The Prognostic Importance of Immunohistochemical Biomarkers in Diffuse Large B-Cell Lymphoma

ABSTRACT Objective: Molecular methods have practical difficulties in identifying sub-groups of diffuse large B-cell lymphoma (DLBCL) in routine clinical practice. The goal of this study was to sub-classify DLBCL patients into sub-groups by immunohistochemical method and to evaluate the effects of sub-groups on prognosis. Methods: For this purpose, the lymph node biopsy specimens of 40 patients with DLBCL have stained with monoclonal antibody immunostains of cluster of differentiation 10, B-cell lymphoma 6 and multiple myeloma oncogene 1 (MUM1). Results: As a result, 6 (15%) patients have germinal centre B-cell like (GCB) phenotype and 34 (85%) patients have non-GCB phenotype. The overall survival (OS) and event-free survival (EFS) was 31.00 ± 15.49 months and 27.66 ± 17.95 months in GCB phenotype, respectively. The OS and EFS were 23.79 ± 17.82 months and 20.97 ± 17.12 months in non-GCB phenotype, respectively. Conclusion: Multiple myeloma oncogene 1 has reached statistical significance among immunostains, and was found negatively correlated with OS and EFS. If these markers are standardized in the future, more accurate treatment schedules will be determined.

A Novel Needle-Injectable Millimeter scale Wireless Electrochemical Glucose Sensing Platform for Artificial Pancreas Applications.

Modern healthcare systems are under constant pressure to deliver personalized, effective care to billions of patients suffering from chronic non-communicable disease like diabetes. A closed-loop disease management system is an ideal solution for such patients. An example of this is an artificial pancreas for diabetes management. For safe and effective closed-loop disease management, the cost, size, longevity, warm-up time, and response speed need to match the performance of a healthy biological system (e.g. the pancreas). In this paper, a novel needle-injectable mm-size wireless sensing platform is presented to fulfill these requirements for an artificial pancreas by combining advanced microelectronics, nanotechnology and advanced biomaterial science. The proposed platform utilizes a sensor that is smaller than a sesame seed and provides fundamental advantages in terms of fast response speed, high accuracy, short warm-up time, and low cost of goods. Owing to these features, the system will enable true closed-loop glucose control (without any meal announcements and carbohydrate calculations), especially among infants and toddlers. The system has the potential to significantly improve diabetes management and in general chronic disease management for billions of patients.

A novel semiconductor based wireless electrochemical sensing platform for chronic disease management.

Electrochemical sensors are very versatile and can be used for a diverse range of biomedical applications. In this paper, a novel fully-integrated wireless electrochemical sensing platform is presented. The platform uses standard semiconductor technology to create a miniaturized integrated bioelectronics system that consists of an electrochemical sensor, potentiostat, signal processing circuitry, wireless power harvesting circuitry, and wireless telemetry unit, all on a single microchip. The platform is orders of magnitude smaller than the state-of-the-art sensing systems and costs a fraction. At 1.4 mm × 1.4 mm size, the sensor costs less than $1 to manufacture. The presented design provides fundamental advantages in decreasing sensor noise and settling time, thus providing superior response compared to existing solutions. System design and implementation details are presented as well as examples for metabolic sensing (glucose, lactate, O2) applications. The system can have widespread applications in biosensing applications.

The prevalence of diffuse idiopathic skeletal hyperostosis in patients with diabetes mellitus.

OBJECTIVE: The relation of diffuse idiopathic skeletal hyperostosis (DISH) and diabetes mellitus (DM) has been frequently reported. However, there is little knowledge about its prevalence in DM. The purpose of this study was to determine that prevalence and whether it differs from that of controls. METHODS: The prevalence of DISH was investigated in 133 patients with DM and 133 nondiabetic controls matched for sex, age, and weight. Radiologic criteria were used for diagnosis. Erythrocyte sedimentation rate, fasting blood glucose levels, glycolized hemoglobin, triglyceride, very low-density lipoprotein, low-density lipoprotein, high-density lipoprotein, calcium, uric acid, alkaline phosphatase, phosphorus, insulin, and insulin-like growth factor-1 (IGF1) levels of both groups were compared. RESULTS: The prevalence of DISH (12%) was higher in patients with DM than the control group (6.8%), but there was no statistically significant difference. The average age of the patients diagnosed with DISH (63.36 +/- 9.27) was significantly higher than that of the others (54.21 +/- 12.12) (P < 0.05). There was no significant difference between the DISH patients and the others in other parameters examined. CONCLUSION: We found no statistically significant difference in the prevalence of DISH between patients with DM and controls. We suggest that the factors thought to be responsible for the etiopathogenesis of DISH such as DM, insulin, and insulin-like growth factor-1 be investigated further.

Relationship between bone mineral density and insulin resistance in polycystic ovary syndrome.

The aim of the present study was to evaluate whether there is a relationship between bone mineral density (BMD) and insulin resistance and hyperinsulinemia in women with polycystic ovary syndrome (PCOS). The study consisted of 28 amenorrheic women with PCOS and 11 amenorrheic women without PCOS. Fifteen healthy women with normal ovulatory function, matched for age and body mass index (BMI), served as controls. BMD was measured at the lumbar spine and left femoral neck with dual-energy X-ray absorptiometry. Blood samples were obtained to measure serum levels of insulin, follicle-stimulating hormone, luteinizing hormone, sex hormone-binding globulin (SHBG), total and free testosterone, androstenedione and estradiol by radioimmunassay. Insulin resistance was estimated by the in sulin tolerance test (ITT), and K(ITT) was taken as the insulin sensitivity index. In the PCOS group, K(ITT) was significantly lower and insulin levels were higher than in either of the control groups (P < 0.001). BMD in the PCOS group was lower than in the healthy group and higher than in the amenorrheic control group (P < 0.05). In the PCOS group, there were positive correlations of BMD of the lumbar spine with insulin (r = 0.42: P < 0.05) and negative correlations of BMD with K(ITT) (r = -0.58; P < 0.001) and SHBG (r = -0.38; P < 0.05). The inverse association of BMD and K(ITT) was independent of BMI, insulin, SHBG, androstenedione, and free testosterone. In conclusion, insulin resistance and hyperinsulinemia in women with PCOS may be a relative protective factor against bone mineral loss.

Asecretory POEMS Syndrome with Widespread Osteosclerotic Lesions.

POEMS syndrome (polyneuropathy, organomegaly, endocrinopathy, M-protein and skin changes) is a rare disease and constitues 1-2% of plasma cell dyscrasia. Most of the patients have few sclerotic bone lesions and more than 90% of patients have serum and/or urinary M-protein. In this report, we present a patient with POEMS syndrome who had severe polyneuropathy and unusual widespread osteosclerotic lesions without M- rotein in serum and urine. According to our knowledge, this is the first case of asecretory POEMS syndrome with multipl sclerotic lesions and polyneuropathy. Our patient is still well and able to work actively 4 years after diagnosis with the treatment of 12 courses of VAD by reducing the vincristine dosage.

Effects of rhG-CSF on neutrophil functions and bone marrow parameters in diabetic rats.

Neutrophils have an important role in the host defense. The elevated serum glucose levels of diabetics affect traditional host defenses such as neutrophil counts and functions. The causes of these impairments are not clear. We aimed to investigate changes of peripheral neutrophil counts and functions and their relation with bone marrow cells in diabetic rats. Thirty-two rats were divided into four equal groups. Group 1 were controls and Groups 2 and 4 were made diabetic by a single intraperitoneal injection of streptozotocin. Granulocyte colony stimulating factor (G-CSF) was injected subcutaneously into Groups 3 and 4. White blood cell count, neutrophil counts and function and bone marrow cell count were determined. Peripheral blood cell counts, neutrophil phagocytosis index were decreased but neutrophil adhesivity index was not different in the diabetes-induced group. There was a difference in circulating white blood cell counts and neutrophil counts between the rhG-CSF treated and non-treated groups. The phagocytosis index of neutrophil in diabetic rats was significantly diminished by rhG-CSF treatment. A hyperplasia of early cells of the myeloid series in G-CSF treated groups was observed when compared with those of nontreated groups (p<0.001). A significant decrease was noted in the number of mature marrow segmented cells diabetic groups (p<0.001). Finally, G-CSF has been shown to cause neutrophilia by acting as a releasing factor for mature marrow neutrophils in diabetic rats. These results suggest that G-CSF may be used to improve nonspecific immunity in diabetic patients.

Prophylaxis of the occurrence of hyperbilirubinemia in relation to maternal oxytocin infusion with steroid treatment.

This study was carried out to investigate the steroid prevention on the occurrence and the severity of red blood cell destruction by the effect of oxytocin usage for labor induction. Venous cord blood was collected from the pregnancies who had oxytocin-induced or augmented labors (20), oxytocin-infused deliveries with steroid use (20), deliveries without oxytocin use (20) and cesarean sections (20). Evaluation of the data showed significant increase in serum bilirubin level, serum lactic dehydrogenase activity, erythrocyte fragility and reticulocyte count (p < 0.0083), and a significant decrease in hemoglobulin concentration, packed red cell volume fraction (p < 0.01) in groups with labor induction or augmentation with oxytocin in comparison to deliveries with oxytocin plus steroid use and the two other methods of delivery. Moreover, with regard to the above data, no significant difference was observed between the deliveries other than oxytocin-only use. Mean corpuscular volume in the oxytocin group was apparently (not significant) higher than the steroid group. The results of this study suggest that the use of 16 mg dexamethasone 21-phosphate at the beginning of the induction or augmentation of labor with oxytocin, followed by an additional 4-mg dose 4 h later intravenously, is advantageous for the prevention of erythrocyte destruction.

Two consecutive spontaneous regressions to chronic phase in a patient with blastic transformation of chronic myelogenous leukemia.

In this report, we present a patient with chronic myeloid leukemia (CML) in blastic phase who had two consecutive episodes of spontaneous regression back to chronic phase without chemotherapy. Although, spontaneous remission (SR) is well documented in acute leukemia, SR in CML blastic phase is extremely rare and to the best of our knowledge only one case has been reported in the world literature. The factors possibly related to this phenomenon are discussed.

The effects of hemodialysis on duodenal and gastric mucosal changes in uremic patients.

From March 1992 to July 1992, 30 uremic patients (15 dialysed, 15 non-dialysed) and 15 non-uremic patients who had dyspeptic complaints were compared in terms of gastric and duodenal diseases. Gastritis and duodenitis graded as I, II and III were not found different in three groups (p > 0.05). Although the incidence of peptic ulcer disease is very high in both groups of uremic patients in comparison with the controls, there was no significant difference between two uremic groups (p > 0.05). Also the prevalence of gastritis determined histologically was not different in dialysed and non-dialysed uremic patients (p > 0.05). The incidence of the histologically proven gastritis was found higher in uremic patients than in non-uremic patients (p < 0.05). But, there were no significant differences among the three groups with regard to the rate of histologically proved duodenitis (p > 0.05). Gastrin levels, urea positivity, the incidence of gastritis and duodenitis and peptic ulcers did not differ in both uremic groups. However, these values were found significantly high in the uremic patients when compared to non-uremics. These findings showed serum gastrin levels, H.-pylori-infection, gastritis and duodenal disease in the uremic patients to be higher than those of the control group. Moreover, no effect of hemodialysis treatment on these results was observed.