Citations

Thrombus formation has been studied in normal rabbits with an experimental method of establishing extracorporeal circulation. In the normal animal circulation in the extracorporeal loop usually ceases in from 6 to 10 minutes, or at most, in very large and vigorous animals, in 25 minutes.1 Cessation of the circulation is due most frequently to obstruction of the venous cannula (sometimes of the arterial cannula) by a mass of white thrombi and secondary fibrin formation around it. The site of the clot is determined somewhat by the swiftness of the blood stream. In the collodion tube red mural thrombi are obtainable as a rule. They are flat and present a wide base resting on tiny white thrombi. After the complete obstruction of the circulation, the blood in the apparatus clots very rapidly. When the obstruction occurs very quickly either in the arterial or venous cannula, or when the blood stream is very slow, the clotting in the loop may occur before platelets are laid down in large numbers or before the formation of the white thrombi is evident. Mixed thrombi are found in the jugular vein, and have their inception in the white thrombi, in the cannula or from the injured intima. They extend in the direction of the blood flow.

AbstractBackground: One of the numerous proteins causing amyloidosis is transthyretin (TTR), a protein usually responsible for the transport of thyroxine and retinol-binding protein. Variants within TTR cause it to aggregate and form insoluble fibers that accumulate in tissue, leading to organ dysfunction.Methods: TTR was immunoprecipitated from serum by use of a polyclonal antibody and subsequently reduced with tris(2-carboxyethyl)phosphine. The purified TTR was then analyzed by fast-gradient liquid chromatography–dual-electrospray ionization Fourier-transform ion-cyclotron-resonance (FT-ICR) mass spectrometry. DNA sequencing was performed on all samples used in this study.Results: Because of the inherent limitations in achieving high mass measurement accuracy based on the most abundant isotopic mass, we applied a fitting procedure that allowed determination of monoisotopic mass. Wild-type TTR (mean molecular mass, 13 761 Da) and its associated variant forms could be distinguished because of the high molecular mass accuracy afforded by FT-ICR (≤3 ppm) except for instances involving isobaric species or when isotopic distributions overlapped significantly. The [M + 11 H+]11+ charge state for all samples was used to determine the mass accuracies for both wild-type and variant forms of the protein. We correctly assigned seven of seven TTR variants. Moreover, using a combination of proteomic and genomic technologies, we discovered and characterized a previously unreported cis double mutation with a mass only 2 Da different from wild-type TTR. Furthermore, DNA sequencing of the TTR gene for all individuals in this study completely agreed with the intact protein measurements.Conclusions: FT-ICR mass spectrometry has sufficient mass accuracy to identify genetic variants of immunoaffinity-purified TTR. We believe that 91% of known TTR variants could be detected by this technique.

1. In acute experimental hydronephrosis chloride retention occurs as well as retention of water, urea, and phenolsulfonephthalein. 2. If both water and chlorides are retained there may be no appreciable rise in the plasma chloride content. 3. When chlorides are retained, but not water, the chloride content of the plasma rises strikingly. 4. After the removal of the ureteral obstruction in acute hydronephrosis all renal functions, water, urea, and chloride excretion, may be rapidly restored in equal degree, or the chlorides may be retained temporarily while there is free excretion of water and urea. 5. In chronic hydronephrosis adequate daily excretion of urea and chlorides may be maintained by a compensatory polyuria. 6. Chloride retention or an abnormal chloride excretion may occur in certain renal lesions when there is no change in the urea, phenolsulfonephthalein, or water excretion.

Seven autoplastic transplantations and one homoplastic transplantation of the spleen of dogs were made. One autotransplantation was successful, the gland being normal at the end of 88 days.

Our experiments on dogs showed that the thyroid gland which was autoplastically transplanted, by means of various methods of blood vessel anastomosis, could live in good condition and functionate favorably several months after the operation, even after the interruption of the circulation for 1½ hours. They further showed that the circulation through the transplanted blood vessels as well as glands was as good as normal, and that permanent successful results of the homoplastic transplantation of the gland are as yet not possible.

Emboli made of paraffin and the animal's own blood were sent into the venous circulation of dogs. Death did not occur until the pulmonary circulation was practically occluded. The results were the same whether the blood pressure of the animal was normal or depressed by ether or disease and whether the procedure was carried out under ether or local anesthesia.

Acute gastric ulcers are found in a large percentage of animals dying from acute adrenal insufficiency. In dogs in which a portion of the jejunum had been transplanted some time previous to the removal of the adrenals, the gastric mucosa showed more marked changes than the transplanted jejunal mucosa. This tends to show that the gastric juice as the cause of the ulcer is but a secondary although necessary factor.

Purpose To determine the maximum tolerated dose, toxicity, and pharmacokinetics of gemcitabine in children with refractory solid tumors. Patients and Methods Gemcitabine was given as a 30-minute infusion for 2 or 3 consecutive weeks every 4 weeks, to 42 patients aged 1 to 21 years. Doses of 1,000, 1,200 and 1,500 mg/m2 were administered for 3 weeks. Subsequently, gemcitabine was given for only 2 consecutive weeks at 1,500, 1,800, and 2,100 mg/m2. Plasma concentrations of gemcitabine and its metabolite, 2′2′-difluorodeoxyuridine, were measured in 28 patients. Results Forty patients who received 132 courses of gemcitabine were assessable for toxicity. The maximum tolerated dose of gemcitabine given weekly for 3 weeks was 1,200 mg/m2. Dose-limiting toxicity was not seen in one-third of children treated at any doses given for 2 weeks. The major toxicity was myelosuppression in three of five patients at 1,500 mg/m2 for 3 weeks, and one of seven patients at 1,800 mg/m2 for 2 weeks. Other serious adverse events were somnolence, fever and hypotension, and rash in three patients. Gemcitabine plasma concentration–time data were fit to a one- (n = 5) or two-compartment (n = 23) open model. Mean gemcitabine clearance and half-life values were 2,140 mL/min/m2 and 13.7 minutes, respectively. One patient with pancreatic cancer had a partial response. Seven patients had stable disease for 2 to 17 months. Conclusion Gemcitabine given by 30-minute infusion for 2 or 3 consecutive weeks every 4 weeks was tolerated well by children at doses of 2,100 mg/m2 and 1,200 mg/m2, respectively.

Thalidomide, initially introduced as a sedative, was withdrawn from the market in the early 1960s after it was found to be a teratogen. However, it later found use as an investigational agent in the treatment of erythema nodosum leprosum, oral ulcers, graft versus host disease, and wasting associated with the human immunodeficiency syndrome. Its antiangiogenic properties were recognized in the early 1990s during a period where the importance of angiogenesis became increasingly apparent as a critical step in the in the proliferation and spread of malignant neoplasms. This led to the evaluation of thalidomide as an antiangiogenic agent in the treatment of several cancers. Thalidomide has already become part of standard therapy for the treatment of patients with relapsed and refractory multiple myeloma. It has also been found to have varying degree of benefit in various other malignancies. Although more clinical trials are needed, Kaposi's sarcoma and myelofibrosis represent other malignancies in which thalidomide has already demonstrated promising activity. The mechanism of action of thalidomide in cancer is still unclear, but do appear to be mediated by several other mechanisms in addition to its anti-angiogenic properties. This article reviews the current status of thalidomide for the treatment of non-plasma-cell malignancies.

PurposeTo describe the predictive value of liver function tests (LFTs), chest x-ray, and diagnostic imaging for detecting melanoma metastasis during routine follow-up after treatment for choroidal melanoma.Materials and MethodsProspective longitudinal follow-up of patients enrolled onto two randomized trials was conducted by the Collaborative Ocular Melanoma Study (COMS) Group. Baseline and annual or semiannual systemic and laboratory evaluations were performed according to a standard protocol for 2,320 patients enrolled on the COMS.ResultsCOMS patients were screened annually for metastasis and new cancers using LFTs (alkaline phosphatase, AST, ALT, or bilirubin). Elevated findings (1.5 to 2 times upper limit of normal) on LFT prompted a diagnostic or imaging test to confirm or rule out cancer recurrence. Of 714 patients with clinical reports of metastasis, 675 patients died. Of these 675 patients, all but four had either histopathologically confirmed or clinically suspected metastatic melanoma present at the time of death. Among all patients, the 5-year cumulative diagnosis rate of metastatic melanoma was 24% (95% CI, 22% to 27%). Based on all patients with reported metastasis, the sensitivity, specificity, positive predictive value and negative predictive value associated with at least one abnormal LFT before first diagnosis of metastasis at any site was 14.7%, 92.3%, 45.7% and 71.0%, respectively.ConclusionUse of LFTs results followed by diagnostic tests has high specificity and predictive values but low sensitivity. Better tests are needed to identify earlier metastatic disease associated with choroidal melanoma.