Evaluation of the accuracy of panoramic radiograph in the definition of maxillary sinus septa

The purpose of this study was to determine the accuracy of panoramic radiography in identification of maxillary sinus septa. Out of 68 sinuses were radiographically examined using both panoramic and computerized tomographic radiographs (CT scan). Using CT scan, 24 (35.9%) out of 68 cases maxillae showed at least one septum, 22 sinuses (32.3%) showed one septum, whereas two sinuses (2.9%) exhibited two septa. Panoramic radiograph led to a false diagnosis regarding the presence or absence of sinus septa in 18 of 68 sinuses (26.5%). On the other hand, they gave negative diagnosis of sinus septa in 12 of 24 septa (50%). There was fully agreement between the two methods (positive septa) only in 12 of 24 septa (50%). We cannot depend on panoramic radiograph for the detection of sinus septa because it can lead to false or negative results.     

Modulation of malignant B cell activation and apoptosis by bcl-2 antisense ODN and immunostimulatory CpG ODN

Inhibition of bcl-2 expression by antisense oligodeoxynucleotides (ODN) might render bcl-2 overexpressing malignant B cells more susceptible to chemotherapy. ODN containing unmethylated CG dinucleotides (CpG) are known to activate B cells. We studied the effects of two bcl-2 antisense ODN, with (G3139) or without CG dinucleotides (NOV 2009) within the sequence, and the effects of a nonantisense, CpG-containing ODN (ODN 2006) on activation and apoptosis of malignant B cell lines and primary B-CLL cells. Without cationic lipids, no antisense-mediated inhibition of bcl-2 synthesis was achieved with G3139 and NOV 2009. Instead, G3139, but not NOV 2009, induced similar changes as ODN 2006 in proliferation, expression of costimulatory and antigen-presenting molecules, as well as in bcl-2 and bcl-xL levels of primary B-CLL cells. G3139 and ODN 2006 inhibited in vitro, spontaneous apoptosis in B-CLL cells of patients with high serum thymidine kinase activity (s-TK, marker for proliferative activity of malignant B cells), whereas in patients with low s-TK activity, apoptosis was induced. In conclusion, our results suggest that modulation of malignant B cell apoptosis by G3139 depends on its immunostimulatory properties rather than on antisense-mediated reduction of bcl-2 expression. Immunostimulatory CpG ODN may have a therapeutic potential in patients with B-CLL, especially those with low s-TK activity.     

Interferon-producing cells: on the front line in immune responses against pathogens

Interferon-producing cells (IPC) constitute a small population of leukocytes that secrete high levels of type I interferons in response to viruses. Although human IPC have been known for almost two decades, murine IPC have been identified only recently. Furthermore, it has been shown that IPC correspond to the enigmatic 'plasmacytoid cells' identified in human lymph nodes during infections. These breakthroughs have brought IPC to the attention of immunologists for their role in innate immunity and in shaping T cell responses. Here we review recent progress and outstanding questions in the field.     

Prognostic value of [<Superscript>18</Superscript>F]FDG-PET imaging in small cell lung cancer

Positron emission tomography (PET) utilizing fluorine-18 fluorodeoxyglucose (FDG) has been used in the evaluation of non-small cell lung cancer (NSCLC). Recently its use in the staging of small cell lung cancer (SCLC) has been reported. However, the prognostic value of FDG-PET imaging in SCLC has not been studied. We performed a retrospective analysis to assess this, with the following hypotheses: (1) PET-positive patients would have a less favorable prognosis than PET-negative patients and (2) a high standardized uptake value (SUV) would be associated with a poor prognosis. Retrospective review of a mixed population of treated and untreated patients imaged between 1995 and 2000 was performed. Results of 62 scans in 46 patients were analyzed. There were 8 untreated and 38 treated patients. Findings were correlated with pathology, computed tomography/magnetic resonance imaging and clinical data. The sensitivity of PET scanning was 100% with pathological correlation. The prognostic value of a positive PET study was determined. Overall survival in PET-positive cases was significantly worse than that in PET-negative cases ( P=0.0108). Correlation of SUV(max) with survival showed a significant negative correlation ( P=0.0021). In the eight untreated patients, scans were strongly positive and in all cases the scan results concurred with the final clinical stage assigned on the basis of conventional methods. We conclude that FDG-PET imaging provides prognostic information in treated patients. A positive study and a high SUV(max) are significantly associated with poor survival. Additionally, FDG-PET may be helpful in staging and follow-up.     

Bcl-2 and bax expression in advanced non-small cell lung cancer: lack of correlation with chemotherapy response or survival in patients treated with docetaxel plus vinorelbine

Surgical series of non-small cell lung cancer (NSCLC) pathologic samples have shown that the expression of the proteins bcl-2 and bax, which regulate cell death, may have prognostic implications. Laboratory data also suggests that these proteins may impact chemotherapy response. In order to determine the rate of bcl-2 and bax expression in advanced NSCLC and assess the impact on chemotherapy response and patient survival, we performed immunohistochemistry on biopsy samples from patients enrolled in a phase I/II trial of vinorelbine plus docetaxel. We chose to study the pathology of patients in this specific trial because both docetaxel and vinorelbine phosphorylate bcl-2 and we hypothesized that this mechanism may affect clinical outcome. The goal of this study was to determine the feasibility of this analysis, and to observe any differences in response rate or survival based on bcl-2 or bax staining results. Unstained slides from paraffin blocks were obtained for 31 patients (55%) on the phase I/II trial. The patient characteristics for this subgroup did not differ significantly from the entire cohort of patients on the trials. Bcl-2 staining was positive in 5/31 samples (16%, 95% CI 3-29%) and bax was positive in 19/28 samples (68%, 95% CI 51-85%). Bcl-2 and bax staining did not correlate with response (p = 0.65 and 1.00 respectively, Fisher's exact test), or survival (by Kaplan-Meier curves). In conclusion, bcl-2 and bax expression was similar in this population with advanced NSCLC to previously reported results for early stage disease, but did not predict response to vinorelbine plus docetaxel in this series.     

产后出血的预防和处理指南

目的:为产后出血(PPH)的预防和临床处理作一综述,为临床医师提供预防和处理产后出血的指南。涉及方面:预防、适当干预、使其影响最小化的方法。结果:建立常规,便于临床医师鉴别可能的高危人群,一旦发生产后过多出血,可指导临床如何迅速处理。证据:遵循加拿大定期健康检查办公室制定的证据等级。评估:由产科专家完善。利弊和成本:评估子宫收缩药和其他积极处理措施的方便性、正确性、有效性和安全性。建议:根据证据的等级,本指南分等级列出了12条建议。确认:按照MeSH词表推荐的postpartum haemorrhage在medline上查询相关文献,在Cochrane图书馆查找相关研究文献,并参考the ALARMcourse Manual。发起人:由产科临床实践委员会制定和综述,并由SOGC(加拿大妇产科协会)委员会批准。     

Lack of sialidase activity in Candida albicans and Candida glabrata

Because several micro-organisms having close contact to animal hosts and man produce sialidase (EC 3.2.1.18) as a tool for adhesion and invasion, we investigated two Candida species for the presence of this enzyme. Two sensitive assays, a fluorometric test with 4-methylumbelliferyl-alpha-D-N-acetylneuraminic acid and a radiometric test with 3H-labelled sialyllactitol as sialidase substrates, were applied to detect sialidase activity. None of 40 Candida albicans and 10 C. glabrata strains grown in three different media exhibited sialidase activity, but the positive control Ophiostoma stenoceras produced sialidase under comparable conditions. Our surprising negative findings are divergent from an earlier positive report, which may be due to strain selection or bacterial contamination. These results indicate that sialidase is probably of no relevance in cutaneous or mucosal candidoses.