Chromosome preparation from hematological malignancies.
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Bone Marrow↗
Biomedical subjects
F M Ross
Publications and source records attributed to F M Ross.
Practice nurses: characteristics, workload and training needs.
AIM: This study set out to identify the present and future training needs of practice nurses in South West Thames Regional Health Authority and to examine these needs within the nurses' current and changing workloads and social, educational and occupational profiles. METHOD: A questionnaire was sent to 899 practice staff identified by family health services authority records whose salaries were in part reimbursed and in whose job title the word nurse appeared. The questionnaire enquired about personal and practice demography, tasks and activities currently undertaken, perceived role development and training requirements, and preferred organization of training. RESULTS: A total of 620 completed questionnaires were returned (69%). Nurses' work involved treatments, immunizations investigations, administration, first contact with patients, support to the general practitioner and health promotion. The areas of role development selected most commonly by nurses were counselling skills (60%) and health promotion (54%); in terms of training the most popular areas were communication skills (62%) and the theory and practice of health promotion (48%). Fewer than one third of the nurses who were engaged in health checks for elderly people or the provision of diabetes care, asthma care or advice about the human immunodeficiency virus (HIV) and the acquired immune deficiency syndrome (AIDS) held an appropriate qualification. CONCLUSION: Practice nurses in the region were engaged in a wide range of activities for which many have had little formal training; the majority wished to develop their role and undertake further training. If practice nurses are to play a key part in the development of primary care services they must be adequately prepared for their clinical and health promotion role.
Education, Nursing, Continuing↗
Evidence for a new tumour suppressor locus (DBM) in human B-cell neoplasia telomeric to the retinoblastoma gene.
Roughly 25% of human B-cell chronic lymphocytic leukaemias (CLL) are characterized by a chromosomal lesion involving 13q14. This region contains the retinoblastoma gene (RB1). We have used a variety of techniques to determine whether RB1 or some other locus is the critical region in 11 cases of low grade B-cell malignancy (mainly CLL), all with deletions or translocations involving 13q14. In all cases, except the one with minimal disease, there was deletion or a structural lesion in the region of D13S25, with at least 4 cases showing homozygous disruption. We conclude that D13S25 lies close to a tumour suppressor locus whose inactivation contributes to the initiation or progression of low grade B-cell malignancy. This locus is located at least 530 kilobases telomeric to RB1.
Alleles↗
Structural abnormalities of the X chromosome in non-Hodgkin's lymphoma.
It has recently been reported that additional X chromosomes occur in over 30% of B-cell non-Hodgkin's lymphomas (NHL), and that monosomy of the X chromosome occurs in 38% of female patients with T-cell leukaemia or lymphoma. These observations have suggested a possible role for the X chromosome in the evolution of NHL. We have now examined 280 cases of NHL, and have identified 19 examples of structurally altered X chromosomes in the malignant cells from 17 of these cases. These abnormalities were mainly characterized by either a translocation involving Xp22, or a translocation/deletion involving Xq28. The relevance of these observations is discussed with respect to other published reports, and together they suggest that lymphoma-associated oncogenes may exist on the X chromosome at bands p22 or q28.
Aneuploidy↗
Karyotypic abnormalities and immunoglobulin gene rearrangements in Hodgkin's disease.
Biopsy samples from seven patients with Hodgkin's disease (HD) were examined for cytogenetic abnormalities and rearrangement of the genes encoding the immunoglobulin chains and T-cell receptor chains. Three samples demonstrated clonal rearrangements of both IgH and IgL genes. No rearrangements of the TCR beta genes were detected in any of the samples. Karyotypic abnormalities were also found but only in the three cases where a clonal rearrangement of the immunoglobulin genes was shown. Two of these three cases had multiple karyotypic abnormalities, with the remaining patient being trisomic for chromosome 16 as the sole abnormality. These results are discussed and compared with previous reports in the literature concerning HD.
Adolescent↗
8;21 translocation with duplication of the der(21) in a patient with myelomonocytic leukemia.
An 8;21 translocation with duplication of the der(21) is described in a 72-year-old man who presented with features of chronic myelomonocytic leukemia. Progression to acute myelomonocytic leukemia occurred within one month of diagnosis. The possible prognostic significance of the t(8;21) with duplicated der(21) in myelodysplasia is discussed.
Aged↗
Patient compliance--whose responsibility?
This paper focuses on general practitioner and district nurse knowledge of prescribed drugs taken by their elderly patients, and the evaluation of a method of improving that knowledge by a patient held drug guide. Serious differences were identified in the knowledge of doctors, nurses and patients about drugs. The drug guide was associated with an improvement in patient knowledge of drugs as well as a reduction in disagreements between doctors and nurses. A key issue addressed is patient culpability in compliance. It is argued that this is a simplification which overlooks important factors such as inadequate communication and lack of knowledge on the part of doctors and nurses as well as the difficulties the patient may have with the regime.
Aged↗
Bcl-2 protein expression in follicular lymphomas in absence of 14;18 translocation.
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Chromosomes, Human, Pair 14↗
Prognostic subgroups in B-cell chronic lymphocytic leukemia defined by specific chromosomal abnormalities.
BACKGROUND AND METHODS: Specific chromosomal abnormalities have been shown to affect the overall survival of patients with acute leukemia, but the possibility that specific chromosomal defects may influence the course of B-cell chronic lymphocytic leukemia (CLL) is controversial. We assessed this possibility as follows: blood mononuclear cells from 433 patients with B-cell CLL in five European centers were cultured with B-cell mitogens, and banded metaphases were studied. RESULTS: Three hundred ninety-one patients could be evaluated cytogenetically, and 218 had clonal chromosomal changes. The most common abnormalities were trisomy 12 (n = 67) and structural abnormalities of chromosome 13 (n = 51; most involving the site of the retinoblastoma gene) and of chromosome 14 (n = 41). Patients with a normal karyotype had a median overall survival of more than 15 years, in contrast to 7.7 years for patients with clonal changes. Patients with single abnormalities (n = 113) did better than those with complex karyotypes (P less than 0.001). Patients with abnormalities involving chromosome 14q had poorer survival than those with aberrations of chromosome 13q (P less than 0.05). Among patients with single abnormalities, those with trisomy 12 alone had poorer survival than patients with single aberrations of chromosome 13q (P = 0.01); the latter had the same survival as those with a normal karyotype. A high percentage of cells in metaphase with chromosomal abnormalities, indicating highly proliferative leukemic cells, was associated with poor survival (P less than 0.001). Cox proportional-hazards analysis identified age, sex, the percentage of cells in metaphase with chromosomal abnormalities, and the clinical stage of the disease (Binet classification system) as independent prognostic variables. CONCLUSIONS: Chromosomal analysis provides prognostic information about overall survival in addition to that supplied by clinical data in patients with B-cell CLL.
Adult↗
Establishment of a karyotypically normal B-chronic lymphocytic leukemia cell line; evidence of leukemic origin by immunoglobulin gene rearrangement.
A new Epstein-Barr virus (EBV) transformed cell line was established from a patient with B-chronic lymphocytic leukemia (B-CLL). The karyotype of the cell line has remained normal for over 12 months in culture; however, identical heavy and light chain immunoglobulin (Ig) gene rearrangements in the patient's blood and the cell line provided evidence that the EBV transformed cells were derived from the neoplastic clone.
Aged↗
Molecular evidence for a single clonal origin in biphenotypic concomitant chronic lymphocytic leukemia and multiple myeloma.
To establish the clonal origin of a case of concomitant B-cell chronic lymphocytic leukemia (IgM kappa) and multiple myeloma (IGA lambda), we analyzed the immunoglobulin (Ig) gene rearrangements in the patient's blood and bone marrow. Despite the different isotypes, pretreatment investigation of the heavy chain gene (JH) revealed a germline fragment and two identical rearrangements in the blood and marrow. Both kappa and lambda light-chain genes were rearranged in the blood, suggesting peripheral blood lymphocyte involvement in the myeloma. Analysis of the Ig genes after chemotherapy demonstrated no change in the JH or CK rearrangements; however, the lambda genes were now in a germline configuration. Our results suggest that in this patient both chronic lymphocytic leukemia and myeloma originated from the same B-cell progenitor.
Antigens, Neoplasm↗
Doctor, nurse and patient knowledge of prescribed medication in primary care.
The prescribed medication of elderly patients receiving district nursing care was studied in an inner London group practice. Information on each patient's medication was obtained independently from the patient's doctor, her district nurse and from the patient herself and then compared. This paper focuses on the areas of agreement and disagreement between professionals and patients, and the doctor/nurse meeting as a method of resolving disagreements. The discussion highlights some of the problems of maintaining accurate records in primary care, and the implications for teamwork.
Aged↗
Telomeric associations in a lymphoblastoid cell line from a patient with B-cell follicular lymphoma.
We have established a new Epstein-Barr virus transformed cell line from a patient with B-cell follicular lymphoma. Telomeric fusions were observed in several subclones, with the nonrandom involvement of chromosomes 1, 5, 12, and 17. Centromeric staining with immunofluorescent anti-kinetochore antibodies was positive in both centromeres of the fused chromosomes, suggesting they were both active. Unlike previously reported cases, we were unable to demonstrate telomeric fusions directly in cells from the patient's blood. However, the finding of identical immunoglobulin gene rearrangements in DNA from the patient's blood and cell line suggested that they originated from the same malignant B-cell clone.
B-Lymphocytes↗
Characterization of a new non-Hodgkin's lymphoma cell line (NCEB-1) with a chromosomal (11:14) translocation [t(11:14)(q13;q32)].
A new cell line, NCEB-1, was established by Epstein-Barr virus (EBV) transformation of peripheral blood mononuclear cells from a patient with centroblastic-centrocytic diffuse lymphoma expressing IgM lambda. The transformed cells were lymphoblastoid, with many cells showing a plasmacytoid morphology. The NCEB-1 cells had cytoplasmic Ig (CyIg), with loss of the surface Ig (SIg) expression. Cytogenetic analysis of the cell line demonstrated two clones with variations: a hypodiploid clone, with a complex karyotype including a t(11;14)(q13;q32) similar to the original tumor cells, and a near tetraploid clone with the same markers. Southern blot analysis of DNA from the patient's neoplastic cells and NCEB-1 demonstrated identical Ig heavy chain gene rearrangement, confirming the origin of the cell line. The cell line was not tumorigenic when tested in an in vitro assay using immunosuppressed mice. NCEB-1 has been in continuous culture for 9 months and will be valuable for the in vivo study of non-Hodgkin's lymphoma and EBV transformation.
Cell Line↗
Clonal chromosome abnormalities in chronic lymphocytic leukemia patients revealed by TPA stimulation of whole blood cultures.
Cells from 52 patients with chronic lymphocytic leukemia and two patients with prolymphocytic leukemia were stimulated in whole blood or bone marrow culture with the polyclonal B-cell mitogen tetradecanoyl phorbol acetate (TPA). Stimulation was successful in 50 of the 54 cases. Comparison with Epstein-Barr virus and pokeweed mitogen showed them to be much less successful mitogens under the conditions used. Twenty-one patients (39%) were found to have clonal abnormalities that were probably disease-related. The most common abnormality was trisomy 12 (five patients). Four patients had a deletion of the long arm of chromosome #11 and one patient had a t(11;14). Five patients had abnormalities of the long arm of chromosome #13, with four probably having breaks in band q14. Two patients were seen with trisomy 3 as the only abnormality. Overall, the results were similar to those of other groups, which shows that considerable karyotypic information can be obtained from the use of a single mitogen on a large series of chronic lymphocytic leukemia patients.
Aged↗
A myelodysplastic syndrome with eosinophilia associated with a break in the short arm of chromosome 16.
A case is reported of a young man with cardiomyopathy and myelodysplasia with bone marrow and peripheral blood eosinophilia. Cytogenetic investigation revealed a (5;16) (q33;p13) translocation. This is the first report of myelodysplasia with eosinophilia associated with a break in 16p13 alone, with no abnormality of 16q22.
Adult↗
Altered cGMP-phosphodiesterase activity in chemotactic mutants of Dictyostelium discoideum.
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3',5'-Cyclic-GMP Phosphodiesterases↗
Streamers: chemotactic mutants of Dictyostelium discoideum with altered cyclic GMP metabolism.
Mutants of Dictyostelium discoideum that developed huge aggregation streams in expanding clones were investigated using optical and biochemical techniques. Representatives of the six complementation groups previously identified (stmA-stmF) were found to be similar to the parental wild-type strain XP55 in both the extent and timing of their ability to initiate and relay chemotactic signals and in the formation of cyclic AMP receptors and phosphodiesterases. The mutants differed from the wild-type in producing an abnormal chemotactic (movement) response visible using both dark-field optics with synchronously aggregating amoebae on solid substrata and light scattering techniques with oxygenated cell suspensions. Mutants of complementation group stmF showed chemotactic movement responses lasting up to 520 s, rather than 100 s as seen in the parental and other strains. Measurements of cyclic GMP formed intracellularly in response to chemotactic pulses of cyclic AMP in stmF mutants showed that abnormally high concentrations of this nucleotide were formed within 10 s and were not rapidly degraded. A causal correlation between defective cyclic GMP metabolism and the altered chemotactic response is suggested, and a model is proposed that accounts for the formation of huge aggregation streams in clones of these mutants.U
Chemotaxis↗