Rolle der Zytologie in der hämatopathologischen Diagnostik

Zusammenfassung: Die Zytologie stellt ein wichtiges diagnostisches Instrument in der täglichen Praxis der Hämatopathologie dar. Durch den zytologisch erfolgten Nachweis nichthämatologischer Ursachen einer Knotenbildung (z.B. Speicheldrüsenneoplasien, Tuberkulose, Melanom- oder Karzinommetastasen) besteht seltener die Notwendigkeit einer chirurgischen Exzision. Die kombinierte Anwendung morphologischer, immunphänotypischer sowie molekularer Analysen und der fachliche Austausch machen diese Untersuchungstechnik sicher. Somit stellt die zytologische Untersuchung in verschiedensten Situationen eine Alternative zur Exzisionsbiopsie dar - auch bei primären hämatologischen Erkrankungen und insbesondere bei Rezidive

Improving Performance of Iterative Methods by Lossy Checkponting

Iterative methods are commonly used approaches to solve large, sparse linear systems, which are fundamental operations for many modern scientific simulations. When the large-scale iterative methods are running with a large number of ranks in parallel, they have to checkpoint the dynamic variables periodically in case of unavoidable fail-stop errors, requiring fast I/O systems and large storage space. To this end, significantly reducing the checkpointing overhead is critical to improving the overall performance of iterative methods. Our contribution is fourfold. (1) We propose a novel lossy checkpointing scheme that can significantly improve the checkpointing performance of iterative methods by leveraging lossy compressors. (2) We formulate a lossy checkpointing performance model and derive theoretically an upper bound for the extra number of iterations caused by the distortion of data in lossy checkpoints, in order to guarantee the performance improvement under the lossy checkpointing scheme. (3) We analyze the impact of lossy checkpointing (i.e., extra number of iterations caused by lossy checkpointing files) for multiple types of iterative methods. (4)We evaluate the lossy checkpointing scheme with optimal checkpointing intervals on a high-performance computing environment with 2,048 cores, using a well-known scientific computation package PETSc and a state-of-the-art checkpoint/restart toolkit. Experiments show that our optimized lossy checkpointing scheme can significantly reduce the fault tolerance overhead for iterative methods by 23%~70% compared with traditional checkpointing and 20%~58% compared with lossless-compressed checkpointing, in the presence of system failures.Comment: 14 pages, 10 figures, HPDC'1

Meta-analysis of insulin aspart versus regular human insulin used in a basal-bolus regimen for the treatment of diabetes mellitus

Background: The objective of the current study was to compare the efficacy of two different insulin formulations, insulin aspart (IAsp) and regular human insulin (RHI), for prandial insulin coverage with neutral protamine Hagedorn (NPH) insulin as basal insulin using a meta-analysis approach. The primary endpoint was change in A1c over time. Secondary endpoints included incidence of hypoglycemia and postprandial glycemic control. Methods: Clinical trials (Type 1 and Type 2 diabetes) complying with Good Clinical Practice, and with individual patient data, were included in the meta-analysis. Trials were randomized, consisting of (at least) two treatment arms and had a minimum duration of 12 weeks. Estimates were calculated using fixed-effects and random-effects models. Heterogeneity was assessed for each analysis. The effect of baseline parameters on A1c was analyzed in extended simultaneous models. Results: The mean difference in A1c was 0.1% (95% confidence interval [CI] [−0.15; −0.04], P < 0.001) in favor of IAsp. Higher accumulated dose of IAsp, higher age and increased rates of hypoglycemia were associated with improved A1c outcome. Fasting plasma glucose was not significantly different between regimens. Postprandial glucose was significantly lower after treatment with IAsp compared with RHI, but the analysis did present a significant level of heterogeneity (P < 0.001). The overall rate of hypoglycemia was the same with both regimens, but nocturnal hypoglycemia was significantly lower with IAsp. Conclusions: A basal–bolus regimen with IAsp as bolus insulin provided minimal, but statistically significant, improvement in overall glycemic control with a lower rate of nocturnal hypoglycemic episodes, compared with a corresponding regimen with bolus RHI

Solitary fibrous tumor of the orbit—two cases and a review of the literature

Solitary fibrous tumors of the orbit (SFT) are mesenchymal lesions that can develop either as malignant or benign neoplasias. We describe the histological features leading to the diagnosis in two females and review the current literature. Diagnosis of SFT only can be performed by histological examination, since clinical signs and radiological features are not specific enough. Even a malignant or benign course cannot be predicted, since clinical and radiological features do not correlate with histological signs of malignancy and vice versa. Radical resection is the treatment of choice, since no other treatment option has been proven to be efficien

Progression of the Total and Individual Capsaicinoids Content in the Fruits of Three Different Cultivars of Capsicum chinense Jacq.

The evolution of individual and total capsaicinoids content in three pepper varieties of Capsicum chinense Jacq. (‘Bode’ (B), ‘Habanero’ (H), and ‘Habanero Roxo’ (Hr)) during fruit ripening was studied. The five major capsaicinoids (nordihydrocapsaicin, capsaicin, dihydrocapsaicin, homocapsaicin, and homodihydrocapsaicin) were extracted using ultrasound-assisted extraction and the extracts were analysed by ultra-performance liquid chromatography with fluorescence detection (UHPLC-Fl). The plants were grown in a glasshouse and sampled every 7 days until over-ripening. As expected, the results indicated that the total capsaicinoids content increases during the ripening of pepper fruits. The maximum contents of capsaicinoids were reached at different fruit development stages depending on the cultivar. The ‘Habanero Roxo’ pepper presented the greatest total capsaicinoids content (3.86 mg g1 fresh weigh, F.W.), followed by the ‘Habanero’ pepper (1.33 mg g1 F.W.) and ‘Bode’ pepper (1.00 mg g1 F.W.). In all the samples, capsaicin represented more than 80% of the total capsaicinoids content. Due to the high variability observed in the evolution of capsaicinoids content over the ripening process, this work intends to contribute to the existing knowledge on this aspect in relation to the quality of peppers

Effects of canagliflozin on cardiovascular biomarkers in older adults with type 2 diabetes

Background: Sodium glucose co-transporter 2 (SGLT2) inhibitors may reduce cardiovascular and heart failure risk in patients with type 2 diabetes mellitus (T2DM). Objectives: To examine the effects of canagliflozin on cardiovascular biomarkers in older patients with T2DM. Methods: In 666 T2DM patients randomized to receive canagliflozin 100 or 300 mg or placebo, we assessed median percent change in serum N-terminal pro-B type natriuretic peptide (NT-proBNP), high-sensitivity troponin I (hsTnI) , soluble (s)ST2, and galectin-3 from baseline to 26, 52, and 104 weeks. Results: Both serum NT-proBNP and serum hsTnI levels increased in placebo recipients but remained largely unchanged in those randomized to canagliflozin. Hodges-Lehmann estimates of the difference in median percent change between pooled canagliflozin and placebo were –15.0%, –16.1%, and –26.8% for NT-proBNP, and –8.3%, –11.9%, and –10.0% for hsTnI at weeks 26, 52, and 104, respectively (all P &lt;0.05). Serum sST2 was unchanged with canagliflozin and placebo over 104 weeks. Serum galectin-3 modestly increased from baseline with canagliflozin versus placebo, with significant differences observed at 26 and 52 weeks but not at 104 weeks. These results remained unchanged when only patients with complete samples were assessed. Conclusions: Compared to placebo, treatment with canagliflozin delayed rise in serum NT-proBNP and hsTnI over 2 years in older T2DM patients. These cardiac biomarker data provide support for beneficial cardiovascular effect of SGLT2 inhibitors in T2DM

When intensive insulin therapy (MDi) fails in patients with type 2 diabetes: Switching to GLP-1 receptor agonist versus insulin pump

Treatment with insulin, alone or with oral or injectable hypoglycemic agents, is becoming increasingly common in patients with type 2 diabetes. However, approximately 40% of patients fail to reach their glycemic targets with the initially prescribed regimen and require intensification of insulin therapy, which increases the risks of weight gain and hypoglycemia. Many of these patients eventually reach a state in which further increases in the insulin dosage fail to improve glycemic control while increasing the risks of weight gain and hypoglycemia. The recently completed OpT2mise clinical trial showed that continuous subcutaneous insulin infusion (CSII) is more effective in reducing glycated hemoglobin (HbA1c) than intensification of multiple daily injection (MDI) insulin therapy in patients with type 2 diabetes who do not respond to intensive insulin therapy. CSII therapy may also be useful in patients who do not reach glycemic targets despite multidrug therapy with basal-bolus insulin and other agents, including glucagon-like peptide (GLP)-1 receptor agonists; current guidelines offer no recommendations for the treatment of such patients. Importantly, insulin and GLP-1 receptor agonists have complementary effects on glycemia and, hence, can be used either sequentially or in combination in the initial management of diabetes. Patients who have not previously failed GLP-1 receptor agonist therapy may show reduction in weight and insulin dose, in addition to moderate improvement in HbA1c, when GLP-1 receptor agonist therapy is added to MDI regimens. In subjects with long-standing type 2 diabetes who do not respond to intensive insulin therapies, switching from MDI to CSII and/or the addition of GLP-1 receptor agonists to MDI have the potential to improve glycemic control without increasing the risk of adverse events

A Simple Photometer as a Helping Device in Measuring Blood Glucose

Measurement of non-invasive blood glucose is one way to increase the frequency of self-monitoring of blood glucose (SMBG). For NIR reflectance spectroscopy, its application in non-invasive constrained by high value of standard error of prediction. The mean standard error of prediction was 25 mg/dL. Theoretically, NIR reflectance spectroscopy still can be used to predict blood glucose levels in certain conditions such as hypoglycemia (&lt;55 mg/dL), controlled fasting blood glucose (FBG) (70-115 mg/dL), and hyperglycemia (&gt;225 mg/dL), which the difference between the three conditions is more than 25 mg/dL. The results showed that there are significant differences in standards values of photometer measurement between controlled FBG and hyperglycemic conditions (P = 0.002). The results also showed that the photometer can be used to assist the monitoring of blood glucose in FBG under control and hyperglycemic conditions. It can be seen from the average percentage of the daily controlled FBG conditions in patients conducting SMBG in photometer-assisted compared to in patients only use SMBG once a day (28% versus 18%, P = 0.344)

Pulse EPR measurements of intramolecular distances in a TOPP-labeled transmembrane peptide in lipids.

We present the performance of nanometer-range pulse electron paramagnetic resonance distance measurements (pulsed electron-electron double resonance/double electron-electron resonance, PELDOR/DEER) on a transmembrane WALP24 peptide labeled with the semirigid unnatural amino acid 4-(3,3,5,5-tetra-methyl-2,6-dioxo-4-oxylpiperazin-1-yl)-l-phenylglycine (TOPP). Distances reported by the TOPP label are compared to the ones reported by the more standard MTSSL spin label, commonly employed in protein studies. Using high-power pulse electron paramagnetic resonance spectroscopy at Q-band frequencies (34 GHz), we show that in contrast to MTSSL, our label reports one-peak, sharp (Δr ≤ 0.4 nm) intramolecular distances. Orientational selectivity is not observed. When spin-labeled WALP24 was inserted in two representative lipid bilayers with different bilayer thickness, i.e., DMPC and POPC, the intramolecular distance reported by TOPP did not change with the bilayer environment. In contrast, the distance measured with MTSSL was strongly affected by the hydrophobic thickness of the lipid. The results demonstrate that the TOPP label is well suited to study the intrinsic structure of peptides immersed in lipids