New species and records of pollen and sap beetles for Iran (Coleoptera: Kateretidae, Nitidulidae)

During recent expeditions in North and Southwest Iran, 10 species of Kateretidae and Nitidulidae (Coleoptera) were found. One species of Kateretidae, Brachyleptus bicoloratus Reitter, 1896, and three nitidulid species, Afrogethes schilskyi (Reitter, 1897), Stachygethes khnzoriani (Kirejtshuk, 1979), and S. nigerrimus (Rosenhauer, 1856) are recorded for the first time for the Iranian fauna (the latter is also a new record for Asia). Thymogethes ahriman (Jelínek, 1981) is herein resurrected to species rank, and two species, Thymogethes kassites sp. nov. and T. khorasanicus sp. nov., are described as new. An updated key to the known Near East and Afghan species of the genus Thymogethes Audisio & Cline, 2009 is also provided. Available and recently collected biological and distributional data, as well as short taxonomic comments, are given for the discussed species.

Four new species of Meligethes Stephens from China and additional data on other species of the genus (Coleoptera: Nitidulidae: Meligethinae)

Four new species of Meligethes Stephens, 1830, M. (s.str.) macrofemoratus (Shaanxi, Ningxia), M. (s.str.) yak (NW Sichuan), M. (s.str.) auropilosus (Tibet) and M. (Odontogethes) aurorugosus (Tibet) spp. nov., are described and illustrated from China. Diagnostic characters distinguishing these new species from closely related taxa are discussed. The previously unknown male of Meligethes (s.str.) aureolineatus Audisio, Sabatelli & Jelínek, 2015 from Sichuan and the previously unknown female of M. (Odontogethes) scrobescens Chen, Lin, Huang & Yang, 2015 from Sichuan are also described. Additional data are also presented on the geographic distribution and life history of other Chinese Meligethes species.

Fauna Europaea: Coleoptera 2 (excl. series Elateriformia, Scarabaeiformia, Staphyliniformia and superfamily Curculionoidea)

Fauna Europaea provides a public web-service with an index of scientific names (including synonyms) of all living European land and freshwater animals, their geographical distribution at country level (up to the Urals, excluding the Caucasus region), and some additional information. The Fauna Europaea project covers about 230,000 taxonomic names, including 130,000 accepted species and 14,000 accepted subspecies, which is much more than the originally projected number of 100,000 species. This represents a huge effort by more than 400 contributing specialists throughout Europe and is a unique (standard) reference suitable for many users in science, government, industry, nature conservation and education. Coleoptera represent a huge assemblage of holometabolous insects, including as a whole more than 200 recognized families and some 400,000 described species worldwide. Basic information is summarized on their biology, ecology, economic relevance, and estimated number of undescribed species worldwide. Little less than 30,000 species are listed from Europe. The Coleoptera 2 section of the Fauna Europaea database (Archostemata, Myxophaga, Adephaga and Polyphaga excl. the series Elateriformia, Scarabaeiformia, Staphyliniformia and the superfamily Curculionoidea) encompasses 80 families (according to the previously accepted family-level systematic framework) and approximately 13,000 species. Tabulations included a complete list of the families dealt with, the number of species in each, the names of all involved specialists, and, when possible, an estimate of the gaps in terms of total number of species at an European level. A list of some recent useful references is appended. Most families included in the Coleoptera 2 Section have been updated in the most recent release of the Fauna Europaea index, or are ready to be updated as soon as the FaEu data management environment completes its migration from Zoological Museum Amsterdam to Berlin Museum für Naturkunde.

The role of chloride in deoxycorticosterone hypertension: selective sodium loading by diet or drinking fluid

To evaluate the role of chloride in the pathogenesis of salt-dependent deoxycorticosterone (DOC) hypertension, we studied young Wistar rats chronically loaded with sodium bicarbonate (NaHCO(3)) or sodium chloride (NaCl) which were administered either in the diet or in the drinking fluid. Selective sodium loading (without chloride) increased blood pressure (BP) in DOC-treated animals only if NaHCO(3) was provided in the diet. In contrast, no significant blood pressure changes were induced by DOC treatment in rats drinking NaHCO(3) solution. Hypernatremia and high plasma osmolality occurred only in rats drinking NaCl or NaHCO(3) solutions. Compared to great volume expansion in NaCl-loaded DOC-treated rats, the degree of extracellular fluid volume expansion (namely of its interstitial fraction) was substantially lower in both NaHCO(3)-loaded groups in which significant hypokalemia was observed. NaHCO(3)-drinking rats without significant blood pressure response to DOC treatment represented the only experimental group in which blood volume was not expanded. In conclusion, our data confirm previous observations that NaHCO(3) loading is less potent in eliciting DOC hypertension than NaCl loading, but blood pressure rise in rats fed NaHCO(3) diet clearly demonstrated that selective sodium loading could potentiate the development of DOC hypertension if NaHCO(3) is offered within the appropriate dietary regimen. The reasons for the failure of NaHCO(3)-drinking rats to elevate blood pressure in response to chronic mineralocorticoid treatment are not obvious. However, the absence of a significant plasma volume expansion together with hypernatremia and increased plasma osmolality suggest a considerable degree of dehydration in these animals which fail to increase their fluid consumption compared to water drinking rats.

The role of chloride in deoxycorticosterone hypertension: selective sodium loading by diet or drinking fluid

To evaluate the role of chloride in the pathogenesis of salt-dependent deoxycorticosterone (DOC) hypertension, we studied young Wistar rats chronically loaded with sodium bicarbonate (NaHCO(3)) or sodium chloride (NaCl) which were administered either in the diet or in the drinking fluid. Selective sodium loading (without chloride) increased blood pressure (BP) in DOC-treated animals only if NaHCO(3) was provided in the diet. In contrast, no significant blood pressure changes were induced by DOC treatment in rats drinking NaHCO(3) solution. Hypernatremia and high plasma osmolality occurred only in rats drinking NaCl or NaHCO(3) solutions. Compared to great volume expansion in NaCl-loaded DOC-treated rats, the degree of extracellular fluid volume expansion (namely of its interstitial fraction) was substantially lower in both NaHCO(3)-loaded groups in which significant hypokalemia was observed. NaHCO(3)-drinking rats without significant blood pressure response to DOC treatment represented the only experimental group in which blood volume was not expanded. In conclusion, our data confirm previous observations that NaHCO(3) loading is less potent in eliciting DOC hypertension than NaCl loading, but blood pressure rise in rats fed NaHCO(3) diet clearly demonstrated that selective sodium loading could potentiate the development of DOC hypertension if NaHCO(3) is offered within the appropriate dietary regimen. The reasons for the failure of NaHCO(3)-drinking rats to elevate blood pressure in response to chronic mineralocorticoid treatment are not obvious. However, the absence of a significant plasma volume expansion together with hypernatremia and increased plasma osmolality suggest a considerable degree of dehydration in these animals which fail to increase their fluid consumption compared to water drinking rats.

[Intensive therapy with paclitaxel (Taxol) and cyclophosphamide followed by administration of G-CSF as a mobilization regimen in patients with breast carcinoma and indications for autologous hematopoietic cell transplantation]

Cyclophosphamide (4 g/m2) and paclitaxel (Taxol) (175, 200 or 250 mg/m2) therapy with subsequent administration of G-CSF (10 micrograms/kg) has been used as intensification and as mobilization therapy for patients with breast cancer. This regimen was used in 19 patients, as part of adjuvant therapy in 14 and as part of therapy of metastatic disease in five. Median number of collected CD34+ cells was 17.5 x 10(6)/kg (2.9-48.1). All patients except one (94.7%) reached minimal required number of CD34+ cells (> or = 3 x 10(6)/kg). Median number of leukapheresis was two. The required number of cells (> or = 3 x 10(6)/kg) was collected in one leukapheresis in 17 out of 19 patients (89.5%) and more than five and 10 x 10(6)/kg CD34+ cells respectively were collected in 14 (73.7%) and 11 (57.9%) patients respectively. No factor significantly influencing the amount of collected cells (except the trend in favour of later year of therapy and large-volume leukapheresis) was identified. Leukopenia gr. 4 was observed in 88.9% of treated patients and febrile neutropenia developed in 46.2% patients. Although the antitumour activity of this chemotherapy was not possible to assess it seems that this intensification could be successfully used as a therapy and as very potent mobilization regimen.

[Congenital aplastic anemia caused by parvovirus B19 infection]

Human parvovirus B19 causes the fifth disease (erythema infectiosum) in childhood. Intrauterine infection by parvovirus in immunocompromised fetus can lead to the severe congenital aplastic anemia. Here we report the case of 2.5-year-old girl with congenital infection with parvovirus B19. The girl was born as a pre-term baby with hydrops, congenital aplastic anemia, and low level of immunoglobulins IgG and IgM. She depended on the repeated blood transfusions and she did not respond to erythropoietin therapy. The parvovirus B19 infection in bone marrow was detected by polymerase chain reaction and its therapy started with intravenous administration of immunoglobulins. Hemoglobin reached normal level one year later, but low levels of parvovirus B19 were detectable for another 6 months. Immunoglobulin treatment was finished when the virus could not be detected in the circulation. However, one-month later parvovirus B19 DNA was detected again. The two months course of immunoglobulin treatment was repeated, and the DNA analysis of blood cells for parvovirus B19 has been negative since then. Five months after the final withdrawal of the immunoglobulin therapy the girl is in a good shape and all lab tests, except for the decreased levels of IgM, are within the normal range. The PCR monitoring of the presence of parvovirus B19 DNA in blood and bone marrow cells during and after the treatment of congenital aplastic anemia caused by parvovirus B19 chronic infection becomes the necessity for the rational therapy.

Linear type trait analysis in the genetic resource ofthe Old Kladrub Horse

Abstract. Linear type evaluations of 214 horses of the Old Kladrub breed for 32 traits were used to analyse the effect of variety (gray and black), sex (stallions and mares) and age. The linear model included the fixed effects of variety, sex and age and interactions variety x sex, variety x age and sex x age. Significant differences were found between the varieties in almost two thirds of the traits. The topline was longer and weaker in the black variety than in the gray one. The Shoulder of the gray horses was longer and more sloped than of the black one. The animals of the gray variety had a wider and deeper ehest. The stance of forelimbs and hind limbs was more correct in the gray variety than in the black one. Significant differences between sexes were observed in a few traits. Only 12 of 32 traits showed significant changes with age. In 10 of 32 traits, at least one of the interactions was significant. The estimates of this study characterise the Old Kladrub breed and its varieties in its current state and allow for more accurate evaluation of the horses.

Function of the isolated perfused kidneys from young or adult rats with post-DOCA-salt hypertension

The function of isolated perfused kidneys in post-DOCA phase of DOCA-salt hypertension was evaluated in rats subjected to DOCA-salt treatment either from youth or only in adulthood. Post-DOCA-salt hypertension was more severe in young than in adult animals. Kidneys isolated from young post-DOCA-salt hypertensive rats had higher renal vascular resistance when compared to adult ones. Perfusion of isolated kidneys over a wide range of perfusion pressure (110-170 mm Hg) has shown similar decrease of glomerular filtration, filtration fraction, diuresis and natriuresis in both age groups of DOCA-salt treated groups. Perfusion pressure-sodium excretion curves had reduced slope and were shifted to the right in both hypertensive groups, indicating huge glomerular damage. Nevertheless, the relative difference in glomerular filtration and sodium excretion between hypertensive rats and age-matched normotensive controls was always greater in younger animals. These results suggest that the more pronounced changes in glomerular hemodynamics and filtration could be involved in higher blood pressure-response of young animals to DOCA-salt treatment.

[Interferon alpha--the drug of choice for patients with chronic myeloid leukemia]

BACKGROUND

The conventional, or standard, treatment of chronic myeloid leukaemia (CML) with hydroxyurea and busulfan has no marked influence on its course or duration. Interferon (IFN) alpha administration has, on the other hand, been shown to induce not only a haematological but also cytogenetic response, i.e. partial or complete bone marrow repopulation by Ph-negative cells. This has triggered studies comparing IFN and conventional chemotherapy. The present work had the purpose to gain experience with IFN alpha treatment and compare the results with hydroxyurea and busulfan treatment, in the chronic phase of CML.

METHODS AND RESULTS

Therapeutic results obtained in 30 patients given IFN alpha and 30 others given conventional chemotherapy were evaluated retrospectively. In spite of the short time of IFN administration (4-27 months), significantly more complete haematological responses (83%) were observed in this than the conventional chemotherapy group (57%). Cytogenetic responses were achieved in 36%, complete cytogenetic remission in 20% of IFN-treated patients. Conventional chemotherapy produced no cytogenetic effect.

CONCLUSION

The results obtained confirm the value and efficacy of IFN-alpha treatment in CML patients, especially if it is started early and the dose is effective. Regular cytogenetic monitoring is necessary. Longer follow-up of the patients will be necessary for evaluation of the IFN effect on the length of their survival.

Three cases of near-tetraploid acute myeloid leukemias originating in pluripotent myeloid progenitors

We report three cases of acute myeloid leukemia (AML) with a near-tetraploid karyotype in most metaphases while lacking chromosomal abnormalities typical for AML. All patients, 63, 72 and 81 years old, were female. In two cases, AML was diagnosed 5-7 months after a cytopenic period while the third patient had a secondary AML after therapy for a pleural tumor. Leukemic blasts were classified as AML M0, AML M1 and AML without further specification. Two patients died on the 18th and 52nd day after the start of cytotoxic chemotherapy, the third patient refused chemotherapy and died 22 days after the diagnosis. The three patients may represent a distinct AML category with the following features: (1) the near-tetraploid karyotype in most bone marrow metaphases examined at diagnosis of AML; (2) the presence of very large myeloid blasts in the bone marrow and dysplastic changes in erythroid and/or megakaryocytic lineages pointing to the origin of AML in pluripotent myeloid progenitor cells; (3) the expression of the CD34 antigen; (4) the low growth of granulocyte-macrophage colony forming cells in culture; and (5) the presence of a preleukemic phase, a higher age and a poor prognosis.

Antitumor action of bovine seminal ribonuclease. Cytostatic effect on human melanoma and mouse seminoma

This paper reports on the antitumor activity of BS RNase on human melanoma and mouse seminoma. Human melanoma cells established in culture were extremely susceptible to BS RNase, administered in concentrations ranging from 1-100 microg/ml. Concentrations of BS RNase over 10 microg/ml caused complete inhibition of cell growth. Bovine pancreatic ribonuclease (RNase A), a prototype of the ribonuclease superfamily, did not exert any effect under these conditions. Based on our previous results, athymic mice bearing human melanoma or mouse seminoma were treated with intratumoral administration of BS RNase (12.5 mg/kg b.w.). This dose was injected for five consecutive days excluding weekends. The intratumoral administration of BS RNase to nude mice bearing human melanoma showed a significant antitumor effect. There were no tumors seen in eighty percent of mice treated for three weeks, and tumors in the other mice diminished significantly. After some delay the tumors started to regrow. Prolonging of the treatment to five weeks had a similar effect. The effect of BS RNase on mouse seminoma was well pronounced. Five to seven doses of BS RNase were sufficient to eliminate tumors in all treated mice. However, as in the previous experiment, the growth of tumor tissue later reappeared.

A comparison of three preinduction cervical priming methods: prostaglandin E2 gel, Dilapan S rods and Estradiol gel

The aim of the study was to evaluate the efficacy of three cervical priming methods. From January 1, 1994 to December 31, 1996 247 patients presenting an indication for induction of labor with an unripe cervix were randomly assigned to one of the following preinduction protocols: 0.5 mg of Prostaglandin E2 gel administered intracervically (n = 83), four hygroscopic Dilapan S rods applied intracervically (n = 82), and 150 mg of Estradiol gel administered intravaginally (n = 82). The inclusion criteria were the patient's informed consent, singleton pregnancy of more than 36 weeks, cephalic presentation, Bishop score < 5 points and reactive non-stress test. If the cervical maturation (Bishop score > or = 5, and/or Bishop score augmentation by 2 points) did not occur after 14 hours of priming, the case was considered a failure. In the opposite case the patient was induced by means of extraamniotic PGE2 administration. The mean gain in the Bishop score was 3.7 points in the PGE2 group 3.9 points in the Dilapan S group, and 2.8 points in the Estradiol group. 71 patients (85.5%) were successfully preinduced in the PGE2 group, 73 (89.0%) in the Dilapan S group, and 63 (76.8%) in the Estradiol group. Labor was induced by preinduction only in 23 patients (31.3%) of the PGE2 group in 17 (20.7%) of the Dilapan S group, and in 14 (17.1%) of the Estradiol group. The mean induction to delivery interval was 7 h 27 min in PGE2 group, 7 h 49 min in the Dilapan S group and 9 h 15 min in the Estradiol group. The Caesarean section rate was 24.4% in the PGE2 group, 10.5% in the Dilapan S group, and 24.4% in the Estradiol group. PGE2 gel and Dilapan S rods proved higher efficacy than Estradiol gel. The highest frequency of labor induced by preinduction only was in the PGE2 group. There were shorter induction to delivery intervals in the PGE2, and Dilapan S groups. The lowest Caesarean section rate was in the Dilapan S group. Neither serious side effects nor negative neonatal outcome were noted in either group.

[Mixed myelodysplastic and myeloproliferative syndromes]

BACKGROUND

An injury to the hemopoietic stem cell may lead to the aplasia of hemopoiesis, myelodysplasia and to an unregulated myeloproliferation. There is not a strict demarcation of them, so that mixed syndromes can develop as are hypoplastic syndromes on one side and mixed myelodysplastic and myeloproliferative syndromes (MDS-MPS) on the other side.

METHODS AND RESULTS

Among our 616 pts with MDS we looked for those cases, who had beside myelodysplasia signs of myeloproliferation with increased number of blood cells. They were examined in detail including bone-marrow histology, bone marrow cultivation, cytogenetics and bcr-abl gen. Signs of MDS-MPS were found in 22 patients at the first contact with the patient (13 patients had thrombocytemia and 9 patients had leukocytosis). Further 7 patients were diagnosed as MDS, proliferative syndrome developed after several months (MDS-MPS in evolution). The level of thrombocytemia was relatively stable, the number of leukocytes was progressive. All subtypes of MDS were found. All subjects had variable degree of anemia. Ring-sideroblasts and myelofibrosis were frequent finding in MDS-MPS. Men prevailed in patients with leukocytosis. Cytogenetic and cultivation findings were similar to MDS cases, deletion of long arm of chromosome 20 was present in 3 patients. Five patients transformed to acute myeloid leukemia.

CONCLUSIONS

Sings of myelodysplasia and myeloproliferation were found in 4% of our MDS patients, designated as mixed myelodysplastic and myeloproliferative syndrome (MDS-MPS). In this syndrome beside evident signs of myelodysplasia thrombocythemia or leukocytosis with the release of bone marrow precursors are present. In only one case polycythemia was encountered.

Human remains from the Moravian Gravettian: the Dolní Vĕstonice 3 postcrania

To add to our knowledge of European earlier Upper Paleolithic (especially Pavlovian) human biology, the postcranial skeleton of the Dolní Vĕstonic 3 partial skeleton was excavated and reassembled. It represents the remains of an adult female, who was buried in a tightly flexed position with the ventral side down and turned slightly to the left. Subsequent compaction led to extensive damage to the axial skeleton and long bone epiphyses. It nonetheless retains the C1 and C2, fragments of the C5 to S3, portions of the pelvis, most of the long bone diaphyses, and a number of manual and pedal remains. Dolní Vĕstonice 3 was a relatively gracile individual in terms of diaphyseal robusticity and especially muscular attachment rugosity, despite the strong development of femoral and tibial diaphyseal structural buttresses. Upper limb asymmetry is slight and variable. She is similar to other earlier Upper Paleolithic remains in having warm temperate to tropical body proportions but is at the lower limit of Gravettian variation in body size indicators. There is no evidence of significant antemortem lesions on the preserved postcrania.

[Hemostasis using vasopressin analogs during conization of the uterine cervix and minor vaginal operations]

Peroperative haemorrhage is a frequent complication of conization of the portio uteri by surgery-by a "cold knife" scalpel or another method (LEEP, laser, etc.). In a clinical study comprising 41 patients with the diagnosis CIN I-III or laceration of the portio uteri classical conization by means of a scalpel was made with concurrent haemostasis with terlipressin (TLP) by paracervical administration (400 micrograms-REMESTYP 2 amp.). Concurrently the blood loss in ml was followed, the Hb level and other effects of the preparation. From the results ensues that side-effects after local administration of TLP were observed only in 12.2%. Peroperative blood losses were on average under 15 ml. Local paracervical TLP administration appears effective from the clinical aspect with regard to the low frequency of side-effects and the favourable haemostatic effect.

[Will transfer of cytostatic drug resistance genes increase hematopoiesis resistance in the treatment of malignant tumors?]

The aim of aggressive antitumor chemotherapy is to kill the tumor with the largest possible dose of a cytotoxic drug. The maximum dose tolerated by the patient is limited by the toxicity to normal tissue, hematopoiesis being frequently the most sensitive system. Transfer of drug resistance genes to hematopoietic cells could protect them against chemotherapy-related toxicity and thus could be a way of gene therapy in cancer. Methylating and chloroethylating derivatives of nitrosourea are effective anticancer drugs, however, acute hematopoietic toxicity and late risk of leukemia are serious side effects. The major lesion responsible for toxic and mutagenic effects of alkylnitrosoureas is O6-alkylation of guanine in DNA. This lesion is specifically repaired by O6-alkylguanine-DNA-alkyltransferase and hematopoietic cells can be protected against toxic and mutagenic effect of nitrosoureas by alkyltransferase gene transfer. Endogenous alkyltransferase in tumor tissue could be inactivated by administration of O6-benzylguanine, while hematopoietic cells could still be chemoprotected by inhibitor-resistant alkyltransferase gene transfer. This approach could increase the therapeutic efficacy of nitrosoureas in gene therapy augmented cancer treatment.

[Preinduction priming of the cervix. Comparison of the intracervical administration of PGE2 gel and vaginal administration of estradiol]

During the period between Jan.1, 1994 and May 31, 1996 at the Second Department of Gynaecology and Obstetrics in Brno preinduction was performed in 40 patients by means of PGE2 gel (Prepidil Upjohn) and in 38 patients by means of an estradiol gel (Biotika). The inclusion criteria in the group were: singleton pregnancy, 38 or more weeks of gestation, cephalic presentation, unripe cervix (Bishop score less than 5) and reactive NST. The gel was introduced into the cervical canal and left in situ for 12 hours. If maturation of the cervix occurred, induction was implemented by extraamnial administration of PGE2. In the group of patients preinduced with Prepidil there was a significantly greater increase of Bishop score and the first stage of labour was shorter during subsequent induction of delivery. As to other investigated parameters, the two methods did not differ significantly.

Mixed myelodysplastic and myeloproliferative syndromes

Aplastic anemia, myelodysplastic syndromes (MDS) and chronic myeloproliferative diseases (MPD) are stem cell disorders. There is no clear-cut demarcation of them. Hypoplastic MDS displays features of aplastic anemia and MDS, on the other side mixed myelodysplastic and myeloproliferative syndromes (MDS-MPS) develop. In our collection of 566 MDS patients, features of myelodysplasia as well as myeloproliferation, MDS-MPS, were present in 25 patients (4.4%). Twelve patients had at the time of diagnosis megakaryocytic proliferation and thrombocythemia beside signs of MDS, and seven had myelodysplasia with granulocytic proliferation and leukocytosis. In another six patients, MDS was the first diagnosis and the proliferative phase developed later during the course of the disease. These patients can be characterized as MDS-MPS in evolution. All subjects had a variable degree of anemia. While the level of thrombocythemia has been relatively stable, the number of leukocytes has been progressive, but rarely extended beyond 100 x 10(9)/l. Ring-sideroblasts and myelofibrosis were frequent findings. Two more homogeneous MDS-MPS groups emerged in our analysis: sideroblastic anemia with thrombocythemia and a group fulfilling the criteria of Philadelphia chromosome negative and bcr-abl negative "atypical chronic myeloid leukemia (aCML)'. One patient with thrombocythemia and three with leukocytosis (23%) transformed to acute myeloid leukemia (AML). Men prevailed (12/13) in patients with leukocytosis and MDS-MPS in evolution. Of the 46% MDS-MPS patients with chromosomal aberrations, del(20)(q) is of interest.

[Labor induction with extra-amnial administration of PGE2 vaginal tablets]

During the period between Jan. 1 1992 and Dec. 31, 1995 at the Second Department of Gynaecology and Obstetrics in Brno labour was induced in 1159 patients by extraamnial fractionated administration of PGE2 vaginal tablets. After assessment of the indication and the baseline examination (NST, amnioscopy, US biometry and cervical score) according to the CS to the patient the first dose of PGE2 was administered into the extraamnial space beyond the inner os uteri (CS 5-8:1.0 mg PGE2, CS > 8 : 0.5 mg PGE2). After two hours the patient was examined again and if regular uterine contractions had started or the finding on the os uteri was larger than 2 cm, the amniotic sac was disrupted. If not, another dose was administered. After two hours the patient was re-examined and if the os was larger than 2 cm, and there were regular uterine contractions, the amniotic sac was disrupted. If the changes did not take place, the induction was considered a failure.

RESULTS

there were 1007 successful inductions (95.5%), the mean period from the onset of induction to the onset of uterine contractions was < 120 mins-269 (24.6%), 120-180 mins.: 501 (45.9%) and > 180 mins.: 322 (29.5%). The mean period of the first stage of labour was 228 mins., stage II 10 mins., stage III 8 mins. Five times uterine hypertonus was recorded and a blood loss greater than 500 ml occurred in four patients. Forty-nine Caesarean sections were made (4.2%) and 51 (4.4%) forceps deliveries. The rate of epidural analgesia was 27 (2.3%). Revision of the uterine cavity was made in 39 patients (3.4%) and manual lysis of the placenta in 30 (2.6%). The Apgar score was inferior to 6 in 10 neonates (0.9%). The protocol of induction of labour described by the authors is effective and associated with a minimum of side-effects, safe for the mother and foetus, well tolerated by patients and cost-effective.

[Programmed labor--beneficial for the mother and fetus or an obstetrical hazard?]

During the period between Jan. 1, 1992 and Dec. 31, 1995 at the Second Department of Gynaecology and Obstetrics 482 full-term pregnancies were terminated by elective induction of labour. Labour was induced by extraamnial administration of PGE2 (Prostin UPJOHN 3.0 mg tablets vag). Depending on the maturity of the portio uteri a maximum of two doses after two hours were administered: 0.5 mg PGE2 when the cervical score was > 8 and 1.0 mg PGE2 when the score was 5-8 points. The results were compared with 278 non-risk pregnant women who were delivered of babies between Jan. 1 and June 30, 1995. The first stage of labour was longer in patients with spontaneous labour. The second stage of labour was longer in patients with induced labour. From the results ensues that an elective induction of labour does not increase the perinatal risk for mother and foetus, and conversely if all conditions are respected it is better for the mother, her family and the staff of the labour ward.

Long-term protection of hematopoiesis against the cytotoxic effects of multiple doses of nitrosourea by retrovirus-mediated expression of human O6-alkylguanine-DNA-alkyltransferase

A human O6-alkylguanine-DNA-alkyltransferase (ATase) cDNA-containing retrovirus was used to infect murine long-term primary bone marrow cultures. High levels of ATase expression were obtained, and colony-forming cells of the granulocyte-macrophage lineage from the cultures transduced with the human ATase retrovirus were three times more resistant to the alkylating agent, N-methyl-N-nitrosourea (MNU), than control cultures. Furthermore, expression of the human ATase protected long-term hematopoiesis, measured as the output of progenitor cells to the nonadherent fraction of the culture, against the cytotoxic effects of repeated exposures to MNU. These results clearly show that a human ATase cDNA-containing retrovirus can be used to infect long-term primary bone marrow cultures and that this attenuates their sensitivity to nitrosoureas.

Derivative (6)t(1;6)(q22;p21) revealed in bone marrow cells by FISH 9 months before diagnosis of acute T-lymphoblastic leukemia

A chromosomal clone with unbalanced translocation resulting in partial trisomy of segment 1q22-qter and partial monosomy of segment 6p21-pter was revealed by fluorescence in situ hybridization (FISH) using a panel of different whole chromosome painting probes. The pathologic clone appeared after sequential chemotherapy treatment for AML-M5 when the patient was in complete remission before development of T-ALL. However, this clone was present during the whole period of treatment for T-ALL. The clone remained the only chromosomal aberration found. Breakpoints were detected more easily and more precisely with the use of the FISH technique than with G-banding only.

[Treatment of post-partum atonic hemorrhage with prostaglandin F2 alpha analogs]

In the authors' group of patients with haemorrhage during childbirth, in 1990-1994 a total of 28 atonic haemorrhages were recorded, 15 of them were controlled by uterotonic treatment, in the remaining 13 cases haemostasis using PG F2 alpha was applied after ruling out post-partum injury. Some patients were given moreover saline infusions. According to initial results and consistent with the literature analogues of PG F2 alpha are effective uterotonic preparations of a new generation. With regard to their simple and rapid administration they are becoming the drug of first aid in the treatment of acute atonic haemorrhage.

[Treatment of chronic myeloid leukemia with bone marrow transplantation at the Institute of Hematology and Blood Transfusion in Prague]

The outcomes of bone marrow transplantation (BMT) performed at the Institute of Haematology and Blood Transfusion from April 1988 to December 1994 in 31 patients with chronic myelogenous leukemia are presented. Age of the patients range from 18 to 49 years, median 34 years. Male:female ratio was 1.58:1. The conditioning regimen consisted of Cyclophosphamide and total body irradiation (TBI) or Busulfan and Cyclophosphamide. The results are evaluated as of January 1, 1995. Nineteen patients (61.3%) are alive, 12 patients (38.7%) died. The causes of death are discussed. The median time of follow up all patients is 10.4 months, range 0.3-81.5. The median time of follow up of surviving patients is 21.8 months, range 2.5-81.5. Probability of 2 years survival by Kaplan-Meier analysis is 58 +/- 10%. Of the 24 transplanted in the first chronic phase, 18 patients are alive. Of the 7 transplanted in advanced phase of the disease, 1 patient is alive. Of the 27 patients, who received bone marrow from an HLA identical sibling, 19 are alive. Of the 4 patients who received bone marrow from other donor than an HLA identical sibling, none is alive. Acute GvHD III.-IV. grade developed in 5 patients (16.1%), moderate and severe chronic GvHD developed in 11 patients (31.5%). Cytogenetic relapse was diagnosed in 1 patient, hematological relapse in 2 patients. Karnofsky scores of patients surviving after BMT range from 30% to 100%, median 90%.

[Induction of cervical maturation using hydrophilic Dilapan rods in term pregnancy]

During the period between July 1, 1993 and July 31, 1994 the authors preinduced 52 pregnant women in term using the cervical dilator Dilapan. The group comprised patients with single pregnancies > or = 38 weeks, vertex presentation, cervical score < 5 and reactive NST. They introduced into the cervical canal 4 Dilapan rods for 12-18 hours and after extraction of the rods, depending on the finding, the patients were induced with Prostin e.a. or oxytocin i.v. The preinduction was successful in 46 patients (88.5%), in 16 patients (30.8%) uterine contractions were induced by Dilapan alone. Forceps delivery was performed 4 times (7.7%) and Caesarean section 12 times (23.1%). Apart from pain in the hypogastrium resembling menstruation pain, no side-effects were recorded. There were no irregularities such as the length of labour stages, blood loss due to injury during labour and the incidence of neonatal hypoxia. Based on the described experience Dilapan can be recommended as a preinduction method for maturation of the portio uteri.

[Induction of cervical maturation using vaginal administration of estrogens]

During the period between September 1, 1993 and September 1, 1994 the authors preinduced 38 pregnant women in term by oestrogen administered by the vaginal route. The group comprised patients with a single pregnancy, PPH, CS 5n and reactive NST. For preinduction 150 mg oestradiol in a viscous gel were used which along with a pessary was inserted 24 hours before the planned induction of delivery by the vaginal route on the portio uteri. After removal of the pessary the CS was evaluated and then delivery was induced by intracervically administered prostaglandin. The preinduction was successful in 32 patients (84.3%), in 6 patients uterine contractions started during preinduction, delivery by forceps was used twice (5.3%) and Caesarean section six time (15.8%). In the course of preinduction there were no side-effects, no irregularities in the course of parturition were observed. The described method can be recommended as the method of choice for the treatment of an immature portio uteri before planned induction of delivery.

[Dilatation of the cervical canal with Dilapan before induced abortion in the first trimester of pregnancy in primigravidas]

During the period between Oct. 1, 1993 and June 30, 1994 the authors inserted by the intracervical route in 32 primogravidae with unwanted pregnancies before abortion with pregnancies shorter than 8 weeks a hydrophil dilator Dilapan. After 12 hours the rod was removed under general anaesthesia and the pregnancy terminated by vacuum aspiration. In three instances after Dilapan insertion slight haemorrhage occurred which, however, did not call for removal of the rod. Apart from slight tenderness in the hypogastrium, similar as during menses, no side-effects were observed. In two instances during Dilapan extraction the rod was disrupted and the residue had to be removed by means of Kocher's forceps. In all patients the dilation of the cervical canal was sufficient for a 6 mm suction curette and further dilation of the cervix by means of metal dilators was not necessary. On examination after menstruation the patients did not report more massive bleeding nor febrile complications or residues. Based on the described results, the authors are of the opinion that gradual dilation of the cervix before abortion in the first trimester should be part of the procedure and all women who must face this situation should be given this opportunity.

[Results of induction therapy in newly diagnosed acute myeloid leukemias in study 911 at the Institute of Hematology and Blood Transfusion]

Thirty-seven patients with de novo acute myeloid leukemias were admitted to the Institute of Hematology and Blood Transfusion in Prague in February 1991-December 1993. Their age was 18-85 years with a median of 46 years. Two patients died on the day of admission, chemotherapy was initiated in 35 patients. Altogether 27 patients (77%) achieved complete remission (CR), i.e. 18 (81%) of 22 patients younger than 55 years and 9 (70%) of 13 patients older than 55 years. Only 7 (35%) of 20 patients achieved CR after a single therapy course 3/7 consisting of 3 doses of daunorubicin 45 mg/m2 on days 1, 3, 5 and cytosine arabinoside 150-200 mg/m2 every 12 hours for 7 days. However, 8 (61%) of 13 patients achieved CR after a single treatment course 4/7 with 4 doses of daunorubicin 45 mg/m2 on days 1, 3, 5, 7 and identical doses of cytosine arabinoside as in the 3/7 treatment. We used the course with 10 high-doses of cytosine arabinoside 2000 mg/m2 every 12 hours and daunorubicin 45 mg/m2 on days 4 and 5 (treatment HDAC/DNR) as the 1st, 2nd or 3rd induction therapy in 12 patients and 9 (75%) of them achieved CR. The treatment was associated with a high toxicity. An intensified therapy 3/7h similar to the 3/7 one but with the doubled dose of cytosine arabinoside 300-400 mg/m2 on days 5-7 was given to 5 patients as the 2nd induction but it did not improve the CR rate and it was associated with a high toxicity similar to the HDAC/DNR therapy.(ABSTRACT TRUNCATED AT 250 WORDS)

[A female patient with near-tetraploid acute myeloid M4 leukemia]

BACKGROUND

Acute myeloid leukemias (AML) are a heterogeneous group of diseases, several types of them are well characterized by typical morphologic, immunologic and cytogenetic features of their leukemic blasts in the MIC classification. We have recently described 2 patients with a new AML type--poorly differentiated near-tetraploid AML L0. The occurrence of very large blasts in a heterogeneous blast population seemed to be a morphological sign of this new type of AML.

RESULTS

The same morphologic characteristics were observed by us when we studied blasts of another 80-year-old patient with a near-tetraploid karyotype. However, 34% of blasts were positive for myeloperoxidase and they exhibited in 24-33% surface myelomonocytic markers CD11b, CD13, CD15 and CD14. The illness was classified as acute myelomonoblastic leukemia M4 without significant dysplastic changes in erythroid and megakaryocytic lineages. The growth of granulocyte-macrophage bone marrow progenitors CFU-GM was low. The patient refused cytotoxic chemotherapy and expired 3 months later on supportive treatment.

CONCLUSIONS

The finding of very large blasts is a typical sign in cases of near-tetraploid AML. Precise classification of leukemia type is essential for successful therapy.

[Late and slow diagnosis of acute promyelocytic leukemias--the main cause of early death]

Acute hypergranular promyelocytic leukemia (AML M3) belongs to malignant diseases leading very rapidly to death. Immediate treatment based on early diagnosis may cure one third of patients. The typical finding in peripheral blood of patients is pancytopenia with or without atypical promyelocytes. In published studies only 15-25% patients exhibit leukocyte counts above 10 x 10(9)/l. Five of our ten patients studied had leukocyte count above 10 x 10(9)/l. The difference might be in connection with late and slow diagnosis of AML M3. AML is not taken into consideration during medical examination even if the disease occurs in medical family. Thus we describe clinical signs of AML M3 that could be divided into three main groups: bleeding, infections and anemia. In patients with bleeding or anemia or with infections repeating within a short period or with an infection and concurrent signs of bleeding or anemia the complete blood cell count should be examined immediately. If blood cell count abnormalities are found the patient should be sent immediately to hematology unit for further examination and treatment. Early diagnosis enables to start "differentiation therapy" with all-trans retinoic acid that could be administered as monotherapy only in patients with leukocytes below 5 x 10(9)/l. Early diagnosis of AML M3 might ameliorate the fate of patients, since four of our five patients referred to us with elevated leukocyte counts expired in the first five days.

Near-tetraploid poorly differentiated acute myeloid leukemia M0 diagnosed by short-term cultures with a phorbol ester TPA

Leukemic blasts of two patients with acute leukemia exhibited similar characteristics. They were heterogeneous in size with a diameter of 14-30 microns in smears and unclassifiable by morphological, cytochemical, immunophenotypic and ultrastructural examinations. Cytogenetic examinations of both revealed a near-tetraploid karyotype. Blasts from both patients differentiated into macrophages in cultures with 10 ng/ml 12-O-tetradecanoylphorbol-13-acetate (TPA) which is a feature specific for myeloid blasts and the cases were thus classified as poorly differentiated acute myeloid leukemias (AML M0). Near-tetraploid poorly differentiated acute myeloid leukemias M0 seem to be a special category of AML in the morphologic, immunologic and cytogenetic (MIC) classification. The presence of very large blasts in the heterogeneous blast population in acute unclassified leukemias could be a morphological sign of near-tetraploid leukemias AML M0.

[Ripening the cervix using intracervical administration of PGE2 with a butterfly needle in terminating pregnancy]

By intracervical administration of 0.75 mg PGE2, using a butterfly needle, the authors preinduced 32 patients with an immature portio vaginalis cervicis (CS 5 points) who had indications for termination of a full-term pregnancy. Slow administration lasted cca 6 hours. Maturation of the portio vaginalis cervicis occurred in 93.5%, in 71% regular uterine contractions started. The length of labour stages, the loss of blood, frequency of injuries during labour and foetal hypoxia were similar as in spontaneous deliveries. Side-effects were recorded in 20.7%. The described method is a suitable alternative to administration of gel substances, in particular because it is cheaper because it is well tolerated by the patients and is simple.

Partial trisomy of 3q detected by chromosome painting in a case of juvenile chronic myelomonocytic leukemia

Juvenile chronic myelomonocytic leukemia (JCMMoL) is a rare disease with no specific type of chromosome aberration yet delineated. We report a 2-year-old boy who had in his leukemic bone marrow (BM) and peripheral blood (PB) cells the 46,XY,der(15)t(3;15)(q13.1;q26) karyotype. Phytohemagglutinin (PHA)-stimulated lymphocytes of peripheral blood had a normal 46,XY karyotype. The origin of the duplicated part of 3q was proved by fluorescence in situ hybridization (FISH) with the pHSR(sat III 15p) DNA probe and a chromosome 3-specific DNA library (i.e., chromosome painting). The chromosome finding in our case provides further proof of the close relationship between the rearrangement in region 3q13-->3q26 and the pathogenesis of acute myeloid leukemia (AML). Our patient has transformed into erythroleukemia [M6 according to the French-American-British (FAB) classification] during the course of the disease.

Granulocyte colony-stimulating factor treatment of mice modulates differently the sensitivity of blood and bone marrow hematopoietic progenitors to retroviral vector infection

The effect of recombinant human granulocyte colony-stimulating factor (G-CSF) administration to mice on the retroviral-mediated transfer of the selectable marker gene neo to hematopoietic cells was studied. After G-CSF treatment, blood mononuclear cells and bone marrow cells were infected with the retrovirus, and the efficiency of gene transfer into myeloid progenitors was increased in peripheral blood and decreased in bone marrow cells. Bone marrow four to six months after transplantation from G-CSF treated mice revealed the presence of the transferred neo gene in 4 out of 104 mice, which is an eightfold lower proportion than in the control group. These data suggest that G-CSF in vivo treatment decreases bone marrow sensitivity and increases the sensitivity of peripheral blood cells to retroviral infection.

[Intercellular communication and signal transduction mechanisms]

Cells in multicellular organisms coordinate their functions by signalling molecules serving as means of communication. Specific receptors enable transduction of chemical information from extracellular environment into a cell. Inside the cell the signal is multiplied and transduced further by intracellular signalling molecules and enzymatic cascades. Phosphorylation of proteins on tyrosine, serine or threonine residues, guanosine triphosphate binding by special G proteins and regulation of DNA transcription seem to be the most important biochemical mechanisms of signal transduction. Products of cellular protooncogenes are involved in all levels of signal transduction, the detailed knowledge of signal pathways is therefore important for our understanding of pathophysiology of malignant disease and strategies for the therapeutic use of growth factors in oncology and haematology.

[The role of the second-look operation in modern therapy of ovarian carcinoma]

The authors evaluate the results of second look operations of ovarian cancer in a group of 34 women. The second look operation was preceded by intraperitoneal and intravenous chemotherapy. This therapeutic protocol contributed to improvement of therapeutic results. In 50% of thus treated women it proved possible to remove the residual tumour and the survival time was prolonged in 75% of women by 1-3 years. The advantages of this therapeutic procedure are according to the authors in particular reduction of the risk of super-radical primary operations and facilitation of the decision whether to terminate treatment or proceed with it.

[Monocytosis and myelomonocytic dysplasia in myelodysplastic syndrome]

Myelodysplastic syndrome (MDS) is frequently associated with monocytosis in the blood and myelomonocytic dysplasia in the bone marrow. In two groups of patients with MDS, all subtypes excluding CMML, the authors demonstrated that monocytosis was present in 15% of the patients in group I according to the haemogram at the time when the diagnosis was established and in 19% in group II where it was required that at least in half the haemograms throughout the course of the disease there were more than 10% monocytes. No difference was found in the prognosis of patients with monocytosis, as compared with patients with monocytopenia as regards the life span and frequency of transformation into AL. The cytogenetic and cultivation findings did not differ either. In some instances, in particular in patients with RA and RAS significant monocytosis was not associated with the expected proliferation of monocytoid cells in bone marrow. The authors assume that proliferation and differentiation of germ cells in the monocytic series is easier than in the granulocytic series and that monocytosis can be considered a manifestation of substituted neutropenia. The work indicates the difficulties associated with the differential diagnosis of RA, RAS and RAEB with monocytosis, MDS with a dominating change of the type of myelomonocytic dysplasia and CMML proper.

[Labor induction using extra-amniotic administration of PGE2]

The authors induced 105 deliveries by extraamniotic administration of PGE2 (prostin Upjohn). The initial dose was 1-2 tablets, depending on the maturity of the portio uteri. If the contractions did not start within two hours, the dose was repeated. The sac was disrupted when the contractions were regular and the os uteri was larger than 2 cm. If necessary uterine activity was stimulated by small doses of Oxytocin (in 29%). Indication for induction was a programmed delivery (44.7%), protraced pregnancy (31.5%), diabetes mellitus (10.5%), a period of more than 24 hours after drainage of amniotic fluid without contractions (5.7%), hypertension or renal disease during gestation (4.8%) and hypotrophy of the foetus (2.8%). Inductions were successful in 96.2% of the patients. The parity of the patients influenced the interval between the onset of induction and the onset of uterine contractions, the duration of the first and second stage of labour and the consumption of Prostin tablets. The age of the patient, occupation, obesity and operation on the uterus did not affect the success of induction. There were no serious pathological findings during the third stage of labour, nor serious side-effects. The condition of the neonates was satisfactory.

[Personal experience with labor induction using prostaglandins 1985-1987]

The authors evaluate 56 Labors induced with Enzaprost and 141 with Prostin. The main indication for induction was a postdate pregnancy (33%), rupture of the amniotic sac 24 hours previously without contractions (24.5%) and a planned confinement (23%). An initial dose of 1 microgram of Enzaprost per min. was administered or 1 tablet of Prostin in increasing doses after 30 mins. up to three tablets. There were 87.5% successful Enzaprost inductions and 96.5% successful Prostin inductions. The difference is significant at the 5% level.

[Personal experience with labor induction using oxytocin from 1982 to 1987]

The authors made a retrospective investigation of 584 induced childbirth during the period between Jan. 1, 1982 and June 30 1987. In group I, i.e. induction by drop infusion of oxytocin without primary disruption of the sac they were successful in 59.2%. In group II, i.e. induction by oxytocin infusion 24 hours after escape of amniotic fluid without uterine activity or after previous disruption of the amniotic sac they were successful in 83.3%. Oxytocin was administered in doses of 3.5 million units/min. and increased after 15-minute intervals till regular uterine contractions were recorded. When the portion of the uterine cervix is mature, in group II success in 85% can be foreseen.

Antidiuretic and pressor actions of vasopressin in age-dependent DOCA-salt hypertension

The role of antidiuretic and pressor effects of vasopressin (VP) in deoxycorticosterone acetate (DOCA)-salt hypertension was studied in young and adult Brattleboro rats. The antidiuretic VP action was a necessary prerequisite for the development of severe DOCA-salt hypertension. The insufficient expansion of extracellular fluid volume in DOCA-salt-treated VP-deficient (DI) rats was associated with the attenuation of their hypertensive response, although they had highly increased blood volume and extracellular sodium. Chronic [deamino]-D-arginine vasopressin supplementation that restored volume and distribution of body fluids in DI rats permitted the full development of DOCA-salt hypertension. Blood pressure response to DOCA-salt treatment was always greater in young than in adult Brattleboro rats (even in animals lacking pressor or both VP effects). In animals in which antidiuretic VP effects were present, the pattern of body fluid response to DOCA-salt treatment was also age dependent. There was a tendency to intravascular expansion in young hypertensive rats, whereas an increase of interstitial fluid volume was found in adult animals. The elimination of VP pressor action lowered systemic resistance much more in adult than in young hypertensive rats. We conclude that 1) in adult but not in young rats antidiuretic VP effects are essential for the occurrence of blood pressure response to DOCA-salt treatment, 2) the restoration of body fluids due to antidiuretic VP action enables the development of hypertension in both age groups of DI rats, and 3) pressor VP effects contribute to the maintenance of hypertension, especially in adult animals.