Analysis of microRNA expression in brush cytology specimens improves the diagnosis of pancreatobiliary cancer.

BACKGROUND/OBJECTIVES: Malignant pancreatobiliary strictures are in many cases clinically indistinguishable and present a major problem to endoscopy specialists. Intraductal sampling procedures such as brush cytology are commonly used for diagnosis with a sensitivity that is low for a diagnostic test used in daily clinical practice. MicroRNA (miR) alterations detected in many cancers are disease-specific, which can be utilized in clinical applications. The aim of the present study was to analyze whether determination of miR expression levels in intraductal brush cytology specimens is a feasible approach to improve the diagnosis of pancreatobiliary cancer. METHODS: Brush cytology specimens have been collected during endoscopic retrograde cholangio-pancreatography (ERCP) and analyzed by routine cytology and ancillary miR assays. Total RNA was extracted using the miRNeasy Mini Kit and the expression of miRs frequently dysregulated in pancreatobiliary cancer (miR-16, miR-21, miR-196a, miR-221) were analyzed by quantitative real-time PCR using RNU6B as internal control. RESULTS: Routine cytology resulted in no false positive diagnoses, however, the combined sensitivity remained at 53.8%. Expression (ΔCt values) of miR-16 (p = 0.0039), miR-196a (p = 0.0003) and miR-221 (p = 0.0049) showed a clear statistical significance between malignant and benign pancreatobiliary specimens (n = 35). Malignancy could be detected combining routine cytology and the miR-196a single marker expression levels with a sensitivity of 84.6% (92.9% in biliary strictures) with no false positives. CONCLUSIONS: The results offer the first direct demonstration that microRNAs are readily detectable in brush cytology specimens obtained during ERCP, and have the potential to help the cytological diagnosis of pancreatobiliary malignancy.

[Iron deficiency anemia caused by occult intestinal bleeding due to milk allergy (author's transl)]. / Eisenmangelanämie infolge okkulter Darmblutungen bei Milchallergie.

With the passive hemagglutination method the authors proved antibodies against milkprotein fractions in three of nine patients with hypochrome anemia aged 7, 12 and 17 months. In these children the X-ray examination showed an intestinal allergy, presumably the reason for occult intestinal bleeding which inturn caused hypochrome anemia. After milk was eliminated from the diet iron therapy restored a normal haemoglobin content. Iron therapy alone only improved the anemia, since continuing intestinal bleeding prevented fullrecovery.

A case of 22-trisomy mosaic.

An extra small acrocentric chromosome was found in 50% of the cultured blood cells of a somato-mentally retarded girl with congenital heart failure and different dysmorphic symptoms. The supernumerary chromosome proved to be chromosome No. 22.

Roentgenologic diagnosis of interstitial plasma cell pneumonia in infancy.

Sixt-two series of radiographs were analyzed. Interstitial plasma cell pneumonia (IPCP) was divided into six radiographic stages. A schematic description of these stages is given. The correlation between this scheme and the actual radiographs is illustrated with a series of nine antero-posterior and lateral radiographs from one infant. The patterns of the individual stages of the disease are then discussed with the aid of pulmonary radiographs of 12 infants and one 12-month-old child with dysgammaglobulinemia. From a prospective and retrospective analysis of these radiographs, we could delineate the development of the disease from the earliest radiologically recognizable lesions to resolution. The long incubation time of IPCP was established by a retograde analysis of several series of radiographs of proved cases; the time interval was determined between the earliest recognizable change and the full-blown picture of stage V, in which the interstitial infiltrative process may be accompained by various degrees of emphysema, edema (used synoymously with alveolar filling process), pneumothorax, and madiastinal emphysema. This scheme has proved its value during 20 years of radiographic diagnostic pactice with 30-35 annual consultations concerning IPCP; IT CORRELATES WELL WITH THE CLINICAL SYMPTOMATOLOGY AND THE RESPONSE TO THERAPY. Points of differential diagnostic importance concerning other interstitial infiltrative processes of the lungs are discussed for every stage of the disease.

[Current aspects of differentiation and treatment of pneumocystis carinii pneumonia (author's transl)]. / Derzeitige Auffassung über die Entstehungsbedingungen und besten Gehandlungsmöglichkeiten der interstitiellen plasmacellulären Pneumonie

There are two types of Pneumocystis carinii pneumonia. One is seen in premature and atrophic infants mainly during the 2nd to 6th month, with massive interstitial proliferation of plasmacells and acute respiratory crisis. The second typ is observed in immunodeficient children and adults with only little or no plasmacell infiltration due to the hypoimmune, hypoergic state. Pentamidine is the drug of choice in the therapy of Pneumocystis carinii pneumonia; in serious cases it will be combined with Pyrimethamine. The cocktail Hydergine + Promethazine proved good as a symptomical drug. There have been reports about recoveries in adults under the treatment with Pyrimethamamine + Sulfamethazole. This combination has been recommended as prophylaxis as well.

45,X/46,XY/47,XYY mosaicism in a phenotypic female with gonadoblastoma.

A case of a phenotypic female patient with 45,X/46,XY/47,XYY mosaicism found in lymphocytes as well as in cell cultures prepared from a gonadoblastoma removed by adnexectomy is reported. The two investigated tissues displayed a different distribution of the three cell lines.