Prognostic Value of the Kiel Classification of Malignant Non-hodgkin's Lymphomas

The aim of the present research was to evaluate the prognostic value of the Kiel classification of malignant non-Hodgkin's lymphomas. For this purpose a series of 100 consecutive, previously untreated adults with advanced malignant non-Hodgkin's lymphomas was analyzed. The median age of the patients was 54 years; 61 patients were males. Although the number of the various groups considered was limited, a statistically significant difference (p < 0.001) was found in the median survival of patients with lymphomas of low-grade malignancy (lymphocytic, lymphoplasmacytoid, centrocytic, centroblastic-centrocytic lymphoma) and lymphomas of high-grade malignancy (centroblastic, lymphoblastic, immunoblastic lymphoma). A difference in survival (p < 0.001) was also observed among the patients with lymphocytic lymphoma and those with centroblastic-centrocytic lymphoma, whereas no significant difference in survival was found between the histological subtypes of high-grade malignant lymphomas. Our observations support the opinion that the Kiel classification is useful in clinical practice to distinguish the histological types with a better prognosis from those with a worse one; in addition this classification appears to be of conceptual value.

Heavy metals accumulation in two syntopic sandhopper species: Talitrus saltator (Montagu) and Talorchestia ugolinii Bellan Santini and Ruffo

We assessed the capacity for heavy metals accumulation in Talorchestia ugolinii by standard methods of heavy metals analysis. To compare the bioaccumulation in syntopic sandhopper species, we collected samples of T. ugolinii and Talitrus saltator living on the same and on different beaches in Corsica. There was a marked difference in the zonal distribution of the two species along the sea-land axis of the beach: T. ugolinii was distributed nearer the water line than T. saltator. The bioaccumulation capacity of T. ugolinii only partly matched that of the Mediterranean T. saltator: while Hg, Zn, Cu, and Cd were accumulated by both species, Al and Fe were accumulated by T. saltator but not by T. ugolinii. Pb was accumulated only by T. ugolinii, while Cr did not seem to be accumulated by either species. The bioaccumulation in sympatric T. saltator and T. ugolinii specimens collected on the same beach reflected the general trend of the two species on the Tyrrhenian and Corsican coasts, respectively. Moreover, six of the eight heavy metals considered (Hg, Pb, Zn, Fe, Al, Cu) were present in higher quantities in T. ugolinii than in T. saltator, independently of whether the trace elements were accumulated by the two species. Thus, there are some differences between T. ugolinii and T. saltator, even when the two species live in the same locality. These differences involve their zonation within the damp belt of sand, the bioaccumulation of some heavy metals (Al, Pb, Fe), and the quantity of each heavy metal in the body, independent of the bioaccumulation capacity.

Different cardiac response to copper in limpets from metal polluted and clean shores of Hong Kong

The gastropod limpet, Cellana grata, is common on moderately exposed to exposed Hong Kong rocky shores. On the basis of the existing literature on trace metal contamination in Hong Kong, four sites were identified, representative of highly polluted (Aberdeen and Lei Yue Mun) and clean (Cape d'Aguilar and Clear Water Bay) conditions. Limpets from the two polluted sites showed similar, but significantly higher body concentrations of copper than limpets from the two clean sites, which were also similar. Non-invasive measurements of cardiac activity of limpets from the four sites showed between site differences in baseline heart rates under standard seawater, irrespective of pollution level. When acutely exposed to water borne copper (2 h, 0.5+/-0.06 SD ppm), however, limpets from clean sites showed a significantly higher increase in inter-beating time (bradycardia) than those from polluted sites. These results highlight the potential use of cardiac activity to assess the exposure of natural populations of limpets to trace metal pollution.

Mediterranean Talitrus saltator (Crustacea, Amphipoda) as a biomonitor of heavy metals contamination

The use of sandhoppers and beachfleas as biomonitors of heavy metals contamination is relatively recent. Using adult individuals of Talitrus saltator from nine localities on the northern Mediterranean Sea, we studied the concentrations of eight trace elements: Al, Cd, Cr, Fe, Hg, Pb, Cu, Zn, both in the substratum and in the individuals. We also carried out a preliminary investigation of the correspondence between the sandhoppers' genetic variability and heavy metal contamination at the sampling sites. T. saltator accumulated Cd, Cu, Zn and Hg (at higher concentrations than in the sand) and also Al and Fe (at lower concentrations than in the sand). It seems that Mediterranean sandhoppers do not accumulate Pb and Cr. An intraspecific comparison between northern European (Baltic) and Mediterranean populations of T. saltator was made. Finally, we observed a tendency to a positive correlation between the sandhoppers' genetic variability and heavy metals contamination.

Variations in cardiac activity following acute exposure to copper in three co-occurring but differently zoned Mediterranean limpets

The cardiac activity of three limpets (Patella rustica, P. caerulea and P. aspera), having a different vertical zonation on the Mediterranean rocky shores, was monitored using a non-invasive technique, during 6 h exposure to copper solutions (0.1 and 0.5 ppm), and after return to copper-free conditions. At 0.1 ppm no significant variation of heart rate was observed in the three species with respect to control conditions, while after 3 h at 0.5 ppm a consistent bradycardia was evident in P. caerulea and P. aspera, but not in P. rustica. After 6 h at 0.5 ppm most of the specimens of the three species were acardic but still reactive to mechanical stimulation. Tests on the resumption of cardiac activity after 6 h exposure to 0.5 ppm showed that even after a prolonged cessation of cardiac activity, limpets quickly resumed heartbeating once returned to clean seawater. However, recovery of heart-beating was faster in the mid- and high-shore species (P. caerulea and P. rustica, respectively) than in the lower-shore P. aspera. Moreover, the cardiac pattern upon recovery was definitely bradycardic in P. aspera, while the other two species showed a significant overshooting in heartbeating rate. Measurement of body burdens of copper showed that P. rustica and P. caerulea were faster in removing the excess of copper than the lower-shore P. aspera. In conclusion, this study showed that taxonomically close and syntopic species having a different zonal distribution exhibit different cardiac responses to water-borne copper and stresses the importance of comparative studies on physiological responses of organisms to metal pollution.

Metabolic responses of the limpet Patella caerulea (L.) to anoxia and dehydration

This study examined the metabolic responses of the limpet Patella caerulea (L.) to anoxia and dehydration, attempting to tease apart the effect of these two stressful conditions, which are often not clearly distinguished in experiments. Specimens were exposed to: (a) oxygen-free sea water; (b) oxygen-saturated water (controls); (c) low-humidity air (55% RH); and (d) high-humidity air (100% RH). For each of the treatments, we took samples of five specimens after 6 and 18 h of exposure to the experimental conditions and determined the concentrations in the foot muscle of succinate, acetate, propionate, aspartate and alanine. Exposure to anoxia caused an increase in the levels of succinate (6 and 18 h) and acetate and propionate (18 h) with respect to control specimens. Anoxia also induced a decrease of aspartate and an increase of alanine after both 6 and 18 h. Exposure to both moist and dry air generally had negligible effects on the organic acid levels. Aspartate content increased after 18 h of exposure to moist air. Alanine levels also increased with respect to control values after exposure to air, with dry air having the more pronounced effect. In conclusion, the results of this study suggest that one should be cautious when inferring anaerobic conditions from the simple exposure of intertidal species to air, without strict control of the experimental conditions and actual respiration rates.

Estimating the energetic cost of fighting in shore crabs by noninvasive monitoring of heartbeat rate

After establishing shore crabs, Carcinus maenas, individually in separate aquaria, we used a noninvasive infrared phototransducer to monitor their heartbeat rate continously before, during and after fights with intruder crabs. We confirmed that heartbeat rate is a reliable indicator of oxygen consumption and then used it to estimate indirectly the energetic cost of fights differing in duration and intensity, and its dependence on prior residence and relative size of opponent. Prior residence in aquaria significantly increased the probability that crabs would initiate fights against intruders. The majority of fights were resolved by aggressive contacts, display being used extensively only against smaller intruders. Fights between evenly sized opponents and between residents and larger intruders involved almost continuous aggression, whereas fights with smaller intruders involved several shorter bouts of aggression. Fight duration was weakly correlated with the relative size of opponents. Heartbeat rate, measured only in residents, was elevated above resting levels throughout fights, hence energy expenditure during fighting increased linearly with fight duration. Contrary to expectation, heartbeat rate was not significantly influenced by relative size of the opponent or by the intensity of aggression. After fighting, heartbeat rate usually returned to resting levels within 30-60 min, recovery taking longer in fights against larger intruders, when the fight was always lost. We propose that prolonged elevation of heartbeat rate in residents that had lost to larger intruders represented a state of alertness, adaptive against impending risks of resource loss or injury. Copyright 2000 The Association for the Study of Animal Behaviour.

Cardiac and behavioural responses of mussels to risk of predation by dogwhelks

We used noninvasive, infrared phototransducers to record continuously the heartbeat of common mussels, Mytilus edulis, experiencing successive phases of interaction with the predatory gastropod Nucella lapillus, from initial threat to attack and consumption. Coupling physiological monitoring with behavioural analysis allowed us to investigate in detail the responses of mussels to predation threat. Compared to values of normal feeding activity, heart rate increased significantly when mussels were in the presence of effluent from dogwhelks. When attacked by dogwhelks, mussels increased their heart rate further, together with the rate of valve gaping. Considering the heart rate as a reliable estimator of respiratory function, these cardiac responses might be a mechanism to compensate for increased energy demand in order to cope with predation hazard. If so, the theoretical importance of trading off energy balance against risk of predation is supported by our results. Cardiac and behavioural responses varied throughout the attack according to the penetration method adopted by dogwhelks. When mussels were attacked through a drilled hole, heart rate tended to increase and periods of cardiac pausing appeared close to the point of death. In contrast, mussels attacked by penetration between the valves showed decreasing heart rate throughout the attack, together with relatively earlier cessation of valve gaping and appearance of cardiac pausing. These differences clearly support the hypothesis that dogwhelks penetrating between the valves are able to induce muscular paralysis of prey by injecting toxins. Copyright 1999 The Association for the Study of Animal Behaviour.

Effect of experience on predatory behaviour of dogwhelks

We used an acoustic transducer to monitor the radular activity of dogwhelks, Nucella lapillus, drilling mussels, Mytilus edulis, in the laboratory and we examined the effect of dietary experience on prey-handling behaviour. For the first time, phases of inspection, penetration and ingestion could be distinguished directly, and consequently the prey-handling process analysed in detail. Dogwhelks with different field-based experience of mussels showed different handling behaviour. Those collected from a mussel-dominated shore more readily adopted the faster method of penetrating between the slightly gaping valves, instead of the slower method of drilling through the shell. Those collected from a barnacle-dominated shore took significantly longer to attack the mussel and then were unable to switch from drilling to penetrating through the gape between valves. Experience of specific prey in the field, by reducing handling time, could promote fitness by reducing exposure to environmental hazards. Laboratory attempts to train dogwhelks from the barnacle-dominated shore to use the gape penetration method failed, suggesting that functional constraints, such as injection of a relaxant when penetrating through the gape and/or genetically controlled behavioural traits, could limit the ability to learn handling skills. Copyright 1999 The Association for the Study of Animal Behaviour.

[Adult-onset Still's disease. Report of 5 cases]

The authors report 5 cases of Still's disease in adults whose symptoms were mainly characterised by high fever, transient exanthema, polyarthralgia and/or polyarthritis, lymphoadenomegaly, splenomegaly and neutrophil leukocytosis. Assays for leukocytosis were positive, as were those for inflammatory markers and serum ferritin was also high in all 3 patients in which it assayed. On the contrary, serum ferritin latex test, Waaler-Rose reaction and all other tests commonly used to diagnose long-term fevers were all negative. All the subjects examined recovered after prolonged steroid therapy. Only one patient reported severe sequelae in the hip joints and subsequently underwent bilateral hip replacement surgery.

In situ and laboratory assessment of heart rate in a Mediterranean limpet using a noninvasive technique

Heart rate of the Mediterranean limpet Patella caerulea L. was investigated on the natural shore and in the laboratory by using a technique based on infrared phototransducers. Field recording occurred in the Gulf of Trieste (northern Adriatic) during March and June 1997. A consistent dependence of heart rate on temperature was observed in limpets both when submerged and when exposed to air in the two periods, but thermal acclimation was evident. During spontaneous activity at high tide, heart rate increased 1.5-1.7 times the values observed during resting in water at corresponding temperatures. The dependence of heart rate on temperature (10 degrees, 16 degrees, and 22 degrees C) and size (wet weight <1.25 and >1.30 g) in submerged limpets from different populations (northern Adriatic and Tyrrhenian) was tested in the laboratory by adopting a factorial design. The results showed a marked effect of temperature, body weight, and their interaction, independent from the site of origin. Smaller limpets showed a linear increase of heart rate in the whole range of temperature tests, while in the larger ones the increase between 10 degrees and 16 degrees C was greater than between 16 degrees and 22 degrees C. Heart rate decreased with increasing body size at control (16 degrees C) and high (22 degrees C) temperature, while at lower temperature (10 degrees C) no effect of body size was evident. When removed from their home scar, limpets increased heart rate to about 1.5 times the reference value. Finally, correlation of oxygen consumption with heart rate of submerged limpets maintained at a different temperature (10 degrees -22 degrees C) was statistically significant.

Plasma fibronectin concentrations in patients with human immunodeficiency virus infection

Plasma fibronectin (PFN) concentrations were assessed in 21 patients with AIDS, in seven with AIDS-related complex (ARC), in 17 asymptomatic seropositive patients, and in 36 age and sex matched healthy control subjects. A single radial immunodiffusion technique was used to determine PFN concentration. A significant decrease in PFN concentrations was observed in patients with ARC and AIDS (especially in those patients with Pneumocystis carinii pneumonitis). On the other hand, normal PFN concentrations were observed in asymptomatic seropositive patients. The determination of PFN concentration in patients with AIDS and ARC may contribute to the diagnosis of such patients.

[Monoclonal gammopathy of uncertain significance in rheumatic disease]

Among 358 patients with rheumatic diseases, the incidence of monoclonal gammopathy of undetermined significance (MGUS) as detected by immunofixation was 4.4% (11 of 248 patients) in rheumatoid arthritis (RA), 3% (1 of 32 patients) in systemic lupus erythematosus (SLE), 6% (3 of 49 patients) in Sjögren's syndrome (SS) and 3% (1 of 29 patients) in progressive systemic sclerosis (PSS). Solid tumor was present in 4 (36%) of the 11 RA-MGUS patients. In these cases the monoclonal component could be related to a paraneoplastic syndrome rather than to rheumatic diseases. The association of rheumatic diseases, MGUS, solid tumor and immunological disorders are discussed.

Total serum IgE levels in children with pertussis

Total serum IgE levels were evaluated in 20 children with pertussis. Increased levels of serum IgE were observed in the group of children between the ages of 3 and 12 years, while normal levels of serum IgE were detected in the groups of children between birth and 24 months old and between 13 and 24 months old. A further and significant increment of serum IgE levels was also found after 10 days of hospitalization.

[Primary malignant non-Hodgkin's lymphoma of the stomach. Case series contribution]

Fourteen cases of primary gastric non-Hodgkin malignant lymphoma have been classified according to the "Working Formulation for Clinical Usage" and according to the Kiel classification. They have been staged according to the Ann Arbor staging system modified by Musshoff and according to the Manchester staging system modified by Rao. They have been also arranged in the Friedman's macroscopic types. Clinical features, radiologic and endoscopic findings, performed surgical operations, histologic reports and prognostic factors are reported and discussed. The patients, after surgery, have been treated with radiotherapy and/or polychemotherapy, according to the suggested therapeutic pattern. The follow-up has evidenced a better prognosis than gastric carcinoma. The importance of the preoperative diagnosis is emphasized. This is often difficult to obtain, but it permits a better surgical treatment and especially the right intraoperative staging.

Serum beta 2-microglobulin levels in multiple myeloma and monoclonal gammapathy of undetermined significance: a clinical study of 55 patients

Previous reports provided clear evidence that serum beta 2-microglobulin (beta 2m) is a marker highly correlated with the total mass of myeloma cells and suggested its use in the follow-up of patients with plasma cell tumors. Serum beta 2m levels were measured in 38 patients with multiple myeloma (MM), in 17 patients with monoclonal gammapathy of undetermined significance (MGUS) and in 32 normal control subjects. While statistically significant differences could be established between controls and both MM and MGUS patients, between patients with MM at stage III and patients with MM at lower stages as well as between patients with MGUS and patients with mostly advanced MM, it was not possible to statistically separate patients with MM at stage I from patients with MM at stage II, patients with untreated MM from patients with treated MM and, finally, patients with MGUS from patients with low cell mass MM. These results substantially confirm the already published data and lead to the conclusion that serum beta 2m determination is a useful test in the clinical management of monoclonal gammapathies, but it does not allow a differential diagnosis between benign and malignant forms of the disease.

Increased total serum IgE concentration in patients who have undergone splenectomy after trauma

Serum immunoglobulin and complement concentrations were evaluated in 20 patients who had undergone splenectomy after trauma. The concentrations of IgE and IgA in the patients were significantly increased compared with those in controls. The IgE values were not correlated with the time after splenectomy or IgA, IgG, IgM, IgD, C3, and C4 values.

Abnormalities of peripheral blood T lymphocyte subsets in polymyalgia rheumatica

The T lymphocyte subsets were studied by monoclonal antibodies in the blood of eight patients with polymyalgia rheumatica. The percentages of circulating T cells (OKT3+) were lower when compared with normal controls (p less than 0.02), as were the proportions of suppressor/cytotoxic (OKT8+) T cells (p less than 0.001), whereas the proportions of helper/inducer (OKT4+) T lymphocytes were not changed. Consequently, the OKT4:OKT8 ratio was higher in patients with polymyalgia rheumatica than in controls (p less than 0.001). On the contrary, circulating B cells were not altered. The decrease in peripheral blood OKT3+ and OKT8+ lymphocyte subsets suggests that there is an impairment of cell-mediated immunity in polymyalgia rheumatica.

[Arthrography of the ankle joint]

Arthrography of the ankle joint was first carried out by Johnson and Palmer at the Military Hospital in Stockholm in 1940. Arthrography can be used for judging the integrity of the articular cartilage, of osteochondritis dissecans, arthritis or adhesive capsulitis. The literature shows, however, that more than 95% of the patients on whom this examination has been performed had suffered from acute trauma.

Cooperative Interactions and Environmental Control in the Intertidal Clustering of Nerita Textilis (Gastropoda; Prosobranchia)

Abstract

1. Somalian populations of the intertidal gastropod Nerita textilis Gmelin show a vertical separation between resting (mid-upper eulittoral) and feeding (lower eulittoral) zone. During high tides and mostly diurnal low tides some snails remain scattered (SF), while other form aggregations (AF) at lower levels of the rocky shore. During the mostly nocturnal low tides both SF and AF migrate downward to feed on microalgae. 2. Lower and upper aggregations are mostly frequented around neap (NT) and spring tides (ST), respectively. Clustering significantly reduces the exposure to waves during high tide, and probably overheating and dehydration during diurnal low tide. 3. About 90 percent of the total population enters into the cluster system throughout each NT-ST-NT cycle. Clustering begins to increase at NT and falls at ST, reaching a maximum (52 percent of the population) between NT and ST. The relative frequency of transition between SF and AF shows a spike after NT and falls after ST. The inverse transition (AF to SF) is negatively correlated to the amount of AF. 4. Return to the original cluster after one feeding excursion is high (76 percent) and decreases slightly at increasing intervals (about 40 percent after 14 feeding migrations), but it becomes significantly lower after one or more rest phases spent in SF. 5. The field study suggests that the periodical (NT) increase in density at the lower rest-zone (tide-pools belt), long-lasting chemical marking of collective rest sites and releasing mucus trails during feeding excursions cause the clustering. According to this hypothesis, a primer group stops at each aggregation site at NT, mostly returning to it by self-trailing after each feeding migration, while the progressive recruitment of snails from SF is caused by the interindividual trail-following during the return migration from the feeding ground. 8. The same model can explain the clustering behaviour of other intertidal gastropods, though the importance of the different parameters (periodical variation in zonation, marking of rest places, trail-following) probably vary among the different species.

[Blood folates in chronic uremic patients in dialysis treatment]

The authors, after having reviewed folic acid and folates chemical and biochemical characteristics and their absorption and excretion modalities, determine serum folate levels by radioassay method on 30 patients with renal failure in chronic dialysis and on 24 normal controls. Low serum folate levels concerned 14 uremic patients (46.6% of th cases): 10 in hemodialysis and 4 in peritoneal dialysis. The mean serum folate values was 3.31 ng/ml (+/- 1.93) for the uremic patients' group and 4.29 ng/ml (+/- 1.21) for the control group. The difference between the mean level of these groups was statistically significant (p less than 0.05). No significant difference was observed among the mean serum folate levels of the uremic patients in peritoneal dialysis and of those in hemodialysis. Significantly low serum folate levels were finally found for the uremic HBsAg-positive patients, but in the same subjects the dialytic treatment period had been very prolonged. The authors conclude emphasizing the usefulness of folic acid treatment in uremic patients on dialysis, also without having an evident hematologic picture of megaloblastic anemia.