[Throat and abdominal symptoms in malignant lymphoma; recognize the alarm signals in children]. / Keel- en buikklachten bij een maligne lymfoom.

In children, a malignant lymphoma can present with life-threatening complications arising from progressive tumour growth, warranting swift diagnosis and treatment. Early recognition can be challenging if a child with paediatric lymphoma presents with abdominal and throat symptoms because of the frequency, and frequently benign nature, of these symptoms in the general paediatric population. In these cases, it is essential for the physician to recognize the alarm signals for suspicion of malignant lymphoma, to allow timely diagnosis and treatment. We present two cases (children age 8 and 16 years) demonstrating the symptoms of malignant lymphoma that should raise alarm in children presenting with unilateral tonsil enlargement or intussusception, and illustrating the importance of timely recognition of these alarm signals, to prevent life-threatening complications due to tumour progression. In patients presenting with unilateral tonsil enlargement, malignant lymphoma should be considered if atypical macroscopic tonsil morphology, cervical lymphadenopathy, dysphagia, snoring, fever or weight loss is present. The presence of a lead point as the cause of intussusception should be considered in children aged > 2 years of age, in a child with an ileo-iliac intussusception and in patients with longstanding abdominal symptoms. In patients presenting with simultaneous symptoms and alarm signals for malignant lymphoma, the relationship between the presenting symptoms should be recognized. Interdisciplinary and intradisciplinary consultation with colleagues can help in the search for an overarching diagnosis, and it is crucial that this should happen without delay to prevent acute life-threatening situations.

[An African boy with haematuria]. / Een Afrikaanse jongen met hematurie.

An 8-year-old, Senegalese boy presented with a history of painless macroscopic haematuria. The diagnosis schistosomiasis was made, based on the urine sediment that revealed eggs from the trematode parasite Schistosoma haematobium. The patient was treated with praziquantel and made a full recovery.

Branched-chain amino acids and arginine supplementation attenuates skeletal muscle proteolysis induced by moderate exercise in young individuals.

This study aimed at evaluating the effect of a single oral intake of branched-chain amino acids (BCAA) with Arg on skeletal muscle protein metabolism during moderate exercise in young individuals. Eight healthy volunteers (4 males and 4 females, means +/- SEM, 26 +/- 1 yrs, 177.8 +/- 3.7 cm, 72.6 +/- 3.9 kg) were studied in a randomized double-blind placebo-controlled cross-over trial. The subjects performed 3 bouts of 20-min cycling exercise (5-min break between each bout) at 126 +/- 13 W corresponding to 50 % of the maximal work intensity. A single oral supplement of either a BCAA drink containing 2 g of BCAA and 0.5 g of Arg or an isocaloric placebo drink was given at 10 min of the 1st exercise bout. Both arterial and venous blood samples were simultaneously taken from the radial artery and the femoral vein, respectively. Blood flow in the femoral artery was determined using the ultrasound Doppler technique. The blood sampling and blood flow measurements were performed at rest, every 10 min during each exercise bout. Net balance of BCAA and Phe across the leg muscles were measured by the arteriovenous difference method. The BCAA ingestion resulted in increases in both the plasma BCAA concentration and BCAA uptake into the working leg. The Phe release from the leg during exercise significantly increased as compared to the basal level in the placebo trial (0.97 +/- 0.28 vs. 0.23 +/- 0.22 micromol/min, p < 0.05). In the BCAA trial, the cumulative Phe release from the leg during the 3rd exercise bout was significantly lower than that in the placebo trial (5.0 +/- 7.4 vs. 35.9 +/- 13.2 micromol/25 min, p < 0.05). These results suggest that endurance exercise at moderate intensity enhances proteolysis in working muscles, and a single oral intake of 2 g of BCAA with Arg at onset of exercise effectively suppresses exercise-induced skeletal muscle proteolysis.

Lupus anticoagulant is significantly associated with inflammatory reactions in patients with suspected deep vein thrombosis.

OBJECTIVE: Lupus anticoagulant (LA) and antiphospholipid antibodies (aPL) are suggested as risk factors for development of deep vein thrombosis (DVT) among patients without systemic lupus erythematosus (SLE). Other conditions, e.g. inflammation, are reported to induce LA and it is uncertain whether the association between LA and DVT is causal. In this study the associations between aPL, LA and inflammation were investigated in 170 consecutive patients without SLE, but with a tentative diagnosis of DVT. MATERIAL AND METHODS: DVT was diagnosed in 64 patients. LA was determined according to the criteria of the International Society of Thrombosis and Haemostasis. The concentration of anticardiolipin (aCL) and beta(2)-glycoprotein I (anti-beta(2)-GPI) antibodies as well as C-reactive protein (CRP) was determined with sensitive and precise methods. RESULTS: LA was demonstrated in 8 patients with DVT and in 10 patients without DVT, relative risk 1.33 (CI: 0.55-3.18). No significant association was observed between aCL or anti-beta(2)-GPI and DVT. Patients suffering from DVT had significantly higher concentrations of CRP than patients without DVT. However, CRP was also significantly higher in patients positive for LA than in patients without LA irrespective of the presence of DVT (p<0.001). CONCLUSIONS: The present study supports a strong association between inflammatory reactions and development of LA in patients with suspected DVT, whereas no significant association was demonstrated between LA or aPL and DVT.

Early phase karyotype analysis of chromosome segregation after formation of mouse-mouse hybridomas with chromosome painting probes.

FISH analysis with chromosome painting probes allows, better than karyotyping after Giemsa banding, the study of chromosome segregation after hybridoma formation. FISH is particularly useful for intraspecies hybrids and allows visualization of small chromosome fragments. Cell hybrids were constructed between P3 x 63Ag8.653 mouse myeloma cells and lymphocytes from BALB/c mice by PEG fusion and by selection in hypoxanthine azaserine medium. Three hybridomas (A4, D8, F10) were selected and, after cloning, the cells were cultivated in vitro over a period of 28 days. During this time in culture, air-dried metaphase spreads were prepared by standard methods. For FISH chromosome painting, digoxigenin- and biotin-labeled mouse chromosome painting probes and rhodamine-antidigoxigenin antibodies and fluorescein-avidin were used for dual color detection. Total chromosome numbers and the numbers of mouse chromosomes 1, X, 6 and 12 were estimated as function of days in culture. Mean chromosome numbers of 78 (D8), 82 (F10) and 150 (A4) were observed. The major rearrangements of chromosome numbers occured in the first 28 days in culture and did not change significantly between day 28 and day 56. Mouse chromosome #12, which had the largest chromosome fragments in the parent myeloma, remained stable while the number of X chromosomes, which were significantly fragmented already in the parent myeloma, decreased by approximately 50%.

[Salivary gland choristoma in the middle ear]. / Spytkirtelchoristoma i mellemøret.

A choristoma is a non-neoplastic proliferation of histologically normal tissue occurring at an abnormal site. The first known Danish case of a salivary gland choristoma in the middle ear is presented. This is a very rare condition of which only 20 cases have been reported. A 16-year-old male was referred to the ENT clinic with a 60-70 dB mixed hearing loss on the right ear. Exploratory tympanotomy showed a lobulated mass attached to the horizontal portion of the facial nerve, which had an abnormal course lateral to the stapes. The incus and stapes were abnormal with no continuity. Biopsy showed salivary gland choristoma. Complete excision was not attempted. Postoperatively the conductive hearing loss was for some reason reduced by 20 dB. The facial nerve function was normal.

[A closed emergency unit. Consequences for referral patterns and economics]. / Lukket skadestue. Konsekvenser for henvendelsesmønster og økonomi.

During the mid 1980's the emergency-room at Faaborg Hospital changed status from being open to semi-closed. From then on the patients had to contact a general practitioner before going to the emergency-room. The general practices in the area were then supposed to have a referring function. We decided to evaluate the consequences of this decision in 1991. From 25 August to 1 December 1991 we registered all patients who contacted the emergency-room. The conclusions were that no changes in the types of patients had occurred, and that it was at a greater cost to the National Health Service.

Structural and mixture analysis of glycerophosphoric acid derivatives by fast atom bombardment tandem mass spectrometry.

It is shown that by a combination of positive and negative FAB mass spectrometry with collision activation using a tandem mass spectrometer diacyl glycerophosphoric acid ester mixtures can be analysed. The following results will be obtained: Molecular masses of the single components, nature of the residue bound to the phosphoric acid (choline, serine etc.), fatty acids present in the single components and (if different) their location at C-1/C-2 as well as a quantitative analysis both of the fatty acids in the mixture and of the various species making up the latter.

High-performance liquid chromatographic analysis of basic compounds on non-modified silica gel and aluminium oxide with aqueous solvent mixtures.

A comparison is made between the use of aluminium oxide and non-modified silica gel as cation-exchange materials for the separation of basic drugs (amines) with aqueous solvent mixtures. The retention behaviour of the amines is studied and appears to be controlled predominantly by the pH and the concentration and nature of the modifier; the nature and concentration of the competing ions and the buffer components of the mobile phase also exert some influence on the retention. Preparations with imidazoline and tetracycline derivatives have been analysed as examples of the application of these ion-exchange systems on non-modified silica gel and aluminium oxide in the analysis of pharmaceutical formulations.

Mitomycin antitumour agents: a review of their physico-chemical and analytical properties and stability.

The review enumerates the physico-chemical and analytical properties of mitomycin antitumour antibiotics, of which mitomycin C is the most important representative. After a short overview of the position of the compounds in oncology the following subjects will be discussed: structural features, prototropic properties, spectroscopy (UV-VIS, ORD, CD, IR, NMR, MS), chromatography and electrochemistry. The chemical stability and aspects of the mechanism of action of the compounds are also discussed. The last part of the review surveys the analysis of mitomycin C in biological fluids.