Splenectomy-induced long-term remission in a patient with multicentric Castleman's disease.

Castleman's disease (CD) is a rare lymphoproliferative disorder with a poorly understood pathogenesis. Multicentric CD can progress in different patterns, none of which can be cured with the current treatment options. We present a patient with multicentric CD in complete remission, eight years after a splenectomy without any other systemic treatment. We discuss the possible mechanism causing this long episode of complete remission in this patient.

Transcutaneous bilirubinometry with the Bilicheck in very premature newborns.

OBJECTIVES: To investigate the potential advantages of use of the Bilicheck in the very preterm population, with special emphasis on the effect of possible adverse skin conditions on the accuracy of the measurements. In addition we estimated the potential for safe reduction of the number of blood samples taken for serum bilirubin determinations by introduction of the Bilicheck into the neonatal intensive-care unit (NICU). METHODS: Total serum bilirubin (TSB) and transcutaneous bilirubin (TcB) were determined in very preterm newborns (gestational age < 30 weeks). To assess the agreement between TSB and TcB values, Bland-Altman plots were analyzed. Accuracy and (intra-device) imprecision were determined by statistical analysis. A screening model was developed to estimate the potential for safe reduction of the number of blood samples taken for TSB determination. RESULTS: Correlations between TcB and TSB values varied between 0.86 and 0.88 and all were statistically significant. Bland-Altman plots and statistical analysis showed that the agreement between TcB and TSB measurements was largest for the group with good skin conditions, as expected. The Bilicheck device had an acceptable level of intra-device imprecision (2.29 +/- 13.51 micromol/l). Applying the screening model to our entire study population, 35 of the 93 TSB measurements (38%) could have been saved. CONCLUSIONS: The Bilicheck is a screening device with the potential to reliably indicate hyperbilirubinemia in very preterm infants. Caution is required when skin measurements are performed in the presence of peripheral edema and/or a poor peripheral circulation. Its application in the NICU environment has the potential to reduce the number of blood samples by 40%.

Parallel DNA template preparation using a vacuum filtration sample transfer device.

Solid-phase techniques have facilitated the handling of biochemical analytes. This has stimulated the development of systems by which large sample panels can be analyzed with high levels of security and quality. We describe a sample transfer device based on the principle of vacuum filtration, which enables parallel handling of 96 samples of analytes bound to Sepharose beads. The tool was employed for strand separation of DNA samples, by attracting the beads to filter probes while passing them between the reagent solutions. The samples were analyzed using Pyrosequencing technology and proved to yield genotyping results of high quality. The presented sample preparation procedure provides an important link in the development of integrated systems for rapid genetic analysis at a low cost. In addition, the same filter could be reused extensively with very low risk for detectable cross-contamination between assays and without any reduction in processing capacity, thus further reducing the cost per analyzed sample.

Differential tolerance to biological and subjective effects of four closely spaced doses of N,N-dimethyltryptamine in humans.

Tolerance of the behavioral effects of the short-acting, endogenous hallucinogen, N,N-dimethyltryptamine (DMT) is seen inconsistently in animals, and has not been produced in humans. The nature and time course of responses to repetitive, closely spaced administrations of an hallucinogenic dose of DMT were characterized. Thirteen experienced hallucinogen users received intravenous 0.3 mg/kg DMT fumarate, or saline placebo, four times, at 30 min intervals, on 2 separate days, in a randomized, double-blind, design. Tolerance to "psychedelic" subjective effects did not occur according to either clinical interview or Hallucinogen Rating Scale scores. Adrenocorticotropic hormone (ACTH), prolactin, cortisol, and heart rate responses decreased with repeated DMT administration, although blood pressure did not. These data demonstrate the unique properties of DMT relative to other hallucinogens and underscore the differential regulation of the multiple processes mediating the effects of DMT.