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OBJECTIVES: To compare the diagnostic accuracy of hand-held point-of-care (POC) versus conventional sonography in a general diagnostic setting with the intention to inform medical providers or clinicians on the rational use of POC ultrasound in resource limited settings. METHODS: Over 3 months in 2010, 47 patients were prospectively enrolled at a single academic center to obtain 54 clinical conventional ultrasound examinations and 54 study-only POC ultrasound examinations. Indications were 48% abdominal, 26% retroperitoneal, and 24% obstetrical. Nine blinded readers (sonographers, residents, and attending radiologists) sequentially assigned diagnoses to POC and then conventional studies, yielding 476 interpreted study pairs. Diagnostic accuracy was obtained by comparing POC and conventional diagnoses to a reference diagnosis established by the unblinded, senior author. Analysis was stratified by study type, body mass index (BMI), diagnostic confidence, and image quality. RESULTS: The mean diagnostic accuracy of conventional sonography was 84% compared with 74% for POC (P < .001). This difference was constant regardless of reader, exam type, or BMI. The sensitivity and specificity to detect abnormalities with conventional was 85 and 83%, compared with 75 and 68% for POC. The POC sonography demonstrated greater variability in image quality and diagnostic confidence, and this accounted for lower diagnostic accuracy. When image quality and diagnostic confidence were similar between POC and conventional examinations, there was no difference in accuracy. CONCLUSIONS: Point-of-care was nearly as accurate as conventional sonography for basic, focused examinations. Observed differences in accuracy were attributed to greater variation in POC image quality.

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We have reported earlier that human T lymphocytes from blood or spleens of normal donors can be propagated in long-term culture in the presence of IL-2, after stimulation either with wheat germ agglutinin (WGA) or phytohemagglutinin (PHA) and with the use of repeated restimulation with supernatants collected after 24 h of such cultures. In the present study we demonstrate that lymphoblast lines generated with this method contain predominantly the cells expressing CD3 molecule and alpha beta heterodimer of T cell receptor (TcR alpha beta). In PHA-initiated lymphoblast lines CD4-CD8+ cells prevailed, whereas in lymphoblast lines generated after WGA-stimulation various proportion of CD4+CD8-, CD+CD8- and CD4-CD8- cells were found. In some cell lines a gradual selective outgrowth of TcR alpha beta CD4+CD8- or CD4-CD8- cells was observed. These data indicate that the long-term growth potential of human normal T lymphoblasts is not restricted to a single subset and that the surface phenotypes acquired during differentiation of the cells can be retained even after more than 100 population doublings in culture.

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Human wheat germ agglutinin (WGA)- or PHA-activated T lymphocytes from either peripheral blood or normal spleens can be propagated in vitro for several months in the presence of IL-2 but not IL-4 when periodically restimulated with supernatants collected from 24 h cultures of mitogen-stimulated human blood or spleen mononuclear cells. Following several rounds of stimulation with these supernatants some of the spleen-derived T lymphoblast lines acquire the ability of continuous growth (over 100 population doublings) in the presence of IL-2 alone. We postulate that the ability of 24 h supernatants from mitogen stimulated mononuclear cells to maintain T lymphoblast IL-2-dependent growth depends upon yet undefined cytokine(s) released early after activation.

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Deaths from cancer in Poland are expected to increase by over 60% during the next 20 years due to aging of the population and increasing age-standardized male cancer mortality. Five-year survivals are much lower than in developed Western countries. Improvement of statistics of cancer incidence and survival in different regions of Poland is essential for operational planning of interventions and resources. Reduction of tobacco smoking must remain a priority in prevention. Legislation enforcing protection from carcinogenic workplace exposures and development of monitoring is necessary. Poor performance of primary health care physicians is the major cause of delays in diagnosis. Interventions in this field should focus on professional training and development of units of rapid diagnosis of cancer. Implementation of state-of-the-art treatment through multicenter programs is recommended. Access to specialized treatment, in particular radiotherapy, should be improved through further development of the oncological networks.

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Both TG and TnonG subpopulations from human peripheral blood were found to secrete helper and suppressor factors for the PHA-induced T cell proliferative response. The TnonG subpopulation contained cells which were both able to secrete helper factor and to respond by proliferation, whereas in the TG subpopulation cells with a proliferative potential could not be conclusively demonstrated. Suppressor and helper activities in TG and TnonG culture supernatants displayed a different time kinetics and were influenced by the dose of mitogen in test cultures.

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The patterns of supravital staining with euchrysine, a fluorescent dye thought to bind preferentially to membranes of lysosomes and other structures involved in endocytosis, were evaluated sequentially in PHA-stimulated cultures of human unseparated, T and non-T lymphocytes under conditions of a reversible, amethopterine-imposed DNA synthesis block. It was found that type I cells (with a single conglomerate of fluorescent granules, constituting approx. 50% of resting T cells) were almost completely replaced by type III cells (with large conglomerates of coarse granules, typical of lymphocytes undergoing blast transformation) up to the end of second day of culture. Type II cells (with very fine fluorescent granules scattered over the cytoplasms, present in about 50% of T and all non-T lymphocytes) did not initially change their number but later were replaced by type III cells, usually starting from the third day of culture. A hypothesis is discussed according to which only type I cells are primarily responsive to PHA, whereas type II cells require "help" from the former, prior to transition into the proliferative stage.

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