ELIM Hospital - The first 100 Years

No Abstrac

Elim hospital - The first 100 years

No Abstract

Disease recurrence and rejection following liver transplantation for autoimmune chronic active liver disease

Autoimmune chronic active liver disease (ACALD), a major indication for liver transplantation, is associated strongly with antigenic determinants HLA-B8 and DR3. A retrospective analysis of 43 patients who underwent OLTx for putative ACALD and who, as well as their tissue organ donors, were typed, was performed. Disease recurrence and graft rejection episodes were determined by chart review and histopathological review of all material available. Disease recurrence was histologically documented in 11 (25.6%) of these 43 cases. Graft rejection episodes occurred in 24 (66.8%). All recurrences were in recipients of HLA-DR3-negative grafts. Nine of the recurrences were in HLA-DR3-poeitive recipients (odds ratio: 6.14, P<0.03). Two of 11 cases of disease recurrence were in recipients who were HLA-DR3-negative. Nine of these 11 had received HLA-DR3-negative grafts. Rejection occurred in 13 HLA-B8-positive recipients, 12 of whom received HLA-B8-negative grafts. Eleven HLA-B8-negative recipients experienced at least one rejection episode and 9 of these had received HLA-B8-negative grafts. Based upon these data we conclude: 1) that recurrence of putative ACALD is more likely to occur in HLA-DR3-positive recipients of HLA-DR3-negative grafts; (2) that recurrences were not seen in recipients of HLA-DR3-positive grafts; (3) that BXA-B8 status does not affect disease recurrence; and (4) that neither the HLA-B8 nor the DR3 status of the graft or recipient has an effect on the observed frequency of rejection. ©1992 by Williams & Wilkins

Comparison of men with acute versus chronic urinary retention: aetiology, clinical features and complications

Background: The objectives were to investigate the aetiology and clinical features of urinary retention and to analyse differences between acute urinary retention (AUR) and chronic urinary retention (CUR).Method: We analysed the clinical data of 558 men admitted to our institution with urinary retention between September 1998 and June 2007.Statistical analysis was performed with Student&rsquo;s t-test, Mann-Whitney and Fisher&rsquo;s exact tests, where appropriate.Results: The mean age of the men was 66.4 years (range 12.8&ndash;94.7). AUR was present in 90.7% and CUR in 9.3%. The most common causes were benign prostatic hyperplasia in 36.6%, adenocarcinoma of the prostate (ACP) in 36.0% and urethral stricture in 14.3%. Mean prostate volume was 56.6 cc (range 15&ndash;262). Comparing the groups with AUR versus CUR, a positive urine culture was significantly more common in the group with AUR (34.1% vs. 8%), whereas anaemia (15.9% vs. 34.1%), renal failure (9.1% vs. 46.2%) and hydronephrosis (23.9% vs. 53.9%) were significantly more common in the group with CUR. There was no significant difference in prostate volume or the proportion of men with histological prostatitis (29.5% vs. 23.1%).Conclusion: The prevalence of ACP and urethral stricture as aetiology of retention was higher than reported in the literature. The prevalence of anaemia, renal failure and hydronephrosis was significantly greater in patients with CUR compared to AUR. There was no significant difference in prostate volume or the prevalence of histological prostatitis, indicating that factors other than prostate size or histological prostatitis determine the development of AUR rather than CUR.Keywords: urine, retention, prostate, urethra, strictur

Wan-Yi Lo, collaborative piano

Maurice RavelGustav MahlerGiacomo Puccin

Urinary Retention in Women: Causes and Management

Objectives: Urinary retention in women is uncommon and there are numerous etiological factors. Most reported studies are from Europe and North America, with few studies from developing countries. The aim of this study was to review the etiology of urinary retention in women referredto our institution, a public sector hospital serving a largely indigent population.Patients and Methods: We reviewed the clinical records of all patients admitted with urinary retention to the Urology wards in our hospital during the period September 1998 to June 2007. In total there were 589 patients with urinary retention, 558 (94.7%) men and 31 (5.3%) women.Results: The average age of the 31 women was 51.9 years (range 20 to 88 years). The underlying pathology was cervical carcinoma (4 patients), urethral carcinoma (4), transitional cell carcinoma of the bladder (3), eosinophilic cystitis (3), hematuria due to miscellaneous causes (3), antiincontinence surgery (2), cerebral palsy (2), multiple sclerosis (1 patient), diabetes mellitus (1), hypotonic detrusor (1), bladder stone (1), vaginal leiomyoma (1), cyclophosphamide cystitis (1), constipation (1), postpartum (1), blocked indwelling catheter and idiopathic (1). Renal dysfunction was present in 17 (55%) of the patients.Conclusion: The most common causes of urinary retention in women in this study were malignancy in 11 patients (36%) and neuropathic bladder dysfunction in 5 (16%). Eosinophilic cystitis, normally a rare condition, was diagnosed in 3 women (10%). The high incidence of malignancy in this study differs from other reported series, in which neuropathic bladder dysfunction was the most common cause of urinary retention in women.Key Words : Urinary retention, women, etiolog

Tensorial Reconstruction at the Integrand Level

We present a new approach to the reduction of one-loop amplitudes obtained by reconstructing the tensorial expression of the scattering amplitudes. The reconstruction is performed at the integrand level by means of a sampling in the integration momentum. There are several interesting applications of this novel method within existing techniques for the reduction of one-loop multi-leg amplitudes: to deal with numerically unstable points, such as in the vicinity of a vanishing Gram determinant; to allow for a sampling of the numerator function based on real values of the integration momentum; to optimize the numerical reduction in the case of long expressions for the numerator functions.Comment: 20 pages, 2 figure

Doxorubicin versus doxorubicin and cisplatin in endometrial carcinoma: definitive results of a randomised study (55872) by the EORTC Gynaecological Cancer Group

BACKGROUND: Combination chemotherapy yields better response rates which do not always lead to a survival advantage. The aim of this study was to investigate whether the reported differences in the efficacy and toxicity of monotherapy with doxorubicin (DOX) versus combination therapy with cisplatin (CDDP) in endometrial adenocarcinoma lead to significant advantage in favour of the combination. PATIENTS AND METHODS: Eligible patients had histologically-proven advanced and/or recurrent endometrial adenocarcinoma and were chemo-naïve. Treatment consisted of either DOX 60 mg/m(2) alone or CDDP 50 mg/m2 added to DOX 60 mg/m2, every 4 weeks. RESULTS: A total of 177 patients were entered and median follow-up is 7.1 years. The combination DOX-CDDP was more toxic than DOX alone. Haematological toxicity consisted mainly of white blood cell toxicity grade 3 and 4 (55% versus 30%). Non-haematological toxicity consisted mainly of grade 3 and 4 alopecia (72% versus 65%) and nausea/vomiting (36 % versus 12%). The combination DOX-CDDP provided a significantly higher response rate than single agent DOX (P <0.001). Thirty-nine patients (43%) responded on DOX-CDDP [13 complete responses (CRs) and 26 partial responses (PRs)], versus 15 patients (17%) on DOX alone (8 CR and 7 PR). The median overall survival (OS) was 9 months in the DOX-CDDP arm versus 7 months in the DOX alone arm (Wilcoxon P = 0.0654). Regression analysis showed that WHO performance status was statistically significant as a prognostic factor for survival, and stratifying for this factor, treatment effect reaches significance (hazard ratio = 1.46, 95% confidence interval 1.05-2.03, P = 0.024). CONCLUSIONS: In comparison to single agent DOX, the combination of DOX-CDDP results in higher but acceptable toxicity. The response rate produced is significantly higher, and a modest survival benefit is achieved with this combination regimen, especially in patients with a good performance status

Elevated expression of artemis in human fibroblast cells is associated with cellular radiosensitivity and increased apoptosis

Copyright @ 2012 Nature Publishing GroupThis article has been made available through the Brunel Open Access Publishing Fund.Background: The objective of this study was to determine the molecular mechanism(s) responsible for cellular radiosensitivity in two human fibroblast cell lines 84BR and 175BR derived from two cancer patients. Methods: Clonogenic assays were performed following exposure to increasing doses of gamma radiation to confirm radiosensitivity. γ-H2AX foci assays were used to determine the efficiency of DNA double strand break (DSB) repair in cells. Quantitative-PCR (Q-PCR) established the expression levels of key DNA DSB repair proteins. Imaging flow cytometry using Annexin V-FITC was used to compare artemis expression and apoptosis in cells. Results: Clonogenic cellular hypersensitivity in the 84BR and 175BR cell lines was associated with a defect in DNA DSB repair measured by the γ-H2AX foci assay. Q-PCR analysis and imaging flow cytometry revealed a two-fold overexpression of the artemis DNA repair gene which was associated with an increased level of apoptosis in the cells before and after radiation exposure. Over-expression of normal artemis protein in a normal immortalised fibroblast cell line NB1-Tert resulted in increased radiosensitivity and apoptosis. Conclusion: We conclude elevated expression of artemis is associated with higher levels of DNA DSB, radiosensitivity and elevated apoptosis in two radio-hypersensitive cell lines. These data reveal a potentially novel mechanism responsible for radiosensitivity and show that increased artemis expression in cells can result in either radiation resistance or enhanced sensitivity.This work was supported in part by The Vidal Sassoon Foundation USA. This article is made available through the Brunel Open Access Publishing Fund