No abstract

The activity of pyruvate dehydrogenase in extracts of pig mesenteric lymphocytes was measured under different preincubation conditions. The mitogens concanavalin A and ionophore A23187 both increased pyruvate dehydrogenase activity. In both cases activation required extracellular Ca2+. Digitonin-permeabilized cells required 0.5 microM free Ca2+ for half-maximal activation of pyruvate dehydrogenase. The stimulation by concanavalin A in intact cells was probably not due to changes in effectors of pyruvate dehydrogenase kinase. This evidence suggests that activation of pyruvate dehydrogenase is by Ca2+ activation of pyruvate dehydrogenase phosphatase and supports the view that the cytoplasmic free [Ca2+] rises to something less than 1 microM on stimulation with mitogens.

In Germany inpatient rehabilitation plays a major role for the treatment of children and adolescents with chronic health conditions. The German Pension Insurance carries out the rehabilitation of children and adolescents with high commitment. Paediatric rehabilitation enables children to go to kindergarten and school without interruption and participate in later professional life. The article specifies the basics of paediatric rehabilitation, describes the disease structure, defines the therapeutic care and explicates survey results.

A patient with common acute lymphoblastic leukaemia (ALL), hypereosinophilic syndrome and t(5;14) (q31.1;q32.3) translocation is described. Even with intensive treatment only short periods of complete remission were achieved. Recurrence of the leukaemia was always accompanied by the appearance of eosinophilic granulocytes in the blood and in the bone marrow. Although there is no experimental proof we assume that the hypereosinophilic syndrome is causally related to the chromosome aberration. Translocation of the GM-CSF gene from chromosome No. 5 to chromosome No. 14, might have led to the deregulation of the gene by enhancer sequences of the immunoglobulin heavy-chain region on chromosome No. 14, with the consequence of an overproduction of neutrophilic and particularly eosinophilic granulocytes. Furthermore, stimulation of the leukaemic cell clone may have occurred by this translocation. The similarity of the clinical course with cases described in the literature suggests that this condition is a unique entity of ALL.

Summary:but the choice of subsequent treatment is still controversial. 4,5 One approach is continuation of salvage chemotherapy. In large studies published, chemotherapy resulted In the BFM Relapse Study registry we retrospectively identified 136 patients with a first marrow relapse who in an event-free survival (EFS) of 20-30%, 6,7 in some trials as high as 35%. 8,9 The main determinants of the outcome had undergone BMT in second complete remission (CR2) (group A) and 33 patients who received transof chemotherapy, as well as bone marrow transplantation (BMT), are duration of the first remission, site of relapse, plants only after a 2nd bone marrow (BM) relapse had occurred (group B). Event-free survival (EFS) rates at and phenotype of leukemic cells. 9-13 Allogeneic BMT is an alternative treatment for children in second CR. However, 6 years after BMT were 0.49 ± 0.05 and 0.48 ± 0.09 for patients transplanted in CR2 and CR3, respectively. In related compatible donors are only available for 15-25% of children. In large series, EFS rates of 40-55% after allocontext with the BFM chemotherapy trials for relapsed childhood ALL there is a clear benefit from BMT in 2nd geneic BMT in 2nd CR have been reported. 11,14-16 Low relapse rates following BMT are purchased at the expense CR for children with unfavorable prognostic features (isolated early BM relapse, very early BM relapse or of serious therapy-related acute complications and late effects, relating to toxicity of conditioning chemotherapy BM relapse of T cell ALL). Similar control of leukemia can be achieved with either chemotherapy or BMT in and radiation, graft-versus-host disease, infections including interstitial pneumonia, immune deficiency, and second late BM relapse of ALL. Assuming a 60% failure rate with chemotherapy for patients in second relapse, a malignancies. To our knowledge there are few corresponding reports on late effects after several courses of chemothird remission can be achieved in about 60% of patients who have received chemotherapy, rendering therapy. [17][18][19][20] Thus, the question arises, if withholding BMT in CR2 and carrying out BMT only after a second bone them eligible for BMT in 3rd CR. With this strategy 58% of these patients would survive and late sequelae marrow relapse occurs is a possible alternative compared to BMT immediately after attaining second remission. This of BMT be restricted to a minority. To withhold BMT in CR2 and not perform BMT before a 2nd BM relapse question is especially interesting for children with late marrow relapse without a related donor. We therefore perforhas occurred, may be a conceivable alternative for children with late ALL BM relapse, at least if no related med a retrospective analysis with the aim of comparing results of BMT in second CR with those obtained with donor is available. Keywords: children; acute lymphoblastic leukemia; bone BMT in third CR. Additionally, known risk factors predictive for the occurrence of a subsequent relapse were taken marrow relapse; allogeneic bone marrow tra...