Hypoplastic superficial femoral artery associated with bilateral persistent sciatic arteries: a diagnostic pitfall.

A patient with unsuspected bilateral persistent sciatic arteries (PSAs) underwent angiography following a gunshot wound to the right thigh. A hypoplastic superficial femoral artery associated with this rare vascular anomaly was misdiagnosed as being traumatically occluded. Pitfalls in the diagnosis of PSA as well as the embryology, clinical features, and complications are discussed.

Prospects for the diagnosis of malignant hyperthermia susceptibility using molecular genetic approaches.

MHS is a heterogeneous pharmacogenetic disorder in the human that is likely to be caused by one of a variety of genetic defects, in one of a number of genes. Direct molecular methods will provide a rapid, efficient, non-invasive, and low-cost screening test once the causative genetic mutations have been identified. However, until this objective is met, indirect molecular genetic methods can be used to demonstrate the inheritance of an abnormal gene in certain family members at risk.

Splenopneumopexy: evaluation with splenoportography.

Splenopneumopexy is a procedure designed to create a portopulmonary shunt in patients with esophageal variceal bleeding who are not candidates for conventional portosystemic shunts. Splenoportography was performed in three patients who underwent this surgical procedure. Portopulmonary shunts were identified in two of three patients.

Subclavian artery angioplasty for treatment of coronary artery steal syndrome.

Three patients underwent percutaneous transluminal angioplasty for treatment of subclavian artery stenosis producing the coronary artery steal syndrome. Technical success and immediate relief of angina were achieved in all three patients. Clinical follow-up ranged from 4 to 16 months.

Biochemical modulation of fluorouracil with leucovorin: confirmatory evidence of improved therapeutic efficacy in advanced colorectal cancer.

In a previous study (J Clin Oncol 7:1407-1417, 1989), we identified two dosage administration schedules of fluorouracil (5FU) combined with leucovorin that were superior to single-agent 5FU for the treatment of advanced colorectal cancer. In this same study, a regimen of 5FU plus high-dose methotrexate (MTX) demonstrated a suggestive advantage over 5FU alone. To permit a more definitive comparison, we have extended our evaluation of these three regimens to involve an additional 259 patients.

Evidence for genetic heterogeneity in malignant hyperthermia susceptibility.

Malignant hyperthermia susceptibility (MHS) is a clinically heterogeneous pharmacogenetic disorder characterized by accelerated metabolism, hyperthermia, and frequently muscle rigidity. MHS is elicited by all commonly used potent inhalation anesthetics and depolarizing neuromuscular blockers and remains an important cause of death due to anesthesia. Recent linkage studies suggest a single genetic locus for this disorder on chromosome 19q13.

Polymorphisms in the transcribed 3' untranslated region of eukaryotic genes.

In this review we present preliminary evidence for a new class of polymorphism that may be used in a systematic way to map cDNAs efficiently and to expedite the construction of a high-resolution genetic map of the human genome. Ultimately, transcribed 3' untranslated polymorphisms will warrant further study because they should be widely distributed throughout the genome within transcribed sequences, and they can be readily identified as a result of cDNA cloning and sequencing. Furthermore, these markers should be universally available on the basis of the sequence data and highly useful in linkage analyses.

A phase II evaluation of menogaril in cisplatin-refractory advanced ovarian carcinoma. A collaborative trial of the North Central Cancer Treatment Group and the Mayo Clinic.

Forty-one women with advanced, recurrent epithelial ovarian carcinoma (in whom prior chemotherapy with a platinum-based regimen failed) were treated with menogaril 200 mg/m2 intravenously every 4 weeks in a Phase II trial. Partial responses were seen in two of 19 (10.5%) measurable disease patients and three of 12 (25%) nonmeasurable but evaluable patients, an overall objective response rate of 16.

Intellectual loss in Alzheimer's dementia and WAIS-R intrasubtest scatter.

Patterns of intrasubtest scatter in the WAIS-R protocols of patients (n = 32) with Alzheimer's disease were compared to those of normal elderly controls (n = 32). The Alzheimer's patients showed more randomly dispersed item failures on some subtests, but normal controls showed more intrasubtest variability on other measures. Rates of correct diagnostic classification based on scatter measures were only slightly better than chance despite the presence of prominent anomia, memory impairment, construction apraxia, and significant decline from premorbid intellectual level in demented patients.

Phase II study of ifosfamide with mesna in adult patients with recurrent diffuse astrocytoma.

Sixteen patients who developed CT or MRI scan evidence of recurrent diffuse astrocytoma after radiation therapy and nitrosourea-containing chemotherapy received ifosfamide (2500 mg/m2/day for 3 consecutive days) and mesna (500 mg/m2/dose, 5 doses/day for 3 consecutive days). Toxicity consisted primarily of leukopenia in that 60 percent of patients developed leukocyte nadirs less than 1500/mcL. Excessive somnolence occurred in three patients and may have contributed to a case of fatal pneumonia in one patient but was reversible in the other two.

Succinylcholine potentiates responses to intravenous acetylcholine in the canine lung periphery.

Using the wedged bronchoscope technique to measure collateral resistance (Rcs), we evaluated the effect of succinylcholine (SCh) on the response to acetylcholine (ACh) and methacholine (MCh) in the lung periphery in six mongrel dogs. Dogs were anesthetized, intubated, and mechanically ventilated. After a stable baseline Rcs was obtained, responses to intravenous ACh (25-200 micrograms), intravenous MCh (3-30 micrograms), and aerosolized ACh (30-100 micrograms/ml for 15 s) were measured.

A phase II randomized trial of megestrol acetate or dexamethasone in the treatment of hormonally refractory advanced carcinoma of the prostate.

The results of a randomized, multicenter, cooperative group trial evaluating hormonal therapy with either megestrol acetate or dexamethasone in advanced, hormonally refractory prostate cancer are reported. Three of 29 patients (approximately 10%) on the megestrol acetate arm experienced an objective response lasting 41, 84, and 202 days, respectively, whereas two of 29 patients (approximately 7%) on the dexamethasone arm achieved an objective response lasting 359 and 512 days, respectively. Twenty of 29 patients (approximately 69%) on the megestrol acetate arm had stable disease lasting for a median duration of 117 days, whereas 21 of 29 patients (72%) on the dexamethasone arm had stable disease for a median duration of 86 days.

In vitro tracheal responses from mice chosen for in vivo lung cholinergic sensitivity.

We selected two inbred strains of mice based on their different in vivo lung responses to intravenous acetylcholine for studies on the in vitro tracheal responses to contractile and relaxing agents. In addition, we studied the role of cyclooxygenase products on the in vitro responses. Tracheal rings were contracted with increasing concentrations of carbachol and KCl and relaxed with increasing concentrations of isoproterenol after contraction with carbachol at the concentration that produced 30, 50, and 70% of the maximal contraction (EC30, EC50, and EC70, respectively) and KCl at the EC50.

A genetic model for evaluation of susceptibility to ozone-induced inflammation.

We examined ozone-induced airway inflammatory responses in inbred mice, and progeny of crosses between them, to investigate genetic susceptibility to ozone. Nine strains of male mice (18-23 g, 5-7 wk) were exposed for 3 h to 2 ppm ozone (O3) or filtered air (control), and pulmonary inflammation was assessed 2, 6, and 24 h after exposure by inflammatory cell counts and total protein content in bronchoalveolar lavage (BAL). The time course of the response to O3 was consistent between the strains.

A genetic approach to the study of lung physiology: understanding biological variability in airway responsiveness.

Genetic techniques are generally applicable to almost any trait or physiological process for which biological variability can be demonstrated. These methods have not commonly been applied to studies on lung pathophysiology, however. The aim of this commentary will be to introduce and discuss the potential application of genetic methods to research on the pathophysiology of asthma.