Primary intraosseous meningioma: CT and MRI appearance

Benign primary intraosseous meningioma presenting with osteolytic skull lesion and soft-tissue component is rare. CT and MR imaging of a patient with frontoparietal scalp swelling showed an osteolytic intracalvarial lesion with an extradural soft-tissue component. Following wide surgical resection, the histological examination revealed an intraosseous chordoid meningioma. The clinical and radiological findings of primary intraosseous meningioma are discussed and the relevant literature is reviewed.     

Juvenile polyarteritis: results of a multicenter survey of 110 children

OBJECTIVE: To characterize pediatric patients who had been diagnosed with polyarteritis nodosa (PAN) through necrotizing vasculitis of the small and mid-size arteries or those with characteristic findings on angiograms data were collected. STUDY DESIGN: Pediatricians were asked to classify their patients into one of the four suggested groups for juvenile PAN. Twenty-one pediatric centers worldwide participated with 110 patients. RESULTS: The girl:boy ratio was 56:54, with a mean age of 9.05 +/- 3.57 years. The cases were classified as: 33 (30%) cutaneous PAN; 5 (4.6%) classic PAN associated with hepatitis B surface antigen (HBs Ag); 9 (8.1%) microscopic polyarteritis of adults associated with antineutrophil cytoplasmic antibodies (ANCA); and 63 (57.2%) systemic PAN. Cutaneous PAN was disease confined to the skin and musculoskeletal system. All patients with HBs Ag-associated classic PAN were diagnosed with renal angiograms. Antiviral treatment was administered in most cases. Microscopic PAN patients had pulmonary-renal disease, in combination or separately. ANCA was present in 87%, and 2 patients progressed to end-stage renal failure. Patients classified with systemic PAN had multiple system involvement, almost all had constitutional symptoms, and all had elevated acute phase reactants. Corticosteroids and cyclophosphamide were the first choices of immunosuppressive treatment. The overall mortality was 1.1%. CONCLUSIONS: There were remarkable differences among pediatric patients with PAN, with different clinical manifestations and overall better survival and lower relapse rates when compared with adults.     

Acute pulmonary edema in a newborn with infracardiac type total anomalous pulmonary venous return and surgical repair

Total anomalous pulmonary venous return (TAPVR) is a rare congenital pathology. Early diagnosis and urgent surgery are life-saving, especially in newborns with pulmonary venous obstruction, which is most commonly seen with infracardiac type. A three-day-old baby boy presented to another clinic with tachypnea and cyanosis. Initial work-up aimed at ruling out persistant pulmonary hypertension, respiratory distress syndrome and pneumonia. Acute pulmonary edema then developed, and on echocardiography obstructive type infracardiac TAPVR was suspected. Cardiac catheterization was done for definitive diagnosis. Urgent surgery was undertaken and pulmonary veins were anastomozed to left atrium with posterior approach. Patient was extubated at 10th day and discharged after three weeks. During one-year follow-up the patient was free of symptoms. Infracardiac type TAPVR is a rare pathology in which early diagnosis and urgent surgery with special postoperative case are mandatory for survival.     

Effects of long-term passive smoking on the diameter of glomeruli in rats: Histopathological evaluation

BACKGROUND AND AIMS: Long-term smoking increases the risk of renal diseases and it also causes the progression of the diseases. The aim of this study was to evaluate the effects of smoking on glomeruli in healthy rats exposed to long-term passive smoking for a short period of time after birth. METHODS: Sixty-five rats were randomly assigned into four groups. Groups 1 (18 males) and 2 (18 females) were exposed to smoke, whereas groups 3 (15 males) and 4 (14 females) were not exposed to smoke. Overall, 130 renal units were evaluated, and diameters of 10 different glomeruli were measured. The renal and bodyweights of the rats were measured. RESULTS: The diameter of the glomeruli was 95.51 +/- 9.25 and 100.91 +/- 4.06 microm in groups 1 and 3, respectively (P < 0.05). It was 97.32 +/- 4.06 and 98.86 +/- 6.25 microm in groups 2 and 4, respectively (P > 0.05). Irrespective of the sex, the diameter of the glomeruli was 96.42 +/- 7.15 microm in smokers and 99.92 +/- 5.56 microm in non-smokers (P < 0.05). The renal weights of the male rats affected by smoke were significantly lower than that of those that were not affected by smoke (P < 0.05). Bodyweights of male rats affected by smoke were significantly lower that of those not affected (P < 0.05). There was a weak correlation between the diameter of the glomeruli and the bodyweights of male rats affected by smoke (r = 0.474, P < 0.05). CONCLUSION: We conclude that passive smoking might have a negative affect on renal morphometry and body growth.     

Prognostic significance of Ki-67 expression for patients with laryngeal squamous cell carcinoma primarily treated by total laryngectomy

The aim of this study was to determine the prognostic value of Ki-67 immunostaining in laryngeal squamous cell carcinomas. Ki-67 labeling was quantified in 63 laryngeal squamous cell carcinomas by counting at least 1,000 tumor cells in the most immunoreactive area in each sample, and the Ki-67 labeling index was calculated as a percentage. The antigen expression was compared with clinical factors, histopathological grading and prognosis. The Ki-67 mean proliferation index for all patients was 25.44% ( range, 2–75%). A significant correlation was found between Ki-67 mean proliferation index and patient age (P<0.05), T-stage (P<0.05), nodal metastasis (P=0.001) and recurrence (P<0.001). There was no significant association between the Ki-67 mean proliferation index and tumor site or histologic grade. A univariate analysis showed that the Ki-67 labeling index >21% (P<0.001), T-stage (P<0.001) and nodal metastasis (P=0.001) are determinants of recurrence. In the multivariate analysis, the Ki-67 labeling index >21% (P<0.001), T-stage (P<0.001) and nodal metastasis (P<0.05) were independent predictors of recurrence. Kaplan-Meier plots of survival in patients with Ki-67 values above and below the median (21%) of the general study population showed that a high Ki-67 labeling index correlated with a shorter disease-free survival (P<0.0001). The analysis of the Ki-67 labeling index at the time of initial surgery may be a powerful prognostic marker for patients with laryngeal squamous cell carcinoma and may be useful for selecting subgroups of patients who should be treated with more aggressive therapies.     

Effects of pneumoperitoneum with or without colostomy on rat colonic anastomotic healing

Background: Elevated intra‐abdominal pressure and colostomy have adverse effects on colonic anastomoses. The aim of the present study was to investigate the effects of laparoscopic colon surgery with and without diverting colostomy on healing of colonic anastomoses in an experimental model. Methods: Thirty‐six male rats were divided into three equal groups: group 1, control (colonic anastomosis and anaesthesia for 180 min only); group 2, 180 min pneumoperitoneum and colonic anastomosis; and group 3, similar to group 2 with a proximal colostomy. On day 7, bursting pressures, tissue hydroxyproline and nitric oxide concentrations and histopathological inflammation scores were determined and compared. Results: Mean bursting pressures were higher in the control group than the two pneumoperitoneum groups (P = 0.0003). Mean tissue hydroxyproline concentrations showed no difference (P > 0.05). Mean tissue nitric oxide concentrations were significantly increased in the control group (P = 0.0013). Histopathological scores demonstrated increased inflammatory response in group 3 compared to the controls (P = 0.0009). Conclusion: Pneumoperitoneum delays collagen maturation and impairs anastomotic strength in the colon. Following pneumoperitoneum, performance of a diverting loop colostomy to protect the anastomosis will not have additional detrimental effects on anastomotic healing.     

The investigation of the genotoxic effects of fenarimol and propamocarb in mouse bone marrow in vivo

In this study, we aimed to evaluate the genotoxic effects of fungicides fenarimol and propamocarb which are used to protect crops from fungi. For this reason, bone-marrow micronucleus and chromosome aberration tests were carried out in Swiss albino mice. Mice were injected with four different doses of fenarimol and propamocarb intraperitoneally; 50, 100, 200 and 400 mg/kg b.w. Fenarimol did not induce any significant increase in micronucleated erythrocytes after 24, 36, and 48 h treatment but it decreased the ratio of polychromatic/normochromatic erythrocytes at all dose groups and sampling intervals. Fenarimol did not increase the number of chromosome aberrations significantly, but it reduced the mitotic index at the higher doses (P < 0.05). Propamocarb did not increase the frequency of micronucleated erythrocytes, but decreased the polychromatic/normochromatic erythrocytes ratio at all sampling intervals. Propamocarb increased only gaps in total chromosome aberrations, but when gaps were excluded, there were no significant differences in total aberrations between the control and dose groups (P > 0.05). Propamocarb also reduced the mitotic index compared with the negative control group (P < 0.001). Contributing these results, we can suggest that fenarimol and propamocarb are non-genotoxic in mouse bone marrow in vivo but have cytotoxic effects.     

Abscess of the spleen

Abscess of the spleen is a very rare lesion. In this study, 4 cases of splenic abscess are presented and discussed along with the literature. The cases were between 16 and 55 years-old and two of them had hematologic malignancy. All of them had been operated on because of acute abdomen, and in two cases splenic rupture was present. Only in one of the cases was salmonellosis detected by microbiological methods. By histological examination, expansion and congestion in splenic sinusoids, and foci of abscess including wide areas of necrosis and inflammatory infiltration by neutrophils were seen in all cases. The most frequent cause of splenic abscess is septic embolism arising from bacterial endocarditis. There are also a few splenic abscess cases seen with malignancies. While splenic abscess is seen rarely, it has a high rate of mortality when it is diagnosed late.     

Atypical meningioma and extensive calvarium defects in neurofibromatosis type 1

A 9-year-old girl with neurofibromatosis type 1 (NF1) presented with a massive atypical meningioma and calvarial defect. Skull radiographs and cranial CT showed an extensive lytic bone lesion at the vertex. MRI demonstrated a large mass invading the calvarium and sagittal sinus. The histopathological and immunohistochemical diagnosis of the resected mass was atypical meningioma. To our knowledge, this is the first case of NF1 associated with atypical meningioma and massive calvarial defect in a child.     

Fine mapping of the alpha-T catenin gene to a quantitative trait locus on chromosome 10 in late-onset Alzheimer's disease pedigrees

Using plasma amyloid beta protein (Abeta42) levels as an intermediate, quantitative phenotype for late onset Alzheimer's disease (LOAD), we previously obtained significant linkage at approximately 80 cM on chromosome 10. Linkage to the same region was obtained independently in a study of affected LOAD sib-pairs. Together, these two studies provide strong evidence for a novel LOAD locus on chromosome 10 that acts to increase Abeta42. VR22 is a large (1.7 Mb) gene located at 80 cM that encodes alpha-T catenin, which is a binding partner of beta catenin. This makes VR22 an attractive candidate gene because beta catenin interacts with presenilin 1, which has many mutations that elevate Abeta42 and cause early onset familial AD. We identified two intronic VR22 SNPs (4360 and 4783) in strong linkage disequilibrium (LD) that showed highly significant association (P=0.0001 and 0.0006) with plasma Abeta42 in 10 extended LOAD families. This association clearly contributed to the linkage at approximately 80 cM because the lod scores decreased when linkage analysis was performed conditional upon the VR22 association. This association replicated in another independent set of 12 LOAD families (P=0.04 for 4783 and P=0.08 for 4360). Bounding of the association region using multiple SNPs showed VR22 to be the only confirmed gene within the region of association. These findings indicate that VR22 has variant(s) which influence Abeta42 and contribute to the previously reported linkage for plasma Abeta42 in LOAD families.