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Positive Cases (positive + case)
Kinds of Positive Cases Selected AbstractsInterpreting Urine Drug Tests: Prevalence of Morphine Metabolism to Hydromorphone in Chronic Pain Patients Treated with MorphinePAIN MEDICINE, Issue 7 2008Ajay D. Wasan MD ABSTRACT Objective., Pain medicine practitioners frequently use urine drug testing (UDT) to monitor adherence to opioid therapy. It can be difficult to interpret a result as normal or abnormal in relation to which opioid compounds are expected to be found in the urine. We investigated whether hydromorphone may be a metabolite of morphine normally appearing in UDT of patients prescribed morphine. Design., This is a retrospective case-control study of urine toxicology results in pain patients taking only morphine. Inclusion criteria included urine results positive for morphine only (controls) or morphine and hydromorphone (cases). Demographic and medical history variables, and any history of aberrant drug behavior were recorded and related to the presence or absence of hydromorphone in the urine. Results., Hydromorphone was present in 21 of 32 cases (66%), none of whom had a history of aberrant drug behavior. Positive cases occurred more frequently in women, in those taking higher daily doses of morphine, and in those with higher urine morphine concentrations (P < 0.05). Only morphine urine concentration was a significant predictor of the hydromorphone metabolite in a logistic regression model (P < 0.05). Conclusions., Hydromorphone is likely a minor metabolite of morphine, normally appearing in the UDT of patients taking morphine. This finding assists in determining whether a UDT result is normal or abnormal, and subsequently whether a patient is compliant with opioid therapy. This observation should be confirmed by a prospective study in a controlled environment. Variables such as gender, morphine dose, morphine urine concentration, and genetic determinants of morphine metabolism should be investigated further. [source] An audit of the accuracy of fine needle aspiration using a liquid-based cytology system in the setting of a rapid access breast clinicCYTOPATHOLOGY, Issue 6 2002L. Joseph We have assessed the effectiveness and accuracy of reporting fine needle aspirates of the breast (FNAB) using a liquid-based cytology (LBC) system (the Cytospin® method) in the pressure situation of a rapid access clinic (RAC). We have reviewed every case from the RAC from June 1997 to February 2001 inclusive. There were 1322 cases, which accounted for 26% of the total FNAB received in our department over the period. There were 323 cancers and 999 benign cases in the group. The inadequate/nondiagnostic rate (C1) was 18%. The absolute sensitivity, including C1 cases, was 73% with the complete sensitivity being 90%. The groups of ,atypical, probably benign' (C3) and ,suspicious, probably malignant' (C4) accounted for a total of 6.2%. There were 28 false negative cases and 1 false positive case (a borderline phyllodes tumour). Comparing our results with the standards recommended by the NHSBSP has shown that the diagnosis of FNAB using this LBC method is feasible, accurate and reliable even in the pressure situation of a RAC. [source] Solid renal masses in adults: Image-guided fine-needle aspiration cytology and imaging techniques,"Two Heads Better Than One?"DIAGNOSTIC CYTOPATHOLOGY, Issue 1 2008José García-Solano M.D. Abstract We have compared the diagnostic accuracy of image-guided 25G-FNA (fine-needle aspiration) and imaging modalities in a group of 31 patients with solid space-occupying renal lesions. All patients had undergone total nephrectomy and histologic sections were available for review. By FNA there were 24 malignant diagnoses, I benign diagnosis, and 6 cases with yield inadequate for diagnosis. The FNA accuracy for malignancy was 100% with no false positive cases; cancer typing by FNA matched the final histologic diagnoses in 91.6% of cases. Sensitivity, specificity, positive predictive value, and negative predictive value were 80%, 14%, 80%, and 14%, respectively. Radiologically there were 26 diagnoses of malignancy, I of benignity, and 4 indeterminate lesions (IL). Accuracy for malignancy was 100%, with one false positive case; cancer typing matched the final histologic diagnoses in 84%. Sensitivity of imaging modalities was 86%, specificity 17%, positive predictive value 83%, and negative predictive value 20%. Four IL corresponded to renal cell carcinoma in the final histologic report: two IL had a previous diagnosis of malignancy by FNA, and the yield of two was inadequate for cytologic diagnosis. Both techniques have 100% accuracy for the diagnosis of malignancy. The sensitivity, specificity, positive predictive value, and negative predictive value of imaging techniques are slightly higher than those obtained by FNA. Imaging techniques and FNA of solid renal masses complement each other in IL and in nondiagnostic FNAs. Diagn. Cytopathol. 2008;36:8,12. © 2007 Wiley-Liss, Inc. [source] GROUNDING SUPPLY CHAIN MANAGEMENT IN RESOURCE-ADVANTAGE THEORY,JOURNAL OF SUPPLY CHAIN MANAGEMENT, Issue 1 2008SHELBY D. HUNT A key issue for strategic supply chain management research is whether purchasing can be a source of long-term competitive advantage. Recent resource-based works in strategic management suggest that purchasing cannot be a source of long-term competitive advantage. In contrast, recent works in supply chain management suggest that purchasing can be such a source. This article explains why works in strategic management and supply chain management come to such radically different conclusions on purchasing strategy. Specifically, this article points out that the negative conclusion concerning purchasing strategy is derived from theories of competition based on the neoclassical, equilibrium economics research tradition. Therefore, the positive case for strategic purchasing needs to be grounded in a research tradition that provides a clean break from the neoclassical, equilibrium economics research tradition. The authors discuss the characteristics of what has come to be labeled "the resource-advantage research tradition" and offer it as an appropriate grounding for purchasing strategy, in particular, and supply chain management, in general. [source] Genetic analysis of SCA 2 and 3 repeat expansions in essential tremor and atypical ParkinsonismMOVEMENT DISORDERS, Issue 13 2007Eng-King Tan MD Abstract Anecdotal reports suggest that patients with spinocerebellar ataxia (SCA 2) patients can present with postural tremor with ataxia. We determined the prevalence of SCA2 and SCA3 mutations in a cohort of ET and atypical Parkinsonism patients. A total of 277 subjects comprising of 177 ET and 100 atypical Parkinsonism were examined. We identified one positive case of SCA3 among those who were diagnosed with ET, yielding a prevalence of 0.5%, but a zero prevalence among our atypical Parkinsonism patients. No study subjects carried an abnormal SCA2 repeat expansion. Our study highlights that SCA3 can present initially with ET symptoms, expanding the spectrum of genetic diseases that can be associated with ET-like phenotype. Routine screening for SCA2 and SCA3 in ET and atypical Parkinsonism patients may not be cost effective. However, in the long-term follow-up of patients who present with an ET phenotype, clinicians should be vigilant for other neurological signs, which may be point to an alternate diagnosis. © 2007 Movement Disorder Society [source] IN DEFENCE OF STATE-BASED REASONS TO INTENDPACIFIC PHILOSOPHICAL QUARTERLY, Issue 2 2010JAMES MORAUTA A state-based reason for one to intend to perform an action F is a reason for one to intend to F which is not a reason for one to F. Are there any state-based reasons to intend? According to the Explanatory Argument, the answer is no, because state-based reasons do not satisfy a certain explanatory constraint. I argue that whether or not the constraint is correct, the Explanatory Argument is unsound, because state-based reasons do satisfy the constraint. The considerations that undermine the Explanatory Argument also generate a strong, positive case for the existence of state-based reasons to intend. [source] A Tort-Based Approach to Damages under the Human Rights Act 1998THE MODERN LAW REVIEW, Issue 5 2009Jason N. E. Varuhas This article argues that a strong case can be made for departing from the current approach to damages under the Human Rights Act 1998, and for the adoption of an alternative tort-based approach. The article critically analyses the English courts' arguments against adopting a tort-based approach and demonstrates that neither the Act nor the European Convention on Human Rights militate against such approach. It makes a positive case for a tort-based approach, arguing that the law of damages in tort provides an appropriate model for damages under the Act as a matter of principle given the common functions and protected interests that underpin both areas of the law. Further, tort law offers an established and elaborate corpus of principles to draw on, which can readily and naturally be read across to the human rights context. A tort-based approach would also promote consistency across English law, while generally affording greater protection to human rights than the English courts' current approach. [source] O-10 Endometrial cells in cervical smears: cytological features associated with clinically significant endometrial pathologyCYTOPATHOLOGY, Issue 2007R. N. Tiam Introduction:, To establish the significance of cytological features which could predict clinically significant endometrial pathology, and therefore guide reporting practice in cervical samples. Methods:, A retrospective review of SurePath liquid-based cytology (LBC) cervical samples between 2002 and 2006, obtained at screening and colposcopy. These smears contained normal endometrial cells present at inappropriate times of the menstrual cycle, endometrial cells with atypia (borderline change) and with features suspicious / diagnostic of endometrial carcinoma (glandular neoplasia). False negative and false positive cases detected on subsequent histology were also included. The control group comprised negative samples and a few abnormal smears. All smears were randomly assigned and blinded to menopausal status, age, use of oral contraceptive pill and hormone replacement therapy and presence of intrauterine device. Each smear was reviewed for 16 cytologic criteria and a cytological diagnosis was given for each. Results:, A total of 219 smears were available for review; 137 were negative, out of which 85 contained normal endometrial cells, 41 contained endometrial cells with atypia, 10 contained endometrial cells with features suggestive of adenocarcinoma and 31 contained endometrial cells with features diagnostic of adenocarcinoma. The feature most associated with benign endometrial cells is top hat with central cell condensation. In contrast, the features associated with malignant endometrial cells are smooth nuclear membrane, pale chromatin, small nucleoli and scalloped borders. Discussion:, The criteria identified in this study do not definitively define a neoplastic process, but appear to be helpful in individual cases. This study emphasises that endometrial changes should be always interpreted with the relevant clinical information, which would otherwise lead to overdiagnosis in premenopausal women. [source] Analysis of proliferating cell fraction determined by monoclonal antibody to M1-subunit ribonucleotide reductase and Ki-67 in relation to p53 protein expression in fine-needle aspirates from non-Hodgkin's lymphomasCYTOPATHOLOGY, Issue 5 2000V. Sviatoha Analysis of proliferating cell fraction determined by monoclonal antibody to M1-subunit ribonucleotide reductase and Ki-67 in relation to p53 protein expression in fine-needle aspirates from non Hodgkin's lymphomas The purpose of this study was to analyse the proliferative fraction with the monoclonal antibody M1-R-R to M1-subunit ribonucleotide reductase and with MIB-1 to Ki-67 antigen in relation to p53 protein expression in fine needle aspirates from B-cell non-Hodgkin's lymphomas. One hundred and thirty-seven cases, previously diagnosed and sub-typed according to the Kiel classification and characterized by immunophenotyping, were included in the study. The M-1 subunit ribonucleotide reductase (M1 -R-R), Ki-67 and p53 antigens were detected using monoclonal antibodies on stored cytospin preparations. There was a good correlation (r = 0.72) between Ki-67 and M1 -R-R positive cell fraction in both high and low grade lymphomas. High-grade lymphomas had a median percentage of M1 -R-R/MIB-1 positive cells of 53.0/73.0 for lymphoblastic, 61.0/52.0 for immunoblastic and 33.5/41.0 for centroblastic lymphomas, respectively. In low grade lymphomas figures of median percentage of M1 -R-R/MIB-1 were 9.0/15.0 for centroblastic/centrocytic, 11.0/9.5 for chronic lymphocytic leukaemia, 16.0/27.0 for centrocytic and 12.0/9.0 for immunocytomas, respectively. The median percentages of M1 -R-R/MIB-1 for high and low grade lymphomas were 37.0/50.5 and 11.0/12.0, respectively. In the p53 positive cases the proliferation rate as measured by staining for M1 -R-R and MIB-1 was higher than in p53 negative cases, but the difference was not statistically significant. The results show that cytospin material obtained by fine needle aspiration and stored at ,70 °C for years can be used reliably for both peroxidase-avidin-biotin and three-step alkaline phosphatase immunocytochemical staining. In addition, proliferation fraction determined by M1 -R-R monoclonal antibody staining correlates well with that measured by an established marker for cell proliferation, the Ki-67 antibody. However, the proliferation fraction as measured by the two antibodies differs in the various subtypes of non-Hodgkin's lymphoma which indicates that they may contribute different prognostic information. [source] Solid renal masses in adults: Image-guided fine-needle aspiration cytology and imaging techniques,"Two Heads Better Than One?"DIAGNOSTIC CYTOPATHOLOGY, Issue 1 2008José García-Solano M.D. Abstract We have compared the diagnostic accuracy of image-guided 25G-FNA (fine-needle aspiration) and imaging modalities in a group of 31 patients with solid space-occupying renal lesions. All patients had undergone total nephrectomy and histologic sections were available for review. By FNA there were 24 malignant diagnoses, I benign diagnosis, and 6 cases with yield inadequate for diagnosis. The FNA accuracy for malignancy was 100% with no false positive cases; cancer typing by FNA matched the final histologic diagnoses in 91.6% of cases. Sensitivity, specificity, positive predictive value, and negative predictive value were 80%, 14%, 80%, and 14%, respectively. Radiologically there were 26 diagnoses of malignancy, I of benignity, and 4 indeterminate lesions (IL). Accuracy for malignancy was 100%, with one false positive case; cancer typing matched the final histologic diagnoses in 84%. Sensitivity of imaging modalities was 86%, specificity 17%, positive predictive value 83%, and negative predictive value 20%. Four IL corresponded to renal cell carcinoma in the final histologic report: two IL had a previous diagnosis of malignancy by FNA, and the yield of two was inadequate for cytologic diagnosis. Both techniques have 100% accuracy for the diagnosis of malignancy. The sensitivity, specificity, positive predictive value, and negative predictive value of imaging techniques are slightly higher than those obtained by FNA. Imaging techniques and FNA of solid renal masses complement each other in IL and in nondiagnostic FNAs. Diagn. Cytopathol. 2008;36:8,12. © 2007 Wiley-Liss, Inc. [source] Fine-needle aspiration cytology in the diagnosis of superficial lymphadenopathy: a 5-year Brazilian experienceDIAGNOSTIC CYTOPATHOLOGY, Issue 2 2006M.Sc., Marcos Roberto Martins M.D. Abstract To determine the accuracy of fine-needle aspiration (FNA) in the diagnostic assessment of lymphadenopathies, a retrospective study was conducted on 627 cases of FNA of the lymph nodes performed at Department of Pathology, UNIFESP (Federal University of São Paulo), between 1997 and 2001. Cytology results were compared to the results of biopsies if available. The cytological diagnosis was unsatisfactory in 14.7% of cases, positive in 46%, and negative in 39.3%. Among the positive cases, 79.4% were classified as metastases, 14.2% as lymphoma, and 6.4% as indeterminate. Anatomopathological exams for the determination of cytohistological correlation were available in 218 of the 627 cases. There were three (1.88%) false-negative and two (1.25%) false-positive cases. Accuracy tests revealed 97.41% sensitivity, 95.45% specificity, and 96.88% efficacy, with cytohistological agreement being almost perfect (, = 0.92). The high accuracy of this study based only on cytomorphological criteria associated to the variety of malignant neoplasias diagnosed by the procedure demonstrates its relevance on patient care, especially in areas of limited financial resources. Diagn. Cytopathol. 2006; 34:130,134. © 2006 Wiley-Liss, Inc. [source] Detection of human papillomavirus DNA in squamous cell carcinoma of the esophagus by auto-nested PCRDISEASES OF THE ESOPHAGUS, Issue 2 2006A. P. Souto Damin SUMMARY., The aim of the present study was to investigate the presence of human papillomavirus (HPV) in surgical specimens of esophageal squamous cell carcinoma. One hundred and sixty-five paraffin-embedded specimens of esophageal carcinoma were analyzed through high-sensitivity auto-nested polymerase chain reaction (PCR) using the consensus GP5+/GP6+ primer. Twenty-six specimens of esophageal mucosa without malignant disease were also studied as a control group. Two different specific primer sets targeting the E6 region of the HPVs 16 and 18 were used for typing. Direct DNA sequence analysis was conducted to confirm positive PCR results. HPV DNA was detected in 26 esophageal carcinomas (15.75%), but in none of the benign esophageal specimens (P < 0.05). Out of the 26 positive cases, 24 were HPV-16 and one was HPV-18. One tumor contained both HPV-16 and -18 DNA. Positive PCR results were confirmed by the amplified viral sequences. Our findings suggest that the presence of either HPV-16 or -18 might be related to development of the malignant phenotype in the esophagus. [source] The validity of an Australian modification of the AUDIT questionnaireDRUG AND ALCOHOL REVIEW, Issue 2 2001LOUISA J. DEGENHARDT Abstract The Alcohol Use Disorders Identification Test (AUDIT) has been used widely and is reported to be superior to conventional questionnaires in detection of current hazardous and harmful alcohol use. We assessed the validity of an Australian modification of the AUDIT (the AusAUDIT), which has been employed widely in Australian and New Zealand early intervention programmes. We used a cross-sectional study of 370 subjects from the follow-up phase of a randomized controlled trial of early intervention to reduce hazardous alcohol consumption. Scores on the AusAUDIT were compared against 12-month ICD-10 diagnoses of harmful alcohol use and dependence, as determined by the Composite International Diagnostic Interview, and against self-report of alcohol consumption exceeding Australian National Health and Medical Research Council (NH&MRC) recommended limits. AusAUDIT had good internal consistency and discriminated significantly between persons meeting criteria for ICD-10 alcohol use disorders, and drinkers who did not. At currently recommended cut-off scores, AusAUDIT detected more than 85% of people meeting criteria for ICD-10 alcohol use disorders, or drinking over NH&MRC recommended limits, but its specificity was limited (29% in men, and 58% in women for drinking over NH&MRC limits). No subset of questions performed as well as the full AusAUDIT in detection of drinking problems, but the alcohol consumption items provided a reasonable screen for drinking over NH&MRC limits. We conclude that AusAUDIT is effective in detecting problematic drinking, but positive cases should be confirmed by clinical assessment. The findings illustrate the need for validation of questionnaire modifications, and the difficulty in increasing test sensitivity without reducing specificity. [source] A survey on two years of medication regulation in horse races in IranEQUINE VETERINARY JOURNAL, Issue 2 2010S. LOTFOLLAHZADEH Summary Reasons for performing study: The present survey evaluated the use of prohibited substances cases in the first 2 years of medication regulation in horseracing in Iran so that the impact of these regulations on the level of positive cases over the period could be assessed. Objectives: To determine the prevalence of positive tests for prohibited substances in horse races during 2 years of a drugs testing programme in Iran. Methods: A total of 656 horses that were winners or second in races were tested during the 2 year study. In the first year 354 horses (209 males and 145 females) and in the second year 302 horses (155 males and 147 females) were tested. In the 2 years, 306 were found to be positive. Urine samples were taken from candidate horses and sent to the Central Doping Laboratory. Blood samples were taken from those horses where a urine sample could not be taken within one hour. Detection and measurement of prohibited substances were carried out by ELISA, GC and HPLC using standard methods. Results: Thirty-two percent of males were positive for prohibited substances, which was not significantly different from the percentage of females (25.5%). In the second year, of the 302 horses tested for prohibited substances, 33.5% of males were positive, again similar to females (33.3%). Almost 83% of horses tested positive for prohibited substances once in the first year, 15% tested positive twice and 2% tested positive 3 times. In the second year 78% tested positive once, 15% tested positive twice and 7% tested positive 3 times. Morphine was the most used prohibited substance and was detected 42 times during the survey, followed by caffeine and phenylbutazone. Morphine was also the most used drug in combination with other drugs in both years. Conclusions: Morphine and caffeine were the most popular prohibited substances found in the measurements. As these substances were found in the environment and food stuffs, their presence in the samples may be due to unintentional feeding of contaminated materials (bread, hay and chocolate). [source] Loop-mediated isothermal amplification targeting the apxIVA gene for detection of Actinobacillus pleuropneumoniaeFEMS MICROBIOLOGY LETTERS, Issue 1 2009Wang Yang Abstract Loop-mediated isothermal amplification (LAMP) is a novel nucleic acid amplification method performed under isothermal conditions with high specificity and efficiency. We developed a diagnostic method based on LAMP for detection of Actinobacillus pleuropneumoniae. Using six specific primers targeting the apxIVA gene, the LAMP assay rapidly amplified the target gene within 30 min, requiring only a laboratory water bath for the reaction to occur. The resulting amplificon was visualized by adding SYBR Green I to the mixture. The results obtained from testing 15 A. pleuropneumoniae reference strains and other seven bacterial species strains showed that the LAMP was as specific as and 10 times more sensitive than nested PCR. Sixty-five tonsil samples were collected from 65 healthy pigs. All the samples were negative for A. pleuropneumoniae by immunomagnetic separation-based (IMS) bacterial isolation, nested PCR and LAMP, respectively. Meanwhile, 115 tonsil samples were also collected from 115 pigs with apparent respiratory problems. Twenty-two were positive by IMS bacterial isolation. All the samples that were positive by IMS bacterial isolation were also positive by nested PCR and LAMP. The LAMP assay demonstrated exceptionally higher sensitivity than nested PCR by picking up 14 additional positive cases (,2 test, P<0.0001); we concluded that LAMP was a highly sensitive and reliable method for detection of A. pleuropneumoniae infection. [source] Domestic Violence and Out-of-hospital ProvidersA Potential Resource to Protect Battered WomenACADEMIC EMERGENCY MEDICINE, Issue 3 2000M. Elaine Husni MD Abstract Objective: The primary objective was to determine the prevalence of domestic violence (DV) in a subset of women presenting to the Boston emergency medical services (EMS) system and to evaluate documentation. A secondary objective was to determine the rate of refusal of transport to the hospital for DV-positive patients, compared with the general population. Methods: A retrospective chart review of ambulance run sheets from a nonconsecutive, convenience sample between July and December 1995 was performed. Women presenting with injury, obstetric/gynecologic complaints, or psychiatric complaints were included. Records were reviewed, and labeled as positive, probable, suggestive, or negative for DV, based on a previously used classification system. A weighted kappa test was performed, and data were analyzed using chi-square and t-test. Results: Among 1,251 charts reviewed, 876 met criteria for inclusion. The percentage of positive cases was 5.4% (95% CI = 3.9% to 6.9%), probable 10.8% (8.8% to 12.9%), suggestive 2.6% (1.6% to 3.7%), and negative 81.2% (78.6% to 83.6%). Among DV-positive patients, the refusal to transport rate was 23.4% (11.3% to 35.5%), compared with a 7.1% (5.8% to 9.3%) rate for the entire study population (n= 876), and 4.7% for the general Boston EMS population during the same year. More DV patients presented during the night shift compared with other shifts. Conclusions: Domestic violence is common in this high-risk population. A substantial proportion of women in this population refuse transport to the hospital. Out-of-hospital personnel should be trained with the tools to identify and document DV, assess patient safety, offer timely resources, and empower victims to make choices. [source] Genomic and clinical analyses of 2p24 and 12q13-q14 amplification in alveolar rhabdomyosarcoma: A report from the Children's Oncology GroupGENES, CHROMOSOMES AND CANCER, Issue 8 2009Frederic G. Barr Alveolar rhabdomyosarcoma (ARMS) is an aggressive pediatric cancer that is related to the skeletal muscle lineage and characterized by recurrent chromosomal translocations. Within the ARMS category, there is clinical and genetic heterogeneity, consistent with the premise that "primary" genetic events collaborate with "secondary" events to give rise to subsets with varying clinical features. Previous studies demonstrated that genomic amplification occurs frequently in ARMS. In the current study, we used oligonucleotide arrays to localize two common amplicons to the 2p24 and 12q13-q14 chromosomal regions. Based on the copy number array data, we sublocalized the minimum common regions of 2p24 and 12q13-q14 amplification to a 0.83 Mb region containing the DDX1 and MYCN genes, and a 0.55 Mb region containing 27 genes, respectively. Using fluorescent in situ hybridization assays to measure copy number of the 2p24 and 12q13-q14 regions in over 100 cases, we detected these amplicons in 13% and 12% of cases, respectively. Comparison with fusion status revealed that 2p24 amplification occurred preferentially in cases positive for PAX3-FOXO1 or PAX7-FOXO1 while 12q13-q14 amplification occurred preferentially in PAX3-FOXO1 -positive cases. Expression studies demonstrated that MYCN was usually overexpressed in cases with 2p24 amplification while multiple genes were overexpressed in cases with 12q13-q14 amplification. Finally, although 2p24 amplification did not have a significant association with clinical outcome, 12q13-q14 amplification was associated with significantly worse failure-free and overall survival that was independent of gene fusion status. © 2009 Wiley-Liss, Inc. [source] High incidence of t(7;12)(q36;p13) in infant AML but not in infant ALL, with a dismal outcome and ectopic expression of HLXB9GENES, CHROMOSOMES AND CANCER, Issue 8 2006Anne R. M. von Bergh The t(7;12)(q36;p13) is a recurrent translocation involving the ETV6/TEL gene (12p13) and a heterogeneous breakpoint at 7q36. A fusion transcript between HLXB9 and ETV6 in AML with t(7;12) is occasionally found. To study the incidence of t(7;12) in infant and childhood acute leukemia, we screened 320 cases <36 months using FISH. Additionally, 28 pediatric cases >36 months with cytogenetic breakpoints at 12p and 7q were investigated. We studied the presence of an HXLB9-ETV6 fusion transcript and quantified the expression of various genes located in the 7q36 breakpoint region. In total, six AML patients carried the t(7;12) of which five were infants and one child of 18 months. Only one out of 99 infant ALL patients harbored the t(7;12). No t(7;12) was found in older children with AML or ALL. AML patients carrying a t(7;12) had a poor outcome with a 3-year EFS of 0%. A fusion of HLXB9 to ETV6 was found in four AML cases with t(7;12). The 7q36 genes NOM1, LMBR1, RNF32, and SHH were equally expressed among t(7;12)-positive AML versus t(7;12)-negative AML, t(7;12)-negative ALL, or normal bone marrow. However, the HLXB9 expression was highly increased in t(7;12)-positive cases, including those with an HLXB9-ETV6 fusion. We conclude that the t(7;12) is almost exclusively present in infant AML and covers 30% of infant AML, while it is extremely rare in infant ALL and older children. The t(7;12) is associated with a poor outcome and an ectopic expression of HLXB9 is commonly involved in this genetic subtype of leukemia. © 2006 Wiley-Liss, Inc. [source] Geographic Pathology of Helicobacter pylori GastritisHELICOBACTER, Issue 2 2005Yi Liu ABSTRACT Background and aim.,Helicobacter pylori is etiologically associated with gastritis and gastric cancer. There are significant geographical differences between the clinical manifestation of H. pylori infections. The aim of this study was to compare gastric mucosal histology in relation to age among H. pylori -infected patients from different geographical areas using the same grading system. The prevalence of atrophy and intestinal metaplasia were also compared with the respective gastric cancer incidence in the different countries. Methods., A total of 1906 patients infected with H. pylori from seven countries were evaluated. Entry criteria included H. pylori positive cases with antral and corpus biopsies between the ages of 18 and 75 years. The minimum number of cases required from a country was 100. Hematoxylin-eosin stained biopsies from antrum and corpus were scored semiquantitatively using the parameters suggested by the Sydney Classification System. Statistical evaluation was performed using Krusakal-Wallis test and Spearman's rank correlation test. Results., The severity of gastric atrophy varied among the different groups with the highest scores being present in Japan. The lowest scores were found in four European countries and in Thailand. The scores for intestinal metaplasia were low in general except for Xi-an, Japan, and Shanghai. For all the countries, the presence of atrophy in the antrum correlated well (r = 0.891) with the incidence of gastric cancer. Conclusion., Using a standardized grading system in a large study of H. pylori -related geographic pathology, we found major differences in the overall prevalence and severity of H. pylori gastritis in relation to age. These differences mirrored the respective incidences of gastric cancer in those geographical areas. [source] The Impact of Interferon Gamma Receptor Expression on the Mechanism of Escape From Host Immune Surveillance in Hepatocellular CarcinomaHEPATOLOGY, Issue 3 2000Mitsuo Nagao M.D. Interferon gamma (IFN-,) plays an important role in host defense mechanism and participates in the progression of chronic liver disease. IFN-, exerts its pleiotrophic effects by transcriptional regulation of expression of numerous genes, such as major histocompatibility complex (MHC) class I and Fas, through interaction with IFN-, receptor (IFN-,-R). Although hepatocytes in normal liver express weak or no IFN-,-R, those in acute and chronic liver disease up-regulate its expression. A study using IFN-,-R ,-chain knock-out mice revealed the actions of IFN-, on tumor cells as an extrinsic tumor-suppressor mechanism. However, it is unclear whether or how hepatocellular carcinoma (HCC) blocks the signal transduction of IFN-, to evade host immune surveillance. We examined the expression of IFN-,-R and IFN-,,inducible genes in 44 cases with HCC using real-time reverse-transcriptase polymerase chain reaction (RT-PCR) and immunohistochemistry. In noncancerous liver tissues (n = 38), IFN-,-R expression on the cell surface was up-regulated in 27 cases. In IFN-,-R,negative cases (n = 15), tumor size was larger (P = .032), serum ,-fetoprotein (AFP) level was higher (P = .001), intrahepatic and extrahepatic metastasis was more common (P = .044 and .013, respectively), and Ki-67 labeling index (LI) was higher (P = .041), compared with IFN-,-R,positive cases. Accordingly, the evasion mechanism may play an important role in progression, especially metastasis, in HCC. The significant correlation between the status of IFN-,-R and the expression of Fas and MHC implies that the loss of IFN-,-R might contribute to the mechanism of escape from host immune rejection in HCC. [source] The Pro variant of the p53 codon 72 polymorphism is associated with hepatocellular carcinoma in Moroccan populationHEPATOLOGY RESEARCH, Issue 9 2007Sayeh Ezzikouri Aim:, Codon 72 polymorphism of the p53 gene has been implicated in cancer risk, and it has been suggested that it may have an impact on the clinical outcome of the disease. Our objective was to evaluate the association between p53 polymorphism at codon 72 and hepatocellular carcinoma (HCC) in the Moroccan population. Methods:, Genomic DNA was extracted from peripheral blood cells of 96 patients with HCC and 222 controls without HCC matched for age, gender and ethnicity. Codon 72 polymorphism of p53 was identified by PCR-restriction fragment length polymorphism, confirmed by sequencing. Results:, Patients with HCC had higher frequencies of Pro/Pro (13.5% vs. 6.3%, P < 0.02) than controls and consequently a 2.3-fold increased risk of liver cancer development (odds ratio [OR], 2.304; 95% confidence interval [CI], 1.014,5.234). In addition, we found a significant association between the p53Arg72Pro polymorphism and the female gender in HCC. Men with Pro/Pro genotype had a 1.57-fold increased risk for HCC, whereas the corresponding genotype in women had a 4.4-fold increased risk of HCC (OR, 4.4; 95% CI, 1.18,16.42). No correlation between the polymorphism and HCC risk was found when comparing the hepatitis C virus (HCV)-positive cases to HCV-positive controls. However, HCV-negative subjects and Pro/Pro genotype had a 3.31-fold increased risk for HCC. Conclusion:, These results provide evidence that p53 polymorphism at codon 72 is a modifier of hepatocarcinogenesis, especially in women and HCV-negative subjects. [source] BCL2 gene abnormalities define distinct clinical subsets of follicular lymphomaHISTOPATHOLOGY, Issue 3 2006J R Goodlad Aims:, Follicular lymphoma (FL) arising primarily in the skin has recently been proposed as a distinct entity on the basis of a low incidence of t(14;18)(q32;q21) and bcl-2 expression, with a very high percentage of patients surviving more than 5 years. However, cases of t(14;18)(q32;q21)-positive primary cutaneous FL (PCFL) and examples of t(14;18)(q32;q21)-negative FL at nodal and other extranodal sites, are well documented. The aim of this study was to test the hypothesis that there is a subtype of FL lacking t(14;18)(q32;q21), which preferentially involves certain sites but is not restricted by anatomical location. Methods and results:, A cohort of 47 stage 1 FL was stratified according to the presence or absence of t(14;18)(q32;q21) using conventional cytogenetics, polymerase chain reaction and interphase fluorescence in situ hybridization. Compared with t(14;18)(q32;q21)-positive cases, FL lacking the translocation were less likely to express CD10 or bcl-2 (P < 0.01), made up a significantly greater proportion of cases arising at extranodal sites (P < 0.001) and had a significantly better overall and disease-specific 5-year survival (P < 0.01). Conclusions:, These results support the concept of a subtype of FL lacking t(14;18)(q32;q21), characterized by low-intensity bcl-2 expression, a predilection for extranodal sites, particularly the skin, and a more favourable outcome than t(14;18)(q32;q21)-positive FL. [source] Incidence of human papillomavirus (HPV) positive tonsillar carcinoma in Stockholm, Sweden: An epidemic of viral-induced carcinoma?INTERNATIONAL JOURNAL OF CANCER, Issue 2 2009Anders Näsman Abstract In the county of Stockholm, between 1970 and 2002, we have previously reported a 3-fold parallel increase in the incidence of tonsillar squamous cell carcinoma (SCC) and the proportion of human papillomavirus (HPV) positive tonsillar SCC. Here, we have followed the above parameters in all patients (n = 120) diagnosed with tonsillar SCC during 2003,2007 in the same area, and also in correlation to our previous data. Ninety-eight pretreatment biopsies were available and presence of HPV DNA and HPV-16 E6 and E7 RNA were tested by polymerase chain reaction (PCR) and RT-PCR. Incidence data were obtained from the Swedish Cancer Registry. Data reported from 1970 to 2002 were also obtained for comparison. HPV DNA was present in 83 of 98 (85%) of the tonsillar SCC biopsies from 2003 to 2007 and 77 of these were HPV-16 positive. HPV-16 E6 and E7 RNA were found in 98% of 52 analyzed HPV-16 positive cases. The proportion of HPV-positive cancers had significantly increased both from 1970 to 2007 (p < 0.0001) as well from 2000 to 2007 (p < 0.01), with 68% (95% confidence interval (CI), 53,81) 2000,2002; 77% (95% CI, 63,87) 2003,2005; and 93% (95% CI, 82,99) 2006,2007. The incidence rate of HPV-positive tumors almost doubled each decade between 1970 and 2007, in parallel with a decline of HPV-negative tumors. In conclusion, the incidence of HPV-positive cancers is still increasing in the County of Stockholm, suggesting an epidemic of a virus-induced carcinoma, with soon practically all tonsillar SCC being HPV positive, as in cervical cancer. © 2009 UICC [source] Human papillomavirus seropositivity and risks of head and neck cancerINTERNATIONAL JOURNAL OF CANCER, Issue 4 2007Elaine M. Smith Abstract We examined antibody response to VLP HPV-16, HPV-16 E6 and E7 antibodies as potential seromarkers of HPV-related head and neck cancer (HNC). The study included 204 HNC cases and 326 controls evaluated for HPV presence in sera using ELISAs for anti-HPV VLP antibodies and HPV-16 E6 and/or E7 antibodies, and in tumor tissue using PCR and DNA sequencing. Anti-HPV-16 VLP was detected in 33.8% of cases and 22.4% of controls, anti-E6 in 20.6% of cases and 0.9% of controls and anti-E7 in 18.6% of cases and 0.6% of controls. HPV-16 DNA was detected in 26.1% of tumors. The adjusted risk of HNC was elevated among those seropositive for HPV-16 VLP (odds ratio (OR) = 1.7, 1.1,2.5), E6 (OR = 32.8, 9.7,110.8) or E7 (OR = 37.5, 8.7,161.2). Compared to HPV DNA-negative/seronegative cases, tumor HPV-16 cases had increased risk of detection with anti-VLP antibodies (OR = 6.8, 3.1,14.9). The odds were more pronounced among cases seropositive for E6 (OR = 69.0, 19.3,247) or E7 (OR = 50.1, 14.7,171). Antibodies against E6 or E7 were associated with risk of cancer in the oral cavity (OR = 5.1, 1.2,22.4) and oropharynx (OR = 72.8, 16.0,330), and with disease characteristics: stage, grade and nodal status. Anti-E6 and/or E7 antibodies were found in 74% of tumor HPV-16 positive cases but in only 5% of tumor HPV-negative cases (K =0.7, 0.6,0.8) suggesting good correlation between the serologic marker and HPV tumor status. Antibodies to HPV-16 E6 and/or E7 represent a more specific biomarker than anti-HPV-16 VLP of an HPV-related HNC. Because of the survival advantage of HPV-related HNC, HPV-16 E6/E7 detection may be useful in therapy targeted for HPV-related tumors. © 2006 Wiley-Liss, Inc. [source] Prevalence of heparin-induced antibodies in patients with chronic renal failure undergoing hemodialysisJOURNAL OF CLINICAL LABORATORY ANALYSIS, Issue 5 2005Iván Palomo Abstract Heparin-induced thrombocytopenia (HIT) type II is a serious complication of heparin therapy. It presents initially as thrombocytopenia, and is associated with thrombosis in 20,50% of the cases. HIT is related to the presence of heparin-induced antibodies (HIA), which show specificity for the PF4-heparin (PF4-H) complex. The Fc,RIIa receptor has been suggested to participate in the pathogenic mechanism of HIA. Since patients undergoing chronic hemodialysis (HD) are exposed repeatedly to heparin, we studied the prevalence of HIA and their eventual relationship with thrombocytopenia and/or thrombosis, and the possible participation of the Fc,RIIa polymorphism. We studied 207 patients with chronic renal failure (CRF) undergoing HD. As a control we included 130 blood donors and 28 patients with CRF without HD. The HIA patients were studied with the use of a PF4-H ELISA. Additionally, in some positive cases for the previous test, a 14C- serotonin release assay (14C-SRA) was performed. The polymorphism Fc,RIIa H/R131 was studied by polymerase chain reaction (PCR) with allele-specific primers. Thirty-seven patients (17.9%) undergoing HD presented with HIA. The majority of these antibodies were IgG, IgM, and IgA. The HIA investigated presented specificity against the PF4-H complex, but not against PF4 alone (P<0.001). Twelve out of 22 (54.5%) PF4-H antibodies were positive when tested with the 14C-SRA. The distribution of the Fc,RIIa polymorphism in patients and healthy controls was 42.6% and 41.6% for H/H131, 41% and 48.9% for the H/R131 isoform, and 16.4% and 9.5% for the R/R131 isoform, respectively. No statistically significant difference in the Fc,RIIa isoform distribution was found. Twenty-nine out of 156 patients (18.5%) presented thrombocytopenia, and 21/207 (12.4%) had thrombosis of the native vein arterio-venous fistula (AVF). We did not find any statistically significant between HIA and thrombocytopenia or thrombosis. An important proportion of patients with CRF undergoing HD developed HIA, but these cases were not associated with thrombocytopenia or thrombosis of AVF. The frequency of the Fc,RIIa polymorphism did not statistically differ between HIT type II and normal controls. J. Clin. Lab. Anal. 19:189,195, 2005. © 2005 Wiley-Liss, Inc. [source] Development of a dipstick dye immunoassay for diagnosing hydatidosisJOURNAL OF CLINICAL LABORATORY ANALYSIS, Issue 6 2003Younes Sbihi Abstract We have developed a kit to diagnose hydatidosis, based on the detection of specific antibodies. This disease, caused by larvae of the cestode Echinococcus granulosus, is a zoonosis commonly found throughout the world. The diagnostic kit discriminates between positive and negative cases in a way that is easily interpreted, i.e., positive cases form a colored band on an inert substrate. The results show test sensitivity to be some 94.87% and specificity 85.71%, which is comparable to those of the ELISA technique. The high sensitivity and specificity of this test affords the great advantage of speed in diagnosing this parasitosis. No other equipment or procedure is required. J. Clin. Lab. Anal. 17:219,222, 2003. © 2003 Wiley-Liss, Inc. [source] Hypersensitivity reactions to penicillins: studies in a group of patients with negative benzylpenicillin G skin testJOURNAL OF CLINICAL PHARMACY & THERAPEUTICS, Issue 3 2009H.-L. Qiao MD PhD Summary Background:, Although skin tests are usually employed to evaluate current penicillin allergy status, a negative result does not exclude hypersensitivity. There is a need for accurate in vitro tests to exclude hypersensitivity. A radioallergosorbent test (RAST) is a potentially good supplementary approach, but there is little information on the suitability of this method to diagnose penicillin hypersensitivity in subjects with a negative skin test to benzylpenicillin. Methods:, A total of 133 patients with a negative skin test to benzylpenicillin G (PG) and all of whom developed allergic reactions to PG were studied. RAST was used to detect eight kinds of specific IgE antibodies to penicillins in serum, which included four kinds of major and minor antigenic determinants to four penicillin drugs. The combination sites for the specific IgE antibodies were studied by RAST inhibition test. Results:, The rate of positive reactions for the specific IgE antibodies was 59·40% (79/133). Of the eight kinds of antigenic determinants, the positive rates for specific IgE against the major and minor determinants were 39·10% (52) and 42·86% (57) respectively. Of the four drugs, positive cases only to PG were 10 (7·5%), were significantly fewer than the cross-reacting positive cases (36) to PG (P < 0·01). In the RAST inhibition studies all drugs exhibited good inhibitory potencies, and in some instances the side-chain of the penicillins could induce specific responses with a variable degree of cross-reactivity among the different penicillins. Conclusion:, Radioallergosorbent test is a good complementary test in persons who are skin-test negative with PG, and the sensitivity of RAST increaes with increasing specificity of IgE antibodies to be detected. 6-APA and the groups, making part of the different side-chains on penicillins, all contributed to the cross-reactivity. [source] Improved prenatal aneuploidy screening using the novel advanced first-trimester screening algorithm: A multicenter study of 10,017 pregnanciesJOURNAL OF CLINICAL ULTRASOUND, Issue 7 2008Peter Schmidt MD Abstract Purpose. It has been postulated that the maternal age component should be completely excluded from first-trimester screening (FTS) for fetal aneuploidies. In this study, we tested a new algorithm known as advanced first-trimester screening (AFS), which disregards maternal age. Method. In a multicenter study, FTS findings were retrieved from 10,017 pregnancies. FTS risk assessment was performed using the Nicolaides method, and the AFS score was calculated. The results of both methods were compared. Results. Within this population, 81 fetuses had an abnormal karyotype. The sensitivity of the 2 algorithms was 86.4%. When the AFS method was used, the positive predictive value rose from 9.6% (FTS) to 12.4% (AFS). Using AFS, the test positive rate could be decreased by 161 cases (,22.2%) (p < 0.0001), due to a reduction of false positive cases. As a result, the false positive rate of AFS was 24.5% lower than that of FTS, while the same number of aneuploidies was detected. Conclusion. AFS can markedly reduce the rate of false positive test results. If these results are confirmed by larger multicenter studies, the new AFS will represent a great improvement in fetal aneuploidy screening. © 2008 Wiley Periodicals, Inc. J Clin Ultrasound, 2008 [source] HER-2/neu expression in extramammary Paget disease: a clinicopathologic and immunohistochemistry study of 47 cases with and without underlying malignancyJOURNAL OF CUTANEOUS PATHOLOGY, Issue 7 2009Jose A. Plaza Extramammary Paget disease (EMPD) is an infrequent skin cancer sometimes representing a secondary event caused by extension of an underlying carcinoma. Her-2/neu overexpression in breast cancer is correlated with a more aggressive behavior, but anti-Her-2/neu therapy improves survival in these patients. We investigated Her-2/neu expression by immunohistochemistry in cases of EMPD with and without underlying malignancy to try to correlate with tumor recurrence, progression and possible targeted therapy. Forty-seven cases were analyzed (6 from the scrotum, 7 perianal region, 1 axilla and 33 vulva). Two cases had invasive EMPD (one from vulva and one from scrotum). The overall Her-2/neu expression was 31.9%. Of the noninvasive EMPD of the vulva (32 cases), Her-2/neu was shown in 38%. The case of invasive vulvar EMPD was negative. All six scrotal EMPD lacked Her2/neu expression. Her-2/neu was expressed in two of seven perianal cases (33.3%). The EMPD on the axilla (one case) was negative. Eighteen cases had recurrence, and of these, 44.4% expressed Her-2/neu in the initial lesion. A high proportion of EMPD showed Her-2/neu expression (31.9%), indicating that these patients may benefit from targeted therapy. The proportion of positive cases was higher in lesions that had recurred at last follow up (44.4%), suggesting a more aggressive behavior. [source] Toxicology and Circumstances of Death of Homicide Victims in New South Wales, Australia 1996,2005JOURNAL OF FORENSIC SCIENCES, Issue 2 2008Shane Darke Ph.D. Abstract:, To determine the prevalence and circumstances of psychoactive substances amongst homicide victims, 485 consecutive cases autopsied at the NSW Department of Forensic Medicine (1/1/1996,12/31/2005) were analyzed. Substances were detected in 62.6% of cases, and illicit drugs in 32.8%. Alcohol, cannabis, opioids, and psychostimulants were most commonly detected. Alcohol and cannabis were both more prevalent amongst males. Mean ages were significantly younger for decedents who tested positive for a substance and for an illicit drug. Cases where death resulted from a physical altercation were more likely to have had alcohol and cannabis present. Illicit drugs were prominent amongst firearms deaths. The proportion of alcohol positive cases increased from 25.0% on Monday to 49.4% for Saturdays/Sundays. Alcohol was more common in incidents in the 0001,0600 h and 1800,2400 h periods. Psychoactive substances appear to substantially increase the risk of homicide, although there are important differences between drug classes in the circumstances of such incidents. [source] | |||||||||||||||||||||||||||||||||||||