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The usefulness of clinical measurements of cell proliferation in gynecological cancer.

This article critically reviews the available methods for the assessment of cell proliferation in clinical practice, and evaluates their applications as diagnostic and prognostic variables in gynecological cancer. The mitotic count is not a standardised method and should not be considered to have inherent value as a measurement of cell proliferation in the clinical situation. In distinguishing benign and malignant uterine smooth muscle tumors, the degree of mitotic activity can only be interpreted in the context of the other pathological and clinical findings. Cytological atypia and the absence of stromal differentiation appear to be more accurate than mitotic activity in delineating high-grade endometrial stromal sarcomas. The potential biological behavior of placental site trophoblastic tumor cannot be reliably predicted on the basis of mitotic counts, and hysterectomy remains the treatment of choice for this condition. Flow cytometry produces accurate cell kinetic data and provides useful prognostic information in ovarian and endometrial tumors. The value of flow cytometry in cervical cancer is questionable and needs clarification. Complete and partial hydatidiform moles are generally distinguishable on the basis of ploidy studies. However, in view of the existence of a diploid partial mole, serial human chorionic gonadotrophin measurement is the only reliable method of establishing or excluding a diagnosis of persistent trophoblastic disease. The other clinical markers of cell proliferation do not have an established role as diagnostic or prognostic parameters in gynecological cancer and merit further critical evaluation. Estimation of mitotic activity is a simple, readily accessible method of assessing cell proliferation in routine histopathological practice and the role of an accurate mitotic index in diagnosis and prognosis must be investigated to determine the true value of counting mitotic figures in histological sections.

Cell Cycle↗

Validity of accelerometry for the assessment of moderate intensity physical activity in the field.

PURPOSE: This study was undertaken to examine the validity of accelerometry in assessing moderate intensity physical activity in the field and to evaluate the metabolic cost of various recreational and household activities. METHODS: Twenty-five subjects completed four bouts of overground walking at a range of self-selected speeds, played two holes of golf, and performed indoor (window washing, dusting, vacuuming) and outdoor (lawn mowing, planting shrubs) household tasks. Energy expenditure was measured using a portable metabolic system, and motion was recorded using a Yamax Digiwalker pedometer (walking only), a Computer Science and Application, Inc. (CSA) accelerometer, and a Tritrac accelerometer. Correlations between accelerometer counts and energy cost were examined. In addition, individual equations to predict METs from counts were developed from the walking data and applied to the other activities to compare the relationships between counts and energy cost. RESULTS: Observed MET levels differed from values reported in the Compendium of Physical Activities, although all activities fell in the moderate intensity range. Relationships between counts and METs were stronger for walking (CSA, r = 0.77; Tritrac, r = 0.89) than for all activities combined (CSA, r = 0.59; Tritrac, r = 0.62). Metabolic costs of golf and the household activities were underestimated by 30-60% based on the equations derived from level walking. CONCLUSION: The count versus METs relationship for accelerometry was found to be dependent on the type of activity performed, which may be due to the inability of accelerometers to detect increased energy cost from upper body movement, load carriage, or changes in surface or terrain. This may introduce error in attempts to use accelerometry to assess point estimates of physical activity energy expenditure in free-living situations.

Activities of Daily Living↗

Statistical inference for serial dilution assay data.

Serial dilution assays are widely employed for estimating substance concentrations and minimum inhibitory concentrations. The Poisson-Bernoulli model for such assays is appropriate for count data but not for continuous measurements that are encountered in applications involving substance concentrations. This paper presents practical inference methods based on a log-normal model and illustrates these methods using a case application involving bacterial toxins.

Algorithms↗

Evaluation of a communications skills workshop for hospital pharmacists.

The ability to communicate is an essential requirement for effective practice. Until recently, however, pharmacy students received no training in this area. The resultant inadequacy was carried forward into practice. Only now has the omission been recognized and attempts made to improve the situation among practising pharmacists. We designed an 8-h workshop on communication skills. It covered the basic principles of communication (Workbook A--preparatory work before the workshop) and their application (Workbook B + case studies, exercises and role-playing--during the workshop). The workshop was presented to a group of hospital pharmacists in the Western Cape. At the end of the workshop participants completed a questionnaire on its usefulness, applicability and presentation on a five-point scale. Responses were counted, averaged and analysed by sex and age. Although the ratings were uniformly high (average 4.3 out of a possible 5.0) there were differences between men and women and between older and younger pharmacists. The possible reasons for and implications of these differences are discussed.

Adult↗

Polymer treatments reduce adhesion of comminuted stone in rat bladder.

A method for inhibiting the adhesion of stone fragments in comminution is presented. Surfaces are coated with a molecular layer of so-called "excluding" polymer. In experimental tests, rat bladders were injected with comminuted urinary stone (phosphate or oxalate) in saline which contained small amounts of excluding polymer (0.1% hyaluronic acid or polyvinyl pyrrholidone). The urinary tract was then irrigated with fresh polymer solution and examined for residual stone. A ten-fold reduction in particle count was obtained, compared with irrigation with normal saline. The possible applications in percutaneous and extracorporeal lithotripsy are discussed. It seems that the "coagulum" and "exclusion" types of polymer irrigant might find complementary uses: the former for manual extraction of coarse particles and the latter for flushing out after fine comminution.

Adhesiveness↗

The pharmacokinetics of ocularly applied timolol in rabbits.

[3H]timolol derived radioactivity and beta-antagonistic activity in the aqueous humour, iris, ciliary body and blood in rabbits were analyzed by liquid scintillation counting (LSC) and radioreceptor assay (RRA) after ocular timolol. After ocular application of tracer labelled timolol, the radioactivity decreased slowly in the iris (Kel = 0.05 h-1) and ciliary body (Kel = 0.02 h-1). In the aqueous humour the elimination rate was faster (Kel = 0.57 h-1). The beta-antagonistic activities of the aqueous humour and plasma decreased rapidly when compared to LSC values. The ethanol extractable pool of the beta-antagonistic activity from the iris and ciliary body was only a few percent of the corresponding LSC estimates. The kinetics of beta-antagonistic activity extractable from iris and ciliary body was identical with that in the aqueous humour. Timolol concentrations in the untreated rabbit eye were sufficiently high to lower the intraocular pressure.

Animals↗

Application of most-probable-number statistics to direct enumeration of microorganisms.

A novel method for rapid determination of total microbial cell numbers was investigated. The method involves the application of most-probable-number estimation statistics to direct microscopic counting of microbial cells by using a particle sizing graticule. Its accuracy and reliability were tested with computer simulations of bacterial cell distributions encountered in ecological studies. Good estimates of cell numbers were obtained when the cell density varied from 3 to 6,000 cells per field, i.e., over 3 orders of magnitude. Low levels of contagion did not markedly influence cell estimates, although high levels, corresponding to discrete scattered microcolonies, did. However, these could be recognized visually. Estimates of cell numbers in Breed smears confirmed its speed and good correlation with the standard quadrat counting technique under real experimental conditions.

Journal Article↗

Volume of emphysema.

A method of determining the volume of emphysema in excised lungs is presented, with its validation. This method is based on macroscopic point counting using a perforated grid but only the holes (points) overlying emphysema need be counted to produce results within a percentage standard error of 5%. Application of the method shows that an adequate assessment of emphysema cannot be made from one lung slice alone, and that the amount of emphysema found in one lung cannot be used to predict the amount of emphysema in the other lung.

Emphysema↗

Effectiveness of topically applied antibiotics on anaerobic bacteria in the pilo-sebaceous duct.

An unspecific cream vehicle containing 1% erythromycin base was applied once a day for 10 days to one side of the forehead of 16 healthy subjects and the same vehicle without the active agent to the other side. Using the same procedure a solution containing 1.19% clindamycin phosphate (corresponding to 1% clindamycin base) and the corresponding unspecific vehicle was administered to another group of 17 healthy males. Prior to the treatment and after the end bacteria were obtained from the pilosebaceous ducts by means of a special sampling technique. Both ointments containing the antibiotics lead to a significant reduction of the bacterial growth in the pilosebaceous ducts regardless of whether evaluation is made of the total bacterial count or of Propionibacteria. Thus, it could be demonstrated that topical application enables some antibiotics to penetrate into the pilosebaceous duct in an adequate concentration to ensure antibacterial effectiveness if a suitable vehicle is used.

Administration, Topical↗

Gene therapy with brain-derived neurotrophic factor as a protection: retinal ganglion cells in a rat glaucoma model.

PURPOSE: To develop a modified adenoassociated viral (AAV) vector capable of efficient transfection of retinal ganglion cells (RGCs) and to test the hypothesis that use of this vector to express brain-derived neurotrophic factor (BDNF) could be protective in experimental glaucoma. METHODS: Ninety-three rats received one unilateral, intravitreal injection of either normal saline (n = 30), AAV-BDNF-woodchuck hepatitis posttranscriptional regulatory element (WPRE; n = 30), or AAV-green fluorescent protein (GFP)-WPRE (n = 33). Two weeks later, experimental glaucoma was induced in the injected eye by laser application to the trabecular meshwork. Survival of RGCs was estimated by counting axons in optic nerve cross sections after 4 weeks of glaucoma. Transgene expression was assessed by immunohistochemistry, Western blot analysis, and direct visualization of GFP. RESULTS: The density of GFP-positive cells in retinal wholemounts was 1,828 +/- 299 cells/mm(2) (72,273 +/- 11,814 cells/retina). Exposure to elevated intraocular pressure was similar in all groups. Four weeks after initial laser treatment, axon loss was 52.3% +/- 27.1% in the saline-treated group (n = 25) and 52.3% +/- 24.2% in the AAV-GFP-WPRE group (n = 30), but only 32.3% +/- 23.0% in the AAV-BDNF-WPRE group (n = 27). Survival in AAV-BDNF-WPRE animals increased markedly and the difference was significant compared with those receiving either AAV-GFP-WPRE (P = 0.002, t-test) or saline (P = 0.006, t-test). CONCLUSIONS: Overexpression of the BDNF gene protects RGC as estimated by axon counts in a rat glaucoma model, further supporting the potential feasibility of neurotrophic therapy as a complement to the lowering of IOP in the treatment of glaucoma.

Animals↗

Monoisoamyl meso-2,3-dimercaptosuccinate as a delayed treatment for mercury removal in rats.

Monoisoamyl meso-2,3-dimercaptosuccinate (Mi-ADMS) was found to be superior to meso-2,3-dimercaptosuccinic acid (DMSA) in decreasing the body burden of 203Hg in rats under conditions of early treatment. In this experiment Mi-ADMS was used as late treatment for mercury removal. Albino rats aged 6 weeks and 7-day-old sucklings received a single intraperitoneal injection of 203Hg (as nitrate). Two weeks later they were treated with DMSA or Mi-ADMS (0.25 mmole/kg bw) on two consecutive days. The radioactivity in the carcass (whole body after removal of the gastrointestinal tract), liver, kidneys and brain was determined by solid crystal gamma scintillation counting six days after chelation therapy administration (3 weeks after 203Hg application). Both chelators reduced the body burden of mercury compared to controls. The effect of Mi-ADMS was superior to DMSA treatment in older rats for decreasing carcass and kidney retention, and in suckling rats for decreasing carcass, liver, and kidney retention. They were equally effective in decreasing brain retention in older rats and had no effect on brain retention in sucklings. The efficiency of Mi-ADMS in reducing the body burden of mercury was generally higher than the efficiency of the DMSA treatment. Therefore, Mi-ADMS deserves further attention as a late treatment for mercury removal.

Aging↗

[Pulmonary hemodynamics, coagulation and morphological changes in the lung after thrombocyte aggregation inhibition and intravasal coagulation in experimental trauma and hemorrhagic shock].

26 mongrel dogs are subjected to a standardized bone trauma followed by a hypotonic hemorrhagic shock. Compared with a control and heparin group prophylactic treatment with Dipyridamol and Acetylsalicylic Acid decreases pulmonary vascular resistance significantly. After an initial period of hyperocagulability secondary fibrinolysis develops. The decrease of the fibrinogen level and the fall of total platelet count after trauma and hemorrhage can partly be prevented by the application of heparin, likewise the development of pulmonary microthrombosis. Histological examination shows a markedly diminished pulmonary microthrombosis.

Airway Resistance↗

Quantitation of gold lymphocyte binding during chrysotherapy.

Carbon rod atomic absorption analysis (CRA) was applied to the quantiation of gold lymphocyte content (GLC) during chrysotherapy. Sensitivity and accuracy of CRA compared favorably with 195Au isotopic scintillation counting, circumventing the limitations and hazards of the latter in clinical applications. Picogram gold quantification of limited sample volume, less than 10 ml blood, e.g., 10(4)-10(5) lymphocytes (5 microliters) containing 5-10 pg was achieved. GLC after IM administration increased significantly in 60% of patients; for the remainder, GLC was observed to be independent of plasma gold content or cumulative dosage. GLC during auranofin administration (6 mg/day p.o.) approached values for IM gold despite significantly lower plasma levels. Unique sensitivity of CRA enables analysis of GLC under therapeutic conditions that could elucidate whether gold alters functional determinants.

Arthritis, Rheumatoid↗

[Autoradiographic studies on the distribution of 14C-piracetam in rat and dog].

Autoradiographic and scintillation counting techniques were used to show that after p.o. and i.v. application of radioactivity labelled piracetam (2-oxo-pyrrolidine-1-acetamide-2-14C) the distribution patterns of this compound are similar in dog and rat. Whereas the level of the drug reaches its maximum in many organs between 30 and 120 min the uptake of piracetam-14C in the brain is somewhat retarded. On the other hand the substance seems to be present much longer in the central nervous system than in most of the other organs. As shown by autoradiographic analysis of brain slices of the dog piracetam-14C is preferably concentrated in the grey matter of the cerebrum and cerebellum, caudate nucleus, hippocampus, lateral geniculate body and chorioide plexus. On the other hand the content in the white matter is low. The heuristic conclusions of this characteristic pattern of distribution of piracetam-14C in the central nervous system are discussed.

Administration, Oral↗

Colorectal carcinoma and its precursors: role of argyrophilic nucleolar organizer regions (AgNORs).

A silver colloid technique to identify Argyrophilic Organizer Region (AgNOR) was applied to 5 hyperplastic polyps, 5 adenomas with low grade dysplasia, 5 adenomas with high grade dysplasia and 15 adenocarcinomas of the large bowel (5 well differentiated, 5 moderately differentiated and 5 poorly differentiated). The authors suggest the plainness and usefulness of simultaneous application of clumps per cell, AgNORs per clump and total AgNORs counts in the evaluation of neoplastic and preneoplastic lesions of the colon. In fact the results show that the number of clumps per cell is useful to distinguish hyperplastic polyps from adenomas with high grade dysplasia and from all the adenocarcinomas. Using the number of AgNORs per clump there is significant difference between hyperplastic polyps and adenomas with high grade dysplasia and between adenomas with low grade dysplasia and well differentiated adenocarcinomas. Finally the total number of AgNORs can discriminate hyperplastic polyps from adenomas with high grade dysplasia and these from adenomas with low grade dysplasia.

Adenocarcinoma↗

Hepatocellular carcinoma and preneoplastic lesions of the liver: evaluation of argyrophilic nucleolar organizer regions (AgNORs).

The authors applied a silver colloid technique to identify Argyrophilic Organiser Region (AgNOR) to 8 groups of hepatic lesions: alcoholic hepatitis with dysplasia (3 cases); chronic active hepatitis with dysplasia (4 cases); cirrhosis with dysplasia (5 cases); focal nodular hyperplasia (4 cases) and hepatocellular carcinomas (3 cases of grade I, 3 cases of grade II and 5 cases of grade III of Edmondson). Four cases of non-specific reactive hepatitis were used as control. This work suggests the simplicity and utility of simultaneous application of clumps per cell, AgNORs per clump and total AgNORs counts in the evaluation of neoplastic and preneoplastic lesions of the liver. The results show, in hepatocellular carcinomas, a relationship between the number of clumps, the AgNORs per clump, the total number of AgNORs and the grading of Edmondson. The nodular lesions that can be considered in the differential diagnosis with carcinoma are sufficiently well discriminated using the two parameters AgNORs per clump and total number of AgNORs.

Carcinoma, Hepatocellular↗

[The adaption growth of the heart in the higher (experimental autoradiographic researches in rats) (author's transl)].

There was examined the influence of the age on the development of a compensatory hypertrophy of the heart in 4 to 16 month old masculin Wistar-rats autoradiographically. The valuation took place at various times after stenosing of the aorta and application of 3H-thymidine separatly in both ventricular walls by counting of the nuclei of the marked muscle- and connective tissue cells of the heart and their mitosis. For the connective tissue cells computation of the 3H-thymidin- and of the mitotic index. Determination of the body- and heart weight.

Aging↗

Local application of IGF1 on dental pulp mechanically exposed; in vivo study on rabbit.

IGF1 (Insulin Growth Factor, 1) was intentionally applied onto pulp tissues, aiming to provoque a dentine regeneration process through the stimulation of the dentinoblasts' potententials. 72 cavities were hence performed on rabbit molars, intentionally exposing the dental pulp. Different concentrations of IGF1 were then applied; The histo and anatomo-pathological observations showed persistent vitality of the pulp without any sign of necrosis, even 6 weeks after the IGF1 application. Dentinoblasts layers (as an indication of the regeneration activity) were counted, according to a pre-established protocol, at days 7, 14, 22, 28 and 42. The type of the applied IGF1, was carefully selected to be "Binding Protein Resistant" (IGF-BPR), so to avoid any inhibition of the IGF1 action by the endogenous binding proteins (Hochscheid and coll). The results were conclusive in indicating the IGF1 as an efficient dental pulp capping product.

Animals↗