Pediatric renal cell carcinoma: A complete response to recombinant interleukin-2 in a child with metastatic disease at diagnosis

Renal cell carcinoma is a rare pediatric malignancy that appears to have a similar clinical outcome in children and adults. We review the experience of Childrens Hospital Los Angeles and compare it with the published pediatric series, reporting on seven cases from 1954 to the present. As in earlier pediatric series, we find that Stage I/II patients do well (five of five complete responses with prolonged disease-free survival) with surgical resection. As in other pediatric series, our only Stage III patient died of disease. We also report on a recent case of renal cell carcinoma, metastatic to lymph nodes and lung parenchyma at diagnosis (Stage IV). This patient was treated with high dose continuous infusion recombinant interleukin-2 and had a partial response. The patient attained a complete response following a second laparotomy and two subsequent cycles of recombinant interleukin-2. He is presently well, without evidence of disease, 3 1/2 years after diagnosis. The significance of this form of therapy to advanced renal cell carcinoma in childhood is discussed. © 1994 Wiley-Liss, Inc.     

Antifungal activities of propolis collected by different races of honeybees against yeasts isolated from patients with superficial mycoses

Yeasts isolated from patients with superficial mycoses were tested against propolis samples collected from different regions and honeybee races. The minimum inhibitory concentration (MIC) values obtained using the agar dilution methods were compared to the diameters of growth inhibition zones by using the disk diffusion method. The results showed that Candida albicans, C. glabrata, Trichosporon spp., and Rhodotorula sp. were susceptible to low concentrations of propolis, the latter showing a higher susceptibility. Relative to the other propolis tested, the propolis sample collected by Apis mellifera caucasica possessed the highest antifungal activity against all of the superficial mycoses. In contrast, the propolis samples collected by A.m. carnica and A.m. anatolica were the least active samples. Also, the propolis sample from the Adana region is more active than samples from other regions. An increase of MIC values was accompanied by a decrease of growth inhibition zone diameters.     

Painful traumatic neuroma after a finger stick

In this case report we present a patient with a painful traumatic neuroma after a finger stick by lancet. The patient benefited from surgical excision of the lesion, and her symptoms were completely abolished with additional sympathetic nerve blocks.     

Mitomycin C prevents strictures in caustic esophageal burns in rats

BACKGROUND: Caustic esophageal injuries lead to stricture formation. Although a number of agents have been tried experimentally to prevent strictures, few have gained clinical application. The purpose of this study was to investigate the effectiveness of Mitomycin C (MMC), which inhibits fibroblastic proliferation in preventing caustic esophageal strictures. MATERIAL AND METHODS: Fifty-six rats were allocated into four groups. Caustic esophageal burns were created as described by Gehanno. Group A was instilled only with saline. Group B was injured and untreated. Groups C and D were injured and received topical MMC at 0.02 and 0.04% concentrations, respectively. At 28 days, stenosis index (SI), collagen deposition, and hydroxyproline content (HP) were determined in distal esophageal segments. Statistical analyses were done. RESULTS: Mean SI in Group B was significantly higher than others (P < 0.05). Mean SI was statistically higher in Group C than A and D and similar between groups A and D. The greatest accumulation of collagen was found in Group B, followed by Group C, D, and A, respectively. Collagen deposition in Group D was statistically lower than Group B (P < 0.01) and similar to Group C. Mean HP in Group B was statistically higher than others (P < 0.05), significantly higher in Group C than Group D (P = 0.047), and similar between Groups A and D (P = 0.73). CONCLUSION: MMC was effective in preventing strictures following experimental caustic esophageal injury, in a dose-dependent manner. We consider that it can gain clinical utilization with the establishment of effective mode, dose, and timing of therapy.     

Effect of amrinone on mucosal permeability in experimental intestinal ischaemia/reperfusion injury

BACKGROUND: The preventive effect of amrinone on ischaemia/reperfusion (I/R) injury has been shown in the medical literature. The purpose of the present study was to investigate the preventive effect of amrinone on I/R injury of the small bowel of the rat. METHODS: Thirty-two Wistar albino rats (140-180 g) were divided into four groups (n = 8). In all groups except the sham group the superior mesenteric artery was clamped for 30 min. At the beginning of reperfusion, 1 mL of 2405 Bq/mL 51Cr-ethylenediamine tetra-acetic acid (EDTA) was administered into the prepared ileal segment. Following 30 min of reperfusion, 1 mL of blood was obtained from the portal vein. After the rats were killed, the small intestine was removed for histopathological studies. A total of 5 mg/kg amrinone was administered to the rats in group 1 before ischaemia and in group 2 before reperfusion, whereas only saline was administered to the rats in the control group. Statistical analysis was carried out with Kruskal-Wallis and chi2 test, P < 0.01 was considered significant. RESULTS: Both the blood 51Cr-EDTA measurements (mean +/- SD) and mucosal injury grades (MIG) were highest in the control group (3.95 +/- 0.71 c.p.m.; MIG, 3-5) followed by group 2 (0.50 +/- 0.35 c.p.m.; MIG, 1-3), group 1 (0.47 +/- 0.34 c.p.m. MIG, 0-3), and sham group (0.12 +/- 0.05 c.p.m.; MIG, 0). The difference between groups 1 and 2 and the control group were statistically significant (P < 0.01 for each comparison). The results of group 1 and 2 were similar statistically (P > 0.05). CONCLUSIONS: Amrinone was found to be effective in preventing intestinal I/R injury.     

The effects of intratracheal dexamethasone on acute lung injury in rabbits--experimental study

BACKGROUND AND OBJECTIVE: The aim of our study was to investigate, in rabbits with hydrochloric (HCl) acid-induced Acute Lung Injury (ALI), the effects of intra-tracheal (i.t.) dexamethasone administration on neutrophil and platelet counts, plasma malonyl dialdehyde (MDA) level, histopathology, and arterial blood gases. METHODS: Twenty-eight New Zealand rabbits were randomly divided into a control (n = 14) and dexamethasone groups (n = 14). Anesthesia was applied with ketamine (50 mg kg(-1) h(-1), i.m.) and tracheostomy was performed. Both groups received 2 ml kg(-1) HCl (hydrochloric acid) i.t.. Five minutes later, 0.9% saline was given to the controls while the other group received i.t. dexamethasone. MDA levels of the plasma, neutrophil and platelet counts, and arterial blood gases were recorded at the beginning of the study and then at two and five hours. The rabbits were ventilated in pressure control mode for 5 hours. At the end of the study, the lungs were examined by light microscopy and the changes evaluated on a scale of 0 to 4. RESULTS: Neutrophil and platelets counts (p < 0.01) and PaO2 (p < 0.05) were greater in the dexamethasone group than the controls at five hours. Plasma MDA level (p < 0.01) and PaCO2 (p < 0.01) were greater in the control group. Histopathological changes were less severe in the dexamethasone group. CONCLUSION: Giving dexamethasone i.t. may have beneficial effects on the development of ALI.     

Retinoic acid isomers protect hippocampal neurons from amyloid-β induced neurodegeneration

Attenuating amyloid-beta mediated neurodegeneration is of major therapeutic consideration in the potential treatment of Alzheimer disease. Previously, we found that a high dietary consumption of retinoic acid was associated with a reduced incidence of Alzheimer disease. Therefore, in this study, we investigated whether amyloid-beta mediated cell death in primary hippocampal neurons could be prevented by retinoic acid isomers. Our results suggest that retinoic acid isomers, including all-trans retinoic acid, 9-cis retinoic acid, and 13-cis retinoic acid, may play an important role in protecting neurons from amyloid-beta -induced cell death. Retinoic acid may therefore afford a novel therapeutic mechanism for the treatment and prevention of Alzheimer disease.     

Parkinsonism caused by cavernoma located in basal ganglion

Deep-seated cavernoma or cavernous angioma is a very rare clinical entity, as is basal ganglia cavernoma presenting with Parkinsonism. The authors demonstrate a 56-year-old man with a cavernoma located in basal ganglion, who subsequently developed Parkinsonism. The patient refused the surgical intervention, and received L-dopa trial; however, no change in the tremor and bradykinesia was observed in spite of high doses of L-dopa. Our case indicates that chronic compression and continuous hemorrhage could cause Parkinsonism, which is uncommon symptom of cavernous angioma.     

Live three-dimensional right parasternal and supraclavicular transthoracic echocardiographic examination

In the present study, we describe the usefulness of the recently developed technique of live three-dimensional transthoracic echocardiography in the assessment of normal cardiac structures and adjacent vessels using the right parasternal and supraclavicular approaches. Examples of some abnormalities diagnosed from these approaches are also illustrated.