SAS amplification in soft tissue sarcomas.

Gene amplification is an important mechanism of increased gene expression in a number of human solid tumors. We have recently identified and cloned sequences from a novel DNA amplification unit in malignant fibrous histiocytoma. The amplified sequences are derived from chromosome 12q13-14 and encode a gene designated SAS (sarcoma amplified sequence). In the present study, a series of soft tissue sarcomas was studied to characterize further the phenomenon of SAS amplification. Seven of 22 (32%) malignant fibrous histiocytomas and three liposarcomas contained SAS amplification. Strikingly, all of the tumors with SAS amplification occurred in central sites (i.e., in the abdominal or inguinal regions) rather than in the extremities (i.e., in the arms of legs). These observations demonstrate that SAS amplification occurs with a significant frequency in mesenchymal tumors and is particularly associated with abdominal disease.     

Evoked potentials and EEG in multiple sclerosis

Thirteen patients with clinically definite multiple sclerosis (MS) were studied with electroencephalogram (EEG), magnetic resonance imaging (MRI), evoked potentials and cerebrospinal fluid (CSF) analysis. We attempted to correlate the findings with physical disability as defined by Kurtzke score and presence of dementia or seizures. More severe plaque disease on MRI and increased physical disability correlated significantly with abnormality on brain-stem auditory evoked potentials (BAEPs) while visual evoked potential (VEP) abnormality correlated only with MRI findings. No such correlation was found with the EEG. The close relationship between BAEP and MRI abnormalities probably reflects frequent involvement of brain-stem corticospinal pathways.     

Gram-negative bacterial pneumonia with secondary aspergillosis in an AIDS patient

Summary A 40-year-old, HIV-infected female patient received antibiotic treatment for a urinary tract infection. After the initial success of therapy and a symptom-free period, she developed pneumonia with septic shock and adult respiratory distress syndrome (ARDS). In spite of intensive care and respirator therapy with positive end-expiratory pressure (PEEP), she died of infectious toxic shock. Autopsy findings showed relapsing, gramnegative, bacterial pneumonia (morphologically compatible with Klebsiella pneumonia) and secondary, invasive aspergillosis. The pathogenesis and epidemiology of these unusual complications of AIDS are discussed.Abbreviations AIDS acquired immunodeficiency syndrome - ARDS adult respiratory distress syndrome - CDC Centers for Disease Control - HIV human immunodeficiency virus - PEEP positive end-expiratory pressure     

Antimalarial medications in dermatology. A review

Antimalarial medications are effective for the treatment of a variety of dermatologic conditions. Their use is often curtailed by concern for adverse reactions, including ophthalmologic side effects; however, recent evidence points to a greater margin of safety with these medications than was previously appreciated. This article reviews the pharmacology of antimalarial medications as well as indications and safe guidelines for their use in the treatment of dermatologic conditions.     

Removal of Blue Periocular Lower Eyelid Veins by Ambulatory Phlebectomy

BACKGROUND: Prominent periocular veins, primarily of the lower eyelid, are a relatively frequent cosmetic problem. Reported treatment techniques have included electrosurgical, sclerotherapy, and longer-wavelength lasers. OBJECTIVE: Ambulatory phlebectomy can be performed on reticular veins of the leg. This technique has been applied over the past few years to periocular reticular veins in order to observe the results and side effects. METHODS: Using a hook specifically designed for reticular veins, we treated 10 patients who had larger reticular periocular eyelid veins. One or several punctures with an 18-gauge needle were made in the center of the targeted length of vein. The reticular vein was then gently dissected by undermining with the stem of the Ramelet phlebectomy hook. RESULTS: All 10 patients tolerated the procedure well. In 8 of 10 patients there was complete elimination with a single procedure. Surprisingly, no significant hematoma was seen in any patient, although two patients had a small hematoma lasting less than 1 week. Two patients had only partial success, as a small segment of vein was difficult to extract. This was eliminated with a second phlebectomy performed 2 months later in both cases. Edema that is usually seen after sclerotherapy was not noted in any of these patients. CONCLUSIONS: Ambulatory phlebectomy appears to be a safe and effective means of permanently eradicating periocular veins.     

A rearranged lambda 2 light gene chain retards but does not exclude kappa and lambda 1 expression

Mice transgenic for the lambda 2 light chain of MOPC315 were established. In newborn transgenics (TG), lambda 2 was the only light chain found on B cells. However, by day 21, lambda 2 high kappa low as well as lambda 2 low kappa high double expresser populations were emerging. lambda 2 was found on an increased fraction of serum immunoglobulins (Ig), this fraction declined with age. Correspondingly, kappa and lambda 1 expression was suppressed in young mice but increased with age. In adult mice kappa or lambda 1 were often co-expressed with lambda 2 in single serum Ig molecules. Most B cell hybridomas from and adult TG secreted lambda 2,kappa mixed molecules and had rearranged their kappa chain genes. One lambda 2,lambda 1 hybridoma and even a lambda 2,kappa,lambda 1 hybridoma were also found. In conclusion, isotypic exclusion in lambda 2 TG is complete in newborns but becomes increasingly leaky with age. Antigen probably expands the lambda 2 low kappa high B cell population; this population is most likely the major source of serum Ig in adult lambda 2 TG mice. In contrast, the lambda 2 high kappa low population, a major fraction of which is CD5+ Mu low delta low, appears only infrequently to develop into antibody-secreting plasma cells.     

Insulin binding to trophoblast plasma membranes and placental glycogen content in well-controlled gestational diabetic women treated with diet or insulin,in well-controlled overt diabetic patients and in healthy control subjects

Summary Insulin binding to trophoblast plasma membranes and the placental glycogen content were measured in twelve healthy women, in eleven well-controlled gestational diabetic women who were treated either with diet alone (n=4) or with insulin (n=7) and in 18 women with well-controlled overt diabetes mellitus (six White B; four White C; eight White D). The competitive binding assay was carried out with 22 concentrations of unlabelled insulin. Binding data were analysed by a non-linear direct model fitting procedure assuming one non-cooperative binding site. Maximum specific binding was unchanged in the total collective of gestational diabetic women, but was decreased by 30% in those treated with diet (6.2±2.2%) and increased by 90% in insulin-treated women (16.4±10.2%) as compared to the control subjects (8.7±2.5%). The diet-treated women had only 40% as many and those treated with insulin had more than twice as many receptors compared to control subjects on a per mg protein basis and if expressed per total placenta. In patients with overt diabetes mellitus maximum specific binding (18.5±10.6 %) was higher (p<0.05) due to more receptors compared to control subjects but was similar to the insulin-treated gestational diabetic patients. Maximum specific binding and receptor concentrations did not correlate linearly with maternal plasma insulin levels. Receptor affinities were virtually similar in all groups (1.8·10⁹ l/mol). The placental glycogen content was reduced (p<0.05) to about 80% of that of control subjects in the diet-treated collective, whereas it was unchanged compared to control subjects in the insulin-treated gestational diabetic women despite a 40% increase (p<0.001) of the maternal-to-cord serum glucose ratio. In overt diabetic patients the maternal-to-cord serum glucose ratio and the placental glycogen content were higher (p<0.05) than in the control subjects. We conclude that trophoblast plasma membranes from gestational diabetic women treated with diet alone express less and those from women treated with insulin express more insulin receptors than those from a healthy control group in vitro. These differences could not have been disclosed without consideration of the mode of treatment. Trophoblast plasma membranes from overt diabetic women have more insulin receptors than those from healthy control subjects.