Molecular heterogeneity in MCL defined by the use of specific VH genes and the frequency of somatic mutations

This study explores whether the presence of somatic mutations or a biased use of IgV(H) genes were associated with the clinical features in a series of 96 patients with mantle cell lymphoma (MCL). The cases were studied by seminested polymerase chain reaction using primers from the FR1 and J(H) regions. There was an unexpectedly high frequency of somatic mutations, with 29 of 103 sequences showing more than 2% of mutations. Biased usage of specific V(H) segments was also found; the most widely used genes in this series were V(H)3-21 (10 cases), V(H)3-23 (9 cases), V(H)4-34 (11 cases), and V(H)4-59 (9 cases). V(H) mutation frequency, taking into account different thresholds, did not distinguish different overall survival probabilities. Nevertheless, a more frequent use of V(H)3-21 or V(H)4-59 (8 of 18) was observed in the group of long-term survivors (18 cases > 5 years; P <.01). None of these long-term survivors presented the V(H)3-23 gene rearrangement. As in other lymphoproliferative disorders, the expression of CD38 or p53 or both was associated with a poorer survival probability. This nonrandom usage of IgV(H) segments suggests that specific antigens may play a pathogenically relevant role in the genesis or progression of subsets of MCL cases and may help in distinguishing a significant group of MCL long-term survivors.     

Brucellosis outbreak due to unpasteurized raw goat cheese in Andalucia (Spain), January - March 2002

Eleven brucellosis cases were identified in three municipalities of Cordoba (Andalucia, Spain). A case-control study was conducted, selecting three cases per control. Persons having eaten unpasteurized raw goat cheese produced in a farmhouse located in the epidemic territory, were at higher risk for presenting brucellosis (OR=21.6, IC95%=1.6-639.8). Brucella melitensis serovar 3 was identified in clinical specimens and in goat tissue and milk samples from the herd's farmhouse. Preventive measures were implemented and the outbreak was stopped after the withdrawal of all suspicious cheeses from the market, additional sanitation of the farmhouse and health promotion activities.     

Immunosuppressant treatment adherence, barriers to adherence and quality of life in renal and liver transplant recipients in Spain

To assess the adherence to immunosuppressant therapy (IST) and perceived barriers affecting IST adherence and quality of life (QOL) in patients who had received a renal (RT) or liver transplant (LT), a questionnaire was sent to over 9000 RT and LT recipients in Spain. Questionnaire comprised questions about patient's socio-demographic, organ transplant and medication characteristics; IST adherence and patient's perceived barriers to adherence; and patient's QOL using the EuroQol. Data from 1983 RT patients and 1479 LT patients were analyzed. Self-reported adherence to IST in RT (92.6%) and LT (88.5%) recipients was high. Daily medication intake (mean of 2-3 doses/d per patient) was considered a lifestyle restriction in about 25% of transplant recipients and was the most common barrier to adherence perceived by over 30% of RT and LT patients. Overall, high-intensity treatment regimens were associated with poorer QOL (EuroQol <70) compared with low-intensity treatment regimens. Most RT (71.0%) and LT (61.4%) patients would prefer to suppress the evening dose if they were able to. Although high adherence rates to IST were reported in this first large Spanish survey in RT and LT patients, adjustment of daily treatment intensity by less frequent dosing may be an adequate strategy to minimize barriers to adherence and improve QOL.     

Strontium in Finnish foods

The strontium content of Finnish foods was analyzed and the average daily intake of strontium estimated according to national food consumption statistics. The average intake was 1.9 mg of Sr/d/person, which is well within the range of intakes found in other industrialized countries. The most important sources were dairy products (35%), and vegetables and fruits (32%). The strontium contents of foods showed a highly significant correlation with their calcium contents. No special problem was evident in dietary strontium in Finland.     

Tocopherols and tocotrienols in Finnish foods: human milk and infant formulas

Individual tocopherols and tocotrienols in human milk, mother's milk substitutes and other infant formulas have been determined by an HPLC method. 107 human milk samples (23 colostral, 22 transitional and 62 mature) obtained from six healthy mothers throughout the lactation were found to contain all the tocopherols, although delta-tocopherol occurred only in traces. A high content of alpha-tocopherol was found in colostrum (average 1.90 +/- 1.62 (SD) mg/100 g), as compared with transitional (0.65 +/- 0.22 mg/100 g) and mature milk (0.47 +/- 0.16 mg/100 g). The content of beta-tocopherol averaged 0.05 +/- 0.03, 0.02 +/- 0.01 and 0.02 +/- 0.01 and gamma-tocopherol 0.11 +/- 0.09, 0.07 +/- 0.04 and 0.07 +/- 0.04 mg/100 g in colostral, transitional and mature milk respectively. The alpha-tocopherol equivalents thus were 1.93, 0.66 and 0.49 mg/100 g; their ratios to the contents of polyunsaturated fatty acids meet the nutritional need of the newborn and young infant: 5.7, 2.1 and 1.4 mg/g in colostral, transitional and mature milk. Mother's milk substitutes and gruel and porridge powders are enriched with tocopherol acetate to vitamin E levels similar to or higher than those in human milk: substitutes contained on average 1.4 mg alpha-tocopherol equivalents/100 g and reconstituted powders 1.1 mg/100 g. The ratio of vitamin E to polyunsaturated fatty acids of these infant formulas was higher than the recommended value of 0.6 mg/g. The average values for alpha-tocopherol equivalents in fruit-berry and meat-vegetable infant formulas were 0.46 and 0.38 mg/100 g.     

The assessment of fetal behavior in early pregnancy: comparison between 2D and 4D sonographic scanning

AIM: To determine the accuracy of 4D sonography in the assessment of embryonic and early fetal motor activity in the first trimester of normal pregnancy, in comparison to the 2D sonography. METHODS: Fifty pregnant women between 6-14 weeks of gestation with singleton pregnancy were assigned for the investigation. Two dimensional and four dimensional recordings were displayed on the screen and recorded on the videotape during the 15 minutes observation period. RESULTS: General body, head and limb movements recorded by 2D sonography were notable by 4D technique in the same gestational age. These movements were presented collectively with maximum, minimum, and median frequencies during 15 minutes observation period. Spearman rank order correlation reached statistical significance (P<0.05) between the frequencies of all observed movement patterns assessed by two different techniques. Several movement patterns, such as sideway bending, hiccup, breathing movements, mouth opening and facial movements could be observed only by 2D sonographic technique in this period of gestation. CONCLUSION: Presently, both 2D and 4D methods are required for the assessment of early fetal motor development and motor behavior. It is reasonable to expect that such technological improvement may provide some new information about the intrauterine motor activity and facilitate the prenatal detection of some neurological disorders.