II and III). Fourteen infants with continuous PVH had spastic diplegia or quadriplegia. Developmental delay was demonstrated in 15 infants with continuous PVH. No PVH pattern I infants had cerebral palsy; only 1 such infant had mild developmental delay. Our study suggests that the extent of PVH reflects the severity of brain damage in neonates with cerebral injuries.
.A
Konishi Y; Kuriyama M; Hayakawa K; Konishi K; Yasujima M; Fujii Y; Sudo M.
.I 274245
.U
91000017
.S
Pediatr Neurol 9101; 6(4):233-9
.M
Anencephaly/*PA; Brain/PA; Brain Death/DI/*PA; Human; Infant, Newborn; Neurologic Examination/*; Neurons/PA.
.T
Anencephaly: clinical determination of brain death and neuropathologic studies.
.P
JOURNAL ARTICLE.
.W
Twelve liveborn anencephalic infants were serially examined to determine if they would meet our clinical criteria for whole brain death within a 7-day period: Protocol 1 infants (6) received intensive care including intubation from birth; and Protocol 2 infants (6) received intensive care during the period in which death was imminent. Brain death was determined by absence of brainstem function, including loss of all cranial nerve responses and sustained apnea (PCO2 greater than 60 torr) for 48 hours with confirmation of findings by an outside consulting child neurologist. The initial examinations of these 12 infants revealed spontaneous movements and startle myoclonus (12), suck, root, and gag responses (7), increased tone (8), deep tendon reflexes (9), absent pupillary responses (9), absent oculocephalic and corneal responses (6), absent auditory/Moro responses (7), and nonvisualization of the optic nerve (8). Mild depression of neurologic function occurred during the first several days of life; subsequently, the infants' responses were easier to elicit and more sustained. Only 2 infants met the clinical criteria for brain death. Neuropathologic findings indicated that observed complex motor responses were not based upon cortical activity because no infant had a normally-formed cerebrum. Brainstem neuronal activity may have accounted for these motor responses in some patients but even at this level neurons were scanty or absent. Our findings suggest that, although rare, clinical brain death can be determined in liveborn anencephalic infants; ophthalmologic and otologic developmental abnormalities may confound examination of cranial nerve function; and absence of cortical neurons supports the widely held opinion that these infants do not experience sensation.
.A
Ashwal S; Peabody JL; Schneider S; Tomasi LG; Emery JR; Peckham N.
.I 274246
.U
91000018
.S
Pediatr Neurol 9101; 6(4):240-4
.M
Adrenocorticotropic Hormone/*AD; Child, Preschool; Dose-Response Relationship, Drug; Electroencephalography/DE; Evoked Potentials/DE; Follow-Up Studies; Human; Infant; Spasms, Infantile/*DT.
.T
ACTH therapy in infantile spasms: relationship between dose of ACTH and initial effect or long-term prognosis.
.P
JOURNAL ARTICLE.
.W
The relationship between the dose of ACTH and the initial effect was investigated in 41 children with infantile spasms. More than 0.015 mg (0.6 IU)/kg/day of ACTH was needed for a good initial response of seizures and electroencephalographic abnormalities. The relationship between the dose of ACTH and long-term prognosis was investigated in 29 patients. There was no relationship between the daily or total ACTH dosage, provided the dose was greater than 0.015 mg (0.6 IU)/kg/day, and the outcome of seizures and electroencephalographic abnormalities; however, ACTH 0.04-0.06 mg (1.6-2.4 IU)/kg/day and a total ACTH dose of 1.1-1.5 mg (44-60 IU)/kg resulted in better mental development than smaller doses of ACTH. Side effects of ACTH increased with dosage. Too small or too large a dose of ACTH does not lead to better mental development. The proper dose of ACTH should be used with careful attention to potential side effects.
.A
Ito M; Okuno T; Fujii T; Mutoh K; Oguro K; Shiraishi H; Shirasaka Y; Mikawa H.
.I 274247
.U
91000019
.S
Pediatr Neurol 9101; 6(4):245-50
.M
Cerebral Palsy/DI/*PP; Child, Preschool; Female; Follow-Up Studies; Human; Locomotion/*PH; Male; Motor Skills/*PH; Muscle Spasticity/DI/PP; Muscles/PP; Neurologic Examination/*.
.T
Gross motor patterns in children with cerebral palsy and spastic diplegia.
.P
JOURNAL ARTICLE.
.W
Rolling, sitting, and crawling patterns were motoscopically analyzed in 72 children with cerebral palsy and spastic diplegia; the relation between these patterns and the severity of the locomotive disability was studied. In rolling, trunk rotation and elbow support were difficult for the most severely diplegic children. When sitting, most patients had a between-heel sitting pattern in which the thighs were adducted and the knees were flexed. When crawling, the reciprocal thigh movements were insufficient and accompanied by lateral bending of the trunk in many patients. In the more impaired patients, the thighs supported the weight in flexion and did not move reciprocally. Creeping on the elbows without reciprocal leg movements was demonstrated in the most severely affected children after 2 years of age.
.A
Yokochi K; Hosoe A; Shimabukuro S; Kodama K.
.I 274248
.U
91000021
.S
Pediatr Neurol 9101; 6(4):257-9
.M
Arthrogryposis/DI; Case Report; Child, Preschool; Diagnostic Errors; Electromyography/*; Fasciculation/*DI/GE; Female; Human; Muscles/IR; Myotonia/*DI/GE; Peripheral Nerve Diseases/*DI/GE; Peripheral Nerves/PP; Reaction Time/PH; Syndrome; Tetany/*DI/GE.
.T
Mistaken diagnoses in continuous muscle fiber activity of peripheral nerve origin.
.P
JOURNAL ARTICLE.
.W
The syndrome of continuous muscle fiber activity of peripheral nerve origin has manifestations that resemble those of many other more common neurologic disorders during childhood and infancy. This similarity often leads to misdiagnosis when an adequate index of suspicion is not entertained and a comprehensive electromyographic examination is not performed. Two affected patients from 1 family are reported to illustrate the type of diagnostic errors that were made before the establishment of the correct diagnosis.
.A
Subramony SH; Parker CC; Evans OB; Hanson RR.
.I 274249
.U
91000022
.S
Pediatr Neurol 9101; 6(4):260-4
.M
Brain/PA; Brain Damage, Chronic/*ET; Brain Edema/ET; Cerebral Ventricles/PA; Child; Child, Preschool; Epilepsy/*ET; Female; Follow-Up Studies; Haemophilus influenzae/*PY; Human; Male; Meningitis, Haemophilus/*CO; Tomography, X-Ray Computed/*.
.T
Haemophilus influenzae meningitis with prolonged hospital course.
.P
JOURNAL ARTICLE.
.W
A retrospective evaluation of Haemophilus influenzae type b meningitis observed over a 2-year period documented 86 cases. Eight of these patients demonstrated an unusual clinical course characterized by persistent fever (duration: greater than 10 days), cerebrospinal fluid pleocytosis, profound meningeal enhancement on computed tomography, significant morbidity, and a prolonged hospital course. The mean age of these 8 patients was 6 months, in contrast to a mean age of 14 months for the entire group. Two patients had clinical evidence of relapse. Four of the 8 patients tested for latex particle agglutination in the cerebrospinal fluid remained positive after 10 days. All patients received antimicrobial therapy until they were afebrile for a minimum of 5 days. Subsequent neurologic examination revealed a persistent seizure disorder in 5 patients (62.5%), moderate-to-profound hearing loss in 2 (25%), mild ataxia in 1 (12.5%), and developmental delay with hydrocephalus which required shunting in 1 (12.5%). One patient had no sequelae.
.A
Martin LD; Kaplan AM; Rudinsky MF; Frost MD.
.I 274250
.U
91000023
.S
Pediatr Neurol 9101; 6(4):265-8
.M
Biopsy; Case Report; Child; Child, Preschool; Chromosome Abnormalities/DI/*GE; Diagnosis, Differential; Dystrophin/*AN; Fluorescent Antibody Technique; Genes, Recessive/*GE; Human; Male; Muscles/*PA; Muscular Dystrophy/DI/*GE; Support, Non-U.S. Gov't.
.T
Dystrophin analysis in the differential diagnosis of autosomal recessive muscular dystrophy of childhood and Duchenne muscular dystrophy.
.P
JOURNAL ARTICLE.
.W
We report 2 patients with childhood autosomal recessive muscular dystrophy. Both patients had slight muscle weakness without enlargement of the calf muscles or involvement of the facial muscles. Their clinical courses are static. Muscle histology revealed characteristic features of muscular dystrophy. Dystrophin was identifiable in the sarcolemma of both patients by immunocytochemical staining with an antidystrophin antibody. At an early age, immunocytochemical analysis with antidystrophin antibody was useful in distinguishing between childhood autosomal recessive and Duchenne muscular dystrophies.
.A
Tachi N; Tachi M; Sasaki K; Nagata N; Chiba S.
.I 274251
.U
91000024
.S
Pediatr Neurol 9101; 6(4):269-71
.M
Case Report; Cerebral Cortex/PP; Electroencephalography/*; Evoked Potentials/PH; Female; Follow-Up Studies; Hemolytic-Uremic Syndrome/PP/*TH; Human; Infant; Plasma/*; Status Epilepticus/PP/*TH.
.T
EEG correlation of improvement in hemolytic-uremic syndrome after plasma infusion.
.P
JOURNAL ARTICLE.
.W
We report a previously undescribed electroencephalographic pattern of epochs of diffuse delta background (85-240 sec) alternating with epochs of classic "burst suppression" (90-270 sec) in a 13-month-old girl with hemolytic-uremic syndrome. A dramatic electroencephalographic improvement was evident on continuous monitoring of cerebral function 3 hours after initiating fresh frozen plasma infusion, well before any clinical improvement was apparent. This patient, in addition to the unusual electroencephalographic findings, illustrates the role of continuous electrophysiologic monitoring of cerebral function and supports the use of fresh frozen plasma in hemolytic-uremic syndrome.
.A
Pascual-Leone A; Dhuna AK; Janousek ST; Talwar D.
.I 274252
.U
91000025
.S
Pediatr Neurol 9101; 6(4):272-4
.M
Adolescence; Biopsy; Case Report; Cerebellar Neoplasms/*DI/PA; Cerebellopontine Angle/*PA; Craniotomy; Female; Human; Lipoma/*DI/PA; Magnetic Resonance Imaging/*; Tomography, X-Ray Computed/*.
.T
Cerebellopontine angle lipoma in a teenager.
.P
JOURNAL ARTICLE.
.W
Lipomas of the cerebellopontine angle are very rare lesions. To date, 18 patients have been reported, 17 of whom were adults. A second child is described with cerebellopontine angle lipoma.
.A
Ashkenasi A; Royal SA; Cuffe MJ; Aronin PA; Tenorio GM; Benton JW.
.I 274253
.U
91000026
.S
Pediatr Neurol 9101; 6(4):275-6
.M
Adolescence; Case Report; Child; Electromyography/DE; Female; Human; Hypertension, Renal/*DT; Kidney Failure, Acute/CO; Kidney Failure, Chronic/CO; Kidney Transplantation; Labetalol/AD/*AE; Male; Neuromuscular Diseases/*CI; Postoperative Complications/DT.
.T
Reversible myopathy due to labetalol.
.P
JOURNAL ARTICLE.
.W
A severe, generalized myopathy developed in 2 children treated with labetalol. An 11-year-old girl and a 14-year-old boy demonstrated proximal weakness and markedly elevated creatine kinase levels during labetalol therapy. Clinical improvement began immediately when labetalol administration was halted; muscle strength was normal within 2 months. Muscle biopsies were consistent with rhabdomyolysis.
.A
Willis JK; Tilton AH; Harkin JC; Boineau FG.
.I 274254
.U
91000027
.S
Pediatr Neurol 9101; 6(4):277-8
.M
Blood Coagulation Tests; Case Report; Cerebral Hemorrhage/*BL/DI; Child, Preschool; Factor XIII Deficiency/*CO/DI; Follow-Up Studies; Hematoma, Subdural/BL; Human; Infant; Male; Subarachnoid Hemorrhage/BL; Tomography, X-Ray Computed.
.T
Factor XIII deficiency and intracranial hemorrhages in infancy.
.P
JOURNAL ARTICLE.
.W
We report an infant with Factor XIII deficiency who had 2 seemingly spontaneous intracranial hemorrhages. It is important to consider Factor XIII deficiency as a possible cause of unexplained intracranial hemorrhages in infancy. Ongoing factor replacement therapy is recommended to prevent further bleeding episodes.
.A
Larsen PD; Wallace JW; Frankel LS; Crisp D.
.I 274255
.U
91000028
.S
Pediatr Neurol 9101; 6(4):279-81
.M
Case Report; Cerebral Angiography; Cerebral Artery Diseases/RA; Chickenpox/*CO/RA; Child; Child, Preschool; Female; Follow-Up Studies; Hemiplegia/*ET/RA; Herpes Zoster Ophthalmicus/CO; Human; Infant; Male; Tomography, X-Ray Computed.
.T
Varicella with delayed hemiplegia.
.P
JOURNAL ARTICLE.
.W
We report 4 children who developed acute hemiplegia 7 weeks to 4 months after varicella infection. In 2 patients, carotid angiography demonstrated segmental narrowing and occlusion of the middle cerebral artery. Their clinical and angiographic features were similar to those associated with contralateral hemiplegia after herpes zoster ophthalmicus, the pathogenesis of which comprises cerebral angiitis due to varicella zoster viral infection. We believe that our patients had the same pathogenesis. In a survey of infectious diseases in our region, the frequency of varicella with delayed hemiparesis was roughly 1:6,500 varicella patients.
.A
Ichiyama T; Houdou S; Kisa T; Ohno K; Takeshita K.
.I 274256
.U
91000029
.S
Pediatr Neurol 9101; 6(4):282
.M
Cell Line/*; Cerebellar Neoplasms/*PA; Child; Human; Medulloblastoma/*PA; Platelet-Derived Growth Factor/*AN; Radioligand Assay; Tumor Markers, Biological/*AN.
.T
Medulloblastoma cell line [letter; comment]
.P
COMMENT; LETTER.
.A
Whelan HT.
.I 274257
.U
91000031
.S
Pediatr Neurol 9101; 6(4):283
.M
Brain/PA; Child, Preschool; Diagnosis, Differential; Encephalitis Periaxialis/*DI; Human; Infant; Magnetic Resonance Imaging; Male; Multiple Sclerosis/*DI.
.T
Infantile MS and Schilder disease [letter; comment]
.P
COMMENT; LETTER.
.A
Stenager E.
.I 274258
.U
91000541
.S
Arch Otolaryngol Head Neck Surg 9101; 116(10):1126,1128
.M
Animal; Bone Development/*/DE/PH; Bone Transplantation/*; Glycoproteins/PD/PH; Human; Proteins/PD/PH; Rats; Skull/*SU; Transforming Growth Factor beta/PD/PH.
.T
Osteoinductive implants in head and neck surgery [news]
.P
NEWS.
.A
Toriumi DM; Larrabee WF Jr.
.I 274259
.U
91000542
.S
Arch Otolaryngol Head Neck Surg 9101; 116(10):1128
.M
Face/SU; Human; Lasers/*TU; Surgery, Plastic; Wound Healing/*RE.
.T
Lasers and wound healing [news]
.P
NEWS.
.A
Meyers AD.
.I 274260
.U
91000543
.S
Arch Otolaryngol Head Neck Surg 9101; 116(10):1135-6
.M
Communicative Disorders; Deafness; Human; National Institutes of Health (U.S.)/*; Research; United States.
.T
Message from the National Institutes of Health. The state of the National Institute on Deafness and Other Communication Disorders.
.P
JOURNAL ARTICLE.
.A
Snow JB Jr.
.I 274261
.U
91000544
.S
Arch Otolaryngol Head Neck Surg 9101; 116(10):1137-42
.M
Aged; Aging/*PA; Forehead/PA/*SU; Human; Middle Age; Rhytidoplasty/AE/*MT.
.T
Management of the aging forehead.
.P
JOURNAL ARTICLE.
.W
Browlifting and forehead procedures are a critical element in the contemporary surgical management of the aging face. Esthetics of the upper third of the face will dictate brow position and its relationship to the supraorbital rim and eyes. Treatment of deformities of the upper third of the face can be varied according to the sex and age of the patient as well as contour of the hairline and forehead. The indications, advantages, disadvantages, and techniques of the coronal forehead, modified pretrichal forehead, midforehead, and direct browlifting procedures are discussed.
.A
Kerth JD; Toriumi DM.
.I 274262
.U
91000545
.S
Arch Otolaryngol Head Neck Surg 9101; 116(10):1143-6
.M
Adult; Bacterial Adhesion/*; Child; Epithelium/MI; Haemophilus influenzae/IM/PH; Human; IgA, Secretory/AN; Nasopharynx/*MI; Otitis Media with Effusion/IM/*MI; Streptococcus pneumoniae/IM/PH; Support, Non-U.S. Gov't.
.T
The role of bacterial adherence in otitis media with effusion.
.P
JOURNAL ARTICLE.
.W
Adherence of nontypable Haemophilus influenzae and Streptococcus pneumoniae to nasopharyngeal epithelial cells was investigated in vitro. Both strains had higher affinity to the epithelial cells of children than to those of adults. In children, the adherence was significantly greater in patients with otitis media with effusion than in normal subjects. Secretory IgA in nasopharyngeal secretions was found to have antibody activity against the bacteria. Adherence of both bacteria was significantly smaller in the group having secretory IgA antibody activity than in the group having no activity. These results suggest that bacterial adherence to the nasopharynx may play an important role in the pathogenesis of otitis media with effusion in children, and that secretory IgA in nasopharyngeal secretions may be related to the decrease of adherence.
.A
Shimamura K; Shigemi H; Kurono Y; Mogi G.
.I 274263
.U
91000546
.S
Arch Otolaryngol Head Neck Surg 9101; 116(10):1147-53
.M
Head/*SU; Human; Neck/*SU; Postoperative Complications; Skin/SU; Tissue Expanders; Tissue Expansion/*/AE/MT.
.T
Tissue expansion of the head and neck. Indications, technique, and complications.
.P
JOURNAL ARTICLE.
.W
Tissue expansion is indicated in the reconstruction of various defects of the head and neck in instances where there is inadequate adjacent tissue to allow either primary closure of the defect or repair with a local flap. It may also be indicated in instances where repair of a defect by an alternative method such as a local, regional, or distant flap will result in an unacceptable donor or recipient site deformity. Although tissue expansion is simplistic in concept, it does require judgment and indepth preoperative planning to ensure optimal results. The complication rate is high for tissue expansion in the head and neck, particularly in the cheek and neck area. Despite the frequency of complications, in the vast majority of cases the intended reconstruction is successful.
.A
Baker SR; Swanson NA.
.I 274264
.U
91000547
.S
Arch Otolaryngol Head Neck Surg 9101; 116(10):1154-8
.M
Adult; Chin/*SU; Female; Human; Implants, Artificial/*; Male; Middle Age; Phthalic Acids; Polyethylene Glycols; Postoperative Complications; Surgery, Plastic/IS/*MT; Surgical Mesh/*; Surgical Wound Infection.
.T
Augmentation mentoplasty using Mersilene mesh.
.P
JOURNAL ARTICLE.
.W
Many different materials are available for augmentation mentoplasty. However, the optimal implant material for chin implantation has yet to be found. During the past several years, a number of experienced surgeons have turned to the use of Mersilene mesh. Mersilene mesh is a non-absorbable Dacron polyester fiber that can be conformed easily into layers to achieve tailored dimensions and shape. At the McCollough Plastic Surgery Clinic PA, Birmingham, Ala, 277 patients over a 10-year period underwent chin augmentation with Mersilene mesh implants. The material provides excellent tensile strength, durability, and surgical adaptability. The overall complication rate was 3.2% (nine patients); infection rate, 2.5% (seven patients); and removal secondary to infection, 1.7% (five patients). Based on this 10-year experience, Mersilene mesh remains our material of choice for chin augmentation.
.A
McCollough EG; Hom DB; Weigel MT; Anderson JR.
.I 274265
.U
91000549
.S
Arch Otolaryngol Head Neck Surg 9101; 116(10):1163-6
.M
Alcohol Drinking/AE; Case-Control Studies; Female; Hair Dyes/AE; Human; Male; Middle Age; Mouthwashes/AE; Radiotherapy/AE; Risk Factors; Salivary Gland Neoplasms/*ET; Smoking/AE; Socioeconomic Factors.
.T
Salivary gland cancer. A case-control investigation of risk factors.
.P
JOURNAL ARTICLE.
.W
Unlike most upper aerodigestive tract cancers, salivary gland cancers are relatively infrequent, are characterized by a diversity of histologic subtypes, and have never been etiologically associated with tobacco exposure. We present the results of a case-control study of risk factors for these cancers, with risk estimates derived from self-administered comprehensive risk-factor questionnaires distributed to patients at The University of Texas M. D. Anderson Cancer Center, Houston. Cases were 64 patients with histologically confirmed salivary gland cancer. Control subjects, randomly selected from the same patient population excluding patients with cancer of the head and neck or nonmelanoma skin cancer, were frequency-matched to the cases by age, sex, and ethnicity to achieve a 2:1 control subjects/cases ratio. On multivariate analysis, prior radiotherapy was a significant risk factor for both men (odds ratio [OR] = 2.1) and women (OR = 2.3). Among women, higher educational attainment (OR = 2.4), alcohol use (OR = 2.0), and hairdye use (OR = 2.5) were also significantly associated with risk. There were no significant differences between cases and control subjects with respect to tobacco exposure or specific occupational or leisure-time exposures. There is biological plausibility for associations with hairdye use and alcohol exposure.
.A
Spitz MR; Fueger JJ; Goepfert H; Newell GR.
.I 274266
.U
91000550
.S
Arch Otolaryngol Head Neck Surg 9101; 116(10):1167-71
.M
Cell Division; Cell Transformation, Neoplastic/PA; Human; Immunoblotting; Intermediate Filament Proteins/AN; Keratin/ME; Laryngeal Neoplasms/ME/MI/*PA; Neoplasm Proteins/ME; Papilloma/ME/MI/*PA; Papillomaviruses/*; Protein Precursors/ME; Stains and Staining; Support, Non-U.S. Gov't; Support, U.S. Gov't, P.H.S.; Thymidine/PK; Tumor Virus Infections/ME/*PA; Uridine/PK.
.T
Abnormal differentiation of human papillomavirus-induced laryngeal papillomas.
.P
JOURNAL ARTICLE.
.W
We studied the proliferation and differentiation of human laryngeal papillomas, which are benign tumors induced by human papillomaviruses. Immunofluorescent stains of tissues for a number of differentiation-specific proteins showed abnormal differentiation. Papilloma tissue fragments in vitro showed a slightly decreased fraction of proliferating cells that incorporated tritiated thymidine and a markedly reduced incorporation of tritiated uridine when compared with normal tissue. We propose that papillomavirus infection results in normal basal cell proliferation but abnormal terminal differentiation and that this abnormality significantly contributes to the hyperplasia of the papillomas.
.A
Steinberg BM; Meade R; Kalinowski S; Abramson AL.
.I 274267
.U
91000551
.S
Arch Otolaryngol Head Neck Surg 9101; 116(10):1172-6
.M
Animal; Antineoplastic Agents, Combined/*TU; Carcinoma, Squamous Cell/*DT/PA; Cisplatin/AD; Drug Administration Schedule; Drug Interactions; Female; Fluorouracil/AD; Human; Male; Mice; Mice, Inbred BALB C; Neoplasm Transplantation; Support, Non-U.S. Gov't.
.T
Cisplatin-fluorouracil interaction in a squamous cell carcinoma xenograft.
.P
JOURNAL ARTICLE.
.W
Patients with squamous cell carcinoma of the head and neck are treated with cisplatin and fluorouracil according to a schedule based on the findings of clinical studies. A similar schedule showed a supra-additive effect in the treatment of xenografted human squamous cell carcinoma of the head and neck. We sought to ascertain whether this schedule was optimal. A single intraperitoneal injection of cisplatin (7.5 mg/kg) was combined with three injections of fluorouracil given during a 24-hour period (total dose, 150 or 80 mg/kg) before, during, or after cisplatin administration. The combined effect of cisplatin and fluorouracil on tumor growth and toxic effects was schedule dependent. Consideration of both toxic effects and tumor growth inhibition, as assessed by reduction of the area under the growth curve, the optimal administration interval was found to be fluorouracil given 3 days after cisplatin administration.
.A
Rydell R; Wennerberg J.
.I 274268
.U
91000552
.S
Arch Otolaryngol Head Neck Surg 9101; 116(10):1177-80
.M
Animal; Hematoporphyrins/TU; Papillomaviruses/*; Photochemotherapy/*; Porphyrins/TU; Rabbits; Support, Non-U.S. Gov't; Support, U.S. Gov't, Non-P.H.S.; Tumor Virus Infections/*DT/PA; Warts/*DT/MI/PA.
.T
Laser photodynamic therapy for papilloma viral lesions.
.P
JOURNAL ARTICLE.
.W
Photodynamic therapy was tested for its therapeutic efficacy in eradicating rabbit papilloma warts. The wild-type viral warts suspension was used to induce treatable papilloma warts in the cutaneous tissue of Dutch Belted rabbits. The photosensitizing agents used intravenously were Photofrin II at 10 mg/kg of body weight and Chlorin e6 monoethylene diamine monohydrochloric acid (Chlorin e6 med HCl) at 1 mg/kg of body weight. The lasers used were an argon-dye laser at 628 and 655 nm and a gold vapor laser at 628 nm. The irradiances of 25 to 180 mW/cm2 were applied topically with an end-on lens optical fiber with total radiant doses of 7.5 to 54 J/cm2. Photofrin II and the argon-dye laser at the highest light dosage (54 J/cm2) and Chlorin e6 monoethylene diamine monohydrochloride administered 2 hours before argon-dye laser irradiation at 655 nm at the highest light dosage (54 J/cm2) produced wart regression. Total wart regression without recurrence was achieved with Photofrin II and the gold vapor laser at all light dosages. The difference observed between the argon-dye laser and the gold vapor laser might be explained by the pulsed nature of the gold vapor laser, with its high-peak powers, some 5000 x the average measured light dose. In this model, the smaller, less cornified lesions were more effectively treated with photodynamic therapy.
.A
Go PM; Reed RN; Straight RC; Waner M.
.I 274269
.U
91000553
.S
Arch Otolaryngol Head Neck Surg 9101; 116(10):1181-5
.M
Adult; Aged; Carcinoma, Squamous Cell/*IM/PA; Female; Head and Neck Neoplasms/*IM/PA; Histocompatibility Antigens Class I/*AN; Human; HLA-D Antigens/*AN; Immunoenzyme Techniques; Male; Middle Age; Mucous Membrane/IM.
.T
HLA class I and class II antigen expression on squamous cell carcinoma of the head and neck.
.P
JOURNAL ARTICLE.
.W
We compared human major histocompatibility (HLA) class I and class II antigen expression on squamous cell carcinoma of the head and neck with that on normal mucosa. Frozen sections of a consecutive series of 30 squamous cell carcinomas were stained with the monoclonal antibodies W6/32 (class I) and anti-DR (class II) using an immunoperoxidase technique. Normal mucosa showed class I and class II expression in the basal layers only. Class I expression on tumors was diffuse in 87%, patchy in 10%, and scattered in 3%. Class II expression on tumors was diffuse in 20%, patchy in 53%, scattered in 20%, and absent in 7%. Patterns of expression did not correlate significantly with clinical parameters, including survival, except that class II diffuse and patchy patterns were found to correlate with more poorly differentiated tumors.
.A
Houck JR; Sexton FM; Zajdel G.
.I 274270
.U
91000554
.S
Arch Otolaryngol Head Neck Surg 9101; 116(10):1186-9
.M
Child; Child, Preschool; Ear, Middle/*PA; Endoscopy/*; Eustachian Tube/PA; Female; Human; Male; Middle Ear Ventilation; Mucous Membrane/PA; Otitis Media with Effusion/*PA/SU; Tympanic Membrane/PA.
.T
Transtympanic endoscopic findings in patients with otitis media with effusion.
.P
JOURNAL ARTICLE.
.W
Using a fine, rigid endoscope (Olympus, SES-1711K), we examined the middle ear, including the tympanic orifice of the eustachian tube, of children with otitis media with effusion (OME) in its active stage (26 ears), in the convalescent stage (13 ears), and during treatment with ventilation tubes for 10 days to 6 months (five ears) through myringotomy with the patients under general anesthesia. Several color photographs of representative ears are shown. In the active stage of OME, edema (73.1%) and hyperemia (23.1%) were characteristic features of the middle ear mucosa, and normal mucosa was seen in only one ear (3.1%). The tympanic orifice of the eustachian tube, which could be examined in 12 ears, were stenosed with edema in four ears (33.3%) or plugged with effusion in three ears (25.0%) in this group. In the convalescent stage of OME, dilated vessels were most often seen (69.2%), but the rest of the patients had normal mucosa (30.8%) in the middle ear, and none of them had edema nor hyperemia. The tympanic orifice of the eustachian tube, which could be examined in five ears, was clearly patent in all the patients in this group. One ear that was treated with a ventilation tube for 1 month showed dilated vessels and less severe inflammation than did ears that were in the active stage of OME, and three ears that were treated for more than 3 months showed almost normal middle ear mucosa.
.A
Takahashi H; Honjo I; Fujita A; Kurata K.
.I 274271
.U
91000555
.S
Arch Otolaryngol Head Neck Surg 9101; 116(10):1190-3
.M
Comparative Study; False Negative Reactions; False Positive Reactions; Head and Neck Neoplasms/PA; Human; Lymph Nodes/PA/*RA; Lymphatic Metastasis/PA/*RA; Neck; Retrospective Studies; Tomography, X-Ray Computed/*.
.T
Computed tomography of metastatic cervical lymph nodes. A clinical, computed tomographic, pathologic correlative study.
.P
JOURNAL ARTICLE.
.W
A retrospective comparative study of 63 neck dissections was undertaken to evaluate further the accuracy of high-resolution computed tomography (CT) in the detection of nodal metastases, as previous studies have indicated a trend toward the superiority of CT scanning over palpation. The respective values of neck examination, CT scanning, and histopathologic examination were assessed in 51 patients with head and neck cancer who underwent a total of 63 neck dissections. The overall agreement between clinical examination findings and histopathologic findings was 92% vs 81% for CT scanning. A retrospective analysis of the CT findings failed to reveal greater accuracy. We found nodes measuring 10 mm or more with central low density always to be malignant. Because CT scanning seems to offer little advantage over palpation in the nonirradiated neck, it should not be regarded as an essential tool in the staging of nodal disease. After radiation therapy, as neck dissection is only performed because of clinical or radiologic suspicion, CT scanning is of utmost importance.
.A
Moreau P; Goffart Y; Collignon J.
.I 274272
.U
91000556
.S
Arch Otolaryngol Head Neck Surg 9101; 116(10):1194-6
.M
Adolescence; Child; Ear, External/*AB; Female; Human; Male; Pedigree.
.T
A survey of accessory auricle anomaly. Pedigree analysis of seven cases.
.P
JOURNAL ARTICLE.
.W
We performed an investigation of 50 accessory auricles on subjects encountered during 1983 through 1985. Fifteen of the families were found to have the same accessory auricular deformity among the probands' family members. From these 15 families, we selected seven pedigrees that were not accompanied by auricular deformities who had filial generations for analysis. Pedigrees 1 through 6 showed autosomal dominant inheritance; two also had irregular dominant properties (pedigrees 4 and 7), and one (pedigree 7) could not be excluded from the possibility of having an X-linked recessive inheritance. During the investigation, there were latent accessory auricles in which the cartilages were seen to be subcutaneous only or protruding slightly. Genetically, the pathogenesis of an accessory auricle should be related to the accessory auricular gene.
.A
Gao JZ; Chen YM; Gao YP.
.I 274273
.U
91000557
.S
Arch Otolaryngol Head Neck Surg 9101; 116(10):1197-201
.M
Adult; Case Report; Female; Human; Implants, Artificial/*; Lip/PA/*SU; Male; Nose/PA; Rhinoplasty/MT; Surgery, Plastic/*MT.
.T
Significant premaxillary augmentation.
.P
JOURNAL ARTICLE.
.W
Substantial premaxillary augmentation is necessary as an adjunctive treatment in most cleft rhinoplasties and in those patients exhibiting an acute nasolabial angle due to retrusion of the premaxila. We describe our technique of evaluation and treatment of this condition using a custom-carved piece of material made from a woven combination of Teflon and organic fibers (Proplast). Detailed technical illustrations as well as patient results are demonstrated. We have found this technique in our hands to be a simple, safe, and effective means of correction of significant premaxillary retrusion.
.A
Cook TA; Wang TD; Brownrigg PJ; Quatela VC.
.I 274274
.U
91000558
.S
Arch Otolaryngol Head Neck Surg 9101; 116(10):1202-4
.M
Adult; Case Report; Cysts/*/PA/TH; Ear Diseases/PA/TH; Ear, External/*; Human; Male.
.T
Pseudocyst of the auricle. Case report and world literature review [see comments]
.P
JOURNAL ARTICLE; REVIEW; REVIEW, TUTORIAL.
.W
We treated a patient with pseudocyst of the auricle and reviewed the 113 cases previously published in the world literature. Pseudocyst of the auricle is an asymptomatic, noninflammatory cystic swelling that involves the anthelix of the ear, results from an accumulation of fluid within an unlined intracartilaginous cavity, and occurs predominantly in men (93% of patients). Characteristically, only one ear is involved (87% of patients), and the lesion is usually located within the scaphoid or triangular fossa of the anthelix. Previous trauma to the involved ear is uncommon. The diagnosis may be suggested by the clinical features, and analysis of the aspirated cystic fluid and/or histologic examination of a lesional biopsy specimen will confirm the diagnosis. Therapeutic intervention that maintains the architecture of the patient's external ear should be used in the treatment of this benign condition.
.A
Cohen PR; Grossman ME.
.I 274275
.U
91000560
.S
Arch Otolaryngol Head Neck Surg 9101; 116(10):1208-9
.M
Adolescence; Airway Obstruction/DI/*PX; Case Report; Child; Conversion Disorder/*/DI; Female; Human; Male; Respiratory Sounds/ET.
.T
Functional upper airway obstruction in adolescents.
.P
JOURNAL ARTICLE.
.W
Functional upper airway obstruction is an uncommon manifestation of a conversive reaction characterized by recurrent stridor attacks caused by adduction of the vocal cords during inspiration. The oxygen saturation never drops to pathologic levels. The stridor is not accompanied by an appropriate degree of anxiety and is not associated with other symptoms. Patients benefit from verbal reassurance and speech therapy, but stridor attacks tend to recur and psychiatric consultation seems necessary in most cases. We present the case histories of three adolescent patients with nonorganic upper airway obstruction and describe the features that may facilitate the diagnosis of this condition. Early diagnosis and intervention may prevent unnecessary and potentially harmful investigations and therapy.
.A
Ophir D; Katz Y; Tavori I; Aladjem M.
.I 274276
.U
91000561
.S
Arch Otolaryngol Head Neck Surg 9101; 116(10):1210-3
.M
Adult; Brain Diseases/*ET/MI/RA; Case Report; Human; Hyphomycetes/*; Male; Mucocele/*ET/MI/RA; Mycoses/*CO/RA; Sinusitis/*CO/MI/RA; Tomography, X-Ray Computed.
.T
Multiple intracranial mucoceles associated with phaeohyphomycosis of the paranasal sinuses.
.P
JOURNAL ARTICLE.
.W
The purpose of this article is to alert clinicians to a new pathogenic fungus of the paranasal sinuses called Exserohilum rostratum. Exserohilum species are one of the etiologic agents of phaeohyphomycosis, a constellation of entities caused by dematiaceous fungi. This class of fungal sinus infection has emerged only in the past decade; it occurs primarily in immunocompetent individuals and produces a tenacious, progressive pansinusitis. To our knowledge, this study describes the first case of multiple intracranial mucoceles secondary to E rostratum. The diagnostic workup includes computed tomography and magnetic resonance imaging followed by direct microscopic examination of tissue biopsy specimens. A craniotomy followed by a bilateral external ethmoidectomy was necessary for complete extirpation of the infected mucoceles. Aggressive surgical management of this mycotic infection is described.
.A
Aviv JE; Lawson W; Bottone EJ; Sachdev VP; Som PM; Biller HF.
.I 274277
.U
91000562
.S
Arch Otolaryngol Head Neck Surg 9101; 116(10):1214-6
.M
Case Report; Child; Cholesteatoma/CN/CO/RA; Ear Diseases/CN/CO/RA; Ear Neoplasms/*/CO/PA/RA; Ear, Middle/*; Human; Male; Osteoma/*/CO/PA/RA; Skull Neoplasms/CO/PA/RA; Temporal Bone/PA/RA.
.T
Osteoma of the middle ear. Report of a case.
.P
JOURNAL ARTICLE.
.W
Osteomas of the middle ear are rare. We report a case of a 7-year-old boy with osteoma originating from the pyramidal eminence, combined with congenital cholesteatoma. The osteoma and cholesteatoma were successfully removed by tympanomastoidectomy. The long process of the incus and the superstructure of the stapes disappeared. The body of the incus was sculpted and used as a columella. Histopathologically, the osteoma was much the same as an external auditory canal osteoma. The possibility of a primary congenital origin of this neoplasm is suggested.
.A
Yamasoba T; Harada T; Okuno T; Nomura Y.
.I 274278
.U
91000563
.S
Arch Otolaryngol Head Neck Surg 9101; 116(10):1217
.M
Human; Otosclerosis/*DT; Sodium Fluoride/AE/*TU.
.T
Fluoride therapy for otosclerosis [letter]
.P
LETTER.
.A
Shambaugh GE Jr.
.I 274279
.U
91000699
.S
J Am Soc Echocardiogr 9101; 3(4):255-65
.M
Echocardiography/*/*MT; Heart Diseases/*US; Human; Image Processing, Computer-Assisted/*; Observer Variation; Support, U.S. Gov't, P.H.S..
.T
Ultrasonic integrated backscatter two-dimensional imaging: evaluation of M-mode guided acquisition and immediate analysis in 55 consecutive patients.
.P
JOURNAL ARTICLE.
.W
We have shown previously that cardiac cycle-dependent integrated backscatter characterizes the physical state of myocardium in patients with ischemic heart disease and cardiomyopathy. In the present study the clinical applicability of M-mode guided two-dimensional integrated backscatter imaging was defined in evaluation of 55 nonselected patients. The mean amplitude of cyclic variation of integrated backscatter in normal segments (long-axis view) was as follows: basal septum, 4.2 +/- 1.3 dB (mean +/- SD; n = 27), mid-septum, 4.5 +/- 1.0 dB (n = 26), basal posterior, 4.8 +/- 1.0 dB (n = 30), and mid-posterior, 4.8 +/- 1.2 decibels (n = 27). The respective mean delay values (R wave to nadir) were as follows: 0.89 +/- 0.09, 0.84 +/- 0.09, 0.86 +/- 0.09, and 0.85 +/- 0.12. At least one cardiac cycle could be analyzed fully in 62% of patients. Limitations included technically difficult two-dimensional echocardiography, inadequate M-line orientation, technically remediable errors, or poor quality integrated backscatter images. In abnormal segments (n = 13) cyclic variation was reduced and delay was prolonged (1.2 +/- 1.1 dB and 1.21 +/- 1.1, respectively). Intraobserver and interobserver variability for amplitude measurements were modest, with respective correlation coefficients of r = 0.93; r = 0.72. The findings demonstrate that M-mode--assisted integrated backscatter is a practical approach for characterization of regional myocardial properties promptly and at the bedside in a large portion of patients with cardiac disease.
.A
Loomis JF Jr; Waggoner AD; Schechtman KB; Miller JG; Sobel BE; Perez JE.
.I 274280
.U
91000700
.S
J Am Soc Echocardiogr 9101; 3(4):266-75
.M
Algorithms/*; Echocardiography/*/*MT; Human; Image Processing, Computer-Assisted/*; Myocardial Contraction/*PH; Support, U.S. Gov't, P.H.S..
.T
Applications of cross-correlation techniques to the quantitation of wall motion in short-axis two-dimensional echocardiographic images.
.P
JOURNAL ARTICLE.
.W
Echocardiography is now a mainstay in the diagnosis of cardiovascular disease. Rapid methods for quantitation of the images would provide an effective tool for the diagnosis of change in left ventricular function. The purpose of this article is to show the feasibility of using the cross-correlation technique to quantify change in left ventricular function over time in two-dimensional short-axis echocardiographic images. Radial histograms of radial distance versus the number of probable specular targets are formed in eight sectors on each frame during the cardiac cycle. These histograms are then shifted to a position of best correlation. The number of radial bins through which the histograms at end systole are shifted to correlate with those of the frame at end diastole defines the regional motion. The methods are described and preliminary findings are presented.
.A
Geiser EA; Wilson DC; Gibby GL.
.I 274281
.U
91000701
.S
J Am Soc Echocardiogr 9101; 3(4):276-84
.M
Adult; Analysis of Variance; Comparative Study; Echocardiography/*; Echocardiography, Doppler/*; Female; Graft Rejection; Heart Transplantation/*PH; Human; Male; Observer Variation; Reference Values; Regression Analysis; Reproducibility of Results; Ventricular Function, Left/*PH.
.T
Variability of Doppler echocardiographic indexes of left ventricular filling in transplant recipients and in normal subjects.
.P
JOURNAL ARTICLE.
.W
This study examines the reproducibility and variability of pulsed wave Doppler versus continuous wave Doppler ultrasound indexes of left ventricular filling in cardiac allograft recipients and in normal subjects. The following indexes were studied: isovolumic relaxation time, pressure half-time, peak early mitral flow velocity, and peak mitral flow velocity after atrial systole. Intraobserver and interobserver variability were assessed by regression analysis. Individual components of variance (subject, reader, beat, day, and tracing) were estimated in a subset of five patients and five normal subjects, and estimated total variance defined for each group. Temporal (day-to-day) variability for 95% confidence was estimated for these patients and for normal subjects. Temporal variability in the group from which the subsets were drawn was measured from absolute and percent change in values on two occasions. Estimated and observed 95% confidence limits were compared. Intersubject variability was the largest component of variance in both transplant recipients and in normal subjects. For all indexes in transplant recipients (in the absence of rejection) and normal subjects, observed absolute mean differences (+/- 2 standard deviations) between values from recordings taken on two different days were larger than the 95% confidence limits estimated from the components of variance analysis. The observed 95% limits for transplant recipients versus normal subjects were as follows: isovolumic relaxation time, 20 msec versus 6 msec; pressure half-time, 16 msec versus 9 msec; peak early mitral flow velocity, 32 cm per second versus 17 cm per second; and peak mitral flow velocity after atrial systole, 28 cm per second versus 10 cm per second.(ABSTRACT TRUNCATED AT 250 WORDS)
.A
Valantine HA; Hatle LK; Appleton CP; Gibbons R; Popp RL.
.I 274282
.U
91000702
.S
J Am Soc Echocardiogr 9101; 3(4):285-93
.M
Aortic Valve Insufficiency/DI/*US; Cardiac Output/PH; Cold/DU; Comparative Study; Echocardiography, Doppler/*; Exercise Test; Female; Human; Male; Middle Age; Nifedipine/DU; Stroke Volume/PH; Support, Non-U.S. Gov't; Vasodilation/DE; Ventricular Function/*PH.
.T
Left and right ventricular flows by Doppler echocardiography: serial measurements in patients with aortic regurgitation during exercise, cold pressor stimulation, and vasodilation.
.P
JOURNAL ARTICLE.
.W
To test the practicality of Doppler echocardiography to measure serial change, biventricular outputs were measured in 15 patients with aortic regurgitation during control periods and during interventions of bicycle exercise, cold pressor stimulation, and vasodilation. Biventricular stroke volumes were measured in 10 normal subjects for validation of methods and differed by 2.8%. Reading errors were 3.7%. Signal quality improved between the first and last observation (p less than 0.05). Velocity signals were corrected for intercept angles, which averaged 12 and 19 degrees for right heart flows and 31 and 32 degrees for the left side of the heart in all subjects. Negative correlations occurred between intercept angles and the chronologic order in which the patients were studied for left (p = 0.02) and right (p = 0.05) flows. Mean flow areas varied 9% in the left ventricle and 20% in the right ventricle. Total variability for measuring flow determined from control values was 11% to 13%. When twice the variability was used as the detectable level of change, only exercise provoked real increases in biventricular flows in the majority of patients. We conclude that serial measurements of flow by Doppler echocardiographic methods had to exceed 20% to 25% to achieve significant change. Measuring intercept angle, resolving flow area, and learning are variables that need greater emphasis.
.A
Wong M; Matsumura M; Omoto R.
.I 274283
.U
91000703
.S
J Am Soc Echocardiogr 9101; 3(4):294-302
.M
Adult; Aged; Blood Flow Velocity/PH; Cardiomyopathy, Congestive/*US; Comparative Study; Coronary Circulation/PH; Echocardiography; Echocardiography, Doppler/*MT; Human; Middle Age; Support, Non-U.S. Gov't.
.T
Flow patterns in dilated cardiomyopathy: a pulsed-wave and color flow Doppler study.
.P
CLINICAL TRIAL; JOURNAL ARTICLE.
.W
In 48 patients with dilated cardiomyopathy, pulsed-wave and color Doppler examination were performed. In addition, 14 normal patients served as control subjects. Peak inflow velocity at the level of the mitral valve, middle left ventricle, and apex and outflow velocity at the level of the apex, middle left ventricle, and subaortic area were measured. In normal patients there was brisk propagation of inflow velocity to the apex. Patients with dilated cardiomyopathy demonstrated delayed propagation and prolongation of the duration of inflow compared with control subjects (p less than 0.04). Continuous apical flow was visualized in 25% of dilated cardiomyopathies and in no normal patients. Apical velocities were significantly increased in cardiomyopathies with significant mitral regurgitation. Outflow velocities were decreased in dilated cardiomyopathy. In patients with dilated cardiomyopathy and apical dyskinesis, flow directed toward the base was measured in the middle left ventricle during isovolumic relaxation secondary to dyskinetic rebound. Patterns of abnormal flow in dilated cardiomyopathies are readily apparent by color M-mode and two-dimensional color Doppler.
.A
Jacobs LE; Kotler MN; Parry WR.
.I 274284
.U
91000704
.S
J Am Soc Echocardiogr 9101; 3(4):303-9
.M
Blood Flow Velocity/PH; Coronary Circulation/PH; Echocardiography, Doppler/*MT; Human; Hypertension, Pulmonary/SU/*US; Mitral Valve/*US; Pulmonary Embolism/SU/*US; Ventricular Function, Left/PH.
.T
Influence of Doppler sample volume location on the assessment of changes in mitral inflow velocity profiles.
.P
JOURNAL ARTICLE.
.W
Previous studies that have validated Doppler indexes of mitral inflow have used pulsed wave sample volume locations either at the level of the mitral valve anulus or at the tips of the mitral valve leaflets. Although significant differences between absolute values for peak velocities and velocity time integrals at these sample volume locations have previously been reported, no information exists that has compared changes in inflow profiles after an intervention to improve left ventricular filling. To address this question, 13 patients with severe pulmonary hypertension (mean pulmonary artery pressure, 50 +/- 13 mm Hg) caused by chronic thromboembolic disease were studied with use of Doppler echocardiography immediately before and after surgical reduction of pulmonary hypertension (pulmonary vascular resistance decreased from 916 +/- 413 to 233 +/- 89 dynes.sec.cm5). This clinical model has been shown to have abnormal mitral inflow velocity profiles that improve markedly after surgery. Doppler measures of early and late peak velocities were significantly lower both before and after surgery when sampling at the mitral anulus compared with the leaflet tips, although late filling parameters and the deceleration of early flow velocity tended to differ little. With surgery, the significant increase in peak early velocity and the ratio of early to late velocity was present regardless of the sample volume location (peak E at leaflet tips, 47.1 +/- 16.0 to 68.9 +/- 15.4 [p less than 0.001], and at anulus, 40.7 +/- 11.3 to 56.2 +/- 14.6 cm/sec [p less than 0.001]; peak E/A at leaflet tips, 0.95 +/- 0.4 to 1.55 +/- 0.9, and at anulus, 0.78 +/- 0.3 to 1.32 +/- 0.7 [both p less than 0.02]).(ABSTRACT TRUNCATED AT 250 WORDS)
.A
Dittrich HC; Blanchard DG; Wheeler KA; McCann HA; Donaghey LB.
.I 274285
.U
91000705
.S
J Am Soc Echocardiogr 9101; 3(4):310-5
.M
Algorithms/*; Blood Flow Velocity; Comparative Study; Computer Graphics/*; Echocardiography, Doppler/*/IS; Human; Image Processing, Computer-Assisted/*.
.T
Do Doppler color flow algorithms for mapping disturbed flow make sense?
.P
JOURNAL ARTICLE.
.W
It has been suggested that a major advantage of Doppler color flow mapping is its ability to visualize areas of disturbed ("turbulent") flow, for example, in valvular stenosis or regurgitation and in shunts. To investigate how various color flow mapping instruments display disturbed flow information, color image processing was used to evaluate the most common velocity-variance color encoding algorithms of seven commercially available ultrasound machines. In six of seven machines, green was reportedly added by the variance display algorithms to map areas of disturbed flow. The amount of green intensity added to each pixel along the red and blue portions of the velocity reference color bar was calculated for each machine. In this study, velocities displayed on the reference color bar ranged from +/- 46 to +/- 64 cm/sec, depending on the Nyquist limit. Of note, changing the Nyquist limits depicted on the color reference bars did not change the distribution of the intensities of red, blue, or green within the contour of the reference map, but merely assigned different velocities to the pixels. Most color flow mapping algorithms in our study added increasing intensities of green to increasing positive (red) or negative (blue) velocities along their color reference bars. Most of these machines also added increasing green to red and blue color intensities horizontally across their reference bars as a marker of increased variance (spectral broadening). However, at any given velocity, marked variations were noted between different color flow mapping instruments in the amount of green added to their color velocity reference bars.(ABSTRACT TRUNCATED AT 250 WORDS)
.A
Gardin JM; Lobodzinski SM.
.I 274286
.U
91000706
.S
J Am Soc Echocardiogr 9101; 3(4):316-9
.M
Aorta/US; Aortic Valve/US; Aortic Valve Insufficiency/*EP/US; Echocardiography, Doppler/*; Human.
.T
Prevalence of aortic regurgitation by color flow Doppler in relation to aortic root size.
.P
JOURNAL ARTICLE.
.W
To determine whether there is a correlation between aortic root size and the prevalence of aortic regurgitation, we performed color flow Doppler echocardiographic studies on 1015 consecutive patients during a 3-month period. Patients were grouped according to their M-mode aortic root diameter as measured in the left parasternal position. The measured groups ranged from 2.0 to 4.5 cm, grouped at 0.1 cm intervals. As the aortic root size enlarged, the prevalence of aortic regurgitation increased linearly (p less than 0.001; correlation coefficient, r = 0.75). At an aortic root size in the "small normal" range of 2.0 to 2.4 cm, the prevalence of aortic regurgitation was 0% to 15%. In the "intermediate" and "top normal" ranges of 2.9 to 3.7 cm, the prevalence of aortic regurgitation increased linearly from 15% to 47%. With aortic root dilation, the prevalence of aortic root regurgitation was generally more than 50%. The severity of aortic regurgitation was semiquantified. Aortic root size was not a good indicator for the severity of aortic regurgitation. Patients with moderate and severe aortic regurgitation had variable aortic root sizes. Throughout the range of aortic root sizes, mild aortic regurgitation predominated. We conclude that aortic regurgitation is a common finding in patients with aortic roots that are dilated or are in the "top normal" size range, that the prevalence of aortic regurgitation increases linearly with aortic root size, and that aortic root size does not correlate with the severity of aortic regurgitation.
.A
Seder JD; Burke JF; Pauletto FJ.
.I 274287
.U
91000707
.S
J Am Soc Echocardiogr 9101; 3(4):320-5
.M
Case Report; Double Outlet Right Ventricle/*US; Echocardiography/*; Female; Human; Infant, Newborn.
.T
Two-dimensional echocardiographic features of double outlet left ventricle.
.P
JOURNAL ARTICLE; REVIEW; REVIEW OF REPORTED CASES.
.W
In a cyanotic newborn infant, the diagnosis of double outlet left ventricle was made from the two-dimensional echocardiographic examination. The diagnosis was later confirmed at cardiac catheterization and surgery. The parasternal and subcostal views were especially useful for identification of the origin of both great arteries from the morphologic left ventricle. A review of the medical literature since 1967 revealed 77 cases of double outlet left ventricle, most of which were diagnosed only at surgery or postmortem examination. The anatomic features demonstrated with two-dimensional echocardiography in this case are representative of the findings cited most often in the cases reported in the medical literature.
.A
Bengur AR; Snider AR; Peters J; Merida-Asmus L.
.I 274288
.U
91000708
.S
J Am Soc Echocardiogr 9101; 3(4):326-30
.M
Aortic Valve Stenosis/*US; Echocardiography, Doppler/*MT; Human.
.T
Evolution of the continuity equation in the Doppler echocardiographic assessment of the severity of valvular aortic stenosis.
.P
JOURNAL ARTICLE; REVIEW; REVIEW, TUTORIAL.
.W
The use of Doppler techniques has greatly enhanced the noninvasive ultrasound technique for evaluation of valvular aortic stenosis. M-mode and two-dimensional echocardiography could not reliably distinguish patients with severe aortic stenosis from those with milder obstructions. The hemodynamic information offered by Doppler complemented echocardiographic imaging and provided an alternative modality for evaluation of patients with aortic stenosis. By application of the modified Bernoulli equation, the pressure gradient across the stenotic aortic valve could be estimated by Doppler echocardiography. Though helpful and widely used, the information provided by the pressure gradient across the valve about the severity of the obstruction was not complete. The assessment of valvular aortic stenosis therefore includes an estimation of the valve area by application of the continuity equation. This review examines the maturation of the continuity equation by Doppler techniques and discusses the implications of the procedure.
.A
Taylor R.
.I 274289
.U
91000709
.S
J Am Soc Echocardiogr 9101; 3(4):331-5
.M
Aortic Valve/*US; Aortic Valve Stenosis/US; Blood Flow Velocity/PH; Cardiac Output; Comparative Study; Echocardiography/*; Heart Catheterization; Human; Indicator Dilution Techniques.
.T
The determination of aortic valve area by the Gorlin formula: what the cardiac sonographer should know.
.P
JOURNAL ARTICLE.
.W
The application of the Gorlin formula in the cardiac catheterization laboratory is the standard of reference for the determination of aortic valve area. The continuity equation now enables the cardiac sonographer to determine aortic valve area noninvasively in the echocardiography laboratory. The comparison of the results obtained by the two methods is inevitable. The cardiac sonographer should have a basic understanding of the theory and pitfalls of the Gorlin formula so that when conflicting results are obtained, the possible reasons why will be clear.
.A
Reynolds T.
.I 274290
.U
91000710
.S
J Am Soc Echocardiogr 9101; 3(4):336-46
.M
Aneurysm, Dissecting/US; Aorta, Abdominal/*US; Aortic Aneurysm/US; Aortic Diseases/*US; Blood Vessel Prosthesis; Echocardiography/*; Human.
.T
The evaluation of the abdominal aorta: a "how-to" for cardiac sonographers.
.P
JOURNAL ARTICLE.
.W
A thorough evaluation of the abdominal aorta can be readily achieved by use of the standard views of the echocardiographic examination. The ultrasound evaluation of the abdominal aorta represents a logical extension of the standard echocardiographic examination of the adult patient. This article provides the information needed to carry out a complete ultrasound examination of the abdominal aorta including the anatomy, the vascular disease, and the steps involved in accomplishing the ultrasound examination of the abdominal aorta.
.A
Reynolds T; Santos T; Weidemann J; Langenfeld K; Warner MG.
.I 274291
.U
91001032
.S
Br Heart J 9101; 64(3):174-6
.M
Adult; Arrhythmia/PC/PP; Electrocardiography/*; Human; Myocardial Infarction/*DT/PP; Risk Factors; Thrombolytic Therapy/*.
.T
Late potentials as predictors of risk after thrombolytic treatment? [published erratum appears in Br Heart J 1991 Feb;65(2):113]
.P
JOURNAL ARTICLE; REVIEW; REVIEW, TUTORIAL.
.A
Breithardt G; Borggrefe M; Karbenn U.
.I 274292
.U
91001034
.S
Br Heart J 9101; 64(3):182-5
.M
Adult; Age Factors; Aged; Aged, 80 and over; Aspartate Aminotransferase/BL; Creatine Kinase/BL; Electrocardiography; Female; Heart Enlargement/ET; Human; Lactate Dehydrogenase/BL; Logistic Models; Male; Middle Age; Multivariate Analysis; Myocardial Infarction/CO/EN/*MO/PP; Prognosis; Prospective Studies; Risk Factors; Stroke Volume.
.T
Multivariate analysis in the prediction of death in hospital after acute myocardial infarction.
.P
JOURNAL ARTICLE.
.W
Prognostic factors in patients with acute myocardial infarction based on clinical and investigative data on admission were evaluated prospectively in 111 consecutive patients. Seventeen patients (15.3%) died during hospital stay. Age, a previous infarct, high Killip class, cardiomegaly, high serum concentrations of cardiac enzymes, a low ejection fraction, and a high wall motion score index correlated significantly with in-hospital mortality; whereas sex, risk factors, and pericardial effusion did not. Multivariate analysis showed that age and the wall motion score index were the best predictors of death in hospital. Wall motion detected by cross sectional echocardiography may reflect the extent of myocardial involvement. Age and wall motion score index predicted in-hospital mortality with a sensitivity of 76.5%, a specificity of 91.5%, and a predictive accuracy of 89.2%. Age and the wall motion score index can be determined on admission and are useful for identifying patients at high risk of cardiac death who might benefit from early intervention.
.A
Sahasakul Y; Chaithiraphan S; Panchavinnin P; Jootar P; Thongtang V; Srivanasont N; Charoenchob N; Kangkagate C.
.I 274293
.U
91001035
.S
Br Heart J 9101; 64(3):186-9
.M
Adrenergic Beta Receptor Agonists/*TU; Adult; Aged; Comparative Study; Double-Blind Method; Exercise; Female; Heart Failure, Congestive/*DT/PP; Heart Rate; Human; Male; Middle Age; Propanolamines/*TU; Stroke Volume; Time Factors.
.T
Ischaemic left ventricular failure: evidence of sustained benefit after 18 months' treatment with xamoterol.
.P
JOURNAL ARTICLE.
.W
The long term effects of treatment with xamoterol in 14 patients aged 44-73 with mild to moderate heart failure as a result of ischaemic heart disease are reported. After 18 months' treatment with xamoterol, patients were assessed in a randomised double blind crossover comparison of xamoterol (200 mg twice a day) and placebo, each given for one month. Compared with placebo, xamoterol significantly increased exercise duration and work done on a bicycle ergometer and reduced the maximum exercise heart rate. Assessment of symptoms and activities at 12 months by visual analogue and Likert scales showed a trend towards the relief of symptoms of breathlessness and tiredness and an improvement in activity. There was an improvement in the clinical signs of heart failure and no haemodynamic deterioration over a 12 month period as assessed by ejection fraction. The improvement in exercise tolerance, symptoms, and activities was sustained for 18 months without side effects or development of tolerance.
.A
Vigholt-Sorensen E; Faergeman O.
.I 274294
.U
91001036
.S
Br Heart J 9101; 64(3):190-4
.M
Adult; Aged; Carcinoid Heart Disease/DI/PA/*US; Echocardiography, Doppler/*; Female; Human; Male; Middle Age; Mitral Valve/PA; Myocardium/PA; Prospective Studies; Support, Non-U.S. Gov't; Tricuspid Valve/PA; Tricuspid Valve Insufficiency/DI/US.
.T
Transoesophageal echocardiography improves the diagnostic value of cardiac ultrasound in patients with carcinoid heart disease.
.P
JOURNAL ARTICLE.
.W
Transthoracic and transoesophageal cardiac echocardiography and Doppler investigations were performed in 31 consecutive patients with malignant midgut carcinoid tumours. The transoesophageal images allowed measurement of the thickness of the atrioventricular valve leaflets and the superficial wall layers on the cavity side of both atria. The mean thickness of the anterior tricuspid leaflet was significantly greater than that of the mitral valve--a difference not seen in a control group of age-matched patients without carcinoid tumours and with normal cardiac ultrasound findings. In addition, the edges of the tricuspid leaflets were thickened giving them a clubbed appearance. Tricuspid incompetence was detected transoesophageally in 71% of the patients with carcinoid compared with 57% by transthoracic investigation. The inner layer of the right atrial wall in the carcinoid patients was significantly thicker than that of the left atrium and that of both atria in the controls. Furthermore, patients with other signs of severe carcinoid heart disease had significantly thicker mean right atrial luminal wall layer than those with less or no signs of right heart disease. Transoesophageal cardiac ultrasound investigation improved the diagnostic accuracy and seemed to show the structural changes typical of carcinoid heart disease established by histopathological investigations.
.A
Lundin L; Landelius J; Andren B; Oberg K.
.I 274295
.U
91001037
.S
Br Heart J 9101; 64(3):195-8
.M
Adult; Aortic Rupture/CO/*US; Echocardiography/*; Echocardiography, Doppler; Female; Heart Catheterization; Heart Septal Defects, Ventricular/CO/DI; Human; Male; Sinus of Valsalva/*.
.T
Echocardiographic diagnosis of a ruptured aneurysm of the sinus of Valsalva: operation without catheterisation in seven patients.
.P
JOURNAL ARTICLE.
.W
A ruptured aneurysm of the sinus of Valsalva was diagnosed by Doppler, colour, and cross sectional echocardiography in a consecutive series of seven patients. The diagnoses were confirmed at operation without cardiac catheterisation. Examination by pulsed and continuous Doppler echocardiography showed continuous turbulence in six patients with aneurysms rupturing into the right ventricular outflow tract and in the patient with rupture of an aneurysm of the non-coronary sinus into the right atrium. Colour Doppler echocardiography showed turbulent flow across the defects in all seven patients. A ventricular septal defect with aortic regurgitation was detected in one patient and an associated ventricular septal defect in another. Doppler, colour, and cross sectional echocardiography were useful non-invasive techniques for diagnosing a ruptured aneurysm of the sinus of Valsalva without the need for cardiac catheterisation.
.A
Sahasakul Y; Panchavinnin P; Chaithiraphan S; Sakiyalak P.
.I 274296
.U
91001038
.S
Br Heart J 9101; 64(3):199-203
.M
Adult; Alcohol Drinking; Blood Pressure; Cholesterol/BL; Cluster Analysis; Coronary Disease/BL/*EP/PP; Cross-Sectional Studies; Diet; Female; Human; Lipoproteins, HDL Cholesterol/BL; Male; Middle Age; Risk Factors; Scotland/EP; Smoking/AE; Socioeconomic Factors; Support, Non-U.S. Gov't.
.T
Geographical clustering of risk factors and lifestyle for coronary heart disease in the Scottish Heart Health Study.
.P
JOURNAL ARTICLE.
.W
A large cross sectional study, the Scottish Heart Health Study, of 10,359 men and women from 22 districts of Scotland was undertaken to try to explain the geographical variation of coronary heart disease mortality. Analysis by district showed that of the classic risk factors only cigarette smoking was strongly associated with heart disease mortality among both men and women. Mean diastolic blood pressure was weakly associated with rates among men and high density lipoprotein cholesterol showed a strong negative association among women. Total cholesterol showed a weak negative association with heart disease mortality, but, because the serum concentrations of cholesterol were uniformly high in all districts, a strong association with mortality would not be expected. In both men and women many dietary factors showed moderate or strong associations with mortality from coronary heart disease in a district--of these a low consumption of vitamin C was most notable. Other factors associated with heart disease included alcohol consumption and serum triglycerides among men, and obesity, physical activity, and serum triglycerides among women. Many factors associated with heart disease showed strong intercorrelations. Clustering of risk factors (including smoking, alcohol, and diet among men, and smoking, diet, and obesity among women) was associated with much of the regional variation in heart disease mortality in Scotland.
.A
Crombie IK; Smith WC; Tavendale R; Tunstall-Pedoe H.
.I 274297
.U
91001039
.S
Br Heart J 9101; 64(3):204-5
.M
Aortic Valve; Aortic Valve Insufficiency/ET/*SU; Arthritis, Infectious/CO; Case Report; Endocarditis, Bacterial/*CO; Female; Heart Valve Prosthesis/*; Human; Infant, Newborn; Staphylococcal Infections/CO.
.T
Replacement of an aortic valve cusp after neonatal endocarditis.
.P
JOURNAL ARTICLE.
.W
Septic arthritis developed in a neonate after an infection of her hand. Despite medical and surgical treatment endocarditis of her aortic valve developed and the resultant regurgitation required emergency surgery. At operation a new valve cusp was fashioned from preserved calf pericardium. Nine years later she was well and had full exercise tolerance with minimal aortic regurgitation.
.A
Tulloh RM; Silove ED; Abrams LD.
.I 274298
.U
91001040
.S
Br Heart J 9101; 64(3):206-7
.M
Adult; Cardiac Tamponade/*CO/TH; Case Report; Drainage; Human; Hyponatremia/*ET; Inappropriate ADH Syndrome/*CO; Male; Paraplegia/CO; Pulmonary Embolism/PC; Warfarin/TU.
.T
Hyponatraemia secondary to an inappropriately high release of antidiuretic hormone in cardiac tamponade.
.P
JOURNAL ARTICLE.
.W
A spontaneous intrapericardial haemorrhage caused cardiac tamponade in a 29 year old paraplegic man who was being treated with warfarin. The associated persistent hyponatraemia, which was believed to be caused by an inappropriately high release of antidiuretic hormone, rapidly resolved after pericardiocentesis.
.A
Groves PH; Shah AM; Hutchison SJ.
.I 274299
.U
91001041
.S
Br Heart J 9101; 64(3):208-10
.M
Aged; Case Report; Coronary Vessel Anomalies/CO/*SU/US; Death, Sudden/*ET; Echocardiography; Human; Male; Mitral Valve Prolapse/CO/SU; Resuscitation.
.T
Aberrant origin of the right coronary artery as a potential cause of sudden death: successful anatomical correction.
.P
JOURNAL ARTICLE.
.W
A man with an aberrant right coronary artery and haemodynamically important prolapse of the mitral valve was successfully resuscitated. The aberrant right coronary artery was thought to be a possible cause of the cardiopulmonary arrest in this patient. Both lesions were corrected at a single operation.
.A
Nelson-Piercy C; Rickards AF; Yacoub MH.
.I 274300
.U
91001042
.S
Br Heart J 9101; 64(3):211-3
.M
Angina Pectoris/ET; Coronary Vessels/*RA; Female; Heart Arrest/ET; Heart Catheterization/AE/*IS; Human; Male; Middle Age.
.T
Cardiac catheterisation with 5 French catheters.
.P
JOURNAL ARTICLE.
.W
From the beginning of November 1987 to the end of January 1989, 526 coronary arteriograms and left ventricular angiograms were performed with 5 French coronary catheters. In 448 (85%) patients diagnostic pictures were obtained with three standard types of 5 French catheters (No 4 Judkins): that is, left coronary, right coronary, and pigtail catheters. In 60 patients (11.4%) various other 5 French catheters were required to complete the study. In nine patients (1.7%), a 7 or 8 French catheter was used. Major complications causing cardiac arrest or requiring urgent operation developed in five patients. Sixty two patients (11.77%) had minor complications that required sublingual nitrates or a single bolus of atropine, or developed a haematoma that did not need intervention or had a mild reaction to the contrast material. Complications of moderate severity developed in 17 patients (3.2%): severe chest pain, arrhythmia requiring a temporary pacemaker, contrast reaction associated with hypotension, haematoma requiring blood transfusion, or a transient ischaemic episode. There were no deaths. 5 French catheters were used for routine coronary angiography and left ventriculography in 98.3% of patients. There were no major complications related to femoral artery puncture. The routine use of 5 French coronary catheters should increase the feasibility of safe coronary angiography in outpatients and should reduce the cost of this investigation.
.A
O'Sullivan JJ; McDonald K; Crean PA; Walsh MJ; McCarthy C; Erwin RJ; Maurer BJ.
.I 274301
.U
91001043
.S
Br Heart J 9101; 64(3):214-8
.M
Adolescence; Adult; Aged; Cardiomyopathy, Congestive/PP/US; Child; Comparative Study; Echocardiography/*; Echocardiography, Doppler/*; Female; Heart Enlargement/PP/US; Human; Male; Middle Age; Mitral Valve/PP/US; Mitral Valve Stenosis/PP/US; Myocardial Infarction/PP/*US; Phonocardiography; Time Factors.
.T
Discrepancies in the measurement of isovolumic relaxation time: a study comparing M mode and Doppler echocardiography.
.P
JOURNAL ARTICLE.
.W
Mitral valve cusp separation on M mode echogram, the mitral valve opening artefact, and the onset of forward transmitral flow recorded by Doppler echocardiography have all been taken to mark the end of isovolumic relaxation, while its onset has been taken either as the aortic closure sound (A2) recorded phonocardiographically or the aortic closure artefact determined by Doppler technique. Possible differences in the measurement of the isovolumic relaxation time were studied when these landmarks were used in 44 healthy people, 14 patients with mitral stenosis, 21 patients with left ventricular hypertrophy, and 24 patients with dilated cardiomyopathy by recording M mode echograms of the mitral valve, and pulsed and continuous wave Doppler spectra of transmitral flow, with simultaneous electrocardiograms and phonocardiograms. A2 was effectively synchronous with the aortic artefact. However, when the onset of Doppler flow was regarded as the end of isovolumic relaxation, the interval was significantly longer than when mitral cusp separation on M mode echograms was used: by 25 (10) ms in healthy individuals, by 25 (15) ms in patients with left ventricular hypertrophy, and by 50 (35) ms in patients with dilated cardiomyopathy. In patients with mitral stenosis the interval was only 5 (5) ms longer. The mitral valve opening artefact consistently followed the onset of flow and corresponded much more closely to the E point on the M mode echogram. This shows that it occurred during the rapid filling period and well beyond isovolumic relaxation by any definition. Thus isovolumic relaxation time measured from A2 to the onset of transmitral flow or the mitral valve opening artefact differs from that derived from A2 to mitral valve cusp separation. These intervals cannot be used interchangeably to measure "isovolumic relaxation time".
.A
Lee CH; Vancheri F; Josen MS; Gibson DG.
.I 274302
.U
91001044
.S
Br Heart J 9101; 64(3):219-22
.M
Aged; Cardiology/*/EC; Great Britain; Health Care Rationing/*EC; Health Resources/SD; Heart Surgery/EC; Human; State Medicine.
.T
Can rationing of cardiological services be rational?
.P
JOURNAL ARTICLE.
.A
Chamberlain D; Alderslade R.
.I 274303
.U
91001045
.S
Br Heart J 9101; 64(3):223-6
.M
Correspondence; Electrocardiography/HI; England; Germany; History of Medicine, 20th Cent.; Netherlands; Physiology/*HI; USSR.
.T
The last portrait of Willem Einthoven: newly discovered links between Sir Thomas Lewis and Alexander Samojloff.
.P
HISTORICAL ARTICLE; HISTORICAL BIOGRAPHY; JOURNAL ARTICLE.
.A
Krikler DM; Hollman A.
.I 274304
.U
91001046
.S
Br Heart J 9101; 64(3):227
.M
Human; Middle Age; Myocardial Infarction/*MO; Risk Factors; Systole/PH; Time Factors.
.T
Estimation of the risk of death after acute myocardial infarction from systolic time intervals [letter; comment]
.P
COMMENT; LETTER.
.A
Weissler AM.
.I 274305
.U
91002375
.S
Br J Dermatol 9101; 123(3):283-9
.M
Administration, Topical; Adolescence; Adult; Epidermis/*DE/ME; Human; Immunoblotting; Immunoenzyme Techniques; Interleukin-1/*ME; Middle Age; Protein Precursors/ME; Support, Non-U.S. Gov't; Tretinoin/AD/*PD.
.T
Effect of topical retinoic acid on the interleukin 1 alpha and beta immunoreactive pool in normal human epidermis.
.P
JOURNAL ARTICLE.
.W
The topical application of 0.1% retinoic acid (RA) on human skin over a period of 4 days, whether or not under occlusion, did not increase either IL-1 alpha or beta immunoreactivity as determined by a sensitive enzymoimmunoassay. No down modulation was seen following the application of a potent topical corticosteroid. Occlusion increased the yield of IL-1 beta immunoreactivity. Immunoblot patterns of epidermal extracts revealed both the mature form of IL-1 (17 kDa) and the precursor (36 kDa) and were identical in amounts whether the specimens were from controls or from RA- or corticosteroid-treated skin. There was a slight modification in the pattern of high molecular weight proteins (52 kDa) probed by the anti-IL-1 alpha and beta sera. It appears that the IL-1 epidermal immunoreactive pools are barely amenable to modulation because they represent a storage form linked to end-stages of keratinocyte differentiation.
.A
Gruaz DC; Didierjean L; Gumowski-Sunek D; Saurat JH.
.I 274306
.U
91002376
.S
Br J Dermatol 9101; 123(3):291-5
.M
Adult; Aged; Antibodies, Monoclonal/ME; Betamethasone/*TU; Calcitriol/*AA/TU; Comparative Study; Double-Blind Method; DNA/*AN; Female; Fluorescent Antibody Technique; Human; Keratin/IM/*ME; Male; Middle Age; Psoriasis/*DT/ME; Skin/ME.
.T
DNA content and Ks8.12 binding of the psoriatic lesion during treatment with the vitamin D3 analogue MC903 and betamethasone.
.P
CLINICAL TRIAL; JOURNAL ARTICLE.
.W
Twenty patients with psoriasis were treated with the vitamin D3 analogue MC903 and betamethasone ointment in a double-blind trial with a left-right comparison. In addition to the clinical severity scores, Ks8.12 binding which detects keratin 16 expression and the DNA synthesis were quantified using flow cytometry. Both markers decreased significantly with treatment, but remained above the normal range even in those who had total clearance of the lesions. Treatment with MC903 with regard to Ks8.12 binding was significantly better than with betamethasone.
.A
de Mare S; de Jong EG; van de Kerkhof PC.
.I 274307
.U
91002377
.S
Br J Dermatol 9101; 123(3):297-304
.M
Adult; Aged; Aged, 80 and over; Cell Movement/DE; Cytokines/*AN; Exudates and Transudates/*IM; Female; Human; Interleukin-1/*AN/PD; Interleukin-6/*AN; Lymphocytes/DE; Male; Middle Age; Mycosis Fungoides/*IM; Skin Neoplasms/*IM; Support, Non-U.S. Gov't.
.T
Skin exudate levels of interleukin 6, interleukin 1 and other cytokines in mycosis fungoides.
.P
JOURNAL ARTICLE.
.W
The role of locally released cytokines in inducing lymphocyte activation and infiltration in the skin lesions of mycosis fungoides has been investigated. The levels of selected cytokines were measured in chamber fluid samples from lesional and control skin. Biologically active interleukin 6 was significantly elevated in lesional samples and a recombinant form of this cytokine was shown to induce lymphocyte migration in an in vitro assay. Biologically active interleukin 1 was detected in all control chamber fluid samples. Significantly reduced levels of this cytokine were present in lesional samples, which may be the result of the release of preformed material. Interleukin 2 and tumour necrosis factor activity, and gamma interferon and granulocyte macrophage colony-stimulating factor immunoreactivity, were not detectable in any of the samples. Interleukins 1 and 6 may play a role in the pathogenesis of the lesional lymphocyte infiltrates in mycosis fungoides.
.A
Lawlor F; Smith NP; Camp RD; Bacon KB; Black AK; Greaves MW; Gearing AJ.
.I 274308
.U
91002378
.S
Br J Dermatol 9101; 123(3):305-12
.M
Adult; Aged; Arthritis, Rheumatoid/DT/PA; Drug Administration Schedule; Elastic Tissue/*DE/PA; Female; Human; Joints/DE; Male; Middle Age; Penicillamine/AD/*AE/TU; Prevalence; Pseudoxanthoma Elasticum/CI/PA; Skin/DE/PA.
.T
Elastic fibre damage induced by low-dose D-penicillamine.
.P
JOURNAL ARTICLE.
.W
We have studied 23 patients receiving penicillamine for the treatment of rheumatoid arthritis to determine the prevalence of penicillamine-induced elastosis. One female patient had pseudoxanthoma elasticum-like skin changes and bramble-bush elastosis without calcification in the involved skin. Penicillamine elastosis was present in the joint capsule in 62% of eight patients or 64% of II joints examined and was detected in joint capsules after as little as I year of treatment.
.A
Dalziel KL; Burge SM; Frith PA; Ryan TJ; Mowat A.
.I 274309
.U
91002379
.S
Br J Dermatol 9101; 123(3):313-8
.M
Basement Membrane; Cell Movement/PH; Chemotaxis/PH; Connective Tissue; Fibroblasts/CY; Human; Male; Neoplasm Invasiveness; Sarcoma, Kaposi's/*PA; Skin Neoplasms/*PA; Support, Non-U.S. Gov't; Tumor Cells, Cultured/DE/PA; Tumor Necrosis Factor/PD.
.T
Invasive migration of epidemic Kaposi's sarcoma cells in vitro.
.P
JOURNAL ARTICLE.
.W
Kaposi's sarcoma (KS) is a low grade malignant neoplasm which shows invasive growth and often occurs in immunosuppressed patients with the Acquired Immune Deficiency Syndrome (AIDS; epidemic KS). It is also found in elderly men where it is usually limited to the skin (classic KS). The present study investigated the chemotaxis and invasive migration of epidemic KS cells in vitro and compared them to cells grown from classic KS lesions and to fibroblasts. Epidemic KS cells demonstrated invasive migration through reconstituted basement membrane (Matrigel) as well as through interstitial connective tissue (collagen I) in early passages, whereas fibroblasts did not invade either barrier. Epidemic KS cells in late passages did not show any invasive migration. Following pretreatment with tumour necrosis factor alpha (TNF-alpha) there was no enhanced migration through the Matrigel and collagen I for epidemic KS cells, whereas classic KS cells showed an increased migration through the type I collagen barrier.
.A
Schirren CG; Roth WK; Hein R; Werner S; Krieg T; Braun-Falco O.
.I 274310
.U
91002380
.S
Br J Dermatol 9101; 123(3):319-23
.M
Adult; Aged; Comparative Study; Female; Human; Male; Middle Age; Neutrophils/*CH; Psoriasis/BL/*ME; Seborrhea/BL/*ME; Support, Non-U.S. Gov't; Zinc/*AN/BL.
.T
Neutrophil zinc levels in psoriasis and seborrhoeic dermatitis.
.P
JOURNAL ARTICLE.
.W
The median zinc content of neutrophils was significantly reduced in 16 patients with psoriasis in comparison to both normal controls and six patients with seborrhoeic dermatitis (P less than 0.05). This reduction was unrelated to the extent of skin involvement. Plasma and erythrocyte zinc levels were unchanged.
.A
Leung RS; Turnbull AJ; Taylor JA; Russell-Jones R; Thompson RP.
.I 274311
.U
91002381
.S
Br J Dermatol 9101; 123(3):325-31
.M
Culture Media; Dermatitis, Atopic/IM; Human; Immunity, Cellular/IM; Leukocyte Culture Test, Mixed/*; Psoriasis/*IM; Support, Non-U.S. Gov't; T-Lymphocytes/*IM.
.T
Autologous mixed lymphocyte reaction is reduced in patients with psoriasis.
.P
JOURNAL ARTICLE.
.W
The autologous mixed lymphocyte reaction (auto-MLR) was studied to test the interactions between immunocompetent cells in patients with psoriasis. The auto-MLR in 20 patients with psoriasis was significantly lower than in 16 normal controls. Lower values were found in untreated psoriatic patients than in those in remission following treatment. The values in the latter group were significantly lower than in controls and in six patients with atopic dermatitis in remission. The tendency for an increase in the auto-MLR with a decrease in disease activity was further confirmed in five patients studied before and after treatment. In contrast, the allogeneic lymphocyte reaction (allo-MLR) in psoriatics was similar to that in normal controls.
.A
Terui T; Rokugo M; Aiba S; Kato T; Tagami H.
.I 274312
.U
91002383
.S
Br J Dermatol 9101; 123(3):339-46
.M
Cell Division/DE; Collagen/BI; Depression, Chemical; Fibroblasts/DE/ME; Fibronectins/BI; Glycosaminoglycans/BI; Human; Keloid/ME; Pentoxifylline/*PD; Scleroderma, Circumscribed/ME; Scleroderma, Systemic/ME; Skin/*DE/ME; Skin Diseases/*ME; Support, U.S. Gov't, Non-P.H.S..
.T
Pentoxifylline inhibits the proliferation of human fibroblasts derived from keloid, scleroderma and morphoea skin and their production of collagen, glycosaminoglycans and fibronectin.
.P
JOURNAL ARTICLE.
.W
Pentoxifylline, an analogue of the methylxanthine theobromine, inhibits the proliferation and certain biosynthetic activities of fibroblasts derived from normal human skin. Fibroblasts from the skin of patients with keloids, scleroderma and morphoea were cultured in vitro in the presence and absence of pentoxifylline (100-1000 micrograms/ml) to determine whether it inhibits fibroblast proliferation and the production of collagen, glycosaminoglycans (GAG), fibronectin and collagenase activity. The exposure of subconfluent fibroblast cultures to pentoxifylline resulted in non-lethal, dose-dependent reductions in serum-driven fibroblast proliferation, with 1000 micrograms/ml pentoxifylline virtually negating the proliferative effect of serum on the cells. The fibroblasts assayed as confluent cultures produced reduced amounts, by up to 95%, of collagen and GAG, dependent on the concentration of pentoxifylline, both in the presence and absence of serum. Pentoxifylline similarly inhibited the fibronectin production by keloid and scleroderma fibroblasts, but had no effect on collagenase activity.
.A
Berman B; Duncan MR.
.I 274313
.U
91002384
.S
Br J Dermatol 9101; 123(3):347-53
.M
Alkaline Phosphatase/BL; Creatinine/BL; Cyclosporins/AD/*AE; Dose-Response Relationship, Drug; Drug Administration Schedule; Human; Hypertension/*CI; Kidney/*DE; Middle Age; Psoriasis/BL/*DT/EN; Time Factors.
.T
Analysis of side-effects of medium- and low-dose cyclosporin maintenance therapy in psoriasis.
.P
JOURNAL ARTICLE.
.W
The side-effects of long-term cyclosporin A (CyA) treatment in 26 patients with severe psoriasis were evaluated. These patients had a mean PASI score of 30.2 and were treated with CyA for between 7 and 37 months (mean 19.5 months). There were three groups according to the dose of CyA, less than 2 mg/kg per day, 2-3 mg/kg per day and greater than 3 mg/kg per day. In all three groups, CyA was found to be equally effective. Treatment with CyA was discontinued in 12 of the 26 patients because of nephrotoxicity and/or development of hypertension. One was in the less than 2 mg/kg per day group, three were in the 2-3 mg/kg per day group and eight in the greater than 3 mg/kg per day group. There was no hepatotoxicity with CyA treatment. One patient developed two squamous cell carcinomas of the skin.
.A
de Rie MA; Meinardi MM; Bos JD.
.I 274314
.U
91002386
.S
Br J Dermatol 9101; 123(3):365-73
.M
Adult; Female; Human; Male; Nails/AH/*US; Ultrasonics; Water/*.
.T
Ultrasound velocity in human fingernail and effects of hydration: validation of in vivo nail thickness measurement techniques.
.P
JOURNAL ARTICLE.
.W
Distal nail thickness was measured using an electronic micrometer and both distal and proximal nail ultrasound times were recorded in 20 volunteers (10 male, 10 female), aged 20-39. The fingernail ultrasound velocity was 2.26 X 10(3) m/s (subject range 2.03-2.69) (analysis of variance technique). The proximal ultrasound transit time was greater than distal ultrasound transit time. In three volunteers, five micrometer and one distal midline ultrasound measurement of five nails were repeated on 10 occasions over 2 weeks. For the micrometer readings the average coefficient of variation was 5.3% (SD +/- 2.4%), and for the ultrasound reading the average coefficient of variation was 4.0% (SD +/- 1.3%). To assess the influence of hydration, in five volunteers the distal nail micrometer thickness and the distal nail ultrasound transit time were measured on five nails before and after 30 min of immersion in water initially at 37 degrees C. The mean distal ultrasound transmission time increased from 0.20 +/- 0.04 microseconds to 0.22 +/- 0.04 microseconds (P less than 0.001) after water immersion. The micrometer measurements and ultrasound velocity did not change significantly (mean ultrasound velocity = 2.01 X 10(3) m/s before, 2.04 X 10(3) m/s after immersion).
.A
Finlay AY; Western B; Edwards C.
.I 274315
.U
91002388
.S
Br J Dermatol 9101; 123(3):381-7
.M
Adult; Arginine/*AD/TU; Feces/CH; Female; Heme/*AD/TU; Human; Infusions, Intravenous; Photosensitivity Disorders/DT; Porphyria/BL/*DT; Protoporphyrins/AN/BL; Skin/DE; Skin Diseases/*DT; Support, Non-U.S. Gov't.
.T
Effects of haem arginate on variegate porphyria.
.P
JOURNAL ARTICLE.
.W
Four patients with variegate porphyria (VP) were treated with repeated haem arginate infusions daily for 4 days and then weekly for 4 weeks. After the initial four daily doses of haem arginate (haem 3 mg/kg), the excretion of faecal protoporphyrin (mean 579 nmol/g dry wt) fell to an almost normal level (mean 123 nmol/g dry wt), and that of coproporphyrin (mean 162 nmol/g dry wt) to the normal level (mean 21 nmol/g dry wt) in all patients. However, during the period of the four weekly infusions of haem the excretion of porphyrins increased almost to the pretreatment level. Phototesting showed no changes in the photoreactivity of the skin, and no improvement in skin lesions was seen during the treatment. Except for one case of thrombophlebitis no side-effects occurred. In a child with homozygous VP, four daily infusions of haem arginate (2 mg/kg) normalized the faecal protoporphyrin content, but had no effect on the increased erythrocyte protoporphyrin concentration.
.A
Timonen K; Mustajoki P; Tenhunen R; Lauharanta J.
.I 274316
.U
91002389
.S
Br J Dermatol 9101; 123(3):389-93
.M
Case Report; Drug Therapy, Combination; Gangrene; Human; Injections, Intravenous; Male; Mezlocillin/*AD/TU; Middle Age; Pyoderma/*DT; Vancomycin/*AD/TU.
.T
Successful treatment of eruptive pyoderma gangrenosum with intravenous vancomycin and mezlocillin.
.P
JOURNAL ARTICLE.
.A
Kang S; Dover JS.
.I 274317
.U
91002390
.S
Br J Dermatol 9101; 123(3):395-401
.M
Adult; Case Report; Female; Gangrene; Human; Male; Metabolism, Inborn Errors/*PA; Receptors, Leukocyte-Adhesion/*DF; Skin/PA; Skin Ulcer/*ME/PA.
.T
Skin manifestations in congenital deficiency of leucocyte-adherence glycoproteins (CDLG).
.P
JOURNAL ARTICLE.
.W
In congenital deficiency of leucocyte-adherence glycoproteins (CDLG) there is an immunodeficiency with impaired leucocyte function and cutaneous and extracutaneous infections occur. In more than 30% of cases the condition has a fatal course. We report the skin manifestations of three siblings with CDLG in which areas of skin necrosis occurred that resembled pyoderma gangrenosum.
.A
van de Kerkhof PC; Weemaes CM.
.I 274318
.U
91002391
.S
Br J Dermatol 9101; 123(3):403-7
.M
Adolescence; Argyria/*ET/PA; Case Report; Female; Foreign Bodies/*CO; Human; Skin/*PA/UL.
.T
An unusual case of acquired localized argyria.
.P
JOURNAL ARTICLE.
.W
We report an unusual cause of localized cutaneous argyria, due to the cutaneous implantation of a silver earring back.
.A
Shall L; Stevens A; Millard LG.
.I 274319
.U
91002392
.S
Br J Dermatol 9101; 123(3):409-12
.M
Case Report; Colon/PA; Crohn Disease/*CO/IM/PA; Female; Human; HLA Antigens/AN; Lip/PA; Melkersson-Rosenthal Syndrome/*CO/IM/PA; Middle Age; Rectum/PA.
.T
Granulomatous cheilitis and Crohn's disease.
.P
JOURNAL ARTICLE.
.A
Kano Y; Shiohara T; Yagita A; Nagashima M.
.I 274320
.U
91002393
.S
Br J Dermatol 9101; 123(3):413-4
.M
Adult; Case Report; Human; Male; Mucocutaneous Lymph Node Syndrome/*PA; Perineum/*PA; Skin/*PA.
.T
Kawasaki disease in a young adult with a perineal rash [letter]
.P
LETTER.
.A
Machet L; Vaillant L; Goutal H; Lanternier G; Khallouf R; Chagnon JL; Lorette G.
.I 274321
.U
91002394
.S
Br J Dermatol 9101; 123(3):414-5
.M
Baths/AE; Case Report; Human; Male; Middle Age; Myelodysplastic Syndromes/*CO; Pruritus/*ET; Water/*AE.
.T
Aquagenic pruritus and the myelodysplastic syndrome [letter]
.P
LETTER.
.A
McGrath JA; Greaves MW.
.I 274322
.U
91002395
.S
Br J Dermatol 9101; 123(3):415-6
.M
Adult; Alopecia/DT; Case Report; Cyclopropanes/*AE; Human; Male; Vitiligo/*CI.
.T
Persistent vitiligo induced by diphencyprone [letter]
.P
LETTER.
.A
Duhra P; Foulds IS.
.I 274323
.U
91002875
.S
Blood 9101; 76(7):1267-8
.M
Bleomycins/TO/TU; Cyclophosphamide/TO/TU; Etoposide/TO/TU; Human; Lymphoma, Large-Cell, Diffuse/*DT/MO; Prednisone/TO/TU; Procarbazine/TO/TU.
.T
Salvage therapy for diffuse large-cell lymphoma [editorial]
.P
EDITORIAL.
.A
Chabner BA.
.I 274324
.U
91002876
.S
Blood 9101; 76(7):1269-80
.M
Human; Immunogenetics; Minor Histocompatibility Antigens/AN/*IM/PH; Support, Non-U.S. Gov't; Transplantation Immunology.
.T
Minor histocompatibility antigens.
.P
JOURNAL ARTICLE; REVIEW; REVIEW, ACADEMIC.
.A
Perreault C; Decary F; Brochu S; Gyger M; Belanger R; Roy D.
.I 274325
.U
91002877
.S
Blood 9101; 76(7):1281-6
.M
Antigens, Differentiation/*AN; Blood Cells/CH/MI; Bone Marrow/CH/CY/MI; Cell Count; DNA, Viral/AN; Hematopoietic Stem Cells/CH/*IM/MI; Human; HIV-1/GE/*IP; Polymerase Chain Reaction; Support, Non-U.S. Gov't.
.T
CD34+ hematopoietic progenitor cells are not a major reservoir of the human immunodeficiency virus.
.P
JOURNAL ARTICLE.
.W
Hematologic abnormalities occur in the majority of patients with acquired immunodeficiency syndrome (AIDS). Infection of the hematopoietic progenitor cells has been proposed as a potential explanation. In this study, different bone marrow cell populations, including the CD34+ hematopoietic progenitor cells, were purified by a fluorescence-activated cell sorter (FACS) and analyzed for the presence of human immunodeficiency virus-1 (HIV-1) proviral DNA using the polymerase chain reaction. A group of 14 patients with AIDS or AIDS-related complex (ARC) was studied (11 with peripheral blood cytopenias). The CD4+ helper cells in the bone marrow were found positive for HIV-1 DNA in all patients. In contrast, CD34+ progenitor cells were positive in only one patient. Two monocyte samples and two samples of CD4-/CD34- lymphocytes/blasts (mainly B and CD8 lymphocytes) were positive. Proviral DNA could not be detected in granulocytes. FACS analysis showed that the percentage of CD34+ hematopoietic progenitor cells was not altered in the bone marrow of AIDS patients in comparison with the HIV-1 seronegative controls. In contrast, the number of CD4+ lymphocytes was markedly reduced in the bone marrow of AIDS patients. These results show that the hematologic abnormalities in AIDS patients are neither explained by direct infection of the hematopoietic progenitor cells with HIV-1 nor by a depletion of progenitor cells.
.A
von Laer D; Hufert FT; Fenner TE; Schwander S; Dietrich M; Schmitz H; Kern P.
.I 274326
.U
91002878
.S
Blood 9101; 76(7):1287-92
.M
Adolescence; Adult; Anemia, Aplastic/*DT; Blood Cell Count/DE; Bone Marrow/DE; Drug Evaluation; Female; Hematopoiesis/DE; Human; Injections, Subcutaneous; Interleukin-3/AD/AE/*TU; Male; Middle Age; Recombinant Proteins/AD/AE/TU.
.T
Effects of recombinant human interleukin-3 in aplastic anemia.
.P
JOURNAL ARTICLE.
.W
In a phase I/II study, nine patients with aplastic anemia were treated with recombinant human interleukin-3 (rhIL-3) to assess the toxicity and biologic effects of this multipotential hematopoietic growth factor. Doses ranging from 250 micrograms/m2 to 500 micrograms/m2 were administered as subcutaneous bolus injections daily for 15 days. An increase in platelet counts from 1,000/microL to 31,000/microL was induced by rhIL-3 in one patient, and an increase in reticulocyte counts by more than 10,000/microL in four patients. The blood leukocyte counts temporarily increased in eight patients 1.5- to 3.3-fold (median, 1.8-fold), mainly due to an increase in the number of neutrophils, eosinophils, lymphocytes, and monocytes. In two patients, bone marrow cellularity increased from 7% to 33% and from 10% to 80%, respectively, but without resulting in a substantial improvement of peripheral blood counts. Mild side effects (headache and flushing) were observed in some patients, while low-grade fever occurred in all patients. Transient thrombocytopenia necessitating discontinuation of rhIL-3 treatment occurred in one patient. In conclusion, rhIL-3 can stimulate hematopoiesis in patients with aplastic anemia; however, no lasting effects were obtained.
.A
Ganser A; Lindemann A; Seipelt G; Ottmann OG; Eder M; Falk S; Herrmann F; Kaltwasser JP; Meusers P; Klausmann M; et al.
.I 274327
.U
91002879
.S
Blood 9101; 76(7):1293-8
.M
Adult; Aged; Aged, 80 and over; Antineoplastic Agents, Combined/AE/TO/*TU; Cyclophosphamide/AD; Etoposide/AD; Human; Injections, Intravenous; Lymphoma, Non-Hodgkin's/*DT/MO/PA; Middle Age; Prednisone/AD; Procarbazine/AD; Remission Induction; Support, U.S. Gov't, P.H.S..
.T
CEPP(B): an effective and well-tolerated regimen in poor-risk, aggressive non-Hodgkin's lymphoma.
.P
JOURNAL ARTICLE.
.W
Eighty-three patients with intermediate- or high-grade non-Hodgkin's lymphoma were treated with CEPP(B) (cyclophosphamide, etoposide [VP-16], procarbazine, and prednisone with or without bleomycin) chemotherapy at Stanford University Medical Center (Stanford, CA) from January 1982 through June 1989. Sixty-nine received CEPP(B) as second-line or subsequent therapy after relapse from previous combination chemotherapy, and 14 patients received CEPP(B) as first-line therapy. Of 75 patients evaluable for response, 30 patients (40%) achieved a complete response (CR) and 24 patients (32%) achieved a partial response (PR), providing an overall response rate of 72%. Complete responses were recorded on 21 of 61 (34%) patients with recurrent disease and 9 of the 14 patients who received CEPP(B) as first line therapy (64%). Myelosuppression was the major side effect of treatment, resulting in eight neutropenic-febrile episodes from a total of 253 courses. A single fatal toxic event occurred on a patient who developed adult respiratory distress syndrome. Overall, CEPP(B) was well-tolerated and proved to be effective palliative therapy for patients with non-Hodgkin's lymphoma after relapse. As such, CEPP(B) may be considered for cytoreduction before ablative therapy and bone marrow transplantation. CEPP(B) may also be considered for initial therapy in selected patients who cannot tolerate doxorubicin-containing regimens.
.A
Chao NJ; Rosenberg SA; Horning SJ.
.I 274328
.U
91002880
.S
Blood 9101; 76(7):1299-307
.M
Aged; Aged, 80 and over; Bone Marrow/DE/*PA; Cell Differentiation/DE; Cell Division/DE; Cells, Cultured; Comparative Study; Evaluation Studies; Female; Granulocyte Colony-Stimulating Factor/PD/TU; Granulocyte-Macrophage Colony-Stimulating Factor/PD/TU; Hematopoiesis/*DE; Human; Karyotyping; Male; Middle Age; Myelodysplastic Syndromes/DT/GE/*PA; Recombinant Proteins/PD/TU; Support, Non-U.S. Gov't; Support, U.S. Gov't, Non-P.H.S.; Support, U.S. Gov't, P.H.S..
.T
Impact of marrow cytogenetics and morphology on in vitro hematopoiesis in the myelodysplastic syndromes: comparison between recombinant human granulocyte colony-stimulating factor (CSF) and granulocyte-monocyte CSF.
.P
JOURNAL ARTICLE.
.W
Marrow cells from 36 patients with myelodysplastic syndromes (MDS) (13 refractory anemia [RA], 14 refractory anemia with excess of blasts [RAEB], 9 RAEB in transformation [RAEB-T]) were evaluated for their in vitro proliferative and differentiative responsiveness to recombinant human granulocyte colony-stimulating factor (G-CSF) or granulocyte-monocyte CSF (GM-CSF). GM-CSF exerted a stronger proliferative stimulus than G-CSF for marrow myeloid clonal growth (CFU-GM) in these patients (44 v 12 colonies per 10(5) nonadherent buoyant bone marrow cells [NAB], respectively, P less than .025). GM-CSF stimulated increased CFU-GM growth in the 16 patients with abnormal marrow cytogenetics in comparison with the 20 patients who had normal cytogenetics (52 and 30 colonies per 10(5) NAB, respectively, P less than .05), whereas no such difference could be demonstrated with G-CSF (11 and 16 colonies per 10(5) NAB, respectively). In contrast, granulocytic differentiation of marrow cells was induced in liquid culture by G-CSF in 15 of 32 (47% patients), while GM-CSF did so in only 4 of 18 (22%) patients (P less than .025) including, for RAEB/RAEB-T patients: 9 of 18 versus 0 of 9, respectively (P less than .025). For MDS patients with normal cytogenetics, G-CSF- and GM-CSF-induced marrow cell granulocytic differentiation in 12 of 18 (67%) versus 3 of 11 (27%), respectively (P less than .025), contrasted with granulocytic induction in only 3 of 14 (21%) and 1 of 7 (14%) patients with abnormal cytogenetics, respectively. We conclude that G-CSF has greater granulocytic differentiative and less proliferative activity for MDS marrow cells than GM-CSF in vitro, particularly for RAEB/RAEB-T patients and those with normal cytogenetics.
.A
Nagler A; Binet C; Mackichan ML; Negrin R; Bangs C; Donlon T; Greenberg P.
.I 274329
.U
91002881
.S
Blood 9101; 76(7):1308-14
.M
Animal; Bone Marrow/DE/ME/*UL; Cells, Cultured; Fibroblasts/DE/ME/*UL; Gene Expression; Human; Macrophage Colony-Stimulating Factor/*ME/PD; Macrophages/DE/ME/UL; Membrane Proteins/GE/ME/PH; Mice; Mice, Inbred BALB C; Protein Precursors/GE/*ME/PH; Receptor, Macrophage Colony-Stimulating Factor/GE/*ME/PH; Support, Non-U.S. Gov't; Support, U.S. Gov't, P.H.S..
.T
Direct stimulation of cells expressing receptors for macrophage colony-stimulating factor (CSF-1) by a plasma membrane-bound precursor of human CSF-1.
.P
JOURNAL ARTICLE.
.W
Secreted forms of macrophage colony-stimulating factor (M-CSF or CSF-1) are generated by proteolytic cleavage of membrane-bound glycoprotein precursors. Alternatively spliced transcripts of the human CSF-1 gene encode at least two different transmembrane precursors that are differentially processed in mammalian expression systems. The larger precursor rapidly undergoes proteolysis to yield the secreted growth factor and does not give rise to forms of CSF-1 detected on the cell surface. By contrast, the smaller human CSF-1 precursor is stably expressed on the plasma membrane where it is inefficiently cleaved to release a soluble molecule. To determine whether the smaller precursor is biologically active on the cell surface, mouse NIH-3T3 fibroblasts expressing the different forms of human CSF-1 were killed by chemical fixation and tested for their ability to support the proliferation of cells that require this growth factor. Only fixed cells expressing human CSF-1 precursors on their surface stimulated the growth in vitro of a murine macrophage cell line or normal mouse bone marrow-derived mononuclear phagocytes. The ability of these nonviable fibroblasts to induce the proliferation of CSF-1-dependent cells was not mediated by release of soluble growth factor, required direct contact with the target cells, and was blocked by neutralizing antiserum to CSF-1. These results demonstrate that the cell surface form of the human CSF-1 precursor is biologically active and indicate that plasma membrane-bound growth factors can functionally interact with receptor-bearing targets by direct cell-cell contact.
.A
Stein J; Borzillo GV; Rettenmier CW.
.I 274330
.U
91002882
.S
Blood 9101; 76(7):1315-22
.M
Animal; Bone Marrow/*CY/DE/ME; Cell Differentiation/DE; Cell Division/DE; Cell Line; Cells, Cultured; Granulocyte-Macrophage Colony-Stimulating Factor/*ME; Hematopoiesis/*DE; Hematopoietic Stem Cells/DE; Interleukin-1/PD; Interleukin-6/*ME; Leukemia, Myeloid/ME/*PA; Lipopolysaccharides/PD; Mice; Support, Non-U.S. Gov't; Transcription Factors/ME; Transforming Growth Factor beta/*PD.
.T
Selective regulation of the activity of different hematopoietic regulatory proteins by transforming growth factor beta 1 in normal and leukemic myeloid cells.
.P
JOURNAL ARTICLE.
.W
The viability of normal bone marrow myeloid precursor cells induced by interleukin-6 (IL-6) or IL-1 alpha and the ability of IL-6 and IL-1 alpha to induce the formation of colonies of granulocytes, macrophages, or megakaryocytes in densely seeded bone marrow cultures was suppressed by transforming growth factor-beta 1 (TGF-beta 1). Induction of normal bone marrow colony formation by IL-3 was much less sensitive to TGF-beta 1, and there was little or no effect of TGF-beta 1 on colony formation induced by macrophage colony-stimulating factor (M-CSF) or granulocyte-macrophage CSF (GM-CSF). In different clones of myeloid leukemic cells, TGF-beta 1 suppressed differentiation induced with IL-6, IL-1 alpha, or lipopolysaccharide (LPS), but did not suppress differentiation induced with IL-3 or GM-CSF. The effect of TGF-beta 1 on differentiation of the leukemic cells can be dissociated from its effect on cell growth. TGF-beta 1 suppressed the production of IL-6 in normal bone marrow cells cultured with IL-1 alpha and the production of IL-6 and GM-CSF in leukemic cells cultured with IL-1 alpha or LPS. The suppression of IL-6 production can explain the suppression by TGF-beta 1 of the effects of IL-1 alpha and LPS that are mediated by IL-6. TGF-beta 1 also suppressed differentiation in clones of myeloid leukemic cells induced with differentiation factor/leukemia inhibitory factor and tumor necrosis factor. In different leukemic clones TGF-beta 1 suppressed or enhanced induction of differentiation with dexamethasone. The results show that TGF-beta 1 can selectively control the activity of different molecular regulators of normal and leukemic hematopoiesis.
.A
Lotem J; Sachs L.
.I 274331
.U
91002883
.S
Blood 9101; 76(7):1323-9
.M
Antibodies, Monoclonal/DU/IM; Antibody Affinity/IM; Biological Assay/*MT; Comparative Study; Enzyme-Linked Immunosorbent Assay; Erythropoietin/AN/*BL/IM; Hematologic Diseases/BL; Human; Magnetics; Plasma/*CH; Radioimmunoassay; Spleen/CY; Support, Non-U.S. Gov't.
.T
A specific in vitro bioassay for measuring erythropoietin levels in human serum and plasma.
.P
JOURNAL ARTICLE.
.W
The accurate measurement of biologically active erythropoietin (Ep) in human serum and plasma using present in vivo and in vitro bioassays is difficult because of the presence of both inhibitors and non-Ep stimulators of erythropoiesis. We have developed a simple procedure to quantitatively purify Ep from serum and plasma for subsequent testing in the phenylhydrazine-treated mouse spleen cell assay. The method involves absorption of Ep to an immobilized high-affinity anti-Ep monoclonal antibody and acid elution of the antibody-bound material. After neutralization, the eluted EP is then tested directly in the in vitro bioassay without interference by other serum proteins. By using magnetic beads as a solid support for the antibody, washing and elution steps can be performed rapidly and efficiently. Recoveries of Ep after this procedure show very little sample-to-sample variation and are consistently between 45% and 55%, which is close to the maximum binding expected for the anti-Ep antibody. Coupled with the 7.4-fold concentration that this procedure affords, there is an overall increase in sensitivity of three- to fourfold, which makes this assay suitable for accurately measuring Ep levels in patients with below-average titers. Results with this magnetic bead assay indicate that accurate and reproducible estimates for Ep levels in the serum and plasma from healthy donors as well as from patients with hematologic disorders can be obtained. Titers of biologically active Ep in the sera from a group of patients with either leukemia or lymphoma were found to be elevated, and the values correlated well with titers of immunoreactive Ep measured in the Ep radioimmunoassay. Because of its specificity and high sensitivity, the magnetic bead assay is a valuable alternative to immunoassays for the measurement of elevated, normal, and even subnormal Ep levels in human serum and plasma.
.A
Wognum AW; Lam V; Goudsmit R; Krystal G.
.I 274332
.U
91002884
.S
Blood 9101; 76(7):1330-5
.M
Animal; Antibodies/IM/PD; Blast Crisis/*PA; Bone Marrow/CY; Cells, Cultured; Cholesterol/AN/PD; Culture Media/AN/PD; Dose-Response Relationship, Drug; Erythrocytes/*CY; Erythroid Progenitor Cells/DE; Erythropoiesis/DE; Erythropoietin/IM/*PD; Female; Hematopoiesis/DE; Hematopoietic Stem Cells/*DE; Lymphocyte Depletion; Megakaryocytes/*CY; Mice; Phosphatidylcholines/AN/PD; Recombinant Proteins/IM/PD; Support, Non-U.S. Gov't.
.T
Induction of mixed erythroid-megakaryocyte colonies and bipotential blast cell colonies by recombinant human erythropoietin in serum-free culture.
.P
JOURNAL ARTICLE.
.W
The effects of recombinant human erythropoietin (rEp) on murine hematopoietic progenitors were studied using a serum-free culture. A high concentration of rEp stimulated the formation of mixed erythroid-megakaryocyte colonies (EM colonies) and blast cell colonies, as well as erythroid colonies, erythroid bursts, and megakaryocyte colonies from normal mouse bone marrow cells. Direct effects of rEp on EM colony, megakaryocyte colony, and erythroid burst formation were confirmed by depletion of accessory cells such as T cells, B cells, and macrophages from crude bone marrow cells, and inhibition of the colonies by the addition of rabbit anti-rEp antibody to the culture in a dose-dependent fashion. Replating experiments were performed to confirm the differentiating ability of blast cell colonies grown in the presence of rEp. Most of the blast cell colonies yielded not only secondary erythroid colonies but also megakaryocyte colonies in the presence of 2 IU/mL rEp. Some of the blast cell colonies produced secondary EM colonies in the presence of 16 IU/ml rEp of 2 IU/mL rEp plus interleukin-3, although no granulocyte-macrophage colonies were found in the secondary culture. These results suggest that Ep acts not only as a late-acting factor that is specific for erythroid progenitors, but also as a bipotential EM-stimulating factor for murine hematopoietic cells.
.A
Nishi N; Nakahata T; Koike K; Takagi M; Naganuma K; Akabane T.
.I 274333
.U
91002885
.S
Blood 9101; 76(7):1336-40
.M
von Willebrand Factor/*ME/PH; Blood Platelets/CY/*PH; Cell Adhesion/DE/PH; Endothelium, Vascular/CY; Human; Platelet Adhesiveness/DE/PH; Platelet Membrane Glycoproteins/*ME/PH; Support, Non-U.S. Gov't; Uremia/*BL/ME/PP.
.T
Uremic platelets have a functional defect affecting the interaction of von Willebrand factor with glycoprotein IIb-IIIa.
.P
JOURNAL ARTICLE.
.W
Uremic patients have an impaired platelet function that has been related to membrane glycoprotein (GP) abnormalities. Using a perfusion system, we have studied the interaction of normal and uremic platelets with vessel subendothelium (SE) under flow conditions. Reconstituted blood containing washed platelets, purified von Willebrand factor (vWF) (1 U/mL), and normal washed red blood cells was exposed to de-endothelialized rabbit segments for 10 minutes at two different shear rates (800 and 1,600 seconds-1). In some experiments a monoclonal antibody to the GPIIb-IIIa complex (EDU3) was added to the perfusates. With normal platelets, the percentage of the vessel covered by platelets (%CS) was 23.1% +/- 3.7% at 800 seconds-1 and 30% +/- 4.3% at 1,600 seconds-1. Platelets were observed in contact or forming monolayers on vessel SE. EDU3 inhibited the spreading of normal platelets. The %CS (11.1% +/- 3.3%) was statistically decreased (P less than .01) and most of the platelets were observed in contact with the vessel surface. These data indicate that, under flow conditions, the interaction of vWF with GPIIb-IIIa can support the spreading of normal platelets in the absence of exogenous fibrinogen. Under the same experimental conditions, the interaction of uremic platelets with SE was markedly impaired at both shear rates studied (P less than .01 v normal platelets). The presence of EDU3 did not modify the interaction of uremic platelets. These results confirm the impairment of the platelet adhesion observed in uremic patients. Furthermore, they indicate the presence of a functional defect in the interaction of vWF with GPIIb-IIIa. The fact that perfusions with normal and uremic platelets in the presence of an antibody to the GPIIb-IIIa complex did not show any differences gives indirect evidence on a functionally normal interaction vWF/GPIb in uremic patients.
.A
Escolar G; Cases A; Bastida E; Garrido M; Lopez J; Revert L; Castillo R; Ordinas A.
.I 274334
.U
91002887
.S
Blood 9101; 76(7):1349-54
.M
Cells, Cultured; Human; Interleukin-2/PD; Killer Cells, Lymphokine-Activated/ME/*PA/PH; Leukemia, B-Cell, Chronic/ME/*PA/PP; Leukemia, Hairy Cell/ME/PA/PP; Leukemia, T-Cell, Chronic/ME/*PA/PP; Lymphoproliferative Disorders/ME/PA/PP; Support, Non-U.S. Gov't.
.T
Lymphokine-activated killer (LAK) cell activity in B and T chronic lymphoid leukemia: defective LAK generation and reduced susceptibility of the leukemic cells to allogeneic and autologous LAK effectors.
.P
JOURNAL ARTICLE.
.W
The capacity to generate lymphokine-activated killer (LAK) cells and the susceptibility of the neoplastic cells to both allogeneic and autologous LAK effectors were studied in B and T chronic lymphoproliferative disorders. While in B-cell chronic lymphocytic leukemia (B-CLL) the depressed natural killer function could be restored after a 7-day incubation with recombinant interleukin (IL-2), B-CLL mononuclear cells showed a reduced LAK activity compared with normal LAK cells. Furthermore, in all but 1 of the 20 B-CLL samples tested the leukemic cells were totally resistant to autologous LAK effectors. In most cases the leukemic cells were also resistant to normal allogeneic LAK cells. Competition experiments demonstrated that the patients' LAK cells, as well as normal LAK effectors, were capable of recognizing B-CLL cells, pointing, therefore, to a postbinding cytolytic defect. In hairy cell leukemia (HCL) an overall reduced LAK activity against allogeneic targets was documented, but, at variance from B-CLL, hairy cells were often susceptible to the lytic effect of normal LAK cells, and in half of the cases tested the neoplastic population was also sensitive in an autologous system. Similarly to B-CLL, in the great majority of T chronic lymphoproliferative disorders studied, the pathologic cells were resistant to normal and autologous LAK effectors and a defective LAK generation was found. These results demonstrate that in most B and T chronic leukemias the LAK function is defective and, when inducible, does not appear directed against the leukemic population. The possibility of exploiting an immunotherapeutic approach with IL-2/LAK cells in the management of chronic lymphoproliferative disorders does not gain support by these findings.
.A
Foa R; Fierro MT; Raspadori D; Bonferroni M; Cardona S; Guarini A; Tos AG; di Celle PF; Cesano A; Matera L.
.I 274335
.U
91002888
.S
Blood 9101; 76(7):1355-60
.M
Antigens, CD/IM; Antigens, Surface/IM; Blood Proteins/PD; Cell Adhesion/DE; Cell Differentiation/DE; Cell Division/DE; Cytotoxicity, Immunologic/IM; Female; Human; Killer Cells, Lymphokine-Activated/IM/*PA/PH; Leukemia, B-Cell, Chronic/BL/*PA/PP; Male; Receptors, Interleukin-2/AN; Stem Cells/PA/PH/UL; Support, Non-U.S. Gov't.
.T
Distinct characteristics of lymphokine-activated killer (LAK) cells derived from patients with B-cell chronic lymphocytic leukemia (B-CLL). A factor in B-CLL serum promotes natural killer cell-like LAK cell growth.
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JOURNAL ARTICLE.
.W
We show that lymphokine-activated killer (LAK) cell precursors derived from patients with B-cell chronic lymphocytic leukemia (B-CLL) and cultured in the presence of recombinant interleukin-2 and normal human serum (NHS), develop into primarily NK cell-like (CD 57+) LAK cells, whereas identically prepared LAK cell precursors from normal subjects develop into mainly T cell-like (CD 3+, CD 8+) LAK cells. B-CLL LAK cells exhibited greater proliferative capacity than did normal LAK cells. When normal LAK cells were grown in B-CLL serum instead of NHS, their proliferation increased; NK cell levels also increased to those found in B-CLL LAK cells, suggesting that B-CLL serum contains a factor that promotes NK cell-like growth, LAK cells derived from normal or B-CLL patients demonstrated similar lytic activity toward K562 and Raji cells. Growth in B-CLL serum did not reduce their lytic potential. Thus, the altered phenotype and growth exhibited by B-CLL LAK cells and normal LAK cells grown in B-CLL serum does not lead to abnormalities in their cytolytic functions. We propose instead that the predominance of NK-like cells in B-CLL LAK cell populations and the presence of an NK cell-like growth factor in B-CLL serum reflect abnormalities related to NK cell-mediated B-cell regulation; ie, either inhibition of normal B-cell growth and/or growth stimulation of the leukemic clone in B-CLL.
.A
Santiago-Schwarz F; Panagiotopoulos C; Sawitsky A; Rai KR.
.I 274336
.U
91002889
.S
Blood 9101; 76(7):1361-8
.M
Antibodies, Monoclonal/*IM; Antigens, Differentiation, T-Lymphocyte/*IM; Cell Line; Cell Transformation, Neoplastic/IM/PA; Cells, Cultured; Human; Leukemia-Lymphoma, T-Cell, Acute, HTLV-I-Associated/IM/*PA; Microscopy, Electron; Neoplasm Circulating Cells/*IM; Phenotype; Sezary Syndrome/IM/*PA; Stem Cells/IM/UL; Support, Non-U.S. Gov't; T-Lymphocyte Subsets/*IM; Tumor Markers, Biological/AN.
.T
A new monoclonal antibody (CH-F42) recognizes a CD7- subset of normal T lymphocytes and circulating malignant cells in adult T-cell lymphoma-leukemia and Sezary syndrome.
.P
JOURNAL ARTICLE.
.W
We describe a new rat immunoglobulin M monoclonal antibody (CH-F42) that recognizes a subset (1.5% to 8%) of normal peripheral blood T lymphocytes. The phenotype of these cells was determined, using dual-color immunofluorescence, to be CD2+, CD3+, CD4+, CD5+, CD7-, CD8-. They do not express T-cell activation markers, and are positive for UCHL1 (CD45RO), but negative for 2H4 (CD45RA). The antigen was expressed on circulating malignant cells in Sezary syndrome (four of four cases) and adult T-cell lymphoma-leukemia (ATLL) (four of six cases) and negative in a variety of other hematologic malignancies tested. These included chronic and acute lymphoid leukemias of B and T lineage, together with chronic and acute myeloid leukemias. However, normal CH-F42+ cells do not display any of the ultrastructural features associated with Sezary or ATLL cells. The marked similarities between these conditions together with the shared expression of an otherwise very restricted surface antigen (CH-F42) provide strong evidence for the existence of a common normal counterpart. Preliminary characterization studies of the antigen, which is also expressed by K562 and Jurkat cells, suggest the CH-F42 antigen is an O-linked, sialated glycan on a glycoprotein.
.A
Labastide WB; Rana MT; Barker CR.
.I 274337
.U
91002890
.S
Blood 9101; 76(7):1369-74
.M
Acute Disease; Aged; Antigens, Differentiation, T-Lymphocyte/IM; Case Report; Cell Transformation, Neoplastic/DE/PA; Chromosomes, Human, Pair 3/*; Female; Granulocyte-Macrophage Colony-Stimulating Factor/PD; Hematopoiesis/DE; Hematopoietic Stem Cells/DE/PA; Human; Interleukin-3/PD; Interleukin-4/PD; Interleukin-6/PD/PH; Leukemia/GE/IM/*PA; Macrophage Colony-Stimulating Factor/PD; Megakaryocytes/PA; Phenotype; Support, U.S. Gov't, P.H.S.; Translocation (Genetics)/*GE; Tumor Cells, Cultured.
.T
Characterization of a factor-dependent acute leukemia cell line with translocation (3;3)(q21;q26).
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JOURNAL ARTICLE.
.W
A strictly factor-dependent cell line (UCSD/AML1) was established from a patient with the syndrome of multilineage acute leukemia with high platelets. The patient's cells and the cell line karyotype were 45,XX,-7,t(3;3)(q21;q26), typical of the syndrome of acute leukemia with high platelets. The cell line expresses CD34, CD7, TdT, and myeloid (CD13, CD14, CD33) and megakaryocyte/platelet (CD36, CD41, CD42b, CDw49b) antigens. In short-term culture, UCSD/AML1 cells proliferate in response to interleukin-3 (IL-3), IL-4, IL-6, macrophage colony-stimulating factor (M-CSF), and granulocyte-macrophage CSF (GM-CSF), but not IL-1, IL-2, IL-5, or G-CSF. In long-term culture, proliferation can be sustained by GM-CSF, IL-6, or M-CSF. When maintained in GM-CSF, a small percentage of cells form multinucleated megakaryocyte-like giant cells. Culture with GM-CSF combined with IL-6, but not with IL-6 alone, increased giant cell formation fourfold to sevenfold. IL-6 alone or in combination with GM-CSF increased expression of platelet-related antigens. In contrast, culture with phorbol ester induced formation of macrophage-like cells. UCSD/AML1 is the first human acute nonlymphocytic leukemia cell line established from a patient with an acute leukemia syndrome associated with a specific chromosome abnormality.
.A
Oval J; Jones OW; Montoya M; Taetle R.
.I 274338
.U
91002892
.S
Blood 9101; 76(7):1380-6
.M
Cell Division/DE; Cell Line; Cell Membrane/ME/UL; Cell Transformation, Neoplastic/DE/ME; Cobalt Radioisotopes/DU; Cytarabine/PD; Dose-Response Relationship, Drug; Down-Regulation (Physiology)/GE; Gene Expression; Human; Leukemia, Erythroblastic, Acute/ME/*PA; Leukemia, Experimental/ME/*PA; Leukemia, Myeloid/ME/*PA; Receptors, Endogenous Substances/DE/GE/*ME; Support, Non-U.S. Gov't; Support, U.S. Gov't, P.H.S.; Transcobalamins/ME/PD; Trypsin/PD; Up-Regulation (Physiology)/GE; Vitamin B 12/DU.
.T
Expression of transcobalamin II receptors by human leukemia K562 and HL-60 cells.
.P
JOURNAL ARTICLE.
.W
Plasma membrane receptors for the serum cobalamin-binding protein transcobalamin II (TCII) were identified on human leukemia K562 and HL-60 cells using immunoaffinity-purified human TCII labeled with [57Co]cyanocobalamin. The Bmax values for TCII receptors on proliferating K562 and HL-60 cells were 4,500 and 2,700 per cell, respectively. Corresponding dissociation constants (kd) were 8.0 x 10(-11) mol/L and 9.0 x 10(-11) mol/L. Rabbit TCII also bound to K562 and HL-60 cells but with slightly reduced affinities. Calcium was required for the binding of transcobalamin II to K562 cells. Brief treatment of these cells with trypsin resulted in almost total loss of surface binding activity. After removal of trypsin, surface receptors for TCII slowly reappeared, reaching pretrypsin treatment densities only after 24 hours. Reappearance of receptors was blocked by cycloheximide. TCII receptor densities on K562 and HL-60 cells correlated inversely with the concentration of cobalamin in the culture medium. This suggests that intracellular stores of cobalamin may affect the expression of transcobalamin receptors. Nonproliferating stationary-phase K562 cells had low TCII receptor densities (less than 1,200 receptors/cell). However, the density of TCII receptors increased substantially when cells were subcultured in fresh medium. Up-regulation of receptor expression coincided with increased 3H-thymidine incorporation, which preceded the resumption of cellular proliferation as measured by cell density. In the presence of cytosine arabinoside, which induces erythroid differentiation, K562 cells down-regulated expression of TCII receptors. When HL-60 cells were subcultured in fresh medium containing dimethysulfoxide to induce granulocytic differentiation, the up-regulation of TCII receptors was suppressed. This event occurred well before a diminution of 3H-thymidine incorporation and cessation of proliferation. Thus, changes in the regulation of expression of TCII receptors