Diffuse membranous glomerulonephritis in children

Nine cases of diffuse membranous glomerulonephritis detected among 90 renal biopsies from children with persistent proteinuria and one necropsy case of a young child who died of chronic membranous glomerulonephritis with uraemia were studied by a variety of techniques. Clinical presentation varies within this single morphological entity and the response to steroid therapy is not yet predictable on either clinical or morphological criteria. Correlation is demonstrated between therapeutic responses and the degree of selectivity of the proteinuria which was determined by studying the relative protein clearances with an immunochemical technique.     

Mosaic genome structure of echovirus type 30 that circulated in Taiwan in 2001

Summary An echovirus type 30 (E30) outbreak occurred in Taiwan in 2001. In this study, one 1998 and nineteen 2001 enterovirus isolates from cerebrospinal fluid (CSF) of children with meningitis were genetically analyzed. Although negative results were obtained using the E30-specific monoclocal antibody in an immunofluorescent assay (IFA) test of all 20 isolates, molecular typing by partial VP1 sequences and subsequent neutralization test identified them as E30. Among those, seven of them were misidentified as echovirus type 4 (E4) when E4-specific monoclonal antibody was used. Complete genome sequences of one E30 isolate (TW-2513) that were IFA-positive to E4 and another (TW-3182) that was IFA-negative to both E30 and E4 were determined and analyzed. The overall percentage nucleotide identity in the structural coding region (P1) between these two isolates is 98.4, while those in the nonstructural regions P2 and P3 are only 83.2 and 84.4, respectively, indicating that the two 2001 Taiwanese E30 strains were probably recombinant. Recombination analysis of these two E30 genomes revealed that their genome structures are mosaic, which might have been formed gradually and frequently over time.     

Features associated with germline CDKN2A mutations: a GenoMEL study of melanoma-prone families from three continents

Background

The major factors individually reported to be associated with an increased frequency of CDKN2A mutations are increased number of patients with melanoma in a family, early age at melanoma diagnosis, and family members with multiple primary melanomas (MPM) or pancreatic cancer.

Methods

These four features were examined in 385 families with ⩾3 patients with melanoma pooled by 17 GenoMEL groups, and these attributes were compared across continents.

Results

Overall, 39% of families had CDKN2A mutations ranging from 20% (32/162) in Australia to 45% (29/65) in North America to 57% (89/157) in Europe. All four features in each group, except pancreatic cancer in Australia (p = 0.38), individually showed significant associations with CDKN2A mutations, but the effects varied widely across continents. Multivariate examination also showed different predictors of mutation risk across continents. In Australian families, ⩾2 patients with MPM, median age at melanoma diagnosis ⩽40 years and ⩾6 patients with melanoma in a family jointly predicted the mutation risk. In European families, all four factors concurrently predicted the risk, but with less stringent criteria than in Australia. In North American families, only ⩾1 patient with MPM and age at diagnosis ⩽40 years simultaneously predicted the mutation risk.

Conclusions

The variation in CDKN2A mutations for the four features across continents is consistent with the lower melanoma incidence rates in Europe and higher rates of sporadic melanoma in Australia. The lack of a pancreatic cancer–CDKN2A mutation relationship in Australia probably reflects the divergent spectrum of mutations in families from Australia versus those from North America and Europe. GenoMEL is exploring candidate host, genetic and/or environmental risk factors to better understand the variation observed.     

Giant Circulating Cancer-Associated Macrophage-Like Cells Are Associated With Disease Recurrence and Survival in Non–Small-Cell Lung Cancer Treated With Chemoradiation and Atezolizumab

BackgroundCancer-associated macrophage-like cells (CAMLs) are a potential peripheral blood biomarker for disease progression. This study used data from a phase 2 clinical trial to evaluate prognostic utility of CAMLs for locally advanced non–small-cell lung cancer treated with definitive chemoradiotherapy (CRT) and atezolizumab (DETERRED; ClinicalTrials.gov NCT02525757).Patients and MethodsSample collection occurred at baseline (T0), during CRT (T1), at end of CRT (T2), and at first follow-up (T3). CAMLs were captured and quantified by the CellSieve system using multiplex immunostaining. Giant CAMLs were defined as characteristic CAMLs ≥ 50 μm. Kaplan-Meier methodology estimated progression-free survival, distant failure-free survival, relapse-free survival, and overall survival at 30 months.ResultsThirty-nine patients were evaluated between December 2015 and March 2018. Median follow-up was 27 months. Most disease was stage III (85%) and comprised squamous-cell carcinoma (38%) or adenocarcinoma (59%). In total, 267 blood samples were analyzed. Giant CAMLs were identified in 57%, 60%, 64%, and 63% of patients at T0, T1, T2, and T3, respectively. Patients with giant CAMLs at T3, occurring at a median of 30 days after completion of CRT, had significantly worse distant failure-free survival (hazard ratio [HR] 4.9, P = .015), progression-free survival (HR 2.5, P = .025), recurrence-free survival (HR 2.4, P = .036), and overall survival (HR 3.5, P = .034) compared to patients with small or no CAMLs.ConclusionsPresence of giant CAMLs after CRT completion was associated with development of metastatic disease and poorer survival despite the use of maintenance immunotherapy. Monitoring CAMLs may help risk-stratify patients for adaptive treatment strategies.     

Exposure assessment of aluminum arc welding radiation

The purpose of this study is to evaluate the non-ionizing radiation (NIR) exposure, especially optical radiation levels, and potential health hazard from aluminum arc welding processes based on the American Conference of Governmental Industrial Hygienists (ACGIH) method. The irradiance from the optical radiation emissions can be calculated with various biological effective parameters [i.e., S(lambda), B(lambda), R(lambda)] for NIR hazard assessments. The aluminum arc welding processing scatters bright light with NIR emission including ultraviolet radiation (UVR), visible, and infrared spectra. The UVR effective irradiance (Eeff) has a mean value of 1,100 microW cm at 100 cm distance from the arc spot. The maximum allowance time (tmax) is 2.79 s according to the ACGIH guideline. Blue-light hazard effective irradiance (EBlue) has a mean value of 1840 microW cm (300-700 nm) at 100 cm with a tmax of 5.45 s exposure allowance. Retinal thermal hazard effective calculation shows mean values of 320 mW cm(-2) sr(-1) and 25.4 mW (cm-2) (380-875 nm) for LRetina (spectral radiance) and ERetina (spectral irradiance), respectively. From this study, the NIR measurement from welding optical radiation emissions has been established to evaluate separate types of hazards to the eye and skin simultaneously. The NIR exposure assessment can be applied to other optical emissions from industrial sources. The data from welding assessment strongly suggest employees involved in aluminum welding processing must be fitted with appropriate personal protection devices such as masks and gloves to prevent serious injuries of the skin and eyes upon intense optical exposure.