The impact of TNF superfamily molecules on overall survival in acute myeloid leukaemia: correlation with biological and clinical features

B cell-activating factor (BAFF), a proliferation-inducing ligand (APRIL) and apoptosis-inducing ligand (TRAIL) were demonstrated in several haematological diseases including acute myeloid leukemia (AML). Those cytokines are capable of activating a broad spectrum of intracellular signalling cascades that can either induce apoptosis or protect from programmed cell death. We have analysed BAFF, APRIL and TRAIL serum concentrations in 76 patients with newly diagnosed AML and 40 healthy volunteers. The values were significantly higher for APRIL and BAFF but lower for TRAIL compared to healthy volunteers. Induction therapy significantly reduced the values for BAFF and increased them for TRAIL. Moreover, the concentration of BAFF and APRIL was significantly lower and the concentration of TRAIL higher in a group of patients with complete remission compared to non-respondent AML patients. In addition, higher concentrations of BAFF and lower of TRAIL predicted a shorter overall survival, suggesting thereby an important prognostic marker and possible therapeutic target in AML.

Lung mass in a 28-year-old male: a case report of a rare tumor

A twenty eight-year-old male presented with a two week history of dyspnea, cough, hemoptysis, chest pain, and fever 38-39°C. He also complained of loss of appetite, general weakness and left leg pain for two months preceding admission. He was referred with suspicion of lung tumor to our institution. Chest X-ray showed almost total atelectasis of the right lung with compensatory overinflation of the contralateral lung. Using computed tomography (CT), a lesion of diameter of 19.3 x 14.1 x 19.1 cm in the right lung, pleuritis, Th3 osteolysis, and compensatory overinflation of the left lung was seen. Bronchoscopy revealed a total obstruction of the right main bronchus due to submucosal infiltration and compression of the right main bronchus with negative histology of bronchial biopsy specimens. Transthoracic fine needle aspiration revealed celullae suspectae probabiliter neoplasmaticae suggesting tumor fusocellularis. USG of the abdomen revealed liver with numerous heterogeneous, solid areas hypo- and hyperechogenic, some of them with features of liquid or the disintegration up to diameter of 74 mm. Subsequent fine needle aspirations of the thorax and liver revealed fibrolamellar hepatocarcinoma and carcinoma adenoides of the lung. Patient underwent chemotherapy with 5-FU/DDP/VCR with no response. This report presents a case of a rare lung metastasis from FL-HCC.

Cannabinoid receptors expression in bone marrow trephine biopsy of chronic lymphocytic leukaemia patients treated with purine analogues

BACKGROUND

Cannabinoid receptors CB1 and CB2 are part the endocannabinoid system that plays an important role in the process of proliferation and apoptosis of different neoplastic cells. B-cell chronic lymphocytic leukaemia is one of the diseases in which these processes are altered.

AIM

The aim of our study was the assessment of cannabinoid receptor expression on the B-lymphocytes in bone marrow trephine biopsy from leukaemic patients at diagnosis and after purine analogue treatment.

METHODS

The biopsy was taken routinely and standard immunohistochemical staining procedure for paraffin embedded sections was applied. The cannabinoid receptors were detected using specific primary polyclonal antibody anti-CB1 and anti-CB2. Additionally, an existence of cannabinoid receptors was confirmed by flow cytometry.

RESULTS

The results showed that the expression of CB1 receptor on the surface of neoplastic cells was lower than that of CB2 (17.0+/-3.1% and 92.1+/-1.7% respectively, p<0.001). Nine of the patients responded to applied treatment with a reduction in leukaemic infiltration (77.2+/-6.9% to 30.2+/-6.5%, p=0.007) and CB1 receptor expression (24.4+/-4.8% to 8.6+/-2.9%, p=0.01), but there was no change in CB2 expression (91.7+/-2.7% vs 90.9+/-2.8%, p=0.69). Four patients without remission expressed even greater number of the receptors. In all of the cases both cannabinoid receptor types antibodies gave positive reaction. Furthermore, the existence of cannabinoid receptors on neoplastic lymphocytes was confirmed by flow cytometry.

CONCLUSION

The study provides original evidence for the existence of cannabinoid receptors on B-lymphocytes in chronic lymphocytic leukaemia patients. The receptors are thought to be a new structure that can modify the course of the disease and may be considered as a new target in leukaemia treatment.

The role of nitric oxide in caerulein-induced acute pancreatitis and the recovery process after inflammatory damage

OBJECTIVES

Nitric oxide (NO) is involved in the control of pancreatic blood flow and secretion, and its role in the maintenance of pancreatic tissue has been suggested. The aim of our study was to evaluate the influence of NO on pancreatic trophic parameters during acute pancreatitis induction and the pancreas recovery process.

DESIGN/METHODS

Acute pancreatitis was induced in rats by a supramaximal dose of caerulein. During acute pancreatitis induction, rats were treated with L-arginine (a substrate for NO synthesis), glyceryl trinitrate (NTG, NO donor), glycine, N(G)-nitro-L-arginine (L-NNA, NO synthase inhibitor), L-arginine + L-NNA, or saline. Pancreatic weight, total contents of RNA, DNA, protein, amylase and chymotrypsin as well as pancreas histology and the number of proliferating acinar cells were evaluated after pancreatitis induction in all groups and additionally after 7 and 14 days of recovery in untreated acute pancreatitis rats or those injected with L-NNA and/or L-arginine.

RESULTS

Pancreas destruction after acute pancreatitis was evidenced by similar decreases of all parameters in untreated acute pancreatitis rats or those treated with L-NNA or glycine when compared to control healthy animals. The recovery process after acute pancreatitis was not affected by L-NNA injections; however, the increased cell proliferation occurred later than in untreated rats. NTG and especially L-arginine treatment resulted in significant attenuation of pancreas damage (partially prevented by L-NNA treatment) as evidenced by biochemical data with a slight improvement in morphology. Treatment with L-arginine alone or in combination with L-NNA resulted in augmented cell proliferation after acute pancreatitis induction followed by earlier recovery in comparison to untreated acute pancreatitis rats or the L-NNA-injected group.

CONCLUSION

The present study suggests the involvement of NO in mild acute pancreatitis and in the recovery process after inflammatory damage.

Ultrasound guided percutaneous fine-needle biopsy of the liver: efficacy of color doppler sonography

BACKGROUND/AIMS

Fine-needle biopsy (FNB) is one of the diagnostic methods for the diagnosis of focal lesions in the liver. The method is relatively fast, inexpensive and safe. Complications after FNB are observed in only a few cases. Color Doppler sonography (CDS) is one way of minimizing the number of FNB complications. The aim of the present study is to evaluate CDS in the monitoring of FNB in the diagnosis of focal lesions in the liver.

METHODOLOGY

The patient group consisted of 73 patients: 28 male and 45 female with a mean age of 53.5 years. Initially, all patients were examined using traditional B-mode gray-scale sonography. After visualization of focal lesions in the liver their echostructure and position were analyzed. Color Doppler sonography was the introduced for the visualization of vascularization of the liver. FNB was performed under the guidance of CDS. The cytological specimens obtained were microscopically evaluated.

RESULTS

Of the 73 patients, 18 cases were diagnosed with liver abscess, 19 with cysts of the liver, and 36 with malignant tumors. Amongst the patients with malignancy tumors, the tumors were unifocal in 15 cases, and multifocal in 221. Histopathologically, there were primary hepatocellular carcinomas in 22 patients and metastatic tumors in 14 patients. During the first 48 hours after FNB no complications such as subcapsular hematoma or intraperitoneal bleeding were observed.

CONCLUSIONS

Introducing CDS for ultrasound guided percutaneous FNB of the liver avoids such complications as bleeding, especially in patients with a high risk of hemorrhage.

Neurogenic muscle hypertrophy in radiculopathy

The course of radiculopathy is sometimes associated with weakness and wasting of muscles. Very rarely in such cases, however, is hypertrophy of muscle fibres observed. Three cases are presented of sciatica with enlarged calves caused by hypertrophy of type 1 or types 1 and 2 muscle fibres. In light of the literature and the results obtained, an attempt is made to explain the cause of rare clinical symptoms and draw attention to diagnostic and therapeutic difficulties.

[Coexistence of polycystic kidney and other developmental defects. Analysis of autopsy specimens 1953-1985]

The cases of polycystic disease of kidney selected from 33 years postmortem data were presented. They were classified into 4 types (according to Osathanond, Potter and Heptinstall) and the results correlated with accompanying malformations. It has been established that type I of polycystic disease of kidney was mostly correlated with CNS, skull and spine abnormalities. Type II and III were coexisting with genitourinary and ++gastrointestinal system malformations. No type IV of the disease has been found.