bcl-1 rearrangement and cyclin D1 protein expression in mantle cell lymphoma.

Centrocytic lymphoma, or mantle cell lymphoma (MCL), is characterized by a chromosomal translocation t(11;14) (q13;q32) involving the bcl-1 locus on chromosome 11. Cyclin D1 is a cell-cycle regulatory protein essential for G1-S transition and has been identified as a potential transforming gene affected by the translocation. In this study, 32 cases of MCL were analysed for the bcl-1 rearrangement and cyclin D1 protein expression. In 17 cases, a rearrangement at the major translocation cluster of bcl-1 could be detected. Twenty-four cases exhibited nuclear cyclin D1 expression that was not detectable in other B-cell lymphomas (n = 40) or in normal B-cells. In nine MCL samples, cyclin D1 was expressed without a detectable bcl-1 rearrangement. The detection of a t(11;14) by means of classical cytogenetics in one of these cases, however, may suggest that this discrepancy could be due to chromosomal breakages outside the typical translocation cluster region. In two cases, a bcl-1 rearrangement was not accompanied by cyclin D1 expression. This study provides further evidence that cyclin D1 is involved in the pathogenesis of MCL and can be exploited as a diagnostic marker in the differential diagnosis of B-cell lymphomas and in the identification of MCL.

Pharmacokinetics of epoetin in haemodialysis patients after subcutaneous administration: influence of chronic treatment.

The purpose of this study was to investigate whether chronic subcutaneous administration of epoetin has an influence on its pharmacokinetics in patients with chronic renal failure and anaemia. 14 Patients were included in the study. The data of 8 patients could be evaluated at the end of the study. All patients were on maintenance haemodialysis. The pharmacokinetic profile of epoetin was studied directly after the first subcutaneous administration of 60 U/kg body weight. Patients were further treated with epoetin to maintain haemoglobin concentration between 6.0 and 6.5 mmol/l. After about one year of treatment the pharmacokinetic profile was studied again, using the same dosage. Between both profiles no significant differences (paired Student's t-test) were found in the pharmacokinetic parameters studied: absorption half-life, time to maximum concentration, maximum concentration, elimination half-life, area under the curve and mean residence time. However, in individual patients large differences may be found.

Arsenazo III: an improvement of the routine calcium determination in serum.

The widely used calcium dye reagent, o-cresolphthalein complexone, was replaced by the less well known metallochromic indicator Arsenazo III in a selective multitest analyser. Calibration stability increased from 12 hours to more than 48 hours. With the Arsenazo III reagent we clearly improved the within-lab and between-lab imprecision of the calcium determination. The accuracy of the Arsenazo III method was established with a reference method (atomic absorption spectrophotometry) and good results were obtained with assayed control sera. Furthermore, the mean calcium values of our out-clinic patients remained constant during the change of reagent. The calcium values are influenced by haemolysis; we correct for the observed decrease by adding 0.015 mmol/l Ca per 10 mumol/l Hb. Furthermore they are influenced by very small amounts of Cu ions from the preceding protein determination in the same cuvette. This latter problem is easily overcome by adding 15 mmol/l thiourea to the calcium reagent.

[Dehydroepiandrosterone sulfate (DHEAS) concentration changes in clomiphene therapy?]. / Dehydroepiandrosteronsulfat-(DHEAS-)Konzentrations-Anderungen während Clomiphen-Therapie?

Plasma DHEAS levels were followed in 10 anovulatory patients, treated with 50 mg clomiphene citrate from the 5th to the 9th day of menstruation as well as 6 ovulatory women, who were taken as controls. A serum progesterone level of 13 nmol/l or more in the luteal phase was found in both, the treatment and the control group. This was considered to be a strong indication, that ovulation had occurred. A significant preovulatory increase in DHEAS levels was found neither in the treatment nor in the control group. A negative influence of DHEAS on the ripening of the follicles due to a single dose of 50 mg of clomiphene during 5 days of menstruation seems unlikely.

[Exertion-induced anaphylaxis]. / Anstrengungsinduzierte Anaphylaxie.

The syndrome of exercise induced anaphylaxis represents a distinct form of physical allergy. This syndrome and the features which distinguish it from other forms of physical allergy are discussed in the context of 10 case reports. The symptoms usually start after 5-30 minutes' exercise with cutaneous pruritus, warmth and progress to urticaria and angioedema. In 3 cases signs of laryngeal edema were present; additional manifestations included upper respiratory distress, gastrointestinal tract symptoms and collapse. The syndrome is distinct from exercise induced asthma or cholinergic urticaria. One patient had both cholinergic urticaria induced by stress, heat and exercise, and anaphylactoid symptoms induced by exercise alone. While the symptoms of cholinergic urticaria subsided after 2-4 hours, the anaphylactoid symptoms lasted up to 48 hours. The symptoms are elicited irregularly, which suggests a multifactorial trigger mechanism. The intake of particular foods or acetylsalicylic acid, and certain weather conditions, are possible cofactors. In 8 of 10 patients an atopic diathesis was found but no exposition to a specific allergen, which could explain the symptoms, was observed. Therapy consists of avoidance of cofactors, change of training habits and cessation of exercise as soon as prodromal symptoms develop. If attacks are frequent, antihistamines or ketotifen can be tried. The acute attack should, like other anaphylactoid reactions, be treated by antihistamines, injection of epinephrine (s.c.) and infusions (colloidal solutions).

[Enzymatic lecithin determination in amniotic fluid for antepartal diagnosis of lung maturity - a multi-center study (author's transl)]. / Enzymatishce Lezithinbestimmung in fruchtwasser zur antepartalen Lungenreifediagnostik - Eine multizentrische Studie.

A new test-combination for the enzymatic determination of lecithin in amniotic fluid for the assessment of fetal lung maturity has been developed by Boehringer Mannheim. This test was evaluated by 12 hospitals and has been compared with the L/S ratio, the foam-test or the densitometric determination of lecithin. The assay is based on the hydrolysis of lecithin by phospholipase C which starts an enzymatic chain reaction in which NADH consumption if measured photometrically. The intra- and interassay precision were characterized by CV values below 10%. Average recoveries of lecithin were 95-102%. It is recommended to centrifuge the samples (10 min, 700 g) and to start the analysis as soon as possible after receipt of the specimen. The total amount of time required is 2 hours for a single determination. Batches of up to 10 samples require little extra time. An opened test-combination can be used for a maximum of 30 single determinations. Comparison of the quantitative enzymatic lecithin determination with other methods showed that the critical value for lecithin is 5.0 mg/100 ml. Above 5.1 mg/100 ml no case respiratory distress syndrome was observed. The good precision accuracy and the simple handling make the enzymatic lecithin determination suitable for routine use.