Atlantoaxial synovial cyst causing isolated unilateral hypoglossal nerve paralysis

Cervical synovial cysts are rare entities that are, most of the time, asymptomatic. They can cause nerve root or spinal cord compression, especially when acute haemorrhage or a marked increase in size occurs. Isolated unilateral hypoglossal nerve paralysis caused by compression of its cisternal segment is also an extremely rare condition. We report the case of a 51-year-old woman who presented with dysarthria and tongue fasciculation. MRI revealed an atlantoaxial synovial cyst that extended cranially through the hypoglossal canal and compressed the fibres of the left XII nerve on its cisternal segment. To our knowledge, this is the first case report of XII nerve paralysis being caused by an atlantoaxial synovial cyst.Spinal synovial cysts are usually found in the lower lumbar spine, being rare in the cervical spine [1–5]. Isolated unilateral hypoglossal nerve paralysis is also a very rare condition [6]. We present a case of an atlantoaxial synovial cyst causing isolated unilateral compressive hypoglossal nerve paralysis in a 51-year-old woman. To the best of our knowledge, this is the first report of a XII nerve paralysis caused by an atlantoaxial synovial cyst.     

False-Positive PCR Detection of Tropheryma whipplei in Cerebrospinal Fluid and Biopsy Samples from a Child with Chronic Lymphocytic Meningitis

We report the case of a teenager with chronic lymphocytic meningitis for whom Tropheryma whipplei 16S rRNA PCR results were positive in two cerebrospinal fluid samples and one duodenal biopsy specimen. PCR targeting another specific sequence of Tropheryma whipplei and sequencing of the initially amplified 16S rRNA fragment did not confirm the results.     

Labile Plasma Iron Generation After Intravenous Iron is Time-dependent and Transitory in Patients Undergoing Chronic Hemodialysis

Iron supplementation in hemodialysis patients is fundamental to erythropoiesis, but may cause harmful effects. We measured oxidative stress using labile plasma iron (LPI) after parenteral iron replacement in chronic hemodialysis patients. Intravenous iron saccharate (100 mg) was administered in patients undergoing chronic hemodialysis (N = 20). LPI was measured by an oxidant-sensitive fluorescent probe at the beginning of dialysis session (T0), at 10 min (T1), 20 min (T2), and 30 min (T3) after the infusion of iron and at the subsequent session; P < 0.05 was significant. The LPI values were significantly raised according to the time of administration and were transitory: −0.02 ± 0.20 µmol/L at the beginning of the first session, 0.01 ± 0.26 µmol/L at T0, 0.03 ± 0.23 µmol/L at T1, 0.09 ± 0.28 µmol/L at T2, 0.18 ± 0.52 µmol/L at T3, and −0.02 ± 0.16 µmol/L (P = 0.001 to 0.041) at the beginning of the second session. The LPI level in patients without iron supplementation was −0.06 ± 0.16 µmol/L. Correlations of LPI according to time were T1, T2, and T3 vs. serum iron (P = 0.01, P = 0.007, and P = 0.0025, respectively), and T2 and T3 vs. transferrin saturation (P = 0.001 and P = 0.0003, respectively). LPI generation after intravenous saccharate administration is time-dependent and transitorily detected during hemodialysis. The LPI increment had a positive correlation to iron and transferrin saturation.     

Preterm birth as a risk factor for high blood pressure in children: a systematic review

Epidemiological studies have suggested that arterial hypertension is a chronic disease that begins in childhood, and that prematurity (birth at less than 37 weeks' gestational age) is potentially associated with the development of hypertension in childhood and adulthood. Our objective was to identify the association between prematurity and high blood pressure in children, using a systematic literature review. Original articles related to the theme and published in English, Portuguese, or Spanish from 1998 to 2009 were selected from the MEDLINE, LILACS, and SciELO databases. We excluded articles without abstracts, review articles, and articles not related to prematurity and hypertension in childhood. Nine articles were located and analyzed: 5 case-control studies, 2 cross-sectional studies, and 2 cohort studies. The majority of the studies failed to show an association between prematurity and arterial hypertension in childhood. However, the influence of prematurity should not be ruled out, given the small number of studies on this theme and the diversity of methodological approaches in the literature.     

Role of Cripto-1 in Stem Cell Maintenance and Malignant Progression

Cripto-1 is critical for early embryonic development and, together with its ligand Nodal, has been found to be associated with the undifferentiated status of mouse and human embryonic stem cells. Like other embryonic genes, Cripto-1 performs important roles in the formation and progression of several types of human tumors, stimulating cell proliferation, migration, epithelial to mesenchymal transition, and tumor angiogenesis. Several studies have demonstrated that cell fate regulation during embryonic development and cell transformation during oncogenesis share common signaling pathways, suggesting that uncontrolled activation of embryonic signaling pathways might drive cell transformation and tumor progression in adult tissues. Here we review our current understanding of how Cripto-1 controls stem cell biology and how it integrates with other major embryonic signaling pathways. Because many cancers are thought to derive from a subpopulation of cancer stem-like cells, which may re-express embryonic genes, Cripto-1 signaling may drive tumor growth through the generation or expansion of tumor initiating cells bearing stem-like characteristics. Therefore, the Cripto-1/Nodal signaling may represent an attractive target for treatment in cancer, leading to the elimination of undifferentiated stem-like tumor initiating cells.Embryonic development involves coordinated processes of proliferation of progenitor stem cells that carry the potential of self-renewal and subsequent differentiation into distinct cell lineages.¹ After fertilization, totipotent stem cells of the blastocyst give rise to all tissues. With subsequent cell divisions, stem cells retain their self-renewal capacity, but they become more restricted in their differentiation potential, becoming progenitor cells (adult or somatic stem cells) that give rise to differentiated somatic cells in specific tissues.¹Therefore, two fundamental properties characterize stem cells: self-renewal, the ability to maintain their identity through a long period of time, and multipotency, the ability to generate all differentiated cell types of a specific tissue. A stem cell that asymmetrically divides can generate a new stem cell and a committed daughter cell. In the adult, a pool of stem cells resides within specific microenvironments or niches in adult tissues and functions as an internal repair system, dividing to replenish specialized cells and also maintaining the normal turnover of regenerative organs, such as blood, skin, or intestinal epithelium.² Stem cells, therefore, are of interest for their potential use in regenerative medicine.Recent progress has identified potential molecular signatures of embryonic stem (ES) cells that delineate pathways that are used by somatic stem cells in the maintenance of self-renewal and in cell fate decisions.³ Among these markers of stemness, Cripto-1 represents an important component of a critical core pathway that is used by ES cells. In this review we highlight the role of Cripto-1 in stem cell self-renewal and differentiation with particular emphasis on the cross talk with other ES cell genes. Finally, re-expression of Cripto-1 in human cancers and its contribution to malignant progression is discussed.