Epidemiological, genetic, and clinical characterization by age of newly diagnosed acute myeloid leukemia based on an academic population-based registry study (AMLSG BiO).

We describe genetic and clinical characteristics of acute myeloid leukemia (AML) patients according to age from an academic population-based registry. Adult patients with newly diagnosed AML at 63 centers in Germany and Austria were followed within the AMLSG BiO registry (NCT01252485). Between January 1, 2012, and December 31, 2014, data of 3525 patients with AML (45% women) were collected. The median age was 65 years (range 18-94). The comparison of age-specific AML incidence rates with epidemiological cancer registries revealed excellent coverage in patients < 70 years old and good coverage up to the age of 80. The distribution according to the European LeukemiaNet (ELN) risk categorization from 2010 was 20% favorable, 31% intermediate-1, 28% intermediate-2, and 21% adverse. With increasing age, the relative but not the absolute prevalence of patients with ELN favorable and intermediate-1 risk (p < 0.001), with activating FLT3 mutations (p < 0.001), with ECOG performance status < 2 (p < 0.001), and with HCT-CI comorbidity index < 3 (p < 0.001) decreased. Regarding treatment, obesity and favorable risk were associated with an intensive treatment, whereas adverse risk, higher age, and comorbidity index > 0 were associated with non-intensive treatment or best supportive care. The AMLSG BiO registry provides reliable population-based distributions of genetic, clinical, and treatment characteristics according to age.

Disruption of host location of western corn rootworm larvae (Coleoptera: Chrysomelidae) with carbon dioxide.

Elevated concentrations of carbon dioxide (CO2) prevented neonate larvae of the western corn rootworm, Diabrotica virgifera virgifera LeConte, from locating the roots of growing corn in behavioral bioassays conducted in soil tubs. When CO2 was pumped into one end of a soil tub, significantly more larvae were recovered from soil at the treated end than from soil around a growing corn plant at the opposite end of the tub. In controls with ambient air pumped into one end of a soil tub, significantly more larvae were recovered from the soil around the corn plant than from soil on the treated side. Larvae were unable to locate the roots of corn seedlings when CO2-generating materials were mixed into the soil. CO2-concentrations in soil were measured by mass spectrometry with selected ion monitoring at m/z 44. Granules composed of baker's yeast, yeast nutrients, and an organic substrate were prepared as a CO2 source and were tested in larger soil tub bioassays. Significantly fewer larvae were recovered from corn roots in the soil tubs with yeast granules than from corn roots in control soil tubs. The CO2-generating granules produced soil CO2 concentrations between 15.8 and 18.5 mmol/mol (compared with 1.7-2.6 mmol/mol in control tubs), and this was sufficient to prevent larvae from locating corn roots. In field trials, organic and inorganic CO2- generating treatments resulted in root ratings that were significantly lower than for the control plants.

Pseudoaneurysm after cardiac catheterization: therapeutic interventions and their sequelae: experience in 86 patients.

After diagnostic cardiac catheterization in 8,715 patients, a pseudoaneurysm was diagnosed in 86 (1%) patients. Primary conservative management by repeated compression bandages (CB) or ultrasound guided compression (UGC) was attempted in all patients. Occlusion of the pseudoaneurysm was achieved significantly more often by UGC (41/47; 87%) than by CB (22/39; 56%; P = 0.016). Of 86 patients, 23 (27%) required surgical treatment. Major clinical acute complications occurred after surgery in 8/23 cases (35%) versus 4/63 (6%; P = 0.0004) following successful CB or UGC. However, intention-to-treat analysis showed no difference in the rate of acute complications in the CB or UGC group (15.4% versus 12.8%, P = 0.7272), because of a trend towards a higher complication rate following secondary surgery in the UGC (4/6 = 66.7%), as compared to the CB group (4/17 = 23.5%, P = 0.1589). During follow up, 22/64 (34%) patients reported persistent inguinal complaints, 9/15 (60%) after surgery and 13/49 (27%) after successful CB or UGC (P = 0.0169). However, according to the intention-to-treat analysis, there was no significant difference between the initial groups (CB: 26.1% versus UGC: 39.0%, P = 0.2958). Despite a higher effectiveness of UGC to achieve occlusion of a pseudoaneurysm compared to CB (87% vs. 56%), UGC is not superior to CB because of a higher rate of acute complications as well as long-term complaints in those patients requiring secondary surgery in the UCG group as compared to the CB group.

Local venous thrombosis after cardiac catheterization.

Pulmonary embolism is a rare but life-threatening complication of cardiac catheterization. Underlying deep venous thrombosis (DVT) is often not detectable clinically. To determine the true incidence of DVT the authors prospectively studied 450 consecutive patients (29% women, 71% men, mean age: fifty-eight years) undergoing a diagnostic cardiac catheterization. Patients were examined clinically and by duplex sonography with a high-resolution (5 or 7.5 MHz) transducer before and twenty-four hours after catheterization before mobilization. Duplex sonography excluded complete proximal DVT in all patients. Only partial occluding thrombi (pDVT) were detected in 11 (2.4%) patients. The thrombi were always localized at the puncture site. In 2 patients a difference was found in the circumferences of the legs, but no other clinical signs of DVT were seen. With use of continuous wave (cw) Doppler sonography, only 3 of these 11 patients (27%) showed a spontaneous (s) sound. Phlebography was performed in 4/11 patients (36%). In 2 patients the diagnosis was confirmed; in 1 patient extravenous compression was assumed, and the other demonstrated a normal-appearing phlebography at the time of investigation. Logistic regression analysis yielded a 3.5 times higher risk for developing a pDVT if a venous puncture was performed in addition to arterial puncture. Furthermore a 9.8 times higher risk was found if more than one venous puncture was necessary. During the follow-up no patient developed clinical signs of pulmonary embolism. The results of this study demonstrate that DVT is a rare complication of cardiac catheterization (0/450 patients), but pDVT occurred in 2.4%. Risk factors for pDVT are the venous puncture itself and multiple puncture attempts. Clinical relevance of pDVT remains to be determined.

Do 5-F-catheters reduce the incidence of a pseudoaneurysm?

Femoral artery pseudoaneurysm is a major problem in patients undergoing cardiac catheterization. This study describes our experience with 5 French (5 F) and 7 French (7 F) introduction sheaths and 7 investigators at our institution regarding the incidence of pseudoaneurysms. During 54 months (1/1990-6/1994) 8715 consecutive patients after diagnostic cardiac catheterization were first clinically checked for pseudoaneurysm and in case of suspicion a duplex sonography was performed. In 86 (1%) patients, 44 (52%) women and 42 (48%) men, mean age 63 +/- 9.7 years we observed this complication by duplex ultrasound. 54 (62%) patients had arterial hypertension, 18 (20%) diabetes and only 3 (3.6%) had peripheral arteriosclerosis. An antithrombotic medication was used in 60% (52 patients). As compared to a control group of 450 consecutive patients a pseudoaneurysm was significantly more likely to occur in patients with a history of hypertension (63% vs 25%, p < 0.0001). Women are also at higher risk representing 51% of all pseudoaneurysms as compared to 29% in the control group (p < 0.0001). Using 7-F catheters more pseudoaneurysms occurred (82/7183; 1%) than using 5 F (4/1532; 0.2%) introduction sheaths (p = 0.0005). There were also significantly more pseudoaneurysms caused by investigator 1 (21/787; 2.7%) as compared to the other investigators (65/7829; 0.8%), (p = 0.0002). Investigator 1 had a more distal puncture technique than the others. Pseudoaneurysms complicating cardiac catheterization occur 5-times more frequent using 7 F (1%) as compared to 5 F catheters (0.2%). Moreover distal puncture site is associated with a higher frequency of pseudoaneurysms.

Drug death autopsies at the Munich Institute of Forensic Medicine (1981-1992).

A total of 638 drug death autopsy cases in southern Bavaria from 1981 to 1992 were analysed, including epidemiological and toxicological investigations. The rate of HIV infections decreased during the last few years. Cocaine does not (yet) play a major role. Suicide rates are high. Heroin intoxications are the most frequent cause of death, mostly in combination with other drugs and alcohol. In 1992 we observed a sharp increase of the number of deaths associated with dihydrocodeine abuse. This seems to be a local phenomenon and has to be explained by uncritical and uncontrolled prescription of large amounts of this opiate by individual physicians.

The role of imagery in self-hypnosis: its relationship to personality characteristics and gender.

30 volunteer Ss practiced self-hypnosis for approximately 4 weeks and wrote a record of their experiences in a diary following each session. Imagery produced during self-hypnosis was coded in 2 ways: the imagery was either reality oriented or it was fantastic and had primary process qualities. Levels of imagery production remained virtually the same over a 4-week period. Self-hypnotic imagery was significantly greater for the female Ss than for the male Ss, particularly primary process imagery. Verbal expressivity (measured as the average number of words per page of each S diary) was calculated to control for the effects of verbal production on Ss' imagery scores. When imagery scores were standardized based on verbal expressivity, female Ss still produced significantly more primary process imagery than male Ss. Personality characteristics (assessed by standardized personality inventories) were examined in relation to self-hypnotic imagery. "Impulse Expression" was positively related to primary process imagery for the female Ss. "Outgoingness" was positively related to primary process imagery for the entire sample, but especially for the female Ss.

The relation of self-reports of hypnotic depth in self-hypnosis to hypnotizability and imagery production.

The relationship of self-reports of hypnotic depth obtained during self-hypnosis to hypnotizability and to the kinds of imagery produced during self-hypnosis is investigated. The sample consisted of 22 highly hypnotizable Ss who practiced self-hypnosis in 1-hour daily sessions for 4 weeks and kept daily journals in which they detailed the contents of their self-hypnosis experiences. The journals were coded for imagery production by scoring for both reality-oriented and primary process imagery. Ss had been taught to monitor their hypnotic depth using a slightly revised version of the Extended North Carolina Scale (ENCS) of Tart (1979). Previously, ENCS has been used only with heterohypnotic Ss. The self-reports of depth using ENCS correlated highly with hypnotizability as measured by the Revised Stanford Profile Scale of Hypnotic Susceptibility. Form I of Weitzenhoffer and Hilgard (1967) and with imagery production. Results demonstrate that ENCS scores are also a valid indicator of self-hypnotic depth among highly hypnotizable Ss. Furthermore, they indicate that both hetero-hypnotizability and imagery production are related to self-hypnotic depth, but that the association between imagery and hypnotizability is due to their individual relationships to self-hypnotic depth.

Specificity in formation of triple-stranded nucleic acid helical complexes: studies with agarose-linked polyribonucleotide affinity columns.

The binding of a variety of deoxyribo and ribo homo- and copolynucleotide complementary duplexes to agarose-linked homopolynucleotide affinity columns has been studied. The results provide information concerning the specificity of recognition of complementary base pairs of nucleic acids through a mechanism that involves triple-helix formation under physiological conditions of ionic strength, pH, and temperature. The method employed made it possible, for the first time, to survey the full range of base triplets conceivable from the canonical nucleic acid bases and, in addition, hypoxanthine and thereby to differentiate between those triplets which can and cannot form. Certain previously observed features of the stereochemistry of double-helical targets for third-strand binding are confirmed, and some unrecognized features are elaborated. These include a general requirement for clusters of purine residues in one strand, protonation of third-strand C residues, the ability of natural third-strand residues to distinguish between A.T/U and G.C base pairs, and a capacity of third-strand (unnatural) I residues to recognize all base pairs within such clusters. Thus, the basis for a third-strand binding code is demonstrated.