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Comparative study of the hydration of hydrophilic contact lenses by refractive index and gravimetry.

PURPOSE: To compare the percent hydration by wet weight of hydrogel contact lenses given by the manufacturers with the values obtained using the refractive index and the gravimetry methods. METHODS: We used a Valentine refractometer to determine the refractive index of new hydrogel contact lenses at equilibrium swelling in the original solution and container. From the refractive indexes we then obtained the percent hydration of the lenses using a previously prepared graph of refractive index vs percent hydration of saccharose in a phosphate buffer solution (pH 7.0). We used an electronic analytical balance of 0.01 mg resolution to obtain the weights of new lenses when dry and at equilibrium swelling dry, and calculated the percent hydration of the lenses from the difference of the wet and dry weights. RESULTS: The hydration values of the contact lenses obtained from the index of refraction differed more than those obtained by gravimetry from the values given by the manufacturers. Acuvue lenses were an exception-the difference for them was negligible. CONCLUSION: Gravimetry is more accurate, but more cumbersome and time-consuming than the index of refraction for the determination of the hydration of the hydrogel contact lenses. However, when a fast and easy method is required to obtain the approximate hydration of hydrogel contact lenses, the use of the refractive index method can give acceptable results for most applications.

Contact Lenses, Hydrophilic↗

[Proposed microbiological indexes for the assessment of air quality in buildings].

An assessment of biological risk in the workplace requires the measurement of microorganisms present in the air. Although it is currently difficult to establish a dose-response relationship on the basis of existing epidemiological data, the number and types of microorganisms present offer a useful index when evaluating the quality of the air. Using the results obtained from a study of 226 different offices located in buildings equipped with forced ventilation we propose an assessment of contamination levels based on a Global Index of Microbial Contamination/m3 (GIMC/m3). This index is calculated as the sum of the values of the total microbial count determined for mesophilic bacteria, psychrophilic bacteria and fungi in all sampled areas. GIMC/m3 fluctuates between a minimum value of 23 and a maximum value of 18.069: the mean value varies depending on the ventilation system mode setting, with a value of 145 when operating in the heating mode, 265 in the air-conditioning mode and 258 under simple forced ventilation. 95.5% of the offices under study had a GIMC/m3 value of below 1000: this value is proposed as a threshold limit above which a more extensive assessment of contamination levels based on the measurement of further microbiological indexes should be carried out. To this aim we propose an Index of Mesophilic bacterial Contamination (IMC), obtained by calculating the ratio between the CFU/m3 value measured for mesophilic and psychrophilic bacteria in the same sampling point. The measurement of the Amplification Index (AI) completes the evaluation and this is determined by calculating the ratio between the GICM/m3 values measured inside the building and those measured outside. When considering these observations as a whole we are able to classify the various work areas under study into groups and categories according to the observed values of the proposed microbial contamination indexes.

Air Microbiology↗

Prevalence of prostatitis-like symptoms in a population based study using the National Institutes of Health chronic prostatitis symptom index.

PURPOSE: The National Institutes of Health (NIH) chronic prostatitis symptom index was used to determine the prevalence of prostatitis-like symptoms among men (age 20 to 74 years) at risk in a community based study. MATERIALS AND METHODS: The study was a cross-sectional postal survey of men age 20 to 74 years in Lennox and Addington counties, which included a large rural area, 1 major town and a suburban area with a stable population of men representative of Canadian demographics. The questionnaire collected information on 2 domains of chronic prostatitis identified in the NIH chronic prostatitis symptom index, including pain (location, severity and frequency), voiding function (irritative, obstructive), demographics, quality of life, general health and health seeking behavior. The self-reported pain score was used to identify prostatitis-like symptoms in the most discriminating domain. Based on analysis of the index final validation study comparing patients with prostatitis to normal controls and those with benign prostatic hyperplasia, the 2 questions most specific for prostatitis, including perineal and/or ejaculatory pain/discomfort, and a total pain score (0 to 21) 4 or greater were used to identify men with significant prostatitis-like symptoms. RESULTS: A total of 2,987 eligible men received the survey, and it was completed by 868 (29%). Of the men 84 (9.7%) were identified as having chronic prostatitis-like symptoms (mean NIH chronic prostatitis symptom index pain score 9.1 +/- 0.3). The average age of the prostatitis population was 50 years compared with 52 years for men without prostatitis-like symptoms. Prevalence was 11.5% in men younger than 50 years and 8.5% in men 50 years or older. Of the sampled population 57 (6.6%) men had prostatitis-like symptoms and an index pain score 8 or greater (moderate to severe). The index voiding score (0 to 10) was 4.1 +/- 0.5 in men younger than 50 years compared with 1.5 +/- 0.1 for normal controls, and 4.7 +/- 0.4 in those 50 years or older compared with 1.9 +/- 0.1 for normal controls. Of the prostatitis group 60% sought medical help for their symptoms. CONCLUSIONS: In our opinion this community based study using the new prostatitis symptom index confirms that chronic prostatitis-like symptoms are common.

Adult↗

[Polyspecific response in the central nervous system. Use of antibody index].

INTRODUCTION: The immune response, oligoclonal in cerebrospinal fluid (CSF), in comparison with the blood evidences is different and polyspecific. Together with specific antibodies against the causative agent, antibodies with many different specificities were synthesized. It is more complex in chronic neurological diseases. OBJECTIVE: Broadcast the characteristics of the polyspecific oligoclonal response and the use of antibody index as diagnostic tool in infectious and chronic diseases. DEVELOPMENT: The use of antibody index discriminates between the blood-derived antibody fraction and the brain-derived specific antibody fraction. Once the CSF/serum specific antibody and the IgG ratio are calculated, the antibody index is the quotient between both ratios. Antibody specific ratio may be obtained by titulation but it is less sensible. It is much better to employ immunoenzymatic methods. To avoid false negative results we must use the limit ratio according to reibergram instead of IgG ratio when the last one is greater than the limit ratio. Pathological antibody indexes are > or = 1.5. In chronic, autoimmune diseases, like lupus eritematosus, Sjögren syndrome or Wegener granulomatosis, could exist pathological antibody index against different viral agents like the antibody index against measles (M), rubella (R) and zoster (Z) viruses, known as MRZ reaction. CONCLUSIONS: The use of antibody index permits the diagnosis of infectious neurological diseases and the characterization of the secondary polyspecific response in chronic neurological processes.

Autoimmune Diseases↗

Colour Doppler ultrasonography of the ophthalmic artery: flow parameters in normal subjects. The significance of the resistance index.

BACKGROUND: The aim of this study was to assess the flow characteristics in ophthalmic arteries and to detect their possible relationships to those in the common and internal carotid arteries. METHODS: Sixty healthy subjects (age range 20-74 years) with normal vascular findings, stratified by age and sex were recruited to the study. A colour Doppler ultrasound examination of the neck arteries was performed, followed by a colour Doppler ultrasound examination of the 120 ophthalmic arteries included. Peak systolic velocity, end diastolic velocity and resistance index (RI) of the common carotid, internal carotid and ophthalmic arteries, as well as the insonation depth of the ophthalmic arteries were measured. RESULTS: The mean values (standard deviation) of the measured parameters for the ophthalmic arteries were: insonation depth: 38.38 mm (2.60 mm), peak systolic velocity: 34.71 cm/sec (6.38 cm/sec), end diastolic velocity: 7.95 cm/sec (1.70 cm/sec), resistive index: 0.77 (0.04). The resistance index of the ophthalmic arteries was, in all cases, greater than that of the ipsilateral common carotid artery which in turn, was greater than that of the internal carotid. The value of the index in the ophthalmic arteries, when the circulation is normal in the extra- and intracranial arteries is rarely lower than 0.70. CONCLUSIONS: When an inversion of the ratio between the resistance index of the ophthalmic artery and that of the common carotid or an index value lower than 0.70 in the ophthalmic artery is observed, further investigation is needed as this situation cannot be considered normal. The resistance index seems to be the most reliable parameter for the estimation of normal circulation in ophthalmic arteries.

Adult↗

The Tei index and exercise capacity.

BACKGROUND: Cardiac function time intervals are known to change with aerobic fitness. Recently, the Tei index of cardiac function [defined as the sum of the isovolumetric contraction (ICI) and isovolumetric relaxation intervals (IRI) divided by the left ventricular ejection time (LVET)] has been proposed to be a very sensitive determinant of cardiac function in patients with cardiomyopathy, i.e. the index is greater in patients with cardiomyopathy than it is in normal subjects. The purpose of this study was to determine the relationship between the Tei index and aerobic endurance in healthy volunteers. METHODS: The relatively new noninvasive method of seismocardiography was used to measure following resting left ventricular (LV) cardiac function time intervals in 51 subjects (18 males and 33 females); Tei index, R-R interval, LV ICI, LV IRI, LVET, LV systole and LV diastole. Designated on the basis of peak treadmill time (Bruce protocol), the following three groups were assigned: Group 1; treadmill time > or = 900 seconds; Group 2: treadmill time ranging from 721 to 899 seconds; and Group 3; treadmill time < 720 seconds. RESULTS: The Tei index value was lower as exercise capacity increased (p < 0.05) primarily due to a reduction in LV IRI (p < 0.05). LVET tended to be longer with increased treadmill time (p < 0.05) but this effect appeared to be secondary to a greater R-R interval in more fit subjects. When adjusted for the R-R interval, a reduced Tei index and LV IRI were still observed in more fit subjects, despite a similar LVET between groups. CONCLUSIONS: Peak treadmill time is inversely related to the Tei index. A reduction of LV IRI appears to be the primary factor in establishing these differences. These data support the important role of LV diastolic function in aerobic fitness.

Adult↗

A water quality index for contact recreation in New Zealand.

We surveyed the opinions of 16 water quality experts in order to develop a water quality index for contact recreation in freshwaters in New Zealand. The index was developed by postal surveys using the Delphi method, involving feedback of information to the panel members at each iteration. Determinands selected for use in the index were as follows: faecal bacterial indicators (faecal coliforms or E. coli), pH, Munsell colour, visual clarity indicators (black disc visibility or turbidity), and nutrients promoting nuisance growths (filtered BOD5, and dissolved forms of phosphorus and nitrogen). "Sub-index" curves relating suitability-for-use to these water quality determinands have been developed. The mean ("consensus") sub-index curves can be used to interpret water quality data in terms of suitability-for-use scores. We advocate using the lowest suitability-for-use score for a water as its overall index value for contact recreation. Thus the water body's suitability-for-use is determined by its "poorest" characteristic. The index is now ready to be tested by water managers for its utility in state-of-environment reporting.

Bacteria↗

The diagnostic value of seminal a-glucosidase enzyme index for sperm motility and fertilizing capacity.

OBJECTIVE: To find out the diagnostic value of seminal a-glucosidase enzyme index in the ejaculated semen samples of proven-fertility and primary infertility patients, for the sperm motility and fertilizing capacity. METHODS: The study which lasted approximately 2 years was carried out in the Andrology Department of the Arab Fertility Center, Jeddah, Kingdom of Saudi Arabia. Eighty-five healthy male patients (age 25-38 years) were admitted into the study. They were divided into 2 main groups as proven-fertility group and primary infertility group. Each group was again subdivided into 4 classes based on the sperm concentrations. The sperm motility assessment was carried out quantitatively by Semi automated Computer assisted Semen analysis using Autosperm analyzer. Simultaneously, a-glucosidase enzyme index was determined in all the semen samples. RESULTS: The results were tabulated as per the standard sperm motility grades of the World Health Organisation, under the classified sperm concentrations of the study. The progressive motility grades were compared with the enzyme index of a-glucosidase in both the groups. The total progressive motility was found higher in the high-density (classes I and II) than the low-density (classes III and IV) semen samples. The enzyme index readings of the various classes of sperm concentrations were significant (p<0.05) and showed a stepwise fall from 89% +/-9% to 52%+/-3% in the proven fertility group. Although, a similar trend has been observed (48%+/-5% to 20%+/-2%) in the primary infertility group, the enzyme index class II sperm concentration (44%+/-6%) was not found significant with class 1 (48%+/-5%) sperm concentration, but the significance was achieved with the other 2 classes. The readings of enzyme index between the groups were found highly significant (p, 0.001). CONCLUSION: The enzyme index of a-glucosidase estimations in semen samples may indicate a positive correlation with progressive motility and fertilizing capacity of spermatozoa and may serve as diagnostic value in individuals showing normal levels of sperm concentration and serum androgen.

Adult↗

[Effect of 962 capsule on liver peroxidation, thymus and spleen index].

OBJECTIVE: To investigate the effect of 962 capsule, a TCM compound recipe, on liver peroxidation and weight of thymus and spleen (thymus index, spleen index) in aged rats, and observe the anti-oxidation effect and the influence on immunological function in rats. METHODS: Rats were divided into young control, aged model, positive control (piracetam), 962 middle (0.9 g/kg) dose and high dose (1.8 g/kg) groups, and the medicated rats used in each group were aged rats. All tested drugs were administered for 1 month by gastrogavage. The liver peroxidation was determined by thiobarbituric acid method. The thymus index and spleen index were determined by weighing method. RESULTS: Middle and high dose of 962 capsule attenuated liver peroxidation, their liver MDA lowered, increased the thymus index of aged rats. There was no effect on spleen index in all medicated groups. CONCLUSIONS: 962 capsule could reduce liver lipid peroxidation and increase thymus index. It is suggested that 962 capsule might be beneficial in retarding aging process.

Aging↗

Flow cytometry vs. Ki67 labelling index in breast cancer: a prospective evaluation of 181 cases.

BACKGROUND: Excessive proliferation is one of the first steps in oncogenic activation and one of the most important biological features defining the aggressiveness of tumors. Quantifying the proportion of tumor cells in S-phase by means of flow cytometry has shown, in the past, to be useful for defining high-risk subgroups in breast cancer. Several antigens closely associated with proliferation are also detectable by means of immunohistochemistry, offering in theory an easy to perform and cheap alternative to flow cytometry for measuring proliferation. To test this hypothesis, we compared both methods prospectively in a series of breast cancers. MATERIALS AND METHODS: We studied the proliferation rate of 181 breast cancers (152 ductal infiltrating, 17 lobular infiltrating, 12 other histological varieties), operated upon at our institution, by means of flow cytometry and the Ki67 labelling index, using the MIBI antibody. Ploidy (expressed as DNA content or DNA-index), S-phase fraction and the Ki67 labelling index were the variables of the study. The S-phase fraction was considered separately for diploid and aneuploid tumors, following the 1992 Maine Consensus guidelines and was judged abnormally elevated if higher than the 75th percentile for each group. The Ki67 labelling index was expressed as percent positive tumor cells, positive cells being those showing specific nuclear staining. RESULTS: DNA-ploidy and the Ki67 labelling index could be evaluated in all tumors. Of the total, 96 (53%) were diploid and 85 (47%) aneuploid. S-phase fraction could be measured in 172 out of the 181 tumors (95%). The 75th percentile cut-offs for diploid and aneuploid tumors were 9.9% and 15.8%, respectively. We found a significant correlation beween rising DNA content and increasing Ki67 index (r = 0.18; p = 0.022), as well as between the percentage of cells in S-phase of the whole tumor population and Ki67 (r = 0.22; p = 0.0055). A Ki67 cut-off of 50% or higher identified most aneuploid tumors, or a small group of diploid ones with a high S-phase fraction (specificity = 96.7%; positive predictive value 92.5%), however at the price of a very low sensitivity (62.6%). This was due to the presence of many aneuploid tumors with a low S-phase fraction. CONCLUSION: The Ki67 labelling index and S-phase fraction are significantly correlated. However, flow cytometry provides additional indirect information on tumor aggressiveness associated with DNA-ploidy. Further studies are needed to determine whether Ki67 alone is sufficient as a routinely applicable method.

Breast Neoplasms↗

Effect of bispectral index monitoring on sevoflurane consumption.

BACKGROUND AND OBJECTIVE: The bispectral index, a parameter derived from the electroencephalograph, has been shown to correlate with the loss of consciousness and sedation. This study was designed to assess the effects of bispectral index monitoring on sevoflurane and its recovery profiles. METHODS: Sixty ASA I and II patients undergoing open abdominal surgery were randomized into two groups: one monitored using the bispectral index (Group BIS) and the other without its use (controls). After a standardized induction, anaesthesia was maintained with sevoflurane in both groups. In Group BIS, sevoflurane was titrated to maintain the bispectral index in the range 40-60. In the control group, the administered sevoflurane concentration was adjusted according to the signs of anaesthesia. The end-tidal sevoflurane concentration, bispectral index and routine haemodynamic variables were noted every 5 min during surgery. The consumption of sevoflurane was computed. At the conclusion of surgery operations, the time to 'open eyes on verbal command', 'motor response to verbal command' and Aldrete's score were recorded by a blinded anaesthesiologist. RESULTS: The difference in the consumption of sevoflurane was not significant between the groups. Bispectral index monitoring was associated with a reduction of 4.73% in sevoflurane usage and 2.19 mL h(-1) was saved. CONCLUSIONS: Bispectral index monitoring during anaesthesia provides only a small advantage related to the need to monitor the depth of anaesthesia.

Abdomen↗

Indexing glomerular filtration rate to suit children.

UNLABELLED: In order to be able to compare individuals of differing size, glomerular filtration rate (GFR) is conventionally indexed to body surface area (BSA). This does not, however, suit children because they naturally have a relatively high BSA simply because of their small size. The aim of the study was to identify an appropriate simple whole-body variable based on height and weight suitable for indexing GFR that would be simultaneously appropriate for both children and adults. METHODS: A database of 532 routine clinical GFR measurements, each based on 3 venous blood samples obtained between 2 and 4 h after injection of (51)Cr-ethylenediaminetetraacetic acid, was analyzed to give GFR and, using only the half-time of the slope of the clearance curve, the quotient GFR to extracellular fluid volume (ECV). BSA was obtained from the Haycock formula, which is based on height and weight raised to indices to give units of area. Both GFR and GFR/ECV were corrected for the 1-compartment assumption using previously published empiric correction formulas. ECV was obtained by dividing GFR by GFR/ECV. An equation analogous to Haycock's was derived in which the indices of height and weight were varied to give an iterative best fit to ECV instead of BSA. RESULTS: GFR, ECV, and BSA increase as functions of age until about age 13 y, corresponding to a BSA of about 1.35 m(2), which was taken as the cutoff point between children and adults. As humans grow, their ratio of height to effective radius changes as a nonlinear function of surface area. Humans must therefore change shape as they grow. Moreover, the ECV-to-weight ratio decreases as a function of body size, suggesting that humans also change body composition as they grow. The new equation, giving an iterative best fit to ECV, was ECV = weight(0.6469) x height(0.7236) x 0.02154. ECV, either measured or estimated from the new equation, corresponding to a BSA of 1.73 m(2), was 12.9 L. Expressed as values normalized to the corresponding average adult values, the new equation and the second-order polynomial fit to ECV were superimposed as they increased as functions of BSA or weight. In contrast, normalized BSA and normalized weight were respectively larger and smaller than normalized ECV in children. GFR indexed to the new equation correlated more closely with GFR indexed to ECV than did GFR indexed to BSA and, along with GFR/ECV, showed a greater fall as a function of age than did GFR/BSA. CONCLUSION: When required in absolute units rather than as a rate of turnover of ECV, GFR is appropriately indexed to indices of height and weight as defined by this new equation, which avoids disadvantages to children from indexing to BSA. This unmasks higher values of filtration function in children than have hitherto been recognized.

Adolescent↗

Cluster analysis: significance, empty space, clustering tendency, non-uniformity. II--Empty Space index.

The here presented Empty Space index (ES) evaluates the fraction of the information space without experimental points, i.e. the space where the distance from an experimental point is significantly larger than the mean distance between the experimental points themselves. ES can be used to eliminate the ambiguity of the some clustering indexes, that aim to evaluate the separation of the data set in clusters, but these clustering indexes are really a mixed measure of clustering, of empty space (the empty space does not necessarily correspond to the break between clusters) and of the degree of uniformity of the objects. The ES index can be used also to correct the MST index, the clustering index based on the distribution of edge lengths in the minimum spanning tree connecting the objects. The corrected MST index seems to be a reliable measure of the clustering degree.

Chemistry Techniques, Analytical↗

[Expression of P21 WAF1/CIP1 in human astrocytomas in correlating with P53, MDM2, and cellular proliferation index].

OBJECTIVE: To study the correlation between the expression of p21, p53, MDM2 gene products and the initiation and progression of human astrocytomas. METHODS: The expression of P21, P53, MDM2, and proliferative cell nuclear antigen (PCNA) labeling index using immunohistochemistry in 41 paraffin embedded human astrocytoma samples. As well as the expression of p21 mRNA using mRNA in situ hybridization in 24 fresh human astrocytoma samples stored at -70 degrees C were investigated. In immunohistochemistry, we divided whole tumor cells by positive tumor cell nuclei to obtain labeling index (LI), in this way we could understand the protein product expression of gene in astrocytoma in different patients. In mRNA in situ hybridization, the expression of p21 mRNA was scored according to the rough percentage of positive cells. RESULTS: In p21 mRNA in situ hybridization, the positive staining was present in 87.5%. In immunohistochemistry, positive P21, P53, MDM2, and PCNA staining were presented in 75.6%, 68.3%, 65.9%, 100% respectively. Higher levels of P21 protein expression were seen in higher histological grade (P = 0.001). The association between P21 expression positively correlated with proliferation index. But not with P53 expression and MDM2 expression. The association between P53 expression and proliferation indices were statistically significant, but the expression of P53 was not related to tumor grade. There was no association between MDM2 expression and grade, or cellular proliferation index. Linear stepwise regression analysis showed the parameters affecting tumor grade were PCNA LI (P = 0.000) and P21 LI (P = 0.001). CONCLUSIONS: (1) Both p21 mRNA and P21 protein were overexpressed in human astrocytomas, the overexpression was related to cellular proliferation index, but was not related to P53 expression, suggesting there could be P53-independent pathway to induce the P21 expression, in addition, the overexpression of P21 alone appeared insufficient to suppress tumor growth, provided the participation of PCNA. (2) The expression of P53 protein was associated with proliferation indices, but was not with the tumor malignancy, this indicated that the inactivation of P53 might be the early event in the growth of human astrocytomas. (3) P21 labeling index and cellular proliferation index influenced the tumor histological grade, our data indicated that p21 gene might play a role in the progression of human astrocytomas.

Adolescent↗

THE HUMAN BLOOD INDEX OF MALARIA VECTORS IN RELATION TO EPIDEMIOLOGICAL ASSESSMENT.

The human blood index, or estimated proportion of the blood meals of a mosquito population obtained from man, is provisionally assessed for certain anophelines from blood-meal samples collected during the period 1959-62 and subjected to precipitin testing at the Lister Institute. In malaria eradication programmes this index is relevant to epidemiological assessment and to the modification of measures to interrupt transmission, since a mosquito's vectorial capacity and the malaria reproduction rate both vary as the square of the human blood index.There are serious difficulties in achieving representative sampling for this index and in interpreting the index obtained. These are discussed in some detail. In practice, the human blood index is often best estimated by applying the unweighted mean of a part-sample collected from human dwellings and one from other types of resting-place.Applying this calculation to the samples under review, it appears that DDT exerts a moderate, and dieldrin a more pronounced, impact on the human blood index of Anopheles gambiae and A. funestus; such an effect, indeed, may be general in house-visiting anophelines. Some 18 anopheline species are tentatively graded as having low, medium or high natural human blood indices. Regular and careful sampling, combined with recording of all relevant information, is recommended in view of the epidemiological and operational importance of the human blood index in assessment of eradication programmes.

Animals↗

[Principal component analysis on ultrasound indexes of schistosomiasis and the assessment on prevalence rate].

OBJECTIVE: To explore the synthetical index for diagnosing schistosomiasis with ultrasound and to assess the prevalence rate with the index. METHODS: Ultrasound indexes of schistosomiasis Japonicum were analyzed by principal component analysis, and the synthetical indexes were assessed by ROC curve. RESULTS: Among the abnormal rates of the 6 indexes, the lowest was 1.6% comparing with the highest of 59.5%. Significant difference was noficed among the abnormal rates (chi(2) = 631.1, P < 0.01). The individual correlation of the six indexes to each other as will as with age distribution was significant (P < 0.05). The three principal components reflected the degree of pathological changes on liver and spleen. The first principal component was the factor reflecting the degree of liver pathological changes, and the second and third principal components reflected the degree of pathological changes on spleen. The synthetical index D(1) = 0.047X(1) + 0.428X(2) + 1.247X(3) + 0.095X(4) + 0.002X(5) + 0.213X(6) - 12.837 was found by adding the three weight principal components, and it's area under the ROC curve was 0.957. When -1.70 was taken as the critical value, the abnormal rate of population was 66.3%, close to the resident's actual prevalence rate 66.9%. CONCLUSION: Ultrasonography was considered as a method which could rapidly assessing the resident's prevalence rate in the endemic areas of schisitosomiasis Japonicum, and could also provide powerful information for development of strategy on chemotherapy.

Adolescent↗

[Study of the prognostic value of DNA ploidy and proliferation index (Ki-67) in renal cell carcinoma with venous thrombus].

INTRODUCTION: Malignant tumours of the renal parenchyma are accompanied by extension to the inferior vena cava in 4% to 10% of cases. The objective of this study was to compare DNA ploidy and proliferation index of renal cell carcinoma (RCC) with renal vein (RV) thrombus and RCC with inferior vena cava (IVC) thrombus and to investigate a correlation between these markers and Fuhrman grade and patient survival. MATERIAL AND METHODS: A retrospective study was conducted in 58 patients with RCC and venous thrombus (40 in the RV and 18 in the IVC). Flow cytometry (FCM) and MiBI antibody immunolabelling (Ki-67 index) were performed on the healthy parenchyma, the renal tumour and the venous thrombus. Eighteen tumours with inferior vena cava thrombus were compared to 40 tumours with renal vein thrombus. Fuhrman grade, the presence of capsular rupture, invasion of the perirenal fat, and the presence of sarcomatoid transformation were investigated for a possible correlation with survival. RESULTS: No difference of expression of Ki-67 antigen expression was observed between the two populations of renal tumours with thrombus (RV/IVC), but a significant difference was observed for the two types of thrombus (RV/IVC). A difference in ploidy index was observed was also observed between tumours with RV and IVC thrombus (p<0.005). The tumours had less intense MiB1 immunolabelling and a lower DNA ploidy than their corresponding renal vein and inferior vena cava thrombi (Ki-67: 1.07% vs 5.12%, p<0.01: DNA index: 1.61 vs 1.87, p<0.01). A correlation between Fuhrman grade and tumour DNA index was demonstrated (1.149 for low grade tumours and 1.857 for high grade tumours, p<0.05). Sarcomatoid transformation, capsular effraction and capsular rupture were significantly correlated with Fuhrman grade (p<0.01) and patient survival (p<0.05). CONCLUSION: The proliferation index is not a prognostic factor, but DNA ploidy appears to be more useful because of its correlation with Fuhrman grade and the level of extension of the thrombus (RV/IVC). The proliferation index and ploidy appear to be involved in the process of carcinogenesis and venous thrombus.

Aged↗

Ex vivo therapeutic index by drug sensitivity assay using fresh human normal and tumor cells.

Toxicity is a major deterrent to achieving substantial improvements in cancer management, since most anticancer drugs inadequately distinguish normal and neoplastic tissues. Improving the differential between beneficial and toxic effects of therapy--therapeutic index--is a major clinical objective, but therapeutic index for cytotoxic drugs is narrow. Fresh tumor and normal cells from 59 patients with acute myeloid leukemia, non-Hodgkin's lymphoma, ovarian cancer and cancers of unknown origin were tested for ex vivo drug sensitivity using apoptosis by morphology assays. Drugs tested included carboplatin, doxorubicin, vincristine, cytarabine, fludarabine, mafosfamide and etoposide. Therapeutic index was derived from the ratio of normal and tumor cell LC90s. Individual patient therapeutic index varied markedly for different drugs and drug therapeutic index varied from patient to patient ranging from extremely unfavourable (<0.001) through excellent (>1000) reflecting patient heterogeneity. Therapeutic index for each drug was consistent with clinical expectations. Significantly, there was no relationship between normal and tumor cell LC90s. We conclude that further laboratory and clinical evaluation is required but the derived ex vivo therapeutic index could enhance choice of chemotherapy by reducing toxicity and/or improving efficacy.

Adolescent↗