Health-related quality of life among paediatric survivors of primary brain tumours and acute leukaemia

Purpose  

Comparative assessment of the HRQL of paediatric survivors of brain tumours (BT) and of acute leukaemia against a population of their healthy peers.     

A new micromethod for the evaluation of Fc receptor expression on polymorphonuclear neutrophils

A simple method for the evaluation of rosetting polymorphonuclear neutrophils is described. It uses small (200 microliter) quantities of heparinized whole blood and is simpler than the micromethod proposed by Buescher and Gallin. The high concentration of neutrophils and paucity of lymphocytes considerably simplify the evaluation of specimens and make the technique particularly useful in granulopenic states. There was a close correlation between results obtained using this technique and those from a standard method requiring the isolation of polymorphonuclear neutrophils.     

Cardiorespiratory efficacy of thrombolytic therapy in acute massive pulmonary embolism: identification of predictive factors.

The aim of this study was to evaluate the contribution of clinical, angiographic and haemodynamic findings in predicting the cardiorespiratory efficacy of thrombolytic therapy in acute massive pulmonary embolism. Haemodynamic measurements and pulmonary angiography were performed before (H0) and 12 h after (H12) initiating thrombolytic therapy in 23 patients with acute massive pulmonary embolism (Miller index > or =20/34), and free of prior cardiopulmonary disease. Patients were divided into two groups according to the variation in oxygen delivery (deltaDO2) between H0 and H12: deltaDO2 >20% (responders, n=10) and deltaDO2 < or =20% (nonresponders, n=13). Before thrombolysis, clinical and angiographic findings were similar in both groups. Mean right atrial pressure (RAP) and total pulmonary (vascular) resistance (TPR) were higher, while cardiac index (CI), DO2 and mixed venous oxygen saturation (Sv,O2) were lower in responders. DO2 and Sv,O2 were more closely correlated with deltaDO2 than RAP, TPR and CI. Eight out of the 10 responders and two out of the 13 nonresponders had an Sv,O2 <55%, while nine of the responders and two of the nonresponders had a DO2 <350 mL x min(-1) x m(-2). In conclusion, the initial oxygen delivery and mixed venous oxygen saturation may predict the cardiorespiratory efficacy of thrombolytic therapy in acute massive pulmonary embolism. When pulmonary angiography is performed, measurement of mixed venous oxygen saturation may be a simple method by which to select patients for thrombolytic therapy.     

S-100 protein content of dermal and oral mucosal blue nevi

Three common blue nevi from skin of the trunk and upper extremities, and 5 from oral mucosae were studied using an immunoperoxidase stain for S-100 protein. The skin lesions were uniformly negative whereas all of the oral mucosal lesions contained numerous positively stained dendritic cells. This difference may, in part, be explained by the different embryologic origins of the connective tissue stromas; the connective tissues of the head and neck are thought to be of neural crest origin whereas the connective tissues in the rest of the body are of mesodermal origin. These findings strengthen and refine the association between S-100 protein content and neural crest derivation.     

Investigating the potential contribution of community pharmacists in identifying,understanding and meeting the bone health needs of patients in collaboration with GPs

Evidence‐based patient‐completed questionnaires were used to assess patients' risk of osteoporosis Community pharmacists significantly increased patient bone health knowledge which was sustained over a 10‐week period; pharmacists significantly contributed to increasing patients' daily calcium intake in line with national recommendations Patients at high‐risk of osteoporosis were identified, appropriately managed in the pharmacy or referred to GPs and followed‐up Patients indicated satisfaction with the programme and felt they had become more aware of bone health All the programme standards were met and gave a mandate for the roll‐out of revised and improved community‐pharmacy based programmes that could meet the bone health needs of patients     

Tissue harmonic imaging of thyroid nodules: initial experience.

OBJECTIVE: To determine the impact of tissue harmonic imaging on visualization of the thyroid and gray scale contrast between thyroid nodules and adjacent thyroid parenchyma. METHODS: A prospective study was performed on 144 patients (148 lesions) undergoing sonographically guided fine-needle biopsy. The fundamental frequency and tissue harmonic images were obtained on a scanner with a wideband 7.5-MHz linear probe. One hundred forty-two benign nodules, 2 papillary carcinomas, 1 anaplastic carcinoma, and 1 metastatic lesion were found. In 1 case a suggestion of a follicular carcinoma was raised, and in 1 case no diagnostic material was obtained. The gray scale intensity of the lesions and adjacent thyroid tissue was measured with graphics software, and the gray scale contrast between lesions and adjacent thyroid tissue was calculated. Additionally, the overall conspicuity and border definition were evaluated by 2 independent observers. RESULTS: Tissue harmonic imaging improved the gray scale contrast between thyroid nodules and adjacent thyroid parenchyma in 116 lesions (78.4%). The overall conspicuity and border definition were improved or equal in the harmonic mode for most lesions. CONCLUSIONS: The tissue harmonic imaging technique used as an adjunct to conventional thyroid sonography may improve lesion detectability and characterization.     

Single germline VH and V kappa genes encode predominating antibody variable regions elicited in strain A mice by immunization with p- azophenylarsonate

We have cloned and sequenced the predominant germline V kappa gene segment expressed by B cells of strain A origin that synthesize antibodies with specificity for Ars. In hybridomas synthesizing anti-Ars antibodies, this V kappa gene segment (V kappa IdCR) has been found exclusively associated with the J kappa 1 gene segment without exhibiting junctional sequence variation. Sequence comparisons of the germline V kappa IdCR gene with expressed derivatives reveals that the latter frequently contain somatically introduced amino acid replacements. Taken together with results of previous structural analyses, these results show that the predominant population of IdCR+ V regions elicited in the secondary immune response is encoded by one or two combinations of V gene segments, has little junctional diversity, and is extensively diversified by somatic mutation in both heavy and light chains.     

High blood pressure and muscle morphology/metabolism – causal relationship or only associated factors?

As muscle tissue constitutes a main target organ for glucose metabolism and is responsible for the development of insulin resistance, it seems plausible to elucidate the relationship between blood pressure and muscle morphology and metabolism. The association between blood pressure and capillarization/morphology of the vastus lateralis muscle and metabolic variables was evaluated in 24 perimenopausal obese women [body mass index (BMI) 34·9 ± 1·1; waist–hip ratio (WHR) 0·90 ± 0·02]. The muscle enzyme activity of lipoprotein lipase (LPL), citrate synthase and glycogen synthase was determined. There was a significant negative correlation between the percentage of type I fibres and relative fibre area of type I on the one hand and systolic and diastolic blood pressure on the other. There was a negative correlation between the capillary density (i.e. number of capillaries/muscle fibre) and a positive correlation between the diffusion distance (fibre area supplied by one capillary) and diastolic blood pressure. The activities of LPL and citrate synthase were positively correlated with the percentage of type I and negatively correlated with the percentage of type II muscle fibres. The activity of LPL was also negatively correlated with plasma glucose and the insulin/C-peptide ratio. The insulin/C-peptide ratio was positively correlated with the percentage of type II muscle fibres. In stepwise multiple regression analyses, 20–30% of the variation in systolic and diastolic blood pressure could be explained by the variables of muscle fibre distribution. Excluding muscle morphological variables from the regression model, the insulin/C-peptide ratio accounted for 13% of the variation in systolic and diastolic blood pressure. The results of the study show the close association between muscle morphology and blood pressure. It remains to be elucidated whether this association indicates a causal relationship.     

A single germline VH gene segment of normal A/J mice encodes autoantibodies characteristic of systemic lupus erythematosus

These experiments tested the hypothesis that unmutated germline genes from normal mice can encode autoantibodies. We found that the unmutated VHIdCR gene segment, which encodes a large proportion of antiarsonate antibodies in A/J mice, also encodes antibodies with the ability to bind to DNA and cytoskeletal proteins. After Ars immunization, at a time when the VHIdCR gene segment mutates and antibody affinity for the hapten increases, reactivity with the autoantigens was lost. Six antibodies obtained after immunization with Ars bound both the Ars and DNA. Results of competitive inhibition assays suggested that the same variable region site in the antibodies bound to both Ars and DNA. The properties of the individual germline-encoded antibodies, which include reactivity to both DNA and cytoskeletal proteins, suggest that autoantibodies characteristic of SLE might be a subset of antibodies encoded by unmutated germline V genes.