Intravenous catheterisation of conventional pigs without application of antimicrobial agents.

In six experiments 43 castrated male conventional pigs weighing 25-41 kg were catheterised by inserting a cannula via the jugular vein into the cranal caval vein. The catheters were taped to the spinal neck region where the tap stops were located. Antimicrobial agents were not applied. One pig died 32 hour after surgery from Porcine Stress Syndrome. The catheters remained patent for at least nine days in 38 of the remaining 42 animals (90%). In two animals the catheter by mistake was not inserted into the jugular vein. Two animals got catheters with a one-way blockage four days after surgery. In these animals autopsy revealed thrombosis and phlebitis of the occluded vein and a valve-like thrombus at the tip of the catheters. In seven of the 43 pigs the effects of anaesthesia, surgery and catherisation were followed using rectal temperature and haematological and some blood biochemical parameters for nine days after the surgery. It is concluded that this catheterisation technique, without application of antimicrobial agents, can be used well for experimental infections and pharmacokinetic studies.

Retinoic acid as antileukemic therapy in a patient with acute promyelocytic leukemia and Aspergillus pneumonia.

A patient with acute promyelocytic leukemia (APL) and laboratory evidence of fibrinolysis who could not be treated with aggressive cytostatic regimens because of Aspergillus pneumonia was treated with cis-retinoic acid (RA), a substance that can induce differentiation and maturation of APL cells. After seven weeks of daily oral treatment, he went into complete remission, and signs of coagulopathy disappeared. Meanwhile, the Aspergillus pneumonia could be treated adequately. Based on the experience in this single patient, RA deserves further evaluation in the treatment of APL.

Serum beta 2-microglobulin: a real improvement in the management of multiple myeloma?

Beta 2-microglobulin (B2-m) determinations in serum have recently been introduced as a method of stratifying patients suffering from multiple myeloma. Conflicting results from several studies prompted us to study retrospectively the correlation of B2-m with presenting features and disease stage, as well as the prognostic value of B2-m, in 87 myeloma patients. Significant correlations were found between B2-m and presenting features such as haemoglobin level, serum calcium level and total body myeloma cell mass. The strongest correlation existed between B2-m and serum creatinine (r = 0.68). B2-m did not discriminate between the different disease stages as defined by Durie and Salmon, nor between myeloma Stage IA and monoclonal gammopathy of undetermined significance (MGUS). Considered alone, B2-m was found to have prognostic value in terms of survival. This correlation disappeared after correction for serum creatinine level and tumour load (multivariate analysis). Furthermore, changes in tumour load during therapy were not reflected in changes in B2-m levels, thereby rendering B2-m levels invalid as tumour marker. Our findings indicate no value for B2-m determinations in the staging and follow-up of myeloma patients.

Plasma spermidine concentrations as early indication of response to therapy in human myeloma.

Eighteen patients with melphalan refractory myeloma were treated with vindesine and prednisone. Plasma spermidine concentrations were measured by radioimmunoassay before and after a single vindesine injection. Seven patients showed a significant rise of plasma spermidine after vindesine and five of these showed a clinical response on further evaluation. Of the 11 patients who did not show raised spermidine concentrations, 10 did not respond to the therapy. The correlation between clinical response/rise of spermidine and between non-response/no rise of spermidine was statistically significant (p less than 0.05). Pretreatment spermidine concentrations did not distinguish those who responded to treatment nor did they differ in patients and controls.

Role of metastatectomy without chemotherapy in the management of osteosarcoma in children.

In a series of 18 consecutive non metastatic osteosarcoma patients, metastases developed in 12 and successful metastatectomies could be performed in 6. No adjuvant chemotherapy was given. Four of these 6 patients survived. The importance of length of disease-free survival is described. Radiotherapy and chemotherapy as adjuvants to prevent or postpone the development of metastases are mentioned and an EORTC-SIOP trial on this subject is briefly discussed.