[Acquired haemophilia A].

A 74-year-old man developed a severe bleeding disorder on the basis of acquired Factor VIII (F VIII) inhibitor. Coagulation assays showed a prolonged activated partial thromboplastin time (APTT) with a normal prothrombin time (PT);F VIII level was 0.07 IU and F VIII inhibitor level 8.

Central nervous system relapse in non-Hodgkin lymphoma. A single-center study of 532 patients.

Objectives: To define the cumulative risk of central nervous system (CNS) relapse in systemic non-Hodgkin lymphoma (NHL); to assess the risk factors of age, sex, malignancy grade, stage, localization, and response to initial therapy; and to evaluate the effect of CNS prophylaxis.

Patients And Methods: An unselected group of 532 patients with systemic NHL. A retrospective analysis.

[Rupture of the quadriceps tendon; cannot be missed?].

In four patients, two men aged 59 and 68 years and two women aged 59 and 50 years, a unilateral rupture of the quadriceps tendon was diagnosed. In two patients the disease was initially misdiagnosed. A depression was palpable in all patients just on the proximal side of the patella.

Nature's high-voltage injuries: sometimes a deadly consequence.

A patient is described who presented with the clinical picture of respiratory failure, persistent comatose state and myocardial injury after being struck by lightning. The discussion reviews the management of lightning injuries with emphasis on cardiovascular and neurological complications.

Using a feed-forward network to incorporate the relation between attractees and attractors in a generalized discrete Hopfield network.

This paper demonstrates how a feedforward network with constant connection matrices may be used to train a Hopfield style network for pattern recognition. The connection matrix of the Hopfield style network is asymmetric and its diagonal is non-zero. The Hopfield style network referred to as a GDHN is trained to incorporate a relation between attractees and attractors.

The spectrum of chronic mature T-cell disorders: a report of four cases.

We describe four patients with a mature T-cell disorder. These four specific entities belong to a group formerly called "T-cell chronic lymphocytic leukaemia" (T-CLL). Nowadays we understand that these chronic T-cell lymphoproliferative disorders consist of four different entities.

Decision making for the surgical management of aortic coarctation associated with ventricular septal defect.

Coarctation of the aorta and associated ventricular septal defect may be repaired simultaneously or by initial coarctation repair with or without banding of the pulmonary artery. The question is whether specific preoperative criteria can enable the surgeon to choose the optimal surgical management. Between 1980 and 1993, 80 infants younger than 3 months with coarctation and ventricular septal defect were treated surgically.

[2 patients with neurocysticercosis].

Cysticercosis of the CNS, caused by the pork tapeworm Taenia solium, was diagnosed on the basis of serological and imaging examination in two patients, a woman aged 50 and a man aged 40 years. The former patient suffered from aphasia, headache and epileptic attacks, the latter mostly from epilepsy. Cysticercosis of the CNS occurs mainly in the tropics but is occasionally observed in the Netherlands in people who have been to the tropics, such as the patients reported.

Creatinine and surveys: an assessment.

We analysed the results of surveys on creatinine held in The Netherlands during the years 1992, 1993 and 1994. Assay results of 113 samples were reviewed: 88 human sera and 25 samples of animal origin. The results of 5 creatinine assays, 4 based on the Jaffé reaction and 1 enzymatic procedure, are discussed.

Classifying cervical cells using a recurrent neural network by building basins of attraction.

This paper describes the result of classifying cervical cells employing a novel way of using a Hopfield-style neural network for classification. This method could be used as part of an automated cervical screening system. Rather than storing the exemplars (training elements) as stable points, a connection matrix is determined, using perceptron-type learning, such that the exemplars are placed in basins of attraction.

Diagnostic analysis of total protein, albumin, white cell count and differential in ascitic fluid.

Accurate and precise procedures are described for the measurement of total protein, albumin, white cell count and differential in ascitic fluid. The total protein method (biuret) on the serum chemistry analyser, Bayer-Technicon Chem-1, was calibrated against the biuret reference method in the measuring range from 1-100 g/l, covering serum as well as ascitic fluid values. The albumin method (bromcresol green) on the Chem-1 was calibrated for the measurement range from 1-50 g/l against the new human plasma protein international reference preparations and compared to the nephelometric method on the Beckman Array, which was also calibrated against these reference preparations.

Influence of age on survival, late hypertension, and recoarctation in elective aortic coarctation repair. Including long-term results after elective aortic coarctation repair with a follow-up from 25 to 44 years.

The optimal age for elective repair of aortic coarctation is controversial. The optimal age should be associated with a minimal risk of recoarctation, late hypertension, and other cardiovascular disorders. The purpose of this retrospective study is to determine the actuarial survival after aortic coarctation repair 25 years or more after operation and to calculate the optimal age for elective aortic coarctation repair.

Repeated episodes of myocardial ischaemia during combined thoracic epidural-isoflurane anaesthesia.

A patient with a history of coronary artery diseases developed new ST segment depressions in the ECG registration during a low dose (0.7%) isoflurane anaesthesia that was combined with a continuous thoracic epidural analgesia. Simultaneously a small decrease in mean arterial blood pressure (MAP) was noted.

Skin contamination, airborne concentrations, and urinary metabolite excretion of propoxur during harvesting of flowers in greenhouses.

In eight greenhouses used for carnation culture, workers engaged in harvesting (n = 16), were monitored for dermal and respiratory exposure and urinary excretion of propoxur. Dermal exposure of hands and forearms was estimated from dislodgable foliar residue, using a transfer factor (a measure of transfer of pesticides from leaves to the skin) and the total number of working hours. Total estimated dermal and respiratory exposure during harvesting ranged from 0.

Risk assessment of dermal exposure of greenhouse workers to pesticides after re-entry.

On 18 farms for rose culture in greenhouses in The Netherlands, dermal exposure of hands and forearms to abamectin (avermectin B1), dodemorph (4-cyclododecyl-2,6-dimethylmorpholinium acetate) and bupirimate (5-butyl-2-(ethylamino)-6-methyl-4-pyrimidinyl dimethylsulphate) was measured during crop activities. Dermal exposure during cutting (75 workers) amounted to 13 micrograms/h, 1.8 mg/h, and 2.

Pesticides in the cultivation of carnations in greenhouses: Part II--Relationship between foliar residues and exposures.

The relationship between the levels of dermal and respiratory exposure to pesticides and the amount of pesticide on the leaves of the plants has been studied during cutting of carnations in greenhouses. The study was focused on four pesticides and performed in 18 farms in the Netherlands. Dermal exposure measured by using long-sleeved cotton gloves is strongly related to the amount of dislodgeable foliar residue (DFR).

Pesticides in the cultivation of carnations in greenhouses: Part I--Exposure and concomitant health risk.

Respiratory exposure and dermal exposure of the hands and forearms to the pesticides chlorothalonil, thiophanate-methyl, thiram, and zineb during application and during crop activities have been measured on 18 farms for carnation culture in glass-covered greenhouses in the Netherlands. Farms were selected according to a "worst case" strategy with regard to dermal exposure during cutting of flowers. For 94 workers, the geometric mean dermal exposure rate during cutting (measured on long-sleeved cotton glove monitors) was 10.

A new model for diurnal blood pressure profiling. Square wave fit compared with conventional methods.

For the characterization of diurnal blood pressure variation, we developed a simple mathematical model that nevertheless does justice to the specific form characteristics of individual blood pressure registrations. Analysis was based on 24-hour continuous intra-arterial measurement of blood pressure obtained in 23 hospitalized patients with mild-to-moderate untreated essential hypertension (mean +/- SD, 112 +/- 13 mm Hg). The day-night difference for mean arterial pressure varied markedly (mean, 18.

Polyclonal versus monoclonal rejection prophylaxis after heart transplantation: a randomised study.

Recent studies comparing the effects of induction therapy with polyclonal antilymphocyte globulins (ALG) or with monoclonal T-cell-specific antibodies are not unanimous. Therefore, 55 heart recipients were allocated to either 7-day courses of polyclonal ALG (n = 28) or of monoclonal OKT3 (n = 27). Additionally, azathioprine and low dose steroids were given.

Occurrence of lymphoproliferative disorder after heart transplantation is related to the total immunosuppressive load.

Heart transplant recipients are at a high risk for the development of post-transplant lymphoproliferative disorders (PTLD). We explored the relationship between the incidence of PTLD and the immunosuppressive therapy in 150 consecutive patients who received a cardiac transplant at our centre. None of our patients treated with cyclosporin A and prednisone only (n = 41) developed PTLD.