Fatty acid binding protein 4 is expressed in distinct endothelial and non-endothelial cell populations in glioblastoma.

AIMS: Glioblastoma (GBM) is the most common and aggressive primary brain tumour in adults. Angiogenesis and vasculogenesis play key roles in progression of GBMs. Fatty acid binding protein 4 (FABP4) is an intracellular chaperone for free fatty acids. FABP4 is detected in microvascular endothelial cells (ECs) in several normal tissues and promotes proliferation of ECs. The goal of this study was to characterize the tissue distribution pattern of FABP4 in GBMs. METHODS: Immunohistochemistry for FABP4 was performed on paraffin-embedded tumour sections and the intensity and distribution of FABP4 immunoreactivity were analysed. Double immunofluorescence was employed for detailed characterization of FABP4-positive cells. RESULTS: FABP4 immunoreactivity was absent in normal brain tissue sections. FABP4-positive cells were detected in 33%, 43%, 64% and 89% of Grade I, Grade II, Grade III and Grade IV glial tumours, respectively. Thus, the percentage of FABP4-positive cells in GBMs was significantly higher than lower-grade gliomas. In general, FABP4-expressing cells were distributed in a non-homogenous pattern, as 'hot spots' in glial tumours. FABP4 expression was detected in a subset of vascular ECs as well as some non-ECs. CONCLUSION: FABP4 is expressed in a significantly higher percentage of GBMs in comparison to both normal brain tissues and lower-grade glial tumours. FABP4 is expressed in some tumour ECs as well as non-ECs in glial tumours. As FABP4 promotes proliferation of ECs, detection of FABP4 in GBM-ECs, but not normal brain ECs suggests that FABP4 may play a role in the robust angiogenesis associated with GBMs.

Detection of prostate cancer by alpha-methylacyl CoA racemase (P504S) in needle biopsy specimens previously reported as negative for malignancy.

AIMS: To investigate the possibility of detecting small focal prostatic cancer by alpha-methylacyl CoA racemase (AMACR)/P504S immunohistochemistry on needle biopsy specimens that were previously interpreted as negative for carcinoma on routine haematoxylin and eosin (H&E)-stained sections. METHODS: Prostate needle biopsy specimens (n = 793) previously interpreted as benign prostatic tissue by conventional morphology from 239 patients with prostatic cancer diagnosed in other biopsy cores taken at the same biopsy session were stained with the P504S monoclonal antibody. If a biopsy specimen stained positively, two pathologists independently reviewed the original corresponding H&E-stained sections to establish the malignant diagnosis. RESULTS: Eighty-four of the 793 biopsy specimens showed AMACR immunoreactivity; nine of these (9/793, 1.1%) contained previously unrecognized small focal prostatic carcinoma (Gleason 6, N = 8; Gleason 8, N = 1). Six of nine (67%) carcinomas showed foamy/pseudohyperplastic (N = 3) or atrophic (N = 3) features. Additionally, five biopsy specimens (5/793, 0.6%) with positive AMACR staining that did not meet the criteria for prostatic cancer on the original H&E slides were considered to be atypia. CONCLUSIONS: In this study, we found a 1.1% false-negative rate for carcinoma on routine H&E-stained sections. AMACR immunohistochemical staining has shown the ability to improve detection of small focal prostatic carcinoma that could be missed by conventional histological examination.

Scotopic sensitivity in dyslexia and requirements for DHA supplementation.

Much interest is shown in reduced scotopic sensitivity in dyslexia and the possible role of docosahexaenoic-acid deficiency as a causative factor. However, we found that significant decreases in scotopic sensitivity are not a general characteristic of dyslexia, which may cast doubt on the value of DHA supplementation.

Cardiopulmonary exercise testing in the evaluation of patients with occupational asthma and reactive airways dysfunction syndrome.

BACKGROUND: Cardiopulmonary exercise testing (CPET) is a well recognized tool for the functional assessment of patients with cardiovascular and pulmonary disorders. The exercise response of asthmatics has been well characterized but the exercise response of patients with occupational asthma is less well understood. In this report we describe the clinical utility of CPET by characterizing the cardiovascular and pulmonary responses to exercise in patients with occupational asthma (OA) and a closely related entity, reactive airways dysfunction syndrome (RADS). METHODS: We evaluated clinical and cardiopulmonary exercise data (mean +/- SD) from patients with OA (n = 22, age = 40.1 +/- 8.9 years, 14 males) and RADS (n = 23, age = 37.7 +/- 9.7 years, 18 males) who exhibited comparable pulmonary function. Oxygen uptake, CO2 output, ventilatory parameters, cardiac hemodynamics, O2 delivery, 12 lead EKG, systemic BP, and O2 saturation were monitored at rest and during cycle ergometer exercise. RESULTS: Compared with the RADS group, OA patients demonstrated higher resting dead-space ventilation (41 +/- 8 vs 35 +/- 9%, p = 0.04), reduced exercise capacity (94 +/- 32 vs 122 +/- 47 W, p = 0.01), higher respiratory quotients at 50 W (0.98 +/- 0.14 vs 0.91 +/- 0.08, p = 0.04), decreased power output past attainment of the anaerobic threshold (28.1 +/- 17.1 vs 44.7 +/- 15.1 W, p = 0.002) and a strong tendency for lower anaerobic thresholds (53 +/- 9 vs 60 +/- 14% pred VO2max, p = 0.06). CONCLUSION: In the 2 groups with occupational bronchial hyperreactivity, each with mild disease severity, OA patients exhibited greater decrements in cardiovascular conditioning when compared with the RADS group, perhaps because of the more prolonged, chronic respiratory insult experienced by the OA group. These data indicate that CPET in patients with work-related bronchial hyperreactivity is of significant utility in the impairment evaluation process.

Respiratory health of Hispanic migrant farm workers in Indiana.

The prevalence of respiratory disease in a Midwest Hispanic (mostly Mexican) migrant farm worker population was investigated. Chronic respiratory symptoms (cough, wheezing, sputum production) in adult workers (n = 354) were elevated (8.5%, 6.2%, 6.5%, respectively) and were accompanied by physiologic abnormalities as determined by pulmonary function testing. Over 15% of the adult cohort exhibited a FEV1/FVC < 75, and over 14% had FEF25-75 values which were less than 60% of predicted. The observed airflow obstruction of both large and small airways was not explained by cigarette usage (43%) in the adult cohort (current/past smokers). Tuberculin skin tests (TST) were positive (> or = 10 mm) in 55/195 men and 35/123 women for a total prevalence of 28.3%. No case of active tuberculosis (TB) was identified by either chest X-ray (CXR) or sputum cultures (in selected cases). In contrast to adult farm workers, who were predominantly born in Mexico (70%), only 36% of adolescent workers (age 11-18 years, n = 107) were born in Mexico with only 7.5% exhibiting TST positivity. Airflow obstruction of large airways (5.8%) and small airways (12.9%) were also less common in adolescents than adults. In summary, these studies document respiratory dysfunction in Hispanic migrant farm workers in Indiana and highlight the need to closely monitor the respiratory health of this high-risk population.

Evaluation of methods to improve communication in the physician-patient relationship.

Parents of children with congenital heart disease participated in an experiment to assess effects of communication methods on retention, anxiety, and satisfaction in regard to information received from physicans. Restatement of medical information by parents was found to be most effective, especially over time, for retention; results were not significant for anxiety or satisfaction.