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Researchers at Baylor College of Medicine , Houston, Texas have
identified a genetic locus for familial atrial fibrillation
on chromosome 10. Although familial atrial fibrillation is extremely
rare, the important question raised by this study is to what extent
genetic defects may be risk factors for atrial fibrillation.
Source: New England Journal of Medicine 1997;336
Scientists at French research institute INSERM, have produced
human hemoglobin from genetically engineered tobacco plants.
The research opens up new possibilities for creating artificial
blood free of infection. The plants contain human DNA that
instructs them to produce human hemoglobin. The researchers,
working with scientists at Biocem at the University of Cezeaux
in Aubiere, France, found the tobacco hemoglobin, once extracted
and purified, transported oxygen and carbon monoxide just like
Source: Nature March 1997
Researchers at the John Wayne Cancer Institute, Santa Monica, CA, have developed a test to determine if a patient will benefit from conventional cancer chemotherapy or needs additional treatment with experimental drugs. The Multidrug Resistance Assay or MDRA, performed on tissue removed during surgery or biopsy, provides results in two hours and, if verified, could spare some patients months of ineffective chemotherapy. The research showed that many chemotherapy-resistant tumors contain high amounts of glucosylceramide a chemical that appears to regulate a molecular pump which removes chemotherapy drugs from inside tumor cells before they have a chance to work. This chemical was elevated in many chemotherapy-resistant cells and tumors, including ovarian cancer which is notoriously difficult to treat, it was absent in tumors that responded to chemotherapy.
The US Centers for Disease Control and Prevention, Atlanta, suggests more screening for chlamydia. Programs that screen for and treat chlamydia have reduced infections among women under age 20. Their studies show that the incidence of chlamydia in the general population decreased from 7% to 13% in regions where programs had been instituted.
A sensitive CRP immunoassay may prove to be a useful prognostic
indicator in the management of ischemic heart disease. Research
using an ultrasensitive immunoassay to measure CRP levels in 2121
patients with angina and evaluated the association between CRP
concentration and subsequent coronary events. After two years
there were 20 sudden deaths, 7 fatal infarcts, and 48 nonfatal
infarcts. One-third of these 75 events occurred in patients whose
initial CRP concentrations were in the highest quintile; this
group had a twofold increase in the risk of coronary events compared
with patients with lower CRP concentrations. CRP level was also
positively associated with older age, smoking, body mass index,
elevated triglyceride levels, coronary stenosis, and history of
Source: Lancet 1997 Feb 15; 349:462-6.
Researchers at Beth Israel Deaconess Medical Center, Boston, Mass have treated cardiac patients with a growth factor that they believe might grow new blood vessels in the heart, offering a permanent solution for coronary artery disease. Physicians implant capsules containing a small amount of basic fibroblast growth factor at or around the site of the blockage. These patients and others in this double blind study will be followed for 12 months to determine the clinical risks and benefits of this approach. To date, there have been no negative side effects.
According to Dr. David L. Witte of Laboratory Control, Ltd. of Ottumwa, Iowa it's cheaper to diagnose iron overload than to treat the complications later on. Hemochromatosis is the most common genetic disorder and there is some evidence that everyone should be screened and that it may be an important factor in mobidity associated with arthritis. Testing involves measurement of both serum iron (SI) and total iron binding capacity (TIBC). Dividing TIBC into SI gives the level of iron saturation. The normal range is between 12% and 45%. High saturation levels indicate a need for immediate treatment, which consists of phlebotomy.
Human leukocyte antigen (HLA) typing may be useful for
prediction of restenosis after coronary angioplasty. Researchers
at the University of Tokyo has shown there were significantly
fewer cases of restenosis after PTCA among patients with (HLA-C
locus) Cw1 and apparently more cases among patients with Cw3.
Of patients with Cw1, 70% had no restenosis, and 70% of those
with Cw3 had restenosis. Many cytokines and growth factors secreted
by cells in the arterial wall after injury are involved in restenosis,
it is therefore suspected that the restenotic process may be related
to a genetically determined immune response.
Source: JAMA 1997;277:983-984.
Studies at the University of Cambridge, Cambridge, UK show that
overexpression of cyclin D1 may contribute to the development
of epithelial ovarian cancers. Overexpression of the cell-cycle
related gene cyclin D1 is known to be oncogenic in breast epithelium
and lymphocytes. This study found the gene was in fact overexpressed
in 26% of the ovarian tumors they examined but only at early stages
of tumor development.
Source: Gynecologic Oncology 1997;64:189-195,187-188.
According to Dr. Michael A. Gerber, Connecticut Children's Medical
Center, Hartford, the use of blood agar plate cultures
may not always be necessary to confirm negative optical immunoassay
test results in the diagnosis of group A beta-hemolytic streptococcal
pharyngitis. Comparing culture with immunoassay in 2,000 patients
with acute pharyngitis, he found both tests performed equally
well. The overall sensitivities of the immunoassay culture were
84% and 78%, respectively, while the specificities were 93% and
99%, respectively. The researchers conclude that with adequately
trained personnel, negative immunoassay test results may not always
need to be routinely confirmed with cultures.
Source: JAMA 1997;277:899-903.
Researchers at the University of Tulsa, Oklahoma have found that
thyroid-stimulating hormone (TSH) appears to be a key immunoregulatory
mediator for the intestine.
Source: Science 1997;275:1897-1898,1937-1939.
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