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PubMed1986

Phenotyping of malignant hematopoietic cells. Analysis of 1200 cases of leukemia-lymphoma.

1255 cases of leukemia-lymphoma were tested between 1972 and 1984 by multiple marker analysis. Routine leukemia phenotyping was performed using standard morphological and cytochemical techniques in combination with clinical and histo-pathological information; the main emphasis was put on immunological surface marker analysis using erythrocyte rosette assays, TdT and a large panel of poly- and monoclonal antibody tests. The 1255 cases were divided into these major types and subtypes: 349 cases of ALL and related immature T- and Burkitt-lymphomas (cALL, pre B-ALL, B-ALL and Burkitt-lymphomas, T-ALL and immature, mostly leukemic T-lymphomas, Null-ALL), 454 cases of mature T- and B-cell malignancies (T-CLL, mycosis fungoides, Sezary-syndrome, T-lymphomas, B-CLL, hairy cell leukemia, multiple myeloma, B-lymphomas), 263 cases of acute myeloid leukemias (AML, AMMoL/AMoL), 182 cases of chronic myeloid leukemias (CML in chronic phase, CMoL, CML in blast crisis), 6 cases of erythroleukemia and 1 case of megakaryoblastic leukemia. A simplified classification scheme which has been used in our laboratories is presented. Phenotyping is of diagnostic, prognostic and therapeutic relevance, most evidently for patients with ALL. Routine leukemia phenotyping should be performed with highly standardized techniques and reagents and by combining information from several fields in the multiple marker analysis. New areas of leukemia research might become very useful for the routine procedure of phenotyping.

Adult↗

PubMed2004

Prognostic value of uPA, PAI-1, and DNA content in adult renal cell carcinoma.

OBJECTIVES: To examine whether urokinase-type plasminogen activator (uPA) and type 1 plasminogen inhibitor (PAI-1), DNA ploidy, and S-phase fraction (SPF) add supplementary prognostic information relative to stage and Fuhrman's grade in renal cell carcinoma. METHODS: A total of 100 patients with primary renal adenocarcinoma treated by nephrectomy were followed up for a median of 42 months. Of the 100 patients, 78 with Stage M0N0-Nx tumors were studied by multivariate analysis. The study population was dichotomized on the basis of the median cytosolic uPA and PAI-1 concentrations (30 pg/mg protein and 12.7 ng/mg protein, respectively). DNA content was measured by flow cytometry (FCM) on multiple tumor samples from each patient. DNA aneuploidy was observed in 67% of cases. The SPF was calculated for aneuploid samples. RESULTS: An FCM classification based on a combination of DNA content and SPF was obtained. High-risk patients were those with aneuploid tumors and high SPF values (greater than 1.7%) and included 23% of patients with M0N0-Nx tumors. Cytosolic uPA and PAI-1 levels were not predictive of metastasis. The stage, grade, SPF, and FCM classification were statistically significant prognostic factors in the univariate analysis, in both the overall population and the M0N0-Nx subgroup. In multivariate analysis, tumor grade and the FCM classification were the only independent predictors of disease-free survival (P = 0.018 and P = 0.046, respectively). CONCLUSIONS: We defined a group of M0N0-Nx patients with aneuploid tumors and high SPF values who are at a high risk of metastasis and who may benefit from closer long-term follow-up.

Adult↗

PubMed2001

Correlations between nuclear/cytoplasmic area ratio and classification of cervical smears.

The aim of this study was to assess the nuclear/cytoplasmic (N/C) ratio using computerized image analysis of cervical smears with intraepithelial neoplasia (CIN) grade I to III associated or not with cellular changes of human papillomavirus (HPV) in an attempt to determine if this method is more sensitive for the estimation of the grade of CIN. One hundred and ten cervical smears from women with a mean age 35.03 years were studied. The cytological diagnosis was as follows: CIN I + HPV (11), CIN II + HPV (11), CIN II + HPV (8), CIN I (7), CIN II (6), CIN III (8), Ca (22), HPV (32), CIN I-II + HPV (2) and CIN II-III + HPV (3). All cases were histologically examined: 93 cases were in agreement and 17 were under- or overestimated cytologically. The morphometric study of cervical smears was carried out by image analysis. Data were analysed by one way analysis of variance followed by Bonferroni test of multiple comparisons. Statistically significant differences were detected between the three grades of CIN or CIN HPV or only HPV (p<0.0001). The results demonstrated that the N/C ratio measured by image analysis on precancerous lesions of cervical smears could be considered as an additional tool for the classification of cervical smears, especially in determining the discrepancies between cytological and histological diagnoses.

Adolescent↗

PubMed1989

[Characteristics of multiple fractures of the long bones of the upper limbs and their treatment].

The authors have studied 103 patients with multiple fractures of the long bones of the upper extremities who have been treated at the basic clinic of the Department of orthopaedics and traumatology, at the clinics of the Donetsk Research Institute of Orthopaedics and Traumatology and at the regional traumatologic hospital during the past 15 years. The severity and the diversity of multiple injuries of the upper extremities were evident from the fact that in the 103 patients 220 segments were injured and there were 227 fractures. A classification of the injuries under study and the most rational methods of treatment have been worked out, which ensured positive results in most cases. They are supported by the analysis of the long-term results of the treatment which has been carried out in 61.16% (63) of the patients.

Adolescent↗

PubMed2006

Higher level phylogeny of Satyrinae butterflies (Lepidoptera: Nymphalidae) based on DNA sequence data.

We have inferred the first empirically supported hypothesis of relationships for the cosmopolitan butterfly subfamily Satyrinae. We used 3090 base pairs of DNA from the mitochondrial gene COI and the nuclear genes EF-1alpha and wingless for 165 Satyrinae taxa representing 4 tribes and 15 subtribes, and 26 outgroups, in order to test the monophyly of the subfamily and elucidate phylogenetic relationships of its major lineages. In a combined analysis, the three gene regions supported an almost fully resolved topology, which recovered Satyrinae as polyphyletic, and revealed that the current classification of suprageneric taxa within the subfamily is comprised almost completely of unnatural assemblages. The most noteworthy findings are that Manataria is closely related to Melanitini; Palaeonympha belongs to Euptychiina; Oressinoma, Orsotriaena and Coenonympha group with the Hypocystina; Miller's (1968). Parargina is polyphyletic and its components group with multiple distantly related lineages; and the subtribes Elymniina and Zetherina fall outside the Satyrinae. The three gene regions used in a combined analysis prove to be very effective in resolving relationships of Satyrinae at the subtribal and tribal levels. Further sampling of the taxa closely related to Satyrinae, as well as more extensive sampling of genera within the tribes and subtribes for this group will be critical to test the monophyly of the subfamily and establish a stronger basis for future biogeographical and evolutionary studies.

Animals↗

PubMed1996

Risk factors for corneal endothelial injury during phacoemulsification.

PURPOSE: To determine the principal risk factors for corneal endothelial injury during phacoemulsification. SETTING: Hayashi Eye Hospital, Fukuoka, Japan. METHODS: We prospectively investigated 859 consecutive eyes of 800 patients who had had phacoemulsification surgery. The percentage of corneal endothelial cell loss at 3 months after surgery was quantitated using specular microscopy. The firmness of the nucleus was graded by Emery's classification prior to surgery. We selected nine variables that could be associated with endothelial injury. The univariate associations between the endothelial cell loss and these variables were evaluated using simple correlation coefficients. A multiple linear regression analysis was performed to identify independent predictors of endothelial cell loss. RESULTS: In the simple regression analysis, older age, small pupil diameter, high nucleus grade, large nucleus, greater infusion volume, type of IOL implanted, and a greater amount of total emitted ultrasound energy were univariately associated with endothelial cell loss. In the multiple linear regression analysis, the best final model (R2 = 0.42) identified high nucleus grade, greater infusion volume, type of IOL implanted, and large nucleus as independent predictors of endothelial cell loss. CONCLUSION: Both univariate and multivariate analyses identified the firmness of the nucleus as the most significant risk factor for endothelial cell loss. Therefore, mechanical contact with nuclear fragments is considered the principal cause of endothelial injury.

Adult↗

PubMed1984

Prevalence survey of respiratory abnormalities in New Mexico uranium miners.

To obtain additional data concerning uranium mining and nonmalignant respiratory diseases, we conducted a prevalence survey of 192 long-term New Mexico uranium miners. Survey procedures included spirometry, completion of a respiratory symptoms questionnaire, physical examination and interpretation of available chest x rays. Total duration of underground uranium mining was used as the exposure index. Of the major respiratory symptoms, only the prevalence of dyspnea increased significantly with duration of uranium mining. With linear multiple-regression analysis, small but statistically significant effects of mining were found for two spirometric parameters, the forced expiratory volume in one sec and the maximal midexpiratory flow. By the 1980 International Labor Organization (ILO) U/C classification, 12 of 143 participants with x rays available for interpretation had at least category 1/0 pneumoconiosis. The opacities were predominantly nodular and compatible with silicosis.

Adult↗

PubMed1987

Diagnostic validity of the McCarron-Dial System in neuropsychological rehabilitation assessment.

The purpose of this study was to investigate the diagnostic validity of a neuropsychologically-based vocational evaluation battery, the McCarron-Dial System (MDS), in differentiating between brain-damaged and non-brain-damaged rehabilitation clients. Multiple discriminant analysis results indicate that 89% of the subjects were correctly classified. The results tentatively support the validity of the MDS for neurobehavioral diagnosis. However, additional emotional and behavioral information may be needed to increase classification accuracy and to determine more specific diagnosis. Because of its long tradition in vocational rehabilitation and established strengths in predicting vocational and community adjustment outcomes, the MDS may be potentially useful for both vocational and clinical neuropsychological assessment.

Adolescent↗

PubMed2005

Columnar cell lesions of the breast: the missing link in breast cancer progression? A morphological and molecular analysis.

Columnar cell lesions (CCLs) of the breast are a spectrum of lesions that have posed difficulties to pathologists for many years, prompting discussion concerning their biologic and clinical significance. We present a study of CCL in context with hyperplasia of usual type (HUT) and the more advanced lesions ductal carcinoma in situ (DCIS) and invasive ductal carcinoma. A total of 81 lesions from 18 patients were subjected to a comprehensive morphologic review based upon a modified version of Schnitt's classification system for CCL, immunophenotypic analysis (estrogen receptor [ER], progesterone receptor [PgR], Her2/neu, cytokeratin 5/6 [CK5/6], cytokeratin 14 [CK14], E-cadherin, p53) and for the first time, a whole genome molecular analysis by comparative genomic hybridization. Multiple CCLs from 3 patients were studied in particular detail, with topographic information and/or showing a morphologic spectrum of CCL within individual terminal duct lobular units. CCLs were ER and PgR positive, CK5/6 and CK14 negative, exhibit low numbers of genetic alterations and recurrent 16q loss, features that are similar to those of low grade in situ and invasive carcinoma. The molecular genetic profiles closely reflect the degree of proliferation and atypia in CCL, indicating some of these lesions represent both a morphologic and molecular continuum. In addition, overlapping chromosomal alterations between CCL and more advanced lesions within individual terminal duct lobular units suggest a commonality in molecular evolution. These data further support the hypothesis that CCLs are a nonobligate, intermediary step in the development of some forms of low grade in situ and invasive carcinoma.

Biomarkers, Tumor↗

PubMed2006

Life satisfaction after traumatic brain injury and the World Health Organization model of disability.

OBJECTIVE: To determine which components of the World Health Organization's International Classification of Functioning, Disability, and Health (ICF) are most predictive of global life satisfaction after traumatic brain injury (TBI). DESIGN: Prospective evaluation of 180 individuals enrolled in a TBI model system project site. RESULTS: Multiple regression analysis indicated that the combination of ICF components (body function and structure, activities, and participation) and demographic factors significantly predicted life satisfaction and accounted for 17% of the variance. Participation was the strongest predictor; activities were a significant, but weaker predictor; and body function and structure did not add to the prediction of life satisfaction. Of all the individual variables evaluated, only social integration and productivity were found to be significant, unique predictors. CONCLUSIONS: When considering the effects of various aspects of disabling conditions on the life satisfaction of individuals who have suffered a TBI, restriction of participation in life activities was found to have the greatest impact. Although the model accounted for a significant percentage in the variation of life satisfaction, a large proportion of the predictive picture (>82%) remains unclear. Doubtless, other variables impinge on life satisfaction that would further clarify the complex relationship between disabling conditions and life satisfaction in TBI.

Activities of Daily Living↗

PubMed1999

Ethnic differences in incidence of stroke: prospective study with stroke register.

OBJECTIVE: To identify ethnic differences in the incidence of first ever stroke. DESIGN: A prospective community stroke register (1995-6) with multiple notification sources. Pathological classification of stroke in all cases was based on brain imaging or necropsy data. Rates were standardised to European and world populations and adjusted for age, sex, and social class in multivariate analysis. SETTING: A multi-ethnic population of 234 533 in south London, of whom 21% are black. RESULTS: 612 strokes were registered. The crude annual incidence rate was 1.3 strokes per 1000 population per year (95% confidence interval 1.20 to 1.41) and 1.25 per 1000 population per year (1.15 to 1.35) age adjusted to the standard European population. Incidence rates adjusted for age and sex were significantly higher in black compared with white people (P<0.0001), with an incidence rate ratio of 2.21 (1.77 to 2.76). In multivariable analysis increasing age (P<0.0001), male sex (P<0.003), black ethnic group (P<0.0001), and lower social class (P<0.0001) in people aged 35-64 were independently associated with an increased incidence of stroke. CONCLUSIONS: Incidence rates of stroke are higher in the black population; this is not explained by confounders such as social class, age, and sex. Ethnic differences in genetic, physiological, and behavioural risk factors for stroke require further elucidation to aid development of effective strategies for stroke prevention in multi-ethnic communities.

Adolescent↗

PubMed1999

Elevated serum thymidine kinase levels identify a subgroup at high risk of disease progression in early, nonsmoldering chronic lymphocytic leukemia.

Chronic lymphocytic leukemia (CLL) shows a remarkably heterogeneous clinical outcome; survival ranges from several months in advanced stages to more than 10 years in early stages. The Binet and Rai staging systems distinguish three major prognostic subgroups, but do not accurately predict the individual risk of disease progression in early CLL (Binet stage A or Rai stage 0 to II). Because most newly diagnosed CLL patients present with early disease, it seems desirable to search for additional prognostic factors to identify early CLL patients at high risk of rapid progression. It has been shown that elevated serum thymidine kinase (s-TK) levels predict disease progression in CLL. Therefore, this study aimed to assess the prognostic value of s-TK in 122 previously untreated patients with Binet stage A CLL (mean age +/- SD, 58.7 +/- 8.5 years). In univariate analyses, 18 of the 22 parameters investigated predicted progression-free survival (PFS). In a stepwise multiple regression analysis, only three parameters provided independent prognostic information on PFS: s-TK greater than 7.1 U/L; presence of lymphadenopathy; and white blood cell (WBC) count greater than 75, 000/microL. When added to the classification of smoldering versus nonsmoldering CLL, s-TK levels separated two groups within the group of nonsmoldering stage A patients: patients with s-TK values greater than 7.1 U/L had a median PFS of 8 months, whereas patients with s-TK values </= 7.1 U/L expected a much longer PFS (49 months; P <. 001), similar to smoldering CLL (42 months). The results demonstrate that s-TK is a prognostic parameter that adds independent prognostic information to the definitions of smoldering and nonsmoldering CLL in Binet stage A.

Adult↗

PubMed1984

Enzyme markers in acute leukemias: advances during the last decade.

Besides the recent advances in immunology that provided important information for the characterization of leukemia cells, enzyme marker analysis is another area of progress in leukemia research. Assays of enzyme activities, both quantitative enzyme levels and qualitative isozyme changes, are of value in the classification of leukemias. The interest in the study of enzyme markers is due not only to technical improvements and new biochemical possibilities, but also to the involvement of enzyme marker analysis in the so-called "multiple marker analysis," which combines traditional and recently developed techniques in leukemia research. The aims of this review are to describe well-known and potential enzyme markers as well as to stress the relevance of enzyme marker analysis combined with multiple marker analysis for leukemia subclassification and the understanding of normal hematopoietic cell differentiation.

5'-Nucleotidase↗

PubMed2004

A molecular modeling and QSAR study of suppressors of the growth of Trypanosoma cruzi epimastigotes.

In this work, we have used molecular modeling and QSAR tools to study 18 dithiocarbamate suppressors of the growth of Trypanosoma cruzi epimastigotes, which have been reported in the literature as superoxide dismutase (SOD) inhibitors. The principal component analysis (PCA) showed that the descriptors superficial area, heat of formation, logarithm of the partition coefficient, charge of the nitrogen atom from the dithiocarbamate group and Charges of the two carbon atoms adjacent to that nitrogen are responsible for the classification between the higher and lower trypanomicid activity. Using multiple linear regression (MLR) and docking methods it was possible to identify the probable bioactive isomers that suppress of the growth of T. cruzi epimastigotes. Our best partial least square (PLS) model obtained with these six descriptors yields a good correlation between experimental and predicted biological activities and compares two different SODs as possible target for interaction with the dithiocarbamates.

Amino Acid Sequence↗

PubMed2005

Disease risks of childhood obesity in China.

OBJECTIVE: To estimate the relative risks of dyslipidemia, hypertension, diabetes mellitus, and metabolic syndromes among overweight and obese Chinese children compared with their normal weight counterparts. METHODS: Overweight and obesity were defined by age- and sex-specific BMI classification reference for Chinese children and adolescents. Pediatric metabolic syndrome (MetS) and each risk factor for MetS were defined using the criteria for US adolescents. Definition of hyper-TC, LDL, and dyslipidemia for adults was applied as well. General linear model factor analysis and chi-square test were used to compare the difference in metabolic indicators among normal weight, overweight, and obese groups. Multiple logistic regression analysis was performed to estimate the odds ratio of metabolic abnormalities between obesity, overweight, and normal weight children, after adjustment for living area, family economic level, age, sex, and daily exercise time and TV watching time, as well as different dietary indices in the model. RESULTS: Significant increases in blood lipids, glucose, and blood pressure were found among overweight and obese children as compared with their counterparts with normal weight. By applying WGOC-recommended BMI classification, the risks for hypertriglyceridemia, low HDL and dyslipidemia among overweight children were 1.9, 1.4, and 1.5 times, and was 3.3, 1.5, and 1.8 times among obese groups compared to their counterparts with normal weight after adjustment for age, sex, region, socioeconomic status, physical activity, and dietary intakes. The overweight and obese children (15-17.9 years) had a high-risk of developing hypertension, which was 2.3 and 2.9 times higher than their counterparts with normal weight. Above 90% obese adolescents had abdominal obesity, while less than 1% normal weight ones had abdominal obesity. No obese adolescents were free from any risk factors for MetS, while 36.9% of normal weight adolescents were from the risk factors. 83.3% obese boys and all obese girls had metabolic syndrome, while only 15.5% normal weight boys and 18.8% normal weight girls had metabolic syndrome. Four risk factors for metabolic syndrome were found in 8.3% obese boys while none in normal weight boys and girls. The prevalence of MetS among normal weight, overweight, and obesity groups was 1.5%, 18.3%, and 38.1% respectively. CONCLUSION: The cardiovascular disease (CVD) risk factors are clustered in obese Chinese children. Our observations strongly suggest that efforts should be made to prevent the onset of overweight and its associated diseases during early childhood.

Adolescent↗

PubMedDate not supplied

Quantitative magnetoencephalography of spontaneous brain activity in Alzheimer disease: an exhaustive frequency analysis.

Quantitative magnetoencephalography (qMEG) was used to investigate differences in the 2 to 60 Hz spectral power, between Alzheimer disease (AD) patients and control subjects. Twenty-two AD patients and 21 age-matched control subjects participated in this study. MEG signal analysis comprised the division of the entire 2 to 60 Hz spectrum in 2 Hz-width subbands. Both the relative power and the contribution of each subband to the correct classification of AD patients and controls were calculated. The relative power in 2 bands comprised between 2 to 4 Hz and 16 to 28 Hz was selected by a restrictive multiple-comparison test, among the entire 2 to 60 Hz spectrum. Using 2 to 4 Hz values it is possible to choose a classification rule with an estimate sensitivity and specificity given by 68% and 76% respectively. Alternatively, when 16 to 28 Hz values are used, it is possible to obtain a better classification rule with an estimate sensitivity and specificity given by 81% and 80%, respectively. To the best of our knowledge, this is the first electroencephalography or MEG study where a so exhaustive analysis of the magneto-electric spectrum has been performed. This study supports the notion that more attention should be devoted to the study of beta band in AD.

Aged↗

PubMed2000

[Comminuted fractures in multiple trauma patients: an analysis of 31 cases].

PURPOSE OF THE STUDY: We analyzed calcaneum burst fractures in multiple trauma patients and propose a management scheme. MATERIAL AND METHODS: In a retrospective study, we isolated 23 patients with 31 calcaneum burst fractures. All were stage V in the Duparc classification. We call them "pied de mine" fractures as they resembled those described in military reports. Half of them (16 cases; 54%) were open fractures. All patients suffered multiple injuries and 12 had a psychiatric history. These fractures were associated with spinal fracture in 17 cases (73%) and half had neurologic deficit, limb fracture in 16 (73%), and pelvic fracture in 12 (52%). The most frequent associated foot injuries were a talus fracture in 9 cases (29%) and Chopart displacement in 10 cases (32%). Clinical evaluation used the Maryland foot score, foot print and radiologic evaluation with lateral retrotibial view. RESULTS: Mean follow-up was 35 months. Mean Maryland foot score was 62.7 and 13 cases were pain free. Pain was due to conflict with the lateral malleolus, bony plantar thorns, medial malleolus and subtalar osteoarthritis. Orthopedic shoes were used 11 times. The other patients used sports shoes. Subtalar mobility was most frequently absent (23/29 cases, 2 amputations). Foot print showed 13/16 flat feet; 6 thorns were indirectly visible. Two patients had retraction toes and were initially treated by external fixation. Radiologic evaluation showed 23/29 complete subtalar arthrodeses, 23/29 migration of the great tuberosity, often(17/23 cases) associated with varus angulation. Eleven patients needed subsequent surgery: 5 for arthrodeses and 6 for resection of bony thorns. Rate of complication was high, especially for open fractures: 2 infections for 15 closed fractures, and 8 infections (50%) for 16 open fractures with 2 cases of chronic osteitis. Secondary amputation was required in 2/31 cases due to sepsis. TREATMENT PROPOSITIONS: For closed calcaneum burst fractures, it is better to wait one week before osteosynthesis. This delay is used to decrease edema with limb elevation and compressive bandaging. Skin tension due to trauma is increased by edema and osteosynthesis gives a high risk of wound disunion. We recommend reduction and Y-plate fixation even for burst fracture. Reduction must lower the tuberosity and correct the varus. After surgery, subtalar spontaneous arthrodesis is usually observed in a good position. Any bony plantar thorn must be resected. For open calcaneum burst fracture, the risk of sepsis is high. First treatment is debridement, stabilization and external fixation with antibiotic therapy. Stabilization should improve vascularization and facilitate internal fixation. The external fixation can be placed on the medial side to free the lateral approach to the calcaneum. Flap repair can be performed after one week when skin tension has subsided and areas of necrosis controlled.

Adult↗

PubMed1995

Statistical techniques for diagnosing CIN using fluorescence spectroscopy: SVD and CART.

A quantitative measure of intraepithelial neoplasia which can be made in vivo without tissue removal would be clinically significant in chemoprevention studies. Our group is working to develop such a technique based on fluorescence spectroscopy. Using empirically based algorithms, we have demonstrated that fluorescence is discriminating normal cervix from low- and high-grade cervical dysplasias with similar performance to colposcopy in expert hands. These measurements can be made in vivo, in near real time, and results can be obtained without biopsy. This paper describes a new method using automated analysis of fluorescence emission spectra to classify cervical tissue into multiple diagnostic categories. First, data is reduced using the singular value decomposition (SVD), yielding a set of orthogonal basis vectors. Each patient's emission spectrum is then fit by linear least squares regression to the basis vectors, producing a set of coefficients for each patient. Based on these coefficient values, the classification and regression tree (CART) method predicts the patient's classification. These results suggest that laser-induced fluorescence can be used to automatically recognize and differentially diagnose cervical intraepithelial neoplasia (CIN) at colposcopy. This method of analysis is general in nature, and can analyze fluorescence spectra of suspected intraepithelial neoplasms from other organ sites. As a more complete understanding of the biochemical and morphologic basis of tissue spectroscopy is developed, it may also be possible to use fluorescence spectroscopy of the cervix as a surrogate endpoint biomarker in Phase I and II chemoprevention trials.

Algorithms↗