Introduction: The integrity and composition of bone marrow core biopsies may be influenced by man... more Introduction: The integrity and composition of bone marrow core biopsies may be influenced by many parameters including patient age, sex, bone density, operator experience, needle selection and biopsy technique. Biopsy needle design impacts on a needle’s performance and the quality of recovered specimens. We studied the effect of modifying the Snarecoil bone marrow biopsy needle tip on the recovery of trabecular bone in core specimens. Methods: 7 patients, ages 35–92, M/F = 4/3, (2 leukemias, 1 lymphoma, 1 cytopenia, 1 anemia, 2 other) underwent a bone marrow biopsy using a 8 gauge Snarecoil needle with a new needle tip (TPNSP). The tip has a twin peak point and more distal Snarecoil position. As a control group, 7 patients biopsied with a standard 8 gauge Snarecoil needle (NTP) were retrospectively identified and matched for age and sex and were ages 37–87, M/F = 5/2, (3 cytopenias, 2 leukemias, 1 lymphoma, 1 other). All biopsies were completed using a minimally manipulative techni...
Classical Hodgkin Lymphoma (CHL) is a monoclonal lymphoid neoplasm that accounts for approximatel... more Classical Hodgkin Lymphoma (CHL) is a monoclonal lymphoid neoplasm that accounts for approximately 30% of all lymphomas in the United States. Although multiagent chemotherapy and radiation therapy have made CHL a highly curable disease, approximately 15-20% of patients are refractory to the treatment or relapsed after remission. The rich inflammatory cellular microenvironment plays an important role in the pathogenesis of CHL. Gene-expression profiling has identified a gene signature of tumor-associated macrophages (TAMs) that was significantly associated with primary treatment failure. The potential of macrophage-specific markers, CD68 and CD163, as prognostic markers for resistance to therapy in CHL patients has been investigated; however, these studies generated inconsistent results. Roughly TAMs could be characterized into two distinct polarization states; the classically activated type 1 macrophages (M1) associated with acute inflammation and T-cell immunity and the alternative...
Lung cancer is a complex disease associated with gene mutations, particularly mutations of Kirste... more Lung cancer is a complex disease associated with gene mutations, particularly mutations of Kirsten Rat Sarcoma Viral Oncogene Homolog (KRAS) and epidermal growth factor receptor (EGFR). Non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC) are the two major types of lung cancer. The former includes most lung cancers (85%) and are commonly associated with EGFR mutations. Several EGFR-tyrosine kinase inhibitors (EGFR-TKIs), including erlotinib, gefitinib, and osimertinib, are effective therapeutic agents in EGFR-mutated NSCLC. However, their effectiveness is limited by the development (acquired) or presence of intrinsic drug resistance. MicroRNAs (miRNAs) are key gene regulators that play a profound role in the development and outcomes for NSCLC via their role as oncogenes or oncosuppressors. The regulatory role of miRNA-dependent EGFR crosstalk depends on EGFR signaling pathway, including Rat Sarcoma/Rapidly Accelerated Fibrosarcoma/Mitogen-Activated Protein Kinase/Ext...
We present a sterilizable ratiometric fluorescent ethanol sensor with sensitivity over a wide ran... more We present a sterilizable ratiometric fluorescent ethanol sensor with sensitivity over a wide range (0-100%) of ethanol concentration v/v. The sensor is composed of a near infra red fluorescent solvatochromic dye, nile blue methacrylamide polymerized into a polyethylene (glycol) dimethacrylate matrix. The dye can typically exhibit two or more wavelength dependent shifts in the fluorescence intensities based on its different micropolar environments. Two different concentrations of the nile blue methacrylamide dye were prepared and polymerized into homogenous films. The fluorescence properties of the two different films were investigated with a view to determining their ethanol sensing capabilities. The sensor was immersed in a water-ethanol solvent mixture. Excitation of the dye was performed at 470 nm. The range of emission wavelengths was 480-800 nm. The ratio of the fluorescence intensities at 620 nm and 554 nm was obtained for ethanol concentrations varying from 0-100% and the ca...
The Journal of the Association of Physicians of India, 2015
OBJECTIVE To study the practice pattern in the management of patients with stable angina (SA) in ... more OBJECTIVE To study the practice pattern in the management of patients with stable angina (SA) in India. METHODS The Stable Angina obseRvational Registry (STAR) prospectively enrolled patients provisionally diagnosed with SA by non-interventional practicing internists in India. Patients were followed for 3 months after enrollment to assess medical treatment, diagnostic management, and interventional treatment of coronary artery disease (CAD). At the study conclusion, a statistical analysis retrospectively categorized patients not at risk of CAD by the Morise-Jalisi scale though this was not part of the study protocol. RESULTS Between January and May 2012, 2079 patients were enrolled at 131 centres. Mean age was 57 ± 11 years, 62% were men, and 40% had a history of diabetes. Over 90% of patients completed follow-up visit, >85% received statins and antiplatelet medications, >70% received beta blockers, and >60% received angiotensin-converting-enzyme inhibitors or angiotensin r...
Allosensitization is a fundamental problem that limits the effectiveness of blood transfusions. P... more Allosensitization is a fundamental problem that limits the effectiveness of blood transfusions. Patients who receive multiple transfusions of blood or blood components frequently develop alloantibodies against donor alloantigens. Allosensitired patients are refractory to further transfusion and difficult t o transplant successfully. CTLA4lg fusion protein, which blocks the CD28-B7 costimulatory pathway in Tlymphocyte activation, was tested for its capacity t o inhibit allosensitization t o blood transfusions. Groups of LEW (RTI') rats were transfused with ACI blood (RTI") together with L6 (a human immunoglobulin G I [IgGl] antibody as isotype control1 or CTLA4lg in different doses (0.004, 0.02, 0.1, and 0.5 mg). Rats were retransfused with ACI blood after 28 and 84 days without any additional CTLA4Ig therapy. Weekly sera samples were tested for alloantibody against donor leukocytes using flow cytometry. CTLA4lg caused a dose-dependent decrease in the IgM alloantibody respon...
Resistive random access memory (RRAM) devices represent promising candidates for emerging non-vol... more Resistive random access memory (RRAM) devices represent promising candidates for emerging non-volatile data storage applications and neuromorphic computing. In those devices, the resistance of a dielectric -often a binary oxide- is switched between a low resistance state (LRS) and one or more high resistance states (HRS) by the application of an appropriate external electrical bias. This resistance switching could be filamentary, i.e., involves the formation of a conductive filament. This filament can be thought of as chains of conductive oxygen vacancies (intrinsic resistance switching) or metallic atoms from an active device electrode (extrinsic resistance switching). In this thesis, the relationship between device electrode material and its resistance switching mechanism in SiOx (x∼1.9)-based RRAM devices was studied. Although it’s widely reported that RRAM devices with electrochemically active top electrodes, such as Ag, switch extrinsically, I show that both mechanisms and thei...
Background Acute appendicitis (AA) is the most common general surgical emergency. Early laparosco... more Background Acute appendicitis (AA) is the most common general surgical emergency. Early laparoscopic appendicectomy is the gold-standard management. SARS-CoV-2 (COVID-19) brought concerns of increased perioperative mortality and spread of infection during aerosol generating procedures: as a consequence, conservative management was advised, and open appendicectomy recommended when surgery was unavoidable. This study describes the impact of the first weeks of the pandemic on the management of AA in the United Kingdom (UK). Methods Patients 18 years or older, diagnosed clinically and/or radiologically with AA were eligible for inclusion in this prospective, multicentre cohort study. Data was collected from 23rd March 2020 (beginning of the UK Government lockdown) to 1st May 2020 and included: patient demographics, COVID status; initial management (operative and conservative); length of stay; and 30-day complications. Analysis was performed on the first 500 cases with 30-day follow-up. ...
Introduction: Quantifying cellularity is an integral component of bone marrow examinations. Estim... more Introduction: Quantifying cellularity is an integral component of bone marrow examinations. Estimates of marrow cellularity may influence the diagnostic interpretation of bone marrow samples. The accuracy of cellularity estimates may be influenced by the variable distribution of cellular elements within the marrow space. To better understand the degree of heterogeneity of bone marrow cellularity, we undertook a study to quantify the variable distribution of bone marrow cells in bone marrow core biopsies. Method: 8 gauge bone marrow core biopsies of 20 patients were retrospectively reviewed by 2 hematopathologists (SI,CL). The specimens were recovered from the posterior superior iliac crest using standard technique with 8G Snarecoil biopsy needles by 3 operators (KH, PK, GD). The percent cellularity was determined in sequential 0.2 X 0.4 cm portions of the core biopsies by each of the hematopathologists. Cellularities were recorded in 10% increments. Results: The mean age of the pati...
Although it has been generally accepted that hypercoagulability contributes to enhancing tumor gr... more Although it has been generally accepted that hypercoagulability contributes to enhancing tumor growth via generation of thrombin (Cancer Cell10:355, 2006), it has not been rigorously proven, nor has the mechanism been established at the cell cycle level. Previous studies have employed thrombin-treated tumor cell lines in vitro and in vivo. In vitro studies were performed in the presence of serum which contains a panoply of growth factors. In vivo studies have used huge non-pathologic concentrations of tumor cells injected into the flank, organ or blood of a mouse. In these situations, tumor growth could be a result of thrombin-induced angiogenesis. We therefore employed a transgenic mouse prostate cancer model (TRAMP) programmed to develop prostate CA over a period of 140–175 days. We treated these animals with thrombin to induce hypercoagulability or hirudin to inhibit endogenous thrombin production, to determine whether thrombin regulates this process independent of angiogenesis. ...
The ubiquitin-proteasome system plays a central role in the regulation of cell growth and cell pr... more The ubiquitin-proteasome system plays a central role in the regulation of cell growth and cell proliferation by controlling the abundance of key cell cycle proteins. Increasing evidence indicates that unscheduled proteolysis of many cell cycle regulators contributes significantly to tumourigenesis and is indeed found in many types of human cancers, including colon and renal cell cancer, non hodgkin lymphomas, and multiple myelomas. Protein degradation pathways are also targets for cancer therapy, as shown by the successful introduction of bortezomib (B), an inhibitor of the 26S proteasome, for the therapy of multiple myeloma. Recently, protease inhibitors conventional in HIV therapy (e.g., ritonavir (R)) have been found to exert an antiproliferative effect on different tumor types, including multiple myeloma cells. More recently, ritonavir has been shown to induce endoplasmic reticulum stress and to sensitize sarcoma cells towards bortezomib induced apoptosis. In this study, we show...
4979 Introduction The JAK2V617F mutation accounts for most cases of myeloproliferative neoplasms ... more 4979 Introduction The JAK2V617F mutation accounts for most cases of myeloproliferative neoplasms (MPN). Only a few case reports of MPN following cytotoxic chemotherapy have been reported, and all of them were published prior to the discovery of the JAK2V617F mutation. We report a series of 6 patients who developed a JAK2V617F positive MPN following cytotoxic chemotherapy. Patients From 2006 to 2009, 6 patients with a history of a hematologic or an oncologic malignancy who developed an MPN were identified and their medical records retrospectively reviewed. One patient had acute lymphoblastic leukemia, 1 had Hodgkin lymphoma, 1 had squamous cell carcinoma of the head and neck, 1 had cervical cancer, and 2 had breast cancer. All patients were in remission from their primary malignancies at the time the MPN was diagnosed. Five were females. The median age at diagnosis was 72 years. Median time to development of the myeloproliferative neoplasm was 14 years. Type of chemotherapy exposure,...
Introduction. The quality and length of bone marrow biopsy core specimens should facilitate accur... more Introduction. The quality and length of bone marrow biopsy core specimens should facilitate accurate diagnositic interpretation of marrow histopathology. A 11G specimen of length 1.6 cm or greater is considered adequate for pathologic evaluation by some authors. The length of specimens recovered with 11G needles appears to depend on needle design. We explored the possibility that the adequacy of bone marrow biopsy specimens may be influenced by patient age and the gauge of biopsy needles. Methods. 88 bone marrow core specimens were recovered from 72 patients using 11G SNARECOIL bone marrow biopsy needles. The mean age of these patients was 61.4 and the m/f ratio was 45/27. The clinical diagnoses were isolated anemia, cytopenias, leukemia, lymphoma, myeloma and other in 18.0%, 33.3%, 13.8%, 13.8%, 5.5% and 15.2% of the patients, respectively. 10 patients underwent multiple procedures (2–6) for evaluation of treatment efficacy. 106 patients underwent 127 bone marrow biopsy procedures ...
1262 PNH is characterized by circulating blood cells that are deficient in the surface expression... more 1262 PNH is characterized by circulating blood cells that are deficient in the surface expression of proteins that require glycosylphosphatidylinositol (GPI). The loss of the GPI-linked complement inhibitors CD55 and CD59 on the red cell results in complement mediated hemolysis, and this defect on the surface of platelets is likely responsible for the marked hypercoagulable state seen in PNH. The loss of GPI-linked proteins is due to the clonal expansion of a stem cell with an acquired somatic mutation in the PIG-A gene, which is responsible for an early step in the production of GPI. In PNH, as in aplastic anemia, there is a decreased stem cell and erythroid progenitor pool, there are oligoclonal T cell expansions, there is an HLA allele association, and cytopenias can occur, which respond to immunosuppression. Normal individuals harbor occult populations of cells with the PNH phenotype and genotype, and there is evidence that PIG-A mutations are growth neutral in animals. These fi...
Introduction: The integrity and composition of bone marrow core biopsies may be influenced by man... more Introduction: The integrity and composition of bone marrow core biopsies may be influenced by many parameters including patient age, sex, bone density, operator experience, needle selection and biopsy technique. Biopsy needle design impacts on a needle’s performance and the quality of recovered specimens. We studied the effect of modifying the Snarecoil bone marrow biopsy needle tip on the recovery of trabecular bone in core specimens. Methods: 7 patients, ages 35–92, M/F = 4/3, (2 leukemias, 1 lymphoma, 1 cytopenia, 1 anemia, 2 other) underwent a bone marrow biopsy using a 8 gauge Snarecoil needle with a new needle tip (TPNSP). The tip has a twin peak point and more distal Snarecoil position. As a control group, 7 patients biopsied with a standard 8 gauge Snarecoil needle (NTP) were retrospectively identified and matched for age and sex and were ages 37–87, M/F = 5/2, (3 cytopenias, 2 leukemias, 1 lymphoma, 1 other). All biopsies were completed using a minimally manipulative techni...
Classical Hodgkin Lymphoma (CHL) is a monoclonal lymphoid neoplasm that accounts for approximatel... more Classical Hodgkin Lymphoma (CHL) is a monoclonal lymphoid neoplasm that accounts for approximately 30% of all lymphomas in the United States. Although multiagent chemotherapy and radiation therapy have made CHL a highly curable disease, approximately 15-20% of patients are refractory to the treatment or relapsed after remission. The rich inflammatory cellular microenvironment plays an important role in the pathogenesis of CHL. Gene-expression profiling has identified a gene signature of tumor-associated macrophages (TAMs) that was significantly associated with primary treatment failure. The potential of macrophage-specific markers, CD68 and CD163, as prognostic markers for resistance to therapy in CHL patients has been investigated; however, these studies generated inconsistent results. Roughly TAMs could be characterized into two distinct polarization states; the classically activated type 1 macrophages (M1) associated with acute inflammation and T-cell immunity and the alternative...
Lung cancer is a complex disease associated with gene mutations, particularly mutations of Kirste... more Lung cancer is a complex disease associated with gene mutations, particularly mutations of Kirsten Rat Sarcoma Viral Oncogene Homolog (KRAS) and epidermal growth factor receptor (EGFR). Non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC) are the two major types of lung cancer. The former includes most lung cancers (85%) and are commonly associated with EGFR mutations. Several EGFR-tyrosine kinase inhibitors (EGFR-TKIs), including erlotinib, gefitinib, and osimertinib, are effective therapeutic agents in EGFR-mutated NSCLC. However, their effectiveness is limited by the development (acquired) or presence of intrinsic drug resistance. MicroRNAs (miRNAs) are key gene regulators that play a profound role in the development and outcomes for NSCLC via their role as oncogenes or oncosuppressors. The regulatory role of miRNA-dependent EGFR crosstalk depends on EGFR signaling pathway, including Rat Sarcoma/Rapidly Accelerated Fibrosarcoma/Mitogen-Activated Protein Kinase/Ext...
We present a sterilizable ratiometric fluorescent ethanol sensor with sensitivity over a wide ran... more We present a sterilizable ratiometric fluorescent ethanol sensor with sensitivity over a wide range (0-100%) of ethanol concentration v/v. The sensor is composed of a near infra red fluorescent solvatochromic dye, nile blue methacrylamide polymerized into a polyethylene (glycol) dimethacrylate matrix. The dye can typically exhibit two or more wavelength dependent shifts in the fluorescence intensities based on its different micropolar environments. Two different concentrations of the nile blue methacrylamide dye were prepared and polymerized into homogenous films. The fluorescence properties of the two different films were investigated with a view to determining their ethanol sensing capabilities. The sensor was immersed in a water-ethanol solvent mixture. Excitation of the dye was performed at 470 nm. The range of emission wavelengths was 480-800 nm. The ratio of the fluorescence intensities at 620 nm and 554 nm was obtained for ethanol concentrations varying from 0-100% and the ca...
The Journal of the Association of Physicians of India, 2015
OBJECTIVE To study the practice pattern in the management of patients with stable angina (SA) in ... more OBJECTIVE To study the practice pattern in the management of patients with stable angina (SA) in India. METHODS The Stable Angina obseRvational Registry (STAR) prospectively enrolled patients provisionally diagnosed with SA by non-interventional practicing internists in India. Patients were followed for 3 months after enrollment to assess medical treatment, diagnostic management, and interventional treatment of coronary artery disease (CAD). At the study conclusion, a statistical analysis retrospectively categorized patients not at risk of CAD by the Morise-Jalisi scale though this was not part of the study protocol. RESULTS Between January and May 2012, 2079 patients were enrolled at 131 centres. Mean age was 57 ± 11 years, 62% were men, and 40% had a history of diabetes. Over 90% of patients completed follow-up visit, >85% received statins and antiplatelet medications, >70% received beta blockers, and >60% received angiotensin-converting-enzyme inhibitors or angiotensin r...
Allosensitization is a fundamental problem that limits the effectiveness of blood transfusions. P... more Allosensitization is a fundamental problem that limits the effectiveness of blood transfusions. Patients who receive multiple transfusions of blood or blood components frequently develop alloantibodies against donor alloantigens. Allosensitired patients are refractory to further transfusion and difficult t o transplant successfully. CTLA4lg fusion protein, which blocks the CD28-B7 costimulatory pathway in Tlymphocyte activation, was tested for its capacity t o inhibit allosensitization t o blood transfusions. Groups of LEW (RTI') rats were transfused with ACI blood (RTI") together with L6 (a human immunoglobulin G I [IgGl] antibody as isotype control1 or CTLA4lg in different doses (0.004, 0.02, 0.1, and 0.5 mg). Rats were retransfused with ACI blood after 28 and 84 days without any additional CTLA4Ig therapy. Weekly sera samples were tested for alloantibody against donor leukocytes using flow cytometry. CTLA4lg caused a dose-dependent decrease in the IgM alloantibody respon...
Resistive random access memory (RRAM) devices represent promising candidates for emerging non-vol... more Resistive random access memory (RRAM) devices represent promising candidates for emerging non-volatile data storage applications and neuromorphic computing. In those devices, the resistance of a dielectric -often a binary oxide- is switched between a low resistance state (LRS) and one or more high resistance states (HRS) by the application of an appropriate external electrical bias. This resistance switching could be filamentary, i.e., involves the formation of a conductive filament. This filament can be thought of as chains of conductive oxygen vacancies (intrinsic resistance switching) or metallic atoms from an active device electrode (extrinsic resistance switching). In this thesis, the relationship between device electrode material and its resistance switching mechanism in SiOx (x∼1.9)-based RRAM devices was studied. Although it’s widely reported that RRAM devices with electrochemically active top electrodes, such as Ag, switch extrinsically, I show that both mechanisms and thei...
Background Acute appendicitis (AA) is the most common general surgical emergency. Early laparosco... more Background Acute appendicitis (AA) is the most common general surgical emergency. Early laparoscopic appendicectomy is the gold-standard management. SARS-CoV-2 (COVID-19) brought concerns of increased perioperative mortality and spread of infection during aerosol generating procedures: as a consequence, conservative management was advised, and open appendicectomy recommended when surgery was unavoidable. This study describes the impact of the first weeks of the pandemic on the management of AA in the United Kingdom (UK). Methods Patients 18 years or older, diagnosed clinically and/or radiologically with AA were eligible for inclusion in this prospective, multicentre cohort study. Data was collected from 23rd March 2020 (beginning of the UK Government lockdown) to 1st May 2020 and included: patient demographics, COVID status; initial management (operative and conservative); length of stay; and 30-day complications. Analysis was performed on the first 500 cases with 30-day follow-up. ...
Introduction: Quantifying cellularity is an integral component of bone marrow examinations. Estim... more Introduction: Quantifying cellularity is an integral component of bone marrow examinations. Estimates of marrow cellularity may influence the diagnostic interpretation of bone marrow samples. The accuracy of cellularity estimates may be influenced by the variable distribution of cellular elements within the marrow space. To better understand the degree of heterogeneity of bone marrow cellularity, we undertook a study to quantify the variable distribution of bone marrow cells in bone marrow core biopsies. Method: 8 gauge bone marrow core biopsies of 20 patients were retrospectively reviewed by 2 hematopathologists (SI,CL). The specimens were recovered from the posterior superior iliac crest using standard technique with 8G Snarecoil biopsy needles by 3 operators (KH, PK, GD). The percent cellularity was determined in sequential 0.2 X 0.4 cm portions of the core biopsies by each of the hematopathologists. Cellularities were recorded in 10% increments. Results: The mean age of the pati...
Although it has been generally accepted that hypercoagulability contributes to enhancing tumor gr... more Although it has been generally accepted that hypercoagulability contributes to enhancing tumor growth via generation of thrombin (Cancer Cell10:355, 2006), it has not been rigorously proven, nor has the mechanism been established at the cell cycle level. Previous studies have employed thrombin-treated tumor cell lines in vitro and in vivo. In vitro studies were performed in the presence of serum which contains a panoply of growth factors. In vivo studies have used huge non-pathologic concentrations of tumor cells injected into the flank, organ or blood of a mouse. In these situations, tumor growth could be a result of thrombin-induced angiogenesis. We therefore employed a transgenic mouse prostate cancer model (TRAMP) programmed to develop prostate CA over a period of 140–175 days. We treated these animals with thrombin to induce hypercoagulability or hirudin to inhibit endogenous thrombin production, to determine whether thrombin regulates this process independent of angiogenesis. ...
The ubiquitin-proteasome system plays a central role in the regulation of cell growth and cell pr... more The ubiquitin-proteasome system plays a central role in the regulation of cell growth and cell proliferation by controlling the abundance of key cell cycle proteins. Increasing evidence indicates that unscheduled proteolysis of many cell cycle regulators contributes significantly to tumourigenesis and is indeed found in many types of human cancers, including colon and renal cell cancer, non hodgkin lymphomas, and multiple myelomas. Protein degradation pathways are also targets for cancer therapy, as shown by the successful introduction of bortezomib (B), an inhibitor of the 26S proteasome, for the therapy of multiple myeloma. Recently, protease inhibitors conventional in HIV therapy (e.g., ritonavir (R)) have been found to exert an antiproliferative effect on different tumor types, including multiple myeloma cells. More recently, ritonavir has been shown to induce endoplasmic reticulum stress and to sensitize sarcoma cells towards bortezomib induced apoptosis. In this study, we show...
4979 Introduction The JAK2V617F mutation accounts for most cases of myeloproliferative neoplasms ... more 4979 Introduction The JAK2V617F mutation accounts for most cases of myeloproliferative neoplasms (MPN). Only a few case reports of MPN following cytotoxic chemotherapy have been reported, and all of them were published prior to the discovery of the JAK2V617F mutation. We report a series of 6 patients who developed a JAK2V617F positive MPN following cytotoxic chemotherapy. Patients From 2006 to 2009, 6 patients with a history of a hematologic or an oncologic malignancy who developed an MPN were identified and their medical records retrospectively reviewed. One patient had acute lymphoblastic leukemia, 1 had Hodgkin lymphoma, 1 had squamous cell carcinoma of the head and neck, 1 had cervical cancer, and 2 had breast cancer. All patients were in remission from their primary malignancies at the time the MPN was diagnosed. Five were females. The median age at diagnosis was 72 years. Median time to development of the myeloproliferative neoplasm was 14 years. Type of chemotherapy exposure,...
Introduction. The quality and length of bone marrow biopsy core specimens should facilitate accur... more Introduction. The quality and length of bone marrow biopsy core specimens should facilitate accurate diagnositic interpretation of marrow histopathology. A 11G specimen of length 1.6 cm or greater is considered adequate for pathologic evaluation by some authors. The length of specimens recovered with 11G needles appears to depend on needle design. We explored the possibility that the adequacy of bone marrow biopsy specimens may be influenced by patient age and the gauge of biopsy needles. Methods. 88 bone marrow core specimens were recovered from 72 patients using 11G SNARECOIL bone marrow biopsy needles. The mean age of these patients was 61.4 and the m/f ratio was 45/27. The clinical diagnoses were isolated anemia, cytopenias, leukemia, lymphoma, myeloma and other in 18.0%, 33.3%, 13.8%, 13.8%, 5.5% and 15.2% of the patients, respectively. 10 patients underwent multiple procedures (2–6) for evaluation of treatment efficacy. 106 patients underwent 127 bone marrow biopsy procedures ...
1262 PNH is characterized by circulating blood cells that are deficient in the surface expression... more 1262 PNH is characterized by circulating blood cells that are deficient in the surface expression of proteins that require glycosylphosphatidylinositol (GPI). The loss of the GPI-linked complement inhibitors CD55 and CD59 on the red cell results in complement mediated hemolysis, and this defect on the surface of platelets is likely responsible for the marked hypercoagulable state seen in PNH. The loss of GPI-linked proteins is due to the clonal expansion of a stem cell with an acquired somatic mutation in the PIG-A gene, which is responsible for an early step in the production of GPI. In PNH, as in aplastic anemia, there is a decreased stem cell and erythroid progenitor pool, there are oligoclonal T cell expansions, there is an HLA allele association, and cytopenias can occur, which respond to immunosuppression. Normal individuals harbor occult populations of cells with the PNH phenotype and genotype, and there is evidence that PIG-A mutations are growth neutral in animals. These fi...
Uploads
Papers by sherif Ibrahim