The bcl-2/JH gene rearrangement is undetectable in Hodgkin's lymphomas: results from the German Hodgkin trial.

Ninety-one Hodgkin's lymphomas (HD), 52 non-Hodgkin lymphomas (NHL) and 33 specimens of non-neoplastic lymphatic tissues were investigated by polymerase chain reaction (PCR) for the presence of the bcl-2/JH gene rearrangement. The majority of the HD cases were drawn from the files of the German Hodgkin trial where diagnoses are established by a panel of four independent histopathologists. Using the very sensitive PCR method which detected 1 positive among 10000 negative cells, the bcl-2/JH gene rearrangement was found in 7/52 NHL and 3/16 tonsils with follicular hyperplasia, but in none of the 91 HD. The bcl-2 protein, however, was expressed by malignant cells of B and T cell lymphomas and by the giant tumour cells in 2/13 HD lymphocyte predominant, 11/28 HD nodular sclerosing I, 14/17 HD nodular sclerosing II, 10/27 HD mixed cellularity and 3/3 HD lymphocyte depleted. The bcl-2/JH rearrangement is thus independent of protein over-expression, the latter being found in all types of lymphomas. Our results do not confirm the findings of others who have detected the bcl-2/JH rearrangement in HD. These discrepancies may be explained by differences in choice of material, the gene rearrangement actually occurring in bystander cells but not in Reed-Sternberg or Hodgkin cells, or by contamination.

In situ amplification of single copy gene segments in individual cells by the polymerase chain reaction.

A method is described using the polymerase chain reaction (PCR) to amplify defined nucleic acid strands in individual cells in situ in conventional smears of bone marrow and peripheral cells. Using radioactively labeled precursors, the incorporation into newly synthesized strands by PCR can be detected by microautoradiography. The specificity of the method can be monitored by gel electrophoresis of the material shed into the reaction mixture. Thus it could be shown that even single genes in individual cells can be amplified to visibility. In a mixture of HIV infected and non infected cells both can be clearly distinguished from one another.

[Multilocular, immature-cell myelogenous infiltrates of the skin in a patient with chronic myelomonocytic leukemia following polycythemia vera and anti-cardiolipin syndrome]. / Multilokuläre, unreifzellige myelogene Infiltrate der Haut bei einer Patientin mit chronisch-myelomonozytärer Leukämie nach Polyzythaemia vera und Anticardiolipin-Syndrom.

We report a 65-year-old patient presenting with disseminated, reddish, thick infiltrates and nodules during chronic myelomonocytic leukaemia and anticardiolipin syndrome. Histological and immunohistochemical investigations revealed immature myelogenous skin infiltrates.

Chronic Lymphocytic Leukemia (B-CLL) and Immunocytoma (LP-IC): Clinical and Prognostic Relevance of this Distinction.

The Kiel classification of non-Hodgkin lymphomas (NHL) has established chronic lymphocytic leukemia (B-CLL) and immunocytoma (LP-IC) as separate entities of low-grade malignant NHL by morphological and immunohistochemical criteria. The clinical and prognostic relevance of this discrimination was evaluated in a prospective multicenter observation study by the Kiel Lymphoma Study Group. From 1975 to 1980, 430 previously untreated patients with B-CLL (n = 217) and LP-IC (n = 213)a were recruited and followed for up to 14 years. While the age and sex distribution and the incidence of clinical stages were quite similar in both entities major differences between initial manifestations in B-CLL and LP-IC became evident, e.g. in the incidence of bone marrow infiltration (99.5 vs. 86%), peripheral blood lymphocytosis (99.5 vs. 60%), or monoclonal gammopathy (1 vs. 30%). A strictly localized tumor (Ann Arbor stage I/IE) was seen in only 1.5% of the LP-IC patients who were successfully treated by local radiotherapy. In all other patients an expectative-palliative treatment concept was pursued. Long-term survival data analysis revealed significant differences between B-CLL and LP-IC and identified the pseudofollicular in B-CLL and the lymphoplasmacytic in LP-IC as the most favorable histological subtypes. The discriminative prognostic potential of clinical stage (Rai or Binet classification) for B-CLL and LP-IC varied and the pattern of prognostic risk factors obtained by multivariate analysis was not identical. Thus, the morphological distinction between B-CLL and LP-IC correlates with characteristic differences between these entities both in their initial clinical presentation and long-term prognosis.

[HIV-1 prevalence in deaths caused by drug overdose in various large cities of West Germany and West Berlin between 1985 and 1988]. / HIV-1-Prävalenz bei Drogentoten in verschiedenen Grossstädten der Bundesrepublik Deutschland und in Westberlin zwischen 1985 und 1988.

The development of the HIV-1-prevalence among drug deaths (n = 753) in several German cities (West Berlin, Frankfurt, Munich, Hamburg, Bremen, Cologne and Stuttgart) from 1985 to 1988 was evaluated; in 1988 43% of 674 deceased drug addicts were examined. The regional prevalence rate was between 15 and 25%; only in Berlin 42% of the drug deaths were HIV-infected (cumulated data of all cities over the 4-year-period: 26%). There was no uniform or steady regional development of HIV-1-prevalence in the different cities. The ratio men/women among drug deaths was 3:1. The HIV-1-prevalence among males was 22%, among females 40%. HIV-infected individuals were 2-3 years older than seronegatives. Predictions concerning the trend of prevalence rates are not possible up to now. Continuous monitoring of the HIV-status of drug deaths seems to be a worthful method to evaluate the spread of this disease among the risk group of intravenous drug addicts.

[HIV infection in legal autopsies]. / HIV-Infektion bei gerichtlichen Leichenöffnungen.

Since May 1987 all postmortem cases at the Munich Institute of Forensic Medicine were screened for HIV-antibodies. If possible, testing was carried out before the postmortem examination in order to allow specific protective measures. 19 of 2631 consecutively tested corpses (= 0.7%) were HIV-infected. Since 1986, the onset of occasional testing, we found 29 HIV-infections. 24 of these were men, 5 were women. At least 15 were i.v.-drug abusers und 8 were homosexuals. In post mortem testing of body fluids false-positive results can be recognized easily even by ELISA-testing alone. Additional testing of several body fluids other than blood and especially of brain tissue proved to be valuable and yielded reliable results. Body fluids and tissues of HIV-infected corpses are potentially infectious as long as one week after death.

The role of coagulation, fibrinogenolysis and fibrinolysis in the development of fluid and clotted cadaver plasma.

Parameters for coagulation, fibrinogenolysis and fibrinolysis were measured in order to understand the formation of fluid or clotted cadaver plasma. All values found were distinctly elevated without significant differences between fluid and clotted material. The electrophoretic banding pattern of the fibrinogen and fibrin material also proved extensive coagulation and fibrinolysis in all cases. In vitro experiments in which similar electrophoretic banding patterns were obtained suggested that the development of fluid cadaver plasma depends on the activation of fibrinolysis prior to complete coagulation, and is enhanced by persistence of circulation as well as a physiological pH (7.4). In correspondence to post mortal time only an increase in elastase values was found.

[Effects of equal amounts of linoleic acid in orally administered, polyunsaturated phospholipids or in safflower oil on blood lipoproteins]. / Die Wirkungen gleicher Mengen Linolsäure in oral zugeführten, mehrfach ungesättigten Phospholipiden oder in Safloröl auf die Lipoproteine des Plasmas.

The effects of polyenylphosphatidylcholine in a dosage of 10 g per day were compared with an equimolar amount of linoleic acid in 7 g safloroil per day in 8 healthy subjects for 3 weeks. The concentrations of cholesterol, triglycerides, phospholipids, apolipoproteins A-I, A-II and B were measured in serum, as well in VLDL, LDL, HDL, HDL2, HDL3 on the day before, after 2 and 3 weeks of application and 6 months after the experiment. The diet was controlled 10 days before and during the experiment using the dietary recall method. According to the dietary records there was an increase of fat supply during application of polyenylphosphatidylcholine inhibiting decrease of LDL cholesterol, which was observed with safloroil. Phospholipid concentrations increased significantly with polyenylphosphatidylcholine in VLDL. Apolipoprotein B in LDL was significantly decreased by both substances. Apolipoprotein A-I and A-II in HDL increased significantly with polyenylphosphatidylcholine. With safloroil this effect was limited to apolipoprotein A-I, but less impressive. The effects of both substances are comparable in the decrease of apolipoprotein B and probably cholesterol. A special effect of polyenylphosphatidylcholine was observed on phospholipids in VLDL and on apolipoprotein A-I and A-II in HDL.

[Decrease of serum lipoproteins and increase in apolipoproteins A-I and A-II following oral administration of multiple unsaturated phospholipids. Observations on the effect of nutrition on the results]. / Abfall der Serumlipoproteine und Anstieg der Apolipoproteine A-I und A-II nach oraler Zufuhr mehrfach ungesättigter Phospholipide. Beobachtungen zum Einfluss der Ernährung auf die Ergebnisse.

Polyenylphosphatidylcholine was given orally in a dosage of 10 g per day to 10 healthy subjects for 4 weeks. The concentrations of cholesterol, triglycerides, phospholipids, apolipoproteins AI, AII, and B were measured in serum, as were very low density lipoproteins, low density lipoproteins, and high density lipoproteins every 3 h on the day before and after the 4 weeks of application. The diet was controlled 10 days before and during the experiment using the dietary recall method. The evaluation of the diet records showed that 5 subjects had increased and 5 subjects had decreased their fat consumption in exchange for carbohydrates during the experiment. Nevertheless body weight remained constant within +/- 1 kg. Cholesterol in serum and low density lipoprotein decreased, but the differences were not statistically significant. In spite of dietary changes apolipoprotein AI and AII in high density lipoproteins increased significantly. We conclude that the influence of drugs on serum lipids can only be evaluated in conjunction with reliable control of the diet.

Diffuse somatostatin-immunoreactive D-cell hyperplasia in the stomach and duodenum.

This paper presents the first case of extensive, diffuse, somatostatin-immunoreactive D-cell hyperplasia in the human stomach and duodenum. It occurred in a 37-yr-old woman, who showed clinical signs of dwarfism, obesity, dryness of the mouth, and goiter. The density of the distribution of D cells was increased 39-fold in the stomach fundus, 23-fold in the proximal antrum, 25-fold in the distal antrum, and 31-fold in the upper duodenum in comparison with normal values. At the same time, the gastrin-immunoreactive cells were increased 2.3-fold in the antrum. Although the range in size of the D cells was within normal limits in all regions examined, the G cells showed pronounced hypertrophy of up to 127%. A possible relationship between the immuno-histochemical findings and the clinical picture is discussed.