ABSTRACT
Acetylcholinesterase (AChE; EC 3.1.1.7) is present in both primitive and mature erythroid cells, and a role has been suggested for the enzyme in regulation of differentiation in the human erythron. AChE is also a major enzyme in the central nervous system; alteration of its activity has been proposed as a therapeutic strategy in Alzheimer disease. We recently treated 18 Alzheimer disease patients with metrifonate, a long-acting AChE inhibitor, over periods up to 7 months, with resulting erythrocyte AChE inhibition as high as 82 per cent of baseline values. Despite chronic reduction of enzyme activity, no significant alterations were noted in erythrocyte, leukocyte or platelet characteristics or numbers that would suggest a deleterious effect of AChE inhibition on normal differentiation. Thus, any modification of developmental pathways appears to be compensated by other regulatory mechanisms in the intact organism.
Subject(s)
Cholinesterase Inhibitors/pharmacology , Hemoglobins/drug effects , Alzheimer Disease/drug therapy , Blood Cell Count/drug effects , Humans , Leukocyte Count/drug effects , Trichlorfon/therapeutic useABSTRACT
One hundred patients with malignant biliary obstruction underwent palliative therapy by means of percutaneous transhepatic placement of 114 biliary endoprostheses. All patients were then followed up for at least 18 months or until death. Retrospective evaluation of the 95 patients who died showed an average survival time of 5.0 months. The five remaining patients have survived an average of 29.8 months. During the 1st week after stent insertion, a second manipulation was performed to improve stent function in nine patients. Overall, 14 (12.3%) of the stents became obstructed and six (5.2%) migrated; 86 patients required no further therapy for biliary obstruction or stent malfunction. The 30-day mortality rate was 12%; none of the deaths were directly attributable to a complication of the stent placement procedure.
Subject(s)
Biliary Tract Neoplasms/complications , Cholestasis/therapy , Pancreatic Neoplasms/complications , Stents , Biliary Tract Neoplasms/epidemiology , Biliary Tract Neoplasms/mortality , Cholestasis/epidemiology , Cholestasis/etiology , Cholestasis/mortality , Humans , Palliative Care , Pancreatic Neoplasms/epidemiology , Pancreatic Neoplasms/mortality , Retrospective Studies , Survival RateSubject(s)
Hernia, Ventral/diagnosis , Hernia/diagnosis , Hernia/diagnostic imaging , Hernia, Femoral/diagnosis , Hernia, Femoral/diagnostic imaging , Hernia, Inguinal/diagnosis , Hernia, Inguinal/diagnostic imaging , Hernia, Obturator/diagnosis , Hernia, Obturator/diagnostic imaging , Hernia, Umbilical/diagnosis , Hernia, Umbilical/diagnostic imaging , Hernia, Ventral/diagnostic imaging , Humans , Lumbosacral Region , Magnetic Resonance Imaging , Tomography, X-Ray ComputedABSTRACT
Hemolytic anemia due to deficiency of erythrocytic pyruvate kinase is a rare autosomal recessive disorder. Pregnancy complicated by pyruvate kinase deficiency is rare; there are only 8 reported cases in the literature. A case is described that was characterized by increased hemolysis during pregnancy, requiring blood transfusions before and after delivery, and complicated by severe preeclampsia at term. Fetal and maternal outcome was successful. Increased hemolysis and favorable perinatal outcome occurred in all 8 reported cases.
