The incidence of glassy corneal striae.

Glassy corneal striae (GCS) are fine colorless lines that run parallel to each other in a vertical or near-vertical orientation in the central cornea near the level of Descemet's membrane. It is postulated that GCS "brace" the stroma, thus adding stability to the cornea. The purpose of this study was to determine the incidence of GCS in patients with "normal" corneas and to determine whether a correlation exists between the presence of GCS and gender, age, iris color, or corneal astigmatism (toricity). Modified marginal retro-illumination biomicroscopy was used to evaluate the cornea for the presence of GCS. One hundred thirteen "normal" right corneas were evaluated for the presence of GCS. A total of 85.8% (97/113) of subjects in our study sample exhibited GCS. However, we were unable to establish a statistically significant correlation between the presence of GCS and gender, age, iris color, or corneal toricity.

Establishment and characterization of a villous lymphoma cell line from splenic B-cell lymphoma.

A new B-cell line (VL51) with cytoplasmic villi was established from a female patient with splenic lymphoma with circulating villous lymphocytes (SLVL). The patient exhibited a clinical picture characteristic of SLVL, including massive enlargement of the spleen. Tartrate-resistant acid phosphatase (TRAP)-negative villous lymphocytes were seen in the peripheral blood, bone marrow (BM) and both red and white pulps of the spleen. Monoclonality of the VL51 cell line was confirmed by clonal genotype abnormalities in the immunoglobulin heavy chain (IgH) gene and the T-cell receptor beta (TCR beta) gene. Evidence for commitment of phenotype of the VL51 cell line to the B lineage was also shown by the immunophenotype, including expression of CD10, CD19, CD20 and surface immunoglobins. The VL51 cells were positive for Epstein-Barr virus nuclear antigen (EBNA). The VL51 cell line is the first SLVL cell line to be established, and it is expected to be useful in clarifying the leukemogenesis of SLVL.

Dual rearrangement of immunoglobulin and T-cell receptor genes in a case of splenic lymphoma with villous lymphocytes.

We report here a case of "splenic lymphoma with villous lymphocytes" (SLVL) which exhibited both B- and T-cell phenotypes and genotypes. The patient was a 73-year-old man. Physical examination revealed splenomegaly and lymphadenopathy. The white blood cell count was 55.2 x 10(9)/L with 70.5% atypical lymphocytes, having cytoplasmic villi, characteristic of SLVL. The atypical cells infiltrated both the red and white pulps. Immunological analysis of the peripheral leukocytes showed both B- and T-cell phenotypes (CD5,CD11c,CD19,CD20,HLA-DR, SmIgM and lambda positive). DNA analysis revealed a dual rearrangement of the immunoglobulin heavy chain gene and T-cell receptor beta gene. SLVL has been identified as a B-cell leukemia with a relatively benign clinical course. This case had both B- and T-cell pheno- and genotypes with a progressive course. To the best of our knowledge, no case of SLVL with dual genotypes has ever been reported.

p53 and N-ras mutations in two new leukemia cell lines established from a patient with multilineage CD7-positive acute leukemia.

Two new myeloid cell lines (K051 and K052) were established from a patient with multilineage CD7-positive acute leukemia. The K051 and K052 were established from the patient's bone marrow cells at diagnosis and at relapse, respectively. The K051 cell expressed myeloid-associated antigens (CD13 and CD33), a platelet-associated antigen (CD41), and an erythroid antigen (glycophorin A). The K052 cell expressed myeloid-associated antigens (CD13, CD14, and CD33), lymphoid markers (CD2, CD5, and CD7), and HLA-DR. Chromosome analysis of both cell lines showed a 17p- chromosome. Both cell lines were investigated for aberrations of the p53 gene and the N-ras gene. A p53 mutation detected in both cell lines consisted of a C-->T substitution in codon 248. An N-ras mutation detected only in the K052 cell consisted of a G-->C substitution in codon 13. Expression of the multidrug resistance gene (MDR1) was also investigated by the semiquantitative reverse transcriptase-polymerase chain reaction (RT-PCR). MDR1-mRNA was more highly expressed by the K052 cell than the K051 cell, being equivalent to that in HEL cells. The functional MDR1-protein against vincristine was also observed, and its function was inhibited by verapamile and Cyclosporin A. The K052 cells were capable of phenotypic or morphologic differentiation after being incubated with granulocyte colony-stimulating factor, interleukin-2, phorbol 12-myristate 13-acetate, or 1,25-dihydroxy-vitamin D3. In contrast, the K051 cells responded phenotypically to retinoic acid. Thus, the K051 and K052 cell lines will be useful for investigating the cellular and molecular events in leukemogenesis and differentiation, and the mechanism of expression of the MDR1 gene.

[Three levels of communication of people with senile dementia. An attempt to understand the 'life world' structured by people with senile dementia].

The aim of this paper is to study the communication of people with senile dementia for understanding the life-world structured by them. This research was conducted in special ward for senile dementia patients in the Aomori Prefectual Hospital, using the method of participant observation. The investigation period extended from September 1990 to August 1991 for a total of 62 days. First, the life-world of patients with senile dementia is described as follows: Patient' backgrounds, an outline of their everyday life in the institution. These patients have a serious intelligence disorder, therefore they have to live in a closed ward. However, the care system in the ward is very flexible so they are not restricted in their movements. An individual's ability to deal with the demands of everyday life is quite variable. And the quality of an individual's life is not limited to the sum total of his or her abilities. Second, the patients' communication processes are described. The procedure was as follows: The first step was to classify an individual's character and methods which they used to facilitate communication into five types. The second step was to illustrate their communication processes. There are many types of communication processes. But when we take notice of the essential qualities of their communications they fall into three basic patterns as follows: 1. Patients engaged in interactive connections in which the form, or the social fact of the interactions was valued over its narrative content. 2. During most communications each patient will inevitably experience a lack of comprehension. When this occurs they respond by introducing a new subject for discussion, or in other ways attempt to manipulate the interaction back to an area they understand. 3. Most interactions provoke intense interest among the other patient, who often gather to watch and comment among each other. In discussion, some common features that support humans' communication were studied through to compare the communication of people with senile dementia and normal people. In conclusion, the feature of their communication as exposure of the form not the content were explained.

El tratamiento quirurgico de los aneurismas de aorta ascendente asociados a valvulopatia aortica. / The surgical treatment of ascending aortic aneurysms associated with aortic valvulopathies

Se presenta la experiencia del Departamento de Cirugia Cardiaca del Hospital de Clinicas con pacientes portadores de aneurisma da aorta ascendente e insuficiencia aortica. Un paciente fue explorado quirurgicamente y fallecio en forma brusca mientras esperaba su reoperacion. Un paciente fue sometido a reemplazo valvular y aneurismorrafia; falecio en el postoperatorio por deterioro marcado de la funcion miocardica. Un paciente fue operado reemplazandose la valvula aortica y el aneurisma de la aorta ascendente en su sector supracoronario, protegiendo con cardiplejia: la evolucion inmediata y alejada fue buena.Se considera que estos pacientes son de tratamiento quirurgico en la actualidad en nuestro medio. La tecnica quirurgica dependera del compromiso de la pared aortica en cada caso. Las protesis valvulares seran mecanicas, dado el alto indice de disfuncion que se han detectado con algunas valvulas biologicas en nuestro medio. Se recomienda el control periodico con aortografia, para detectar precozmente complicaciones locales postoperatorias