Liquid-based rapid onsite evaluation of endobronchial ultrasound cytologies.

INTRODUCTION: Rapid onsite evaluation (ROSE) generally uses smears made at the site of the procedure ("smear-based ROSE"). It requires considerable time, generally 2 individuals, technical expertise, and it can be difficult to estimate material available for ancillary studies. We developed an alternative ROSE using liquid-based cytology ThinPrep with hematoxylin and eosin (H&E) stain ("liquid-based ROSE") and assessed its advantages. MATERIALS AND METHODS: Clinicians rinse the sample(s) into CytoRich Red and send to Pathology. A defined proportion of the needle rinse is removed for a ThinPrep stained with a rapid H&E. Adequacy and diagnosis were compared to final outcome. Total time was recorded. RESULTS: Among 52 liquid-based ROSE readings, 28 (53.8%) were interpreted as "adequate" with final as adequate; 17 (32.7%) were interpreted as "inadequate" with final as inadequate; 7 (13.5%) were interpreted as "inadequate" with final as adequate. Of 23 readings provided with onsite diagnosis, 15 (65.2%) were interpreted as definitive positive or negative diagnoses; 6 (26%) were interpreted as nondiagnostic; and 2 (8.7%) were interpreted as atypical. All definitive diagnoses were concordant with final diagnoses. The time for liquid ROSE performance ranges from 6 to 22 minutes (mean: 13 minutes) and required only 1 individual. CONCLUSIONS: Liquid-based ROSE allows accurate adequacy determination and diagnosis, takes about 15 minutes of cytologist time, and can be performed by just 1 person. The technique produces well-preserved and stained slides, it may allow a better estimation of the total amount of material in the specimen vial and may provide a better platform for telecytology.

'The world is full of magic things, patiently waiting for our senses to grow sharper' (WB Yeats): enhancing resilience among deaf young people in South Africa through photography and filmmaking.

This article concerns deaf children and young people living in South Africa who are South African Sign Language users and who participated in an interdisciplinary research project using the medium of teaching film and photography with the goal of enhancing resilience. Specifically, this paper explores three questions that emerged from the deaf young people's experience and involvement with the project: (i) What is disclosed about deaf young people's worldmaking through the filmic and photographic modality? (ii) What specific impacts do deaf young people's ontologically visual habitations of the world have on the production of their film/photographic works? (iii) How does deaf young people's visual, embodied praxis through film and photography enable resilience? The presentation of findings and related theoretical discussion is organised around three key themes: (i) 'writing' into reality through photographic practice, (ii) filmmaking as embodied emotional praxis and (iii) enhancing resilience through visual methodologies. The discussion is interspersed with examples of the young people's own work.

Purtscher-like retinopathy in a patient with HELLP syndrome.

PURPOSE: To report the antepartum presentation of Purtscher-like retinopathy and hemolysis, elevated liver enzymes, low platelets (HELLP) syndrome that resulted in severe permanent visual loss. DESIGN: Interventional case report. METHODS: A 25-year-old primigravida patient at 38.5 weeks gestation presented with severe bilateral loss of vision. Immediate hospitalization with complete evaluation, urgent medical treatment, and cesarean section was performed. RESULTS: Ophthalmoscopic evaluation showed bilateral Purtscher-like retinopathy. Laboratory studies revealed elevated liver enzymes, thrombocytopenia, and evidence of intravascular coagulation consistent with HELLP syndrome. Despite the successful delivery of a healthy baby, the patient developed permanent visual loss. CONCLUSION: Purtscher-like retinopathy with permanent visual loss can occur antepartum in patients with HELLP syndrome.

The specificity and molecular basis of alpha1-adrenoceptor and CXCR chemokine receptor dimerization.

It is now well established that rhodopsin-like, family-A G protein-coupled receptors (GPCRs) can exist within homo- and heterodimeric/oligomeric complexes. However, limited information is currently available on the molecular basis of these interactions or their selectivity. Using the alpha1-adrenoceptor family as a model, this has been examined using assays including coimmunoprecipitation, saturation bioluminescence resonance energy transfer (BRET), time-resolved fluorescence resonance energy transfer (FRET), and bimolecular fluorescence complementation. We demonstrate key roles for transmembrane helices I and IV in homodimeric/oligomeric interactions of the alpha1b-adrenoceptor and suggest that other interactions indicate that this GPCR can exist as a higher-order oligomeric complex. Literature reports on heterodimerization between chemokine receptor family members and the effects or otherwise of agonist ligands are complex. It was recently indicated that although the CXCR2 receptor is able to homodimerize, this is not the case for the closely related CXCR1 receptor and that these two GPCRs do not heterodimerize. We have reinvestigated these issues using combinations of coimmunoprecipitation, saturation BRET, and a novel endoplasmic reticulum-trapping strategy. Unlike the previous report, we demonstrate that CXCR1 is able to both homodimerize and heterodimerize with the CXCR2 receptor and that the relative affinity of these interactions suggests that with coexpression of these two GPCRs a random mixture of homo- and heterodimers will be present.

The CXCR1 and CXCR2 receptors form constitutive homo- and heterodimers selectively and with equal apparent affinities.

Both homo- and heterodimeric interactions between the CXCR1 and CXCR2 chemokine receptors were observed following co-expression of forms of these receptors in HEK293 cells using assays, including co-immunoprecipitation, single cell imaging of fluorescence resonance energy transfer, cell surface time-resolved fluorescence resonance energy transfer, and bioluminescence resonance energy transfer. These interactions were constitutive and unaffected by the presence of the agonist interleukin 8 and selective as no significant interactions were noted between either the CXCR1 or CXCR2 receptor and the alpha(1A)-adrenoreceptor. Saturation bioluminescence resonance energy transfer indicated that heteromeric interactions between CXCR1 and CXCR2 were of similar affinity as the corresponding homomeric interactions. A novel endoplasmic reticulum trapping strategy demonstrated that these interactions were initiated during protein synthesis and maturation and prior to cell surface delivery. These studies indicated that CXCR1-CXCR2 heterodimers are as likely to form in cells co-expressing these two chemokine receptors as the corresponding homodimers and stand in contrast to previous studies indicating an inability of the CXCR1 receptor to homodimerize or to interact with the CXCR2 receptor (Trettel, F., Di Bartolomeo, S., Lauro, C., Catalano, M., Ciotti, M. T., and Limatola, C. (2003) J. Biol. Chem. 278, 40980-40988).

Selectivity in the oligomerisation of G protein-coupled receptors.

G protein-coupled receptors can exist as dimers and/or higher order oligomers. Such quaternary structure appears central to their plasma membrane delivery and, potentially, to function. Recent evidence that these receptors can form hetero- as well as homo-dimers/oligomers has significant implications for pharmacology and pathophysiology. Knowledge of the basis and selectivity of GPCR hetero-dimerisation is thus vital. Current understanding of these areas is reviewed.