Hodgkin's disease in the elderly

Phenotypic diversity and metabolic specialization of renal endothelial cells

Complex multicellular life in mammals relies on functional cooperation of different organs for the survival of the whole organism. The kidneys play a critical part in this process through the maintenance of fluid volume and composition homeostasis, which enables other organs to fulfil their tasks. The renal endothelium exhibits phenotypic and molecular traits that distinguish it from endothelia of other organs. Moreover, the adult kidney vasculature comprises diverse populations of mostly quiescent, but not metabolically inactive, endothelial cells (ECs) that reside within the kidney glomeruli, cortex and medulla. Each of these populations supports specific functions, for example, in the filtration of blood plasma, the reabsorption and secretion of water and solutes, and the concentration of urine. Transcriptional profiling of these diverse EC populations suggests they have adapted to local microenvironmental conditions (hypoxia, shear stress, hyperosmolarity), enabling them to support kidney functions. Exposure of ECs to microenvironment-derived angiogenic factors affects their metabolism, and sustains kidney development and homeostasis, whereas EC-derived angiocrine factors preserve distinct microenvironment niches. In the context of kidney disease, renal ECs show alteration in their metabolism and phenotype in response to pathological changes in the local microenvironment, further promoting kidney dysfunction. Understanding the diversity and specialization of kidney ECs could provide new avenues for the treatment of kidney diseases and kidney regeneration.

Familial Hodgkins disease

Three cases of Hodgkins Disease in one family are described. The index case presented with pyrexia of unknown origin and the diagnosis of Hodgkins Disease was made at post mortem. Two other members of the family had died of a similar cause many years previously. Triple occurrence of Hodgkin's Disease within one family is very uncommon as is a long time interval between cases.

Epidemiological study of socioeconomic factors and clinical findings in Hodgkin's disease, and reanalysis of previous data regarding chemical exposure

An association between malignant lymphoma (both Hodgkin's disease (HD) and non-Hodgkin lymphoma) and exposure to organic solvents, phenoxy acids, or chlorophenols was previously reported. A reanalysis of this investigation regarding the cases with HD and exposure to various chemicals was performed and resulted in comparable findings to the whole group of malignant lymphoma. There was an overrepresentation of cases with primary involvement of the gastrointestinal tract which was associated with exposure to these chemicals. The influence of previous diseases and socioeconomic factors was analysed through a supplementary questionnaire to the cases with HD and their matched controls. No differences were found in cases and controls for such variables except for tonsillectomy which was overrepresented among the cases as well as a history of previous duodenal or ventricular ulceration. These findings were, however, insignificant.

Epidemiology of hodgkin's disease in the young

Many features of Hodgkin's disease (HD) among adolescents and young adults suggest that it has an infectious etiology. However, the proposal that HD is a contagious disease which can be transmitted by patients or their close contacts has not been substantiated. An alternative infectious disease model is suggested by analogy with paralytic poliomyelitis (PP). For both diseases, the peak age of incidence is delayed as living conditions improve. For both, increased risk is associated with higher social class and small family size. Like PP, HD may be a rare manifestation of a common infection with the probability of disease development increasing as age at infection is delayed. This analogy is supported by the report that the risk of HD is higher for persons who had a low frequency of childhood infectious diseases. If this model is valid, HD patients represent no hazard to their contacts. However, the incidence of HD among young adults may increase in the coming decade because of the current high standard of living and small family size.