Splenic metastasis from endometrial carcinoma: report of a case and review of literature

Introduction  

Splenic metastasis from endometrial carcinoma is a rare clinical event, with only 11 cases documented previously in the literature.     

Excessively high bilirubin and exchange transfusion in very low birth weight infants

Aim: To evaluate the performance of exchange transfusion in very low birth weight (VLBW) infants with excessively high serum bilirubin levels. Methods: A population‐based observational study using data collected by the Israel National VLBW Infant Database. The study sample comprised 13 499 infants. Two definitions of excessively high‐peak bilirubin levels that might be considered as threshold levels for performance of exchange transfusion were used. First, a bilirubin level of ≥15 mg/dL for all infants (PSB‐15), and second, incremental bilirubin levels ranging from 12 to 17 mg/dL according to gestational age (PSB‐GA). Results: Four hundreds sixty‐eight (3.5%) and 1035 infants (7.7%) infants in the PSB‐15 and in the PSB‐GA groups respectively had peak serum bilirubin levels above thresholds for exchange transfusion. Exchange transfusions were performed in 66 (14.1%) of these infants in the PSB‐15 group and 91 (8.8%) in the PSB‐GA group. Using logistic regression analysis, peak serum bilirubin was found as an independent factor for performing exchange transfusion. Conclusion: Exchange transfusion was performed in only 9–14% of VLBW infants with excessively high bilirubin levels. We speculate that this may be a result of an absence of definitive guidelines or the possible belief that the risks of exchange transfusion outweigh the potential risk of bilirubin‐induced neurological injuries.     

A novel recombinant soluble splice variant of Met is a potent antagonist of the hepatocyte growth factor/scatter factor-Met pathway

PURPOSE: The Met receptor tyrosine kinase and its ligand, hepatocyte growth factor/scatter factor (HGF/SF), are involved in a wide range of biological activities, including cell proliferation, motility, invasion, and angiogenesis. The HGF/SF-Met signaling pathway is frequently activated in a variety of cancers, and uncontrolled Met activation correlates with highly invasive tumors and poor prognosis. In this study, we investigated the inhibitory effect of a novel soluble splice variant of Met on the HGF/SF-Met pathway. EXPERIMENTAL DESIGN: Using our alternative splicing modeling platform LEADS, we have identified a novel splice variant of the Met receptor, which encodes a truncated soluble form of the receptor. This variant was produced as a recombinant Fc-fused protein named Cgen-241A and was tested in various cell-based assays representing different outcomes of the HGF/SF-Met pathway. RESULTS: Cgen-241A significantly inhibited HGF/SF-induced Met phosphorylation as well as cell proliferation and survival. In addition, Cgen-241A showed a profound inhibitory effect on cell scattering, invasion, and urokinase up-regulation. The inhibitory effects of Cgen-241A were shown in multiple human and nonhuman cell types, representing different modes of Met activation. Furthermore, Cgen-241A showed direct binding to HGF/SF. CONCLUSIONS: Taken together, our results indicate that Cgen-241A is a potent antagonist of the HGF/SF-Met pathway, underlining its potential as a therapeutic agent for the treatment of a wide variety of human malignancies that are dependent on this pathway.     

Sleep-wake patterns in children with intrauterine growth retardation

The purpose of this study was to characterize the sleep patterns of children with intrauterine growth retardation, known to be at risk for neurodevelopmental disorders, and seek a possible correlation with behavior, concentration, and attention problems. The sleep patterns of 26 children with intrauterine growth retardation aged 4 to 7 years were compared with those of 47 control children using activity monitors (actigraphs). In addition, data were collected from the parents regarding sleep habits, behavior, concentration, and attention. Children with intrauterine growth retardation aged 4 to 7 years were found to have a tendency toward poorer quality of sleep than their matched controls. This inclination was statistically significant only for one sleep measure, the true sleep time. A tendency toward increased fragmentation of sleep, prolonged waking, and decreased sleep efficiency, although not statistically significant in this study, was demonstrated. Our results showed that 58% of the children with intrauterine growth retardation, compared with 40% of the children in the control group, could be defined as "poor sleepers" (sleep efficiency lower than 90% or three or more waking episodes per night). This disturbed sleep profile is probably an integral part of the neurodevelopmental profile typical of these at-risk children. No significant correlations were found between sleep quality and behavior, concentration, and attention problems.     

Halichondramine,a new tetracyclic bipiperidine alkaloid from the marine sponge Halichondria sp

Halichondramine (1), a new tetracyclic alkylbipiperidine alkaloid, has been isolated from the marine sponge Halichondria sp., collected in the Dahlak archipelago (the Red Sea), Eritrea. The structure of halichondramine was elucidated by interpretation of MS, COSY, HMQC, HMBC, TOCSY, and HSQC-TOCSY data.     

Nucleus accumbens dopamine and learned fear revisited: a review and some new findings

A role for the nucleus accumbens (NAcc) and its dopamine (DA) innervation in fear and fear learning is supported by a large body of evidence, which has challenged the view that the NAcc is solely involved in mediating appetitive processes. Unfortunately, due to conflicting findings in the aversive conditioning literature the role of the NAcc in aversive conditioning remains unclear. This review focuses on the results of recent in vivo microdialysis studies that have examined the release of NAcc DA during Pavlovian aversive conditioning. In addition, we present additional new findings, which re-examine the involvement of NAcc DA in aversive conditioning. DA release was measured in the NAcc core using in vivo microdialysis during discrete cue Pavlovian aversive conditioning in four experiments. In all cases no change in DA levels was observed either during training or in response to the CS presentations despite robust behavioural evidence of discrete cue Pavlovian aversive conditioning. These findings contrast with some previous studies that show that primary and conditioned aversive stimuli increase DA release in the NAcc. We suggest that the inconsistencies in the literature might be due to procedural differences in the measurement of aversive conditioning, and the precise location of the probe in the NAcc region. Hence, rather than discount an involvement of NAcc DA in affective processes, we propose that functionally dissociable sub-regions of the NAcc may contribute to different aspects of Pavlovian aversive learning.     

Cystic fibrosis and neonatal calcified scrotal masses

We report a case of an infant who presented with failure to thrive and in whom the identification of calcified scrotal masses led us to the diagnosis of cystic fibrosis.     

Treatment of severe, drug resistant obsessive compulsive disorder with the 5HT1D agonist sumatriptan

The serotonergic system has been implicated in both the aetiology and pharmacological treatment of obsessive compulsive disorder. In pharmacological challenge tests, mCPP, a 5-HT agonist, with an affinity for 5HT_2C as well as 5HT_1A and 5HT_1D, receptors, was associated with a transient exacerbation of obsessive compulsive symptoms. Chronic administration of mCPP was found to bring about some relief of these symptoms. Sumatriptan is an antimigraine agent, which interacts most potently with 5HT_1D receptors. In the cases to be presented, we report the effects of chronic administration of Sumatriptan to three severe, treatment resistant, OCD patients. Following chronic administration of sumatriptan, these patients, who have been resistant to any former pharmacological treatment, responded with an improvement in their depression and a modest reduction in their obsessive compulsive symptoms.     

Adjustment to breast cancer: the contribution of resources and causal attributions regarding the illness

The study examined personal resources (sense of coherence and social support) and attributions concerning the causes of illness, and their relationship to adjustment to breast cancer. The research sample included 60 Israeli women with breast cancer, who responded to questionnaires at two stages of their illness: the stage of initial discovery (after first learning of the illness) and approximately six months later (the stage of mitigation and accommodation). The overall level of adjustment to the illness was moderate. While the patients adjusted relatively well in the family and domestic environments, their adjustment in the dimensions of health care, psychological distress, and sexual relations was relatively low. The most frequent causal attributions were psychological factors and family history of illness. The patients' subjective state of health, sense of coherence, and levels of social support were related to most of the adjustment dimensions examined, although both internal and external causal attributions correlated negatively with adjustment in every dimension.