Chromosomal abnormalities in untreated patients with non-Hodgkin's lymphoma: associations with histology, clinical characteristics, and treatment outcome. The Nebraska Lymphoma Study Group

We describe the chromosomal abnormalities found in 104 previously untreated patients with non-Hodgkin's lymphoma (NHL) and the correlations of these abnormalities with disease characteristics. The cytogenetic method used was a 24- to 48-hour culture, followed by G- banding. Several significant associations were discovered. A trisomy 3 was correlated with high-grade NHL. In the patients with an immunoblastic NHL, an abnormal chromosome no. 3 or 6 was found significantly more frequently. As previously described, a t(14;18) was significantly correlated with a follicular growth pattern. Abnormalities on chromosome no. 17 were correlated with a diffuse histology and a shorter survival. A shorter survival was also correlated with a +5, +6, +18, all abnormalities on chromosome no. 5, or involvement of breakpoint 14q11-12. In a multivariate analysis, these chromosomal abnormalities appeared to be independent prognostic factors and correlated with survival more strongly than any traditional prognostic variable. Patients with a t(11;14)(q13;q32) had an elevated lactate dehydrogenase (LDH). Skin infiltration was correlated with abnormalities on 2p. Abnormalities involving breakpoints 6q11-16 were correlated with B symptoms. Patients with abnormalities involving breakpoints 3q21-25 and 13q21-24 had more frequent bulky disease. The correlations of certain clinical findings with specific chromosomal abnormalities might help unveil the pathogenetic mechanisms of NHL and tailor treatment regimens.     

The dopamine response in mouse neuroblastoma cells is mediated by serotonin 5HT3 receptors

Serotonin (5HT) and dopamine (DA) induce, in neuroblastoma N1E-115 cells, a transient membrane depolarization associated with an inward current. The half-maximum response is obtained with 2 microM 5HT or 200 microM DA. The maximum response to 5HT is 2-3 times that to DA. The selective 5HT3 receptor antagonists ICS 205-930 and MDL 72222 at nanomolar concentrations block both the 5HT- and the DA-induced response. High concentrations (10 microM) of 5HT2 receptor antagonists are without effect. It is concluded that, in N1E-115 cells, 5HT and DA activate a single population of 5HT3 receptors.     

高效毛细管电泳/前沿分析及其在手性药性药物-蛋白结合研究中的应用

目的：综述了高效毛细管电泳／前沿分析（HPCE／FA）方法的原理、特点、及其在手性药物－蛋白结合研究中的应用。方法：采用HPCE／FA方法。结果：不同的手性药物对映体与蛋白结合可能存在判别,同一药物对映体之间与不同蛋白结合率可能存在差别,HPCE／FA仅需极少量样品即可同时测定手性药物各对映体在蛋白结合中的游离浓度。结论：HPCE／FA是一种高效、分析迅速、样本用量极少的研究蛋白结合方法,特别是对于手性药物与昂贵不易获得的蛋白结合研究。     

Autoimmune hemolytic anemia in Kawasaki disease: a case report

A 3-year-old boy presented with the fever, conjunctivitis, rash, and lymphadenopathy diagnostic of Kawasaki disease. Treatment with antibiotics, aspirin, and intravenous immunoglobulin was instituted. The hematocrit decreased from 35 percent on admission to 11 percent by hospital Day 10, and the white cell count had increased from 13.7 to 42 × 10(3) per microL, and the patient had a leukoerythroblastic blood smear. The direct antiglobulin test demonstrated IgG but not complement on the red cell (RBC) surface. An acid eluate reacted (titer of 4) with all panel cells in the antiglobulin phase. Intravenous immunoglobulin from the same lot used for treatment did not contain antibody that reacted with the patient's group O RBCs or a panel of group O RBCs, but did contain IgG anti-A and -B (titer of 4). The patient received a transfusion and was given methylprednisone. The direct antiglobulin test and acid eluate were negative 4 days later. The patient had an uneventful recovery. The distinction between antibody-mediated hemolytic anemia and autoimmune hemolytic anemia is important in the treatment of this disease.     

示指桡侧指背动脉逆行岛状皮瓣移植修复示指缺损

目的:观察示指桡侧指背动脉逆行岛状皮瓣移植对示指指端缺损的修复效果。方法:选择2002-08/2005-09南华大学附属第一医院急诊收治的外伤性示指末节部分缺损患者13例,手术方法的选择在术前均得到患者同意,且得到医院伦理道德委员会批准。组织缺损大小在1.5cm×1.0cm～2.0cm×1.5cm之间,所有缺损均有指骨和(或)大部分的指腹组织缺损,采用示指桡侧指背动脉逆行岛状皮瓣移植修复,皮瓣设计:旋转点位于近侧指间关节的近端,皮瓣轴为示指的桡背侧,皮瓣部分设计在第2掌指关节的近侧,蒂宽约0.8mm。术后定期随访,主要观察皮瓣质地和感觉的恢复情况,将感觉恢复的评估标准分为5级:S1:无感觉;S5:在神经单一分布区恢复两点鉴别能力。结果:13例患者全部进入结果分析,无脱落。①术后随访三四个月者10例,随访五六个月者3例。②术后9例皮瓣完全成活;4例皮瓣远端部分坏死,经换药表皮爬行创面愈合。③外形基本满意,皮瓣色泽、质地良好。④术后1个月随访时,3例患者两点辨别觉大于6.0mm,感觉恢复S4;术后五六个月随访时,3例患者两点辨别觉4.0～6.0mm,感觉恢复S5。结论:示指桡侧指背动脉逆行岛状皮瓣设计的旋转点位于近侧指间关节的近端,可以简化手术而不影响皮瓣存活,是示指部分缺损修复的可选方法。     

Single-strand conformation polymorphism analysis is a rapid and effective method for the identification of mutations and polymorphisms in the gene for glycoprotein IIIa

Glanzmann thrombasthenia (GT) is the most common inherited disorder of platelets. Most of the molecular defects previously identified in GT have been caused by point (or other small) mutations in the genes for glycoprotein (GP) IIb or GPIIIa. We have used single-strand conformation polymorphism (SSCP) analysis to rapidly identify single- base changes in the GPIIIa gene. Using genomic DNA from normal individuals and patients with GT, each GPIIIa exon and a short stretch of flanking intronic sequence was amplified, heat-denatured, and separated in nondenaturing acrylamide gels. Only those fragments with an abnormal migration pattern were isolated and the nucleotide sequence determined. Using SSCP, we detected the polymorphism in the HPA-1 (P1A) system and all three known silent polymorphisms in the GPIIIa gene. Screening 14 GPIIIa exons from 5 patients with GT, one mutant allele was identified. The nucleotide sequence of the abnormal 240-bp SSCP fragment was determined and a G-->A substitution in the splice donor site of exon iv was identified. Analysis of platelet RNA resulting from this mutation showed two mRNA species: one contained a deletion of exon iv, whereas the other had a 27-bp addition to exon iv due to the use of a cryptic splice site in the downstream intron. Single-base substitutions are the most common mutation in GT and often result in abnormal mRNA splicing. SSCP is a rapid and sensitive technique for identifying mutations or polymorphisms in the GPIIIa gene.     

Bedside filtration of blood products in the prevention of HLA alloimmunization--a prospective randomized study. Alloimmunisation Study Group

To test the efficacy of poststorage bedside leucodepletion of blood products in the prevention of primary HLA alloimmunization and its clinical sequelae, 172 patients with hematologic malignancy requiring intensive red blood cell and platelet support were randomized to receive either standard or filtered red blood cells and platelets. Quality control of bedside filtration was explored by sequential sampling downstream of the filter, but this did not predict the total number of leucocytes transfused. After exclusions, 123 evaluable patients were assessed every two weeks until the end of therapy. HLA antibodies developed in 21 of 56 (37.5%) nonfilter (NF) and 15 of 67 (22%) filter (F) patients (risk ratio estimate, 0.60 [95% confidence interval, 0.34 to 1.05]; P = .07). Patients with acute myeloid leukemia (AML; n = 53) had higher alloimmunization rates in both arms of the study, with a greater effect of filtration (62.5% NF and 31.0% F; P = .025). Bedside filtration did not affect the overall incidence of febrile transfusion reactions (FTRs; 37% NF and 34% F; P = .71) or of platelet refractoriness assessed in 50 patients (30% NF and 26% F), despite an association between broad HLA reactivity and both FTRs and refractoriness. However, FTRs were also seen in 28 patients without HLA antibodies. Five alloimmunized refractory patients (2 F and 3 NF) required HLA-selected platelets. This report, the first prospective study of bedside filtration, has failed to show clear clinical benefit. Methodological limitations may account in part for this failure, notably the difficulties in accurately assessing the number of leucocytes transfused.