Induction of apoptosis and down regulation of cell cycle proteins in mantle cell lymphoma by flavopiridol treatment

Typical mantle cell lymphoma (MCL) is a distinct B-cell non-Hodgkin's lymphoma associated with over-expression of cyclin D1 related to translocation between the IgH and BCL-1 genes. Due to the important functional interaction between cyclin D1 and cyclin dependent kinases, cyclin dependent kinase inhibitors such as flavopiridol are under consideration for treatment of patients with MCL. The present study investigated the in vitro effects of flavopiridol on the MCL cell line (JeKo-1). Flavopiridol at a dose of 10nmol/L induced apoptosis by 6h of treatment as noted by flow cytometric analysis, morphologic examination and Western blotting. The cleavage of procaspase-3 and PARP and the decrease of flavopiridol-induced apoptosis by pan-caspase inhibition suggested that the caspase pathway serves an important role in the apoptotic process. Furthermore, MCL cells exposed to flavopiridol showed down regulation of key cell cycle proteins acting at the restriction point control between the G1 and S phases. The onset of flavopiridol-induced apoptosis also coincided with the down regulation of Mcl-1, anti-apoptotic protein. Collectively, our data indicates that flavopiridol may have significant therapeutic potential in the context of MCL.     

Treatment of radiation-induced hemorrhagic cystitis with laparoscopic cystoprostatectomy

Hemorrhagic cystitis can occur 6 months to 10 years after pelvic irradiation. Various palliative treatment alternatives may be unsuccessful in the management of severe hemorrhagic cystitis, so that in rare cases radical surgery will be the last resort.A 77-year-old man with persistent bleeding due to hemorrhagic cystitis after radiotherapy for prostate cancer was initially treated with conservative measures. All of these treatment methods were unsuccessful. His condition deteriorated and became life-threatening. As a last resort, laparoscopic cystoprostatectomy and mini-laparotomy ileal conduit diversion were successfully performed with no intraoperative or postoperative complications. To our knowledge, this is the first report on laparoscopic cystoprostatectomy for a patient with previous radiotherapy to the pelvis.     

Synchronous endometrial and cervical tumors in a 26-year-old nullipara: diagnostic modalities updated

Proton magnetic resonance spectroscopy (MRS), performed on conventional magnetic resonance imaging (MRI) scanners, provides useful information at the biochemical level. MRS has been used to measure tissue concentrations of proton-containing compounds such as organic and amino acids, and sugars in living tissues. We have used MRS in a 26-year-old female with suspected cervical and endometrial carcinomas. With the use of the above mentioned technique, biochemical differences in the endometrium and the cervix tissues were detected. The presented case is the first virgin patient in the relevant literature in whom endometrial and cervical carcinoma was detected. Choline (Cho), creatine (Cr), N-acetylaspartate (NAA), lipid and lactate region of the MRS spectrum suggested that the technique could be used as an indicator of metabolic alterations in the cervical and endometrial tumor cells.     

Pneumococcal infections among immunised and splenectomised patients in Israel

Pneumococcal sepsis is a life-threatening complication in splenectomised patients even since the introduction of a polyvalent pneumococcal vaccine. Eight episodes of pneumococcal sepsis in seven properly vaccinated splenectomised patients are described. All but two of the causative serotypes were included in the vaccine. The fact that most of the patients were immunosuppressed may explain the failure of the vaccine in these particular patients. A survey of 59 episodes of pneumococcal bacteraemia during 1982 at the Soroka Medical Center, however, shows that 32% of the strains of pneumococci isolated were among seven types not included in the vaccine. The addition of continuous antibiotic prophylaxis in vaccinated and splenectomised patients is suggested.     

Some aspects of self-mutilation in the general population of a large psychiatric hospital

Summary The entire population of a large psychiatric hospital was screened with regard to the clinical symptom of self-mutilation. One out of every 23 patients, or 4.29 per cent, presented as at least one symptom a significant tendency toward self-injury. The attacks of men upon their bodies appeared generally more violent than those of women upon theirs. The frequency of self-mutilation by males was strikingly less than by females, 12.81. This frequency of self-mutilation, short of suicide, was almost the inverse of that of accomplished suicide in males as compared with females, 3.671.From the department of psychiatry, State University of New York, Upstate Medical Center in Syracuse, and Willard State Hospital, Willard, N. Y.     

The role of MRS in the differentiation of benign and malignant soft tissue and bone tumors

Objective

The aim of our study was to investigate the value of choline in the discrimination of benign and malignant soft tissue and bone tumors.

Materials and methods

The study group consisted of thirty subjects with bone or soft tissue tumors larger than 1.5 cm in diameter. The experiments were performed in a 1.5 T MR scanner. Coils were selected according to specific locations. A single-voxel MRS was performed for three different TE (time to echo) (31, 136, 272 ms). The volume of interest was positioned on the brightest enhancement. The presence of a cholin peak on at least 2 of these spectrums was considered as the marker of malignancy. The sensitivity, specificity and accuracy of the MRS in the detection and diagnosis of malignant lesions were calculated. The reproducibility of MRS and histopathological results were tested with kappa statistics.

Results

Histopathologically, 18 (60%) of the lesions were classed as malignant whereas 12 (40%) were classed as benign. With MRS, 15 (50%) of these lesions were classed as malignant and 15 (50%) as benign. Two patients who were found spectroscopically to have malignant tumors were shown histopathologically to have benign types. Five patients with an MRS showing a benign type were classed with malignant types in histopathological examinations. MRS had a sensitivity rate of 72.2%, specificity of 83.3%, and an accuracy rate of 76.6% in detecting malignant bone and soft tissue tumors. The interrater reliability of both techniques had a kappa value of 0.533.

Conclusions

MRS may help in the differentiation of benign and malignant soft tissue and bone tumors.