Hairy Cell Leukemia, an Ultrastructural Study with Double Immunogold Labeling

Two cases of hairy cell leukemia were studied using a novel method of sequential double immunogold labeling for both scanning and transmission electron microscopy. Characteristic ribosome lamellae complexes were observed in one case only. The antigens expressed on the surface of hairy cells were those recognized by anti-CD 11c and anti-CD20 murine monoclonal antibodies. All hairy cells, in both cases, co-labeled for the corresponding antigens, as demonstrated by recognizing colloidal gold markers of distinct sizes (5 and 20 nm, or 15 and 40 nm) under SEM and TEM. The specificity of the double labeling method seems to be most satisfactory. Immuno-electron microscopy enables us to characterize the integrated ultrastructural and antigenic phenotype of hairy cells at the single cell level. This represents an unique analytical approach which may contribute significantly in further studies aimed at a better understanding of the pathogenesis of hairy cell leukemia.     

Spleen alterations in hairy cell leukemia: a scanning electron microscopic study

In Hairy Cell Leukemia (HCL) peripheral blood and bone marrow cells show under the scanning electron microscope (SEM) a characteristic surface with numerous ruffles and microvilli. The spleen of a patient affected by HCL was studied by SEM after fresh sectioning and routine preparation. Cells with the typical "hairy" surface were observed infiltrating the red pulp, altering the normal reticular meshwork and causing red blood cell distortion. In the sinuses, hairy cells adhered to the endothelial cells causing sinus dilatation and destruction. Aggregates of hairy cells delimiting pooled erythrocytes were also observed and may represent the "pseudosinuses" described in previous light and transmission electron microscopic studies. These preliminary findings may explain the condition of hypersplenism which characterizes HCL. In addition, SEM is proposed as a rapid and simple method to identify HCL spleen involvement.     

Electroacupuncture in rats normalizes the diabetes‐induced alterations in the septo‐hippocampal cholinergic system

Diabetes induces early sufferance in the cholinergic septo‐hippocampal system, characterized by deficits in learning and memory, reduced hippocampal plasticity and abnormal pro‐nerve growth factor (proNGF) release from hippocampal cells, all linked to dysfunctions in the muscarinic cholinergic modulation of hippocampal physiology. These alterations are associated with dysregulation of several cholinergic markers, such as the NGF receptor system and the acetylcholine biosynthetic enzyme choline‐acetyl transferase (ChAT), in the medial septum and its target, the hippocampus. Controlled and repeated sensory stimulation by electroacupuncture has been proven effective in counteracting the consequences of diabetes on cholinergic system physiology in the brain. Here, we used a well‐established Type 1 diabetes model, obtained by injecting young adult male rats with streptozotocin, to induce sufferance in the septo‐hippocampal system. We then evaluated the effects of a 3‐week treatment with low‐frequency electroacupuncture on: (a) the expression and protein distribution of proNGF in the hippocampus, (b) the tissue distribution and content of NGF receptors in the medial septum, (c) the neuronal cholinergic and glial phenotype in the septo‐hippocampal circuitry. Twice‐a‐week treatment with low‐frequency electroacupuncture normalized, in both hippocampus and medial septum, the ratio between the neurotrophic NGF and its neurotoxic counterpart, the precursor proNGF. Electroacupuncture regulated the balance between the two major proNGF variants (proNGF‐A and proNGF‐B) at both gene expression and protein synthesis levels. In addition, electroacupuncture recovered to basal level the pro‐neurotrophic NGF receptor tropomyosin receptor kinase‐A content, down‐regulated in medial septum cholinergic neurons by diabetes. Electroacupuncture also regulated ChAT content in medial septum neurons and its anterograde transport toward the hippocampus. Our data indicate that repeated sensory stimulation can positively affect brain circuits involved in learning and memory, reverting early impairment induced by diabetes development. Electroacupuncture could exert its effects on the septo‐hippocampal cholinergic neurotransmission in diabetic rats, not only by rescuing the hippocampal muscarinic responsivity, as previously described, but also normalizing acetylcholine biosynthesis and NGF metabolism in the hippocampus.     

Immunogold scanning electron microscopy applied to the study of Langerhans cells immunophenotype

An immunogold technique in scanning electron microscopy was applied to the detection of Langerhans cell surface CD1a antigen in a heterogeneous human epidermal cell suspension. Scanning electron microscopy investigations performed in the secondary electron imaging mode and in the backscattered electron imaging mode allowed to define Langerhans cell surface morphology and the labeling degree, respectively. In particular, the backscattered electron imaging mode of the scanning electron microscope appeared very useful in identifying colloidal gold particles and, as a result, made it possible to make total counts of the labeled surface antigenic sites. Finally, the combination of secondary electron and backscattered electron signals generated mixed images with the Langerhans cell surface morphology well recognizable together with distinct gold particles. The immunogold labeling in scanning electron microscopy here described represents a highly sensitive method and yields a new improvement in the study of Langerhans cells immunophenotype.     

Position in the second stage of labour and de novo onset of post-partum urinary incontinence

Introduction and hypothesis

The aim of this study was to evaluate the role of the maternal position at the time of delivery on the onset of de novo symptoms of urinary incontinence (UI) in the post-partum period.

Methods

This prospective study evaluated the data of consecutive women undergoing labour and delivery, between January 2014 and July 2014. We included only women with a singleton pregnancy undergoing vaginal delivery. During the study period, patients chose to deliver in the position that they considered the most comfortable. The onset of UI was evaluated according to the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-sf).

Results

Overall, 716 primiparous women were included in the study. Sixty women refused the 12-week post-partum interview (8.4%). Women were divided in two groups: 296 women (45.1%) who chose an upright position during delivery (group 1) and 360 women (54.9%) who chose a supine position (group 2). Group 1 had a significantly lower episiotomy rate, but a higher rate of greater than second degree perineal tears. In group 1 we found a significantly lower rate of de novo UI (40.5% vs 48.9%, p?=?0.03) and in particular of stress urinary incontinence. Via multivariate analysis, birth position was the only factor correlating with the occurrence of urinary incontinence in the post-partum period (OR: 1.52; 95%CI: 1.06, 2.18; p?=?0.02).

Conclusions

Upright positions at delivery are related to a lower episiotomy rate and a higher rate of greater than second degree perineal tears. Supine positions are an independent risk factor for the onset of de novo UI.

     

Sexual dimorphism and laterality in the evolution of the primate prefrontal cortex

Social selective pressures are commonly considered as the main driving force of primate brain evolution. Primate social behaviour is, however, known to be sexually dimorphic, and no previous study has made a direct comparison between male and female brain structures across species. We quantify sex-specific evolutionary trends in the prefrontal cortex of anthropoid primates (including humans) to investigate how sexual selection has shaped brain evolution in primates. The prefrontal cortex is of particular importance to the investigation of sexual dimorphism in primate brain evolution because of its association to those cognitive capacities central to primate (and human) evolution: sociality and higher-order cognitive processing. Our results demonstrate sex-by-hemisphere differences in the evolution of the prefrontal cortex in humans and non-human anthropoid primates congruent with the principal selective pressures considered to underlie anthropoid behavioural evolution. Our findings further show how sexual selection can shape brain adaptation in primates and provide an evolutionary framework for interpreting sex and sex-by-hemisphere differences in cortical organization in humans and non-human primates.     

Receptiveness and changes in the nursing work process in healthcare units in Campinas, São Paulo, Brazil

This article describes changes in the nursing work process resulting from implementation of the process referred to as "receptiveness", following introduction of the Paidéia Family Health Program in health care units in Campinas, S?o Paulo, Brazil, since 2001. Data were collected through participant observation and semi-structured interviews to examine the nursing work process, specifically in relation to "receptiveness". The analysis was based on two possible definitions of "receptiveness": as an attitude towards users and their needs, and as a device for reorganizing the work process. The study also analyzes "receptiveness" in relation to: organization of the work process, guarantee of accessibility, expanded demands on the health service and health team, changes in the nursing work process, humanization, and bonding.     

Esophageal involvement as an uncommon modality of relapse of Hodgkin lymphoma

We present a case of systemic Hodgkin's lymphoma, relapsed with esophageal involvement after 3 years of complete remission. The importance of an accurate diagnostic work-up is emphasized. Esophagectomy and chemotherapy followed by bone marrow transplantation allowed a complete response and the long-term survival of the patient.