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71.
Splenomegaly is uncommon in myelodysplasia (MDS) and, although cytopenias may be severe, therapeutic splenectomy is rarely performed. We report the histologic, histochemical, and immunophenotypic findings of nine cases of surgical splenectomy and four postmortem spleens from MDS patients. Four histologic patterns were identified: one dominated by erythrophagocytosis, one characterized by red pulp plasmacytosis, one with extramedullary hematopoiesis as the only salient finding, and one with marked red pulp expansion caused by a monocytic proliferation. Wright-Giemsa and histochemical stains were performed on touch preparations in three cases and played a critical role in the precise subclassification of one MDS patient's hematologic disorder, which ultimately proved to be chronic myelomonocytic leukemia. Splenectomy led to sustained improvement of cytopenias in three cases, but did not eliminate transfusion dependence for the remaining patients. Three splenectomy cases exhibited clustered Leder-negative mononuclear elements: two of these patients experienced disease progression to refractory anemia with excess blasts in transformation or acute myelogenous leukemia during post-splenectomy follow-up, whereas none of the three splenectomy patients without clustered mononuclear elements did. We conclude that splenomegaly in MDS usually reflects the sequelae of dyspoiesis rather than evidence of a proliferative phase, that clustering of Leder-negative large cells may correlate with either a substantial monocytic component or, possibly, increased risk of disease progression, and that the spleen can provide diagnostic as well as prognostic information in MDS patients with splenomegaly. 相似文献
72.
G Cantù N Pizzi F Mattavelli P Salvatori L Licitra CL Solero 《Canadian Metallurgical Quarterly》1998,18(3):135-142
This article introduces the basic principles of reading electrocardiograms (ECGs) for nurses who are unfamiliar with reading them. For more experienced practitioners there are a number of useful articles and books (e.g. Hampton, 1992a, b) that will help further their knowledge. The ECG records cardiac electrical activity as a graph; interpretation is illustrated here by sinus rhythm. A single ECG lead (lead II) is used throughout this article. Atrial fibrillation is described to show a contrasting dysrhythmia. Specific nursing care is suggested for patients being monitored or having ECGs taken. 相似文献
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JG Gribben GJ Freeman VA Boussiotis P Rennert CL Jellis E Greenfield M Barber VA Restivo X Ke GS Gray 《Canadian Metallurgical Quarterly》1995,92(3):811-815
The regulation of T cell-mediated immune responses requires a balance between amplification and generation of effector function and subsequent selective termination by clonal deletion. Although apoptosis of previously activated T cells can be induced by signaling of the tumor necrosis factor receptor family, these molecules do not appear to regulate T-cell clonal deletion in an antigen-specific fashion. We demonstrate that cross-linking of the inducible T-cell surface molecule CTLA4 can mediate apoptosis of previously activated human T lymphocytes. This function appears to be antigen-restricted, since a concomitant signal T-cell receptor signal is required. Regulation of this pathway may provide a novel therapeutic strategy to delete antigen-specific activated T cells. 相似文献
75.
KB/7D cells represent a multidrug-resistant subclone of human nasopharyngeal carcinoma KB cells generated by continuous exposure to the topoisomerase II inhibitor VP-16 (etoposide). KB/7D cells also show cross-resistance to doxorubicin and vincristine. Phenotypic traits of the cell line include a 2-fold decrease in topoisomerase II levels and a decrease in the uptake of VP-16 without an increase in the rate of drug efflux or expression of P-glycoprotein, suggesting a novel mechanism associated with the uptake of anticancer drugs. This study demonstrated that the multidrug-resistance associated protein (MRP) is overexpressed in KB/7D cells, and that the loss of resistance in revertant cells correlates with the loss of MRP. The resistance to VP-16 and doxorubicin could be overcome, partially, and resistance to vincristine could be overcome completely, by the L-enantiomer of verapamil, but not by the D-enantiomer or by BIBW 22 (4-[N-(2-hydroxy-2-methyl-propyl)-ethanolamino]-2,7-bis[cis-2,6-++ +dimethylmorpholino)-6-phenylpteridin), an inhibitor of MDR-1. L-Verapamil was shown to be significantly more potent than D-verapamil in modulating the accumulation defect in KB/7D cells towards doxorubicin, as measured by flow cytometry and confocal microscopy, and towards VP-16, as measured by increases in protein-linked DNA strand breaks. This suggests that KB/7D cells are multidrug resistant due to decreases in topoisomerase II levels and the overexpression of MRP, that MRP leads to a decrease in drug accumulation, and that L-verapamil can modulate the MRP-associated accumulation defect and drug-resistance phenotype. This contrasts with previous studies that suggest that MRP causes multidrug resistance by exporting cytotoxic drugs out of the cell and that did not show modulation of MRP by verapamil. 相似文献
76.
77.
JP Edwards SJ West CL Pooley KB Marschke LJ Farmer TK Jones 《Canadian Metallurgical Quarterly》1998,8(7):745-750
Typhoid fever is often associated with abnormal liver biochemical tests, but severe hepatic involvement with a clinical feature of acute hepatitis is a rare complication. There have been more than 150 cases of salmonella hepatitis reported from both developed and developing countries. The documented incidence varies widely from less than 1% to 26% patients with enteric fever. The possible associated factors for development of salmonella hepatitis are virulence of the organisms, delayed treatment and poor general health of the patients. The pathogenesis of severe hepatic involvement in salmonella infection may be multifactorial and includes endotoxin, local inflammatory and/or host immune reactions. Clinical jaundice in salmonella hepatitis usually occurs within the first 2 weeks of the febrile illness. Hepatomegaly and moderate elevation of transaminase levels are common findings. Extreme hepatic dysfunction with hepatic encephalopathy is a rare coexisting complication in salmonella hepatitis. A positive culture for salmonella from blood or stool is essential to differentiate salmonella hepatitis from other causes of acute hepatitis. Hepatic pathology is characterized by the presence of typhoid nodules with marked hyperplasia of reticuloendothelial cells. The prognosis is usually good as salmonella hepatitis responds well to a specific antibiotic therapy and juandice resolves with clinical improvement. The clinical course can be severe with a mortality rate as high as 20%, particularly with delayed treatment or in patients with other complications of salmonella infection. As enteric fever is a common infection, the recognition of salmonella hepatitis is of clinical importance. 相似文献
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79.
Chih-Ming Hsu 《Neural computing & applications》2014,24(6):1293-1309
Multiresponse parameter design problems have become increasingly important and have received considerable attention from both researchers and practitioners since there are usually several quality characteristics that must be optimized simultaneously in most modern products/processes. This study applies support vector regression (SVR), Taguchi loss function, and the artificial bee colony (ABC) algorithm to develop a six-staged procedure that resolves these common and complicated parameter design problems. SVR is used to model the mathematical relationship between input control factors and output responses, and the ABC algorithm is used to find the optimal control factor settings by searching the well-constructed SVR models in which the Taguchi loss function is applied to evaluate the overall performance of a product/process. The feasibility and effectiveness of the proposed approach are demonstrated via a case study in which the design of a total internal reflection (TIR) lens is optimized while fabricating an MR16 light-emitting diode lamp. Experimental results indicate that the proposed solution procedure can provide highly robust design parameter settings for TIR lenses that can be directly applied in real manufacturing processes. Comparisons with the Taguchi method reveal that the Taguchi method is an undesirable and inappropriate method for resolving multiple-response parameter design problems, while the ABC algorithm can search the solution spaces in continuous domains modeled via SVR instead of in the limited discrete experiment levels, thus finding a more robust design than that obtained by the traditional analysis of variance. Consequently, the proposed integrated approach in this study can be considered feasible and effective and can be popularized as a useful tool for resolving general multiresponse parameter design problems in the real world. 相似文献
80.
Highly oriented poly(p-phenylene benzobisthiazole) films were stressed in a miniature hydraulic tensile tester interfaced to a fast scanning Fourier transform infra-red spectrometer. The changes in relative intensity, polarization, frequency and shape of infrared bands have been useful in the elucidation of microstructures. With the short time resolution achievable, vibrational bandshape and frequency have been shown to change at different rates when an external stress was applied. 相似文献