Systemic-to-pulmonary collateral vessels and shunts develop in patients with isolated unilateral absence of a pulmonary artery (IUAPA). Two cases of IUAPA (right and left) with hemoptysis in adult life are presented. Selective embolization of these systemic vessels controlled hemoptysis successfully. These cases represent an example of an alternative treatment for this rare anomaly.

Adult↗

PubMedDate not supplied

Ontogeny of IgM and IgM-bearing cells in rainbow trout.

We have studied the ontogenic development of immunoglobulin M (IgM) and of IgM-bearing cells in the rainbow trout, Oncorhynchus mykiss. Lymphocytes showing cytoplasmic IgM were first observed in embryos at 12 days before hatch (14 degrees C). At this stage, no cells positive for surface IgM were present. Lymphocytes bearing surface IgM were observed at 8 days before hatch (14 degrees C). Unfertilized trout eggs contained detectable amounts of IgM (11.2 +/- 2.6 micrograms/g of egg weight), indicating that transfer of IgM from mother to embryo can occur in salmonids. The levels of IgM from whole fish increase slowly after the appearance of intraembryonic cells that express surface IgM. The amount of IgM/g of tissue peaks around hatch, but this parameter shows lower values up to 2 months after hatch.

Animals↗

PubMedDate not supplied

Renal transplants with delayed graft function show decreased renal function despite monitoring with postabsorptive levels.

Cyclosporine (CyA) monitoring with postabsorptive levels can predict the risk of an acute rejection episode (ARE). Large doses of CyA are needed to obtain adequate drug exposure. The impact of this strategy on renal function, especially in patients with delayed graft function (DGF), is unknown. We report our experience comparing C3 (3-hour postdose) monitoring with a historical series of cadaveric renal transplants. Sixty-three consecutive patients who received cadaveric renal transplants were followed for 1 year. Group A (historical n = 31) patients received 6 mg/kg/d CyA with the dose adjusted according to the trough level (target, 250-350 ng/mL), group B (study n = 32) received 10 mg/kg/d CyA with dose adjustments based upon C3 (target, 1100-1500 ng/mL). All patients received cyclosporine prednisone and a third agents. The general characteristics of the donors and recipients were comparable. The incidence of biopsy-proven ARE at 1 year in group A was 42% and 19% in group B (P <.05). Patients achieving C3 levels >1000 ng/mL at 1 week displayed significantly lower ARE rates (8% vs 50%; P <.05). The rate of DGF was similar in both groups, but the duration was longer in group B (15 vs 21 days, P <.05). The serum creatinine (SCr) level was significantly higher in group B at 3 months (1.47 mg/dL group A vs 1.76 mg/dL group B; P <.05). Patients in group B with DGF showed significantly higher SCr values at 1 year (1.18mg% vs 2.03 mg%; P <.05). C3 level monitoring of CyA yields excellent results in terms of decreased ARE, but an increased SCR was observed among patients with DGF.

Creatinine↗

PubMedDate not supplied

Cerebrospinal fluid and plasma dopamine-beta-hydroxylase activity in human hypertension.

Cerebrospinal fluid (CSF) and plasma dopamine-beta-hydroxylase (DBH) activity was measured in 22 normotensive (NT), 31 essential hypertensive (EH), and 11 renal hypertensive (RH) patients. Although no differences were observed in their plasma DBH, the mean CSF-DBH activity and specific activity of EH were significantly lower than those of NT and RH patients. Very low CSF-DBH (less than 0.15 units/ml of CFS or less than 0.5 units/mg of CSF protein) was found only in EH (26% of EH). Of the 31 EH patients, 19(60%) had CSF-DHB activities lower than 0.5 units/ml, whereas only 5 of 22 NT (23%) and no RH fell within this range. Nevertheless, 20% of EH, 55% of NT, and 40% of RH patients had CSF-DBH activities above the mean value for NT (less than 0.9 units/ml). NT subjects with very low plasma DBH (less than 50 units/ml) had CSF-DBH activities that fell within normal range. With the exception of these subjects, the specific activity of CSF-DBH was always lower than that of the plasma enzyme. The concentration of albumin, alpha 1, beta, and gamma globulins was measured in plasma and CSF obtained from the last five NT, four EH, and two RH patients. A positive linear relationship was obtained when the log of the plasma/CSF concentration ratio for these proteins was plotted against their molecular weight. Similar slopes and intercepts were obtained for these patients, suggesting that no major differences seem to exist in their blood-brain-barrier permeability to proteins. The results suggest that measurements of CSF-DBH could be of help in the differential diagnosis of human hypertension and in the neurochemical characterization of EH. If CSF-DBH reflects central noradrenergic activity, its reduction might indicate the existence of a central catecholaminergic defect in a subgroup of EH patients.

Adolescent↗

PubMedDate not supplied

[Morbidity of childhood bronchial asthma in the emergency room].

BACKGROUND: An allergic etiology could be found in more than the 80% of the patients with bronchial asthma. Specific immunotherapy is the only known etiologic treatment, reducing clinical symptoms and requirement of medication. However only a few patients are controlled by an allergist. The aim of the present study was to verify the influence of control and treatment carried out by patients in childhood asthma recruitment that came to the emergency room of our hospital (Hospital Clínico San Carlos) between December 95 and June 96. MATERIAL AND METHOD: Children to 15 years old were included in the study. We analysed: age, sex, clinical record, previous treatment (pharmacological and etiological), basal symptoms, necessity to be admitted to hospital, medical previous control. RESULTS: 163 patients came to emergency room because of asthma exacerbation. They were divided in two groups: less than 3 years (average 17.45 months) and more than 3 years (average 8 years) (Sd: 3.4). Sex: 65% male sex and 35% female sex. 44.17% came during the greater pollinization period in our field, with a statistical significance compared with other periods (p: 0.0023). 81 patients (49.7%) had been previously diagnosed of bronchial asthma. 15% of the patients were controlled by an allergist, with a stable situation in 92% of them. 68.4% of patients who were controlled by a paediatrician and 40% who were controlled in a officially approved centre (p: 0.015) were stable. 55 patients had continuous treatment and 21.8% of them were been treated with immunotherapy. 17.7% of patients without immunotherapy were admitted to hospital. None of the patients on immunotherapy were hospitalised. CONCLUSIONS: It is essential to do an early diagnosis and a combined follow-up by an allergist and a paediatrician to succeed in a good control of the disease from its beginning. In our experience, the children who were controlled by an allergist had a more stable situation and were also more easily controlled. The specific treatment should be initiated in the early stage of the disease being the only factor that modify the immune response and prevents against the development of asthma in children with rhinitis.

Adolescent↗