Handgrip Strength: Associations with Clinical Variables,Body Composition,and Bone Mineral Density in Adults with Cystic Fibrosis

Background: Loss of fat-free mass (FFM) is associated with an increase in morbidity and mortality in cystic fibrosis (CF) patients. Handgrip strength (HGS) measures muscle function and may be associated with clinical parameters with prognostic value. Our objectives were to evaluate muscle strength through HGS in CF patients and to determine if there are any associations with respiratory clinical variables, FFM, and bone mineral density (BMD). Methods: A cross-sectional study conducted in clinically stable patients. We evaluated muscle function through HGS, respiratory function—forced expiratory volume in 1 s (FEV1) (%), forced vital capacity (FVC) (%), bronchorrhea, annual exacerbations, and body composition (FFM and FFM index, FFMI: fat-free mass in kg/height in m²) and Bone Mineral Density (BMD) through densitometry (DXA). Results: The study included 53 CF patients (58.5% females, mean age 28.3 ± 8.1, body mass index (BMI) 21.7 ± 3.4). The mean values for dynamometry were 40.2 ± 8.1 kg in males and 23.1 ± 7.0 kg in women, being 20.8% below the 10th percentile. Patients with lower muscle strength showed significantly more exacerbations and lower FEV1% and FVC%, as well as lower BMI, worse BMD (g/cm²), T-score, and Z-score. A significant and positive correlation was found between the mean and maximum dynamometry values and age, FVC%, BMI, FFMI, FFM (kg), and BMD. Conclusions: For adults with CF, HGS is a practical tool for assessment of health status. Low values reflect poor nutritional status and are associated with poor respiratory function, low fat-free mass and low bone mineral density.     

Iris melanocytoma mimicking the Cogan-Reese syndrome with monocular pigment dissemination

PURPOSE: To report a case of iris melanocytoma mimicking the Cogan-Reese syndrome. METHODS: A 37-year-old woman presented with pigmentary glaucoma in her left eye. There was diffuse pigmentary dispersion in the anterior segment, pedunculated pigmented nodules on the anterior iris surface, mild iris atrophy, and ectropion iridis. Neither intrinsic vasculature nor a sector cataract was found. The angle was open with marked trabecular pigmentation and no anterior synechiae. The intraocular pressure was 30 mmHg with maximum medical treatment and there was glaucomatous optic atrophy. The differential diagnosis included iris pigmented tumor and iridocorneal endothelial syndrome (Cogan-Reese syndrome). An iris biopsy was performed for diagnostic purposes. RESULTS: Histologic diagnosis after evaluation of the specimen was iris melanocytoma. CONCLUSIONS: This case presents signs considered quasi-pathognomonic of iridocorneal endothelial syndrome (Cogan-Reese syndrome): glaucoma, mild iris atrophy associated with pedunculated iris nodules, and ectropion iridis. Therefore, iris melanocytoma can present with features that mimic the Cogan-Reese syndrome.     

MCF-7 breast cancer cells grown as multicellular spheroids in vitro: effect of 17 beta-estradiol.

To obtain multicellular spheroids from MCF-7 human breast cancer cells we adhered to the following procedure: (a) limiting the adherence of cell to the substratum; (b) seeding more than the minimum number of cells; (c) guaranteeing the presence of estrogens in the culture medium. Charcoal-dextran (CD)-treated sera seemed to inhibit spheroid formation. A reduction in the concentration of CD-human sera (from 10% to 5%) added to phenol-red-free medium facilitated progress from cellular aggregates to multicellular spheroids. Once the spheroids became initiated, size increased at a rate that showed a good fit to a Gompertzian equation (A = 0.368 +/- 0.067 alpha = 0.065 +/- 0.013, r range = 0.890-0.989). Three different patterns of spheroid morphology and proliferative kinetic were defined: (a) spheroids with diameter less than 200 microns had a constant pattern of heterogeneity in the distribution of 3H-TdR-labelled cells and in the expression of estrogen receptors; (b) spheroids 250 to 700 microns in diameter showed a decrease in the proportion of 3H-TdR-labelled cells accompanying inward progression (50% in the outer shell, less than 10% in a cell layer located at a depth of 150 microns) while, at a depth of 170 microns, of signs of concurrent cellular degeneration and death were apparent; and (c) spheroids with a diameter of greater than 750 microns showed a crust of viable cells uniformly labelled with thymidine without impairment of the proportion of labelled cells when progressing inward from the spheroid crust. The larger the spheroid volume, the lower its growth fraction and the longer its volume doubling time. The hormone-dependence of MCF-7 cells in forming multicellular spheroids represents a unique experimental model for assessing estrogen action on cell organization and proliferation.