18F‐fluoro‐2‐deoxy‐D‐glucose positron emission tomography and positron emission tomography/computed tomography imaging of malignant pleural mesothelioma*

Malignant pleural mesothelioma (MPM) is the most common primary pleural tumor and its incidence is rising. Its diagnosis, staging and response assessment are challenging for imaging. Integrated positron emission tomography (PET)/CT increases the accuracy of overall staging in patients with mesothelioma and improves the selection of patients for curative surgical resection. It is particularly useful in identifying occult distant metastases. It may be used to predict prognosis and to assess the metabolic response to therapy.     

Modified core wash cytology procedure for the immediate diagnosis of core needle biopsies of breast lesions

BACKGROUND:

Core wash or touch imprint cytology is often used to obtain a quick, preliminary diagnosis on a core needle biopsy (CNB) of breast lesions, essential for the management of the 1‐day breast clinic. Contradictory results of both techniques in the literature led to this preclinical study investigating an alternative method of touch imprint and core wash cytology.

METHODS:

Thirty breast lesions were biopsied by a core needle in a laboratory setting. The CNBs were collected in RPMI fluid (Roswell Park Memorial Institute fluid). The touch imprint cytology was performed taking the biopsy out of the fluid and smearing it on a microscopic slide and May‐Grunwald Giemsa stained. The core wash cytology was made by fixating the remaining cells in Fixcyt and prepared with a liquid‐based preparation method and Papanicolaou stained. The cytologic findings were categorized into benign, atypical favoring benign, atypical, suspicious, and malignant and compared with the histologic CNB results.

RESULTS:

The CNBs showed 20 of 30 samples to be malignant, 2 to be phylloides tumors, 7 to be benign, and 1 to be unsatisfactory. Both techniques showed a sensitivity of 95% and specificity of 100%. Touch imprint yielded insufficient diagnoses (13.3%), compared with core wash (6.6%). Of the core wash cases, 86% showed a good quality versus 30% in touch imprint cytology.

CONCLUSIONS:

This preclinical study on modified touch imprint and core wash techniques led to results that were comparable to or better than those in the literature. The core wash cytology is preferred to touch imprint because of the better morphology. Cancer (Cancer Cytopathol) 2009. © 2009 American Cancer Society.     

Rare chromosomal complement of trisomy 21 in a boy conceived by IVF and cryopreservation

This report describes a case of mosaic Down syndrome due to an unusual karyotype in a patient conceived by assisted reproductive techniques and cryopreservation. The chromosomal complement consists of two different cell lines, one predominantly trisomic with a derivative chromosome due to a Robertsonian translocation (21;21) and another carrying a ring chromosome 21. The present work analyses the different mechanisms that could have led to mosaicism.     

Pyruvate kinase Greensboro. A four-generation study of a high K0.5s (phosphoenolpyruvate) variant [published erratum appears in Blood 1988 Dec;72(6):2082]

The proband with lifelong hemolytic anemia has a high K0.5s phosphoenolypyruvate (PEP) erythrocyte pyruvate kinase (PK) variant substantially but incompletely normalized by the allosteric modifier fructose-1,6-diphosphate (F-1,6-P2) with conversion of sigmoidal to hyperbolic kinetics. Heterozygotes in four generations express qualitatively identical but less severely abnormal kinetics and lack overt hemolysis. Kinetic abnormalities are closely mimicked by sulfhydryl modification of normal PK. Three distinct clinical and metabolic phenotypes characterize the proband and two sisters: variant PK and hemolytic anemia, variant PK without clinical manifestations or hemolysis, and complete normality. Their mother, whose red cell PK is entirely normal except for a questionably slightly low Vmax, is postulated to express the gene products of nonidentical alleles, one encoding a product with mildly less favorable catalytic characteristics. At low PEP concentrations, the proband and heterozygotes for the PK mutant express only a very small fraction of normal PK activity despite apparent inheritance of one normal allele in the latter. Evidence suggests that disproportionately lowered PK activity may be a property of a heterotetrameric PK. Illusory abnormalities in nucleotide specificity are artifacts of diminished substrate affinity characterizing the mutant PK.     

Variations of the Pursestring Suture in Skin Cancer Reconstruction

BACKGROUND: The pursestring suture (PSS) utilizes a circumferentially placed intradermal suture to decrease the size of a defect. Its primary application in dermatologic surgery has been to allow placement of a smaller full-thickness skin graft and to enhance secondary intention wound healing. OBJECTIVE: To present our experience with 3 variations of the PSS. METHODS: The oval defects resulting after surgical excision of cutaneous malignancies were managed with 3 variations of the traditional pursestring technique. These variations included (1) complete closure of the PSS-reduced defect by the placement of traditional interrupted sutures; (2) PSS with the Burow's triangle graft; (3) use of a PSS only part way around an oval defect to avoid distortion of a nearby free margin. RESULTS: In the 7 years of performing these variations of the PSS technique, we have consistently achieved favorable results. CONCLUSION: We report 3 simple-to-use variations of the PSS technique that have been extremely useful in the management of cutaneous malignancies.     

紫杉醇诱导的人乳癌细胞凋亡相关表达基因的克隆研究

应用mRNA差异显示法对紫杉醇诱导的人乳癌细胞（BCaP37）凋亡相关表达基因进行克隆研究。经Nor山ern杂交反应证实，12个克隆基因表达变化与紫杉醇诱导的细胞凋亡反应有关，其中克隆C3P3CDNA序列与人腺鲁基蛋氨酸合成酶同源性达99％，而且其转录水平与基因产物的酶活性水平变化呈现一致。提示这些表达的克隆基因可能参与紫杉醇诱导的细胞凋亡的调节作用，其详细机制有待进一步研究。     

Primary spinal epidural extraosseous Ewing’s sarcoma: Report of five cases and literature review

Ewing’s sarcoma is the most common malignant bone tumour occurring in children and adolescents and exists in two different clinicopathological entities: osseous Ewing’s sarcoma (OES) and extraosseous Ewing’s sarcoma (EES). Five cases of primary epidural EES are described, which presented with non‐specific symptoms leading to a long diagnostic delay. The median age at diagnosis was 22 years (range 13–36 years). The median diagnostic delay was 3 months. All patients had one or more neurological deficits. All underwent surgical exploration with a laminectomy and partial resection followed by adjuvant radiotherapy to a dose of 46–50 Gy and chemotherapy with VAC (vincristine, adriamycin and cyclophosphamide) alternating with ICE (ifosphamide, cisplatin and etoposide) for at least six cycles. The mean follow‐up period is 21.2 months (range 11–32 months). Four of the five patients achieved a complete remission and are disease free at the time of writing this report. Two patients have a residual neurological deficit – both having presented with long history of neurological deficit. Primary spinal epidural EES should be suspected whenever young patients present with back pain and/or radicular pain, have abnormal neurology and an extradural mass is demonstrated on MRI. Surgical excision followed by adjuvant radiotherapy (50 Gy) and combination chemotherapy (VAC alternating with ICE) achieved local and systemic control in these patients. A greater number of patients and longer follow up are required to evolve a generally accepted treatment policy for this aggressive but potentially curable malignancy.