Sarcomatoid collecting-duct carcinoma of the kidney

Collecting duct carcinoma is a distinct entity among renal cell carcinoma, which is characterized by an aggressive behavior. Sarcomatoid variants of this tumor are rarely described. We report the case of a 62-year-old woman who presented with a left kidney tumor. A radical nephrectomy was performed. The tumor was firm with a white appearance, located in the medulla with infiltrating margins. Pathological examination showed a biphasic tumor with carcinomatous areas consisting of a collecting-duct carcinoma and sarcomatous areas with malignant fibrous histiocytoma-like appearance. Immunohistochemical studies confirmed the diagnosis of sarcomatoid collecting-duct carcinoma. The patient died 8 months after the diagnosis.     

Single-cell analysis of human skin identifies CD14+ type 3 dendritic cells co-producing IL1B and IL23A in psoriasis

Inflammatory skin diseases including atopic dermatitis (AD) and psoriasis (PSO) are underpinned by dendritic cell (DC)–mediated T cell responses. Currently, the heterogeneous human cutaneous DC population is incompletely characterized, and its contribution to these diseases remains unclear. Here, we performed index-sorted single-cell flow cytometry and RNA sequencing of lesional and nonlesional AD and PSO skin to identify macrophages and all DC subsets, including the newly described mature LAMP3⁺BIRC3⁺ DCs enriched in immunoregulatory molecules (mregDC) and CD14⁺ DC3. By integrating our indexed data with published skin datasets, we generated a myeloid cell universe of DC and macrophage subsets in healthy and diseased skin. Importantly, we found that CD14⁺ DC3s increased in PSO lesional skin and co-produced IL1B and IL23A, which are pathological in PSO. Our study comprehensively describes the molecular characteristics of macrophages and DC subsets in AD and PSO at single-cell resolution, and identifies CD14⁺ DC3s as potential promoters of inflammation in PSO.     

Management of cardiac arrhythmias during pregnancy

Introduction

Pregnancy can precipitate or exacerbate cardiac arrhythmias. Management of those arrhythmias is not very different from that in non-pregnant women.

Objective

In this review we tried to specify factors which favour arrhythmias in pregnant women and to show their specific management.

Methods

We carried out a search through PubMed using as keywords: pregnancy, cardiac arrhythmias, antiarrhythmics.

Results

Hemodynamic perturbations, direct electrophysiological effects of hormones and underlying heart disease are potential factors that can promote arrhythmias in pregnancy. Usually, no drug therapy is needed for the management of supraventricular or ventricular premature beats but potential promoting factors should be eliminated. In paroxysmal supraventricular tachycardia, vagal maneuvers should be tried firstly. Adenosine could be used if vagal maneuvers are ineffective. In pregnant women with atrial fibrillation, the goal of treatment is the conversion to sinus rhythm or the control of ventricular rate. Ventricular arrhythmias are usually uncommon during pregnancy and often occur in the absence of structural heart disease and are responsive to drug therapy. Symptomatic bradycardia rarely complicates pregnancy and its management does not differ from that in non-pregnant women.     

Les carcinomes endocrines à petites cellules de la vessie: à propos d’une observation

Introduction

The small cell carcinoma of the bladder is a rare entity representing 0.5% of the whole bladder tumours, it is highly aggressive. It is characterized by a very high metastatic potential. The treatment is multidisciplinary associating the surgery and chemotherapy and, sometimes, the radiotherapy in order to improve the forecast of the disease and the survival of the patients.

Observation

Wereport a case of endocrine carcinoma of the bladder in a 64-years-old patient. The immuno-histochemical study showed the positivity of the tumoral cells for the chromogranine, the synaptophysine, TTF-1, the cytokeratine and a negativity for the specific antigen of the prostate (PSA). The patient was treated by chemotherapy only. The evolution was marked by the death of the patient eight months after the diagnosis.

Conclusion

The CPC of the bladder represents a particular histological entity being quickly aggressive and metastatic, with a severe forecast and a potentially effective intensive treatment, thus requiring a multidisciplinary assumption of responsibility.     

Allotopic mRNA localization to the mitochondrial surface rescues respiratory chain defects in fibroblasts harboring mitochondrial DNA mutations affecting complex I or v subunits

The possibility of synthesizing mitochondrial DNA (mtDNA)-coded proteins in the cytosolic compartment, called allotopic expression, provides an attractive option for genetic treatment of human diseases caused by mutations of the corresponding genes. However, it is now appreciated that the high hydrophobicity of proteins encoded by the mitochondrial genome represents a strong limitation on their mitochondrial import when translated in the cytosol. Recently, we optimized the allotopic expression of a recoded ATP6 gene in human cells, by forcing its mRNA to localize to the mitochondrial surface. In this study, we show that this approach leads to a long-lasting and complete rescue of mitochondrial dysfunction of fibroblasts harboring the neurogenic muscle weakness, ataxia and retinitis Pigmentosa T8993G ATP6 mutation or the Leber hereditary optic neuropathy G11778A ND4 mutation. The recoded ATP6 gene was associated with the cis-acting elements of SOD2, while the ND4 gene was associated with the cis-acting elements of COX10. Both ATP6 and ND4 gene products were efficiently translocated into the mitochondria and functional within their respective respiratory chain complexes. Indeed, the abilities to grow in galactose and to produce adenosine triphosphate (ATP) in vitro were both completely restored in fibroblasts allotopically expressing either ATP6 or ND4. Notably, in fibroblasts harboring the ATP6 mutation, allotopic expression of ATP6 led to the recovery of complex V enzymatic activity. Therefore, mRNA sorting to the mitochondrial surface represents a powerful strategy that could ultimately be applied in human therapy and become available for an array of devastating disorders caused by mtDNA mutations.     

Pelvic actinomycosis: two cases

INTRODUCTION: Actinomycosis is a chronic suppurative granulomatous disease caused by different Actinomyces species, mostly bacillus: the Actinomyces israeli. The pelvis location of this infection is rare. OBSERVATIONS: We report two cases of actinomycosis that were diagnosed after the surgical treatment of a suspected ovarian tumor and a suspected acute peritonitis. Diagnosis in both cases was based on the histopathologic findings. CONCLUSION: The incidence of pelvic actinomycosis is increasing since 1960 related to the frequent use of intra uterine device. The clinical symptomatology is not specific, simulating a neoplastic or an inflammatory process. The treatment combines operative and antibiotic therapy.     

Tuberculosis of the knee: MRI findings in two pediatric cases

Osteo-articular tuberculosis is rare in infants. The MRI findings reported for adolescents and young adults mainly relate to spinal involvement. Two cases of osteo-articular tuberculosis of infants located at the knee are presented. Vaccination has been correctly done. Skin test and chest radiography were normal. Evolution was insidious for one case. Osseous, medullary, cartilaginous and soft tissue abnormalities revealed by MRI were suspicious for tuberculosis. Diagnosis was confirmed at histology for both cases and bacteriology for one case. The aim of this study is to report the MRI features of osteo-articular tuberculosis in pediatric patients.     

Double location of breast and spine tuberculosis. A case report

We describe the case of a 38-year-old woman with breast tuberculosis associated with a second localization in the lumber spine. These features simulated breast cancer with vertebral metastasis. Clinical and imaging findings are described herein.