Impact of trisomy 19 on outcome according to genetic makeup in patients with acute myeloid leukemia

We retrospectively studied 97 AML patients with trisomy 19 (tris-19; median age at diagnosis 57 years; range, 17-83 years) treated between 2001 and 2019 within two multicenter study groups. Tris-19 occurred solely in 10 (10.5%), with additional abnormalities in non-complex karyotypes in 8 (8%) and within complex karyotypes in 79 (82%) patients. Altogether, karyotypes characterized by trisomies only were present in 27 (28%) patients. Data on response and outcome of intensively treated patients were available in 92 patients and median follow-up was 6.4 years (95%-CI, 2.9-9.0 years). Complete remission (CR) after induction therapy was achieved in 52% (n=48) and early death rate was 10% (n=9). Notably, patients with tris-19 as sole abnormality had a CR rate of 89%. An allogeneic hematopoietic stem cell transplantation (allo-HCT) was performed in 34 (35%) patients (CR, n=19; active disease, n=15). Five-year relapse-free and overall survival (OS) rates were 26% (95%-CI, 16-43%) and 20% (95%-CI, 13-31%), respectively. OS rates were significantly higher in patients with tris-19 as sole abnormality or within karyotypes characterized by trisomies only (P=0.05). An Andersen-Gill model including allo-HCT as a time dependent covariable on OS revealed tris-19 as sole abnormality or within karyotypes characterized by trisomies only as favorable factors (HR, 0.47; P=0.021); higher age at diagnosis had an adverse impact (10 years difference; HR, 1.29; P=0.002), whereas allo-HCT had no beneficial impact (OR, 1.45; P=0.21). In our cohort, patients with tris-19 as sole abnormality or within karyotypes characterized by trisomies only had a high CR rate and better clinical outcome.

Chlorhexidine Inhibits the Proteolytic Activity of Root and Coronal Carious Dentin in vitro

The purpose of this study was to evaluate the effect of chlorhexidine on the proteolytic activity of carious coronal and root dentin collected from patients. Sound dentin from freshly extracted human teeth was used as a control. Dentin fragments were mixed with a synthetic substrate for proteolytic enzymes (N-benzoyl-DL-arginine-naphthylamide--BANA) and the suspensions mixed with either 0.12% chlorhexidine digluconate or distilled water. These mixtures were incubated for 18 h at 37 degrees C, color was developed by the addition of 0.1% Fast Garnet and their optical density was recorded spectrophotometrically. BANA hydrolysis measured by the optical density of incubated specimens was detected in all tested groups, but was significantly higher for carious than for sound dentin (p < 0.05). The proteolytic activity was reduced for carious coronal and root dentin by chlorhexidine (p < 0.05; 50 and 30%, respectively). Chlorhexidine also reduced the proteolytic activity in sound root dentin (p < 0.05; 20%). Conversely, changes in the proteolytic activity of sound coronal dentin were not observed in the presence of chlorhexidine. The reduction in proteolytic activity by chlorhexidine was significantly higher in carious coronal dentin than in carious root dentin (p < 0.05). In conclusion, part of the effect of chlorhexidine in controlling caries progression in humans may be due to a decrease in the proteolytic activity of carious coronal and root dentin. Because of the prolonged incubation time in the present study, similar results may be obtained clinically with prolonged dentin exposure to chlorhexidine, e.g. chlorhexidine-containing varnishes.

Conformational studies by dynamic NMR. 84.(1) structure, conformation, and stereodynamics of the atropisomers of N-aryl-tetrahydropyrimidines

The existence of stereolabile atropisomers for a number of N-aryl-tetrahydropyrimidines in solution has been deduced from the observation of the anisochronous NMR signals of prochiral methylene groups. The interconversion barriers for these atropisomers have been measured by line shape analysis of dynamic NMR spectra at various temperatures: a Molecular Mechanics modeling resulted in good agreement with these values. In an appropriate case, distinct NMR signals for the two enantiomeric forms could be observed at ambient temperature in a chiral environment. Evidence was also obtained for an exchange process occurring between two conformers experiencing a very biased equilibrium. Single-crystal X-ray diffraction of one such compound yielded a molecular structure in good agreement with the results obtained by ab initio calculations.

A model for clinical evaluation of the effect of antimicrobial agents on carious dentin

PURPOSE

To evaluate, longitudinally, the effect of a chlorhexidine varnish on the proteolytic activity of dentin caries in vivo.

MATERIALS AND METHODS

20 permanent molars and 8 primary molars with carious lesions in dentin were studied in subjects 18-35 yrs old (n=20), and 5-6 yrs old (n=8) respectively. These lesions were clinically evaluated according to texture and color. Carious dentin specimens were obtained by means of biopsies performed with a #4 carbide bur at the initial visit (TO) before application of a 10% chlorhexidine varnish and 2, 4, 8, and 12 wks thereafter. The dentin biopsies were immersed in Sorensen's buffer, vortexed for 30 s, and mixed with a 1.67 mM solution of n-benzoyl-DL-arginine-naphthylamide (BANA), a substrate for proteolytic enzymes. Samples were incubated overnight at 37 degrees C and color was developed with 0.1% fast garnet. The optical density (OD) of reaction mixtures was recorded photometrically. All teeth were grouped for analysis, as Mann-Whitney tests revealed no statistically significant differences between median values for OD for both age groups. ANOVA was used to compare progressive inhibition of proteolytic activity in dentin caries samples over time.

RESULTS

The average proteolytic activity at the dentin substrates (OD) at TO and 2, 4, 8 and 12 wks thereafter were 0.794+/-0.089, 0.741+/-0.071, 0.676+/-0.087, 0.600+/-0.094, and 0.508+/-0.108 respectively. The chlorhexidine varnish mediated a significant inhibition of the proteolytic activity present in dentin caries after 12 wks (P<0.0001). At T0, 100% of the carious lesions examined were characterized as soft upon exploration. After 12 wks, 54% (15/28) of the lesions were partially hardened and 46% (13/28) hardened/nonprogressing. The dentin color was yellow/light brown in 100% of the lesions at baseline, and dark brown/black in 86% (24/28) after 12 wks.

CLINICAL SIGNIFICANCE

This study demonstrated that chlorhexidine varnishes arrested active caries in vivo and inhibited the proteolytic activity present in these lesions. These findings strengthen the rationale for including chlorhexidine in the overall treatment strategy for patients with high caries activity.

Acromegaly and hyperprolactinemia in a patient with polyostotic fibrous dysplasia: dynamic endocrine studies and treatment with the somatostatin analogue octreotide

Acromegaly and hyperprolactinemia have been described in association with polyostotic fibrous dysplasia; the pathogenetic mechanisms involved in the development of the endocrinopathies is unknown. We report a 26-year-old man with polyostotic fibrous dysplasia and hypersecretion of GH and PRL. Plasma GH, PRL, and insulin-like growth factor-I (IGF-I) were elevated. Glucose-non-suppressible plasma GH concentrations, GH responsiveness to TRH and GHRH, and GH suppression after a test-dose of somatostatin, octreotide, and bromocriptine were found. Plasma GHRH levels were within the normal range (< 25 ng/l). Computed tomography of the sella turcica and visual fields were normal. [111In-DTPA-D-Phe1]-octreotide scintigraphy were used to localize a possible tumor; no radioactivity was visualized at the site of the hypothalamus, the pituitary or elsewhere in the body but a considerable accumulation of radioactivity was found in the os frontalis. Therapy with octreotide by continuous sc infusion partially suppressed GH and IGF-I (and normalized PRL). The results suggest that hypersecretion of GH in our patient is not due to a GH-secreting pituitary tumor, eutopic or ectopic hypersecretion of GHRH or autonomous somatotroph function. The origin of the disease in this patient might be an abnormal hypothalamic regulation of somatotrophs and/or an alteration in the transmembrane signalling systems.

Comparison of breast cancer mucin (BCM) and CA 15-3 in human breast cancer

The Breast Cancer Mucin (BCM) enzyme immunoassay utilizes two monoclonal antibodies (Mab), M85/34 and F36/22, for the identification of a mucin-like glycoprotein in serum of breast cancer patients. We have compared BCM with CA 15-3, another member of the human mammary epithelial antigen family. Serum BCM was evaluated in 151 and CA 15-3 in 134 patients with breast cancer, in 30 normal controls, in 9 pregnant women, and in 13 cancer patients (non-breast). Neither the normal controls nor the pregnant women had BCM levels greater than 25 U/ml. In contrast, 87 of 115 patients (75%) with metastatic breast cancer had BCM levels greater than 25 U/ml. All control persons had CA 15-3 levels less than 25 U/ml, but 2 out of 9 pregnant women (22%) had levels greater than 25 U/ml. Seventy-four out of 97 patients (76%) with metastatic breast cancer had CA 15-3 levels greater than 25 U/ml. A statistically significant correlation was found between BCM and CA 15-3 in the breast cancer patient group (r = 0.883, p less than 0.001, n = 134) and in the normal control group (r = 0.743, p less than 0.001, n = 30). BCM and CA 15.3 both showed no correlation with CEA in breast cancer patients (r = 0.060, n = 81; and r = 0.146, n = 78, respectively). BCM had a range of sensitivity similar to that of the CA 15-3 RIA. Our results suggest that BCM may be a useful new marker for monitoring the clinical course of patients with breast cancer.(ABSTRACT TRUNCATED AT 250 WORDS)

Basal cell adenoma of prostate

A case of basal cell adenoma originating in the prostate is presented. This lesion might develop from proliferation of basal epithelial cells of the prostate gland under unknown mechanism.