Pleural malignant mesothelioma (MM), which is an aggressive neoplasm with a high mortality, frequently manifests initially as pleural effusions. The sensitivity of cytologic examination for its diagnosis varies widely in literature and most of the figures are from earlier studies with conventional cytologic preparations. The objective of this study was to provide the current evidence on the role and sensitivity of cytologic examination of pleural fluid in the diagnosis of MM. We reviewed the cytologic findings in pleural effusions of a large series of histologically proven MM (234 cases) diagnosed in our institution between 2001 and 2008. Of all cases, 154 (66%) had cytologic material examined. A specific diagnosis of MM was rendered or suspected in 53% (79 patients). The lowest sensitivity (20%) was noticed in sarcomatoid MM cases. MM was favored over adenocarcinoma in 97% of patients with positive cytologic findings that have been confirmed with immunohistochemistry. In this series, five cases were inadequate and five cases were initially reported as atypical, whereas 65 cases (44%) were reported as negative for malignancy. On review of the cytology slides, only four cases were upgraded from benign to suspicious compared to four cases downgraded from suspicious to atypical but no significant improvement to the diagnosis could be made on revision. These data suggested that a cytologic diagnosis contributed useful information in patients with epithelioid and biphasic pleural MM. Limitations of the cytologic examination of MM should also be acknowledged.
A study of 140 days duration was performed to examine if human male volunteers (n = 5) respond to ovine follicle stimulating hormone (oFSH) immunization (administered adsorbed on Alugel on days 1, 20, 40 and 70) by producing antibodies capable of both binding and neutralizing bioactivity of human FSH. The kinetics of antibody production for both the immunogen (oFSH) and the cross-reactive antigen (hFSH) were essentially similar. The volunteers responded only to the first two immunizations. The boosters given on days 40 and 70 were ineffective, probably because of the presence of substantial amounts of circulating antibody to oFSH. Of the antibodies generated to oFSH, 25-45% bound hFSH with a mean binding affinity of 0.65 x 10(9) +/- 0.53 M(-1). The binding capacities at the time of high (30-80 days of immunization) and low (>110 days) titres were 346 +/- 185 and 10.5 +/- 5.8 ng hFSH/ml respectively. During the period of high titre, free serum FSH (value in normal males 1-5 ng/ml) was not monitorable. A 50 microl aliquot of the antiserum obtained from different volunteers between days 30 and 80 and on day 140 blocked binding of (125)I-labelled hFSH to its receptor by 82 +/- 9.7 and 53 +/- 12.2% respectively. The antibody produced was specific for FSH, and no significant change in the values of related glycoprotein hormones (luteinizing hormone/testosterone and thyroid stimulating hormone/thyroxine) were recorded. Seminal plasma transferrin, a marker of Sertoli cell as well as of seminiferous tubular function, showed marked reduction (30-90%) following immunization with oFSH. Considering that endogenous FSH remained neutralized for approximately one sperm cycle only (65 days), the reduction in sperm counts (30-74%) exhibited by some volunteers is encouraging. Immunization with oFSH did not result in any significant changes in haematology, serum biochemistry or hormonal profiles. There was no production of antibodies capable of interacting with non-specific tissues. It is concluded that it should be possible to obtain a sustained long-term blockade of endogenous FSH action in men by using oFSH as an immunogen. This is a prerequisite for obtaining significant reduction in the quality and quantity of spermatozoa produced, thus leading to infertility.
Pregnancy is a physiological state accompanied by a high-energy demand and an increased oxygen requirement. Augmented levels of oxidative stress would be expected because of the increased intake and utilization of oxygen. Evidence of increased oxidative stress in normal pregnancy in comparison with nonpregnant controls was estimated by measuring Thiobarbituric acid reactive substance (TBARS), enzymatic antioxidants like Superoxide dismutase, Glutathione peroxidase, Glutathione reductase and catalase. It was observed that pregnant women were more susceptible to oxidative damage than non-pregnants as indicated by increased TBARS and decreased antioxidants.
The present study was designed to evaluate the lipid peroxidation and non-enzymatic antioxidants in pregnancyinduced hypertension (PIH) compared with healthy normal pregnant and non-pregnant as controls. 75 cases were studied of which 25 were normal healthy controls (Group A), 25 healthy pregnant women (Group B) of third trimester and 25 were PIH (Group C) of the same trimester. In PIH, malondialdehyde a lipid peroxidation product was significantly increased as compared to normal pregnant and non-pregnant controls. The nonenzymatic antioxidants like reduced glutathione, Vitamin-E, Vitamin-C and Vitamin-A were significantly decreased in normal pregnants as compared to controls. A further significant decrease was noticed in PIH compared to normal pregnants. A significant negative correlation was detected between lipid peroxidation and non-enzymatic antioxidant levels. Our study clearly indicates a relationship between elevated lipid peroxidation, decreased non-enzymatic antioxidant in PIH. The measurement of non-enzymatic antioxidants in plasma may be useful predictor of the likely development of PIH.
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