Retinoic acid inhibits junctional communication between animal cells

Retinoic acid inhibits junctional communication between a varietyof vertebrate cell types in culture. It reduces the intercellulartransfer of ³H-nucleotides between Syrian hamster kidney fibroblasts(BHK 21/13), Chinese hamster lung fibro-blasts (V79), rat liverepithelial cells (BRL), Swiss mouse embryo fibroblasts (3T3),rainbow trout gonadal fibroblasts (RTG2) and Xenopus embryofibroblasts (Xen). It also reduces metabolic cooperation betweenhypoxanthine-guanine phosphoribosyl transferase deficient mutantand wild-type BHK cells. The inhibition is rapid (intercellulartransfer of iontophoretically injected Lucifer Yellow CH betweenBRL cells is completely blocked after the cells have been exposedto 10^–4 M retinoic acid for 5 min), and is fully reversedwhen the drug is removed. Based on these results and the observationthat the amount of gap junctional protein isolated from cellsgrown in the presence of retinoic acid for 1 h is the same andafter 24 h is increased (1.3- to 3.1-fold) compared with theamount isolated from untreated cells, we suggest that the inhibitoryeffect is mediated by the reversible closure of junctional channels.     

The effect of highly active antiretroviral therapy on cervical cytologic changes associated with oncogenic HPV among HIV-infected women.

OBJECTIVE: Cervical intraepithelial neoplasia (CIN), a common condition among HIV-infected women, has been linked to HIV load and immune status. Highly active antiretroviral therapy (HAART) improves immunologic and virologic status. This study was undertaken to determine the relationship between HAART use and CIN. DESIGN: Cohort study. The Women's Interagency HIV Study (WIHS) in five cities in the USA (Bronx/Manhattan, New York; Brooklyn, New York; Chicago, Illinois; Los Angeles, California; San Francisco Bay area, California; Washington, District of Columbia). METHODS: HIV-infected women were followed every 6 months with Papanicolaou smears and cervicovaginal lavage for human papillomavirus (HPV) DNA testing. To characterize exposures that changed over time and to capture the dynamic nature of cytologic changes, Papanicolaou smear findings from each participant's consecutive visits were defined as a pair. We determined the proportion of all pairs that exhibited either regression or progression, according to HAART exposure, HPV results and Papanicolaou smear status. As participants could contribute multiple pairs, inferences were based on robust methods to adjust for correlated observations. RESULTS: Women with persistent HPV infection were more likely to have progression of their lesions. After adjustment for CD4 cell count and Papanicolaou smear status, women on HAART were 40% (95% confidence interval, 4-81%) more likely to demonstrate regression and less likely (odds ratio, 0.68; 95% confidence interval, 0.52-0.88) to demonstrate progression CONCLUSIONS: HAART altered the course of HPV disease in HIV-infected women, reducing progression and increasing regression. As HPV disease is a common sex-specific manifestation of HIV disease this effect of HAART would be a major additional benefit from this modality of therapy.     

Porokeratosis Causing Change in Melanocytic Nevi

Large cell transformation of mycosis fungoides (MF) is an uncommon phenomenon. We present a case of CD30‐positive large cell transformation and discuss its possible pathophysiology. A 74 year‐old male with a 36‐year history of patch stage MF presented with a 3‐month history of right chest cellulitis that was refractory to IV antibiotic treatment. Skin biopsies from his thigh demonstrated a patchy dermal infiltrate of irregular and hyperchromatic lymphocytes and epidermotropism. The majority of the infiltrate was positive for CD4, CD3, CD2, and negative for CD7. Only 10% were positive for CD25 and CD8. Biopsies obtained from the ulcerated chest nodules showed a dermal infiltrate of large and pleomorphic lymphoid cells with prominent nucleoli. These large lymphoid cells were strongly positive for CD3, CD30, CD25, CD2 and UCHL‐1. Occasional cells were positive for CD4 and CD20. They were negative for ALK‐1, TIA‐1, CD7, CD8, and CD15. T‐gamma receptor gene rearrangement analyses by polymerase chain reaction demonstrated a clonal process with similar rearrangement patterns identified in the patch stage MF as well as in large cell transformation areas. Examinations of his peripheral blood and bone marrow were negative. The patient had tolerated one cycle of CHOP chemotherapy.     

Severe Combined Immunodeficiency (SCID)-Associated Dyschromia with Subsequent Repigmentation: A Report of Two Patients

Abstract:  Severe combined immunodeficiency (SCID) often presents with mucosal infections, cutaneous infections and eczematous rashes. We present two patients with history of SCID diagnosed at an early age who experienced diffuse dyschromia associated with their bone marrow and stem cell transplants. Dyschromias may be caused by numerous factors including medications, genetics, environmental contacts, or as a sequela of underlying chronic disease. These case reports describe progressive repigmentation to original skin color after the occurrence of dyschromia in two patients with SCID.     

Trauma to the elbow and forearm

Elbow and forearm trauma constitute a significant percentage of upper extremity injuries. A thorough understanding of the anatomy and mechanism of injury is necessary for obtaining the most accurate radiographic interpretation in both the pediatric and adult populations. Proper radiographic positioning and choice of the best imaging modality are crucial to ensure the best orthopedic treatment and reduce the incidence of post-treatment complications.     

Radiology of wrist and hand injuries in athletes

Traumatic injuries are a major cause of hand and wrist pain in athletes. Wrist injuries include fractures, dislocations, and instability patterns. Hand injuries include tendon injuries, ligamentous injuries, and fractures. In this article we have presented the radiographic appearance of the more common of these injuries.     

How serious of a problem is staff turnover in substance abuse treatment? A longitudinal study of actual turnover

In the substance abuse treatment field, the annual turnover rate is cited as being anywhere between 19% and 50% (J.A. Johnson & P.M. Roman, 2002; S.L. Gallon, R.M. Gabriel, J.R.W. Knudsen, 2003; H.K. Knudsen, J.A. Johnson, & P.M. Roman, 2003; A.T. McLellan, D. Carise, & H.D. Kleber, 2003). However, no research to date has evaluated these claims by tracking turnover longitudinally using organizational turnover data from substance abuse treatment centers. This research presents the results of a longitudinal study designed to systematically examine actual turnover among counselors and clinical supervisors. Twenty-seven geographically dispersed treatment organizations, serving a wide range of clients in the public and private sector, provided data for the study over a 2-year time span (2008–2009). The annual turnover rate was 33.2% for counselors and 23.4% for clinical supervisors. For both groups, the majority of turnover was voluntary (employee-initiated). Specific reasons for turnover were largely consistent across the two groups, with the most common reason being a new job or new opportunity. The findings are discussed in terms of the unique employment context of substance abuse treatment. Practical recommendations are also discussed to help stem the tide of turnover in the field of substance abuse treatment.     

Kritik der verschiedenen Lagerungs- und Verbandmethoden bei Schussfracturen der unteren Extremitäten,besonders für den ersten Transport der Verwundeten

Ohne Zusammenfassung     

Improvement in the routine screening performance of cytotechnologists over time

BACKGROUND:

Documenting the performance of gynecologic screening in actual practice settings is difficult to achieve. In the current study, the screening performance of 11 individual cytotechnologists as well as that of the overall laboratory over 2 consecutive time periods was examined using the rapid prescreening (RPS) method.

METHODS:

RPS was performed by all cytotechnologists in a single laboratory over 2 separate 8‐month periods. The sensitivity of screening for individual and groups of cytotechnologists was examined. For purposes of comparison, cytotechnologists were divided into 2 groups: screeners with an overall routine sensitivity ≥95% and screeners with an overall sensitivity <95%.

RESULTS:

Atypical squamous cells (ASC) were used as a threshold, and routine screening sensitivity was found to vary from 68.3% to 96.8%. The overall sensitivity of the laboratory for RPS and routine screening was 43.6% and 88.4%, respectively. Over time, the overall laboratory sensitivity of routine screening improved from 85.3% to 91.3% (P = .01). During this same time frame, the sensitivity of the screeners with an overall sensitivity <95% improved from 79.3% to 91.2% (P < .001), whereas the sensitivity of screeners with an overall routine sensitivity ≥95% remained the same (96.1% to 96.4%; P = .6).

CONCLUSIONS:

In addition to improved overall performance of the laboratory by detecting and correcting errors, the results of the current study indicate that using RPS consistently over time might play a role leading to improved performance of cytotechnologists with an overall routine sensitivity <95% but not of cytotechnologists with an overall routine sensitivity ≥95%. Cancer (Cancer Cytopathol) 2009. © 2009 American Cancer Society.