Prolonged survival in chronic lymphocytic leukemia: a case report.

A patient with long-standing chronic lymphocytic leukemia with both humoral and cellular immunodeficiency had lymph node receptor evidence of a B lymphocyte disorder. He was also found to secrete the Epstein--Barr virus and, late in his illness, developed a markedly positive antinuclear antibody. Interrelationship of these findings may be important in the ultimate determination of the etiology and functional mechanisms in lymphocyte malignancies.     

c-Myc and E1A induced cellular sensitivity to activated NK cells involves cytotoxic granules as death effectors.

The contact of natural killer (NK) cells with foreign cells and with certain virus-infected or tumor cells triggers the cytolytic machinery of NK cells. This triggering leads to exocytosis of the cytotoxic NK cell granules. The oncoproteins c-Myc and E1A render cells vulnerable to NK cell mediated cytolysis yet the mechanisms of sensitization are not well understood. In a model where foreign cells (rat fibroblasts) were cocultured with human IL-2 activated NK cells, we observed that NK cells were capable of efficiently killing their targets only if the cells overexpressed the oncogene c-Myc or E1A. Both the parental and the oncogene expressing fibroblasts similarly triggered phosphoinositide hydrolysis in the bound NK cells, demonstrating that NK cells were cytolytically activated in contact with both resistant parental and oncogene expressing sensitive target fibroblasts. The cell death was independent of wild-type p53 and was not inhibited by an anti-apoptotic protein EIB19K. These results provided evidence that c-Myc and E1A activated the NK cell induced cytolysis at a post-triggering stage of NK cell-target cell interaction. In consistence, the c-Myc and E1A overexpressing fibroblasts were more sensitive to the cytolytic effects of isolated NK cell-derived granules than parental cells. The data indicate that oncogenes activate the cytotoxicity of NK cell granules. This mechanism can have a role in directing the cytolytic action of NK cells towards the virus-infected and cancer cells.     

Musculoskeletal neoplasms after intraarterial chemotherapy: correlation of MR images with pathologic specimens

The most accurate prognostic indicator in patients with musculoskeletal sarcomas is the percentage of tumor necrosis after intraarterial chemotherapy. Magnetic resonance (MR) imaging was evaluated to determine its ability to indicate the percentage of necrosis in musculoskeletal neoplasms after treatment. Fourteen patients with musculoskeletal neoplasms underwent treatment protocols including intraarterial chemotherapy (n = 14), radiation therapy (n = 6), and systemic chemotherapy (n = 14). All patients underwent MR imaging before and after treatment, and all underwent either limb salvage surgery (n = 8) or amputation (n = 6) within 1 week of the last MR examination. Standard unehanced spin-echo T1-, spin-density-, and T2-weighted MR sequences were used. The MR images were compared with the pathologic specimens. On T2-weighted images, the signal intensities of viable tumor, tumor necrosis, edema, hemorrhage, and necrosis overlapped. With the unenhanced spin-echo technique, MR imaging cannot be used to predict the percentage of tumor necrosis in musculoskeletal neoplasms after intraarterial chemotherapy.     

Unexpected brain hemorrhages and the value of computerized tomography.

Intracerebral hemorrhage has been thought in the past to be manifested by sudden onset of hemiplegia, severe headache and deep coma proceeding to death in most cases. There are patients who present with less ominous symptoms who have heretofore been though to have cerebral infarction or transient ischemic attacks who in reality have intracerebral hemorrhages. Computerized tomography has allowed us to identify these patients and to separate them from the large group of patients with ischemic infarcts either due to thromboses or emboli. Six patients were reported with unexpected brain hemorrhages and their good prognosis is emphasized.     

Concurrent CBF and CMRGlc changes during human brain activation by combined fMRI-PET scanning

A novel approach for concurrent measurement of regional cerebral blood flow (CBF) and regional cerebral metabolic rate for glucose consumption (CMRGlc) in humans is proposed and validated in normal subjects during visual stimulation. 18F-labeled fluorodeoxyglucose was administered during the measurement of CBF by continuous arterial spin labeled magnetic resonance imaging (MRI). Subsequent positron emission tomographic (PET) scanning demonstrated the distribution of labeled deoxyglucose during the MRI acquisition. An excellent concordance between regional CBF and regional CMRGlc during visual stimulation was found, consistent with previously published PET findings. Although initially validated using a brief, non-quantitative protocol, this approach can provide quantitative CBF and CMRGlc, with a broad range of potential applications in functional physiology and pathophysiology.