Successful HLA haploidentical myeloablative stem cell transplantation for aggressive hepatosplenic alpha/beta (αβ) T-cell lymphoma

Hepatosplenic T cell lymphoma (HSTCL) is a type of hematologic neoplasia with a poor prognosis and a high frequency of refractoriness to conventional chemotherapy. The results obtained by high dose chemotherapy followed by autologous stem cells transplantation seem to be a more effective option but still unsatisfactory. Also the role of allogeneic stem cell transplantation is still unclear, although the few cases reported on the literature would seem to show good results in overall survival rates.

In this paper, we reported the patient׳s medical history affected by a αβ variant of hepatosplenic T cell successfully rescued with a haploidentical transplant.

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Hepatosplenic T-cell lymphoma is associated with a poor prognosis.

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Allogeneic stem cell transplantation has a role in treatment of refractory lymphoma.

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The haploidentical SCT may offer a strategy in patients without a matched donor.

Renal Artery Thrombosis

The diagnosis of acute renal infarction is often delayed or failed due to the rarity of the disease and to its non-specific clinical presentation. Cigarette smoking, with its vasoconstrictive and prothrombotic effects, is a known and sure risk factor for the development of the atheroembolic artery disease.

Case study

This is the report of a case of acute renal infarction in a heavy-smoking patient, a 66-year-old man who arrived at our ward for right worsening backache with vomit and abdominal pain not reacting to the analgesic therapy. A urgent ultrasound showed excretory axes not dilated bilaterally. Therefore, we had to perform further diagnostic tests (CT and then angiography) which highlighted a case of a right massive renal infarction due to complete thrombotic obstruction of the renal artery with patent contralateral ramification. We performed a PTA and then a local infusion of thrombolytic (metalyse 2 mg in 10’). After this treatment the patient showed an immediate stop of the hurting symptomatology, an improvement of the flow and an opacification of the parenchyma. (lower and medium part) with persistence of vision concerning endoluminal thrombosis. A CT angiography 20 days later, after home therapy with LMWH at therapeutic doses, confirmed a restored and normalized vascularization of the lower and medium part of the right kidney.

Conclusions

In the light of these case results - good revascularization of the lower 2/3 of the right kidney, despite a prolonged time of ischemia from the beginning of the symptoms to the diagnosis and to the further thrombolytic therapy (about 14 hours) -, we assume that a wider use of the Doppler method can be of some usefulness, in case of recurring colics especially not reacting to analgesic therapy with negative ultrasonography check-up for the dilatation of the excretory routes, in order to considerably reduce the diagnosis time of renal diseases of vascular type.

Chiral separation of amino acids by copper(II) complexes of tetradentate diaminodiamido-type ligands added to the eluent in reversed-phase high-performance liquid chromatography: a ligand exchange mechanism

In this paper we report a study on the mechanism of the enantiomeric separation of unmodified D,L-amino acids in RP-HPLC by copper(II) complexes of two tetradentate diaminodiamido ligands, (S,S)-N,N'-bis(phenylalanyl)ethanediamine (PheNN-2) and (S,S)-N,N'-bis(methylphenylalanyl)ethanediamine (Me2PheNN-2), added to the eluent. The aim is to investigate whether and how a copper(II) complex with no free equatorial positions can perform chiral discrimination of bidentate analytes such as unmodified amino acids. The problem is approached in a systematic way by: (a) varying the different chromatographic parameters (pH, selector concentration, eluent polarity); (b) performing chiral separation with the selector adsorbed on the stationary phase; (c) studying the ternary complex formation of these ligands with D- and L-amino acids in solution by glass electrode potentiometry and electrospray ionization MS. All the experimental data are consistent with a mechanism of chiral recognition, based on ligand exchange, which involves as selectors the species [Cu2L2H(-2)]2+ and [CuLH(-2)] and proceeds by displacement of two binding sites from the equatorial positions, giving rise to the ternary species [CuLA]+ and [CuLH(-1) A]. The most important factor responsible for chiral discrimination seems to be the affinity of the diastereomeric ternary complexes for the stationary phase since no enantioselectivity is observed in solution.

Stent implantation without predilation in patients with a single, noncalcified coronary artery lesion

The purpose of this study was to assess the feasibility of stent implantation without predilation in patients with a single, noncalcified coronary artery lesion. A total of 122 patients were randomized to receive a stent with or without predilation; direct stent placement was possible in 59 of the 61 patients (97%) with an immediate and long-term clinical follow-up similar to that observed in the group of patients treated conventionally.

[The hemodynamics laboratory without cine film. A comparison between the production costs of 35-mm film and the recordable compact disk]

BACKGROUND

For more than 35 years, cine film has been used as the standard recording medium for coronary angiography. At present, the DICOM and the CD-R format have been established as the standard media for the transport of cardiac angiographic images in place of cine angiographic film. The aim of the study was to compare the media production costs between two cardiac catheterization laboratories, with and without cine film.

METHODS

We collected data from two different laboratories in the same geographic area which perform about 1000 procedures/year, using a similar digital x-ray imaging system. In one lab, images are recorded on 35-mm film at 25 frames/sec. In the other one, the image support is based on a CD-R. For each laboratory we considered both direct patient and variable equipment costs. Direct patient costs in the film-lab include: cine film, processing chemicals, processing labor, chemical disposal, maintenance; in the digital lab: CD-R costs and masterization time. Equipment costs in the film-lab include: cine camera, cine film processor and cine projector; in the filmless lab a DICOM formatter and a review workstation. The equipment amortization costs are considered over a three-year period.

RESULTS

Total direct patient costs are 90,000 lira for the film and 14,000 lira for the CD-R. Equipment costs are 193,000,000 lira in the film-lab and 150,000,000 lira in the filmless one. Overall cost per patient is 154,300 lira for the cine film and 64,000 lira for the CD-R.

CONCLUSIONS

This study shows that the media costs per patient for a digital DICOM CD-R format system are substantially less than for 35-mm film, permitting savings of more than 90,000,000 Italian lira per year in a mid-volume cardiac catheterization laboratory.

Copper(II) complexes of N2-alkyl-(S)-amino acid amides as chiral selectors for dynamically coated chiral stationary phases in RP-HPLC

Copper(II) complexes of N2-octyl-(S)-phenylalaninamide (Noc-Phe-NH2), N2-dodecyl-(S)-phenylalaninamide (Ndo-Phe-NH2), and N2-octyl-(S)-norleucinamide (Noc-NLeu-NH2), dynamically adsorbed on a reversed-phase C18 column, were able to perform the direct enantiomeric separation of unmodified amino acids, amino acid amides and esters, hydroxy acids, and dipeptides by elution with aqueous or mixed aqueous-organic solutions containing copper(II) sulphate or acetate. The role played by several parameters in the separation procedure was examined with the copper(II) complex of Noc-Phe-NH2 [concentration of the copper(II) ion in the eluent, pH and eluent polarity, amount of adsorbed selector]. The separation was shown to occur entirely on the stationary phase. The mechanism of chiral discrimination is discussed in terms of the chromatographic parameters and of the structure of the copper(II) complexes in solution and in the solid state. The chiral stationary phase maintained its separation ability for about 3 months. However, the column could be easily restored by recovering the selector with methanol and repeating the loading procedure.

Analysis of variance applied to determinations of equilibrium constants

The statistical analysis of variance has been applied to the values of the equilibrium constants of the glycinate-proton and glycinate-nickel systems, determined in different laboratories by pH-titration in aqueous solution. The analysis shows how the main part of the error derives from the variability from one titration to another even in the same laboratory. Therefore the data for a single titration (k) must be processed separately, thus yielding a mean value for the equilibrium constant logbeta (pqr)(k) of the species M(p)H(q)L(r); from these mean values for different titrations in each laboratory l, a within-laboratory grand average, logbeta (pqr)(l), can be calculated; the variance of this grand average measures the experimental error. A further analysis of the data from the different participating laboratories shows that there were no significant differences between laboratories for the constants reported. From these results it can be inferred that all the values of the mean constants logbeta (pqr)(k) for one species, as determined separately for each titration in four laboratories, belong to the same population. A chi(2) analysis of these populations demonstrates that the stability constants of the species HL, H(2)L(+), NiL(+), NiL(2) (with L(-) = glycinate) are normally distributed, but not that for NiL(-)(3). Therefore, general mean values of the first four constants can be calculated and proposed as reliable standard values at 25 degrees and I = 1.0M Na(Cl): protonation of glycinate, log beta(011) = 9.651(12), log beta(021) = 12.071(26); nickel-glycinate complexes, log beta(101) = 5.615(35), log beta(102) = 10.363(62). These values indicate that the standard deviations are rather higher than those often reported in the literature.