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PubMed2000

Virulence profiles and other biological characters in water isolated Aeromonas hydrophila.

Thirty water isolates of A. hydrophila were tested for potential virulence profiles, antibiotic resistance and Bacteriocin-Like Substances (BLS) production. Cytotoxic activity was present in all strains tested, 87% were hemolytic and 70% adhesive. Lysine decarboxylase reactions (LDC) positivity was correlated with virulence factors: 100% versus cytotoxicity, 84% versus adherence, 76% versus hemolytic activity. The correlation was also present in the LDC-negative strains. Hemolytic and cytotoxic activities were frequently associated: high cytotoxicity, corresponding to high hemolytic activity and vice versa. The in vitro susceptibility of A. hydrophila to 28 antibacterial agents showed that cefotaxime was the most active beta-lactam antibiotic, and Cefuroxime inhibited 90% of the strains. Isolates were resistant to Penicillin G, Ampicillin, Carbenicillin, Amoxicillin, Cephalotin and Cefaclor. Tetracycline, Chloramphenicol, Nitrofurantoine, the quinolones and the aminoglycosides (except Streptomycin) were consistently active. BLS production never emerged against closely-related microorganisms. On the contrary A. hydrophila presented a heteroinhibitory activity against non-taxonomically related genera such as Listeria spp. (L. seeligeri NCTC 11856, L. welshimeri NCTC 11857, L. ivanovii NCTC 11846) and S. aureus ATCC 25923. Although a large number of strains showed virulence determinants together with other biological characters such as antibiotic resistance and BLS production, it was not possible to relate these factors to the observed plasmids.

Aeromonas hydrophila↗
PubMed2001

Effect of IFN-gamma on expression of HLA in bare-lymphocyte syndrome-like cell line HAJ.

We compared HLA antigen expression on new B-lymphoblastoid cell line (B-LCL) HAJ with that on B-LCLs expressing normal HLA levels as well as on B-LCLs derived from bare lymphocyte syndrome (BLS) patients and in vitro mutated B-LCLs of BLS-like phenotype. HAJ cells had no expression of HLA class II and low expression of class I antigens similarly to some of BLS B-LCLs, although HAJ cell line was derived from lymphocytes of HLA class I- and class II-normally expressing donor. HAJ cells displayed B lymphocyte markers, surface immunoglobulin and CD19. Culture of HAJ cells in the presence of interferon y resulted in HLA class I antigen upregulation, but did not restore class II expression. The cell line HAJ may prove useful for studies on factors influencing HLA class I cell surface expression.

Animals↗
PubMed2004

[The workshop of cardiopulmonary resuscitation for medical doctors in Jichi Medical Hospital].

The Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care (ECC) established in 2000 (Guidelines 2000) are the standard for cardiopulmonary resuscitation (CPR) all over the world. Written guidelines based on Basic Life Support (BLS) and Advanced Cardiac Life Support (ACLS) are widely available throughout Japan and are studied by physicians but ACLS training courses have been made available only recently. In 2003, our hospital formed a committee to address standards of patient safety and one of the recommendations of the committee was the attendance of standardized BLS by health care workers and of ACLS by physicians. In May, 2003 a total of 447 physicians from our hospital participated in a workshop on BLS which provided lectures, demonstrations and a written examination. After completion of this workshop, it has been concluded that standardization in the area of resuscitation is mandatory, and efforts to disseminate this workshop to health care practitioners are to be undertaken.

Cardiopulmonary Resuscitation↗
PubMed1992

[The emergency telephone number--the essential weak link in an emergency system. Prospective studies involving cardiac arrests observed by bystanders].

The first link in the "chain of survival" concept is the activation of the emergency medical system (EMS) by a bystander after recognition of cardiac arrest (CA) or its immediate prodrome. Our ongoing study is aimed at evaluating the current effectiveness of bystander EMS activation for all cases of CA in the city and area of Mainz. Methods. Starting February 1991, we began to prospectively examine collapse-intervention intervals in all cases of CA treated by our physician-manned ambulance. Precision voice recorders carried by the ambulance crews are activated and linked to the EMS dispatcher to time the arrival of the ambulance vehicle. Time intervals starting from the time of collapse are then reconstructed from the dispatcher's time and the tapes. The emergency phone number dialled initially by the bystander and the time of collapse in witnessed cardiac arrests are identified. RESULTS. Sixty-six CAs were witnessed and included in this study. In 20% of those cases, the number dialled initially by the bystander was 19222 (EMS dispatcher), in 38% 110 (police), and in 42% other numbers (family practitioners or their on-call service, fire department). The time interval, as median (25th percentile; 75th percentile), between collapse and receipt call by the emergency dispatchers was 4 min (2; 8) for all patients (n = 66), and 6.5 min (3; 12) whenever numbers other than emergency phone numbers were dialled. All following time intervals (start of BLS or ACLS procedures) showed differences (P less than 0.05) between the 110 or 19222 group [BLS: 8.5 min (4.8; 13.1) or 10 min (7.35; 12.1); ACLS: 11.3 min (9.1; 13.45) or 12.9 min (10.6; 21.5)] vs the group, in which other phone numbers were initially dialled [BLS: 15.25 min (9.25; 19.4); ACLS: 20.11 min (12.6; 28.3)]. The first ECG rhythm showed VF in 56% and 54% in case 110 and 19222 were dialled, but only in 32% in the other group. CONCLUSION. Even one single weak link in the "chain of survival" can lower overall survival rates. An indispensable, but apparently underrated component of an effective EMS includes an informed citizenry able to call swiftly for help. Lack of an unequivocal emergency number, well known and accepted by the citizens, produces confusion and delays. In our systems, the correct medical emergency phone number (19222) was dialled in 20% of the cases only, thus demonstrating clearly the lack of public awareness of this 5-digit number. In a higher percentage, the three-digit police number (110) was dialled. In cases where numbers other than emergency numbers were dialled (42%), the longest time intervals between collapse and receipt of call by the dispatchers occurred, associated with the longest time intervals until initiation of CPR and the lowest percentage of patients found in ventricular fibrillation. We conclude that establishment of a simple three-digit EMS phone number, preferentially Europe-wide, in combination with an intensification of public awareness, could be a vital step not only to reduce time intervals between collapse and CPR in our EMS system but also to improve survival.

Emergency Medical Service Communication Systems↗
PubMed2006

[Prehospital life support in trauma patients: basic or advanced trauma life support].

The controversy between Advanced Trauma Life Support (ATLS) and Basic Life Support (BLS) in the prehospital care of trauma patients has not been resolved yet. The purpose of this study was to examine the literature with respect to the type of prehospital care applied to the trauma patients. A total of 76 papers on ATLS and/or BLS for trauma were reviewed regarding the variables such as intravenous catheter application, prehospital fluid resuscitation, transport time, intubation and mortality. As a conclusion, the data in the literature do not support the routine use of on-field ATLS in trauma patients. Prospective randomized trials comparing ATLS and BLS in prehospital management of trauma patients are needed to clarify this issue.

Advanced Cardiac Life Support↗
PubMed2006

[Differential expression of immune-associated genes in two subcloned cell lines from a same human bladder cancer].

AIM: To screen and identify differentially expressed genes in subcloned lines from a same human bladder transitional cell carcinoma (TCC). METHODS: Two bladder TCC cell lines (BLX and BLS-211) with different phenotypes but same origin were used to screen for differentially expressed genes by suppression subtractive hybridization (SSH). RESULTS: 9 over-expressed genes in BLX and 15 in BLS-211 cells were obtained, respectively. Some Bacillus Galmette-Guerin(BCG)- associated genes, such as BCG induced integral membrane protein(BIGM103), fibronectin(FN), complement factor B(BF), were over-expressed in BLX cells. And 8 new ESTs(Expressed Sequence Tag) in BLS-211 cells were collected by GenBank dbEST database with the accession number of DY505708-13, DY230447-8. CONCLUSION: SSH is a powerful method for the identification of differentially expressed genes in different cell lines or clones. Some BCG-associated genes, which are differentially expressed in different cells may contribute to the different response to clinical BCG therapy. The identified new ESTs can be cloned for full length to further study their functions.

Carcinoma, Transitional Cell↗
PubMed1989

Retention of cardiopulmonary resuscitation skills among nursing personnel: what makes the difference?

The American Association of Critical-Care Nurses' Position Statement on cardiopulmonary resuscitation (CPR) certification states that "nurses who care for the critically ill must have annual BCLS or CLS certification...." Review of literature, however, did not reveal any studies among nurses that examined the question of whether Basic Cardiac Life Support (BCLS) was superior to other forms of CPR education, such as Basic Life Support-A (BLS-A) (Heartsaver). The purpose of this 2 by 3 factorial design study was to examine the relationship between the method of instruction and the quality of retention of one-person CPR skills at 4 and 8 months after the initial class. The two methods of instruction under consideration were a BLS-course A (hospital-wide Heartsaver course) and a BLS-course C (Basic Cardiac Life Support course). In addition, the variable of potential use of CPR skills was studied. The three levels of potential use (high, medium, low) were identified according to the area of work, such as critical care, general medical-surgical, and obstetrics-psychiatric, respectively. Other variables that were described in the literature were education, practice of skills, current position, years in profession, previous CPR training, motivation, and felt level of competence. These variables also were included in the study to find out the total variable impact on CPR retention. At least 30 registered nurses were selected from each of the high, medium, and low use areas and randomly assigned to one of the instruction groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Educational Status↗
PubMed1988

[Influence of flow disturbance on an anastomotic intimal hyperplasia: experimental and clinical study].

Experimental and clinical studies were made of the localization and morphology of anastomotic intimal hyperplasia (AIH) at the end-to-side anastomosis in relation to flow disturbances. In vitro experimental findings showed that boundary layer separation (BLS) became prominent as proximal outflow segment (POS) flow increased. An aorto-right iliac bypass was performed on 30 dogs using 22 Biografts, 3 EPTFES and 5 Dacron grafts. Distal end-to-side anastomoses were made at 3 different angles, i.e., 30 degrees (Group I), 90 degrees (Group II) and 150 degrees (Group III). BLS was likely to occur at the toe in Group I because POS flow exceeded 50%, while not in Group III. Up to 35 months observation, AIH was noted to develop at the toe 36% in Group I, 25% in Group II but in none in Group III. Thirty five reconstructions using Biograft in which angiography was performed later than 6 months postoperatively were chosen for clinical study. Invariably in all cases of AIH occurring following a femoropopliteal bypass, severe stenosis was noted to occur at the toe and heel of the distal end-to-side anastomosis. In conclusion, a disproportionate increase in POS flow was considered a likely cause of marked BLS and, consequently, an important precipitating cause of AIH. When POS flow exceeds 50%, a distal anastomosis dividing flow distribution should be considered as a salvage operation of potential usefulness.

Anastomosis, Surgical↗
PubMed1995

Differences between Burkitt's lymphomas and mouse plasmacytomas in the immunoglobulin heavy chain/c-myc recombinations that occur in their chromosomal translocations.

Burkitt's lymphomas (BLs) and mouse plasmacytomas (MPs) are characterized by chromosomal translocations juxtaposing the c-myc oncogene to one of the immunoglobulin loci. Here we describe illegitimate recombinations and the DNA sequence at the junction between c-myc and immunoglobulin heavy chain (IgH) regions in these B-cell lineage tumors. In 15 BLs and in 29 MPs, recombination products were amplified by PCR and sequenced. Molecular analysis of the IgH/c-myc junctions revealed the following characteristics: (a) rearrangements in BLs represent nearly reciprocal exchanges between c-myc and IgH switch sequences, whereas in MPs, several hundred bp of c-myc may be duplicated or deleted; (b) short homologies of up to 5 bp between immunoglobulin and c-myc sequences can be found at most junction sites in both tumors; and (c) pentameric sequences typically found in switch regions and V(D)J recognition motifs also occur frequently at the sites of recombination in c-myc.

Animals↗
PubMedDate not supplied

Bare lymphocyte syndrome with lack of HLA class I and II antigens. Presentation of two cases.

Bare lymphocyte syndrome (BLS) is a rare disorder characterized by deficient expression of human leukocyte antigens (HLA antigens) and combined immunodeficiency to various degrees. Recurrent severe infections especially due to opportunistic organisms are common. Here, we present two patients with BLS who lack both class I and II antigens (Type III). They had the typical clinical and immunologic findings of BLS. The first patient showed marked improvement in pulmonary symptoms resulting from cytomegalovirus infection by means of gancyclovir treatment. However, intramuscular injections of interferon-alpha (IFN-alpha) had no beneficial effect in either the expression of HLA antigens or the clinical status. The second patient died of septicemia while being prepared for bone marrow transplantation.

Female↗
PubMedDate not supplied

Development of an enzyme-linked immunosorbent assay for the serological diagnosis of big liver and spleen disease.

An enzyme-linked immunosorbent assay (ELISA) was developed for the serological diagnosis of big liver and spleen (BLS) disease. The test utilizes a soluble, BLS-specific antigen that can be recovered from the livers of infected hens and that is known to react in the agar gel immunodiffusion (AGID) test. For use in ELISA, the BLS-specific antigen is fractionated by gel filtration chromatography and immobilized on microtiter plates using glutaraldehyde. The ELISA was evaluated using sera from infected and uninfected flocks originating in the United Kingdom and the United States. An ELISA format that incorporated control antigen recovered from the livers of uninfected birds for each serum tested was found to be more sensitive than the AGID test. A less sensitive but more cost-effective format that did not incorporate this control is considered suitable for large-scale flock screening programs.

Animals↗
PubMed1996

Human T cell repertoire generation in the absence of MHC class II expression results in a circulating CD4+CD8- population with altered physicochemical properties of complementarity-determining region 3.

In this study, we have investigated the impact of deficient MHC class II expression on the use of TCRBV6 and TCRBJ gene elements, and on the pattern of amino acid incorporation exhibited in the N1-D-N2 segments of the third complementarity-determining region (CDR3) of these TCRBV6 rearrangements. To this end, we have analyzed circulating T cells from three, nonrelated MHC class II-deficient (bare lymphocyte syndrome (BLS)) patients and three MHC class II-expressing family members. The patients and healthy controls exhibited similar, nonrandom usage profiles of TCRBV6 and TCRBJ gene elements in both the CD4+CD8- and the CD4-CD8+ subsets of peripheral blood T cells. No statistically significant differences between patients and controls were detected in the length of CDR3, or in the amount of non-germline modification at the sites of recombination. However, detailed analysis of the TCRBV6 rearrangements derived from the CD4+CD8- subsets from the BLS patients revealed patterns of amino acid incorporation into the N1-D-N2 region of CDR3 that resulted in altered charge and hydropathicity properties of the presumed Ag binding site. In this way, we have been able to demonstrate that human T cell repertoire development in the absence of MHC class II expression results in a circulating CD4+CD8- T cell population bearing TCRs with altered CDR3 profiles. Such altered profiles are likely to be a direct reflection of the lack of MHC class II-mediated selection processes in these BLS patients.

Amino Acid Sequence↗
PubMed1996

Type III bare lymphocyte syndrome: lack of HLA class II gene expression and reduction in HLA class I gene expression.

The bare lymphocyte syndrome (BLS) consists of an association between a combined immunodeficiency disease and a significantly reduced expression of either human histocompatibility leukocyte antigens (HLA) class I (HLA-A, -B, -C) or HLA class II (HLA-DP, -DQ, -DR) at the cell surface. BLS type III, the more frequent form of this syndrome, is characterized by impaired expression of both class I and class II antigens on patients' cells, in particular on leukocytes. We describe herein the demonstration that expression of HLA class I molecules was reduced by approximately half on Epstein-Barr virus-transformed B cells (LCL) derived from type III BLS patients. HLA class I mRNA level was also decreased to the same extent. Expression of HLA class I molecules was also very significantly reduced at the surface of these fibroblasts as was mRNA specific for HLA class I. Simultaneously, the expression of HLA-DR molecules on LCL was even more greatly decreased, and the expression of HLA-DQ antigens was virtually abolished. Molecular analysis demonstrated an absence of mRNA for the alpha- and beta-chains of HLA-DQ and HLA-DR in the patients' lymphocytes. In general, such patients present with an association of an absence of expression of HLA class II antigens and a significantly reduced expression of HLA class I antigens. The mechanism of this association is still uncertain.

Child↗
PubMed1996

Phenotype-related differences in the expression of D-type cyclins in human B cell-derived lines.

Exposure of normal resting B lymphocytes to EBV in vitro leads to activation, subsequent immortalization, and the establishment of lymphoblastoid cell lines (LCLs). The endemic form of Burkitt's lymphoma (BL) is associated with EBV. EBV-positive BL lines maintain the original tumor phenotype (group I BL) initially and express only one EBV-encoded protein, EBV nuclear antigen (EBNA)-1. Most of them drift toward a LCL-like phenotype during in vitro culturing and express all nine EBV-encoded growth transformation-associated proteins (group III BL). Cyclin D2 and D3 have been found previously to differ in their mRNA expression in BL and LCL. Cyclin D2 expression has been attributed to EBV gene expression and to EBNA-2 and EBNA-5 in particular. We have studied cyclin D2/D3 expression in larger series of LCLs, BL lines, and freshly EBV-infected peripheral blood B lymphocytes, both at the mRNA and protein levels. The predominant cyclin D2 expression in the LCLs and group III BLs correlated with an activated B-cell phenotype. In contrast, only cyclin D3 was expressed in the group I BL lines. EBV-carrying group II BL lines that retained the BL-associated CD10 did not express cyclin D2. A collection of in vitro EBV-converted sublines of originally EBV-negative BLs that expressed a full set of the growth transformation-associated EBV proteins maintained their CD10 and cyclin D3 expression. Blood B lymphocytes expressed no D2 or D3 as judged by immunostaining. Cyclin D2 could be detected by immunostaining in a proportion of the activated blasts 40 h postinfection. Cyclin D3 that is expressed at a low level in the established LCLs was stained easily in B blasts at this time. The level of cyclin D3 at 72 h postinfection was two to three times higher than in the exponentially growing LCLs, as detected by immunoblotting. It was still 5-10 times lower than in group I BLs. Mitogen stimulation of primary B cells induced cyclin D3 at a similar level as in the LCLs. Our data are consistent with the notion of cell lineage-specific D-type cyclin expression. They also indicate that B cells may switch their D-type cyclin expression during differentiation.

B-Lymphocytes↗
PubMed1997

Correction of defective expression in MHC class II deficiency (bare lymphocyte syndrome) cells by retroviral transduction of CIITA.

Retrovirus-mediated gene transfer was used to restore expression to MHC class II-negative patient cells from complementation group A(II) of MHC class II immunodeficiency or bare lymphocyte syndrome (BLS). The cells of these patients do not transcribe MHC class II genes due to a defect in the trans-acting factor, CIITA. We constructed a vector, pGAG/Ii-CIITA, with the MHC class II-associated invariant chain promoter driving CIITA expression. Cocultivation with the virus producer line was consistently shown to be the optimal method for infection of all cell types. The induction of MHC class II expression after virus infection was rapid, and high levels of expression were achieved in cell lines within 1 wk of infection. In addition, expression was easily detectable even in peripheral blood cells of a BLS patient within a few days. Cell lines maintained in vitro for several months remained positive, and the proportion of cells with surface expression of DR was correlated with the number of integrated proviruses. Moreover, transduced B lymphoblastoid cell lines readily established tumors in CB17-scid/scid mice, and the MHC class II-positive cells demonstrated a clear competitive advantage in vivo. Ultimately, we hope to use this transduction system to restore normal immune function to a BLS patient for which no other therapeutic option currently exists.

Antigens, Differentiation, B-Lymphocyte↗
PubMed1997

Detection rate and intratumoral virus load of human herpesvirus-8 in immunodeficiency-related B-cell lymphoid malignancies.

Human herpesvirus-8 (HHV-8), associated with Kaposi's sarcoma, primary effusion lymphoma, and Castleman's disease, has been found in circulating B-cells and might have a causative role in B-cell malignancies associated with immunodeficiency syndromes. We determined the rate of detection and intratumoral virus load of HHV-8 by means of a semiquantitative approach in post-transplant lymphoproliferative diseases (PTLDs), AIDS-related non-Hodgkin's lymphomas (NHLs), including both Burkitt's lymphomas (BLs) and large cell lymphomas (LCLs), as well as in control groups consisting of follicular hyperplasias (FHs) and HIV-negative LCLs. HHV-8 sequences were detected at a similar rate in HIV-negative PTLDs (24%), HIV-negative LCLs (22%) and HIV-negative FHs (17%). The detection rate was significantly higher in HIV-positive BLs (73%), HIV-positive LCLs (67%), and HIV-positive FHs (65%) supporting the view of an epidemiological link between HHV-8 and HIV infections. The viral load was 10(2) genome copies per cell in the single case of primary effusion lymphoma included in the LCL group while it was 10(-3) copy per cell (median value; range: 10(-4)-10(-1)) in all the other HHV-8-positive samples. No significant difference of viral load was found according to HIV status. The virus loads of PTLDs and HIV-positive LCLs were significantly higher than those observed in HIV-positive BLs and FHs, suggesting, to some extent, that the degree of immunodeficiency may influence HHV-8 replication. However, with the exception of the single case of primary effusion lymphoma studied, the low intratumoral load of HHV-8 strongly argues against a direct causative agent of the virus in the occurrence of PTLDs and AIDS-related NHLs.

Case-Control Studies↗
PubMed1999

Improved out-of-hospital cardiac arrest survival through the inexpensive optimization of an existing defibrillation program: OPALS study phase II. Ontario Prehospital Advanced Life Support.

CONTEXT: Survival rates for out-of-hospital cardiac arrest are low; published survival rates in Ontario are only 2.5%. This study represents phase II of the Ontario Prehospital Advanced Life Support (OPALS) study, which is designed to systematically evaluate the effectiveness and efficiency of various prehospital interventions for patients with cardiac arrest, trauma, and critical illnesses. OBJECTIVE: To assess the impact on out-of-hospital cardiac arrest survival of the implementation of a rapid defibrillation program in a large multicenter emergency medical services (EMS) system with existing basic life support and defibrillation (BLS-D) level of care. DESIGN: Controlled clinical trial comparing survival for 36 months before (phase I) and 12 months after (phase II) system optimization. SETTING: Nineteen urban and suburban Ontario communities (populations ranging from 16 000 to 750 000 [total, 2.7 million]). PATIENTS: All patients who had out-of-hospital cardiac arrest in the study communities for whom resuscitation was attempted by emergency responders. INTERVENTIONS: Study communities optimized their EMS systems to achieve the target response interval from when a call was received until a vehicle stopped with a defibrillator of 8 minutes or less for 90% of cardiac arrest cases. Working both locally and provincially, communities implemented multiple measures, including defibrillation by firefighters, base paging, tiered response agreements with fire departments, continuous quality improvement for response intervals, and province-wide revision and implementation of standard dispatch policies. All response times were obtained from a central dispatch system. MAIN OUTCOME MEASURE: Survival to hospital discharge. RESULTS: The 4690 cardiac arrest patients studied in phase I and the 1641 in phase II were similar for all clinical and demographic characteristics, including age, sex, witnessed status, rhythm, and receipt of bystander cardiopulmonary resuscitation. The proportion of cases meeting the 8-minute response criterion improved (76.7% vs 92.5%; P<.001) as did most median response intervals. Overall survival to hospital discharge for all rhythm groups combined improved from 3.9% to 5.2 % (P = .03). The 33% relative increase in survival represents an additional 21 lives saved each year in the study communities (approximately 1 life per 120000 residents). The charges were estimated to be US $46900 per life saved for establishing the rapid defibrillation program and US $2400 per life saved annually for maintaining the program. CONCLUSION: An inexpensive, multifaceted system optimization approach to rapid defibrillation can lead to significant improvements in survival after cardiac arrest in a large BLS-D EMS system.

Aged↗
PubMed1999

Expression of Epstein-Barr virus lytically related genes in African Burkitt's lymphoma: correlation with patient response to therapy.

A study on the Epstein-Barr virus (EBV)-associated malignancy (endemic) Burkitt's lymphoma (BL) was initiated on fine-needle-aspiration biopsies from 46 proven BL cases in Malawi. Gene expression that might correlate with patient serology (where high levels of antibodies to lytically related genes are commonly observed) was explored. In two-thirds of the cases, we identified the EBV BZLF1 replication activator intermediate early protein ZEBRA in varying quantities and to varying extents in cells by immuno-cytochemistry. The early lytic-cycle gene transcript BHLF1 was assessed positively by solid-phase hybridisation in over half of the same tumours. Evidence of transcription of these genes was confirmed on a smaller number of surgically removed fresh biopsies by RT-PCR. We asked whether our findings, which are generally counter to the established notion that EBV gene expression in BLs is restricted to the latent function, EBNA1, might offer some explanation for the differential responses to chemotherapy observed among African patients. Where the duration of follow-up was sufficient to assign the cases (37 in number) to one of 3 categories, namely, complete, partial or no response, a significant correlation between expression of the viral function ZEBRA and a positive patient response to treatment was found. Lack of this was associated with poor prognosis. Clinical data and EBV gene expression results support the postulate of subgroups of African BLs, the intermediate early antigen providing a marker of potential use in patient management.

Adolescent↗