Diagnosis of malignancy in thyroid nodules by factor analysis of spectral and dynamic structures: a simultaneous dual-isotope dynamic study with thallium-201 and iodine-131.

The aim of this study was to identify malignant thyroid nodules using iodine-123 and thallium-201 simultaneous dynamic acquisition. The image sequences acquired were processed by factor analysis of spectral and dynamic structures (FASDS). Some 49 patients were investigated, and their diagnoses were confirmed by histological examination. Data processing enables the estimation of the spectra of the two isotopes and the evaluation of the kinetics and spatial structures related to each tracer. The superimposition of thallium and iodide sum images allowed us to delineate the nodule accurately. Two groups were defined: 21 patients who had 201Tl uptake in the nodule, and 28 who had none. In the first group, 5 nodules were carcinomas, whereas all nodules in the second group were benign. The results of the 201Tl dynamic study improved the diagnosis of carcinoma as the number of false-positive cases decreased. FASDS succeeds in extracting spectral and kinetic information, proving its usefulness in clinical diagnosis.     

Prognostic value of the immunohistochemical expression of: Ki67, p53, PCNA and Bcl2 in the superficial tumors of the bladder

AIM: To study a serie of superficial tumors of the bladder and to assess the prognostic significance of p53, Ki67, PCNA and bcl2 in these tumors. METHODS: We studied 59 bladder tumors: 43 pTa and 16 pT1. All Patients had cystoscopy 3 months after the resection and tumors that did not recur had a minimum follow up of 5 years. RESULTS: Age more than 65 years (p = 0,001), multifocality (p=0,022) and tumoral size > or = 3 cm (p = 0,022) were correlated with the recurrence. The expression of p53 was correlated with the recurrence in the year following the tumoral resection (p = 0,035). That of of Ki67 was correlated with the histological grade (p = 0,03) and stage (p=0,002). CONCLUSION: Our results suggest to practise regular endoscopic controls during the first year following the resection of the primitive tumor if it expresses p53. The immunohistochemical expression of Ki67 being correlated with the grade, this marker could help to better classify the tumors of intermediate grade.     

Molecular Basis of In Vivo Resistance to Sulfadoxine-Pyrimethamine in African Adult Patients Infected with Plasmodium falciparum Malaria Parasites

In vitro sulfadoxine and pyrimethamine resistance has been associated with point mutations in the dihydropteroate synthase and dihydrofolate reductase domains, respectively, but the in vivo relevance of these point mutations has not been well established. To analyze the correlation between genotype and phenotype, 10 Cameroonian adult patients were treated with sulfadoxine-pyrimethamine and followed up for 28 days. After losses to follow-up (n = 1) or elimination of DNA samples due to mixed parasite populations with pyrimethamine-sensitive and pyrimethamine-resistant profiles (n = 3), parasite genomic DNA from day 0 blood samples of six patients were analyzed by DNA sequencing. Three patients who were cured had isolates characterized by a wild-type or mutant dihydrofolate reductase gene (with one or two mutations) and a wild-type dihydropteroate synthase gene. Three other patients who failed to respond to sulfadoxine-pyrimethamine treatment carried isolates with triple dihydrofolate reductase gene mutations and either a wild-type or a mutant dihydropteroate synthase gene. Three dihydrofolate reductase gene codons (51, 59, and 108) may be reliable genetic markers that can accurately predict the clinical outcome of sulfadoxine-pyrimethamine treatment in Africa.     

Calcium,magnesium, sodium and potassium levels in foodstuffs from the second French Total Diet Study

Calcium (Ca), magnesium (Mg), sodium (Na) and potassium (K) contents in 1319 foodstuffs habitually consumed by the French population were determined for the second French Total Diet Study (TDS), using micro-sampling flame atomic absorption spectrometry after microwave-assisted digestion. Concentration and distribution of these minerals in food samples were reported and compared with results from the previous French TDS. For Ca, the results indicate that the food presenting the highest levels are dairy products (1597 mg kg^?1), tofu (802 mg kg^?1) and some fish and cereal products; for Mg, tofu (1340 mg kg^?1), “Sweeteners, honey and confectionery” (672 mg kg^?1) especially dark chocolate (2225 mg kg^?1) and certain grains such as nuts and oilseeds (1069 mg kg^?1) and some cereal products; for Na, processed meats such as delicatessen (12,422 mg kg^?1), “Salts, spices, soup and sauces” (21,028 mg kg^?1), some cheeses and cereal products; and for K, “Cereal and cereal products” (4378 mg kg^?1), “Meats and offal” (3993 mg kg^?1), “Nuts and oilseeds” (7355 mg kg^?1) and “Sweeteners, honey and confectionery” (3445 mg kg^?1) (especially chocolate).     

Standardization and comparison of endogenous erythroid colony assays performed with bone marrow or blood progenitors for the diagnosis of polycythemia vera

The reliability of the assay of endogenous erythroid colony (EEC) formation in serum-free, cytokine-free collagen-based media was investigated in a multicentric study including 140 patients with polyglobuly (80 polycythemia vera (PV), 54 secondary erythrocytosis (SE), six idiopathic erythrocytosis (IE)) and 10 healthy donors. In each center, EEC assays were performed in parallel with progenitor cells from bone marrow (BM) and peripheral blood (PB); two commercialized media and 'low' and 'high' cell plating densities were tested. Negativity of EEC assays was considered certain only when sufficient BFU-E growth was obtained in control cultures with cytokines. In the two media, EEC formation was specific - never observed in cultures of healthy donors or SE patients - and comparable. BM EEC assays were positive (presence of eythroid colonies) for 75% ('low' plating) to 100% ('high' plating) of PV patients; PB EEC assays were positive for 83.3% ('low' plating) to 93.7% ('high' plating) of PV patients (differences not significant). Depending on the medium, 86.2-93.7% of patients with a positive BM EEC assay had a positive PB EEC assay. Hence, a standardized collagen-based EEC assay can be performed with either BM or PB progenitors; the EEC assay described here is positive for at least 75% of PV patients when a single EEC assay is performed, and for at least 94% of PV patients when both BM and PB EEC assays are performed.     

First Description in Tunisia of a Point Mutation at Codon 119 (CCT→TCT) in the α1-Globin Gene: Hb Groene Hart in Association with the − α3.7 Deletion

Herein we describe the case of a Tunisian girl who presented with 3% Hb Bart's (γ₄) at birth. At the age of 3 years, she showed microcytosis and hypochromia in the absence of iron deficiency. The first step of molecular analysis was to test for the common Mediterranean mutations and the classical ? α^3.7 deletion was found in the heterozygous state. Since this finding could not explain the level of Hb Bart's at birth, or the hypochromia and microcytosis, all the α-globin genes were sequenced. This revealed a rare point mutation at codon 119 (CCT→TCT) in the α1-globin gene, identified for the first time in Tunisia, and which has previously been described as an unstable hemoglobin (Hb) variant named Hb Groene Hart [α119(H2)Pro→Ser (α1)]. Here the ? α^3.7/αα^{119(CCT→TCT)} genotype is responsible for the α-thalassemia (thal) trait phenotype.     

Cutaneous tuberculosis. A review of 38 cases

INTRODUCTION: Cutaneous tuberculosis (CT) represents only 2% of extra-pulmonary locations. This form should be studied because it may indicate visceral forms of tuberculosis. MATERIAL AND PROCEDURES: Retrospective study of patients affected by CT, conducted in the dermatology department of Charles Nicolle Hospital from 1991 to 2002. Tuberculids have been excluded. RESULTS: We have studied 38 cases of CT subdivided on 8 lupus tuberculosis, fourteen scrofuloderma, two warty tuberculosis, one association between lupus tuberculosis and scrofuloderma, twelve BCG specific reactions and one unclassifiable form. The average age of our patients was 43 years. The sex ratio (H/F) was 1,91. Concomitant visceral tuberculosis was discovered in 9 patients. All cases were confirmed by anatomopathologic examination and half of them had a caseous necrosis. CONCLUSIONS: The incidence of cutaneous tuberculosis seems to be increasing in our country: from 3 per 1000 new consultants in our dermatology department between 1970 and 1977 to 0.44 per 1000 new consultants from 1991 to 2002. Our study points out a male predominance in cutaneous tuberculosis. Clinical forms are still dominated by scrofuloderma which is a multibacillary form.     

Immunohistochemical expression and distribution of proteoglycans and collagens in sclerocornea

To immunolocalize corneal keratan sulfate (KS) and its core protein lumican, aggrecan, type I and type III collagens in sclerocornea specimens and compare their expression and distribution to age-matched healthy corneas and scleras. Sclerocornea specimens (n = 3) and age-matched normal corneoscleral rim specimens (n = 3) were studied by light microscopy and histochemically. KS, lumican, aggrecan, type I and type III collagens were immunolocalized in the specimens using indirect immunofluorescence. The fluorescence intensity in each specimen was scored from 0 to 4, with 0 representing no fluorescence and 4 representing intense fluorescence. The sclerocornea specimens showed histologic features typical of sclerocornea. KS and lumican immunolabeling in the corneal stroma in sclerocornea was decreased, whereas aggrecan immunolabeling was increased compared to that seen in normal cornea and normal sclera. KS and lumican staining was more intense in the posterior part of sclerocornea specimens, whereas aggrecan staining was distributed throughout the stroma. The staining intensity and distribution of type I collagen in sclerocornea was similar to that seen in normal cornea. Type III collagen was faint to absent in both normal cornea and sclerocornea but strong labeling was noted in normal sclera. The immunophenotype of sclerocornea is similar to that of normal cornea but with reduced labeling intensity of KS and lumican and increased labeling intensity of aggrecan. This change could potentially contribute to the abnormal fibril assembly in sclerocornea.     

Lower limb hypertrophic osteoarthropathy can reveal aortic graft infection in Behçet syndrome

SIR, Pierre–Marie–Bamberger syndrome [1], or secondaryhypertrophic osteoarthropathy (HOA), is characterized by clubbingof digits, periosteal new bone formation and synovial effusion.Secondary HOA accompanies a variety of disorders, thoracic affectionsin particular, and may precede clinical features of the disease.Forms of HOA localized to one or two limbs occur as the resultof an endothelial injury, such as an infection of arterial aneurysmsor vascular grafts [2]. We report the case of a 44-yr-old womanwith Behçet disease (BD) with predominantly unilaterallower limb HOA revealing an aortic