Patient eligibility for hematopoietic stem cell transplantation: a review of patient-associated variables.

Assessing patient eligibility for hematopoietic stem cell transplantation (HSCT) remains a complex, multifaceted challenge. Among these challenges, the paucity of comprehensive clinical data to guide decision making remains problematic coupled with unclear trade-offs between patient, disease and local HSCT center factors. Moreover, it is unclear that the modification of poor patient characteristics will improve post-HSCT outcomes. However, the use of Comorbidity Indices and Comprehensive Geriatric Assessments helps meet this challenge, but may be limited by overlapping patient characteristics. The increasing consideration for pre-HSCT psychosocial assessments and interventions remains to be studied. Ultimately, the decision to proceed with a HSCT remains interdisciplinary while considering the available evidence discussed in this review.

Single nucleotide polymorphisms in the methylenetetrahydrofolate reductase gene are common in US Caucasian and Hispanic American populations.

To investigate the prevalence of the C677T and A1298C single nucleotide polymorphisms (SNPs) in the methylenetetrahydrofolate reductase (MTHFR) gene in Caucasian and Hispanic populations, EDTA-anticoagulated whole blood specimens were collected from a total of 100 random patients, 50 Caucasians and 50 Hispanics of Puerto Rican dissent. The prevalence of the two MTHFR SNPs was determined by polymerase chain reaction (PCR) mediated restriction fragment length polymorphism analysis. In the Caucasian population, homozygosity for the MTHFR A1298C SNP was detected in 4% (2/50) of the individuals tested, while 42% (21/50) were heterozygous for this SNP. Among Hispanics, 4% (2/50) were homozygous and 38% (19/50) heterozygous for the A1298C SNP. Homozygosity for the C677T MTHFR SNP was detected in 16% (8/50) and 10% (5/50) of Caucasians and Hispanics, respectively. In this study, the frequency of the C677T heterozygotes was very high at 56% (28/50) and 52% (26/50) Caucasians and Hispanics, respectively. C677T and A1298C are common SNPs in the MTHFR gene. The high prevalence of these SNPs in both Caucasian and Hispanic populations demonstrates the possibility of compounding effects of these SNPs in the pathogenesis of human diseases. While subgroups of patients may exhibit some clinical phenotype linked to these SNPs, our analysis demonstrates the need for careful interpretation of SNP data in the context of population screening.

A multivariate approach to the prediction of hypnotic susceptibility.

The present study examined the relation between various self-report measures and two measures of hypnotizability within a multivariate framework. A group of 748 participants was tested on the Harvard Group Scale of Hypnotic Susceptibility, Form A (HGSHS:A), the Tellegen Absorption Scale (TAS), as well as the Preference for an Imagic Cognitive Style (PICS) questionnaire. One hundred ninety of these participants also completed the Paranormal Experiences Questionnaire (PEQ). Data were analyzed using hierarchical multiple regression equations, and the results of the analyses indicated that both the TAS and PICS accounted for significant amounts of unique variance in each of two 373-member samples of HGSHS:A scores. A further sub-sample of participants (n = 161) was tested on the Stanford Hypnotic Susceptibility Scale, Form C (SHSS:C) to see if these results would generalize to another measure of hypnotizability. Hierarchical multiple regression analyses revealed that although the PEQ predicted significant amounts of unique SHSS:C variance over and above that predicted by the TAS, the PICS failed to do so. This inconsistency in results may be due in part to the generally low intercorrelation between the different hypnotizability scales and points to the need to develop new predictor variables that are orthogonal to each other.

An evaluation of laser Doppler readings obtained from human gingival sulci.

A small laser doppler probe with an outside diameter comparable to a conventional periodontal probe (0.5 mm) was developed. The objectives of this investigation were to determine if intrasulcular laser doppler readings (LDR): 1) are reproducible; 2) can detect vascular changes associated with trauma from probe placement; 3) were reproducible when obtained with a stabilizing stent or without a stent; and 4) could detect vascular changes following the injection of a local anesthetic with vasoconstrictor. Nine adult volunteers with clinically healthy gingiva were evaluated for 30 second intervals at 5 sites. Baseline LDR were obtained twice at each site utilizing an acrylic stent to stabilize the probe and once without the stent (trial 1). All LDR were repeated at one month (trial 2) and again two months (trial 3) after baseline. One additional reading per subject was obtained following the administration of a local anesthetic with a vasoconstrictor during the second trial. Inter-trial comparisons found no significant difference in mean LDR between any of the three observation times. However, intra-trial comparison between the first and second LDR revealed an increase of approximately 50% in mean LDR. A 3-fold reduction in mean LDR (P < 0.001) was noted following the administration of a local anesthetic with vasoconstrictor. Intra-class correlation coefficients for stent stabilized LDR were 0.51 (P < 0.01) and 0.63 (P < 0.01) while intra-class correlation for hand held LDR was 0.40 (P < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Effect of 1,25-dihydroxyvitamin D3 treatment on bone formation by transplanted cells from normal and X-linked hypophosphatemic mice.

Bone cells isolated from the Hyp mouse, the murine homologue for hypophosphatemic vitamin D-resistant rickets, produce abnormal bone when transplanted to either normal or phosphate-supplemented Hyp mice. To assess whether correction of the bone formation by mutant cells transplanted into either normal or Hyp mice could be achieved in the presence of supraphysiologic serum concentrations of 1.25-dihydroxyvitamin D3 (1.25-(OH)2D3), recipient mice of both genotypes were infused continuously with 1.25-(OH)2D3 (0.2 micrograms/kg/day). Bone nodules present in transplants recovered after 14 days were characterized by measuring the osteoid thickness and volume. Administration of 1.25-(OH)2D3 to Hyp mice corrected the defective bone formation by normal cells but not by pair-transplanted Hyp cells, despite normalization of serum phosphate levels and 3-fold increases in serum 1.25-(OH)2D3. The osteoid thickness and volume in Hyp transplants into 1.25-(OH)2D3-treated Hyp mice were, however, markedly reduced down to values observed for Hyp transplants into recipient normal mice. Administration of 1.25-(OH)2D3 to normal mice improved further bone formation by mutant cells without affecting that by pair-transplanted normal cells. Administration of 24.25-(OH)2D3 (1 microgram/kg/day) combined with 1.25-(OH)2D3 to recipient mice of both genotypes prevented the sharp fall in serum 24.25-(OH)2D3 but was not more beneficial than 1.25-(OH)2D3 alone for improving bone formation by transplanted Hyp cells. These observations demonstrate an abnormal response of the mutant cells to the extracellular environment and support the concept of an intrinsic osteoblast defect in the Hyp mouse.

Effect of dietary phosphate deprivation and supplementation of recipient mice on bone formation by transplanted cells from normal and X-linked hypophosphatemic mice.

The hypophosphatemic (Hyp) mouse is the murine homolog for human hypophosphatemic vitamin D-resistant rickets. We previously reported that bone cells isolated from normal and Hyp mice produced abnormal bone when transplanted intramuscularly into mutant mice. To assess the role of hypophosphatemia on bone formation in transplants, normal and Hyp mouse periostea were pair transplanted into control or phosphate (P)-supplemented Hyp mice and into control or P-deprived normal mice. The bone nodules formed in transplants after 2 weeks were characterized by measuring the thickness of the surrounding osteoid seams and the relative osteoid volume. P restriction in normal recipient mice impaired bone formation by transplanted normal cells and aggravated the defective bone formation by Hyp cells. The osteoid thickness and volume remained significantly higher in Hyp transplants than in normal cotransplants, however. P supplementation of Hyp recipient mice normalized bone formation by transplanted normal cells but not by Hyp cells. However, a marked decrease in osteoid thickness and volume was observed in Hyp transplants down to values observed in normal recipient mice. These results indicate that hypophosphatemia is not the only cause of abnormal bone formation in the Hyp mouse but that an osteoblast dysfunction contributes to the bone disease. These observations further support the concept that the osteoblast may be an important target for the Hyp mutation.

Defective bone formation by Hyp mouse bone cells transplanted into normal mice: evidence in favor of an intrinsic osteoblast defect.

The hypophosphatemic (Hyp) mouse is an animal model for human hypophosphatemic vitamin D-resistant rickets. We have reported that bone cells isolated from Hyp mice born to homozygous mutant females produce abnormal bone when transplanted into normal mice. To test whether an environmentally acquired defect of the mutant cells contributed to the impaired bone formation observed in transplants, periostea and osteoblasts from normal and Hyp littermates were transplanted intramuscularly into normal animals. To test more specifically for an hypophosphatemia-induced cell alteration before transplantation, bone cells isolated from phosphate-depleted normal mice were transplanted into normal animals. The bone nodules formed in 2 week transplants were characterized by measuring their osteoid thickness and volume. Impaired bone formation was evidenced in Hyp transplants compared to normal littermate transplants by increased osteoid thickness and volume. In contrast to cells from mutant mice, cells isolated from normal mice with comparable hypophosphatemia produced normal bone. These results indicate that the inability of Hyp osteoblasts to produce normal bone when placed in a normal environment is not the consequence of prior exposure to an altered environmental but likely of an intrinsic cellular abnormality. These observations add further support to the concept that the osteoblast is an important target for the Hyp mutation.

Potential jurors' opinions on the effects of hypnosis on eyewitness identification: a brief communication.

The present study examined a selected group of potential jurors' opinions on the effects of hypnosis on eyewitness identification and testimony. A group of 78 undergraduate psychology and optometry students completed a 2-part multiple choice questionnaire. The first part assessed Ss' knowledge of several issues concerning eyewitness testimony. The second part of the questionnaire contained 11 items which assessed Ss' beliefs and expectations concerning the effects of hypnosis on eyewitness identification and testimony. It was found that Ss' opinions on the effects of hypnosis on eyewitness testimony and identification were at odds with current empirical findings. These results, in accord with the previous literature, suggest that it is imperative that the courts be informed of the use of hypnosis during police work and that adequate precautions be taken to avoid a potential source of miscarriage of justice.

Hypnotizability, preference for an imagic cognitive style, and memory creation in hypnosis.

We sought to extend the finding (Laurence & Perry, 1983) that it is possible through hypnosis to create a pseudomemory of a specific event. Subjects were compared on their responses to a hypnotic suggestion. We also examined the relation between nonhypnotic measures (Preference for an Imagic Cognitive Style [PICS] test and the Tellegen Absorption Scale [TAS]) and response to the suggestion. Highly (45.45%) and moderately-highly (46.15%) susceptible subjects believed that the pseudomemory was veridical, but none of the low susceptible subjects did so. Together, hypnotic susceptibility, the PICS, and their interaction more strongly predicted pseudomemory creation than any of these main effects alone. Performance on the TAS was also related to the occurrence of pseudomemory, but this relation was redundant with performance on the other measures. These results point to the complexity of the variables involved in pseudomemory creation during hypnosis.

Bateman bipolar hip arthroplasty for femoral neck fractures. A five- to ten-year follow-up study.

Displaced femoral neck fractures in 128 patients were treated with cemented Bateman universal proximal femoral bipolar hemiarthroplasties. The follow-up period ranged from five to ten years. In the surviving 49 cases, the average follow-up period was seven years and five months. Seventy-nine percent of surviving patients had no or slight pain after their primary procedure. None of these patients developed acetabular protrusio. Ten percent of the survivors required late revision; 88% of the unrevised hips had no or slight pain. When compared with studies of noncemented Moore and Thompson fixed-head prostheses, the cemented Bateman bipolar prosthesis had decreased protrusio and less pain.

Studies on the subchronic nephrotoxic potential of styrene in Sprague-Dawley rats.

The nephrotoxic potential low non-toxic dose of styrene was studied in male Sprague-Dawley rats. Groups of rats received i.p. injections of styrene in corn oil at doses 0, 2.9, and 5.8 mmol/kg once daily, 5 days/week for 6 consecutive weeks. After collection of urine for 0-24 and 24-48 h following the end of the treatment, the rats were sacrificed. A significant increase in the excreted urinary volume was noticed at 5.8 mmol styrene during 0-24 and 24-48 h, relative to control, whereas urinary concentrations of gamma-glutamyl transpeptidase and glucose were significantly elevated during the 24-48-h period. Urinary activity of N-acetyl-beta-D-glucosaminidase was increased at the higher dose of styrene during 0-24 and 24-48 h. The capacity of renal cortical slices to accumulate p-aminohippurate was significantly reduced 48 h after the exposure to any dose of styrene. Electron microscopic examination of renal cortex 48 h after the exposure to a higher dose revealed the presence of enlarged mitochondria having more electron dense matrix. The data suggest that subchronic exposure to a very low non-toxic dose of styrene may have the potential to elicit nephrotoxicity preferentially in the proximal tubular region of the rat kidney.

[Prospective study of arterial pressure during pregnancy. Prediction of hypertensive complications]. / Etude prospective de la tension artérielle au cours de la grossesse. Prédiction des complications hypertensives.

A prospective study of measure of blood pressure was conducted in 366 pregnant women at each antenatal visit, using an automatic random-zéro sphygmomanometer. In fourteen patients, among 244 primigravidae, who developed preeclampsia, systolic and diastolic arterial blood pressures were already significantly elevated by 13-16 weeks of pregnancy. This difference was sustained throughout until delivery. In addition, the systolic and diastolic arterial blood pressure, in those women destined to develop preeclampsia, did not show a dip between 13-20 weeks as in the normotensive group. There was no difference in arterial blood pressure during pregnancy between primigravidae and multigravidae who remained normotensive.