Adenocarcinoma of the lung: electron microscopy of fine-needle aspiration biopsy specimens--a review of 73 cases.

During a 10-yr period, 128 consecutive cases of pulmonary adenocarcinoma of varying differentiation were diagnosed with percutaneous fine-needle aspiration biopsy. Sediments from the needle and syringe washings with 3% glutaraldehyde were obtained and processed for electron microscopic evaluation in 73 cases. Our results showed three types of adenocarcinoma: 62 cases of nonciliated bronchiolar cell origin, 6 cases of bronchioloalveolar cell origin, and 3 cases of mucous cell origin. In addition, there was an example of combined adenosquamous carcinoma and an instance of amphicrine carcinoma. Our study provided a more precise definition of the cytologic diagnosis and insight into the heterogeneity of lung adenocarcinoma. However, prognostic differences between cell types of lung adenocarcinoma were not observed.     

Cholinergic modulation of neostriatal output: a functional antagonism between different types of muscarinic receptors.

It is demonstrated that acetylcholine released from cholinergic interneurons modulates the excitability of neostriatal projection neurons. Physostigmine and neostigmine increase input resistance (RN) and enhance evoked discharge of spiny projection neurons in a manner similar to muscarine. Muscarinic RN increase occurs in the whole subthreshold voltage range (-100 to -45 mV), remains in the presence of TTX and Cd2+, and can be blocked by the relatively selective M1,4 muscarinic receptor antagonist pirenzepine but not by M2 or M3 selective antagonists. Cs+ occludes muscarinic effects at potentials more negative than -80 mV. A Na+ reduction in the bath occludes muscarinic effects at potentials more positive than -70 mV. Thus, muscarinic effects involve different ionic conductances: inward rectifying and cationic. The relatively selective M2 receptor antagonist AF-DX 116 does not block muscarinic effects on the projection neuron but, surprisingly, has the ability to mimic agonistic actions increasing RN and firing. Both effects are blocked by pirenzepine. HPLC measurements of acetylcholine demonstrate that AF-DX 116 but not pirenzepine greatly increases endogenous acetylcholine release in brain slices. Therefore, the effects of the M2 antagonist on the projection neurons were attributable to autoreceptor block on cholinergic interneurons. These experiments show distinct opposite functions of muscarinic M1- and M2-type receptors in neostriatal output, i.e., the firing of projection neurons. The results suggest that the use of more selective antimuscarinics may be more profitable for the treatment of motor deficits.     

Pharmacogenomic polygenic risk score for clopidogrel responsiveness among Caribbean Hispanics: A candidate gene approach

This multicenter clinical study was aimed at conducting a targeted pharmacogenomic association analysis of residual on‐clopidogrel platelet reactivity in 474 Caribbean Hispanic patients. Platelet reactivity was measured using the VerifyNow P2Y12 assay and clopidogrel resistance was defined as P2Y12 reaction units (PRUs) greater than or equal to 208. Genotyping was performed using the whole‐genome Infinium MEGA BeadChip array. An ancestry‐adjusted, weighted polygenic risk score (wPGxRS) was developed to account for the effect of multiple variants on PRU and compared between clopidogrel responders and nonresponders. The mean PRU across the study cohort was 173.8 ± 68.5 and 33.5% of patients were defined as clopidogrel resistant. Multivariate linear regression showed that 19% of PRU variability was attributed to nine independent predictors, with CYP2C19*2 (rs4244285) accounting for ~ 7% of observed PRU variation (p < 0.001). PON1 rs662, ABCB1/MDR1 rs2032582, PEAR1 rs12041331 carrier status, and the interaction between African ancestry and rs12041331 carriers also predicted PRU among the participants (p ≤ 0.05). A clear gene‐dose effect was detected between PRU and CYP2C19*2 genotype, consistent with previous studies in European patient populations, as well as rs12777823. Importantly, a significant positive correlation was detected between our novel wPGxRS (4 variants) and PRU among the Hispanic patient population (r _p = 0.35, p < 0.001). Moreover, the wPGxRS discriminated between nonresponders and responders (p = 0.003), indicating that this multigene‐based score is a useful predictor of clopidogrel resistance among Caribbean Hispanics. Taken together, these results help close the gap of knowledge on clopidogrel pharmacogenomics and its potential clinical implementation in this under‐represented population.

Study Highlights

• WHAT IS THE CURRENT KNOWLEDGE ON THE TOPIC?

CYP2C19*2 is significantly associated with an impaired response to clopidogrel in patients of mainly European ancestry, but this genetic variant accounts for only a small fraction of observed variability in clopidogrel resistance.

• WHAT QUESTION DID THIS STUDY ADDRESS?

This study answers the question of whether there is an association of relevant candidate pharmacogenes involved in clopidogrel absorption, metabolism, and pharmacodynamics with antiplatelet response among Caribbean Hispanics using a multigene‐based score approach.

• WHAT DOES THIS STUDY ADD TO OUR KNOWLEDGE?

This study closes the existing gap of knowledge about clopidogrel pharmacogenomics in Caribbean Hispanics by both confirming and identifying relevant genetic determinants of clopidogrel responsiveness in this underrepresented population after developing an ancestry‐based polygenic risk score model.

• HOW MIGHT THIS CHANGE CLINICAL PHARMACOLOGY OR TRANSLATIONAL SCIENCE?

By gaining a better understanding of underlying determinants of poor clopidogrel response among marginally represented groups, such as Caribbean Hispanics, worldwide efforts to translate such findings into a global precision medicine paradigm of true benefit for everyone can finally bring cardiovascular health equity to the population at large.     

Effect of the Structural and Morphological Properties of Surfactant-Assisted Hydroxyapatite on Dermal Irritation and Antibacterial Activity

Hydroxyapatite (HAp) nanoparticles with a homogeneous rod morphology were successfully synthesized using the hydrothermal method. The powders were characterized using Fourier transform infrared spectroscopy, X-ray diffraction, and scanning electron microscopy. The antibacterial and dermal irritation analyses of the samples were performed and discussed. The use of cationic and anionic surfactants, namely, cetyltrimethylammonium bromide (CTAB) and sodium dodecyl sulfate (SDS), respectively, at a low concentration (2.5 mol%) modified the length/diameter (L/D) ratio of the HAp rods. Structural characterizations of hydroxyapatite synthesized without surfactant (HA), with 2.5 and 5 mol% of SDS (SDS− and SDS+, respectively), and with 2.5 and 5 mol% of CTAB (CTAB− and CTAB+, respectively) revealed well-crystallized samples in the hexagonal phase. The CTAB− sample presented antibacterial activity against Pseudomonas aeruginosa, Escherichia coli, Streptococcus anginosus, Staphylococcus aureus, Micrococcus luteus, and Klebsiella pneumoniae, suggesting that antimicrobial susceptibility was promoted by the bacterial nature and the use of the surfactant. Dermal irritation showed no clinical signs of disease in rabbits during the study, where there was neither erythema nor necrosis at the inoculation sites.     

From the organ bath to the whole person: a review of human colonic motility

Motor function of the colon is essential for health. Our current understanding of the mechanisms that underlie colonic motility are based upon a range of experimental techniques, including molecular biology, single cell studies, recordings from muscle strips, analysis of part or whole organ ex vivo through to in vivo human recordings. For the surgeon involved in the clinical management of colonic conditions this amounts to a formidable volume of material. Here, we synthesize the key findings from these various experimental approaches so that surgeons can be better armed to deal with the complexities of the colon.     

Fine-needle aspiration cytology of extraskeletal Ewing's sarcoma

Extraskeletal Ewing's sarcoma (EES) is a round-cell malignancy that manifests most commonly in the paravertebral and intercostal regions. It occurs predominantly in adolescents and young adults, between the ages of 10 and 30 yr, and follows an aggressive course with a high recurrence rate. Distant metastasis is also common. The tumor is often confused with other round, small-cell neoplasms, including primitive neuroectodermal tumor, neuroblastoma, embryonal rhabdomyosarcoma, and lymphoma. This report pertains to a fine-needle aspiration cytologic diagnosis of EES, supported by clinicopathologic and fine structural correlations in a 56-yr-old man who presented with a rapidly growing, massive, right groin mass. The smears showed a diffuse cellular population of malignant round cells composed of two types: one group of larger cell exhibiting a thin-rim, pale cytoplasm, less hyperchromatic nuclei, nucleoli, and diffusely dispersed chromatinic nuclear details; and the second group of smaller and darker cells with highly hyperchromatic and almost smudged nuclei. These are chief cells and dark cells, respectively. Special studies revealed significant intracytoplasmic glycogen and positive vimentin and HBA-71 immunostaining. Cytogenetic findings of chromosomal 11;22 translocation is also supportive of the diagnosis of EES. Diagn. Cytopathol. 1998;18: 137–140. © 1998 Wiley-Liss, Inc.     

Altered pattern of cytokine production by peripheral blood CD2+ cells from B chronic lymphocytic leukemia patients

To determine if activation-induced cytokine production is altered in CD2+ lymphocytes from B-CLL patients, cytokine levels were determined by ELISA in supernatants of PHA-stimulated cultures of CD2+ cells from 33 B-CLL patients and 22 healthy controls. The production of Interferon γ (IFN-γ) and Tumor Necrosis Factor (TNF-α) by mitogen-activated CD2+ lymphocytes from B-CLL patients was higher than that found in healthy controls, while no differences were found in TNF-β production. IFN-γ and TNF-α levels determined at 72 h in PHA-stimulated CD2+ cell cultures from B-CLL patients statistically correlated with the percentages of CD3+CD45RO+ and CD3−CD56+ lymphocytes, respectively. Although there were differences in the production kinetics of interleukins (ILs) 2 and 4 between B-CLL patients and the healthy controls, no differences were found at the time when the levels of both interleukins peak. The production of both IFN-γ and IL-4 by PHA-stimulated CD2+ lymphocytes from non-smouldering B-CLL patients was significantly higher than that from smouldering B-CLL patients while no significant differences were found in the production of IL-2, TNF-α, and TNF-β between the two B-CLL patient groups. These data suggest that functional alterations in the production of cytokines by CD2+ cells from B-CLL patients could help to explain the expansion of leukemic cells in B-CLL patients. Am. J. Hematol. 57:93–100, 1998. © 1998 Wiley-Liss, Inc.