Effects of visual disorders on the academic achievement of French secondary school students.

PURPOSE: This study aimed to determine the relationship between the presence of visual problems and academic success, in a population of students aged 15-22 years. METHODS: This was a prospective, nonrandomized study involving clinical testing and structured interviews. At recruitment (September 2012 to April 2013), participants were asked to answer a questionnaire consisting of 28 questions aiming to identify symptoms commonly related to visual disorders. Each question was graded from 0 (no symptoms) to 2 (frequent). This questionnaire was followed by a visual screening including binocular function. If a problem was identified, participants were referred to an ophthalmologist for a comprehensive examination and an orthoptic work-up (September 2012 to June 2013). Participants returned in September 2013 for a follow-up. The findings were analyzed regarding academic grades and the scores obtained during national examinations in June 2014. RESULTS: Many participants in this study had visual disorders and the presence of these disorders was not associated with the expression of visual discomfort: 24.3% of participants expressed visual discomfort while 86.5% had visual disorders. More than half of the participants had hyperopia often associated with binocular vision problems, which they were not aware of because both their distance and near visual acuity were good. CONCLUSION: Although the results of this study cannot be extrapolated to all young people aged 15-22 years, the study confirms the link between visual problems and academic achievement while emphasizing the high prevalence of such problems in the population studied.

Primary proliferative T cell response to wild-type p53 protein in patients with breast cancer.

Mutations in the p53 tumor suppressor gene are the most frequent genetic alterations found in human tumors. There are mainly point mutations that lead to single amino acid substitutions. The mutated proteins have a longer half-life than wild-type p53 and accumulate in the nucleus of tumor cells. Anti-p53 antibodies have been found in sera of patients with several types of cancers including breast cancer. This report describes a T cell immune response in three patients with breast tumors who had mutated p53 gene and accumulated p53 protein. All showed a humoral response to p53 protein and the T cells of these patients recognized the wild-type p53 protein and proliferated in response to it. The data reported here are relevant to the immune processes leading to autoimmunity and have a bearing on anti-p53 vaccine development in tumor immunology.

Immunohistochemical demonstration of neurone specific enolase in bone marrow infiltrated by neuroblastoma.

One hundred and two bone marrow samples were analysed by histological and immunohistochemical methods for neurone specific enolase (NSE). The biopsies were performed to determine the extent of bone marrow disease in 84 neuroblastomas, nine embryonal rhabdomyosarcomas, five Ewing's sarcomas, two cases of Hodgkin's disease and two lymphoblastic lymphomas. Twenty seven (32%) of neuroblastoma bone marrows showed metastases by conventional histological techniques and 33 (39%) after immunohistochemical staining with NSE. Five embryonal rhabdomyosarcomas, five Ewing's sarcomas, and two lymphoblastic lymphomas showed bone marrow metastases. Only one of these cases was reactive for NSE. NSE represents a very sensitive immunomarker for the follow up of neuroblastoma and improves detection of bone marrow invasion by neuroblastoma.

Significance of keratin 13 and 6 expression in normal, dysplasic and malignant squamous epithelium of pyriform fossa.

It has been suggested that cytokeratin 13 is a useful marker of malignancy. We examined normal squamous cell epithelia, hyperplasia, dysplasias of various grades, intraepithelial neoplasia and invasive squamous cell carcinomas of the pyriform fossa using K13 and KL1. Positive staining for K13 was seen in all normal or hyperplastic benign epithelia, was inconstant in dysplasia, and intraepithelial neoplasia and carcinoma was negative. KL1 expression is constant and non significant. These results suggest that tumour cells are unable to synthesize keratin 13 a finding which may be valuable in surgical pathology.

[Immunohistochemical study of 20 synovial sarcomas in children]. / Etude immunohistochimique de 20 sarcomes synoviaux de l'enfant.

Histopathologic study of 20 cases of synovial sarcoma (S.S.) in children has been conducted to evaluate the usefulness of immunohistochemistry in the diagnostic assessment of this tumor. Two of the 6 antibodies studied have been found to be the most informative: staining for keratin and vimentin proteins has been observed in most cases, outlining the epithelial and sarcomatous components of this tumor. The results are in accordance with those already described for S.S. in adults. The presence of cytokeratins in S.S. is discordant with classical histogenetic conceptions.

[Immunohistochemical study of 11 epithelial tumors of the thymus or thymomas with anti-keratin antibodies: KL-1]. / Etude immunohistochimique de 11 tumeurs épithéliales du thymus (TET) ou thymome avec un anticorps anti-kératine: KL-1.

Eleven cases of epithelial tumours of the thymus or thymoma and two thymuses without tumour were studied, using immunohistochemistry with anti-keratin antibodies (KL-1) which recognise cyto-keratin with a high molecular weight. In the normal thymus, KL-1 positivity seems to be limited to medullary epithelial elements and in particular Hassal's corpuscles. All the epithelial thymic tumours studied showed a net positivity for KL-1 overall in the tumour cells. This result and the demonstration of more or less well differentiated Hassal's corpuscles in these tumours make one think that these epithelial thymic tumours express some characters in relation with a differentiation of medullary type.

Lymphocyte subsets in tumour of patients with undifferentiated nasopharyngeal carcinoma: presence of lymphocytes with the phenotype of activated T cells.

We have analyzed lymphocytes infiltrating nasopharyngeal carcinomas, using a combination of immunoperoxidase staining of frozen and paraffin-embedded sections, and immunofluorescence on lymphocyte suspensions recovered from teased tumours. A panel of monoclonal antibodies was used to define lymphocytic subsets on frozen sections of 14 different tumours. The vast majority of peri- and intra-tumoral lymphocytes were stained by OKT3 antibody. In 8 sections, T4 positive cells were largely predominant, while T8 positive cells were the majority in three sections. Twenty-nine paraffin-embedded sections from other NPC patients stained with HNK-1 antibody showed a variable percentage of positive cells reaching 6 to 15% in nine patients. Most HNK-1 positive cells had the morphology of large granular lymphocytes typical of natural killer cells. Double staining experiments on lymphocytes isolated from 7 tumours revealed a constant presence of T3 positive, HLA-DR positive lymphocytes (from 6 to 29% of mononuclear cells), and of lymphocytes coexpressing the T3 and the Tac (IL-2 receptor) antigens (from 5 to 12% of mononuclear cells). Lymphocytes with a phenotype of activated T-cells are thus constantly found in NPC tumours.

[Immunohistologic marking of epithelial antigens in sarcomatoid carcinomas of the upper aerodigestive tracts]. / Marquage immunohistologique d'antigènes épithéliaux dans les carcinomes sarcomatoïdes des voies aérodigestives supérieures.

The immunoperoxidase localization of epithelial antigen (keratin, epithelial membrane antigen) was identified in 18 cases of sarcomatoid carcinomas localized in the upper aero-digestive tract. These tumors are an association of a differentiated squamous cell carcinomatous component and of spindle, or pleomorphic cells component. The anti-keratin monoclonal antibody KL1 stained the sarcomatoid component in 4 cases. A continuous staining between differentiated squamous cells and spindle cells in observed in two cases. The identification of cytokeratin is better with KL1 than with the polyclonal anti-keratin antiserum KT. The monoclonal antibody HMFG2 is not retained. These results suggest the dedifferentiation of epithelial cells in sarcomatoid component. They confirm the heterogeneity of these tumors, which has been previously found in ultrastructural studies. These immunostaining are helpful in recognizing sarcomatoid carcinoma, when they are only represented by the sarcomatoid component.

[Immunoperoxidase study of 18 malignant lymphoblastic lymphomas (LMLbl) in children]. / Etude par immunopéroxydase de 18 lymphomes malins lymphoblastiques (LMLbl) de l'enfant.

Eighteen cases of malignant lymphoblastic lymphomas in children were studied by immunoperoxidase technique on frozen tissue sections and/or cytological samples. Different monoclonal or polyclonal antibodies were used: OKT8, OKT11, OKB2, OKIal, anti immunoglobulins (mu, kappa, lambda chains). The results were compared with those of classical histology: three histologically unclassified malignant lymphoblastic lymphomas were linked to a Bor T line (one pre-B lymphoma and two T lymphomas). One diagnosis of T lymphoma could not be confirmed by immunoperoxidase technique. The technique did not reveal any surface immunoglobulins in two cases of malignant lymphomas of Burkitt type. Every one of the remaining 12 cases gave concordant results between morphological and immunological studies. In 12 cases it was possible to compare the results of immunological typing on tissue sections and cell suspension. The results were concordant in 11/12 cases. An advantage of this immunochemical technique on frozen sections and/or cytological samples is that it gives good visualisation of the cells and their reactivity with the antibodies.

HNK-1 antibody detects an antigen expressed on neuroectodermal cells.

The HNK-1 antibody known to define a subpopulation of human lymphocytes with natural killer and killer cell activities was shown to detect a common neuroectodermal antigen. Most tumor lines and paraffin-embedded tumors and normal tissues of neuroectodermal origin were specifically stained by HNK-1. Lines and tissues of other derivations were negative except a trophoblastic tumor line and a percentage of Ewing's sarcomas, whose histogenesis is poorly understood. These data indicate that HNK-1 antibody could be of interest in clinical histopathology but cannot be considered as specific for a lymphocyte subset.

Cytochemistry of Reed-Sternberg cells in lymph node imprints.

Cytochemical reactions were examined in lymph node imprints from a group of 53 previously untreated patients with histologically proven Hodgkin's disease. In 40 of 51 cases investigated, Reed-Sternberg (R-S) cells, irrespective of the cytologic appearances and the histologic types, showed moderate to strong reactions with acid phosphatase (ACP). In 12 cases ACP activity was present in more than 25% of the R-S cells. The reaction consisted of formation of small- to medium-sized granules, which were located close to the nuclei on a diffusely positive background or irregularly distributed throughout the cytoplasm. In three cases, a coarse granular reaction product with periodic acid-Schiff was present. R-S cells were positive to the naphthol-AS acetate esterase and beta-glucuronidase reactions in four and two cases, respectively. Alkaline phosphatase and naphthol-AS-D-chloroacetate esterase reactions were completely negative. Our results have revealed a pattern of staining in the diagnostic R-S cells similar to that in its morphologic variants; this supports the view that these cells may derive from a common primitive cell. Moreover, the quality and quantity of the ACP reaction product shows that R-S cells differ from both neoplastic histiocytes of malignant histiocytosis and neoplastic lymphocytes of T-cell lymphomas. This study confirms that R-S cells lack definite cytochemical characteristics of each of supposed progenitor cells: histiocytes and T-lymphocytes.

A cytochemical and immunohistochemical approach to malignant histiocytosis.

Malignant histiocytosis (MH) is a true histiocytic disorder, whose identification is still based on too broad morphologic criteria. Using routine histology, cytochemical and immunohistochemical techniques on involved lymph nodes, 15 cases of MH have been investigated. Pleomorphism and cellular atypia, phagocytosis, lack of cohesiveness between proliferating cells, sinusoidal involvement, and plasmacytic infiltrate were the most common histologic features. MGG-stained imprints from 14 cases showed a composite tumor population mainly consisting of histiocyte-appearing cells, poorly differentiated atypical cells, and multinucleated giant cells. These cells, irrespective of cytologic features, revealed a diffuse, moderately to strongly positive reaction with acid phosphatase and nonspecific esterase. Naphthol-AS-D-chloroacetate esterase, Sudan black B, alkaline phosphatase, and beta-glucuronidase reactions were completely negative. Immunoperoxidase studies in 11 cases demonstrated that tumor cells stained positively for both kappa and lambda chains. These cells were also positive for albumin. Polytypic staining for IgG was observed in two cases, and a weak staining for lysozyme was found in two other nodes. Global results confirm the value of these studies for functional profile determination of MH proliferating cells. A combined approach using a variety of cytochemical and immunohistochemical techniques should be routinely considered in MH as useful additional studies for a more precise diagnostic definition of the disease.

[Non-Hodgkin's malignant lymphoma: reliability of "typing" using cyto-enzymatic markers. Comparison with immunological markers (author's transl)]. / Lymphomes malins non hodgkiniens: fiabilité du "typage" par les marqueurs cyto-enzymatiques. Comparaison avec les marqueurs immunologiques.

Comparison between membrane markers and enzyme markers was made in 74 cases of non-Hodgkin's malignant lymphomas and a good correlation appears between both methods in order to distinct lymphomas into T and B origin. Enzyme markers are reliable and provide quickly made and easily interpretable documents. As far as T-lymphomas are concerned, three hydrolases namely acid phosphates e, acid esterase and B-glucuronidase give the same good results. As for B-lymphomas, a specific enzyme marker has to be found. Furthermore, typing of malignant lymphomas by enzymatic and/or immunologic methods appears to be quite better than from morphologic features such as convoluted or cleaved nuclei for example.