Use of atypical anti-psychotics in the management of post-traumatic confusional states in traumatic brain injury.

The use of atypical anti-psychotics (AAP) in the treatment of organic neuropsychiatric syndromes is little reported. We present a case of post-traumatic delirium with delusions treated with Risperidone and discuss the use of AAP's in this situation.

US-guided core biopsy of the spleen in children.

PURPOSE: To evaluate the safety, diagnostic yield, and clinical benefits of performing ultrasonography (US)-guided percutaneous splenic core biopsy in children. MATERIALS AND METHODS: US-guided splenic core biopsy was performed in 30 children aged 6 months to 15.3 years (mean, 7.0 years), with focal lesions in 27 patients and homogeneous splenomegaly in three. Four patients underwent repeat biopsy to identify changes in splenic disease. Four types of biopsy needles were used in this series. General anaesthesia was used in 21 patients and conscious sedation in nine. Medical records were reviewed to assess diagnostic accuracy, influence on treatment, and biopsy-related complications. RESULTS: All biopsies were performed without complication. Among the 30 biopsies, an accurate diagnosis was obtained in 25 (83%), a false-negative result was obtained in two (7%), and three (10%) were nondiagnostic. All conclusive results influenced treatment decisions. The mean number of needle passes was 2.7 per patient (range, 2-5 passes). Use of needles was 50%-100% successful in the acquisition of adequate tissue cores. Use of the 18-gauge needle was always successful in the safe acquisition of adequate tissue, with a maximum of three passes. CONCLUSION: US-guided splenic core biopsy is a minimally invasive, simple, and safe procedure for use in children. It provides relatively high diagnostic accuracy while minimizing complications when compared with alternative, more invasive procedures.

Heterogeneity of B-lymphoid tumors in E mu-myc transgenic mice.

The clinically important issue of tumor heterogeneity was studied in C57BL/6-E mu-myc transgenic mice, which provide a genetically uniform model system in which all animals eventually develop B cell lymphomas after additional genetic changes beyond enforced expression of the transgenic oncogene. Three different approaches were compared for discerning the cellular and genetic homogeneity of these tumors. Analysis of Igh gene rearrangement showed mainly monoclonality and only infrequent oligoclonality in the tumors from a given animal. In contrast, cytogenetic examination indicated a substantial degree of heterogeneity in the tumors from a given animal and showed that a wide variety of secondary genetic changes occur in E mu-myc transgenic mice. Flow cytometry of DNA content also revealed a high degree of heterogeneity within and among the tumor masses from single E mu-myc mice. Estimates of tumor heterogeneity revealed by these three techniques often did not coincide, indicating that these different approaches reflect distinct cellular parameters. Transgenic E mu-myc mice additionally homozygous for the scid mutation displayed enhanced levels of secondary genetic changes that were valuable for the methodological comparisons performed here, and demonstrated that the extent of tumor heterogeneity can be influenced by specific genes other than the primary E mu-myc transgene. In summary, a combination of methodologies appears to be required to reveal the full extent of tumor heterogeneity within a single individual.

Large-scale production and concentration of human lymphoid interferon.

A stable and predictable production system is described for pilot plant quantities (milligram) of human lymphoid interferon, using suspension culture of an African Burkitt's lymphoma derived cell line Namalva with induction by Newcastle disease virus, B-1 strain. Cell cultures were grown in impeller-driven 50-liter fermentors with dilution of the postinduction culture using serum-free medium. High levels of dissolved oxygen were necessary for optimum cell growth. A total of 4,207 liters of interferon culture was produced in a series of 116 fermentor runs. An average yield of 3.5 log(10) international units of interferon per ml was realized before processing. Trichloroacetic acid was used to precipitate the interferon. An average of 3.35 log(10) international units of interferon per ml was recovered in the final nonpurified product.

Biological characterization of an Epstein-Barr nuclear antigen-positive American Burkitt's tumor-derived cell line.

Two distinct cultures derived from a lymphoid cell line designated NAB were characterized immunologically, morphologically, and cytogenetically. Both cultures were positive for Epstein-Barr nuclear antigen. NAB I cultures were negative for virus capsid antigen and early antigen and were not affected by treatment with 5-iododeoxyurdine. NAB II cultures were positive for virus capsid antigen and early antigen, which increased with 5-iododeoxyuridine treatment. Both cultures were superinfected with virus prepared from P3HR-1 cells. Cell-free virus concentrates prepared from both cultures were inactive for transformation and infectivity. NAB I and NAB II cells were lymphoid as determined by light and electron microscopy. NAB II cells showed morphological alterations characteristic of herpes infection. 5-iododeoxyuridine-treated cells from both cultures revealed ultrastructural characteristics of cells infected with herpes-viruses but without particles. In addition, the induction of tubuloreticular structures within the endoplasmic reticulum was observed. Cytogenetic analysis of both cultures revealed a rearranged chromosome 14 and several other chromosome aberrations, three of which may be used as a reliable means of identifying NAB cultures.