Analytical detection of immunoglobulin heavy chain gene rearrangements in gastric lymphoid infiltrates by peak area analysis of the melting curve in the LightCycler System

Because it is difficult to differentiate gastric mucosa-associated lymphoid tissue (MALT) lymphoma from chronic gastritis in gastric lymphoid infiltrates, molecular detection of monoclonality through immunoglobulin heavy chain (IgH) gene rearrangements is commonly performed. However, heterogeneity in the performance and results obtained from IgH gene rearrangements has been reported. To improve the accuracy in the diagnosis of gastric lymphoid infiltrates, we developed an analytical approach based on one-peak area analysis of the melting curve in the LightCycler System. Using a training-testing approach, the likelihood ratio method was selected to find a discriminative function of 4.64 in the training set (10 gastric MALT lymphomas and 10 chronic gastritis cases). This discriminative function was validated in the testing set (five gastric MALT lymphomas, six abnormal lymphocytic infiltrates with subsequently demonstrated gastric MALT lymphomas, and six cases of chronic gastritis). All but one case of gastric MALT lymphoma, as well as abnormal lymphocytic infiltrates, clustered under 4.64, and all chronic gastritis cases clustered above 4.64. These results were validated by conventional electrophoreses confirming one or two sharp bands in cases of gastric MALT lymphomas and a smear of multiple bands in cases of chronic gastritis. Analytical detection of IgH gene rearrangement in gastric lymphoid infiltrates by one-peak area analysis correctly distinguishes gastric MALT lymphomas from chronic gastritis, even in cases with diagnosis of abnormal lymphocytic infiltrates.     

The influence of water ingestion during prolonged exercise on affect

This study examined the influence of water ingestion on affect and perceived exertion during sub-maximal running. Fifteen endurance-trained men performed two counterbalanced 90-min treadmill runs at 70% V O2 max. No fluid was ingested during one trial (NF-trial), whereas a single water bolus (5.0 mLkg(-1) body mass) was ingested immediately preexercise and every 20 min during exercise (2.0 mLkg(-1) bodymass) in a fluid replacement trial (FR-trial). Affect and perceived exertion were repeatedly assessed and physiological changes monitored. Perceived exertion and heart rate increased significantly during the run but there were no differences between conditions. Such similarities were not reflected in the pleasure-displeasure ratings, which were maintained above baseline levels during exercise in the FR-trial but declined below baseline during the NF-trial. A significant postexercise improvement in rated pleasure-displeasure was found only in the FR-trial, leading to significantly higher ratings of pleasure-displeasure during the recovery period compared to the NF-trial. Self-reported Energy was also enhanced postexercise only in the FR-trial. Body mass decrease was significantly larger and thirst ratings were significantly higher in the NF-trial compared to the FR-trial. In summary, water ingestion attenuated the during-exercise decrease in pleasure-displeasure and elicited an improvement after prolonged, submaximal running.     

A comparison of 3 and 6 weeks' anticoagulation in the treatment of venous thromboembolism

One hundred hospital in-patients treated for pulmonary embolism (PE) and/or deep vein thrombosis (DVT) were randomly allocated to receive 3 or 6 weeks' anticoagulation with heparin and warfarin. At one year recurrence rates were 12% in the 6 week group and 10% in those treated for 3 weeks. No patient died as a result of recurrence. Our study suggests that 3 weeks' anticoagulation therapy, using intravenous heparin for the first 5 days and warfarin from the third day, is adequate for patients without persisting risk factors.     

Investigation of patients with abnormal response to warfarin.

In 55 patients in whom warfarin control had been satisfactory for at least 4 months, warfarin dose, plasma warfarin concentration and plasma clearance were measured. The mean dose to maintain the BCR (INR) between 2.3 and 3.3 was 5.1 +/- 2 mg day-1 (range 1.5-10 mg). Plasma warfarin concentrations and warfarin clearance were log-normally distributed with 95% confidence limits between 0.8 and 2.4 mg l-1 and 2.5 and 8.71 day-1 respectively. These confidence limits were used to construct algorithms which correctly predicted the cause of abnormal warfarin sensitivity in two patients and resistance in two further patients. These algorithms should help to identify the cause of abnormal warfarin responsiveness in the clinical setting.