Options for Immunologic Support of Renal Transplantation Through the HLA and Immunology Laboratories

HLA and immunology laboratories are an integral part of clinical kidney transplant programs. They assist transplant clinicians with evaluating the immunological suitability of potential recipients for transplantation and selecting donor-recipient combinations with a low risk of immunological failure. With sophisticated new techniques becoming available for posttransplant immunological monitoring, laboratories play an increasing supporting role during posttransplant follow up. The level of precision at which immunological testing predicts clinical outcome, however, leaves room for improvement. In this article, we summarize the current state of diagnostics, discuss problems, and point out promising developments.     

病理技术质量控制的探讨

病理技术是病理学诊断不可分割的一部分,正确的染色结果是病理诊断的重要依据之一.病理技术的规范与否,制片质量的好坏很大程度上影响病理医生作出正确的病理诊断.     

Clinical parameters that predict histology of postchemotherapy retroperitoneal lymph node mass in testicular cancer

BACKGROUND: Since the advent of cisplatin-based chemotherapy, the majority of metastatic testicular cancers can be cured by chemotherapy followed by retroperitoneal lymph node dissection (RPLND). However, postchemotherapy RPLND confers no therapeutic benefit if the residual mass contains no viable cells. Therefore, to determine which parameters predict a patient's likelihood of having only necrosis in the residual mass, we retrospectively analyzed clinical parameters of patients who underwent postchemotherapy RPLND. METHODS: Data from 27 patients with metastatic testicular cancer were analyzed. The histology of the primary tumor was seminoma in 11 cases and non-seminoma in 16 cases. All of the patients with non-seminoma showed a normalization of tumor markers after chemotherapy. Analysis of clinical parameters included data for the initial histology, pretreatment tumor marker levels, postchemotherapy retroperitoneal mass size, and the histology of the dissected RPLNs. RESULTS: Histological examination of dissected RPLNs showed residual tumor in 27% of seminoma patients and 38% of non-seminoma patients. In seminoma patients, no viable cells were found in all six patients with pretreatment lactate dehydrogenase (LDH) levels below 7.5 times the upper limit of normal, or in all five of the patients with postchemotherapy RPLNs less than 2.5 cm. In non-seminoma patients, no viable cells were found in nine of 10 patients with pretreatment alpha-fetoprotein (AFP) levels less than 2700 ng/mL, or in eight of nine patients with residual mass less than 2.5 cm. CONCLUSIONS: Both postchemotherapy RPLN mass size and pretreatment tumor marker levels are possible predictors for necrosis of the residual mass in testicular cancer patients.     

Chronic GVHD in minor salivary glands and oral mucosa: histopathological and immunohistochemical evaluation of 25 patients

BACKGROUND: Graft-vs.-host disease (GVHD) is the major cause of morbidity and mortality in patients undergoing allogeneic Bone Marrow Transplantation (BMT). The aim of our study was to identify the most relevant histological features for diagnosis of chronic Graft-vs.-Host Disease (cGVHD) in oral mucosa and minor salivary glands of 25 patients, as well as to evaluate the immunophenotype of the inflammatory cells. METHODS: Sixteen patients that were submitted to allogeneic BMT but did not present cGVHD were selected as a control group. The sections were studied on H & E and CD68, CD45, CD4, CD8, CD20 staining. RESULTS: The most frequent histologic findings in oral mucosa at the day of diagnosis of cGVHD were: hydropic degeneration of the basal layer of the epithelium, apoptotic bodies, lymphocytic infiltration, and focal or total cleavage between the epithelial and connective tissue. In the labial salivary glands (LSG), lymphocytic infiltration, acinar loss and fibrosis were the main alterations. Cytotoxic CD8-T cells and macrophages were predominant both in the epithelium and connective tissue, as well as in minor salivary glands. CONCLUSIONS: Histological features were useful in the diagnosis of oral cGVHD. It is suggested that CD8-T cells and macrophages play important role in the pathogenesis of the disease.     

Extragastrointestinal stromal tumor possibly originating from the prostate

We report a case of extragastrointestinal stromal tumor possibly originating from the prostate. The patient underwent radical prostatectomy because of no metastatic evidence. No recurrence and metastasis have been found during 14 months of follow up. To our knowledge, this may be the third such case published in a report in terms of pathological type.     

Effects of haloperidol and amisulpride on motor and cognitive skill learning in healthy volunteers

Buprenorphine is a mu opioid partial agonist currently used as an analgesic, and being developed for the treatment of opioid dependence. The purpose of this study was to determine the abuse liability of parenteral buprenorphine in volunteers maintained on daily sublingual (SL) buprenorphine (8 mg). In a residential laboratory, eight volunteers underwent pharmacologic challenges two times per week. Medication challenges were 16 h after the daily dose of buprenorphine, and consisted of double-blind IM injections of buprenorphine (4, 8, 16 mg), the prototypic mu opioid agonist hydromorphone (9 and 18 mg), or saline. Assessments consisted of physiologic monitoring, subjects’ self-reports, and a trained observer’s ratings of drug effects, and were collected for 0.5 h before and 2.0 h following injection. Supplemental doses of IM buprenorphine produced opioid agonist-like effects, indicating some abuse potential of parenteral buprenorphine in buprenorphine-maintained patients. There was incomplete cross-tolerance to the effects of hydromorphone, suggesting that higher maintenance doses of buprenorphine may be needed to maximize clinical efficacy. However, there was a lack of graded dose-effects for hydromorphone, suggesting that buprenorphine’s combination of partial agonist effects and high affinity for opioid receptors may limit the magnitude of effects of supplemental full agonists. Finally, participants tolerated cumulative doses of maintenance buprenorphine plus challenge buprenorphine without adverse effects, suggesting higher doses of buprenorphine can be safely administered to opioid dependent patients. Received: 22 February 1996/Final version: 23 August 1996     

An alternative method for significance testing of waveform difference potentials

Guthrie and Buchwald (1991) proposed an ad hoc procedure for assessing the statistical significance of waveform difference potentials that may arise in a variety of psychophysiology research contexts. In our paper, an alternative method is presented and demonstrated that has fewer underlying assumptions than does the Guthrie-Buchwald test and may, therefore, produce better results in some situations. In particular, the test proposed here (a) is distribution free, (b) requires no assumption of an underlying correlation structure (e.g., first-order autoregressive), (c) requires no estimate of the population autocorrelation coefficient, (d) is exact, (e) produces p values for any number of subjects and time points, and (f) is highly intuitive as well as theoretically justifiable. This procedure may be used to carry out multiple comparisons with exact specification or experimentwise error, however, this test is based on permutation principles and may require large amounts of computer time for its implementation.     

实验性尘细胞灶与胸片细网状阴影形成的关系

本文从21只实验性矽肺家兔中筛选出5只胸片有细网状阴影者,用病理与 X 线对照观察的方法,探讨了实验性矽肺尘细胞灶与死后胸片细网状阴影形成的关系。证明,分布在肺细叶内直径约1mm 的尘细胞灶,其分布密度为113个/cm~2以上时,可构成胸片细网状阴影。实验排除了弥漫性肺间质纤维化的结论。并对胸片细网状阴影的形成从肺细叶解剖与 X 线投影进行了讨论。     

可见光对培养的人RPE细胞生长的影响以及SOD和CAT的防护作用

目的：观察外源性超氧化物歧化酶(superoxide dismutase,SOD)和过氧化氢酶(caralase，CAT)对培养的人视网膜色素上皮(retinal pigment epithelium,RPE)细胞光化学损伤的保护作用． 方法:将铺满期原代培养的人RPE细胞分为三组．A组直接作光照处理，B组在培养液中加入SOD(90U/mL)和CAT(900U/ml)后30分钟进行光照，c组为对照组．光照强度2 400 Lx，时间6小时．处理结束后将三组细胞以2.4X10⁵/ml的密度分别接种于24孔板，每孔0.4m1l．于接种后1、3、5和7天观察细胞形志，井进行细胞计数． 结果：光照后3天时，A、B组细胞生长缓慢，C组细胞生长活跃，3天后B组细胞生长接近C组，比A组明显活跃(P＜0.05)相似文献