Improved alcohol-fixed smears of fine-needle aspirates for cytology of breast and other palpable lesions

The application of fine-needle aspiration cytology for the diagnosis of solid lesions is well-established. Its sensitivity as a diagnostic tool for both benign and malignant lesions can vary significantly, however, and depends on the quality of the smears submitted. In particular, air-drying artifact can render wet alcohol-fixed smears unsatisfactory for diagnosis. This study examines the basic cause of air-drying artifacts, which is directly related to the moisture of the aspirate that varies among tissues and specimens from any tumor type. A simple modification to the standard smearing technique incorporating precoated slides that introduces moisture into the aspirate is recommended. The technique is applicable to aspirates from all sites without compromising accepted diagnostic cytologic criteria, and offers excellent cytologic clarity with routine stains as well as being flexible enough for other investigative staining methods.     

A GENERALIZED APPROACH TO MODELING THE HIERARCHICAL MAXIMAL COVERING LOCATION PROBLEM WITH REFERRAL

ABSTRACT Several investigators have developed hierarchically structured maximal covering location problems, especially for hierarchies with two levels such as clinics and hospitals: Moore and ReVelle developed and applied a hierarchical covering model to a medical service delivery problem in Houduras; and Church and Falon developed two alternate model forms of hierarchical covering that were applied to a medical services planning, problem in Colombia. In this paper, we proposed a hybrid formulation that encompasses all three of these previous models and which allows for the trade-off of up of four different objectives. This new model formulation is also an improvement in that it has a significantly more efficient and compact structure, even while encompassing a more complete location problem, of which the three previous works are special cases. Example solutions are given for two different data sels involving regions in Colombia and Uganda. In addition, two further model formulations of a closely related nature are presented without computational results.     

Arthroplasty implant biomaterial particle associated macrophages differentiate into lacunar bone resorbing cells

OBJECTIVE: To study the pathogenesis of aseptic loosening: in particular, to determine whether macrophages responding to particles of biomaterials commonly used in arthroplasty surgery for arthritis are capable of differentiating into osteoclastic bone resorbing cells, and the cellular and hormonal conditions required for this to occur. METHODS: Biomaterial particles (polymethylmethacrylate, high density polyethylene, titanium, chromium-cobalt, stainless steel) were implanted subcutaneously into mice. Macrophages were isolated from the foreign body granulomas that resulted, cultured on bone slices and coverslips, and assessed for both cytochemical and functional evidence of osteoclast differentiation. RESULTS: Tartrate resistant acid phosphatase (TRAP) negative macrophages isolated from granulomas containing particles of all types of biomaterial composition were capable of differentiating into TRAP positive cells capable of extensive lacunar bone resorption (assessed by scanning electron microscopy). The presence of both UMR106 rat osteoblast-like cells and 1,25-dihydroxy vitamin D3 was necessary for this to occur. CONCLUSION: All implant materials produce wear particles that are the focus of a heavy foreign body macrophage response in the fibrous membrane between a loose implant component and the host bone undergoing resorption. These findings underline the importance of biomaterial wear particle generation and the macrophage response to different types of biomaterial wear particles in the pathogenesis of aseptic loosening.     

The use of interference currents and iodobromine baths in the therapy of patients with chronic nonobstructive pyelonephritis

30 patients were exposed to interference currents (IC) alone (group 1) versus 34 patients treated with IC plus iodobromine baths (group 2). After IC action on the region of the kidney projection patients of group 1 experienced positive changes in cellular and humoral immunity providing an antiinflammatory effect. In group 2, the improvement was seen in renal and urinary functions, 24-h urinary excretion of oxalates and calcium diminished. Interference current proved beneficial in chronic pyelonephritis patients with latent inflammation. The combined therapy was effective in patients at high risk of lithogenesis.     

Lipopolysaccharide-stimulated osteoclastogenesis is mediated by tumor necrosis factor via its P55 receptor

Chronic bone infection, as attends periodontitis, is often complicated by severe osteolysis. While LPS is believed to be central to the pathogenesis of the osteolytic lesion, the mechanisms by which this bacteria-derived molecule promotes bone resorption are unknown. We find that LPS induces bone marrow macrophages (BMMs) to express c-src, a protooncogene product that we demonstrate is a specific marker of commitment to the osteoclast phenotype. We next turned to possible soluble mediators of LPS-induced c-src. Of a number of osteoclastogenic cytokines tested, only TNF-alpha mirrors the c-src-enhancing effect of LPS. Suggesting that LPS augmentation of c-src is TNF-mediated, endotoxin sequentially induces BMM expression of TNF, followed by c-src. TNF and c-src expression, by cultured BMMs derived from LPS-injected mice, reflects duration of exposure to circulating endotoxin, intimating that endotoxin's effect in vivo is also mediated by TNF. Consistent with these findings, thalidomide (which antagonizes TNF action) attenuates c-src induction by LPS. An anti-TNF antibody blocks LPS enhancement of c-src mRNA, validating the cytokine's modulating role in vitro. Using BMMs of TNF receptor-deleted mice, we demonstrate that TNF induction of c-src is transmitted through the cytokine's p55, but not p75, receptor. Most importantly, LPS administered to wild-type mice prompts osteoclast precursor differentiation, manifest by profound osteoclastogenesis in marrow cultured ex vivo, and by a profusion of marrow-residing cells expressing the osteoclast marker tartrate resistant acid phosphatase, in vivo. In contrast, LPS does not substantially enhance osteoclast proliferation in mice lacking the p55TNF receptor, confirming that LPS-induced osteoclastogenesis is mediated by TNF in vivo via this receptor. Thus, therapy targeting TNF and/or its p55 receptor presents itself as a means of preventing the osteolysis of chronic bacterial infection.     

Using airborne laser scanning to monitor tree migration in the boreal-alpine transition zone

The boreal tree line is expected to advance upwards into the mountains and northwards into the tundra due to global warming. The major objective of this study was to find out if it is possible to use high-resolution airborne laser scanner data to detect very small trees — the pioneers that are pushing the tree line up into the mountains and out onto the tundra. The study was conducted in a sub-alpine/alpine environment in southeast Norway. A total of 342 small trees of Norway spruce, Scots pine, and downy birch with tree heights ranging from 0.11 to 5.20 m were precisely georeferenced and measured in field. Laser data were collected with a pulse density of 7.7 m^− 2. Three different terrain models were used to process the airborne laser point cloud in order to assess the effects of different pre-processing parameters on small tree detection. Greater than 91% of all trees > 1 m tall registered positive laser height values regardless of terrain model. For smaller trees (< 1 m), positive height values were found in 5-73% of the cases, depending on the terrain model considered. For this group of trees, the highest rate of trees with positive height values was found for spruce. The more smoothed the terrain model was, the larger the portion of the trees that had positive laser height values. The accuracy of tree height derived from the laser data indicated a systematic underestimation of true tree height by 0.40 to 1.01 m. The standard deviation for the differences between laser-derived and field-measured tree heights was 0.11-0.73 m. Commission errors, i.e., the detection of terrain objects — rocks, hummocks — as trees, increased significantly as terrain smoothing increased. Thus, if no classification of objects into classes like small trees and terrain objects is possible, many non-tree objects with a positive height value cannot be separated from those actually being trees. In a monitoring context, i.e., repeated measurements over time, we argue that most other objects like terrain structures, rocks, and hummocks will remain stable over time while the trees will change as they grow and new trees are established. Thus, this study indicates that, given a high laser pulse density and a certain density of newly established trees, it would be possible to detect a sufficient portion of newly established trees over a 10 years period to claim that tree migration is taking place.     

Accuracy of asthma treatment in schoolchildren in NSW, Australia

Insufficient use of anti-inflammatory drugs, such as inhaled corticosteroids and cromoglycate, may contribute to the disease burden associated with asthma. Conversely, aggressive treatment of mild disease may result in avoidable costs and/or adverse drug effects. The aim of this study was to determine the relationship between asthma severity and inhaled corticosteroid/cromoglycate use in a large (n=4,909) random sample of children, aged 8-11 yrs, in NSW, Australia. Asthma and its treatment were assessed by questionnaire responses. Asthma, defined as diagnosis plus current wheeze, was present in 901 children (18% of the sample), of whom 225 (5%) had moderate asthma, defined as asthma plus additional symptoms (sleep disturbance), utilization (hospital, casualty), or disability (reduced activity, school absence). Use of inhaled corticosteroid/cromoglycate was reported by 636 children (13% of the sample). Determinants of use included: asthma diagnosis, current wheeze, and troublesome dry nocturnal cough. There was also a strong relationship between anti-inflammatory treatment and a multicomponent asthma severity score constructed for each child. Inhaled corticosteroids and/or cromoglycate were used by 56% of the children with asthma (24% daily) and by 76% of children with moderate asthma (42% daily). Undertreatment, defined as less than daily inhaled corticosteroids/cromoglycate in moderate asthma, was identified in 130 children (14% of those with asthma or 3% of the sample). Conversely, apparently aggressive treatment, defined as inhaled corticosteroid/cromoglycate use in children with persistent minimal symptoms (asthma severity score of less than 3) was identified in 101 children (2% of the sample). Although there were significant differences between regions in the choice of anti-inflammatory drugs and in the prevalence both of undertreatment and apparently aggressive treatment, there was no clear relationship to regional utilization of emergency and hospital services for asthma. Nevertheless, the frequency of undertreatment suggests an opportunity to reduce asthma morbidity by more consistent application of current therapeutic guidelines.     

Aminopeptidases in cells of non-Hodgkin's lymphoma of varying degrees of malignancy and in lymphogranulomatosis

26 cases of lymphoproliferative diseases were studied: 8 cases of reactive follicular hyperplasia (RFH), 11 cases of non-Hodgkin's malignant lymphomas (NML), 7 cases of lymphogranulomatosis (LGM). Only gamma-glutamyl transpeptidase (GGT) was found in lymphoid cells of B- and T-dependent areas of lymph nodes with reactive changes as well as in tumor cells of NML and LGM. GGT activity was more pronounced in NML of high-grade malignancy (centroblast and immunoblast) as compared to lymphomas of lower grade of malignancy (lymphocytic, centroblast-centrocytic and in Lennert lymphoma). GGT activity in cells of Hodgkin and Berezovsky-Sterberg in some cases of LGM was high, in others low. Significant differences in GGT activity between RFH and follicular centroblast-centrocytic lymphoma were not found. Activity of aminopeptidase M was observed in histiocytes, fibroblasts, vessels and areas of connective tissue growth. Aminopeptidase A activity was observed in vessels only. Activity of dipeptidyl(amino)peptidase IV was observed in some lymphoid cells in RFH, NML and LGM. Thus, GGT activity may be considered as a differential-diagnostic marker in separating NML of high and low degree of malignancy and this may presume a different sensitivity to the therapy.