Enhancing lung cancer detection through hybrid features and machine learning hyperparameters optimization techniques.

Machine learning offers significant potential for lung cancer detection, enabling early diagnosis and potentially improving patient outcomes. Feature extraction remains a crucial challenge in this domain. Combining the most relevant features can further enhance detection accuracy. This study employed a hybrid feature extraction approach, which integrates both Gray-level co-occurrence matrix (GLCM) with Haralick and autoencoder features with an autoencoder. These features were subsequently fed into supervised machine learning methods. Support Vector Machine (SVM) Radial Base Function (RBF) and SVM Gaussian achieved perfect performance measures, while SVM polynomial produced an accuracy of 99.89% when utilizing GLCM with an autoencoder, Haralick, and autoencoder features. SVM Gaussian achieved an accuracy of 99.56%, while SVM RBF achieved an accuracy of 99.35% when utilizing GLCM with Haralick features. These results demonstrate the potential of the proposed approach for developing improved diagnostic and prognostic lung cancer treatment planning and decision-making systems.

Longitudinal 8-Epi-Prostaglandin F2-Alpha and Angiogenic Profile Mediator Evaluation during Pregnancy in Women with Suspected or Confirmed Pre-eclampsia.

Background: In this exploratory study, we aimed to evaluate the dynamics of angiogenic [soluble fms-like tyrosine kinase-1 (sFlt-1), placental growth factor (PlGF), soluble Endoglin (sEng), and sFlt-1/PlGF, PlGF/sFlt-1, and sEng/PlGF ratios] and oxidative stress [8-epi-prostaglandin F2 alpha (8-epi-PGF2α) and 8-epi-PGF2α/PlGF ratio] mediator levels in women with suspected or confirmed pre-eclampsia (PE) at least two times during pregnancy. We also wanted to identify the possible correlations between 8-epi-PGF2α and angiogenic mediator levels at the time of inclusion of pregnant women. Methods: We included 40 pregnant women with suspected or confirmed PE, with a mean age of 29 years (range between 18 and 41 years) and gestational age between 18 and 28 weeks at inclusion in this study. The Enzyme-Linked Immunosorbent Assay (ELISA) method to measure the levels of serum angiogenic and oxidative stress mediators was used. Results: The evaluation of baseline sFlt-1/PlGF ratios using a cut-off of 38 suggested that 25 pregnant women had a sFlt-1/PlGF ratio of >38 (sFlt-1/PlGF ratio of >38 group) and 15 had a sFlt-1/PlGF ratio of ≤38 (sFlt-1/PlGF ratio of ≤38 group). The increases in sFlt-1/PlGF ratio in the sFlt-1/PlGF ratio of >38 group were caused by both an increase in sFlt-1 (2.04-fold) and a decrease in PlGF levels (2.55-fold). The 8-epi-PGF2α median levels were higher in the sFlt-1/PlGF ratio of >38 group (1.62-fold). During follow-up after pregnancy, we observed that the mean values of sFlt-1 and sEng and the median values of 8-epi-PGF2α and sFlt-1/PlGF, sEng/PlGF, and 8-epi-PGF2α/PlGF ratios increased directly proportional to gestational age for each measurement time until delivery in both groups. For five women who had a sFlt-1/PlGF ratio ≤38 at inclusion, sFlt-1/PlGF ratio was observed to increase to >38 later in pregnancy. We observed that, in the sFlt-1/PlGF ratio >38 group, baseline 8-epi-PGF2α levels better correlated with angiogenic mediator levels. Conclusions: Our study shows that 33.33% of pregnant women evaluated for suspected or confirmed PE with a sFlt-1/PlGF ratio of ≤38 displayed a rise in sFlt-1/PlGF ratio in subsequent weeks. In addition, together with angiogenic mediators, 8-epi-PGF2 α can be utilized as an independent predictor factor to help clinicians identify or predict which pregnant women will develop PE.

Preoperative Immunocyte-Derived Ratios Predict Postoperative Recovery of Gastrointestinal Motility after Colorectal Cancer Surgery.

The aim of this study was to assess the role of immunocyte-derived ratios (IDRs), such as the systemic immune-inflammation index (SII), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and lymphocyte-to-monocyte ratio (LMR), as markers for the postoperative recovery of gastrointestinal function following colorectal cancer surgery. A retrospective analysis was conducted on a consecutive cohort of 260 patients who underwent radical colorectal cancer surgery within the timeframe spanning from January 2016 to December 2022. Data concerning the postoperative recovery of gastrointestinal function included the I-FEED score, time to pass flatus, toleration for liquids in the first 48 h, and the need for nasogastric tube reinsertion in the immediate postoperative period. A special emphasis was allocated towards the examination of IDRs and their interrelation with the postoperative gastrointestinal functional parameters. The I-FEED score exhibited a positive correlation with the NLR, SII, and PLR. The univariate analysis indicated that all IDRs, multiorgan resection, hemoglobin and protein levels, regional nodal extent of the tumor (N), and obesity significantly affected nasogastric tube reinsertion. The multivariate analysis showed that the SII and N1 stages were risk factors for nasogastric tube reinsertion after colorectal cancer surgery. The SII and multiorgan resection were the only classifiers that remained significant in the multivariable analysis for the toleration for liquids. In summation, certain preoperative IDRs, such as the SII, PLR, and NLR, may hold potential as predictive determinants for postoperative gastrointestinal functional recovery following colorectal cancer surgery.

Preoperative Immunocite-Derived Ratios Predict Surgical Complications Better when Artificial Neural Networks Are Used for Analysis-A Pilot Comparative Study.

We aimed to comparatively assess the prognostic preoperative value of the main peripheral blood components and their ratios-the systemic immune-inflammation index (SII), neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), and platelet-to-lymphocyte ratio (PLR)-to the use of artificial-neural-network analysis in determining undesired postoperative outcomes in colorectal cancer patients. Our retrospective study included 281 patients undergoing elective radical surgery for colorectal cancer in the last seven years. The preoperative values of SII, NLR, LMR, and PLR were analyzed in relation to postoperative complications, with a special emphasis on their ability to accurately predict the occurrence of anastomotic leak. A feed-forward fully connected multilayer perceptron network (MLP) was trained and tested alongside conventional statistical tools to assess the predictive value of the abovementioned blood markers in terms of sensitivity and specificity. Statistically significant differences and moderate correlation levels were observed for SII and NLR in predicting the anastomotic leak rate and degree of postoperative complications. No correlations were found between the LMR and PLR or the abovementioned outcomes. The MLP network analysis showed superior prediction value in terms of both sensitivity (0.78 ± 0.07; 0.74 ± 0.04; 0.71 ± 0.13) and specificity (0.81 ± 0.11; 0.69 ± 0.03; 0.9 ± 0.04) for all the given tasks. Preoperative SII and NLR appear to be modest prognostic factors for anastomotic leakage and overall morbidity. Using an artificial neural network offers superior prognostic results in the preoperative risk assessment for overall morbidity and anastomotic leak rate.

A Numerical Investigation on Hydrothermal Performance of Micro Channel Heat Sink with Periodic Spatial Modification on Sidewalls.

Electronic gadgets have been designed to incorporating very small components such as microcontrollers, electronic chips, transistors, microprocessors, etc. These components are exceptionally heat sensitive and can be wrecked if heat is not released. As a result, the thermal control of such components is critical to their optimum performance and extended life. The use of a microchannel heat sink (MCHS) has shown promising solutions to remove the excess heat. In this paper, we have proposed a novel design of MCHS and investigated it numerically. Four different surface modifications on the sidewall of the passage, namely, extended triangular surface (ETS), extended circular surface (ECS), triangular groove surface (TGS), and the circular groove surface (CGS) in the passage of the microchannel have been exploited in the Reynolds number of 100-900. In the presence of geometrical modification, the cooling capacities have been enhanced. The results show that the Nusselt numbers of ETS-MCHS, ECS-MCHS, TGS-MCHS, and CGS-MCHS are increased by 4.30, 3.61, 1.62, and 1.41 times in comparison to the Nusselt number of MCHS with smooth passage, while the friction factor values are increased by 7.33, 6.03, 2.74, and 1.68 times, respectively. In addition, the thermohydraulic performance parameter (THPP) has been evaluated and discussed. The fact that MCHS have THPP values greater than unity demonstrates that the passage's geometries are a practical means of achieving effective thermal management.

The histopathological features and their prognostic impact in the postoperative follow-up of colorectal cancer patients.

The validation of histological prognostic markers in colorectal cancer not only for survival parameters but also for early postoperative outcomes is of paramount importance. The aim of our study was to search for the tumor histopathological (HP) characteristics that may influence the postoperative morbidity, especially the occurrence of anastomotic leakage. Our results indicated that peritumoral inflammatory cell infiltrate appeared to correlate with both anastomotic fistula and overall postoperative complications. Likewise, high-grade and undifferentiated colorectal tumors seemed to be correlated with a higher incidence of postoperative leakage and complications. No relation could be established between the other HP features and the postoperative untoward outcomes.

The potential value of diagnostic and predictive serum biomarkers for preeclampsia.

BACKGROUND: Preeclampsia (PE), one of the classes of hypertensive pregnancy disorders, is one of the three causes of maternal morbidity and mortality worldwide. The angiogenic and anti-angiogenic factors are useful markers in predicting and diagnosing PE. AIM: This study aims to detect and measure the serum level of some biomarkers [hypoxia-inducible factor-1 subunit alpha (HIF-1A), vascular endothelial growth factor (VEGF), interferon-gamma-inducible protein of 10 kDa (IP-10), matrix metalloproteinase-13 (MMP-13)] in patients with PE and their correlation with the severity of the disease, to find a good predictor for PE. PATIENTS, MATERIALS AND METHODS: This prospective study aims to monitor 48 pregnant women who address obstetric consultation and who present risk factors for PE, and a control group with characteristics similar to the study group. Patients were divided into three groups: Group I (n=15) including normal pregnant (NP) women with blood pressure <140∕90 mmHg, without proteinuria, Group II (n=18) including patients with mild PE (MildPE), Group III (n=15) including patients with severe PE (SeverePE). The analysis of serum biomarkers was based on a quantitative sandwich enzyme-linked immunosorbent assay (ELISA), according to the manufacturer's instructions. RESULTS: In our study, we found that all biomarkers investigated have higher concentrations in the serum of patients with SeverePE and MildPE than those in the control subjects (Group I, NP), the concentrations were increasing along with the disease activity. The means concentrations of HIF-1A, VEGF, IP-10, MMP-13, better correlated with indices in SeverePE group than in MildPE group. We found that VEGF was the biomarker that best correlates with indices that assess the severity of PE. The best separation of patients with SeverePE from those with MildPE can be done with the help of MMP-13 (82% accuracy), followed by VEGF (80.40% accuracy) and the least good detection being done by dosing IP-10. CONCLUSIONS: We can say that, due to high specificity diagnostic accuracy, determination of serum concentrations of MMP-13 and VEGF, could be useful in the diagnosis and distinguishing of patients with SeverePE and may prove useful in the monitoring of the disease course.

Smart Cutting Tools Used in the Processing of Aluminum Alloys.

The processing of aluminum alloys in optimal conditions is a problem that has not yet been fully resolved. The research carried out so far has proposed various intelligent tools, but which cannot be used in the presence of cooling-lubricating fluids. The objective of the research carried out in the paper was to design intelligent tools that would allow a control of the vibrations of the tool tip and to determine a better roughness of the processed surfaces. The designed intelligent tools can be used successfully in the processing of aluminum alloys, not being sensitive to coolants-lubricants. In the research, the processing by longitudinal turning of a semi-finished product with a diameter Ø = 55 mm of aluminum alloy A2024-T3510 was considered. Two constructive variants of smart tools were designed, realized, and used, and the obtained results were compared with those registered for the tools in the classic constructive variant. The analysis of vibrations that occur during the cutting process was performed using the following methods: Fast Fourier Transform (FFT); Short-Time Fourier-Transformation (STFT); the analysis of signal of vibrations. A vibration analysis was also performed by modeling using the Finite Element Method (FEM). In the last part of the research, an analysis of the roughness of the processed surfaces, was carried out and a series of diagrams were drawn regarding curved profiles; filtered profiles; Abbott-Firestone curve. Research has shown that the use of smart tools in the proposed construction variants is a solution that can be used in very good conditions for processing aluminum alloys, in the presence of cooling-lubrication fluids.

Heterogeneity among diffuse large B-cell lymphoma: new entities in WHO classification, a first step in personalized therapy.

Diffuse large B-cell lymphoma (DLBCL) is the most common type of aggressive lymphoma, being part of mature B-cell neoplasm according to the 2016 World Health Organization (WHO) Classification of lymphoid tumors. This type of non-Hodgkin's lymphoma (NHL) can develop in the lymph nodes in most cases, or in extranodal sites (the most frequent involvement being the digestive tract, but also the thyroid, central nervous system, testes, etc.). Despite being an aggressive lymphoma, DLBCL benefits of potentially curable therapy. The addition of monoclonal antibodies to standard chemotherapy in the therapeutic approach of DLBCL leads to some net superior results to those obtained by chemotherapy alone. Despite the fact that the aggressive therapy is very efficient, 10% of patients remain refractory to it, 30-40% of them after obtaining a complete response (CR) will relapse, and 90% of refractory DLBCL have poor survival rates. Based on these findings, an explanation for the differences in clinical outcome and therapy response was attempted. The important progresses made in the understanding of DLBCL heterogeneity were based on molecular biology studies and showed differences in chromosomal alterations and in signaling pathways activation. These findings have paved the way for new therapeutic targets in order to improve therapy response. The large heterogeneity of DLBCL is acknowledged by the 2016 WHO Classification of lymphoid neoplasms, with 17 DLBCL subtypes, some of them as new varieties, compared to the 2008 Classification, and others introduced as provisional entities.

Correlations between clinical and placental histopathological and immunohistochemical features in women with and without hereditary thrombophilia.

AIM: The primary objective of this study was to correlate hereditary thrombophilia (high- or low-risk) with specific placental histopathological (HP) and∕or immunohistochemical (IHC) changes, for confirming∕ruling out a possible linkage between these two biological parameters. PATIENTS, MATERIALS AND METHODS: We present a 3-year prospective study conducted between 2016 and 2019 that enrolled 90 women registered in two Clinics of Obstetrics and Gynecology in Craiova, Romania, with personal thrombotic and/or pathological obstetrical history. The HP and IHC analysis of the placenta was performed using monoclonal anti-cluster of differentiation 34 (CD34) antibody, anti-hypoxia-inducible factor-1 alpha (HIF-1α) and anti-endothelial nitric oxide synthase (eNOS) antibody. RESULTS: There was a high incidence of all thrombophilia (TPh) mutations in Caucasian women with thrombotic and obstetrical complications. Among them, both HP and IHC examination revealed significant changes. These were more severe in the placentas of patients with homozygous Factor V Leiden (FVL) gene mutation and double heterozygous FVL∕PII gene mutation. Multiple placental infarctions with massive fibrinoid necrosis and an increase in syncytial knots are common findings. In the same group, we found by means of IHC examination - intense positive HIF-1α and eNOS immunoexpression, and low positive CD34 expression, especially in fibrinoid necrosis and thrombosis areas. We found no correlation between clinical, HP and IHC changes in patients with low-risk TPh or without TPh. CONCLUSIONS: Among patients with obstetric and thrombotic complications, there is a high prevalence of TPh. It appears that hypercoagulability reported in high-risk thrombophilia (HR-TPh) has major effects on placental tissue (fibrinoid necrosis, multiple thromboses, hypoxia and oxidative stress). Significant placental changes were found predominantly in women with HR-TPh. Strategies for TPh screening based on HP/IHC pattern would be, most probably, more cost-effective compared with the extended TPh testing offered in large populations. This way, a smaller number of patients will be tested and in this group a higher proportion of patients will be found as having HR-TPh mutations.

Indication of total parathyroidectomy for an Epstein syndrome patient with end-stage renal disease.

Epstein syndrome is an extremely rare genetic disorder characterized by the association of nephritis, deafness and megathrombocytopenia. We present the case of a 21-year-old patient diagnosed with Epstein syndrome and hyperparathyroidism secondary to chronic kidney disease. The main particularity of this case resides in the association between megathrombocytopenia and secondary hyperparathyroidism requiring surgery, which could lead to a series of concerns regarding the intra- and postoperative hemorrhagic risk of the procedure. Nevertheless, both the surgical procedure and the postoperative recovery were uneventful, suggesting that the lower threshold for preoperative thrombocyte count in megathrombocytopenia should be specifically considered on an individual case analysis.

Primary diffuse large B-cell lymphoma of the testis.

Non-Hodgkin's lymphomas are chronic lymphoproliferative disorders, with nodal or extranodal onset, most of which being digestive tract lymphomas. Testicular primitive lymphoma generally affects men; it is rare but aggressive type of lymphoma. We present the case of the only patient diagnosed with testicular lymphoma in Hematology Clinic of Craiova, Romania, in the last 20 years. Histopathological and immunohistochemical exams confirmed the diagnosis of diffuse large B-cell lymphoma, and the stage was IIB. According to International Prognostic Index (IPI) score, the patient was classified as low risk. He received combined treatment consisting of surgery, chemotherapy, central nervous system prophylaxis and radiotherapy. The outcome was very good, the patient achieving complete remission. After 36 months, he is still in complete remission with clinical and biological evaluation performed every three month, and computerized tomography once a year.

The prognostic role of Bcl-2, Ki67, c-MYC and p53 in diffuse large B-cell lymphoma.

Diffuse large B-cell lymphoma (DLBCL) is a heterogeneous group of lymphoid malignancies, which counts for more than a third of non-Hodgkin's lymphoma cases. The aim of the current study is to evaluate the prognostic role of several immunohistochemical (IHC) markers involved in the pathological process of DLBCL. This is a retrospective analysis of the 97 de novo DLBCL patients admitted between January 2007 and December 2016 in the Department of Hematology, "Filantropia" Municipal Hospital, Craiova, Romania. The expression of Bcl-2, Ki67, c-MYC and p53 was assessed by immunohistochemistry. A significant level of association was observed between high prognostic index values and Bcl-2, Ki67, c-MYC and p53 positive cases. Moreover, overall survival and disease-free survival were higher in patients with negative expression for these markers. Bcl-2, Ki67, c-MYC and p53 could make important diagnostic and therapeutic targets; therefore, their routine assessment should be mandatory.

Correlation between Immunohistochemical Subtype and Clinicopathological Features in Patients with Diffuse Large B-cell Lymphoma.

The aim of this study was to establish correlations between certain clinical, biological, therapeutic factors and diffuse large B-cell lymphoma (DLBCL) subtypes. For this purpose, between January 2007 and December 2016 a total number of 97 patients with de novo diffuse large B-cell lymphoma were analyzed. Patients with a high prognostic index and non-GCB DLBCL positively correlated and exhibited lower survival rates than low IPI, GCB patients. IPI scoring system and cell-of-origin classification should be used together as a single valid prognostic evaluation tool for DLBCL.

Therapeutic Options in Diffuse Large B-Cell Lymphoma - A Retrospective Study and Review of the Literature.

The aim of this retrospective study was to assess the differences between standard R-CHOP and other Rituximab-associated chemotherapy (R-miniCHOP and R-CHOEP) regimens in terms of survival and potential adverse effects. The six-month survival outcomes of 94 diffuse large B-cell lymphomas (DLBCL) patients indicated no statistical difference between overall survival and disease-free survival in the two subgroups. The biological response to therapy (blood count, LDH levels) was similar in both subgroups. Despite having different clinical indications, R-miniCHOP and R-CHOEP provide viable therapeutic alternatives to the standard R-CHOP regimen.

Secondary haemochromatosis in a patient with thalassemia intermedia.

Haemochromatosis is due to excessive accumulation of iron in tissues and organs impairing their function. The most common haematologic disorders that are subject to an intensive transfusion regimen bringing excess iron in the body are: thalassemia and myelodysplastic syndrome. The value of serum ferritin in these patients (indicator of iron stores condition) reaches high values. Red cell substitution bringing additional iron intake must be accompanied by administration of chelation therapy in order to prevent haemochromatosis and related complications. We present the case of a patient with thalassemia intermedia, integumentary secondary haemochromatosis, cirrhosis with haemochromatosis, and secondary diabetes, who died at the age of 33 years because of upper gastrointestinal bleeding due to the rupture of oesophageal varices.

Evaluation of parameters with potential prognosis impact in patients with primary gastric diffuse large B-cell lymphoma (PG-DLBCL).

BACKGROUND: Primary gastric lymphoma is the most common malignancy of the stomach after gastric adenocarcinoma. Most cases are represented by the aggressive histological type (diffuse large B-cell lymphoma). AIM: Identification of factors with potential prognosis impact in the aggressive primary gastric lymphoma and the prognosis profile of the patient with impact on the response to therapy and overall survival. PATIENTS AND METHODS: The study group is composed of 49 patients diagnosed with primary gastric diffuse large-cell non-Hodgkin's malignant lymphoma at "Fundeni" Hematology Clinic of Bucharest and at the Hematology Clinic of Craiova, Romania, in the period 2005-2010. There were evaluated the following parameters in the attempt to establish correlations between the various studied parameters and the response to treatment, in order to establish the prognosis factors: erythrocyte sedimentation rate (ESR), hemoglobin, serum albumin, serum lactate dehydrogenase (LDH), beta-2 microglobulin, presence of serous infiltration, presence of locoregional adenopathies, bulky tumor, stage of disease, international prognostic index (IPI), quick response to therapy (reduction of >50% in tumor volume after two courses), presence of disease relapses, type of treatment - resection + chemotherapy versus chemotherapy alone, chemotherapy versus chemotherapy + Rituximab. RESULTS: We found the following negative prognosis factors: the presence of disease relapse, the value of beta-2 microglobulin higher than 3 mg/dL, the presence of serous infiltration, IPI 3. CONCLUSIONS: Identifying prognostic factors is important for personalized therapy approach to obtain optimal response with minimal adverse reaction.

Micromolecular multiple myeloma with chronic kidney failure in a young female patient on continuous hemodialysis.

The maximum incidence of multiple myeloma appears in the 6th-7th decade of life and although the number of patients aged les than 60 years is increasing in recent years, the diagnosis of a monoclonal gammopathy in a young patient, under the age of 40 years remains a rarity. Literature data cite an incidence of approximately 2.2% in patients less than 40-year-old and an incidence of 0.3% in patients less than 30-year-old of all cases diagnosed with multiple myeloma. We present the case of a 32-year-old patient, being on continuous hemodialysis for chronic kidney failure for about a year, at the Hematology Clinic of Craiova, Romania. We investigate the origin of a serum monoclonal component revealed when performing serum protein electrophoresis. Bone marrow examination revealed the presence of a plasma cell infiltrate of 18%, which associated with the presence of a serum monoclonal component and in the conditions of renal failure as a complication of the disease, has allowed the diagnosis of multiple myeloma.

A case of non-Hodgkin lymphoma in a patient with chronic myeloid leukemia.

Chronic myeloid leukemia is a clonal expansion of hematopoietic progenitor cells characterized by exaggerated proliferation of granulocytic lineage, with chronic phase, accelerated phase and blast crisis. Accelerated phase and blast crisis may be associated with extramedulary disease. Extramedullary transformation of CML can be determined both in nodal and extranodal sites. Non-Hodgkin lymphoma is rare in chronic myeloid leukemia and may be misdiagnosed as an extramedullary lymphoid blast transformation; the majorities are T-cell lymphomas with an immature thymic phenotype, while peripheral B-cell lymphomas are rarer. We report the case of a 79-year-old woman carrier Ph+ chronic myeloid leukemia who developed at eight months of diagnosis an accelerated phase of CML associated simultaneous with a tumor of soft palate, which was initial considering an extramedullary disease. The patient was treated with specific chemotherapy for accelerated phase of CML (Cytosinarabinoside) + Anagrelide, and reversed to secondary chronic phase of CML, but soft palate tumor persists. The immunohistochemical findings of bone marrow trephine biopsy examination showed chronic phase of CML (negativity for immature cells such as CD34, Tdt) and the biopsy of soft palate tumor and immunohistochemical findings revealed a primitive non-Hodgkin lymphoma (NHL) with medium B-cells (CD20, CD79a positive) and excluding an extramedullary blast crisis (CD34 negative, Tdt negative). Cytogenetic analysis in tumor revealed absence of Philadelphia chromosome. The patient was treated with local radiotherapy for NHL, with a favorable evolution and Hydroxyurea 1 g/day for CML with hematological remission. A localized lymphoid neoplasm may be an extramedullary localized blast crisis of CML or a distinct malignancy, with distinguished therapy and prognosis. A correct diagnosis based on a complex investigation: immunohistochemistry, conventional cytogenetic analysis and fluorescence in situ hybridization (FISH), molecular analysis (Southern blot and RT-PCR) is necessary. Further studies are required to clarify the pathogenetic relationship between chronic myeloid leukemia and non-Hodgkin lymphomas.

Surface morphology of leukemic cells from chronic myeloid leukemia under atomic force microscopy.

Atomic force microscopy (AFM) represents an important instrument for measuring mechanical properties of biological materials ranging from single molecules to normal or malignant cells. AFM provides a 3D profile of the surface on a nanoscale, by measuring forces between a sharp probe (<10 nm), supported on a flexible cantilever, and surface at very short distance (0.2-10 nm probe-sample separation). The AFM tip "gently" touches the surface and records the small force between the probe and the surface. The patients were three normal human subjects and nine patients with chronic myeloid leukemia in different phases of disease. With atomic force microscope, numerous spicules were observed on the surface of leukemic cells, especially in blastic phase of CML.