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Lymphocytosis is a marker of subcutaneous interleukin (IL)-2 therapy efficacy, whereas baseline elevated inflammatory indices were noticed in IL-2-resistant disease. The aim of this study was to analyse the relationship between pretreatment circulating values of IL-6, neopterin, sIL-2R, ESR and the changes in lymphocyte number in response to IL-2 administration. Twenty metastatic renal cell cancer patients were treated with subcutaneous IL-2 immunotherapy (6 000 000 IU day[SUP-1] for 6 days per week for 4 weeks); tumour response consisted of partial response (PR) in four patients, stable disease (SD) in eight patients and progressive disease (PD) in eight patients. Abnormally high pretreatment values of each marker were found as follows: IL-6 in seven patients, neopterin in nine patients, sIL-2R in 13 patients. In response to IL-2 immunotherapy, a significantly higher mean increase in lymphocyte number and a higher percentage of patients with tumour response or stable disease were observed when pretreatment values of IL-6, neopterin and sIL-2R were within the normal range, in comparison to patients with high values for these markers. The pretreatment excess of these serum inflammatory markers seems to negatively influence both the host and tumour response to IL-2 administration, by preventing the IL-2-induced lymphocytosis and resulting in tumour progression. Further studies are requested to verify if overall survival and quality of life may depend on pretreatment host immune status and/or lymphocyte response after IL-2 administration. [ABSTRACT FROM AUTHOR]

Four adult patients with pericardial cysts were studied by two-dimensional echocardiography. In all cases echocardiography demonstrated a round echo-free structure, of varying size, related to one of the cardiac chambers, from which it was separated by a definite wall of echoes. M-mode echocardiography in the three cases in which it was performed, failed to yield the diagnosis. This report assesses the importance of two-dimensional echocardiography and its greater reliability and sensitivity compared with: (1) M-mode echo in identifying pericardial tumors and establishing their relationships to nearby cardiac structures, and (2) standard chest X-ray in differentiating solid masses from cysts and in defining the characteristics of cysts walls. Particular stress is laid on the role of two-dimensional echo cardiography leading directly to surgery in patient number 4, who had a teratoma and in whom early surgery was essential. The high sensitivity and the ability of the technique to differentiate solid from cystic masses and to define their relationships with cardiac chambers make it a reliable method for assessing pericardial cysts. [ABSTRACT FROM PUBLISHER]

In order to evaluate whether or not criteria for surgical revascularization in patients with early post-infarction angina (EPIA) should be different from those commonly used for patients with angina, the incidence and prognostic implications of EPIA were analysed in 188 AMI patients in Killip's class I or II on admission. Sixty-two patients (33%) complained of EPIA (Group I) and 126 patients were symptom-free (Group II).There were no differences between the two groups in in-hospital and late mortality and reinfarction. On the contrary, severity of angina was significantly associated with the occurrence of in-hospital and late cardiac death, reinfarction and revascularization procedures.EPIA patients underwent revascularization procedures significantly more frequently than group II patients, both during hospitalization (29% versus 1%; P < 0·001) and follow up (10% versus 1%; P < 0·01). Coronary artery involvement was significantly more severe in group I than in group II and in the operated patients compared with the non-operated ones.Our data suggest that the severity of angina should be the leading criterion for surgery, as it is able to identify most of the patients with severe coronary artery disease and poor prognosis. [ABSTRACT FROM PUBLISHER]