Gastrinoma of duodenal G-cell origin.

A 65-year-old man with hypergastrinemia associated with the Zollinger-Ellison syndrome was found to have a duodenal "carcinoid-islet cell tumor." Gastrin levels have remained normal for more than 1 year following total gastrectomy and removal of the duodenal tumor. Immunohistochemical studies for gastrin localization revealed positive staining of the tumor and of a population of nonneoplastic G-cells in the adjacent duodenal mucosa and Brunner's glands. These results support the hypothesis that gastrinomas may arise as primary tumors from duodenal G-cells rather than from ectopic pancreatic tissue. "Carcinoidislet cell tumors," like other tumors of APUD-cell origin, may express dual biochemical functions in the form of polypeptide hormone and/or amine secretion. Their content of specific hormonal products may be predicted on the basis of sensitive histochemical and immunohistochemical techniques.     

Weekly topotecan for recurrent small cell lung cancer - a retrospective anatolian medical oncology group study

Aim: To evaluate efficacy and tolerability of topotecan treatment for recurrent small cell lung carcinoma.Patients and Methods: A total of 62 patients were evaluated retrospectively. Statistical analysis was performedusing GraphPad Instat (version 3.05). Results: DFifty five of patients (89%) were male and 7 (11%) were female.Median age was 56.7±9.3 (34-75). Forty eight of patients (80%) were extensive stage (ES) at the time of diagnosis.Fifty of the patients (80.6 Medical Oncology Clinic) were given median 5.36 cycles of cisplatin-etoposide (2-8 cycles).Time to recurrence was 15.6±6.13 weeks in patients with limited stage (LS) and 6.3±3.82 weeks in extensivestage (ES) (p<0.0001). Overall survival was 14.0±6.08 months in ES and 17.9±6.88 months in LS. The differencebetween two groups was statistically meaningful (p=0.0447). The overall survival of the patients was 14.8±6.43months (4.5-40 months). In terms of survival, there was no difference between males and females (p=0.1171).In 17 (27%) patients who were refractory to topotecan or in whom progression occurred other chemotherapieswere used. Conclusion: Small cell lung cancer is chemosensitive, but recurrences occur in short time. Otherchemotherapy regimens are used in progression. Topotecan is one of them. Patients who were young and in whomrecurrences occur late had given better response to topotecan. Because of the retrospective nature of the study,we couldn’t reach the records exactly and consequently, rate and duration of response couldn’t be calculated.In recurrent SCLC topotecan is one of the treatment choices. But both hematological and non hematologicalside effects should be taken into consideration.     

Convergent and invariant object representations for sight,sound, and touch

We continuously perceive objects in the world through multiple sensory channels. In this study, we investigated the convergence of information from different sensory streams within the cerebral cortex. We presented volunteers with three common objects via three different modalities—sight, sound, and touch—and used multivariate pattern analysis of functional magnetic resonance imaging data to map the cortical regions containing information about the identity of the objects. We could reliably predict which of the three stimuli a subject had seen, heard, or touched from the pattern of neural activity in the corresponding early sensory cortices. Intramodal classification was also successful in large portions of the cerebral cortex beyond the primary areas, with multiple regions showing convergence of information from two or all three modalities. Using crossmodal classification, we also searched for brain regions that would represent objects in a similar fashion across different modalities of presentation. We trained a classifier to distinguish objects presented in one modality and then tested it on the same objects presented in a different modality. We detected audiovisual invariance in the right temporo‐occipital junction, audiotactile invariance in the left postcentral gyrus and parietal operculum, and visuotactile invariance in the right postcentral and supramarginal gyri. Our maps of multisensory convergence and crossmodal generalization reveal the underlying organization of the association cortices, and may be related to the neural basis for mental concepts. Hum Brain Mapp 36:3629–3640, 2015. © 2015 Wiley Periodicals, Inc.     

Chronic migraine associated with the Chiari type 1 malformation

OBJECTIVE: Our objective was to assess the frequency and clinical characteristics of migraine in the patients with CM-1. METHODS: We analyzed migraine in 73 patients with CM-1. Migraine was classified according to the new International Headache Society criteria. We did not include patients who had intracranial, parenchymal, or cervical lesions other than CM-1 on brain and cervical magnetic resonance imaging. RESULTS: Of the 73 patients diagnosed as having CM-1, 11 (15.06%) had migraines; of them, 8 (10.95%) had chronic migraines, 2 (2.73%) had migraines with auras, and 1 (1.36%) had migraines without auras. The patients who had both migraines and CM-1 (group 1) were compared regarding clinical characteristics and demographic features to the control group having chronic migraines. The control group comprised subjects free of CM-1. Onset age of pain was earlier and the frequency of headache days per month, baseline pain intensity, exacerbation of pain intensity, nausea, vomiting, and pain aggravated by physical activity were significantly higher in group 1. CONCLUSIONS: Although we found the frequency of migraine to be similar to that in population-based studies, we detected a threefold increased frequency of chronic migraine in this special population. We believe that CM-1 may be a factor associated with chronic migraine.     

Modification of acrylamide neuropathy in rats by selected factors

A modified rotarod technique was used to determine whether dietary deficiencies in pyridoxine or thiamine, bilateral adrenalectomy or cortisol treatment and pretreatment with microsomal enzyme inducers (DDT or phenobarbital) would modify the course of onset and recovery from functional acrylamide neuropathy in rats. Neither pyridoxine or thiamine deficiency nor daily injections of cortisol had any measurable effect on the cumulative dose of acrylamide required to produce functional impairment. Although adrenalectomized animals were more susceptible to acrylamide, the effect seemed nonspecific. The total cumulative doses of acrylamide required to produce neurologic deficit in DDT- and phenobarbital-pretreated rats were 520 and 600 mg/kg, respectively, compared to 360 mg/kg for the controls. Hepatic in vitro metabolism of acrylamide was studied to determine whether the observed delay could be explained by an increased capacity of the liver to detoxify acrylamide. There was a greater loss of acrylamide from incubation mixtures containing 9000 g supernatants from phenobarbital-pretreated rat livers than from control livers. Histologic studies of peripheral nerves from acrylamide-treated rats revealed that at the time of onset of functional impairment young and phenobarbital-pretreated adult rats had severe peripheral nerve damage, while no discernible peripheral nerve injury was seen in unpretreated adult rats.     

Stress-related responses after 3 years of exposure to terror in Israel: are ideological-religious factors associated with resilience?

BACKGROUND: The inhabitants of 3 different types of population centers in Israel were assessed as to stress-related symptomatology during 2003 and 2004. These centers have been exposed to 2 distinct forms of violence-sporadic, large-scale terror attacks in the metropolitan areas in the heart of Israel and daily "war-zone" conditions in the settlements beyond the 1967 borders of Israel. METHOD: A semistructured interview and questionnaire survey of a random sample of 314 inhabitants of a suburb of Tel-Aviv, a settlement in the West Bank (Kiryat-Arba), and the Gush-Katif settlement cluster in the Gaza Strip was performed. Symptoms of acute stress and chronic (posttraumatic) stress as well as symptoms of general psychopathology and distress were assessed. RESULTS: The inhabitants of Gush-Katif, in spite of firsthand daily exposure to violent attacks, reported the fewest and least severe symptoms of stress-related complaints, the least sense of personal threat, and the highest level of functioning of all 3 samples. The most severely symptomatic and functionally compromised were the inhabitants of the Tel-Aviv suburb, who were the least frequently and least directly affected by exposure to violent attacks. Because the Gush-Katif population is exclusively religious, the data were reassessed according to religiousness. The religious inhabitants of Kiryat-Arba had almost the same symptom profile as the Gush-Katif population, whereas secular inhabitants of Kiryat-Arba reported faring worse than did either population in the Tel-Aviv suburb. CONCLUSION: Deeply held belief systems affecting life-views may impart significant resilience to developing stress-related problems, even under extreme conditions. Religiousness combined with common ideological convictions and social cohesion was associated with substantial resilience as compared to a secular metropolitan urban population.     

Epidemiological and clinical characteristics of headache in university students

OBJECTIVE: Epidemiological studies regarding headache are abundant in developed countries; however, the data in developing countries are scarce. This study aims to detect the prevalence and clinical features of headache in Gaziosmanpasa University students in Tokat, Turkey. PATIENTS AND METHODS: 2168 subjects were selected with randomized stratified sampling, and 92.5% of them participated in the study (2023 students). Two neurologists from our medical faculty interviewed and examined the students with headache. Assessment was done according to The International Classification of Headache Disorders, 2nd edition. RESULTS: In our study, 22.64% of the students had tension-type headache (TTH), 17.89% had migraine headache, 0.29% TTH plus migraine headache, 0.20% had cluster and variants type of headache. Migraine type of headache was more common in females than in males (p=0.0001); however, no significant difference was present between males and females who had migraine with aura and tension-type headache. DISCUSSION: The clinical features of tension-type headache and migraine in our university students were similar to the ones of general population and to the studies conducted on university students.     

Adjunctive thalidomide therapy for childhood tuberculous meningitis: results of a randomized study

Childhood tuberculous meningitis is associated with serious long-term sequelae, including mental retardation, behavior disturbances, and motor handicap. Brain damage in tuberculous meningitis results from a cytokine-mediated inflammatory response, which causes vasculitis and obstructive hydrocephalus. Thalidomide, a potent tumor necrosis factor alpha inhibitor, was well tolerated and possibly showed some clinical benefit in children with tuberculous meningitis during a pilot study. The purpose of the present study was to assess the effect of adjunctive thalidomide in addition to standard antituberculosis and corticosteroid therapy on the outcome of tuberculous meningitis. Thalidomide (24 mg/kg/day orally) or placebo was administered in a double-blind randomized fashion for 1 month to patients with stage 2 or 3 tuberculous meningitis. The study was terminated early because all adverse events and deaths occurred in one arm of the study (thalidomide group). Thirty of the 47 children enrolled received adjunctive thalidomide, of whom 6 (20%) developed a skin rash, 8 (26%) hepatitis, and 2 (6%) neutropenia or thrombocytopenia. Four deaths (13%) occurred in patients with very severe neurologic compromise at baseline; two deaths were associated with a rash. Motor outcome after 6 months of antituberculosis therapy was similar in the two groups, even though the thalidomide group showed greater neurologic compromise on admission. In addition, the mean IQ of the two treatment groups did not differ significantly (mean IQ thalidomide group 57.8 versus mean IQ control group 67.5; P = .16). These results do not support the use of adjunctive high-dose thalidomide therapy in the treatment of tuberculous meningitis.