Relationship of decreased chemotaxis of technetium-99m-HMPAO-labeled lymphocytes to apoptosis

The purpose of this study was to evaluate chemotaxis and its relationship to apoptosis in 99mTc-HMPAO-labeled lymphocytes. METHODS: Peripheral lymphocytes, obtained from 12 healthy volunteers using lymphoprep, were divided in three equal fractions. One fraction was used as the control, one was labeled with cold HMPAO and one was labeled with 1.5 mCi (55.5 Mbq) 99mTc-HMPAO. Chemotaxis of T-lymphocytes was measured by the Boyden microchamber technique (BMA) (n = 8) using human monocyte chemotactic protein-3 (MCP-3) as chemoattractans. A chemotactic index was calculated as the number of HMPAO and 99mTc-HMPAO-labeled cells that migrated towards the MCP-3 solution, divided by the number of nonlabeled migrated lymphocytes. Apoptosis evaluation (n = 10) of unlabeled, HMPAO-labeled and 99mTc-HMPAO-labeled cells was performed using flowcytometry (FCM) forward light scatter analysis, 900 light scatter analysis, fluorescein-isothiocyanate (FITC)-labeled Annexin V and dye exclusion of propidium iodide. RESULTS: Chemotaxis of 99mTc-HMPAO-labeled T-lymphocytes was found to be reduced by approximately 31% (migration index of 0.69) (p = 0.01) as compared to both unlabeled and HMPAO-labeled lymphocytes, both the latter showing no difference in migration index. Whereas the mean percentages apoptotic lymphocytes in the unlabeled, 18.5%, and HMPAO-labeled fraction, 16.6%, were more or less comparable (p = 0.1), the mean percentage apoptotic cells in the 99mTc-HMPAO-labeled fraction was 51.8%, yielding a difference of 33.3% between 99mTc-HMPAO-labeled and unlabeled cells (p = 0.003). The procentual concordance between apoptotic cells (33.3%) and chemotactic impaired cells (31%) in the 99mTc-HMPAO-labeled fraction may be explained by the formation of a rigid cytoskeleton early in the apoptotic process that may theoretically limit chemotaxis. CONCLUSION: Using the BMA, chemotaxis of 99mTc-HMPAO-labeled lymphocytes was found to be reduced by approximately 31%. Furthermore, the percentage apoptotic lymphocytes induced by irradiation after labeling with 99mTc-HMPAO concurs well with the percentage of chemotaxis impaired cells.     

Computer-assisted medical education

The article evaluates the multimedia titles offer for IBM PC compatible computers for medicine teaching in comparison with the other titles serving mostly as information source for postgraduate studies. The author explains common forms and functions used for comfortable information exploitation. The conclusion is that the year 1995 in the break point in the computer assisted medicine teaching and now some disciplines can use tenths of programs already.     

Bone marrow transplantation for severe aplastic anemia: has outcome improved?

Bone marrow transplants for severe aplastic anemia were first performed in the 1970s. Transplant regimens, supportive care, and patient selection have changed substantially since then. Our objective was to determine the impact of these changes on transplant outcome. We studied 1,305 recipients of HLA-identical sibling transplants for aplastic anemia between 1976 and 1992, reported to the IBMTR by 179 centers. We compared survival of transplants performed in three intervals (1976 through 1980 [n = 186], 1981 through 1987 [n = 648], and 1988 through 1992 [n = 471]) using Cox proportional hazards regression. Five-year survival (+/-95% confidence interval) increased from 48% +/- 7% in the 1976-1980 cohort to 66% +/- 6% in the 1988-1992 cohort (P < .0001). Risks of graft-versus-host disease (GVHD) and interstitial pneumonia decreased over time, but the risk of graft failure did not. Higher long-term survival resulted primarily from decreased mortality in the first 3 months posttransplantation. Late mortality risks were low and changed little over the intervals studied. In multivariate analysis, changes in transplantation strategies accounted for most but not all of the improved outcome. Use of cyclosporine to prevent GVHD was the most important factor. Changes in patient selection did not seem to explain improved survival. Survival after HLA-identical sibling bone marrow transplantations for aplastic anemia has improved since 1976. Changes in GVHD prophylaxis account for much of this improvement. Other changes may also operate.     

Prognostic factors in advanced stage non-small cell bronchial cancer: experiences of the European Lung Cancer Working Party

The European Lung Cancer Working Party has investigated prognostic factors for response, overall survival, long term survival in a population with advanced non small cell lung cancer registered in a clinical trial evaluating platinum derivatives-containing chemotherapy regimens. Various factors have been identified in multivariate analyses and were classified using RECPAM methodology. In addition to the clinical factors such as disease extent and performance status were shown, as significant predictors, rarely studied biological factors like pretherapeutic leucocyte and polynuclear levels. The obtention of an objective response to chemotherapy appeared to be a major prognostic factor for further survival.     

Age-dependent tetrahydrothiophenium ion formation in young children and adults receiving high-dose busulfan

Busulfan, a bifunctional alkylating agent, is a mainstay of myeloablative preparative regimens before hematopoietic stem cell transplantation. The apparent oral clearance of busulfan expressed relative to body surface area is 2-3-fold higher in children 1-4 years old than it is in adults. The first step in busulfan elimination is the formation of a tetrahydrothiophenium ion (THT+) in a glutathione S-transferase-catalyzed reaction. We present computer simulations that demonstrate that the ratio of the AUC of THT+ to that of busulfan over 6 h [(AUC(THT+)/AUC(BU))(0-->6)] is highly correlated (r2 = 0.805) with the determinants of THT+ formation and is virtually independent of the determinants of its elimination (r2 = 0.0201). We compared (AUC(THT+)/AUC(BU))(0-->6) determined in 14 children (0.5-4 years) to that of 11 adults (12-54 years) and found a 1.5-fold elevation in the area ratio (P = 0.0098) and a similarly significant increase in busulfan apparent oral clearance expressed relative to body surface area (P = 0.042). The only common explanation for the elevated busulfan apparent oral clearance and (AUC(THT+)/AUC(BU))(0-->6) is an enhanced ability of children to metabolize busulfan through glutathione conjugation.