Lymphoma in Sjögren's syndrome: no need for repetitive screening ultrasounds of the major salivary glands and neck in asymptomatic patients.

OBJECTIVE: Patients with primary Sjögren's syndrome (pSS) have an increased risk of lymphoma, especially mucosa-associated lymphoid tissue (MALT) lymphoma of the salivary glands. Risk factors for lymphoma are well known, but there are no studies on screening by imaging. Therefore, we aimed to assess the usefulness and adverse effects of ultrasound of the major salivary glands and neck as lymphoma screening. METHOD: A retrospective, single-centre, analysis of imaging studies in pSS patients was conducted. Imaging studies were classified as either screening examinations (asymptomatic patients) or occasion-related (imaging due to signs of lymphoma or at least moderate systemic activity). Results were categorized as: not suspicious; requiring control; triggering tissue sampling with exclusion of lymphoma; or triggering tissue sampling with diagnosis of lymphoma. RESULTS: The study included 134 patients and covered 1031 patient-years. Lymphoma was diagnosed in 15 patients (11.2%), all of whom had clinical signs of lymphoma at the time of diagnosis. During this period, 569 screening examinations and 179 occasion-related examinations were conducted. None of the screening examinations detected lymphoma, but follow-up imaging was recommended in 17.1% (95% CI 14.2-20.4%) and invasive exclusion of lymphoma was performed in 0.5% (95% CI 0.1-1.5%). In contrast, lymphoma was detected in 6.1% (95% CI 3.5-10.6%) of occasion-related examinations. CONCLUSION: pSS patients with neither signs of lymphoma nor increased systemic disease activity did not benefit from screening. In contrast, patients with symptoms of lymphoma or at least moderate systemic activity can benefit from imaging of the neck and major salivary glands.

Evolution of internal stresses in the plain ferritic steel studied by neutron diffraction in situ upon tensile straining.

The present in situ neutron diffraction study aims to investigate the response of selected lattice planes in the polycrystalline material upon tensile loading. For this purpose, the 0.1C-0.4Mn construction steel was selected as a simple model material. The tensile deformation test was performed in the incremental mode in which each individual deformation step was followed by unloading. The neutron diffraction spectra were collected both upon loading and unloading and the behavior of the diffraction profiles in the elastic as well as in the plastic region of the deformation curve was examined in detail. Whereas the behavior of the lattice strains during straining and the evolution of the residual intergranular strains have already been described in other papers, the present work is focused mainly on profile broadening effects measured in the same deformation regime. The estimate of microstrain evolution was done by using the single-line profile analysis method. Comparison of microstrain values in the loaded/unloaded state and in the elastic and plastic regions offers an interesting possibility to estimate the contribution of the type II and type III microstrains.

Conformation of poly(L-lysine)-graft-poly(ethylene glycol) molecular brushes in aqueous solution studied by small-angle neutron scattering.

Small-angle neutron scattering (SANS) has been employed for the analysis of conformations of poly(L-lysine)-graft-poly(ethylene glycol) (PLL-g-PEG) molecular bottle brushes in aqueous solutions. The degree of polymerisation of the PEG chains was systematically varied in order to unravel dependence of the conformational properties of the bottle brushes on the molecular weight of the grafted chains. The grafting density was kept constant and high enough to ensure strong overlap of the PEG chains. The scattering spectra were fitted on the basis of the model of an effective worm-like chain with the account of average radial distribution and local fluctuations of the PEG density in the bottle brush. The results of the fits indicate that molecular brushes retain weakly bent configuration on the length scale of the order of (or larger than) the brush thickness. This finding is in agreement with earlier simulation and recent theoretical results.

Phase Behavior, Structure, and Physical Properties of the Quaternary System Tetradecyldimethylamine Oxide, HCl, 1-Hexanol, and Water.

The phase diagram of the ternary surfactant system tetradecyldimethylamine oxide (TDMAO)/HCl/1-hexanol/water shows with increasing cosurfactant concentration an L(1) phase, two L(alpha) phases (a vesicle phase L(alpha1) and a stacked bilayer phase L(alphah)), and an L(3) phase, which are separated by the corresponding two-phase regions L(1)/L(alpha) and L(alpha)/L(3). In this investigation, the system was studied where some of the TDMAO was substituted by the protonated TDMAO. Under these conditions, one finds for constant surfactant concentration of 100 mM TDMAO a micellar L(1) phase, an L(alpha1) phase (consisting of multilamellar vesicles), and an interesting isotropic L(1)(*) phase in the middle of the L(1)/L(alpha) two-phase region. The L(1)(*) phase exists at intermediate degrees of charging of 30-60% and for 40-120 mM TDMAO and 70-140 mM hexanol concentration. At surfactant concentrations less than 80 mM the L(1)(*)-phase borders directly on the L(1) phase. The phase transition between the L(1) phase and the L(1)(*) phase was detected by electric conductivity and rheological measurements. The conductivity values show a sharp drop at the L(1)/L(1)(*) transition, and the zero shear viscosity of the L(1)(*) phase is much lower than in L(1) phase. The form and size of the aggregates in L(1)(*) were detected with FF-TEM and SANS. This phase contains small unilamellar vesicles (SUV) of about 10 nm and some large multilamellar vesicles with diameters up to 500 nm. The system exhibits another peculiarity. For 100 mM surfactant, the clear L(alpha1)-phase exists only at chargings below 30%. With oscillating rheological measurements a parallel development of the storage modulus G' and the loss modulus G" was observed. Both moduli are frequency independent and the system possesses a yield stress. The storage modulus is a magnitude larger than the loss modulus. Copyright 2000 Academic Press.

[Vaginal sonography in the diagnosis of and therapeutic indications in cervical incompetence]. / La vaginosonographie dans le diagnostic et l'indication thérapeutique de l'insuffisance cervicale.

Besides its contribution to the diagnosis, the vaginal sonography or transvaginal ultrasound is a remarkable support in the indication of the treatment of cervical incompetence and its control after cerclage. The study group consisted of 40 patients, their gestational age between 16 and 29 weeks, admitted in the department for cervical incompetence. After transvaginal ultrasound examination combined to the results of clinical evaluations, 32 pregnant women were retained for cervical cerclage. The other cases were given only medical treatment. It springs out from the analyse of the criteria of exploration, the absence of a funnel shaped formation of internal os in the cases non retained for cervical cerclage at the vaginosonography examination. Likewise, but in a less degree (6/8) a cervical dilatation greater than or equal to 10 mm. The softening of the cervix was also absent in the majority of the cases (5/8) at the clinical examination. On the contrary, the cervix was shortened in all cases, both in clinical and ultrasound examination. Another important element is the advanced gestational age which is in favour of medical treatment and ultrasound check up. The average gestational age of the group without cerclage is 26.87 weeks and that of the whole study group is 23.64 weeks. The vaginalsonography makes possible the follow up, in the postoperative periods after cervical cerclage and the appreciation of the outline of internal os and the localisation of the band used for cerclage.

[Hygienic relations and stability of drugs in peridural long-term infusion with implanted or external pumps]. / Hygieniche Verhältnisse und Stabilität der Medikamente bei periduraler Langzeit-Infusion mit implantierten oder externen Pumpen.

Implantable devices (implanted pump/implanted catheter and port) are recommended for continuous epidural application of opiates or local anaesthetics in order to reduce hygienic problems during long term epidural medication. No signs of contamination could be found during bacteriologic culture of residual volumes of 30 patients treated with epidural drug delivery systems and of samples collected during an in vitro investigation (incubation of filled external pump systems at body temperature/storage of syringes with a premixed solution of opiate and local anaesthetic for repeated epidural bolus application). As demonstrated in a case report prophylactic antibiotic coverage prior to implantation may be necessary in patients with a preexisting susceptibility to infection. The concentrations of morphine (radioimmuno-assay) and of bupivacaine (gas-solid chromatography) within the reservoir were stable during clinical therapy as well as during the in vitro experiments.