Hypophosphatemia-induced neuropathy: clinical and electrophysiologic findings

Severe hypophosphatemia has rarely been reported as a cause of acute paralysis. We present the clinical and electrophysiological findings on a patient who developed quadriparesis following several surgeries for complicated cholecystectomy. The paralysis was most likely the result of severe hypophosphatemia causing a neuropathy which improved readily after proper phosphate replacement. The possible pathogenic mechanisms of hypophosphatemic neuropathy are discussed.     

Prognostic significance of bcl-2 protein expression in aggressive non-Hodgkin's lymphoma. Groupe d'Etude des Lymphomes de l'Adulte (GELA)

Little is known about the expression of bcl-2 protein in intermediate and high grade non-Hodgkin's lymphoma (NHL) and its clinical and prognostic significance. We performed immunohistochemical analysis of bcl-2 expression in tumoral tissue sections of 348 patients with high or intermediate grade NHL. These patients were uniformly treated with adriamycin, cyclophosphamide, vindesine, bleomycin, and prednisone (ACVBP) in the induction phase of the LNH87 protocol. Fifty eight cases were excluded due to inadequate staining. Of the 290 remaining patients, 131 (45%) disclosed homogeneous positivity (high bcl-2 expression) in virtually all tumor cells, whereas 65 (23%) were negative and 94 (32%) exhibited intermediate staining. High bcl-2 expression was more frequent in B-cell NHL (109 of 214, 51%) than in T-cell NHL (6 of 35, 17%) (P = .0004), and was heterogeneously distributed among the different histological subtypes. Further analysis was performed on the 151 patients with diffuse large B-cell lymphoma (centroblastic and immunoblastic) to assess the clinical significance and potential prognostic value of bcl-2 expression in the most frequent and homogeneous immunohistological subgroup. High bcl-2 expression, found in 44% of these patients (67 of 151), was more frequently associated with III-IV stage disease (P = .002). Reduced disease-free survival (DFS) (P < .01) and overall survival (P < .05) were demonstrated in the patients with high bcl-2 expression. Indeed, the 3-year estimates of DFS and overall survival were 60% and 61%, respectively (high bcl-2 expression) versus 82% and 78%, respectively (negative/intermediate bcl-2 expression). A multivariate regression analysis confirmed the independent effect of bcl-2 protein expression on DFS. Thus bcl-2 protein expression, as demonstrated in routinely paraffin-embedded tissue, appears to be predictive of poor DFS, in agreement with the role of bcl-2 in chemotherapy-induced apoptosis. It might be considered as a new independent biologic prognostic parameter, which, especially in diffuse large B-cell NHL, could aid in the identification of patient risk groups.     

Rhabdomyosarcoma of the orbit. Evaluation with MR imaging and CT

Rhabdomyosarcoma is the most common primary orbital malignancy of childhood. It can present insidiously, mimicking other (benign) processes clinically and radiographically. CT and MR imaging are crucial in the diagnostic evaluation, treatment planning, and follow-up monitoring of the disease. Such imaging, especially when contrast is used, can accurately detect and state the extent of tumor involvement.     

Lack of association between type of hepatitis C virus, serum load and severity of liver disease

The NOD mouse is known as a spontaneous model of insulin-dependent diabetes mellitus. Fetuses in this strain present anomalies of the viscera, and the incidence increases in fetuses from dams with clinically manifested diabetes. To examine the role of maternal diabetes and the genetical influence in inducing heterotaxy, NOD dams were mated with males of the ICR strain (the original strain of the NOD) and with C57BL/6J sires (not genetically related to the NOD). The frequency of visceroatrial heterotaxy in fetuses from diabetic dams varied with the fetal genotype, being 65% (33/51) in NODxNOD (dam X sire, respectively), 24% (12/50) in NODxICR, and 7% (4/57) in NODxC57BL/6J. The cases with heterotaxy showed a tendency toward right isomerism of the viscera and had severe cardiac defects, such as endocardial cushion defect and double-outlet right ventricle or transposition of the great arteries. The fetal body weight from diabetic dams in each mating was lower than that from non-diabetic dams (P < 0.05), suggesting that maternal diabetes, rather than abnormal situs, is the main determinant for decreased fetal growth. These findings demonstrate that the liability to heterotaxy induced by maternal diabetes is influenced by the fetal genotype.     

Effect of different experimental parameters on the potentiometric evaluation of blood electrolytes using K+ as a test cation

Potentiometric evaluation of ionic concentrations in physiological media has been reported to be significantly affected by the albumin containing matrix. Previous studies have attempted to clarify the origin of different patterns of variation of E versus albumin concentration at a constant 0.01 mol dm-3 KCl, depending on the experimental methodologies. This paper reports on measurements of K+ in albumin (BSA) containing KCl solutions, which have been pursued following different methodologies concerning the sequence of measurements, i.e., starting either from the most concentrated solution (100 g dm-3) (A) or from the most dilute solution (20 g dm-3) (B), and solution preparation, (a) dilution of an initial 100 g dm-3 albumin solution by successive addition of 0.01 mol dm-3 KCl, (b) concentration of an initial 20 g dm-3 albumin solution by addition of solid substance, (c) independent preparation of each albumin solution (20, 40, 60, 80 and 100 g dm-3) or (d) preparation of each albumin solution from direct dilution of a 100 g dm-3 stock solution with 0.01 mol dm-3 KCl. Convenient calculations were made and showed a significant contribution of albumin to the liquid-liquid junction potential. The variation of potential with albumin concentration is smaller for hypertonic than for isotonic bridge solutions, both for the dilution series (A,a and A,d) and for the concentration series (B,c and B,d). When the method for increasing the concentration is performed by addition of a solid substance to an initially diluted albumin (B,b), the slope of the E versus albumin concentration plot is larger for hypertonic than for isotonic reference electrolytes. This latter finding is in agreement with Payne's results when ultrafiltration was used to concentrate a protein solution. These observations are a clear indication that the method of preparation of concentrated protein solutions may significantly affect the results.