Chemiluminescence by polymorphonuclear leukocytes from patients with active bacterial infection

Polymorphonuclear leukocytes of 18 patients during 19 episodes of active bacterial infection produced increased chemiluminescence (mean +/- standard error [SE], 56.3 +/- 4.4 X 10(3) cpm) when the production was compared to that of 29 uninfected controls (35.3 +/- 2.4 X 10(3) cpm; P less than 0.01). Chemiluminescence production remained increased with persistent infection but fell to the levels of controls with appropriate therapy. Phagocytic uptake as determined with radiolabeled bacteria was increased, and chemotactic responsiveness was markedly enhanced in the patients (mean index +/- SE, 260 +/- 51) when these responses were compared with those of controls (77 +/- 18). Chemiluminescence and chemotactic activity correlated in the patients with bacterial infection (r = 0.76), but one function did not appear to depend upon the intactness of the other. The ratio of cyclic guanosine 3',5'-phosphate to cyclic adenosine 3',5'-hosphate in the polymorphonuclear leukocytes of patients with infections (mean +/- SE, 0.102 +/- 0.0008) was also significantly higher than in controls (0.067 +/- 0.007). These data indicate that the polymorphonuclear leukocytes of the majority of patients with active bacterial infection are in an activated state both functionally and metabolically.     

Height and Body Mass Index in Relation to Colorectal and Gallbladder Cancer in Two Million Norwegian Men and Women

Objectives: The present study aimed at exploring the relations between BMI and stature and colorectal and gallbladder cancer in a huge Norwegian cohort with measured height and weight.Material and methods: Height and weight were measured in two million Norwegian men and women aged 20–74 during 1963–2001. During follow-up, 47,117 colorectal and 1715 gallbladder cancer cases were registered. Relative risks (RRs) of colorectal and gallbladder cancer were estimated using Cox proportional hazards regression.Results: The risk of colon cancer increased with increasing BMI in men; the RR of colon cancer per unit increase in BMI was 1.04 (95% CI: 1.04–1.05). For mucinous colorectal adenocarcinomas, the risk increased to a larger extent with increasing BMI in both sexes. The RR of colorectal cancer associated with 10 cm increase in height was 1.14 (95% CI: 1.11–1.16) in men and 1.17 (95% CI: 1.14–1.20) in women. The risk of gallbladder cancer increased with increasing BMI in women; the overall RR associated with one unit increase in BMI was 1.06 (95% CI: 1.04–1.07). There was no association between height and gallbladder cancer in either sex.Conclusion: The risk of colon cancer increased with increasing BMI in men, and the risk of gallbladder cancer increased with increasing BMI in women. In both sexes, the risk of colon cancer increased with increasing height.     

Histopathological outcome in 167 patients operated on with radical retropubic prostatectomy

OBJECTIVE: To evaluate the histopathological outcome in patients with prostate cancer operated on with radical retropubic prostatectomy. MATERIAL AND METHODS: A total of 167 patients with clinically organ-localized prostate cancer treated with open radical retropubic prostatectomy between 1996 and 2001 were divided into three equally sized consecutive cohorts (cohorts I-III). The prostatectomy specimens were re-examined by two pathologists with respect to pathological tumour stage, tumour grade and surgical tumour margins. RESULTS: The mean preoperative prostate-specific antigen (PSA) value was statistically significantly higher in cohort I compared to cohorts II and III: 13.2, 9.0 and 8.5 ng/ml, respectively (p<0.05). The incidence of locally advanced (pT3a-3b) tumours was 44% in cohort I and 20% in both cohorts II and III (p<0.05). The incidence of positive tumour margins was 58% in cohort I, compared to 30% in cohort II and 13% in cohort III (p<0.05). The incidence of positive intracapsular tumour margins was 55% in cohort I, compared to 25% in cohort II and 8.9% in cohort III (p<0.05). The incidence of positive tumour margins in the pT2 tumours in cohorts I-III was 57%, 26% and 8.9%, respectively (p<0.05). Cohort III had significantly more low-grade tumours (Gleason score 4-6; 58.9%) compared to cohorts I (31.5%) and II (34%). There was a higher incidence of Gleason score >or=7 in the pT3 tumours compared to the pT2 tumours (80% vs 46%) and in margin-positive compared to -negative tumours (69.6% vs 48.6%) (p<0.05). CONCLUSIONS: The decline in pT3 tumours and positive tumour margins between cohorts I-III is probably due to a gradually more strict selection of patients for radical retropubic prostatectomy. The successive reduction in positive intracapsular tumour margins is most likely due to an improved surgical technique.     

Measurement of nursing care time of specific interventions on a hematology-oncology unit related to diagnostic categories

The aim of this study was to develop a tool that can aid nurse managers in planning nurse staffing levels and assessing workload in hematology-oncology wards. A task-oriented method based on a time-and-motion study was used. Three general nursing procedures and 7 specific oncologic and hematologic activities were clocked. It was checked in the charts of the patient, for each day of the admission, how often selected nursing procedures were performed. Then total amount of time needed for each patient was calculated. Data from 29 admissions to the ward were analyzed and divided into 5 categories based upon the treatment performed during that admission. The categories chosen were: autologous stem cell transplantation, allogeneic stem cell transplantation, graft versus host reaction, leukemia treatment, and chemotherapy for solid neoplasm. The results obtained are an estimate of the different daily workload that is required for these categories of patients in selected nursing procedures.     

Biologic aspects of thrombopoietins and the development of therapeutic agents

Thrombopoiesis is a multistage process beginning with pluripotent hematopoietic stem cells, progressing through proliferating cells committed to megakaryocytopoiesis, to megakaryocytes, and eventually ending with the shedding of platelets from megakaryocytes. Many growth factors stimulate thrombopoiesis; this review addresses those that act through binding to the thrombopoietin receptor. The cloning of thrombopoietin in 1994 greatly accelerated progress in understanding the biology of thrombopoiesis and of hematopoiesis in general. Detailed structural and functional studies of the thrombopoietin receptor, coupled with novel molecular pharmacology approaches, have led to new classes of thrombopoietic mimetics. Initial clinical trials with recombinant thrombopoietins faltered as they encountered significant neutralizing antibodies or difficulty finding a significant clinical niche in support of chemotherapy. Ongoing studies with the new thrombopoietic agents have invigorated the field, with positive results now reported in idiopathic thrombocytopenic purpura.     

Chronic mucocutaneous candidiasis and primary hypothyroidism in two families

We describe the clinical and immunological features of two families with chronic mucocutaneous candidiasis (CMC) and primary hypothyroidism. Family A includes three siblings with both candidiasis and hypothyroidism and four individuals with hypothyroidism only. Family B includes four members with candidiasis, of whom one (a male child) also had hypothyroidism. All individuals affected with CMC had suffered from oral candidiasis and onychomycosis since infancy. Facial seborrhoic dermatitis, general folliculitis and scaling blepharitis were main manifestations. Hypothyroidism became evident during childhood. No thyroid antibodies were present in the affected siblings in family A, while the male in family B with hypothyroidism had antibodies against thyroid peroxidase at diagnosis. Immunological evaluation revealed intra-individual variations in serum immunoglobulin levels, lymphocyte subsets and proliferative responses, but there were no consistent abnormalities. Vaccine responses were normal. AIRE gene region microsatellite markers did not segregate with disease nor were autoantibodies typical for autoimmune polyendocrine syndrome type 1 detected in the families. Conclusion: the link between hypothyroidism and chronic mucocutaneous candidiasis remains to be identified.Abbreviations AADC aromatic l -amino acid decarboxylase - APS 1 autoimmune polyendocrine syndrome type 1 - CMC chronic mucocutaneous candidiasis - GAD glutamic acid decarboxylase - MBL mannose-binding lectin - 17OH 17-hydroxylase - 21OH 21-hydroxylase - SCC side-chain cleaving enzyme - TG-Ab anti-thyroglobulin antibodies - TPO-Ab anti-thyroperoxidase antibodies