Mucinous tubular and spindle cell carcinoma: a report of 15 cases and a review of the literature

Mucinous tubular and spindle cell carcinomas are low-grade renal epithelial neoplasms, which were first recognized as a specific entity in the World Health Organization 2004 classification. Forty-five documented cases have been reported. We present 15 additional cases that were incidentally discovered in ten women and five men, with a mean age of 53 years. The tumor is characteristically made up of large eosinophilic regular spindle cells separated by a myxoid stroma with intercellular alcian-blue-positive clear droplets. In peripheral areas, elongated tubules and papillae covered by cubic cells are found. Until this entity had been defined, pathologists used to classify these tumors as variants of solid papillary carcinomas with compressed and elongated papillae, metanephric adenomas, and sarcomatoid carcinomas. In the literature, cytogenetic data indicate various chromosomal losses and gains, but no loss of 3p or trisomy 7 and/or trisomy 17. In two cases, we demonstrate chromosomal loss involving chromosomes 1, 4, 6, 11, 8, 13, 14, 15, 18, and 22. In our 15 cases, immunohistochemistry favored a distal tubule origin (EMA⁺, AE1/AE3⁺, CK7⁺, CK19⁺, E-cadherin⁺, AMACR⁺, and CD10⁻). Prognosis was favorable in our cases, while in the literature, two metastatic cases were reported. Further investigations are required to determine the frequency and true prognosis of these tumors, which are easily identifiable morphologically.     

Resynchronization of hormonal rhythms after an eastbound flight in humans: effects of slow-release caffeine and melatonin

The aim of this work was to investigate the potential chronobiotic properties of slow-release caffeine, in comparison with melatonin, on resynchronization of endogenous melatonin and cortisol secretions after an eastbound flight by jet incurring a time loss of 7 h. A group of 27 reservists of the US Air Force received either slow-release caffeine (300 mg), melatonin (5 mg) or placebo before, during and/or after the transmeridian flight. Saliva and urine were sampled before the flight in the United States (from day –2 to day 0) and after the flight in France (from day 1 to day 10). Saliva was collected once a day on waking to determine saliva melatonin and cortisol concentrations. In addition, concentrations of caffeine in saliva were determined three times a day and of 6-sulphatoxymelatonin in urine collected overnight to check that the treatment regimes had been complied with. From day 3 to day 5, post-flight saliva melatonin concentrations were significantly different from control values in the placebo group only. During treatment with melatonin, the mean urinary 6-sulphatoxymelatonin concentration in the melatonin group was more than twice as high as in the two other groups. In the slow-release caffeine group and the melatonin group, mean saliva cortisol concentrations were significantly lower than control from day 2 to day 5, whereas the placebo group had a mean saliva cortisol concentration significantly lower than the control value from day 2 to day 9. In conclusion, these results indicate that administration of slow-release caffeine, as well as of melatonin, allows a faster resynchronization of hormone rhythms during the 4 days following an eastbound flight incurring the loss of 7 h. Electronic Publication     

Bone marrow-derived progenitor cells contribute to lung remodelling after myocardial infarction

BACKGROUND: Congestive heart failure (CHF) causes structural modifications of the lungs that contribute to the functional limitations of affected subjects. We hypothesized that bone marrow-derived progenitor cells could contribute to lung structural remodelling after myocardial infarction (MI). METHODS: Wistar rats were irradiated and received a bone marrow transplant (BMT) from green fluorescent protein (GFP) transgenic rats, followed 5 weeks later by coronary artery ligation or sham operation. Five weeks after MI, lung immunofluorescence studies were performed and GFP expression evaluated by Western immunoblotting. RESULTS: After MI, rats developed lung structural remodelling characterized by myofibroblast (MF) proliferation in the alveolar septa. After BMT, some GFP+ cells were found in the lungs of sham animals. The amount of GFP+ cells in the lungs of MI rats was greatly increased with evidence of differentiation into MFs, as evaluated by co-localization correlation analysis with smooth muscle alpha-actin (P<.01). These cells were particularly abundant in the perivenular regions where they incorporated into the wall of blood vessels. There was a threefold increase in lung GFP protein expression after MI (P=.01). CONCLUSIONS: After MI, bone marrow-derived progenitor differentiates into lung MFs. This novel pathophysiologic process may contribute to the pulmonary manifestations of CHF and could have significant therapeutic implications.     

Parental Perception of Body Weight Status of Their 8-year-old Children: Findings from the European CHOP Study

Maternal and Child Health Journal - Maternal perception of child weight status in children with overweight or obesity has received a lot of attention but data on paternal perception of children...     

The oro-dental phenotype in Prader-Willi syndrome: a survey of 15 patients.

BACKGROUND: Prader-Willi syndrome (PWS) is a rare disorder caused by genetic defects in certain regions of chromosome 15q11-13. It is characterized by severe neonatal hypotonia and feeding problems, childhood-onset hyperphagia and obesity, short stature, facial dysmorphy, hypogonadism, learning and behavioural difficulties, and dental abnormalities. AIM: To describe the oro-dental phenotypic spectrum of patients with PWS. DESIGN: Fifteen PWS patients (3-35 years of age) being followed at the Centre for Human Genetics of the University Hospital of Leuven were examined at the dental clinic of the same institution. Medical information collected included age at diagnosis, body mass index (BMI) and level of cognitive functioning. Oral, clinical and radiological evaluations were performed. Caries experience (cavitation level), dental erosion and salivary flow rates were assessed. RESULTS: The 15 patients had dmft/DMFT scores ranging from 0 to 28, while nine were cavity-free. Those with severe caries experience also presented advanced dental erosion. BMI ranged from 16 to 42.6. There was no association between BMI and caries experience or erosive tooth wear. The PWS patients in our survey presented with a more favourable oral health status than those in previous studies. This might be due to early diet management or better oral hygiene during childhood or both.     

Invasive pulmonary and central nervous system aspergillosis after near-drowning of a child: case report and review of the literature

Invasive aspergillosis is extremely rare in immunocompetent children. Here we describe the clinical, radiologic, and laboratory course of fatal invasive pulmonary and central nervous system aspergillosis in a previously healthy child after a near-drowning incident with submersion in a pond. Findings were compared with data from the literature, which is reviewed. Serum Aspergillus galactomannan levels were determined retrospectively and were compared with the results of routine microbiological and radiologic examinations, showing a significant diagnostic and therapeutic delay of the routine diagnostic approach in comparison with the use of the Aspergillus galactomannan assay. This delay may have contributed to the fatal course. Serial determination of serum Aspergillus galactomannan may be helpful in diagnosing invasive aspergillosis early in case of pulmonary disease after near-drowning and may contribute to an early appropriate treatment. Currently voriconazole, eventually in combination with caspofungin, should be considered as the drug of choice in the management of invasive aspergillosis after near-drowning.     

Repeatability of quantitative parameters derived from diffusion tensor imaging in patients with glioblastoma multiforme

Purpose

To quantify the repeatability of apparent diffusion coefficient (ADC) and fractional anisotropy (FA) in patients with glioblastoma multiforme.

Materials and Methods

IRB approval and informed consent were obtained for this Health Insurance Portability and Accountability Act‐compliant study. Sixteen patients with glioblastoma multiforme underwent MR imaging at two time points without interval intervention. ADC and FA maps were registered to the contrast‐enhanced and fluid‐attenuated inversion recovery (FLAIR) image volumes. Volumes of tumor‐related enhancement (TRE) and FLAIR signal abnormality (FSA) were defined using a semiautomated segmentation technique.

Results

Repeated observations of mean ADC and mean FA were highly consistent within both TRE (ADC: r = 0.947,P < 0.0001; FA: r = 0.947, P < 0.0001) and FSA (ADC: r = 0.979, P < 0.0001; FA: r = 0.972, P < 0.0001). Within TRE, repeatability coefficients and 95% confidence intervals (CIs) for change measured 0.104 × 10^?3 mm²S^?1 and 7.4% (ADC) and 0.0196 and 13.9% (FA), respectively. Within FSA, repeatability coefficients and 95% CI for change measured 0.071 × 10^?3 mm²S^?1 and 5.2% (ADC) and 0.0159 and 8.7% (FA), respectively. To detect 10% changes in mean ADC, sample sizes of nine (TRE) and six (FSA) patients would be required. The same change in mean FA would require sample sizes of 21 (TRE) and 10 (FSA) patients, respectively.

Conclusion

Changes after therapy greater than the repeatability coefficient or 95% CI for change are unlikely to be related to variability in the measurement of ADC and FA. J. Magn. Reson. Imaging 2009;29:1199–1205. © 2009 Wiley‐Liss, Inc.