Prolonged suppressed thyroid-stimulating hormone levels in hyperthyroidism in a neonate born to a mother with Graves' disease

Abstract We report here a case of neonatal hyperthyroidism born to a mother, whose pregnancy was complicated by poorly controlled Graves' disease. The patient demonstrated exophthalmos and marked goiter at birth, indicating the existence of thyrotoxicosis in utero. The mother's Graves' disease was well controlled in the third trimester, resulting in a slightly lower level of free thyroxine (FT₄) in the umbilical cord blood serum; however, thyroid-stimulating hormone (TSH) was undetectable. Thyroid-stimulating hormone remained undetectable for 2 months, while FT₄ levels varied in the course. This case suggests that severe and prolonged thyrotoxicosis in utero, due to poor control of pregnancy with Graves' disease, might induce unresponsiveness of the hypothalamo-pituitary system in the newborn.     

Stage IV ovarian clear cell adenocarcinoma treated effectively by chemotherapy with etoposide and cisplatin (EP)

We report a case of stage IV ovarian clear cell adenocarcinoma (OCCA) in a 72-year-old woman who was treated postoperatively with etoposide combined with cisplatin (EP). The patient exhibited bulky intrapelvic and para-aortic lymph nodes with metastases to the cervical lymph nodes. The primary lesion was resected and, postoperatively, she received one course of combination chemotherapy consisting of cyclophosphamide, 500 mg/m²; doxorubicin, 50 mg/m²; and cisplatin, 70mg/m² (CAP), followed by six courses of combination chemotherapy consisting of etoposide, 80mg/m² days 1 through 5 and cisplatin, 70 mg/m² on day 5 every 4 weeks. After five courses of EP, the lymph node metastases had virtually disappeared. The patient is now disease-free 21 months after the initial surgery. These findings suggest that EP may be useful in treating OCCA.     

The validity of bioelectrical impedance phase angle for nutritional assessment in children

BACKGROUND/PURPOSE: Bioelectrical impedance analysis (BIA) is a quick and noninvasive method for estimating body composition. Many prediction equations have been reported recently using bioelectrical impedance to calculate fat free mass (FFM) and fat mass (FM). These equations are based on the assumption that the composition and density of FFM are stable. In children, the composition and density of FFM vary according to age and clinical state, so the use of these equations is limited. However, phase angle is directly determined from resistance (Rz) and reactance (Xc) without equations and reflects body cell mass. The authors, therefore, investigated the validity of phase angle for nutritional assessment in children. METHODS: Bioelectrical impedance analysis and anthropometric measurements were performed in 81 patients, including 71 well-nourished and 10 malnourished children. RESULTS: Phase angle correlated with body weight (R = 0.818) and arm muscle circumference (r = 0.901) in well-nourished children. Malnourished patients showed lower phase angle than that of well-nourished children. CONCLUSION: Bioelectrical impedance phase angle is a useful parameter for nutritional assessment in children.     

Overexpression of the aldo-keto reductase family protein AKR1B10 is highly correlated with smokers' non-small cell lung carcinomas.

PURPOSE: Squamous cell carcinoma (SCC) and adenocarcinoma of the lung are currently subject to similar treatment regimens despite distinct differences in histology and epidemiology. The aim of this study is to identify a molecular target with diagnostic and therapeutic values for SCC. EXPERIMENTAL DESIGN: Genes specifically up-regulated in SCC were explored through microarray analysis of 5 SCCs, 5 adenocarcinomas, 10 small cell lung carcinomas, 27 normal tissues, and 40 cancer cell lines. Clinical usefulness of these genes was subsequently examined mainly by immunohistochemical analysis. RESULTS: Seven genes, including aldo-keto reductase family 1, member B10 (AKR1B10), were identified as SCC-specific genes. AKR1B10 was further examined by immunohistochemical analysis of 101 non-small cell lung carcinomas (NSCLC) and its overexpression was observed in 27 of 32 (84.4%) SCCs and 19 of 65 (29.2%) adenocarcinomas. Multiple regression analysis showed that smoking was an independent variable responsible for AKR1B10 overexpression in NSCLCs (P < 0.01) and adenocarcinomas (P < 0.01). AKR1B10 staining was occasionally observed even in squamous metaplasia, a precancerous lesion of SCC. CONCLUSION: AKR1B10 was overexpressed in most cases with SCC, which is closely associated with smoking, and many adenocarcinoma cases of smokers. These results suggest that AKR1B10 is a potential diagnostic marker specific to smokers' NSCLCs and might be involved in tobacco-related carcinogenesis.     

中药与日本汉方药原植物的差异比较及原因分析

依据 2000年版《中国药典》和第十四改《正日本药局方》收载植物类生药品种 ,列表比较了中药与日本汉方药原植物的差异 ,并对产生差异的现象和原因进行了分析和探讨。     

婴儿出生后24小时内乙型肝炎疫苗低接种率的原因及居民教育

为防止乙型肝炎 (乙肝 )病毒 (HBV)母婴传播 ,婴儿出生后 2 4h内接种乙肝疫苗 (HepB)非常重要 ,但其接种率很低。为探讨接种率低的原因及其对策 ,在甘肃省访问了承担预防接种的工作人员 ,并对婴儿家长及乡村医生进行了小组访谈。调查结果显示 ,几乎所有婴儿家长对乙肝知识了解甚少或有错误。本次调查中 ,2 4h内接种HepB的婴儿全部在医院出生 ,2 4h内未接种的全部在家出生。即使及时接种的婴儿家长亦不知 2 4h内接种HepB的重要性 ,只不过是因为在医院出生才偶然做到了 2 4h内接种。另外 ,在家分娩且非乡村医生接生时 ,婴儿家长即使知道 2 4h内接种的重要性 ,但如不及时通知乡村医生 ,乡村医生也不能及时到家接种。因此 ,为提高婴儿出生后 2 4h内HepB接种率 ,对婴儿家长的宣传教育 ,特别是对孕妇和新婚夫妇的教育非常必要。     

qMRI relaxometry of mandibular bone marrow: A monomodal distribution in sickle cell disease

Purpose:

To identify and characterize sickle cell disease (SCD)‐related changes in the composition of mandibular bone marrow using qMRI relaxometry histograms.

Materials and Methods:

Thirteen SCD patients and 17 controls underwent brain MR imaging with the mixed turbo spin‐echo (TSE) pulse sequence at 1.5T. The mandible was manually segmented and divided into body, angle, ramus, and condyle. T1 and T2 histograms of each mandible were modeled with Gaussian functions. The relaxation time histogram peaks were calculated, and the number of monomodal versus bimodal curves was compared.

Results:

SCD patients exhibited monomodal distributions on both T1 and T2 histograms, consistent with a composition of predominantly red hematopoietic marrow. Eighty‐eight percent of mandibles in control subjects exhibited a bimodal distribution in T1 and all showed a bimodal distribution in T2, indicating mixed but predominantly yellow marrow composition. The second peak in control subjects was shorter in T1 and longer in T2, consistent with yellow marrow composition.

Conclusion:

Instead of physiological fatty replacement, SCD patients exhibit red marrow persistence in the mandible, likely due to the increased demand for hematopoiesis. This phenomenon can be manifested by a monomodal curve in both T1 and T2 relaxometric histograms. J. Magn. Reson. Imaging 2013;37:1182–1188. © 2012 Wiley Periodicals, Inc.     

Pelvic insufficiency fracture after definitive radiotherapy for uterine cervical cancer: retrospective analysis of risk factors

The purpose of this study is to determine the incidence, clinical characteristics and risk factors of postradiation pelvic insufficiency fracture (PIF) in women with uterine cervical cancer. We reviewed the medical records of 126 patients who received definitive radiotherapy (RT) for uterine cervical cancer between 2003 and 2009 at our institution. Among them, 99 patients who underwent at least one computed tomography (CT) or magnetic resonance imaging of the pelvis during their follow-up at more than 6 months were included in this analysis. The relationship between the incidence of PIF and several patient- and treatment-related factors was analyzed. The median follow-up period was 21 months. Of the 126 patients, 33 (with a total of 50 lesions) were diagnosed with PIF. The 2-year cumulative incidence was 32%. Univariate analysis showed that age ≥70 years (P= 0.0010), postmenopausal state (P = 0.0013), and lower CT density of bone and bone marrow (P= 0.020) significantly related to PIF. In a multivariate analysis, of the 59 patients whose CT densities were evaluable, lower CT density was the only significant factor associated with PIF (P = 0.0026). In conclusion, postradiation PIFs were detected in a considerable number of patients after definitive RT for cervical cancer. Predisposing factors were older age, postmenopausal state, and decreased density of bone and bone marrow on CT.