Uterine leiomyosarcoma in pregnancy

Summary A leiomyosarcoma was found unexpectedly during a cesarean section. The tumor was a solitary pedunculated mass and there was no evidence of spread beyond the uterus. The management of this patient, because of her age, low parity and desire for having more children, was conservative. At 3 years after cesarean section there was no evidence of recurrence.     

Elevated platelet count before ileal pouch-anal anastomosis for ulcerative colitis is associated with the development of chronic pouchitis

Acute pouchitis (AP) after ileal pouch-anal anastomosis (IPAA) is common and easily treated. However, chronic pouchitis (CP) remains a difficult management problem and may represent a form of Crohn disease (CD) of the ileal pouch. Because CD patients have higher platelet counts than ulcerative colotis (UC) patients, we prospectively evaluated the association between preoperative platelet count and pouchitis development in 159 patients undergoing IPAA. Reactive thrombocytosis (RT) was defined as a platelet count > 450 x 10(9)/L. Median preoperative platelet count was 312 x 10(9)/L (range, 103 x 10(9)/L to 886 x 10(9)/L). One hundred twenty-five patients (79%) had a normal (150 x 10(9)/L to 450 x 10(9)/L) platelet count (-RT patient group). Twenty-eight patients (18%) had RT. Six patients (3%) had a platelet count below 150 x 10(9)/L. After a median follow-up of 13 months, 45 patients (28%) developed pouchitis. Pouchitis developed in 33 +RT patients (26%) versus 9 -RT patients (32%) (P = NS). UC patients who had +RT had a 25 per cent incidence of CP compared to only 7 per cent of those UC patients who had -RT (P = 0.03). The incidence of CP was significantly higher after IPAA in UC patients having thrombocytosis before surgery compared to UC patients having a normal platelet count before surgery.     

Perceived risk for developing stroke among older adults

BACKGROUND: Persons who perceive their risk for stroke accurately may be more likely to engage in prevention practices to reduce their risk. METHODS: In 2004, 800 adults aged 45 years and older in two counties participated in a telephone survey to assess their perceived risk for stroke and their history of stroke risk factors. RESULTS: Overall, 39% of respondents perceived themselves to be at risk for having a stroke. In the multivariate analyses, younger age, current smoking, and a history of diabetes, high blood pressure, high cholesterol, heart disease, and stroke/TIA were independently associated with perceived risk for stroke. Respondents with atrial fibrillation were no more likely to report being at risk for stroke compared to respondents without atrial fibrillation. Perceived risk for stroke increased as the number of risk factors increased. However, 46% of respondents with three or more risk factors did not perceive themselves to be at risk. CONCLUSIONS: Many adults with multiple risk factors do not perceive themselves to be at risk for stroke. Clinical and public health efforts are needed to increase awareness of the risk for stroke.     

Ecological and agricultural significance of bacterial polyhydroxyalkanoates

Polyhydroxyalkanoates (PHAs) are a group of carbon andenergy storage compounds that are accumulated during suboptimal growth by many bacteria, and intracellularly deposited in the form of inclusion bodies. Accumulation of PHAs is thought to be used by bacteria to increase survival and stress tolerance in changing environments, and in competitive settings where carbon and energy sources may be limited, such as those encountered in the soil and the rhizosphere. Understanding the role that PHAs play as internal storage polymers is of fundamental importance in microbial ecology, and holds great potential for the improvement of bacterial inoculants for plants and soils. This review summarizes the current knowledge on the ecological function of PHAs, and their strategic role as survival factors in microorganisms under varying environmental stress is emphasized. It also explores the phylogeny of the PHA cycle enzymes, PHA synthase, and PHA depolymerase, suggesting that PHA accumulation was earlier acquired and maintained during evolution, thus contributing to microbial survival in the environment.     

Are CD34+ cells found in renal interstitial fibrosis?

BACKGROUND: The CD34 antigen is a marker of precursor myeloid cells and endothelial cells, but also of a subset of spindle cells. METHODS: To establish the possible role of CD34+ cells in the progression of glomerulonephritis, 30 renal biopsies were investigated. Immunohistochemistry for CD34 and smooth muscle actin (SMA) were performed by standard methods. The results were assessed semiquantitatively. The relative interstitial volume (RIV) was evaluated by the point counting method. Clinical data such as sex, age, serum creatinine and urea levels were taken into account. RESULTS: CD34+ spindle cells and SMA+ myofibroblasts were present in the renal interstitium in all but one case. In membranous, membranoproliferative and segmental-proliferative glomerulonephritis, CD34+ cells were seen in clusters, while in IgA nephropathy and in segmental and focal glomerulosclerosis, single, scattered cells were seen. The density of CD34+ cells showed a positive correlation with the myofibroblast density and the RIV. Serum creatinine and urea levels were associated with the RIV of the kidney and to a smaller degree with the number of myofibroblasts and CD34+ cells. CONCLUSION: These results show that in glomerulonephritis, CD34+ spindle cells appear in the interstitium. At present, their possible role can only be speculated.     

Diurnal variations of the glycogen and fat stores in the liver and breast muscle of the insect bat, Tadarida nigeriae

A study of the glycogen and fat stores in the liver and breast muscle of the insect bat, Tadarida nigeriae was carried out in relation to their roosting and feeding behaviour. Glycogen concentration in the liver increased at mid-day but dropped precipitously in the evening. Muscle glycogen increased two-fold in the evening. Liver and muscle fat increased markedly at mid-day, but while liver fat dropped considerably in the evening, muscle rat remained unchanged. These results are discussed in comparison with those previously reported for the fruit bat, Eidolon helvum.     

Male pseudohermaphroditism due to 5 alpha-reductase deficiency. Ultrastructure of the gonads

We report here the results of the endocrine studies and the morphological findings of the gonads in two male pseudohermaphrodite siblings with 5 alpha-reductase deficiency. Basal levels of luteinizing hormone, follicle-stimulating hormone, and prolactin were elevated and rose to very high levels in response to gonadotropin-releasing hormone and thyrotropin-releasing hormone,, when compared to those in normal males, while thyroid-stimulating hormone response was normal. Serum testosterone levels were within the normal range, and estradiol values were modestly elevated. Diagnosis was confirmed by lack of conversion of 3H-testoterone to 3H-dihydrotestosterone by fibroblasts taken from perineal skin. Pathologic examination of the testes in both patients disclosed tubular atrophy and complete arrest of spermatogenesis, with numberous hyperplastic Leydig cells containing large Reinke crystalloids.