A Review of Tissue Plasminogen Activator in the Treatment of Veno-Occlusive Liver Disease after Bone Marrow Transplantation

Veno-occlusive disease (VOD) of the liver is a potentially life-threatening complication that usually occurs secondary to high dose-chemotherapy with or without total body irradiation as preparative therapy for bone marrow transplantation. The key event in the development of VOD is damage to the vascular endothelium in the liver, which produces a hypercoagulable state triggering the clotting cascade. Factor VIII and fibrinogen are deposited in the hepatic venules, leading to obliteration of the venules. Tissue plasminogen activator (t-PA) converts fibrin-bound plasminogen to plasmin, thereby producing clot lysis. Review of the literature suggests that t-PA can be administered safely, with some limitations, for the treatment of VOD. (Pharmacotherapy 1997;17(5):929–937)     

River water genotoxicity evaluation using micronucleus assay in fish erythrocytes

The quality of Caí river water (Rio Grande do Sul State) in an area under the influence of a petrochemical complex was studied using the micronucleus assay in erythrocytes from peripheral blood of the fathead minnow Pimephales promelas. This cytogenetic in vivo assay was performed to evaluate the effects of petrochemical effluents on the stream. Organisms were exposed to samples collected at four sites, during an 11-month period. Three different exposure periods were used (7, 14, and 21 days) to evaluate their influence in genotoxic detection. The 14-day exposure period was most effective in detecting genotoxicity in samples from this area. The presence of substances with clastogenic and/or aneugenic potential could be detected at the different sites analyzed. This in vivo assay allowed the detection of genotoxicity in the area studied, indicating the potential for environmental genotoxicity monitoring.     

ASXL1 mutations are frequent and prognostically detrimental in CSF3R‐mutated chronic neutrophilic leukemia

Colony stimulating factor 3 receptor gene (CSF3R) mutations have recently been associated with chronic neutrophilic leukemia (CNL). Fourteen patients with CSF3R‐mutated CNL (median age 67 years; 57% males) were screened for additional mutations; 8 (57%) and 5 (38%) harbored an ASXL1 and/or SETBP1 mutation (two patients expressed both), respectively. Two patients developed blastic transformation, both SETBP1‐mutated and ASXL1‐unmutated, whereas two other cases evolved into chronic myelomonocytic leukemia (CMML), both ASXL1‐mutated and SETBP1‐unmutated. Median survival was 23.2 months (10 deaths documented). On multivariable analysis mutated ASXL1 (P = 0.009; HR 19.6, 95% CI 2.1–184.1) and thrombocytopenia (P = 0.005; HR 28.8, 95% CI 2.8–298.2) were independently predictive of shortened survival. This study provides information on the natural history of CSF3R‐mutated CNL and identifies mutant ASXL1 and thrombocytopenia as risk factors for survival. The study also suggests pathogenetic roles for SETBP1 and ASXL1 mutations in disease evolution into blast phase disease and CMML, respectively. Am. J. Hematol. 90:653–656, 2015. © 2015 Wiley Periodicals, Inc.     

Aggressive variant of morphologically typical T large granular lymphocyte leukemia/lymphoma lacking NK cell markers

A 46-year-old woman with a previous diagnosis of sarcoidosis presented with morphologically typical large granular lymphocyte (LGL) leukemia/lymphoma with an aggressive clinical course. Epstein-Barr virus DNA was detected in peripheral blood mononuclear cells by PCR. The phenotype was typical of the T cell lineage (CD2+ CD3+ CD5+ CD7+ CD8+ TCRalphabeta+) but with the absence of the CD16, CD56, CD57 NK cell markers. In addition, the LGLs expressed CD122 (p75) in the absence of CD25 which is characteristic of LGLs. These leukemic LGLs did not exhibit NK activity. The clonal nature of this proliferation was demonstrated by the rearrangement of the TCRgamma gene. This phenotypically unusual but morphologically typical LGL leukemia/lymphoma may represent the clonal expansion of a minor normal subset of T-LGLs which do not express any NK cell markers, probably corresponding to in vivo activated T cells.     

Theophylline metabolism in patients with hepatosplenic mansoniasis and cirrhosis.

The pharmacokinetics of theophylline were studied in 12 patients with hepatosplenic mansoniasis, 14 patients with cirrhosis and 16 normal controls. Following a single intravenous dose of aminophylline volumes of distribution, serum half-lives and body clearances were determined. Volumes of distribution of theophylline in patients with schistosomiasis (mean 0.624 l/kg) did not differ from cirrhotic patients (mean 0.616 l/kg) or normal controls (mean 0.593 l/kg). Cirrhotic patients had a prolonged half-life compared to normal subjects (mean 22.1 vs. 9.9 h), while patients with schistosomiasis did not substantially differ from normal controls (15.8 vs. 9.9 h). Body clearance in patients with schistosomiasis was similar to controls (34.02 vs. 49.20 ml/h per kg) but decreased (29.24 ml/h per kg) in patients with cirrhosis. Individual analysis of the group with schistosomiasis disclosed three patients with reduced theophylline elimination. No relationship was found between laboratory tests of liver function and the pharmacokinetics of theophylline in any group. The administration of theophylline to patients with hepatosplenic schistosomiasis, although less dangerous than in cirrhosis, must be closely followed.     

Lesions of the dorsomedial hypothalamic nucleus do not influence the daily profile of pineal metabolism in rats

The present study attempted to characterize the effects of electrolytic lesions of the hypothalamic dorsomedial nucleus on the daily profile of pineal metabolism as well as on the inhibition of pineal melatonin synthesis induced by acute light exposure during the night. Adult male Wistar rats (n = 107, 12:12 h light-dark cycle) were left intact (n = 47) or lesioned (n = 60). Lesioned rats and their respective controls were killed at six time points distributed throughout the light-dark cycle. At ZT (zeitgeber time) 18 the animals were killed either in the dark or after 15 min of light stimulation. Pineal glands were assayed using high-performance liquid chromatography with electrochemical detection (HPLC-ED). There was no difference in the amounts of pineal indoles between lesioned and control rats under any of the experimental situations tested. These results suggest that in rats, the hypothalamic dorsomedial nucleus does not participate in either the neural control of daily pineal metabolism or the nocturnal light-induced inhibition of the pineal metabolism.     

Neuroethological evaluation of audiogenic seizures and audiogenic-like seizures induced by microinjection of bicuculline into the inferior colliculus. I. Effects of midcollicular knife cuts.

Audiogenic seizures (AS) are a model of generalized tonic-clonic seizures. The inferior colliculus (IC) and the GABAergic neurotransmission seems to be the most critical site and neurotransmitter system, respectively, of the auditory midbrain involved in AS origin and development. Thus, audiogenic-like seizures are evoked by GABAA antagonists such as bicuculline (BIC). Wistar audiogenic AS resistant (R) rats were sham-transected through the midcollicular line and microinjected with IC bicuculline (BIC; 80 ng/0.2 microliters) (n = 8); transected through the midcollicular line and microinjected with IC saline 0.9% (n = 8); transected through the cortex above the midcollicular line and microinjected with IC BIC (n = 3); transected through the midcollicular line up to 6.0 mm depth and microinjected with IC BIC (80 ng/0.2 microliters or 120 ng/0.3 microliters (n = 8). Wistar AS susceptible (S) rats were submitted to cortical transections (n = 8) and midcollicular transections (n = 7). Animals were studied by means of an ethological method before and after microinjections and/or transections in order to evaluate possible pathways in the AS-like evoked seizures. Bicuculline-evoked seizures were very similar to those evoked by acoustic stimulation, but lacked the tonic-clonic component. No modification in animal behavior was observed in the presence of sound, once the AS-like behavior was initiated. A small percentage of the animals, however, presented procursive behavior which was increased by sound. The IC BIC-evoked patterns were almost totally blocked by midcollicular but not cortical transections. Furthermore, midcollicular but not cortical transections blocked the tonic-clonic component of AS in genetically S animals without modifying the wild running component. These data suggest that the inferior colliculus-superior colliculus connection may be involved in the sensorimotor transduction necessary for AS-like behaviors.     

Study of P 300 in schizophrenia. Some reflexions on methodological difficulties]

We underscore the methodological difficulties in studying cognitive evoked potentials in schizophrenic patients. The main difficulties of such a study include the interruption of medication, the need of cooperation and immobility of subjects during the recordings, as well as of a correct patient-control matching for motivation, intellectual quotient, social and cultural levels. To establish correlations between clinical symptomatology and P 300 amplitude and latency we used both the DSM III-R and clinical rating scales. Clinical and electrophysiological testing must be performed the same day and have an excellent interrater agreement. Otherwise correlations are not reliable. Use of small patient samples is one major drawback which prevents to draw definitive conclusions. These difficulties usually unsaid are inherent to research in biological psychiatry and may partially explain the heterogeneity of results in the literature.