Spontaneous right atrial thrombus in a patient with Crohn's disease: an unusual right atrial mass

Crohn's disease is associated with systemic manifestations including increased risk of thromboembolism. We report a young female patient with active Crohn's disease who presented with spontaneous right atrial thrombus.     

Influence of hypercalcic and/or hyperoxalic diet on calcium oxalate renal stone formation in rats

OBJECTIVE: To test whether increasing dietary calcium intake prevents calcium oxalate stone formation when the diet is oxalate-rich. Material and methods. Four groups, eight rats in each, were subjected to a lithogenic diet by the addition of 0.5% ethylene glycol to drinking water for 3 weeks. The first group, used as a control, simultaneously received a standard diet. The second group was supplemented with calcium at 500 mg/100 g of diet and the third group with oxalate at 3 g/100 g of diet. The diet given to the last group was supplemented with similar doses of calcium and oxalate. One day before the end of treatment, each animal was placed in a metabolic cage to collect 24-h urine samples and determine urinary parameters. The kidneys were removed to determine calcium oxalate deposits and for histological examination. RESULTS: The number of calcium oxalate crystals in renal tissue was highest in the oxalate group and calcium oxalate deposits were also found to be elevated in this group. Hyperoxaluria and hypocitraturia, induced by a oxalate-rich diet, seemed to be the major causes contributing to aggravated renal stone formation. The protective effect of dietary calcium supplementation, which was clear in the calcium + oxalate group, was probably due to intestinal binding of oxalate by calcium, thereby reducing urinary oxalate excretion. CONCLUSION: Increased dietary calcium intake can prevent calcium oxalate stone formation only when the diet is oxalate-rich.     

Loss of heterozygosity at the BRCA1 locus in Tunisian women with sporadic breast cancer

Breast cancer in Tunisia is characterized by a much higher incidence of aggressiveness compared with Western countries. The pattern of allelic loss at the BRCA1 locus in Tunisian women with breast carcinoma has not been studied. Therefore, the aim of this present preliminary study was mainly focused on loss of heterozygosity (LOH) analysis of the BRCA1 gene to determine if this tumor suppressor gene is involved in sporadic breast carcinoma among Tunisian women. We investigate allelic losses by analyzing three microsatellite markers in the BRCA1 region, in a panel of 21 human breast tumors. D17S1322 marker had the highest frequency of LOH (59%), followed by the D17S1323 (35%), and EDH-17B (20%). Collectively out of 21 informative cases 13 (62%) showed LOH at at least one BRCA1 locus. This data provides evidence that allelic loss at BRCA1 is a frequent event in sporadic breast tumorigenesis among Tunisian women, and suggests that the BRCA1 gene might play an important role as a tumor suppressor gene.     

Lectin reactivity of expanded mouse blastocysts after exposure to sera from women with unexplained recurrent spontaneous abortion

Embryotoxic factors existing in maternal sera may influence their effects via specific binding to, or alteration of cell surface molecules in the conceptus. This study was undertaken to determine the effects of sera from women with unexplained recurrent spontaneous abortion (URSA) on cell surface glycoconjugates of the early conceptus. Four cell stage embryos were cultured in medium supplemented with sera from women with URSA, from normal women, or in medium without serum. Developmental competence was assessed as the stage distribution of embryos advancing to during 96 h in culture. Hatched (expanded) blastocysts were stained with wheat germ agglutinin (WGA), peanut agglutinin (PNA) and dolichos biflorus agglutinin (DBA) to detect surface glucoconjugates. We observed that patient sera could be divided into high- and low-risk groups on the basis of the ability to decrease the number of four-cell embryos reaching the expanded blastocyst stage. Furthermore, the intensity of reactivity to PNA changed after exposure to high-risk sera. Morula formation was reduced and blastocyst formation was delayed. Although the sera from women with URSA had embryotoxic effects, no influence on the glycoconjugate patterns were evident in hatched blastocysts, aside from PNA reactivivity. We suggest altered developmental display of PNA-reactive proteins was a biomarker for poor developmental quality due to emrbyotoxic factors in serum from URSA patients.     

Clinicopathologic significance of DNA methyltransferase 1, 3a, and 3b overexpression in Tunisian breast cancers

DNA methyltransferase 1, 3a, and 3b affect DNA methylation, and it is thought that they play an important role in the malignant transformation of various cancers. The current study was designed to analyze DNA methyltransferase expression by immunohistochemistry in a series of 94 Tunisian sporadic breast carcinomas. Results were correlated to clinicopathologic parameters and promoter methylation status of 8 tumor suppressor genes (BRCA1, BRCA2, RASSFA1, TIMP3, CDH1, P16, RARβ2, and DAPK). Overexpression of DNA methyltransferase 1, 3a, and 3b was detected in 46.8%, 32%, and 44.7% of cases, respectively. A significant correlation was found between DNA methyltransferase 1 overexpression and Scarff-Bloom-Richardson histologic grade III (P = .01). DNA methyltransferase 3a overexpression was significantly associated with menopausal status (P = .01), Scarff-Bloom-Richardson histologic grade III (P = .0001), estrogen (P = .04) and progesterone (P = .007) receptor negativity, and HER2 overexpression (P = .004). However, DNA methyltransferase 3a overexpression was found less frequently in the luminal A intrinsic breast cancer subtype (9.7%) than in luminal B (53%), HER2 (41%), and triple-negative (50%) subtypes (P = .001). DNA methyltransferase 3b overexpression shows significant correlation with promoter hypermethylation of BRCA1 (P = .03) and RASSFA1 (P = .04) and with the hypermethylator phenotype (more than 4 methylated genes, P = .01). These data suggest that overexpression of various DNA methyltransferases might represent a critical event responsible for the epigenetic inactivation of multiple tumor suppressor genes, leading to the development of aggressive forms of sporadic breast cancer.     

Tumeur myofibroblastique inflammatoire de la vessie

Myofibroblastic inflammatory tumor is considered as an intermediate neoplasm according to the WHO classification. It can occur in different organs: lung, pancreas, mesentery and uterus. The localization in the bladder is unusual. We report a case of a 38-year-old patient who presented with hematuria. Echography showed a 3 cm tissular structure of the bladder. Histological analysis and immunohistochemistry concluded to the diagnosis of myofibroblastic tumor of the bladder. The present work will give a general view of the myofibroblastic tumor, and will review its differential diagnosis.     

Isolated skin recurrence following salvage mastectomy for intramammary recurrence (after initial breast conservation therapy): is it a fatal event?

Aims

The authors analyzed the outcome of patients with Isolated Skin Recurrence After Salvage Mastectomy (ISRASM) performed after conservative treatment for breast carcinoma, taking into account initial tumor characteristics, intramammary recurrence (first recurrence) characteristics, local skin recurrence (second recurrence) characteristics, and the type of treatment at each stage of the breast cancer continuum.

Methods

Forty-two patients who had ISRASM between 1976 and 2007 were included in this retrospective study. Twenty-six factors were studied in univariate and multivariate analyses.

Results

Mean Overall Survival (OS) was 70.3 (±4.1) months. The 5-year OS rate was 66.6%. 31% of patients did not present any recurrence, 52% had locoregional recurrence and 14% metastatic recurrence following ISRASM. Univariate analysis showed that 4 prognostic factors were significantly related to OS and/or Disease-Free Survival (DFS): (1) initial chemotherapy after primary breast cancer (P = 0.09 and 0.01 respectively), (2) presence of emboli at the site of intramammary recurrence (first recurrence) (P = 0.02 and 0.03), (3) interval between first and second surgery of less than 3 years (P = 0.09 and 0.0003), and (4) inflammatory skin involvement at ISRASM (P = 0.005 and 0.17). Multivariate analysis showed that presence of emboli at the site of intramammary recurrence was significantly related to OS and that an interval between first and second recurrence of less than 3 years was significantly related to DFS.

Conclusion

Our results show that ISRASM affects a group of breast cancer patients with predominantly local rather than metastatic disease. Prognostic factors depend on characteristics at initial breast cancer, first recurrence and second recurrence. Evidence-based guidelines are still required for ISRASM management.