Analysis of helper activity on pokeweed mitogen- and interleukin 2-driven immunoglobulin synthesis by neoplastic T4+ cells.

The neoplastic T cells of a series of seven patients with chronic T-cell neoplasia were tested for helper activity on pokeweed mitogen (PWM)-induced and interleukin 2 (IL-2)-induced Ig synthesis. The neoplastic T cells of all patients had a T3+4+8-11+I1- phenotype but differed in expression of the 3A1 antigen. The neoplastic T cells of three patients had helper activity on both PWM- and IL-2-driven Ig synthesis, and in addition produced IL-2 in response to PWM stimulation. Two of these patients had hypergammaglobulinemia. In contrast, the neoplastic T cells in the remaining four patients did not produce IL-2 and did not support PWM-driven Ig synthesis. The T4+ cells of these four patients, however, provided excellent helper activity on IL-2-driven Ig synthesis. These findings emphasize the role of IL-2 in T cell-dependent Ig synthesis and clearly show that IL-2 production is required for helper activity in the PWM-driven system. It is concluded that the combined use of PWM- and IL-2-driven Ig synthesis systems allows separate analysis of IL-2 production and T-helper activity in health and disease.     

克隆测序确认HLA新等位基因B*3712

目的：由于技术原理的限制，目前尚不能对所有的HLA等位基因进行严格的区分，特别是以往没有发现的新基因序列只能通过测序的方法解决，然而，当遇到等位基因杂合时，测序给出的结果仍然无法确认新的序列改变发生在等位基因的哪一侧，这时需要用分子生物学方法分离杂合子然后进行测序才能确定新的基因序列。采用基因克隆方法确认HLA新等位基因。 方法：实验于2006-01／05在河南省红十字血液中心HLA实验室，美国海军骨髓库HLA实验室完成。造血干细胞血样由中华骨髓库提供。采用荧光微珠HLA分型方法对中华骨髓库捐献者血样进行HLA分型检测，无法给出确切结果的摸棱两可结果标本用基因克隆（TOPO TA Cloning）、DNA测序的方法确认新的HLA基因序列。 结果：通过克隆分离杂合等位基因，再进行测序确认发现新的序列与B^＊3709相比，出现4个核苷酸改变：1．355nt C〉A，2．363nt C〉G，3．412nt G〉A，4．477ntC〉G，而且均发生在H哺B基因外显子3（exon3）。4处改变引起氨基酸编码改变：①编码95CTC〉ATC，氨基酸改变L〉1（亮氨酸〉异亮氨酸）。②97AGC〉AGG．S〉R（丝氨酸〉精氨酸）。③114GAC〉AACD〉N（天门冬氨酸〉天冬酰胺）。（9135GCC〉GCGA=A无氨基酸改变。 结论：①新的基因序列已经在GenBnak注册，被WHO的HLA因子命名委员会得到正式命名为HLA-B^＊3712基因。②基因克隆是确认HLA新基因的根本方法。     

Pilot Data on the Endoscopic Placement of Covered Metal Stents to Treat Gastrojejunal Leaks in a Porcine Model

Background  

Placement of stents may be an alternative option to treat gastrojejunal (GJ) anastomotic leaks after Roux-en-Y gastric bypass (RYGB) surgery. The aim was to evaluate the performance of a covered metal stent (Alimaxx-E, 18 × 100 mm) across a GJ leak in a porcine model.     

Improving rates for screening colonoscopy: Analysis of the health information national trends survey (HINTS I) data

Background Colonoscopy is an effective modality for colorectal cancer screening. The objectives of this study were to identify colorectal cancer knowledge and barriers to screening colonoscopy in the general US population. Methods Data was obtained from the health information national trends survey (HINTS I). The dataset (n = 6369) examined the influence of age, race, gender, education, income, media usage, and interactions with health care providers on knowledge, attitudes, and behavior regarding colonoscopic screening for colorectal cancer. Results The term ‘colonoscopy’ was recognized by 80% of participants (over the age of 35), however only 35% of respondents perceived it as a major method for colon cancer screening. Hispanics had the least awareness of colonoscopic screening (16% versus 39% non-Hispanic). Female gender, education, and income all correlated with knowledge and use of colonoscopic screening. There was a positive correlation between media usage and having a colonoscopy (r = 0.095, p < 0.01). Having a health care provider was strongly correlated with having undergone a colonoscopy (r = 0.249, p < 0.01). Reasons for not having a colonoscopy were ‘no reason’ (29%), ‘doctor didn’t order it’ (24%), and ‘didn’t know I needed the test’ (15%). Personalized materials were the preferred media for receiving cancer-related information. Conclusions Knowledge of and participation in screening colonoscopy is low in the US population, especially among Hispanics. The most important immediate action is to increase physician referral for screening colonoscopy. Education materials focused on specific sociodemographic segments and targeted communication campaigns need to be developed to encourage screening.     

Incidence of non-traumatic complaints of arm, neck and shoulder in general practice

Incidence densities in primary care are often based on disease or region-specific code registration (e.g. 'epicondylitis', 'shoulder symptom') according to the International Classification of Primary Care (ICPC). Few estimates are available on arm, neck and shoulder complaints. Unknown, is the proportion missed due to registration with a non-region-specific code (e.g. 'muscle pain'). Therefore, we estimated the incidence in non-traumatic arm, neck and shoulder complaints in the age-group 18-64 years, and determined the contribution of non-specific codes to the total figure. In this prospective registration study, 21 general practitioners (GPs) from 13 Dutch general practices classified and registered patient's symptoms and diagnoses according to ICPC at each consultation during 12 consecutive months. Incidence densities were calculated. The incidence density was 97.4/1000 person-years (95% CI: 91.2-103.7). This results in 147 (95% CI: 138-157) incident cases/year for an average-sized GP-practice (2350 patients). Main contributors were: shoulder (L92, L08) and neck complaints (L01, L83). Of all incident consultations, 23% were registered with non-region-specific codes, mainly 'other musculoskeletal disease' (L99). Non-traumatic complaints of arm, neck and shoulder are frequently consulted for in Dutch primary care. When estimating morbidity in primary care, based on diagnostic codes, one should be aware of possible underestimation of morbidity and corresponding workload, when excluding codes not specific for that region or disease.     

Metastatic Spiradenocarcinoma Occurring in an 8‐Year‐Old Boy

We recently saw the case of an 8‐year‐old boy with histologic findings of spiradenocarcinoma. Malignant adnexal tumors in children are exceedingly rare, and cases of spiradenocarcinoma in children are absent in the literature. We report the case of an 8‐year‐old boy with metastatic spiradenocarcinoma. A biopsy 2 years before his presentation at our institution was interpreted as a benign lesion, but when the lesion regrew, a repeat biopsy was performed that demonstrated ominous findings, prompting a reexcision. This reexcision demonstrated an area with significant necrosis, many mitoses, and cellular pleomorphism apparently arising out of a sharply demarcated, adjacent, lower‐grade area. The histologic features of this patient's biopsies were those of spiradenocarcinoma, potentially arising out of a preexisting spiradenoma, a finding that has not been documented previously in this age group. Staging studies demonstrated multiple bilateral pulmonary nodules, which were confirmed using thoracoscopic biopsy to be metastatic disease. His chemotherapy regimen has included several cycles of cisplatin and 5‐flourouracil, with ongoing disease progression of pulmonary disease. It has been 16 months since he presented to our institution (>3 years since the appearance of his initial lesion). Imaging studies demonstrate a slowly increasing size and number of pulmonary lesions. The long‐term prognosis is guarded.     

Detection and viability of tumor cells in peripheral blood stem cell collections from breast cancer patients using immunocytochemical and clonogenic assay techniques [see comments]

Although peripheral blood stem cell collections (PBSC) are thought to have less tumor involvement than bone marrow (BM), the incidence of circulating tumor cells in patients with breast cancer has not been widely investigated. We prospectively investigated the incidence and viability of tumor cell involvement in PBSC and BM collections from breast cancer patients undergoing high-dose chemotherapy/hematopoietic stem cell transplantation. Paired samples of PBSC and BM from 48 patients were analyzed using an immunocytochemical technique that detects one epithelial-derived tumor cell per 5 x 10(5) mononuclear cells. Immunostained tumor cells were detected in 9.8% (13/133) PBSC specimens from 9/48 (18.7%) patients and in 62.3% (38/61) BM specimens from 32/48 (66.7%) patients, a significantly higher rate than in PBSC (P < .005). The geometric mean concentration of tumor cells in contaminated PBSC specimens was 0.8/10(5) mononuclear cells (range 0.33 to 2.0/10(5)) compared with 22.9/10(5) mononuclear cells in BM (range 1 to 3,000/10(5), P < .0001). In culture experiments, clonogenic tumor colonies grew in 21/26 immunocytochemically positive specimens. No tumor colony growth was detected in 30/32 immunocytochemically negative specimens. Immunocytochemical detection of tumor involvement in BM and PBSC correlated significantly with in vitro clonogenic growth (P < .0001). We conclude that PBSC contain fewer tumor cells than paired BM specimens from patients with advanced breast cancer and that these tumor cells appear to be capable of clonogenic growth in vitro.