RESUMEN
Background: In the neoadjuvant GeparSixto study, adding carboplatin to taxane- and anthracycline-based chemotherapy improved pathological complete response (pCR) rates in patients with triple-negative breast cancer (TNBC). Here, we present survival data and the potential prognostic and predictive role of homologous recombination deficiency (HRD). Patients and methods: Patients were randomized to paclitaxel plus nonpegylated liposomal doxorubicin (Myocet®) (PM) or PM plus carboplatin (PMCb). The secondary study end points disease-free survival (DFS) and overall survival (OS) were analyzed. Median follow-up was 47.3 months. HRD was among the exploratory analyses in GeparSixto and was successfully measured in formalin-fixed, paraffin-embedded tumor samples of 193/315 (61.3%) participants with TNBC. Homologous recombination (HR) deficiency was defined as HRD score ≥42 and/or presence of tumor BRCA mutations (tmBRCA). Results: A significantly better DFS (hazard ratio 0.56, 95% CI 0.34-0.93; P = 0.022) was observed in patients with TNBC when treated with PMCb. The improvement of OS with PMCb was not statistically significant. Additional carboplatin did not improve DFS or OS in patients with HER2-positive tumors. HR deficiency was detected in 136 (70.5%) of 193 triple-negative tumors, of which 82 (60.3%) showed high HRD score without tmBRCA. HR deficiency independently predicted pCR (ypT0 ypN0) [odds ratio (OR) 2.60, 95% CI 1.26-5.37, P = 0.008]. Adding carboplatin to PM significantly increased the pCR rate from 33.9% to 63.5% in HR deficient tumors (P = 0.001), but only marginally in HR nondeficient tumors (from 20.0% to 29.6%, P = 0.540; test for interaction P = 0.327). pCR rates with carboplatin were also higher (63.2%) than without carboplatin (31.7%; OR 3.69, 1.46-9.37, P = 0.005) in patients with high HRD score but no tmBRCA. DFS rates were improved with addition of carboplatin, both in HR nondeficient (hazard ratio 0.44, 0.17-1.17, P = 0.086) and HR deficient tumors (hazard ratio 0.49, 0.23-1.04, P = 0.059). Conclusions: The addition of carboplatin to neoadjuvant PM improved DFS significantly in TNBC. Long-term survival analyses support the neoadjuvant use of carboplatin in TNBC. HR deficiency in TNBC and HRD score in non-tmBRCA TNBC are predictors of response. HRD does not predict for carboplatin benefit.
Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Carboplatino/uso terapéutico , Reparación del ADN por Recombinación/genética , Neoplasias de la Mama Triple Negativas/terapia , Antraciclinas/farmacología , Antraciclinas/uso terapéutico , Protocolos de Quimioterapia Combinada Antineoplásica/farmacología , Proteína BRCA1/genética , Proteína BRCA2/genética , Mama/patología , Mama/cirugía , Hidrocarburos Aromáticos con Puentes/farmacología , Hidrocarburos Aromáticos con Puentes/uso terapéutico , Carboplatino/farmacología , Supervivencia sin Enfermedad , Doxorrubicina/análogos & derivados , Doxorrubicina/farmacología , Doxorrubicina/uso terapéutico , Resistencia a Antineoplásicos/genética , Femenino , Estudios de Seguimiento , Humanos , Mastectomía , Persona de Mediana Edad , Mutación , Terapia Neoadyuvante/métodos , Paclitaxel/farmacología , Paclitaxel/uso terapéutico , Polietilenglicoles/farmacología , Polietilenglicoles/uso terapéutico , Pronóstico , Análisis de Supervivencia , Taxoides/farmacología , Taxoides/uso terapéutico , Neoplasias de la Mama Triple Negativas/genética , Neoplasias de la Mama Triple Negativas/mortalidad , Neoplasias de la Mama Triple Negativas/patologíaRESUMEN
PURPOSE: Hormone receptor (HR)-positive breast cancer (BC) shows a poor response to neoadjuvant chemotherapy (NACT). New treatment targets like the Cyclin D1-CDK4/CDK6 complex are promising adjuvant/post-neoadjuvant therapeutic strategies. Evaluating Cyclin D1 overexpression in residual tumor could recognize those patients that benefit most from such post-neoadjuvant treatment. In this study, we determined Cyclin D1 expression in residual BC after NACT. Secondary aims were to correlate Cyclin D1 expression levels with clinicopathological parameters and to assess its prognostic value after NACT. METHODS: We retrospectively assessed the nuclear expression of Cyclin D1 on tissue microarrays with residual tumor from 284 patients treated in the neoadjuvant GeparTrio (n = 186) and GeparQuattro (n = 98) trials. Evaluation was performed with a standardized immunoreactive score (IRS) after selecting a cut-off value. RESULTS: A high expression level (IRS ≥ 6) of Cyclin D1 was found in 37.3% of the assessed specimens. An increased Cyclin D1 expression was observed in HR-positive tumors, compared to HR-negative tumors (p = 0.02). Low Cyclin D1 levels correlated with clinical tumor stage 1-3 (p = 0.03). Among patients with HR-positive/Her2-negative tumors and high Cyclin D1 expression, a better disease-free survival (DFS) was graphically suggested, but not significant (p = 0.21). CONCLUSION: Our study demonstrates a measurable nuclear expression of Cyclin D1 in post-neoadjuvant residual tumor tissue of HR-positive BC. Cyclin D1 expression was not prognostic for DFS after NACT. Our results and defined cut-off suggest that the marker can be used to stratify tumors according to protein expression levels. Based on this, a prospective evaluation is currently performed in the ongoing Penelope-B trial.
Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Biomarcadores de Tumor/metabolismo , Neoplasias de la Mama/terapia , Mama/patología , Ciclina D1/metabolismo , Adulto , Biomarcadores de Tumor/análisis , Mama/citología , Mama/cirugía , Neoplasias de la Mama/mortalidad , Neoplasias de la Mama/patología , Núcleo Celular/metabolismo , Ciclina D1/análisis , Supervivencia sin Enfermedad , Femenino , Perfilación de la Expresión Génica/métodos , Humanos , Mastectomía , Persona de Mediana Edad , Terapia Neoadyuvante/métodos , Neoplasia Residual , Pronóstico , Receptor ErbB-2/metabolismo , Receptores de Estrógenos/metabolismo , Receptores de Progesterona/metabolismo , Estudios Retrospectivos , Análisis de Matrices Tisulares/métodosRESUMEN
BACKGROUND: In routine clinical practice, chemotherapy doses are frequently capped at a body surface area (BSA) of 2.0 m2 or adjusted to an ideal weight for obese patients due to safety reasons. MATERIALS AND METHODS: Between August 2004 and July 2008, a total of 3023 patients were enrolled in the GAIN study, a randomized phase III adjuvant trial, comparing two types of dose-dense (dd) regimen [epirubicin, docetaxel and cyclophosphamide (iddETC) versus epirubicin and cyclophosphamide (EC) followed by docetaxel (T) plus capecitabine (X)]. We retrospectively evaluated a total of 555 patients with a BMI of ≥30 for safety and outcome. RESULTS: Eighteen percent of all patients were obese: 31% of those received chemotherapy according to an unadjusted BSA. For the remaining patients, BSA was adjusted to ideal weight or was capped at 2.0 m2. A total of 15% of obese patients receiving full (unadjusted) dose of chemotherapy versus 6% of obese patients with an adjusted BSA experienced febrile neutropenia (P = 0.003) and 9% versus 3% high-grade thrombopenia (P = 0.002). Overall, 17% versus 10% had a thromboembolic event (P = 0.017), which was high grade in 13% versus 6%, respectively (P = 0.019), and 3% versus 0.3% high-grade hot flushes (P = 0.013). Dizziness (5% versus 11%; P = 0.016), diarrhea (19% versus 27%; P = 0.033) and an increase in serum creatinine (7% versus 14%; P = 0.019) were higher in the adjusted group. However, no differences in disease-free survival (DFS) and overall survival (OS) were observed between non-obese patients, obese patients receiving full-dose chemotherapy or according to an adjusted BSA [5-year DFS 81% (confidence interval 79% to 83%) versus 82% (75% to 87%) versus 81% (76% to 84%); P = 0.761; 5-year OS 90% (88% to 91%) versus 86% (80% to 91%) versus 88% (84% to 91%); P = 0.143]. CONCLUSION: Obese patients receiving dd chemotherapy according to their real BSA have a higher risk of developing severe toxicities without influencing survival. Therefore, a dose adjustment of intense dd chemotherapy should be carried out to avoid life-threatening complications.
Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/administración & dosificación , Neoplasias de la Mama/tratamiento farmacológico , Relación Dosis-Respuesta a Droga , Obesidad/tratamiento farmacológico , Protocolos de Quimioterapia Combinada Antineoplásica/efectos adversos , Índice de Masa Corporal , Superficie Corporal , Neoplasias de la Mama/complicaciones , Neoplasias de la Mama/fisiopatología , Capecitabina/administración & dosificación , Ciclofosfamida/administración & dosificación , Supervivencia sin Enfermedad , Docetaxel , Epirrubicina/administración & dosificación , Neutropenia Febril/inducido químicamente , Neutropenia Febril/patología , Femenino , Humanos , Metástasis Linfática , Obesidad/complicaciones , Obesidad/fisiopatología , Taxoides/administración & dosificaciónRESUMEN
AIDS: It may be possible for an inexpensive dose of vitamin A to reduce HIV transmission from mother to fetus. Last year, Dr. Richard Semba of Johns Hopkins University did a study involving vitamin A and pregnant HIV-positive African women in Malawi. The women taking vitamin A had a significantly lower percentage of HIV transmission to their infants. These women also had a lower mortality rate. In the United States, several university studies have shown that HIV-positive persons with diets high in vitamins, including vitamin A, have lower mortality rates. To prevent toxic reactions to high levels of vitamin A, use beta carotene, a form of the vitamin, and eat a diet rich in fruits and vegetables. The government recommends that pregnant HIV-positive women use AZT to prevent HIV transmission to the fetus. The government has overlooked the benefits of vitamin A.^ieng
Asunto(s)
Infecciones por VIH/transmisión , Vitamina A/uso terapéutico , Ensayos Clínicos como Asunto , Ensayos Clínicos Controlados como Asunto , Femenino , Infecciones por VIH/prevención & control , Humanos , Transmisión Vertical de Enfermedad Infecciosa , EmbarazoRESUMEN
Over a 6-year-period (January 1, 1985 to December 31, 1990) 86 women with cancer of genital organs were detected in the region of Baranya. According to the census of the year 1981, 27416 women have lived in Baranya, and in the above mentioned period 23533 examinations were done at the Women Welfare Clinic of the Health Centre Beli Manastir. In the period from 1985 to 1989, the average frequency of cervical cancer was 63.1%, uterine corpus cancer followed with 19.7%, ovarian and tubal with 13.1%, vulvar with 2.6% and vaginal with 1.3%. In the period from January 1 to December 31, 1990, cervical cancer accounted for 45.4% of all cancer cases, corpus cancer for 27.2%, ovarian and tubal cancer for 18.1%, without detection of any vulvar or vaginal cancer cases. In the observed period mean annual incidence of genital cancer was 52.9 per 100,000. According to organ sites mean annual incidence of cervical cancer was 32.1, corpus cancer 10.9, ovarian and tubal cancer 7.3, vulvar 1.2 and vaginal cancer 0.7 per 100,000. During the six year period cervical cancer incidence was reduced from 43.8 in 1985 to 18.2 per 100,000 in 1990. Corpus cancer incidence in 1985 was 14.6 as compared to 10.9 in 1990. Ovarian and tubal cancer incidence in 1985 and 1990 was 10.9 and 7.3, respectively. In the observed period preinvasive lesions of genital organs were discovered in 208 women, 201 (96.6%) of whom had cervical lesions--mean incidence here is 122.2 per 100,000. The overall proportion of preinvasive to invasive cervical lesions in the observed period was 79.1% to 20.9%.(ABSTRACT TRUNCATED AT 250 WORDS)
Asunto(s)
Neoplasias de los Genitales Femeninos/epidemiología , Adulto , Anciano , Croacia/epidemiología , Femenino , Neoplasias de los Genitales Femeninos/patología , Humanos , Incidencia , Persona de Mediana EdadRESUMEN
In the period from 1985 to 1989, 2521 pregnant women, making up 18.7% of women in fertile age, were controlled in antenatal surgeries in the area of Baranja. In 73 (2.9%) women a cytologic picture of cervical atypia was found: in 2.1% of them there was a cytologic picture of light and moderate dysplasia (group IIIA), in 0.6% a picture of severe dysplasia (group IIIB), and in 0.2% pregnant women there was a picture of carcinoma in situ (group IV). Progression of cytologic findings into a higher stage was noted in 23.3% women, persistence was recorded in 21.9% and regression in 54.8% women. A total of 71.2% pregnant women with the cytologic atypia of the cervix were colposcopically examined. An abnormal colposcopic picture was found in 65.4% of them. By the end of the puerperium histologic verification was made in 38.4% cases and 61.6% were controlled only cytologically and colposcopically. By means of histologic examination of the tissue specimen, progression of an intraepithelial lesion into an invasive carcinoma was not found in any of the women. These results corroborate the point of view that in pregnant women with the cytologic atypia of the uterine cervix the histologic verification can be postponed until after the delivery without any considerable risk. Only in the case of a cytologic or colposcopic suspicion of invasion it is necessary to verify the finding histologically.
Asunto(s)
Complicaciones del Embarazo/patología , Displasia del Cuello del Útero/patología , Neoplasias del Cuello Uterino/patología , Femenino , Humanos , Embarazo , Complicaciones del Embarazo/epidemiología , Complicaciones Neoplásicas del Embarazo/epidemiología , Complicaciones Neoplásicas del Embarazo/patología , Displasia del Cuello del Útero/epidemiología , Neoplasias del Cuello Uterino/epidemiología , Yugoslavia/epidemiologíaRESUMEN
In the 1980-1989 period, 671 women were diagnosed with a malignant tumour of reproductive organs at the Department of Gynaecology, Cervical cancer proved most frequent, with 46.5% of the cases, followed by the cancer of the uterine body occurring in 29.5% of the patients. In 18.8% of the women, ovarian and oviductal cancer was diagnosed, whereas vulvar and vaginal cancer was found in 5.5% of the cases. There were 76.1% of the patients older than 50 years. Nulliparas suffered from ovarian and uterine body cancer significantly more often than from cervical cancer (t = 3.794; p less than 0.001, i.e. t = 2.974; p less than 0.001). However, terti- or multiparas had cervical cancer significantly more often than the cancer of ovaries or the uterine body (t = 3.711; p less than 0.001, i.e. t = 3.000; p less than 0.01). The first stage ovarian cancer was diagnosed in 15.0% of women only, whereas 37.1% of cervical and 78.3% of uterine body cancers were discovered at the first stage. At the time of diagnosis, the mean age of the patients with cervical cancer was 55.8 years, with ovarian cancer 57.9 years, with oviductal cancer 57.3 years, with uterine body cancer 60.8 years and with vulvar cancer 71.7 years. There were 34% of cervical cancer patients at the premenopausal age 15.5% with uterine body cancer and 27.5% of those suffering from ovarian cancer. The general five-year survival rate for patients suffering from the cancer of reproductive organs was 40.6%, i.e. 40.5% for cervical cancer, 54.7% for uterine body cancer, 23.4% for ovarian and oviductal cancer and 17.7% for vulvar or vaginal cancer. The total of 25% of the patients were lost from the evidence.
Asunto(s)
Neoplasias de los Genitales Femeninos , Adulto , Anciano , Femenino , Neoplasias de los Genitales Femeninos/mortalidad , Neoplasias de los Genitales Femeninos/patología , Humanos , Persona de Mediana EdadRESUMEN
A bacteriological analysis was made of pyogenic agents from the cervical canal of 260 pregnant women with cervical incompetency, in whom the cerclage of the cervix was performed. Pyogenic agents were found in 139 (53.5%) pregnancies. The most frequently isolated pathogenic agent was Enterococcus--in 19.2% of all pregnant women and in 36.0% in those with a pathologic swab. E. coli was isolated in 16.5% of all pregnant women and in 30.9% of those with the pathologic swab. A significantly higher number of pathologic swabs were found in women with colpitis and the cleanliness 3 degree of the vaginal discharge and without colpitis (6.4%). In pregnant women with a pathologic swab, in spite of the cervical cerclage, spontaneous abortions and premature deliveries were significantly more frequent (8.2% and 16.4% respectively) than in pregnant women with a sterile swab (1.8% and 6.1% respectively).
Asunto(s)
Bacterias/aislamiento & purificación , Cuello del Útero/microbiología , Incompetencia del Cuello del Útero/microbiología , Femenino , Humanos , Embarazo , Resultado del EmbarazoAsunto(s)
Displasia del Cuello del Útero/epidemiología , Neoplasias del Cuello Uterino/epidemiología , Adolescente , Adulto , Carcinoma/diagnóstico , Carcinoma/epidemiología , Carcinoma in Situ/diagnóstico , Carcinoma in Situ/epidemiología , Femenino , Humanos , Persona de Mediana Edad , Displasia del Cuello del Útero/diagnóstico , Neoplasias del Cuello Uterino/diagnóstico , Frotis Vaginal , YugoslaviaRESUMEN
Glycerophosphate acyltransferase present in an extract of rat adipocytes is strongly inhibited by excess palmitoyl-CoA. This inhibition is released by serum albumin but an excess of serum albumin is inhibitory, particularly at low palmitoyl-CoA concentrations. An optimal activity is reached when the ratio palmitoyl-CoA/albumin is in the range of 3-6. In the absence of albumin, oleic acid inhibits the activity at all palmitoyl-CoA concentrations. This inhibition is released by albumin and, inversely, oleic acid releases the inhibition by high concentrations of albumin. Another effect of fatty acids is to favour the inactivation of the glycerophosphate acyltransferase in extracts of adipocytes kept at 0 degree C. This inactivation is time-dependent and cannot be reversed by the addition of albumin to the assay mixture. Treatment of adipocytes with noradrenaline had no effect on the activity of the enzyme as long as the cells had been separated from fatty acids and albumin. With extracts of unwashed cells, the effect of noradrenaline on both the activity and stability of glycerophosphate acyltransferase could be explained by the presence of fatty acids in the extract.
Asunto(s)
Aciltransferasas/metabolismo , Tejido Adiposo/enzimología , Glicerol-3-Fosfato O-Aciltransferasa/metabolismo , Norepinefrina/farmacología , Tejido Adiposo/citología , Tejido Adiposo/efectos de los fármacos , Animales , Ácidos Grasos/farmacología , Glicerol-3-Fosfato O-Aciltransferasa/antagonistas & inhibidores , Técnicas In Vitro , Cinética , Masculino , Ratas , Ratas Endogámicas , Albúmina Sérica Bovina/farmacologíaRESUMEN
In this prospective study, primary urothelial bladder tumour specimens from 64 patients were investigated by means of DNA Feulgen cytophotometry. The patients were followed clinically for at least 7 years. The objective cytophotometric parameters correlated well with the histopathological grading and the cytochemical data were of considerable prognostic value. They were closely correlated with the stage of the tumour, 5- and 7-year survival rates and the probability of tumour recurrence. It is concluded that DNA cytophotometry can serve as a method for the standardisation of histological grading and can give more objective and more detailed prognostic information than conventional histopathology.
Asunto(s)
Carcinoma de Células Transicionales/patología , ADN de Neoplasias/análisis , Neoplasias de la Vejiga Urinaria/patología , Adulto , Anciano , Carcinoma de Células Transicionales/genética , Carcinoma de Células Transicionales/mortalidad , Femenino , Citometría de Flujo , Humanos , Masculino , Persona de Mediana Edad , Recurrencia Local de Neoplasia , Ploidias , Pronóstico , Estudios Prospectivos , Neoplasias de la Vejiga Urinaria/genética , Neoplasias de la Vejiga Urinaria/mortalidadRESUMEN
We confirmed that, as reported by Sooranna & Saggerson [(1982) Biochem. J. 202, 753-758], the affinity of 6-phosphofructo-1-kinase (PFK) for fructose 6-phosphate in an adipocyte extract was increased after incubation of the cells in the presence of noradrenaline. The participation of fructose 2,6-bisphosphate in this kinetic modification could be excluded, because the noradrenaline effect persisted after extensive gel filtration of the extracts and also because the treatment did not cause any change in the concentration of fructose 2,6-bisphosphate in the adipocytes. Oleic acid was found to be another potent positive effector of PFK in an adipocyte extract, with a Ka of 10 microM. Its effect was synergistic with that of fructose 2,6-bisphosphate and AMP, and was counteracted by serum albumin. Palmitic acid had a similar effect. We conclude that the large increase in fatty acid concentration caused by noradrenaline treatment is an explanation for the activation of phosphofructokinase at low fructose 6-phosphate concentrations in an adipocyte extract.
Asunto(s)
Tejido Adiposo/enzimología , Norepinefrina/farmacología , Fosfofructoquinasa-1/metabolismo , Adenosina Monofosfato/farmacología , Tejido Adiposo/citología , Tejido Adiposo/efectos de los fármacos , Animales , Activación Enzimática/efectos de los fármacos , Ácidos Grasos/metabolismo , Fructosadifosfatos/farmacología , Fructosafosfatos/metabolismo , Técnicas In Vitro , Masculino , Ácido Oléico , Ácidos Oléicos/farmacología , Ratas , Ratas EndogámicasRESUMEN
Pyrophosphate : fructose-6-phosphate phosphotransferase (PPi-PFK) has been purified 150-fold from potato tubers and the kinetic properties of the purified enzyme have been investigated both in the forward and the reverse direction. Saturation curves for fructose 6-phosphate and also for fructose 1,6-bisphosphate were sigmoidal whereas those for PPi and Pi were hyperbolic. In the presence of fructose 2,6-bisphosphate, the affinity for fructose 6-phosphate and for fructose 1,6-bisphosphate were greatly increased and the kinetics became Michaëlian. The effect of fructose 2,6-bisphosphate was increased by the presence of fructose 6-phosphate and decreased by the presence of Pi. Consequently, the Ka for fructose 2,6-bisphosphate was as low as 5 nM for the forward reaction and reached 150 nM for the reverse reaction. On the basis of these properties, a procedure allowing one to measure fructose 2,6-bisphosphate in amounts lower than a picomole, is described.
Asunto(s)
Fructosadifosfatos/análisis , Hexosadifosfatos/análisis , Fosfotransferasas/aislamiento & purificación , Plantas/enzimología , Cinética , MicroquímicaRESUMEN
Successful percutaneous transluminal dilatation of an anonyma stenosis is reported. The patient was a 40 year-old male with the aortic arch syndrome. Five years before an occlusion of the central carotid artery, as well as anonyma and left subclavian stenoses were treated by means of vascular grafts. On recurrence of the neurological symptoms, reocclusion of the right graft to the anonyma artery and subtotal stenosis of the left carotid bifurcation was noted. The anonyma stenosis was dilated by means of PTD. Haemodynamic success was demonstrated by Doppler sonography.
Asunto(s)
Angioplastia de Balón , Síndromes del Arco Aórtico/terapia , Arteriopatías Oclusivas/terapia , Tronco Braquiocefálico , Adulto , Síndromes del Arco Aórtico/diagnóstico por imagen , Aortografía , Arteriopatías Oclusivas/diagnóstico por imagen , Arteriopatías Oclusivas/cirugía , Prótesis Vascular , Tronco Braquiocefálico/diagnóstico por imagen , Trombosis de las Arterias Carótidas/diagnóstico por imagen , Trombosis de las Arterias Carótidas/cirugía , Humanos , MasculinoRESUMEN
Cervical pregnancy in a 23-year-old patients is presented. The local finding corresponded to criteria for the diagnosis of cervical pregnancy. The diagnosis was confirmed by an immunological test (Gonavislide) and ultrasound. Conization was applied, and in the conization material the pathologist found chorial villi with a great many trophoblasts in direct contact with the muscular cervical layer.
Asunto(s)
Embarazo Ectópico/cirugía , Adulto , Cuello del Útero/cirugía , Femenino , Humanos , Métodos , EmbarazoAsunto(s)
Fructosadifosfatos/análisis , Hexosadifosfatos/análisis , Saccharomyces cerevisiae/aislamiento & purificación , Cromatografía por Intercambio Iónico , Fructosadifosfatos/metabolismo , Fructosadifosfatos/farmacología , Cinética , Fosfofructoquinasa-1/metabolismo , Saccharomyces cerevisiae/enzimologíaRESUMEN
Amniocentesis was performed 56 times in 42 pregnant women with Rh immunisation. In 6 cases of Rh immunisation there was a high delta bilirubin extinction in the B zone of the Liley diagram; in these cases immunosuppressive therapy with corticosteroids was applied. In all these cases also exsanguinotransfusion in children proved necessary. In 16 pregnant women, in whom the delta bilirubin extinction was in the A zone of the Liley diagram, high bilirubin values required exsanguinotransfusion in children.
Asunto(s)
Amniocentesis , Líquido Amniótico/análisis , Bilirrubina/análisis , Inmunización , Sistema del Grupo Sanguíneo Rh-Hr/inmunología , Adulto , Femenino , Humanos , Recién Nacido , EmbarazoRESUMEN
A girl presented with an important growth retardation, hepatomegaly, fasting hypoglycemia, lactic acidosis, increased serum cholesterol, triglycerides and uric acid, and increased liver glycogen (7.5%). There was no rise in blood glucose after IV galactose or fructose, but glucagon gave a delayed response. Type Ib glycogen storage disease was suggested by the low normal activity of glucose-6-phosphatase (G-6-Pase) which reached 1.8 units/g (normal, 2 to 10 units/g) and the normal activity of other glycogenolytic enzymes, measured in homogenates prepared in H2O (mean +/- S.E. in control subjects: 59% +/- 7; in type Ia GSD: 92% +/- 3). The activity of G-6-Pase measured as described above increased to 3.8 units/g of liver 1 year after PCS and 7.85 units/g of liver after 3 years. At that time, a simultaneous assay of the enzyme in a fresh, previously not frozen liver biopsy, homogenized in 0.25 M sucrose, revealed only about 29% of the activity of the same sample prepared in H2O (mean +/- S.E. in three controls: 95.8% +/- 8.9.
Asunto(s)
Enfermedad del Almacenamiento de Glucógeno Tipo I/cirugía , Derivación Portocava Quirúrgica , Adolescente , Femenino , Glucosa-6-Fosfatasa/metabolismo , Enfermedad del Almacenamiento de Glucógeno Tipo I/diagnóstico , Enfermedad del Almacenamiento de Glucógeno Tipo I/enzimología , Humanos , Hígado/enzimologíaRESUMEN
Forty-nine patients with transitional cell tumors of the urinary bladder were followed up clinically for a period of at least 36 months (average time 61.4 months). Initial tumors were examined by means of DNA-Feulgencytophotometry. Histologic grading was performed according to Bergkvist et al. (1965). Clinical behavior clearly demonstrates the validity of the grading schedule used and shows the significance of DNA-Feulgencytophotometry for the standardization of bladder tumors and for the comparability of diagnostic and therapeutic results. Determination of the individual prognosis of low-malignancy tumors and the differentiation of histologic borderline cases does not appear to be possible by means of DNA-Feulgencytophotometry.