CD44 IS AN INDEPENDENT PROGNOSTIC FACTOR IN CONVENTIONAL RENAL CELL CARCINOMAS

PURPOSE: CD44 is a transmembrane glycoprotein involved in cell-cell and cell-matrix interactions. De novo expression of CD44 and its variant isoforms has been associated with aggressive behavior in various tumors. Since few data are available concerning the role of CD44 in the biological behavior of locally confined renal tumors, we analyzed the expression of CD44 in a large set of conventional renal cell carcinomas to determine its prognostic value in association with other clinicopathologic variables. MATERIALS AND METHODS: Ninety-one patients with locally confined conventional renal cell carcinomas were studied. CD44 standard form (CD44H) and v6 isoform expressions were semiquantitatively evaluated on paraffin-embedded tumor tissue by immunohistochemistry. The prognostic value of the usual clinicopathological variables and CD44 expression was tested using Kaplan-Meier plots by the log rank test and Cox multiple hazard regression analysis. RESULTS: No immunostaining was observed in normal renal tissue. Thirty-two of the 66 conventional renal cell carcinomas (48%) showed CD44H membranous staining of the tumor cells. Only 2 cancers displayed CD44v6 immunostaining. Among the different clinicopathological variables analyzed, tumor stage (p = 0.001), nuclear grade (p = 0.01), size (p = 0.02), vascular (p = 0.05) and perirenal adipose tissue invasion (p = 0.005), and CD44H expression (p = 0.01) were found to be significant prognostic parameters for survival using univariate analysis. Moreover, multivariate analysis indicated stage, nuclear grade and CD44 expression as independent prognostic factors both for overall and disease-free survival. CONCLUSION: CD44 can be considered as a useful prognostic parameter in conventional renal cell carcinoma and may be used in evaluation of the outcome of these tumors.     

Algorithms for sleep–wake identification using actigraphy: a comparative study and new results

The aim of this study was to investigate two new scoring algorithms employing artificial neural networks and decision trees for distinguishing sleep and wake states in infants using actigraphy and to validate and compare the performance of the proposed algorithms with known actigraphy scoring algorithms. The study employed previously recorded longitudinal physiological infant data set from the Collaborative Home Infant Monitoring Evaluation (CHIME) study conducted between 1994 and 1998 [ http://dccwww.bumc.bu.edu/ChimeNisp/Main_Chime.asp ; Sleep 26 (1997) 553 ] at five clinical sites around the USA. The original CHIME data set contains recordings of 1079 infants <1 year old. In our study, we used the overnight polysomnography scored data and ankle actimeter (Alice 3) raw data for 354 infants from this data set. The participants were heterogeneous and grouped into four categories: healthy term, preterm, siblings of SIDS and infants with apparent life‐threatening events (apnea of infancy). The selection of the most discriminant actigraphy features was carried out using Fisher’s discriminant analysis. Approximately 80% of all the epochs were used to train the artificial neural network and decision tree models. The models were then validated on the remaining 20% of the epochs. The use of artificial neural networks and decision trees was able to capture potentially nonlinear classification characteristics, when compared to the previously reported linear combination methods and hence showed improved performance. The quality of sleep–wake scoring was further improved by including more wake epochs in the training phase and by employing rescoring rules to remove artifacts. The large size of the database (approximately 337 000 epochs for 354 patients) provided a solid basis for determining the efficacy of actigraphy in sleep scoring. The study also suggested that artificial neural networks and decision trees could be much more routinely utilized in the context of clinical sleep search.     

Perceptual context and the selective attention effect on auditory event-related brain potentials

Two experiments examined the effect of the perceptual context established through tonal grouping on neuroelectric responses during selective listening. Subjects monitored one of the extreme pitches in four-pitch tone sequences and detected rare longer tones of the designated pitch. In the first study, tonal grouping was manipulated by changing the tonal separation between the extreme pitches and their nearest neighbor, keeping the extreme pitches constant. Grouping increased the negativity of the attended–unattended difference potential. A second study examined the effect of grouping on the attention-related negativity when it opposed the effect of physical similarity. The proximity of extreme pitches varied, keeping the middle pitches constant. The effect of grouping on event-related potentials (ERPs) for the middle pitches was varied according to the tone being attended. ERPs for the middle tone adjacent to the attended tone became more negative with grouping, whereas ERPs for the distant middle tone became less negative with grouping. These effects suggest that the attention-related negativity is sensitive to contextual information.     

Platelet alpha2 adrenoceptors in Parkinson''s disease: decreased number in untreated patients and recovery after treatment

[3H]-yohimbine binding sites were quantified in platelets from Parkinsonians with no clinical signs of dysautonomia. Never-treated Parkinsonians had a lower specific binding than control subjects. This alteration was associated with decreased epinephrine-induced platelet aggregation. Treatment with dopaminergic agents induced a significant increment of [3H]-yohimbine binding sites. These results show that Parkinson's disease is associated with a reduced number of peripheral alpha 2 adrenoceptors and that dopaminergic agents induce partial recovery.     

BCL6 gene rearrangements also occur in marginal zone B-cell lymphoma

Marginal zone B-cell lymphoma (MZBCL) represents a distinct subtype of B-cell non-Hodgkin's lymphoma (NHL) which has been recently recognized and defined as a disease entity. Cytogenetically, these lymphomas reveal a high prevalence of trisomy 3, and recent data obtained by comparative genomic hybridization indicate that the chromosomal regions 3q21-23 and 3q25-29 might be of particular pathogenetic significance. We identified structural chromosomal abnormalities involving the region 3q27 and rearrangements of the BCL6 proto-oncogene in three out of 34 (9%) well-defined cases of extranodal, nodal and splenic MZBCL using cytogenetic analysis, Southern blot, and fluorescence in situ hybridization (FISH). All three cases were characterized by a t(3;14)(q27;q32). Two of them showed additional chromosomal abnormalities including trisomy 3, which was found in one case. The patients displayed extranodal disease and did not demonstrate any striking clinical and histological differences when compared with MZBCL lacking BCL6 rearrangement. The present study for the first time demonstrates the occurrence of t(3;14)/ BCL6 gene rearrangement in MZBCL, thus suggesting a role of the BCL6 proto-oncogene in the pathogenesis of MZBCL.     

DISCURSIVE STRATEGIES OF SUBJECTS WITH HIGH ALTITUDE HYPOXIA: EXTREME ENVIRONMENT

A discourse analysis was carried out on nine European lowlanders during a 2-month scientific expedition at high altitude including a 3-week stay in extreme survival conditions at the summit of Mt Sajama (6542 m), in order to contribute to the understanding of psychological adaptation to extreme environments. This discourse analysis was part of a wide-ranging scientific investigation involving 12 scientific and medical research protocols which targeted human adaptation to high altitude chronic hypoxia. The objective of this study is to better understand the presence of linguistic markers capable of translating the subject's psychological state when faced with a threatening environment. This study was based on a method of propositional speech analysis developed by Ghiglione and Blanchet which emphasizes the cognitive function of verb categories, modalizers and adjuncts used by subjects. The method was developed in conjunction with psychopathological studies of the depressive state. Speech was recorded at time T 1, 4 days after reaching the summit of Mt Sajama, and at time T 2, 2 days before descending the mountain peak. These results revealed that in the absence of depression in any psychopathological sense of the word, normal subjects would react to their environment with a depressive component. However, the results of this study equally illustrate for some subjects a correspondence between those states with a depressive component and a physiological incomplete adaptation to high altitude. This correspondence could reflect the pathogenic effect of an adaptation deficit or could be in keeping with the literature concerning an incomplete adaptation effect induced by a latent depressive state.©1997 John Wiley & Sons,Ltd.     

OPTIMAL DISCRIMINANT ANALYSIS FOR ORDINAL RESPONSES

Optimal classification formulation is adapted to the context of discrimination when the response is ordinal. The resulting method, optimal discriminant analysis for ordinal responses (ODAO), is presented and compared with two reference discrimination techniques used in this context (proportional-odds ordinal logistic regression and normal discrimination) using a study of prognosis following burn injuries and simulated data. The ODAO method clearly outperforms both reference methods in terms of classification accuracy (in training and validation samples), robustness to outliers, simplicity of use and applicability in clinical settings. ODAO is a promising method for improving classification performance in discrimination with ordinal responses and merits further investigation. © 1997 by John Wiley & Sons, Ltd.     

Electromagnetic Interference of External Pacemakers by Walkie-Talkies and Digital Cellular Phones: Experimental Study

A number of experimental and clinical studies have documented the risk potential of interference with implanted pacemakers by various types of cellular phones. Radiofrequency susceptibility of external medical equipment has also been reported in experimental studies. The purpose of this experimental study was to evaluate electromagnetic interference of external pacemakers by walkie-talkies and digital cellular telephones. External bipolar pacing was monitored using a digital oscilloscope to record pacemaker pulses and electromagnetic interference separately. Tests with the walkie-talkie, Private Mobile Radio (PMR) (160 MHz, 2.5 W) were conducted during the calling phase. Tests with the cellular phones, global system for mobile communications (GSM) (900 MHz, 2 W) and Digital Cellular System (DCS) (1,800 MHz, 1 W) were conducted in the test mode. Nine widely used external pacemakers from four manufacturers were tested. Various disturbances including pacing inhibition and asynchronous pacing were observed in eight pacemakers by the PMR, in four by the GSM phone, and in two by the DCS phone. The maximum distance that interference persisted ranged from 10–200 cm. This experimental study shows a potential risk of interference of external pacemakers by walkie-talkies and cellular digital phones. Appropriate warnings should be issued against the potentially serious risks of using communication devices in the vicinity of acutely ill patients treated with temporary transvenous cardiac pacemakers.