Diagnostic considerations in prolymphocytes in pleural fluid: a case report

BACKGROUND: Prolymphocytes are nucleolated cells that are the defining features of the 2 chronic lymphoproliferative disorders, prolymphocytic leukemia (PLL) and chronic lymphocytic leukemia (CLL) with increased prolymphocytes. Prolymphocytes appear relatively unfamiliar in cytopathology practice, and, particularly when present in body fluids, may resemble blasts or adult T-cell leukemia/ lymphoma (ATLL) cells. CASE: A 32-year-old man, referred to us with a diagnosis of acute leukemia, presented with shortness of breath for 2 months and loss of appetite for 3 months. He had enlarged liver and spleen, 6 and 8 cm, respectively, below the costal margin and pleural effusion. The raised total leukocyte count chiefly comprised prolymphocytes that, especially in the pleural fluid, had prominent nucleoli and significant pleomorphism, raising the possibility of blasts or ATLL. CONCLUSION: Prolymphocytes in body fluids can be misinterpreted as blasts or even ATLL cells. Better awareness among cytopathologists about prolymphocytes and the disease states in which they occur, as well as insistence, in a clinical setting of leukemia, on interpreting the pleural fluid in relation to the clinical and laboratory findings, especially those of the peripheral blood and bone marrow, can prevent misdiagnosis. Equally importantly, immunophenotyping must be done in such situations.     

Diagnostic impression cytology: a simple technique for the diagnosis of external eye disease

Diagnostic impression cytology: a simple technique for the diagnosis of external eye disease
The technique of impression cytology was used for cytologic examination of conjunctival samples from 128 patients with a variety of external eye diseases. The method of sample collection and the staining procedure are described. Microscopic examination showed 62 cases with allergic conjunctivitis, 23 with bacterial or viral infection, 26 cases with changes typical of dry eye and 17 cases with non-specific chronic inflammation. The cytologic features and numerous applications of impression cytology are discussed.     

Third degree laceration at delivery; etiological considerations,and a technique for repair

In a series of 14,080 cases in which either median or mediolateral episiotomy was used to facilitate delivery, third degree extension occurred in 75 cases (0.5 per cent). In related data extension of laceration was observed to occur in an inordinately high proportion of cases in association with use of forceps, greater than normal anterior pelvic depth, delivery of a large baby, primiparity, abnormal position and presentation, use of median incision (although extension also occurred in some cases in which mediolateral episiotomy was done), and hyperflexion and extreme abduction of the thighs. The method of immediate postpartum repair employed was associated with a minimal amount of postpartum discomfort, and late complications were almost nil.     

Taxonomy and phylogenetics: Some considerations

The relationships between taxonomy and phylogenetics are discussed. It is suggested that they are distinct biological subdisciplines and some consequences of this position are set out.     

Aldehyde-fuchsin: Historical and chemical considerations

Summary The staining mechanisms of Gomori's aldehyde-fuchsin are not yet fully understood. It seemed therefore timely to review the history of this dye class in context with current dye and aldehyde chemistry. In 1861 Lauth treated basic fuchsin with acetaldehyde. This dye became known as Aldehyde Blue, but consisted of violet and blue dyes. Schiff (1866) studied several aldehyde-fuchsins; these compounds contained two molecules of dye and three molecules of aldehyde. Acetaldehyde-fuchsin prepared according to Schiff's directions showed staining properties similar to those of Gomori's aldehyde-fuchsin. This dye class was soon superseded by new dyes more suitable for textile dyeing, and chemical investigations of aldehyde-fuchsins ceased around the turn of the century. Gomori's aldehyde-fuchsin has been regarded as a Schiff base. However, according to chemical data, low molecular aliphatic aldehydes and aromatic amines tend to form condensation products. Correlations of chemical and histochemical observations suggest such processes during aging of dye solutions. Models of dimers and polymers of aldehyde-fuchsin could be built without steric hindrance. The nature of the bonds formed by various components of aldehyde-fuchsin solutions is not clear. However, cystine in proteins, e.g. in basement membranes, apparently does not play a role in the binding of aldehyde-fuchsin by unoxidized Carnoy- or methacarn-fixed sections.     

Methodical considerations when estimating nutrient digestibility in horses using the mobile bag technique

Total collection of faeces is considered the golden standard for estimating apparent total tract digestibility (ATTD) in horses. However, the evaluation of individual feedstuffs is limited and determination of nutrient digestibility in different segments of the gastrointestinal tract (GIT) is excluded. The rationale for performing this study was that the mobile bag technique (MBT) can provide information on individual feedstuffs' degradation, and the use of fistulated animals does provide additionally information regarding degradation in individual segments of the GIT. Recommendations for using the MBT in ruminants are well established, but limited methodical studies have been published with horses. The objective of this study was to evaluate the MBT by comparing the ATTD with the nutrient disappearance and degradation kinetics of hay in horses. It was hypothesised that DM degradation as estimated by the MBT is equal to the ATTD of the DM. Furthermore, we hypothesised that bag size has no effect on nutrient disappearance but increasing the feed to surface area (FSA) decreases the DM disappearance. Five caecum cannulated horses were fed a hay-only diet (6.7 kg DM/day) with 14 days of adaptation followed by four consecutive days of total faeces collection. Three bag sizes (height × length × side, cm; 1.2 × 10 × 2, 3 × 4 × 2, 1 × 6 × 2) and three FSAs (10.4, 20.8 and 41.7 mg/cm²) were administrated at each meal (3 meals/day) on days 1 and 2 of the collection. Faeces were checked for bags every 6th h, the collection time was noted and the DM disappearance together with the transit time (TT) for each bag type was estimated. Dry matter disappearance from the individual bags was fitted to degradation profiles, and the effective degradability (ED) and degradation (D_t) were determined. The results of the study showed that the ATTD of DM, organic matter (OM), NDF and ADF can be predicted based on their disappearance from the mobile bags, but that ash and CP are overestimated in comparison to the ATTD. The TT for the bags was 29.2 h, and when using a mean retention time of 30 h to predict ED and D_t, it was clear that ED was underestimated, whereas D_t reflected the ATTD of DM. In conclusion, the MBT can be used to estimate the degradability of DM, OM and fibre as these nutrients resemble the ATTD. The bag size did not affect the DM disappearance, but the FSA should be kept below 20 mg/cm² as higher levels might limit the degradation kinetics.     

Aldehyde-fuchsin: historical and chemical considerations.

The staining mechanisms of Gomori's aldehyde-fuchsin are not yet fully understood. It seemed therefore timely to review the history of this dye class in context with current dye and aldehyde chemistry. In 1861 Lauth treated basic fuchsin with acetaldehyde. This dye became known as Aldehyde Blue, but consisted of violet and blue dyes. Schiff (1866) studied several aldehyde-fuchsins; these compounds contained two molecules of dye and three molecules of aldehyde. Acetaldehyde-fuchsin prepared according to Schiff's directions showed staining properties similar to those of Gomori's aldehyde-fuchsin. This dye class was soon superseded by new dyes more suitable for textile dyeing, and chemical investigations of aldehyde-fuchsins ceased around the turn of the century. Gomori's aldehyde-fuchsin has been regarded as a Schiff base. However, according to chemical data, low molecular aliphatic aldehydes and aromatic amines tend to form condensation products. Correlations of chemical and histochemical observations suggest such processes during aging of dye solutions. Models of dimers and polymers of aldehyde-fuchsin could be built without steric hindrance. The nature of the bonds formed by various components of aldehyde-fuchsin solutions is not clear. However, cystine in proteins, e.g. in basement membranes, apparently does not play a role in the binding of aldehyde-fuchsin by unoxidized Carnoy- or methacarn-fixed sections.     

Maxillary reconstruction: functional and aesthetic considerations

Maxillary reconstruction is a challenging endeavor in functional and aesthetic restoration. Given its central location in the midface and its contributions to the key midfacial elements--the orbits, the zygomaticomaxillary complex, the nasal unit, and the stomatognathic complex--the maxilla functions as the keystone of the midface and unifies these elements into a functional and aesthetic unit. Maxillary defects are inherently complex because they generally involve more than one midfacial component. In addition, most maxillary defects are composite in nature, and they often require skin coverage, bony support, and mucosal lining for reconstruction. In the reconstruction of maxillary defects secondary to trauma, ablative tumor surgery, or congenital deformities, the following goals must be met: (1) obliteration of the defect; (2) restoration of essential functions of the midface, such as mastication and speech; (3) provision for adequate structural support to each of the midfacial units; and (4) aesthetic reconstruction of the external features. This review will discuss the pertinent anatomic considerations, the historical approaches to maxillary reconstruction, and the merits of the techniques in use today, with an emphasis on state-of-the-art reconstruction and dental rehabilitation of extensive maxillary defects.     

Chiniquodontid cynodonts: systematic and morphometric considerations

Systematic and morphometric reappraisal of most specimens previously assigned to the cynodont clade Chiniquodontidae reveal that the group is diagnosed by two autapomorphies: (1) the distinctive angulation between the posterior portion of the maxillary and the anterior portion of the zygomatic arch and (2) very extended pterygoid flanges, ending in a thin projection; and a combination of features including: posterior postcanines sectorial with principal cusps backwardly recurved, and a long osseous palate. The species Chiniquodon theotonicus (including Belesodon magnificus , Probelesodon kitchingi , P. lewisi and P. minor ) and C. sanjuanensis (comb. nov.) were the only recognised members of the family on the basis of qualitative characters. The South American species Cromptodon mamiferoides , Probainognathus jenseni and Thrinaxodon brasiliensis are thus excluded from the group, as are the African taxa Aleodon brachyrhamphus and Cistecynodon parvus . Allometric analysis of chiniquodontids sensu stricto reveals that: (1) all specimens can be confidently arranged in a single growth series, irrespective of their original species assignments; and (2) most of the measurements change isometrically with respect to skull length. Adults are virtually scaled–up juveniles, showing a deepened zygoma, a longer osseous palate, and a wider anterior muzzle in the canine region. Thus, allometric data reinforce the proposed synonymy of all forms, with the specific status of C. sanjuanensis supported by qualitative diagnostic traits.     

Radioimmunotherapy: Clinical results and dosimetric considerations

Radiolabeled antibodies for cancer therapy are being investigated in clinical trials in more than 30 centers. ¹³¹Iodine-labeled antibody (Ab) therapy of solid tumors has produced few responses when given alone. When given in conjunction with chemotherapy and external beam therapy in hepatoma patients, objective responses have occurred. Because of the short range of ¹³¹I, ⁹⁰Y and ¹⁸⁶Re are being studied and objective responses have occurred in patients without the addition of other therapies. ¹³¹I-labeled Ab therapy of lymphoma, a radioresponsive tumor, has produced a much higher objective response rate than in other solid tumors. Regional RIT has not been shown to offer a definite advantage over the intravenous route. Tumor doses have generally been less than 2000 cGy per treatment with some tumors receiving higher doses. The bone marrow is the dose-limiting organ for RIT and marrow cryopreservation with subsequent reinfusion may prove useful.     

Alcohol and the heart: theoretical considerations

It is now well established that consumption of ethyl alcohol, both acute and chronic, exerts deleterious effects on the heart. Evidence is presented that the initial event that precipitates both acute and chronic changes reflects the physical effects of alcohol on membrane phospholipids and perhaps proteins. The presence of alcohol increases membrane fluidity, a condition that leads to an adaptive change in the phospholipid composition of the membranes, with resultant greater rigidity of the membranes. The effects of alcohol on the lipid bilayer of the plasma membrane, when combined with other nonspecific insults, may lead to a drastic increase in calcium permeability; the resulting calcium influx may cause cell necrosis and initiate irreversibly cardiomyopathy. It is likely that changes in membrane fluidity also exert profound effects on enzyme and transport activities of membrane-bound proteins. In addition, alcohol may interact directly with the hydrophobic regions of proteins. Such interactions may play an important role not only in membrane-bound proteins, but also in alcohol-induced changes in contractile proteins of the heart. It is suggested that, in general, the effects of alcohol are similar to those of other anesthetic agents, and that the elucidation of the pathogenesis of alcoholic cardiomyopathy may require a deeper understanding of the physical interaction among alcohol, phospholipids, and proteins.     

Neuropeptides and their peptidases: Functional considerations

The properties of the various brain membrane peptidases capable of hydrolysing released neuropeptides are reviewed, with particular emphasis on endopeptidase-24.11 and angiotensin converting enzyme. The substrate specificities of both enzymes are defined and their relative contribution to the degradation of tachykinins in vitro are considered. One approach to assessing the physiological roles of identified peptidases involves examining the protective effect of selective peptidase inhibitors on the degradation of peptides released from brain slices. This procedure has been applied to study the release of substance P-like immunoreactivity from slices of rat substantia nigra. Inhibition of endopeptidase-24.11, but not of angiotensin converting enzyme, produces a significant increase in recovery of substance P. The specificity and distribution of endopeptidase-24.11 would therefore not be inconsistent with a role in the physiological inactivation of tachykinins, as well as enkephalins. At peripheral sites, LHRH and atrial natriuretic peptide may be important substrates of the enzyme. The endogenous neuropeptide substrate(s) for striatal angiotensin converting enzyme remain unclear.