Lung Deposition and Inspiratory Flow Rate in Patients with Chronic Obstructive Pulmonary Disease Using Different Inhalation Devices: A Systematic Literature Review and Expert Opinion.

BACKGROUND: Our aim was to describe: 1) lung deposition and inspiratory flow rate; 2) main characteristics of inhaler devices in chronic obstructive pulmonary disease (COPD). METHODS: A systematic literature review (SLR) was conducted to analyze the features and results of inhaler devices in COPD patients. These devices included pressurized metered-dose inhalers (pMDIs), dry powder inhalers (DPIs), and a soft mist inhaler (SMI). Inclusion and exclusion criteria were established, as well as search strategies (Medline, Embase, and the Cochrane Library up to April 2019). In vitro and in vivo studies were included. Two reviewers selected articles, collected and analyzed data independently. Narrative searches complemented the SLR. We discussed the results of the reviews in a nominal group meeting and agreed on various general principles and recommendations. RESULTS: The SLR included 71 articles, some were of low-moderate quality, and there was great variability regarding populations and outcomes. Lung deposition rates varied across devices: 8%-53% for pMDIs, 7%-69% for DPIs, and 39%-67% for the SMI. The aerosol exit velocity was high with pMDIs (more than 3 m/s), while it is much slower (0.84-0.72 m/s) with the SMI. In general, pMDIs produce large-sized particles (1.22-8 µm), DPIs produce medium-sized particles (1.8-4.8 µm), and 60% of the particles reach an aerodynamic diameter <5 µm with the SMI. All inhalation devices reach central and peripheral lung regions, but the SMI distribution pattern might be better compared with pMDIs. DPIs' intrinsic resistance is higher than that of pMDIs and SMI, which are relatively similar and low. Depending on the DPI, the minimum flow inspiratory rate required was 30 L/min. pMDIs and SMI did not require a high inspiratory flow rate. CONCLUSION: Lung deposition and inspiratory flow rate are key factors when selecting an inhalation device in COPD patients.

Observation of Oscillatory Radial Electric Field Relaxation in a Helical Plasma.

Measurements of the relaxation of a zonal electrostatic potential perturbation in a nonaxisymmetric magnetically confined plasma are presented. A sudden perturbation of the plasma equilibrium is induced by the injection of a cryogenic hydrogen pellet in the TJ-II stellarator, which is observed to be followed by a damped oscillation in the electrostatic potential. The waveform of the relaxation is consistent with theoretical calculations of zonal potential relaxation in a nonaxisymmetric magnetic geometry. The turbulent transport properties of a magnetic confinement configuration are expected to depend on the features of the collisionless damping of zonal flows, of which the present Letter is the first direct observation.

Carcass characteristics, physicochemical changes and oxidative stress indicators of meat from sheep fed diets with coffee pulp / Características de carcaça, alterações físico-químicas e indicadores de estresse oxidativo de carne de ovinos alimentados com dietas com polpa de café

The purpose of this study was to determine how feeding sheep coffee pulp affects carcass characteristics and what changes occur in physicochemical, antioxidant capacity and oxidation of the meat during refrigerated storage. The experiment was carried out in 15 Blackbelly lambs weighing an average 22.86±0.76kg. The animals were assigned to three treatments: T0=control diet, T1=diet with 8% coffee pulp, and T2=diet with 16% coffee pulp. After fattening for 56 days, the sheep were slaughtered and the carcasses assessed. The inclusion of 16% coffee pulp in the diet increased carcass dressing from 48.19 to 50.83% and decreased the amount of fat in rumen and intestines from 3.43 to 2.53% (P<0.05). The inclusion of coffee pulp in the diet did not alter the amount of crude protein or fat in meat or its oxidation and antioxidant capacity during refrigerated storage. However, the inclusion of coffee pulp in the diet decreased fat in the rumen and intestines, and thus increased the amount of usable meat...

Objetivou-se determinar características de carcaça, alterações físico-químicas, capacidade antioxidante e de oxidação da carne de ovinos alimentados com polpa de café, durante o período de armazenamento refrigerado. O experimento foi realizado com 15 cordeiros Blackbelly com um peso médio de 22,86 ± 0,76kg. Os animais foram distribuídos em três tratamentos: T0=dieta controle, T1=dieta com 8% de polpa de café e T2=dieta com polpa de café de 16%. Depois de 56 dias de engorda, cordeiros foram abatidos, e a carcaça avaliada. Inclusão de polpa de café de 16% na dieta aumentou o rendimento de carcaça de 48.19 para 50.83% e diminuiu a quantidade de gordura no rúmen e nos intestinos de 3.43 para 2.53% (P<0,05). A inclusão de polpa de café na dieta não alterou a proteína ou a gordura na carne nem a oxidação e a capacidade antioxidante durante o armazenamento refrigerado. A inclusão de polpa de café na dieta de cordeiros diminui a gordura no rúmen e nos intestinos e aumenta a quantidade de carne na carcaça...

Carcass characteristics, physicochemical changes and oxidative stress indicators of meat from sheep fed diets with coffee pulp / Características de carcaça, alterações físico-químicas e indicadores de estresse oxidativo de carne de ovinos alimentados com dietas com polpa de café

The purpose of this study was to determine how feeding sheep coffee pulp affects carcass characteristics and what changes occur in physicochemical, antioxidant capacity and oxidation of the meat during refrigerated storage. The experiment was carried out in 15 Blackbelly lambs weighing an average 22.86±0.76kg. The animals were assigned to three treatments: T0=control diet, T1=diet with 8% coffee pulp, and T2=diet with 16% coffee pulp. After fattening for 56 days, the sheep were slaughtered and the carcasses assessed. The inclusion of 16% coffee pulp in the diet increased carcass dressing from 48.19 to 50.83% and decreased the amount of fat in rumen and intestines from 3.43 to 2.53% (P<0.05). The inclusion of coffee pulp in the diet did not alter the amount of crude protein or fat in meat or its oxidation and antioxidant capacity during refrigerated storage. However, the inclusion of coffee pulp in the diet decreased fat in the rumen and intestines, and thus increased the amount of usable meat.

Objetivou-se determinar características de carcaça, alterações físico-químicas, capacidade antioxidante e de oxidação da carne de ovinos alimentados com polpa de café, durante o período de armazenamento refrigerado. O experimento foi realizado com 15 cordeiros Blackbelly com um peso médio de 22,86 ± 0,76kg. Os animais foram distribuídos em três tratamentos: T0=dieta controle, T1=dieta com 8% de polpa de café e T2=dieta com polpa de café de 16%. Depois de 56 dias de engorda, cordeiros foram abatidos, e a carcaça avaliada. Inclusão de polpa de café de 16% na dieta aumentou o rendimento de carcaça de 48.19 para 50.83% e diminuiu a quantidade de gordura no rúmen e nos intestinos de 3.43 para 2.53% (P<0,05). A inclusão de polpa de café na dieta não alterou a proteína ou a gordura na carne nem a oxidação e a capacidade antioxidante durante o armazenamento refrigerado. A inclusão de polpa de café na dieta de cordeiros diminui a gordura no rúmen e nos intestinos e aumenta a quantidade de carne na carcaça.

Dietary supplemented and meat-added antioxidants effect on the lipid oxidative stability of refrigerated and frozen cooked chicken meat.

The oxidation of fatty acids decreases the quality and shelf-life of meats. To reduce this process, dietary supplemented and meat-added antioxidants were evaluated on the lipid oxidative stability of cooked chicken meat. Broilers were fed 2 levels of vitamin E (10 or 100 mg•kg(-1) of feed; VE-10 and VE-100, respectively) or oregano essential oil (100 mg•kg(-1) of feed; OR-100). Additionally, honey (3%) or butylated hydroxytoluene (0.02%; BHT) were added to chicken meat from the control treatment (VE-10). Breast meat was ground, formed into patties, and cooked on electric grills until it reached an internal temperature of 74°C. Cooked meat was cooled at room temperature, packaged, and stored under refrigeration for 9 d (4°C) or frozen for 45 d (-20°C). The 2-thiobarbituric acid reactive substance test was used to quantify malondialdehyde (MDA) values in the meat. Data were analyzed using a repeated measures design, 5 treatments with 12 replications each, and the least squares means were compared with 4 orthogonal contrasts. The results showed that the meat of the VE-10 treatment had higher values of MDA (P ≤ 0.05) compared with the other antioxidant treatments in all the storage days. There were no differences (P ≥ 0.05) in MDA values between the dietary supplemented and meat-added antioxidant treatments. The meat added with honey had lower MDA values than the one with BHT (P ≤ 0.05). Meat of the VE-100 treatment showed lower MDA values than the one of OR-100 (P ≤ 0.05) in most storage days. In conclusion, supplementation of 10 mg•kg(-1) of vitamin E to the diet resulted in a higher development of lipid oxidation in the meat. Both dietary supplemented or meat-added antioxidants had similar effects on the lipid oxidative stability. The addition of honey maintained longer the lipid oxidative stability of the meat than BHT. Finally, dietary supplementation of vitamin E at the same level of oregano oil, 100 mg•kg(-1), resulted in a higher antioxidant effect on the meat.

Vanishing neoclassical viscosity and physics of the shear layer in stellarators.

The drift kinetic equation is solved for low density TJ-II plasmas employing slowly varying, time-dependent profiles. This allows us to simulate density ramp-up experiments and describe from first principles the formation and physics of the radial electric field shear layer. The main features of the transition are perfectly captured by the calculation, and good quantitative agreement is also found. The results presented here, that should be valid for other nonquasisymmetric stellarators, provide a fundamental explanation for a wealth of experimental observations connected to the shear layer emergence in TJ-II. The key quantity is the neoclassical viscosity, which is shown to go smoothly to zero when the critical density is approached from below. This makes it possible for turbulence-related phenomena, and particularly zonal flows, to arise in the neighborhood of the transition.

Effects of dietary oregano essential oil and vitamin E on the lipid oxidation stability of cooked chicken breast meat.

The antioxidant effect of oregano essential oil and vitamin E was evaluated in cooked chicken breast meat. In total, 480 broilers were randomly assigned to 6 treatments and 4 replications. Broilers were raised with a corn-soybean meal diet including either crude soybean oil or acidulated soybean oil soapstock, each supplemented with vitamin E at 10 or 100 mg or oregano essential oil at 100 mg/kg of feed. At 42 d, broilers were slaughtered and their breast meat was prepared into strips (1.5 × 10 cm) or patties (150 g). Fatty acid composition of the muscle was determined. For lipid oxidation stability, both meat strips and patties were cooked to an internal temperature of 74°C and malonaldehyde contents were assessed during 0, 3, 6, and 9 d of storage at 4°C. Each storage day had 4 replications per treatment. The meat lipid oxidative stability was estimated by content of malonaldehyde values. Results showed that feed consumption, weight gain, and feed conversion were not affected by the dietary oils or antioxidants, except for the mortality in acidulated soybean oil soapstock with the 10-mg vitamin E treatment. The fatty acid composition of the meat was similar between the 2 diets given the same antioxidant supplement. The oxidation stability of meat lipids in both types of meats showed a significant (P < 0.05) interaction between oils, antioxidants, and storage time. In the crude soybean oil oil diet, the malonaldehyde value in the 10-mg vitamin E treatment was the highest, followed by oregano essential oil, and then the 100-mg vitamin E treatment at 9 d of storage, whereas the value of oregano essential oil in the acidulated soybean oil soapstock diet was the highest, followed by the 10-mg vitamin E, and then the 100-mg vitamin E treatment during the 9 d of storage. In conclusion, the dietary oils and antioxidants used can be included in broiler diets without negative effects on their productivity. The antioxidant effect of vitamin E was higher with a higher supplementation level, regardless of the oil treatment, whereas the antioxidant effect of oregano essential oil was better in crude soybean oil than in the acidulated soybean oil soapstock diet.

Nonequilibrium spin-glass dynamics from picoseconds to a tenth of a second.

We study numerically the nonequilibrium dynamics of the Ising spin glass, for a time spanning 11 orders of magnitude, thus approaching the experimentally relevant scale (i.e., seconds). We introduce novel analysis techniques to compute the coherence length in a model-independent way. We present strong evidence for a replicon correlator and for overlap equivalence. The emerging picture is compatible with noncoarsening behavior.

[Lung scintigraphy with technetium 99m depreotide in the assessment of solitary pulmonary nodules]. / La gammagrafía con 99mTc-depreótida en la valoración del nódulo pulmonar solitario.

A solitary pulmonary nodule (SPN) is defined as a parenchymal lesion measuring less than 3 cm in diameter that is not associated with other lesions. Ninety percent of SPNs are discovered incidentally and most are benign. The management of radiographically indeterminate SPNs has not been established and invasive procedures must be undertaken in order to understand the nature of the nodule. We review our experience with the use of somatostatin receptor scintigraphy with technetium Tc99m depreotide in 10 patients with suspected malignant SPN. We discuss the limitations and applications of this technique in the evaluation of whether SPNs are benign or malignant for the purpose of identifying patients for biopsy. For this application, this technique can be considered an alternative to positron emission tomography using fluorine-18 fluordeoxyglucose.

Expression of Bcl-2 by human bone marrow mast cells and its overexpression in mast cell leukemia.

Bcl-2 protein plays a major role in the prevention of programmed cell death of differentiating cells. In the present study, the expression of cytoplasmic bcl-2 by human Bone Marrow Mast Cells (BMMC) from both normal and pathological bone marrow samples was examined. A total of 35 subjects corresponding to 9 healthy volunteers, 8 cases of adult indolent systemic mast cell disease (SMCD), 4 cases of pediatric mastocytosis (PM), 11 cases of hematological malignancies (HM), 2 cases of reactive bone marrow, and 1 case of mast cell leukemia (MCL) were analyzed. The expression of bcl-2 was studied using quantitative three-color flow cytometry. We also studied the molecular configuration of the bcl-2 gene and other relatives by Southern blot and polymerase chain reaction (PCR) in the MCL case. Bcl-2 expression was detected in BMMC from all samples analyzed. No significant differences on the expression of bcl-2 were detected between BMMC from healthy subjects and patients with SMCD, PM, HM, and reactive bone marrow. By contrast, bcl-2 protein was overexpressed in BMMC from MCL patient without gene rearrangement. Our results show that bcl-2 protein was constitutively expressed by BMMC. BMMC from MCL display overexpression of bcl-2, which could not be related to molecular rearrangements involving the bcl-2 gene. The expression of this protein by mature MC may play a role in the prevention of MC apoptosis and thus help to explain the long survival of these cells. The overexpression of bcl-2 by BMMC in MCL may help to explain their resistance to chemotherapy-induced apoptosis.

Human bone marrow mast cells from indolent systemic mast cell disease constitutively express increased amounts of the CD63 protein on their surface.

The quantitative measurement of the expression of both cytoplasmic and surface CD63 antigen by human mast cells from both normal and pathological bone marrow samples was studied by use of flow cytometry. Our major goal was to analyze whether in vivo CD63 expression by human bone marrow mast cells could be useful to discriminate bone marrow mast cells from patients with mastocytosis from other conditions. For that purpose, a total of 65 subjects corresponding to 12 healthy volunteers, 25 B-cell chronic lymphoproliferative disorders, 5 reactive bone marrow samples, 4 myelodysplastic syndromes, and 19 mastocytosis were analyzed. The expression of both surface and cytoplasmic CD63 by human bone marrow mast cells is clearly demonstrated. Our results show that high amounts of CD63 are present in human bone marrow mast cells most of it corresponding to an intracellular localization. No significant differences in CD63 expression were observed as regards both total and cytoplasmic CD63, except for higher CD63 levels in adult patients with mastocytosis (P = 0.05). By contrast, the mean level of surface CD63 significantly varied between the different groups of individuals. Accordingly, patients with monoclonal gammopathies displayed a slight decrease (P = 0.1) in surface CD63 expression, whereas bone marrow mast cells from adults with indolent systemic mast cell disease showed significantly (P = 0.0005) higher levels of surface CD63 as compared to healthy controls.

Immunophenotypic characterization of human bone marrow mast cells. A flow cytometric study of normal and pathological bone marrow samples.

The goal of the present paper was to define the immunophenotype of bone marrow mast cells (BMMC) from healthy controls and patients with hematologic malignancies (HM) based on the use of multiple stainings with monoclonal antibodies analyzed by flow cytometry. Our results show that BMMC from both groups of individuals display a similar but heterogeneous immunophenotype. The overall numbers of BMMC are higher in the HM group of individuals (p = 0.08). Three patterns of antigen expression were detected: (1) markers constantly positive in all cases analyzed (CD9, CD29, CD33, CD43, CD44, CD49d, CD49e, CD51, CD71, CD117, and Fc(epsilon)RI), (2) antigens that were constantly negative (CD1a, CD2, CD3, CD5, CD6, CD11a, CD14, CD15, CD16, CD19, CD20, CD21, CD23, CD25, CD30, CD34, CD38, CD41a, CD42b, CD65, CD66b, HLA-DR, and CD138), and (3) markers that were positive in a variable proportion of cases--CD11b (50%), CD11c (77%), CD13 (40%), CD18 (20%), CD22 (68%), CD35 (27%), CD40 (67%), CD54 (88%) and CD61 (40%). In addition, BMMC from all cases explored were CD45+, and this antigen was expressed at an intensity similar to that of mature granulocytes. In summary, our results show that BMMC from both healthy controls and HM patients display a relatively heterogeneous immunophenotype. Interestingly, we have observed clear differences between the immunophenotype of BMMC and MC from other tissues. This could be due either to the heterogeneity of human MC according to their tissue localization or to the sensitivity of the method used for antigen detection.

Normal and clonal B lineage cells can be distinguished by their differential expression of B cell antigens and adhesion molecules in peripheral blood from multiple myeloma (MM) patients--diagnostic and clinical implications.

Human MM is a haematologic disorder characterized by the accumulation of malignant plasma cells (PC), primarily in the bone marrow (BM). Although these cells characteristically home to the BM, in recent years several groups have detected the presence of related malignant B cells in the peripheral blood (PB) which could be implicated in the progression and spread of the disease. However, the proportion and origin of these clonotypic circulating B cells is still controversial. In this study, using a triple-staining flow cytometric procedure and a whole blood lysis method, PB B lineage cells could be divided into two populations according to their distinct repertoires of cell adhesion molecules and B cell antigens in untreated MM patients. The results show that: (i) the percentage and the absolute number of PB CD19+ B cells were decreased in MM patients compared with controls; (ii) the quantity and percentage of B cell antigens (CD20, CD22, CD24, DR, CD138) and adhesion molecules (beta1- and beta2-integrins, CD44, CD54, CD56, CD61 and CD62L) expressed by these PB CD19+ cells of MM patients and healthy subjects were similar and all of them were virtually polyclonal cells; (iii) a very minor circulating CD19-CD38++CD45-/dim subset was also detected which expressed CD138 (B-B4) (high intensity), monoclonal cytoplasmic immunoglobulin (cIg), and was negative for pan-B antigens (CD19, CD20, CD24, DR), surface immunoglobulin (sIg) and several adhesion molecules such as CD62L, CD18 and CD11a; this CD19-CD38++CD45-/dim CD138++ subset was not found in normal blood and exhibited a phenotypic profile which was closely related to that of malignant BM plasma cells, with the exception of the CD56 antigen. Polymerase chain reaction (PCR) analysis of IgH clonotypic rearrangements confirmed these results. We postulate that, in MM patients, circulating B lineage cells may be divided into two different categories: polyclonal CD19+ B cells and a very minor proportion of clonal CD138++ PC that escape from the BM.

Indolent systemic mast cell disease in adults: immunophenotypic characterization of bone marrow mast cells and its diagnostic implications.

The aim of the present study was to explore the diagnostic value of the immunophenotypic analysis of bone marrow mast cells (BMMC) in indolent systemic mast cell disease (SMCD) patients. For that purpose, a total of 10 SMCD patients and 19 healthy controls were analyzed. Our results show that BMMC from SMCD are different from normal BMMC with regard to both their light scatter and immunophenotypic characteristics. Accordingly, forward light scatter (FSC), side (90 degrees) light scatter (SSC), and baseline autofluorescence levels were higher in BMMC from indolent SMCD patients than they were in control subjects. From the immunophenotypic point of view, the most striking findings were the constant expression of CD2 (P = .0001), CD25 (P = .0001), and CD35 (P = .06) molecules by BMMC from SMCD patients, markers that were absent from all normal controls. In contrast, CD71, absent in BMMC from indolent SMCD, was positive in BMMC from normal subjects. Although, slight differences between BMMC from SMCD patients and normal controls were found in several other markers, they did not reach statistical significance. In conclusion, our results show that simultaneous assessment of FSC/SSC and reactivity for the CD117, CD2, CD25, CD33, and CD35 forms the basis for the immunophenotypic characterization of BMMC from SMCD in adults and should be integrated with clinical and morphologic studies for the diagnosis of the disease.

[Von Willebrand disease: characteristics and response to desmopressin. Study of 103 cases]. / Enfermedad de Von Willebrand: características y respuesta a desmopresina. Estudio de 103 casos.

BACKGROUND: To describe the main characteristics and response to desmopressin infusion in 103 patients suffering from von Willebrand disease (vWD). PATIENTS AND METHODS: The criteria for diagnosis were (except for type 2N) the coexistence of von Willebrand factor ristocetin cofactor (vWF:RCo) activity < 50 U/dl with bleeding disease or one of the following data: von Willebrand factor antigen (vWF:Ag) activity < 50 U/dl, factor VIII (FVIII) activity < 50 U/dl or the existence of a increased bleeding time (BT). Multimeric studies of vWF were performed in 51 cases and ristocetin induced platelet aggregation (RIPA) was also performed. RESULTS: Spontaneous bleeding was found in 36 patients, while in 18 cases the diagnosis was done after surgical bleeding. Thirteen patients (6 presenting with mild bleeding) were studied for abnormalities in the routine preanestesic tests. Other 22 patients were diagnosed with vWD by familial studies. There were 3 patients with type 2B, 1 case with type 2N and other patient with type 3. BT was found increased in 26 out of 58 patients. The activities of vWF:CoR and vWF:Ag were 38.4 (9.4) U/dl and 45.8 (23.2) U/dl, respectively, while the activity of FVIII was 49.9 (20.8) U/dl. Prophylactic DDAVP (desmopressin) was infused in 32 patients. After 1 h, basal activities of vWF:CoR and vWF:Ag were increased by 3.1 (3.2) and 3.4 (3.1) times, respectively, and maintained for 3 h. FVIII activity increased 3.6 (2.3) times the basal levels decreasing after 3 h (2.9 [2.1]; p < 0.01). The BT was corrected in 8 out of ten patients. CONCLUSIONS: vWD is a major cause of surgical bleeding. Preanestesic anamnesis and coagulation tests can be useful to identify vWD. Many patients with vWD have normal BT. A failure in the response to desmopressin infusion is unusual.

Sequential immunophenotypic analysis of mast cells in a case of systemic mast cell disease evolving to a mast cell leukemia.

The immunophenotypic characteristics of both bone marrow (BM) and peripheral blood (PB) mast cells (MC), from a patient suffering from an aggressive systemic mast cell disease (SMCD), were sequentially analyzed by flow cytometry using direct immunofluorescence. Analysis was carried out at diagnosis, during clinical response induced by interferon alfa-2h/prednisone therapy, and later at relapse. Our results show that together with the CD117 and IgE characteristic markers, at diagnosis BM MC showed strong expression of CD11c, CD13, CD29, CD33, CD44, CD45, CD63, and CD71, and they were also positive for CD2, CD22, CD25, and CD54 although at a lower level. PB MC displayed similar immunophenotypic characteristics although they had a lower expression of CD11c, CD25, CD33, CD63, CD69, and CD71 with a higher reactivity for CD117. Unlike BM MC, PB MC were weakly positive for CD41a and CD61. Sequential studies showed decreased numbers of both BM and PB MC during clinical response associated with a higher expression of the CD29 and CD54 adhesion molecules. In turn, clinical relapse was related to increased numbers of PB and BM MC together with lower CD2, CD11c, CD45, and and CD54 expression and a higher reactivity for the CD117 and CD25 antigens. CD2 had become negative at the last follow-up study. In addition, an increased proportion of S-phase MC was observed at relapse. These findings suggest that the assessment of the quantitative expression of cell-adhesion molecules and growth-factor receptors together with cell cycle studies of mast cells could be of value for monitoring therapy and predicting clinical outcome in aggressive SMCD.

Flow cytometric analysis of mast cells from normal and pathological human bone marrow samples: identification and enumeration.

In the present paper we have used a three-color immunofluorescence procedure combined with flow cytometry cell analysis and sorting for the identification and enumeration of human mast cells in both normal and pathological bone marrow samples. Our results show that bone marrow mast cells are clearly identifiable on the basis of their light-scatter properties and strong CD117 expression. These cells were negative for the CD34, CD38, and BB4 antigens. In addition, they were CD33+ and displayed a high reactivity for the anti-IgE monoclonal antibody. The identity of the CD117-strong+ cells (mast cells) was confirmed by both microscopic examination and flow cytometry analysis. The overall frequency of mast cells in the bone marrow samples analyzed in the present study was constantly lower than 1%. The lowest frequencies corresponded to normal human bone marrow samples (0.0080 +/- 0.0082%) and the highest to those patients suffering from indolent systemic mast cell disease (0.40 +/- 0.13%). In summary, our results show that the identification and enumeration of bone marrow mast cells can be achieved using multiparametric flow cytometry. Moreover, once identified, mast cells are suitable for being characterized from the phenotypic and the functional point of view, facilitating the comparison between normal and abnormal mast cells.

Expression of lymphoid-associated antigens in mast cells: report of a case of systemic mast cell disease.

In this study the expression of 'classically' considered lymphoid-associated antigens (CD2, CD3, CD4, CD5, CD7, CD8, CD10, CD19, CD20, and CD22) was explored both in peripheral blood (PB) and bone marrow (BM) mast cells (MC) in a case of systemic mast cell disease (SMCD) by means of using multiple stainings and a direct immunofluorescence technique. CD2 and CD22 were expressed in both PB and BM MC, all the remaining lymphoid-associated markers were negative. Our results suggest that the reactivity for both CD2 and CD22 in PB and BM MC would be aberrant.

Juvenile chronic lymphocytic leukemia with unusual intracisternal inclusions: an ultrastructural study.

The electron microscopic analysis of intracisternal inclusions in lymphocytes of the bone marrow and peripheral blood in a case of juvenile chronic lymphocytic leukemia is described. These inclusions consist of well-ordered microtubules attached to a central axis. The contribution of electron microscopic analysis in establishing the substructural pattern of these inclusions is discussed.