Relapsed ALCL are highly chemosensitive but over 40% of the patients experience several relapses. Prolonged conventional chemotherapy based on vinblastine might, in some cases, be as efficient as short intensive treatment with ABMT.

Abstract. The data concerning the value of duplex sonography in diagnosing parenchymatous renal allograft dysfunction are controversial. Most early studies did not take into consideration the many factors influencing resistance parameters. We therefore performed a prospective, biopsy-controlled study with exclusion of all known sources of error regarding resistance parameters. Furthermore we investigated the value of a new resistance parameter, the systolic deceleration percentage. Forty-seven duplex sonographic studies were performed on 43 patients (30 male, 13 female, median age 47 years, range 7-70). Fourteen studies were done on normally functioning grafts (control group) an average of 33 days after transplantation. Thirty-three studies were performed on dysfunctional grafts immediately prior to biopsy. Grafts which had been transplanted more than a year previously or with vascular findings or any other clinical or sonographic pathology probably explaining function deterioration were excluded. In all patients, the resistive index (RI), pulsatility index (PI) and systolic deceleration percentage (DP) were calculated in the main renal artery and in the interlobar artery. Of the 33 grafts with dysfunction, nine had vascular rejection (VR), 11 interstitial rejection (IR), 11 cyclosporin A toxicity (CAT) and two other histologies (OR). The mean RI in normal grafts ( . For DP we calculated 28±5% and 29±6% (NO), 43 ±14% and 36 ±6% (VR), 29 ±9% and 27 ± 9% (IR), 31 ± 8% and 32 ± 7% (CAT ) and 32 ± 4% and 28 + 3% (OR). The sensitivity/specificity for VR with a cutoff mean+ 2 SD was 0.44/1 for RI, 0.55/0.97 for PI and 0.33/0.89 for DP. It was concluded that:Correspondence and offprint requests to: Prof. K. Jager, Division of Angiology, Petersgraben 4, University Hospital, CH-4031 Basel, Switzerland.(1) despite the high selection of our patient group, diagnostic accuracy of duplex sonography for diagnosing parenchymatous function disorder in renal allograft remains insufficient; (2) in vascular rejection only, the resistance parameters differ significantly from the values of normal aUografts; (3) the higher the cutoff of resistance parameters, the better the specificity and the worse the sensitivity for diagnosing vascular rejection; (4) of all investigated resistance parameters, the RI is the most practical due to a simple measurement technique.

The presence of albumin receptors on the plasma membrane of isolated human hepatocytes was investigated employing albumin-coupled latex minibeads. Hepatocyte-latex reaction was visualized by phase contrast and scanning electron microscopy.The experiments demonstrate that hepatocytes exhibit binding activity for polymeric and monomeric forms of glutaraldehyde-treated albumin. Additionally, the reaction was shown to be speciesnonspecific.These findings support the hypothesis that polymerized albumin may act as a bridge between receptors on hepatitis B virus and human hepatocytes.Considerable data support a role of polymerized human serum albumin (P-HSA) and its receptors in hepatitis B virus (HBV) infection (1-3). Indeed, a speciesspecific receptor for P-HSA is detectable on Dane particles and on 22-nm particles of hepatitis B.Imai (2) proposed the hypothesis that P-HSA may act as a bridge between the virus and target liver cells, thus explaining the restricted host and organ tropism of HBV infection. This requires that the human hepatocyte is also provided with P-HSA receptors as has been demonstrated for rabbit hepatocytes (4). So far, human hepatocytic albumin receptors have been shown in liver sections only (5, 6). A direct demonstration of such receptors on the outer aspect of intact liver cells, however, has not been accomplished.By a micro method which permits electron microscopy of small numbers of mechanically isolated hepatocytes and utilizes albumin-coupled latex minibeads, human albumin receptors were demonstrated on human hepatocytes by phase-contrast and scanning electron microscopy (SEM).

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SUMMARY Coronary arteriography was performed twice in 256 nonoperated patients, including 92 surgical candidates who were recatheterized because of the long wait for surgery. Criteria to define progression and regression were established in advance. Analysis of separate segments, reflecting separate lesions, revealed that progression percentages increased proportionally with the degree of initial narrowing and the Interval between atheterizations, ranging from 1.2% to more than 20%. The highest progression percentages were shown by the proximal right coronary artery, the left anterior descending artery distal to the first septal and first diagonal branches, and the obtuse marginal branch of the circumflex artery. In 56.3% of the patients, progression was found in at least one segment, ranging from 40% in patients who were recatheterized within 1 year to 92%'in patients who were recatheterized after 5 years or longer (p < 0.025). In 12 patients (4.7%), regression had occurred; in two cases obstructions had reverted to less than 50% narrowing. Regression was associated with progression in other branches in three cases. Indications for recatheterization did not correlate significantly with progression, but a higher progression percentage was found in patients who had sustained a myocardial infarction during follow-up than in those who had not (p < 0.05). Comparison of potential surgical procedures based on the first and second angiogram revealed that at the second catheterization more distal anastomoses were required to achieve complete revascularization in 29.3% of the patients and that left ventricular contractions had deteriorated markedly in 15.6%. These fractions correlated with the duration of the Interval between catheterizations.REPEATED arteriographic visualizations of the coronary circulation in patients with coronary atherosclerosis permit study of the anatomic evolution of the disease during life. As surgical revascularization may have an additional unknown influence on the disease process, data should be obtained primarily on nonoperated patients. However, the majority of patients who are considered surgical candidates are operated on soon after catheterization, so only a small and selected group of nonoperated patients is available for follow-up; in these patients, it is difficult to justify recatheterization on a routine basis. Therefore, the few studies on this subject have mostly dealt with patients selected for specific reasons.'-1In the Netherlands, the number of angiographic facilities has surpassed the expansion of the surgical capacity, leading to long waits for coronary surgery. This has particularly concerned patients in stable or improving clinical condition who were felt to be in no immediate jeopardy. In this study we analyzed the evolution of coronary lesions in 256 patients who had significant coronary artery disease and in whom arteriography had been performed two times. In particular, we studied the anatomic patterns of progression and regression and attempt to assess its implications...