Mitosis identification in diffuse gliomas: implications for tumor grading

BACKGROUND: The histologic differentiation of mitotic figures is a cornerstone of several highly predictive grading systems for gliomas. In some systems, the presence of even a single mitotic figure is sufficient to classify an astrocytoma as high grade. However, the extent of microscopic examination necessary to exclude the presence of significant mitotic activity has not been determined. METHODS: Hematoxylin and eosin-stained slides from 410 astrocytomas and 107 oligodendrogliomas/oligoastrocytomas were reviewed until the first mitosis was identified or 100 400x fields had been reviewed without identification of a mitosis. The number of the field in which the first mitosis was found was correlated with diagnosis, grade, and survival. RESULTS: A review of 50 400x fields was necessary to achieve a >90% sensitivity in identifying a mitosis in a Grade 3 astrocytoma specimen, compared with 20 400x fields in anaplastic (Grade 3 and 4) oligodendroglioma specimens. For Grade 3 astrocytomas, there was a significant independent correlation between survival and the field in which the first mitosis was found (P = 0.02). For the oligodendroglial tumors, there was a strong correlation between the number of fields counted until the first mitosis was found and grade (P < 0.0001). CONCLUSIONS: The evaluation of mitotic activity offers more prognostic information than can be obtained by the simple approach of noting only their presence or absence. Data were acquired regarding the diligence of the microscopic examination necessary to evaluate the presence or absence of mitotic activity. A 1 cm x 0.1 cm needle biopsy contains adequate tissue to evaluate mitotic activity for the purpose of histologic grading; however, this adequacy is dependent on the sample's being representative and composed entirely of cellular tumor.     

Modulation of murine Lyme borreliosis by interruption of the B7/CD28 T-cell costimulatory pathway

Mammalian uteri are unreceptive to blastocyst implantation except during a relatively brief period. The transmembrane, cell surface mucin, Muc1, is present on epithelial cells of nonreceptive uteri in various species and has been demonstrated to have antiadhesive properties. These activities of Muc1 may prevent interaction of the embryonic trophoblast cells with the uterine epithelium. A previous study indicated that Muc1 expression in the rabbit, as in primates, is up-regulated by progesterone. This response would be expected to create a nonadhesive uterine surface during the progesterone-dominated receptive phase. In the current study, Northern blot analysis was used to evaluate Muc1 messenger RNA expression in the endometrium of estrous and progesterone-treated estrous rabbits and in endometrium from different stages of pregnancy or pseudopregnancy. Steady state levels of Muc1 messenger RNA were increased 10-fold when estrous animals were treated with progesterone for 5 days. Muc1 message was elevated 2- to 6-fold over estrous levels in endometrium of pseudopregnant females and 30-fold in preimplantation stage (6.75 days postcoitum) uteri. During implantation (7.25 day postcoitum), the high level of Muc1 expression continued in nonimplantation regions, but was dramatically reduced in endometrium from implantation sites. Using immunofluorescence localization, Muc1 protein was present on the apical surface of epithelial cells of estrous, pseudopregnant (4 and 6.75 days), preimplantation (6.75 days), and implantation (7.25 day) stage uteri. At the latter stage, luminal epithelium apposed to blastocysts had a marked reduction or absence of Muc1 immunostaining. Muc1-immunoreactive cells included luminal and cryptal epithelium in pregnant/pseudopregnant uteri, whereas the glandular cells stained weakly. Short term coculture of uterine epithelial cells with trophoblastic vesicles derived from 6.75-day blastocysts also resulted in a local reduction in apical epithelial Muc1 staining. These findings demonstrate that Muc1 expression is up-regulated by progesterone in the rabbit uterine epithelium and increases incrementally during pre- and periimplantation stages. Removal of Muc1 from the epithelial surface at implantation sites is accomplished locally via signals apparently produced by the blastocyst.     

MR detection of hyperacute parenchymal hemorrhage of the brain

OBJECTIVE: This study aimed to assess the effect of contact lens wear on the mucosal defenses of the outer eye against infection. DESIGN: A case-controlled study of daily contact lens wearers in their initial 6 months of contact lens wear. PARTICIPANTS: Contact lens wearers (mean age, 23.1 years; 47 subjects) were compared with age-matched control subjects (mean age, 24.7 years; 44 subjects). INTERVENTION: Outer eye defenses were studied by assay of tear constituents and quantitative conjunctival microbiology. MAIN OUTCOME MEASURES: Antimicrobial activity of tears was studied by assay of total immunoglobulin A (IgA), IgA isotype-specific antibodies reactive with Escherichia coli, Haemophilus influenzae, Staphylococcus epidermidis, albumin and lysozyme, and the ocular surface microbial load determined using quantitative microbiology of the conjunctival sac. RESULTS: The IgA isotype-specific antibodies reactive with E. coli (P = 0.03) and S. epidermidis (P = 0.068) were lower in contact lens wearers, but antibody:albumin ratios were not significantly different in the two groups. Contact lens wear also had no significant effect on tear IgA, albumin, or lysozyme or its ratios with albumin. Bacterial numbers and colonization rates for coagulase-negative staphylococci were greater in contact lens wearers than in age-matched control subjects. Corynebacterium sp. and non-Enterobacteriaceae (P = 0.007) were isolated more frequently and in greater numbers from contact lens wearers. Colonization rates were increased for Corynebacterium sp., but non-Enterobacteriaceae were transient. In both daily contact lens wearers and age-matched control subjects, most conjunctival flora were transient rather than colonizing, and no subject developed an outer eye infection during the study. CONCLUSION: These results suggest that daily contact lens wear does not significantly alter the mucosal defenses of the outer eye that function to eliminate organisms from the conjunctival sac and prevent outer eye infection.     

Ethics and the professional practice of psychologists: The role of virtues and principles.

We evaluate the potential relevance of virtue ethics to the training and practice of professional psychologists, and we contrast them with principle ethics. Typically, principles are used to facilitate the selection of socially and historically acceptable answers to the question "What shall I do ?" when confronted by ethical dilemmas. Virtue ethics, however, generally focus on the question "Who shall I be?" Strengths and weaknesses of each approach are presented. The impact of each is discussed with respect to informed consent and the therapeutic construct "genuineness." We conclude that virtue ethics are an essential component of responsible ethical training and practice. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Structure of Salmonella typhimurium nrdF ribonucleotide reductase in its oxidized and reduced forms

The first class Ib ribonucleotide reductase R2 structure, from Salmonella typhimurium, has been determined at 2.0 A resolution. The overall structure is similar to the Escherichia coli class Ia enzyme despite only 23% sequence identity. The most spectacular difference is the absence of the pleated sheet and adjacent parts present in the E. coli R2 structure; the heart-shaped structure loses its tip. From sequence comparisons, it appears that this feature is shared with all other class Ib enzymes and, in this respect, is more like the mammalian class Ia enzymes. Both the oxidized and reduced iron forms have been investigated. In the ferric iron center, both iron ions are octahedrally coordinated and bridged by one carboxylate and one oxide ion. The ferrous form has lost the bridging oxide ion but is bridged by two carboxylates. Accompanying the change in redox state, helix E changes its conformation from one covering the metal center in the oxidized form to a more open reduced form. A narrow channel is opened which may permit easier access of oxygen to the ferrous iron site and to efficiently generate the tyrosyl radical.     

Child homicide in Oklahoma: a continuing public health problem

Homicide is a leading manner of injury to cause death in children. To assess this phenomenon in Oklahoma, the demographic characteristics and causes of death of the victims of child homicide in Oklahoma have been reviewed. One hundred eleven consecutive cases of homicide in children less than age 13 years were reviewed and the demographic characteristics of the victims were analyzed. The majority of homicides occurred in Tulsa and Oklahoma Counties (55.8%). The ratio of male to female victims was approximately equal. The races of the victims were 66.6 percent White, 24.3 percent Black, 8.1 percent Native American and 0.9 percent Asian. The most common cause of death was head injury (45.9%). An unexpected finding was that in 23.4 percent of cases, an additional fatality occurred in the family due to family violence. This fatality involved either suicide of the perpetrator or homicide of a sibling. These findings indicate a continuing family violence problem in Oklahoma.     

Effects of tablet core dimensional instability on the generation of internal stresses within film coats part II: Temperature and relative humidity variation within a tablet bed during aqueous film coating in an accela-cota

Temperature and relative humidity variations within a tablet bed were measured during a complete typical aqueous film coating procedure in an Accela-Cota Model 10. Characteristic thermal and moisture patterns on which it was possible to distinguish the stages of coating process were obtained. Inlet air temperature as a processing variable and different locations within the tablet bed were found to influence these patterns significantly.