Observations regarding hairy cell leukemia and chronic lymphocytic leukemia within the proposed new classification of lymphoid neoplasms.
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Biomedical subjects
Publications and source records attributed to J Demeter.
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Members of the RCC1 protein family are chromatin-associated guanine nucleotide exchange factors that have been implicated in diverse cellular processes in various organisms, yet no consensus has been reached as to their primary biological role. The fission yeast Schizosaccharomyces pombe, a single-celled eukaryote, provides an in vivo system in which to study the RCC1/Ran switch by using a temperature-sensitive mutant in the RCC1-related protein pim1. Mitotic entry in the pim1-d1ts mutant is normal, but mitotic exit leads to the accumulation of cells arrested with a medial septum and condensed chromosomes. Although the yeast nuclear envelope normally remains intact throughout the cell cycle, we found a striking fragmentation of the nuclear envelope in the pim1-d1ts mutant following mitosis. This resulted in chromatin that was no longer compartmentalized and an accumulation of pore-containing membranes in the cytoplasm. The development of this terminal phenotype was dependent on the passage of cells through mitosis and was coincident with the loss of viability. We propose that pim1 is required for the reestablishment of nuclear structure following mitosis in fission yeast.
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Molecular genetical techniques could be developed for detection of the chimera gene of Philadelphia chromosome or that of its gene product, due to the relatively conserved structure of the chimera gene. The authors successfully analysed 123 blood/bone marrow samples from 106 patients using these molecular techniques adapted from the literature. Patients were classified by the first diagnosis, 65 CML, 7 AML, 13 ALL patients were studied. 12 patients had the diagnosis of myeloproliferative syndrome, and 9 patients were after bone marrow transplantation. 57% of the total, and by diagnosis, 74% of CML, 28% of AML, 54% of ALL, and 33% of post-transplant samples have shown the chimera gene structure characteristic for Philadelphia chromosome. All patients of myeloproliferative syndrome were negative. In some cases the authors had the opportunity to study simultaneously the peripheral blood and the bone marrow sample of the same patient and of the same date. The ratio of the positivity of the two samples varied from one to infinite. The authors could follow the effect of interferon in one case, the change of clonality of the leukemic cell line in an other case. They had the opportunity to detect two different abnormal gene structures in the sample of an AML patient.
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Pleural involvement is a rare complication of chronic lymphocytic leukemia (CLL). We report a CLL case of T-cell origin (documented by cell surface marker as well as DNA rearrangement studies) where the lymphoid cells of the pleural fluid were found to belong to the same monoclonal population of T cells as those of the peripheral blood.
Tumor necrosis factor alpha, the cytokine that participates in the autocrine growth control of hairy cell leukemia has strong bone resorptive properties. This prompted us to look for bone involvement in HCL. Bone mineral density (BMD) was not decreased in 14 HCL patients who did not have radiographic evidence of bone destruction. Osteopenia was found in only two HCL patients with skeletal complications of the disease and bone pain preceded diagnosis in both cases. Lymphomatous infiltration of the vertebral bodies T 12/L1 was confirmed histologically in the female patient while bilateral necrosis of the femoral head preceded the diagnosis of HCL in the male patient. Histomorphometry of bone biopsy samples was performed in another 12, previously untreated male HCL patients. Trabecular bone volume was found to be reduced in 11, greatly reduced in 5 of them, while osteosclerosis was found in only one patient. The increase of trabecular bone pattern factor, a new parameter for simple quantification of trabecular interconnection indicated a poorly connected trabecular lattice in eight of these 12 patients.
It often occurs during ultrasonography, that the gallbladder is not visible. The cause of this is most frequently cholelithiasis, but one must know the less common causes as well. Authors review the characteristic reasons and give accounts of their own experience, which was gained in the course of more than 60,000 examinations.
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The effect of Clostilbegyt + Humegon + Pregnyl ovulation inductive combination therapy was examined in the woman members of 20 sterile couples appearing at the Outpatient Department of Cryospermatology, Department of Obstetrics and Gynaecology Postgraduate Medical School. In 18 of the 20 cases follicle maturation and ovulation could be induced. In the male members of the couples therapy-resistant sterility existed at the same. By using artificial insemination by donors with cryopreserved sperms, gravidity could be obtained in 14 cases. The importance of the optimal timing of AID has been emphasized. In the course of transvaginal ultrasonography folliculometry was completed with the control of the pre-ovulatory changes of the endometrium. The appearance of the pre-ovulatory ring preceded the occurrence of pregnancy in all cases, being a sign of predictive value considering conception.
The transabdominal ultrasonography has less importance in the diagnosis of colonic tumors. To increase the diagnostic efficiency, the authors examined the colon with ultrasound - during water enema. They found 5 tumors and 4 polyps from 85 patients. They found, that this method is suitable for the intraluminal tumors' diagnosis. They want to investigate the other changes of the intestinal wall in the future.
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Expression of differentiation and activation antigens on peripheral blood mononuclear cells of four chronic lymphocytic leukaemia (CLL) patients was studied before and during interferon-alpha 2b therapy. Patients had clinical stage B(II) disease, a lymphocyte count of over 60 G/l and a lymphocyte doubling time shorter than 12 months. One of the patients unresponsive to previous chemotherapy experienced a substantial decrease of the lymphocyte count during interferon-alpha 2b (IFN-alpha 2b) therapy, with a nadir at one fifth of the initial value while on this therapy. The lymphocyte count decreased slightly in a further patient, while it increased in two patients. Treatment with IFN-alpha 2b left the phenotype of CLL lymphocytes essentially unchanged. The elevated serum beta-2 microglobulin values increased further during treatment with the exception of the CLL patient responsive to IFN-alpha 2b therapy. The clinical stage of the disease did not change in any of the patients when evaluated according to the criteria of the International Workshop on CLL. Further studies are necessary to determine which of the CLL patients benefit from therapy with interferon-alpha 2b.
Authors--beside the admission of ultrasound examination's obvious priority--do not think that the complete cease of the gall-bladder's X-ray examination is reasonable. They have been found this on the basis of the literature and their own observations. Authors suggest the gall-bladder's examination after a negative ultrasound, if the complaints of the patient are unchanged.