Telomerase activity and proliferation index in aggressive mature B-cell lymphoma: comparison to germinal center phenotypic markers

Cell proliferation may be evaluated by various methods, including Ki-67 immunohistochemistry and measures of telomerase activity. Both methods would theoretically show comparable increases in a given case. To evaluate the relationship between these 2 markers of proliferation in aggressive mature B-cell lymphomas, 48 cases were studied. The study group included 5 cases of mantle cell lymphoma (MCL); 6 cases of Burkitt's/Burkitt's-like lymphoma (BL); 9 cases of follicular lymphoma, grade 3 (FLC); and 28 cases of diffuse large B-cell lymphoma (DLC). Telomerase activity was measured as total product generated (TPG) units, and TPG results for the aforementioned cases were compared to the TPG results for 10 cases of reactive follicular hyperplasia. An overlap in TPG scores between reactive cases and lymphoma cases was found. Significant differences in both log TPG (P = 0.0443) and Ki-67 (P = 0.0006) were seen in the different lymphoma types. A positive correlation between Ki-67 percentage and TPG score was identified in FLC (r = 0.9281; P = 0.0003), but a poor correlation between these 2 indicators was seen in the other lymphoma types. Cluster analysis identified distinct patterns for MCL, FLC, and BL, but heterogeneous patterns for DLC. Because increases in both Ki-67 proliferation and telomerase activity are reported in normal germinal centers (GCs), these tests were also evaluated for usefulness as markers of a GC cell phenotype. Among the FLC and DLC cases, features of a GC phenotype significantly correlated with increased Ki-67 percentage (P = 0.0152), but not with increased log TPG. An elevated log TPG correlated with CD10 expression, and elevated Ki-67 percentage correlated with both CD10 and BCL-6 expression. TPG level and Ki-67 percentage did not correlate with the presence of t(14;18) or BCL-2 protein expression. Although the proliferation patterns were fairly distinctive for MCL, FLC, and BL, these studies show that markers of cell proliferation do not by themselves,identify distinct subtypes of large cell lymphomas. With the exception of FLC, the tumors exhibited poor correlation between telomerase activity and Ki-67 proliferation index. These tests did show some correlation with expression of GC cell phenotypic markers, however.     

Scanning electron microscopic examination of human pulonary capillaries using a latex replication method

The human pulmonary microvasculature from the apical bronchopulomanary segment was studied by scanning electron microscopy using latex relpicas. The latex replica was composed of a blend of vinyl chloride latexes using a plasticized vinyl chloride copolymer with a vinyl chloride copolymer. The polymerized latex produced a cast of the pulmonary arterial vascular tree, including the capillary patterns, which freely anastomose, thereby draining blood into pulmonary veinules and veins. The latex was injected via a gravity flow system modified from its earlier application in Guinea pig lungs. The apparently normal lungs from two recently deceased humans (dead for 5-6 hours and held in refrigeration) were perfused with heparinized Ringer's solution and subsequently injected with latex. The resulting latex casts of the capillaries revealed a three-dimensional network arranged in irregular vascular rings or ovals. This patterns was most conspicuous in deep and intermediate bronchopulmonary segmental areas. However, the subpleural capillaries produced casts that often terminated blindly, as observed with stereo SEM, suggesting that these vessels may tend to form thrombi more easily as compared with capillaries from other regions of the lung alveoli. The pulmonary arteriolar replicas contained indentations representing endothelial cell nuclei, and the capillary replicas projected oval evaginations that may represent discrete loci or capillary mural attenuations.     

Ultrastructural Morphometric Study of Follicular Center Lymphocytes: II. Analyses of Cleaved-Cell Populations Do Not Support the Lukes-Collins' Concept

Ultrastructural morphometric analysis was carried out on six cases of lymph node biopsies with reactive hyperplasia to establish the frequency and depth of invaginations in nuclear profiles situated in the mantle zones and follicular centers. The frequency distribution of the depth of invaginations was similar in nuclear profiles whether in the small lymphocytes of mantle zones or the small, partially transformed (centrocytes) and fully transformed (centroblasts) lymphocytes of follicular centers. Invaginated and cleaved lymphocytes were not confined to the partially transformed (centrocytic) lymphocytes of follicular centers, and nuclear profiles with invaginations bore no resemblance to those depicted in the Lukes-Collins model. A considerable proportion of mantle zone lymphocyte nuclear profiles had invaginations (ranging from 7.5% to 53.6%) and there was no difference between the frequency of deep indentations or clefts in mantle zone lymphocytes (8.1 ± 5.4%) and the small unstimulated (9.3 ± 5.3%) and partially transformed (8.4 ± 1.4%) lymphocytes in follicular centers. Computer modeling of stylized nuclei with conical indentations indicated that all lymphocytic nuclei likely have multiple invaginations or groove-like creases.     

The brain and thymus have much in common: a functional analysis of their microenvironments

Research into the neural and immune systems has begun to converge. Since the first reports that interleukins play important roles in both systems and that lymphocytes secrete neuronal factors, scientists have been surprised by the ever-increasing list of interactions. Here, Rolf Mentlein and Marion Kendall examine the major supporting cells of the brain and thymus - astrocytes and thymic epithelial cells - the similar neuroectodermal origin of which could explain such fundamental analogies.     

Testing human sera for antibodies against avian influenza viruses: Horse RBC hemagglutination inhibition vs. microneutralization assays

BACKGROUND: The hemagglutination inhibition (HI) assay is a frequently used method to screen human sera for antibodies against influenza A viruses. Because HI has relatively poor sensitivity in detecting antibodies against avian influenza A strains, a more complicated microneutralization (MN) assay is often preferred. Recent research suggests that the sensitivity of the HI assay can be improved by switching from the traditionally used turkey, guinea pig, human, or chicken RBCs to horse RBCs. OBJECTIVE: To evaluate the performance of the horse RBC HI when screening for human antibodies against avian influenza types H3, H4, H5, H6, H7, H9, H11, and H12. STUDY DESIGN: We evaluated the reproducibility of horse RBC HI and its agreement with MN results using sera from people exposed or not exposed to wild and domestic birds. RESULTS: The horse RBC HI assay had high reliability (90%-100%) and good agreement with MN assay results (52%-100%). CONCLUSION: The horse RBC HI assay is reliable, less expensive, less complex, and faster than the MN assay. While MN will likely remain the gold standard serologic assay for avian viruses, the horse RBC HI assay may be very useful as a screening assay in large-scale epidemiologic studies.     

Temporary antibiotic loaded acrylic hip replacement: a novel method for management of the infected THA

Postoperative infection after hip joint replacement is an uncommon but potentially devastating complication in contemporary orthopaedics. Management in two stages is the more favored approach in North America. This introduces difficulty with patient management in the interval between stages, delays rehabilitation, and introduces technical difficulty during the second stage. A method has been developed whereby a temporary antibiotic-loaded facsimile of the hip is introduced at the first stage, designed to maintain stability of the joint, length of the limb, and mobility of the patient. It has been used in a total of 86 cases to date. The results in 46 cases with a minimum follow-up of 2 years are reviewed in this article. The infection was controlled in 93.5% of cases.     

The relative effectiveness of three reminder letters. On making and keeping mammogram appointments

One hundred fifty women who had previously had at least one mammogram were sent one of three prompt letters informing them that they were due for screening. The letters were either reassuring, anxiety provoking, or the standard hospital prompt. Based on a review of the literature, we hypothesized that the reassuring letter would be most effective in motivating women to schedule and keep appointments, the anxiety-provoking letter would produce an intermediate level fo compliance, and the standard hospital letter would be least effective. Our hypothesis was partially supported. Overall, 45% of the women in the study scheduled mammogram appointments. This included 54% of those who received the reassuring letter, 42% of those who received the anxiety provoking letter, and 38% of those who received the standard letter. Although the results were in the predicted direction, the results of a chi-square test indicated that differences among groups were not statistically significant. When the dependent measure was number of appointments kept, rather than scheduled, however, significantly more women who received the reassuring letter actually kept their appointments compared with those who received the standard hospital letter. Subsequent analyses suggested that having a family history of breast cancer, receiving a reassuring letter, and being older than 50 years were important factors in scheduling appointments.     

A holistic nursing model for spiritual care of the terminally ill

Terms such as religion and spirituality usually imply a mature understanding of philosophical values of life principles and existence. In a holistic paradigm, nurses are ethically obligated to support spiritual aspects of care just as they do the biophysical elements. But how often is this all important step overlooked in our assessments and interventions? This essay contains a discussion of basic spiritual and religious principles, the moral obligations to alleviate spiritual suffering and the principles of altruism, beneficence, goodness, individuality, and the need for continuing spiritual education as a component of a holistically competent practice.     

Supratentorial cavernous haemangiomas and epilepsy: a review of the literature and case series

OBJECTIVES: To characterise the clinical features and response to treatment of supratentorial cavernomas associated with epilepsy. METHODS: A systematic review of the literature was carried out and a retrospective case series of patients with cavernoma diagnosed by MRI and/or histology was compiled. Patient selection biases in the literature review were reduced as far as possible by selection of unbiased publications. RESULTS: In the literature, cavernomas were relatively less common in the frontal lobes. There were multiple cavernomas in 23% of cases. The main clinical manifestations were seizures (79%) and haemorrhage (16%). The annual haemorrhage rate was 0.7%. The outcome after excision was good with improvement in seizures in 92% of patients. In the case series the surgical outcome was less favourable, reflecting inclusion of a higher proportion of patients with intractable epilepsy. In both the literature review and the case series, outcome was poorer in cases with a longer duration of seizures at the time of surgery. CONCLUSIONS: The good surgical results, particularly in cases treated earlier, and the significant cumulative haemorrhage rate, suggest that excision is the optimum treatment. However, these factors have not been examined prospectively and, despite the availability of several retrospective studies, the optimum treatment, particularly for non-intractable cases, will only be determined by a prospective study.