Helicobacter pylori (H. pylori) molecular signature in conjunctival mucosa-associated lymphoid tissue (MALT) lymphoma.

Conjunctival mucosa-associated lymphoid tissue (MALT) lymphoma is an extranodal marginal zone B-cell lymphoma that is characterized by an exaggerated clonal expansion of B cells, which implicate a pathological proliferative response to antigen(s) including bacteria. Helicobacter pylori (H. pylori) infection is recognized as one of the causative agents of gastric MALT lymphoma; however, it has not been reported in extra gastric MALT lymphoma. We studied 5 patients (4 adults and 1 child) with salmon-colored conjunctival lesions. One patient also had a history of abnormal bone marrow biopsy a year earlier with lymphoid aggregates involving 5% of the overall bone marrow. The conjunctival lesions of the 5 patients were biopsied. Histopathological diagnoses were consistent with conjunctival MALT lymphoma. Lymphoma and normal conjunctival cells were microdissected using laser capture microscopy or manual techniques. DNA was extracted and subjected to PCR amplification using H. pylori gene-specific primers from the urease B and vac/m2 gene. Cells from chronic conjunctivitis (normal lymphocytes), conjunctival human T-cell lymphotropic virus type-1/adult T-cell leukemia/lymphoma (HTLV-1/ATL), and orbital B-cell lymphoma were also microdissected, processed and analyzed. PCR amplification and Southern blot hybridization demonstrated H. pylori DNA in the conjunctival MALT lymphoma cells of 4/5 cases. The negative case was the one with a history of abnormal bone marrow. In contrast, H. pylori gene was not detected in normal conjunctival cells from the cases of MALT lymphoma or the lymphocytes, ATL and orbital B-lymphoma cells from the controls. These data suggest that H. pylori may play a role in conjunctival MALT lymphoma.

Correlation of high-frequency ultrasound backscatter with tumor microstructure in iris melanoma.

OBJECTIVE: This study aimed to correlate histologic characteristics with high-frequency ultrasound backscatter spectra in malignant melanomas of the iris. DESIGN: The study design was a cohort (case series) study of patients diagnosed with iris melanoma in the authors' clinic. PARTICIPANTS: Sixteen patients with iris melanoma participated. INTERVENTION: The patients were scanned with a 50-MHz ultrasound unit equipped for digitization of raw echo data. Spectral parameter images representing the spatial distribution of size and concentration of tissue inhomogeneities were produced. MAIN OUTCOME MEASURES: The variation of spectral properties within and between tumors was determined. In the two tumors in this series for which histologic material was available, the authors compared scatterer concentration and size with histology and mathematically modeled the effect of melanocyte distribution on spectra. RESULTS: Ultrasound scattering characteristics differed considerably among tumors. Where histology was available, acoustic parameters correlated with the size and number of melanocytes present. CONCLUSIONS: Iris melanomas exhibited a wide range in acoustic backscatter properties. Whereas characteristics such as vascularity and necrosis might contribute to this, in the two cases examined here, backscatter characteristics could be largely accounted for by melanocyte distribution. A better understanding of the relationship of histology to noninvasive ultrasound data will enhance the diagnostic utility of this technique.

Imaging and spectrum analysis of contrast agents in the in vivo rabbit eye using very-high-frequency ultrasound.

We have conducted initial studies that demonstrated the feasibility of employing ultrasonic contrast agents with very-high-frequency ultrasound (VHFU), using wideband transducers with center frequencies near 40 MHz. These studies were undertaken with an ultimate objective of quantifying perfusion in vessels in the eye and other organs. We expanded the model developed by Lizzi et al. (1983) to incorporate the scattering characteristics from encapsulated bubbles, such as contrast agents. Our analysis shows how the spectral slopes and intercepts measured from contrast agents are related to factors that include the radii and concentration of contrast-agent particles. We conducted in vitro experiments to validate the theoretical predictions and obtained excellent agreement. We obtained in vivo VHFU data from the eyes of anesthetized rabbits before and after injection of Albunex and Aerosomes. Digitally computed B-mode images demonstrated echo enhancement within the ciliary body and its processes. The magnitudes of these enhancements were quantified using calibrated spectrum-analysis techniques.

Three-dimensional ultrasound imaging. Clinical applications.

OBJECTIVE: The aim of this report is to describe the technology of three-dimensional (3-D) ultrasonic imaging and its impact on improved diagnosis and monitoring of ocular disease. DESIGN: The authors reviewed techniques for acquiring and displaying 3-D ultrasound data of the eye. PARTICIPANTS: The authors applied these techniques to representative individual cases, including a choroidal hemorrhage, a ciliary body melanoma, a ciliary body detachment, a displaced posterior chamber intraocular lens, and topographic analysis of a normal cornea. INTERVENTION: A computer-controlled motion system was used to perform very high-frequency (VHF) (50-MHz) and conventional (10-MHz) digital 3-D ultrasound data collection. The scanning system allowed digitization of ultrasound data from a series of parallel planes. The 3-D data could be manipulated interactively to obtain two-dimensional images in any plane through the scan volume. The 3-D images were constructed by volume rendering and could be positioned for viewing from a variety of perspectives. The 3-D ultrasound parameter images representing acoustic scatterer properties were generated by spectrum analysis of digitized echo data. Color maps representing the contour and thickness of the epithelium and stroma of the central corneal were generated by digital signal processing of 3-D echo data. RESULTS: Quantitative volume measurement and biometric techniques enhanced the diagnostic and treatment planning information content in 3-D ultrasound images. The location and extent of hemorrhage and clots within the suprachoroidal space were shown with solid modeling. Volume changes in ciliary body melanoma over time were documented and 3-D ultrasound parameter image changes associated with radiation therapy observed. In ciliary body detachment, the extent of the detachment was shown. Solid modeling of a posterior chamber intraocular lens showed misplacement of the haptic in relation to the lens capsule remnants. Keratopachymetric maps showed the range and variance of thickness and local radius of curvature measurements in the cornea. CONCLUSIONS: Quantitative volume measurement and biometric tools combined with segmentation of 3-D ultrasound images improve diagnostic and treatment planning informational content of 3-D ultrasound images through improved localization of tissue structures.

Ultrasonically induced hyperthermia for adjunctive treatment of intraocular malignant melanoma.

PURPOSE: This report describes results of a prospective pilot trial to evaluate the safety and efficacy of hyperthermia as an adjunct to enucleation or brachytherapy in the treatment of patients with intraocular malignant melanoma. METHODS: Twenty-five patients with intraocular malignant melanomas were treated with ultrasonically induced hyperthermia. In 14 patients, hyperthermia was administered before enucleation (median follow-up period, 44 months), and in 11 patients, hyperthermia was used as an adjunct to brachytherapy (median follow-up period, 79 months). RESULTS: Patient survival in each group was compared with that of a control group treated with enucleation or brachytherapy alone, using Kaplan-Meier and Cox analysis. Taking into account the simultaneous effects of tumor size and location, the relative risk ratios and 95% confidence bounds associated with adjunctive hyperthermia were 1.68 (range, 0.60-4.72) and 0.68 (range, 0.16-2.89) for the enucleation and brachytherapy groups, respectively. CONCLUSIONS: Patients receiving adjunctive hyperthermia with brachytherapy showed increased survival, whereas those receiving hyperthermia before enucleation showed decreased survival. Neither trend was statistically significant in this small series. The synergism of hyperthermia with radiation may offer the possibility of improved tumor management.

Ophthalmic, ultrasonographic findings in primary central nervous system lymphoma with ocular involvement.

PURPOSE: To describe and classify ophthalmic, ultrasonographic findings in patients with primary central nervous system lymphoma with ocular involvement. METHODS: B- and A-scan ultrasonography was performed on the eyes of 13 patients with primary central nervous system lymphoma with ocular involvement. RESULTS: In seven patients, the eyes were the site of initial involvement. In the other six patients, both ocular and central nervous system disease were present at the initial evaluation. All patients had abnormal ultrasonographic findings. The most common were vitreous debris (n = 10), choroidal-scleral thickening (n = 6), and widening of the optic nerve (n = 4). Elevated chorioretinal lesions (n = 3) and retinal detachment (n = 2) were also found. CONCLUSION: Ophthalmic ultrasonography is a useful adjunctive diagnostic technique for characterizing ocular involvement in lymphoma. Ocular lymphoma may present as chorioretinitis, vitreitis and nonspecific uveitis; it produces characteristic, but nonspecific findings on ultrasonography. The diagnosis of ocular involvement is an important factor in determining treatment.

Developmentally regulated herpesvirus plaque formation in arterial smooth muscle cells.

Previous studies of age-related susceptibility to viral infection have focused largely on the effects of aging on the immune response. Little attention has been given to age-related changes in the infectivity of target cells. We show here a fourfold greater plating efficiency of herpes simplex virus type 1 (HSV-1) for cultured vascular smooth muscle cells derived from adult rats compared with cells from genetically identical pup rats. The difference in plating efficiency appeared to be due to differences in initial attachment of the virion to the cell surface. There were no differences in the rate of viral entry or the efficiency of viral replication at high multiplicities of infection and no resistant "subpopulation" of pup cells. The pup cells did not release a soluble inhibitor of infection. Infection in both cell types was inhibited similarly by basic fibroblast growth factor (bFGF). Although adult cells exhibited a more vigorous mitogenic response to bFGF than did pup cells, binding studies did not demonstrate significant differences in the binding of bFGF to the cell surface, suggesting that differential expression of high-affinity FGF receptors could not be correlated with the difference in infectivity. We speculate that differences in the distribution of heparan sulfate in the cell surface, which serves as the initial attachment site for HSV-1, may explain the observed differences in plating efficiency. Since age is a risk factor for the development of atherosclerosis, these results have potential implications for susceptibility of the vasculature to herpesviral infections as a function of the development of the vessel wall.

[Carbonic anhydrase inhibitors in the treatment of gastro-duodenal ulcer]. / Inhibidores de la anhidrasa carbónica en el tratamiento de la ulcera gastro-duodenal

The authors present the results of treatment with acetazolamide of gastroduodenal ulcer (356 gastric ulcer, 1.250 duodenal ulcers--859 with craters--, 24 pyloric stenosi with functional components, and 42 postgastrectomy peptic ulcers). The acetazolamide was administed in daily dosis of 25-30 mg/kg of body weight, sodium and potassium salts were added, and the liquid intake was increased (approx. 2 1 daily). A control was kept of the clinical, secretory, radiological, enzymological, and hydrolectrolytical modification. A decrease is observed of the in the carbonic anhidrase of the gastric mucosa and of the gastric secretion. There is also an increase in the gastric protection factors and a disappearance of ulcer pain. There are no significant hydroelectrolytic modifications of the blood. From a radiogical point of view, the crater of the postoperative gastric, pyloric and peptic ulcer disappears after 2 weeks of treatment, and in duodenal ulcers in 89% of the cases in 3 weeks. The method is the same time a quick, simple, an efficient therapeutic test for the differentiation of the gastric craters. The drug is well tolerated. Nevertheless a clinical, secretory and radiological control of the patients is necessary taking into account the counter-indication for the administration of acetazolamide.