Expression of the neural cell adhesion molecule (NCAM) on the haemopoietic cell line Nalm-16

Quality of care for patients with traction in shahid beheshti hospital in 2012

Background

With increasing incidence of traumatic fractures, the use of orthopedic intervention such as traction has increased. Inappropriate traction care may cause substantial morbidity and delay the patient rehabilitation.

Objectives

This study was conducted to evaluate the quality of care for patients with traction in the orthopedic unit of Kashan's Shahid Beheshti Hospital, Kashan, Iran.

Patients and Methods

This observational study was conducted on 100 patients with traumatic fractures of hip and femur bones who were admitted to Kashan Shahid-Beheshti Hospital during the first 6 months of 2012, and for whom skeletal or skin traction was performed. Data were collected using a checklist including questions about the personal characteristics and 23 items related to care for patients with tractions. These items were in three domains including caring while establishing traction, recording care and patient’s education. Descriptive statistics were calculated and data were analyzed using the independent sample t-test and Pearson correlation coefficient.

Results

The mean age of patients was 51.16 ± 23.28 years and 66% of them were male. In total, 47% of the patients were treated by skin traction and 53% by skeletal traction. The overall mean score of quality of care was 10.20 ± 2.64. Quality of establishing traction was good in 55% of patients, but the quality of care was poor in the domains of recording care (88%) and patient education (96%). Total mean of quality of care was significantly different between male and female patients (P < 0.02).

Conclusions

The quality of care of patients with traction was not optimal. Therefore it is necessary to improve measures in this area.

CD56-Positive Large B-cell Lymphoma

CD56 (NCAM), a neural adhesion molecule, is normally expressed on natural killer cells and subsets of T cells and is commonly seen on hematolymphoid neoplasms such as plasma cell myeloma and acute myelogenous leukemia. It is uncommon in B-cell lymphoma. From 2001 to 2003 a cohort of 20 cases of CD56 B-cell lymphomas was identified by flow cytometry (<0.5% of all B-cell lymphomas studied) during a 2-year period. Most (90%) expressed CD10 and 5/5 tested cases were BCL6, suggesting a follicular origin. An extranodal disease presentation was seen in 45% and may be related to CD56 expression. These CD56 B-cell lymphomas may represent a new subset of large B-cell lymphoma. The relationship of cells with this antigenic profile to normal B-cell differentiation is explored.

Correlation between expression of CD56/NCAM and severe leukostasis in hyperleukocytic acute myelomonocytic leukaemia

OBJECTIVE

The possible contribution of surface molecules to the development of leukostasis syndrome in hyperleukocytic acute myeloid leukaemia (AML) was assessed by routine immunophenotyping and grading of the probability of clinical leukostasis.

METHODS

Fifty-three patients (23 women, 30 men, median age 59 yr) with hyperleukocytic AML [white blood count (WBC) above 50 x 10(9)/L] were graded for the probability of clinical leukostasis according to the severity of neurologic, pulmonary and other symptoms possibly caused by leukostasis using a recently published scoring system. Age, WBC, absolute blast count, haemoglobin, cytogenetic risk group, infection, relative CD56 expression and absolute count of CD56 positive blasts were analyzed in multivariate stepwise backward logistic regression analysis.

RESULTS

In patients with acute monocytic leukaemia (AML M4/M5) the absolute count of leukaemic blasts expressing CD56/NCAM was highly associated with the development of symptoms graded as highly probable leukostasis and all three patients succumbing to early death were CD56 positive. Only the absolute count of CD56 positive blasts was a significant predictor of risk of severe leukostasis (P = 0.020). This was not found in AML without monocytic involvement (AML M1, M2, M3v).

CONCLUSIONS

The expression of CD56/NCAM, a surface marker used in routine immunophenotyping of AML, may help to predict severe and potentially fatal leukostasis in hyperleukocytic acute myelomonocytic leukaemia. These results emphasize the usefulness of this four-stage clinical grading scale for analysing the factors, which lead to severe leukostasis in hyperleukocytic patients. We extend previous findings that the mechanisms of leukostasis are different depending on the involvement of the monocytic lineage.

PRELI, the human homologue of the avian px19, is expressed by germinal center B lymphocytes

We report the identification of a human cDNA encoding a 25 kDa protein of relevant evolutionary and lymphoid interest (PRELI). PRELI was cloned by screening a B lymphocyte-specific cDNA library with a probe generated by mRNA differential display. PRELI amino acid sequence is 85% similar to the avian px19 protein, expressed within the blood islands and in the liver during avian embryo development. PRELI and px19 contain tandem repeats (A/TAEKAK) of the late embryogenesis abundant (LEA) motif, characteristic of a group of survival molecules and originally thought to be present only in plant proteins. Interestingly, PRELI expression is high in the fetal liver, a major site for B cell lymphopoiesis, while the mRNA levels in other fetal tissues such as the brain, lung, and kidney are comparatively low. At the adult stage, PRELI expression is drastically reduced in the liver but exhibits high mRNA levels in the spleen, brain, lung and kidney tissues, suggesting that PRELI expression may be important for the development of vital and immunocompetent organs. Moreover, PRELI is also highly expressed in the adult lymph nodes and peripheral blood leukocytes, further stressing that at the adult stage, PRELI expression may be important during secondary immune responses. Consistent with this hypothesis, the expression of PRELI is predominant within germinal centers (GC), a stage in which B lymphocytes are under a stressful selection pressure. Taken together these data: (i) strongly support the notion that the conserved LEA motif represents a phylogenetic link between plants and animals, (ii) reveal a novel molecule whose expression may play a role in the maturation of distinct human tissues, and (iii) suggest that PRELI expression may be important for GC B lymphocytes.

Expression of N-CAM (CD56) on acute leukemia cells: relationship with disease characteristics and outcome

Expression of CD56 was analyzed by indirect immunofluorescence method on bone marrow samples from 94 newly diagnosed patients with acute leukemia (AL), including 59 acute myelogenous leukemias (AML) and 35 acute lymphoblastic leukemias (ALL). CD56 was expressed on 17 +/- 18% (range: 0-72%) of AML cells and 24 +/- 24% (range: 0-98%) of ALL cells, without significant differences between FAB subtypes in AML, nor immunologic subtypes in ALL. Expression of CD56 was not associated with any clinical or biological characteristic at diagnosis, nor with prognosis in AML or ALL. We do not confirm previously described relationships between CD56 expression and initial characteristics and evolution of acute leukemia.

NCAM (CD56)-positive malignant lymphoma

CD56 has been found to identify an isoform of the neural cell adhesion (NCAM). NCAM is a member of the immunoglobulin superfamily of cell adhesion molecules; it is related to a variety of leukocyte antigens and to several cell adhesion molecules believed relevant to malignant behavior in a variety of neoplasms. It contains polysialic acid, which appears to regulate binding avidity of NCAM and other cell adhesion processes. We have identified a group of NCAM-positive lymphomas. Compared to a group of NCAM-negative lymphomas, this group exhibited frequent involvement of unusual sites and a generally aggressive course. Another series of CD56-positive hematolymphoid malignancies has recently been described, from Hong Kong; this group also exhibited involvement of unusual sites and displayed a very aggressive course. Together these series suggest that NCAM on lymphoma is of biological and clinical significance in terms of tumor behavior and spread.