Diagnostic validity of bone metabolic markers for bone metastasis

We measured bone resorption markers in tumor patients with and without bone metastases and evaluated the diagnostic validity of these biochemical parameters in the diagnosis of neoplastic bone involvement. On the basis of radiography and bone scintigraphy findings, subjects were divided into 3 groups, 83 patients without bone metastases (META(-)), 22 patients with 1 or 2 bone metastases (META(+)) and 22 patients with more than 3 bone metastases (META(++)). Among the biochemical markers, urinary pyridinoline (PYR), circulating C-terminal telopeptide of type I collagen (ICTP) and urinary N-terminal telopeptide of type I collagen (NTx) were especially sensitive and specific and increased significantly not only in META(++) but also even in META(+). The efficacy of several bone metabolic markers in differentiating between patients with and without bone metastases was evaluated by receiver-operating characteristic (ROC) analysis, and PYR, ICTP and NTx were proved to have high diagnostic validity (area under the ROC curve; 0.75 for PYR, 0.77 for ICTP and 0.77 for NTx). Furthermore, their odds ratios showed significantly high values for both META(+) and META(++)(to META(++); 7.91 for PYR, 5.33 for ICTP and 5.70 for NTx). On the other hand, urinary deoxypyridinoline (DPYR) and serum total alkaline phosphatase (ALP) showed relatively low sensitivities, the odds ratio of ALP in particular being insignificant. In conclusion, several bone metabolic markers were proved to be useful in the diagnosis of bone metastases in patients with malignancies, particularly PYR, ICTP and NTx had rather high diagnostic validities among all markers examined in this study.     

Diagnosis of bone metastasis by thermography

The uptake of D-[(14)C]mannose by adult rat kidney cortex slices has been examined. The process involved appeared to be saturable and oxygen dependent and to be inhibited by glucose, galactose, chi-methyl-D-glucoside, and phlorizin. Extensive metabolism of the sugar occurred. (14)CO(2) was produced to an extent comparable to that from D-glucose. Radioactive compounds accumulated in the tissue, approximately 50% of which were in the form of phosphorylated or other polar intermediates. The remaining neutral fraction consisted of mannose with a small amount of label in glucose and an unidentified compound which behaves like an alditol. Mannose concentration in the intracellular fluid was never greater than that of the medium.     

Coincidence of sarcoidosis and amyloidosis

Amyloidosis was diagnosed in a patient with sarcoidosis. There was no evidence of any other disease known to be associated with amyloidosis. The joint occurrence of amyloidosis and sarcoidosis appears to be extremely rare, and to our knowledge, this is the second such patient to be reported. Whether the association of the two diseases in this patient represents a causal relationship remains an open question.     

Thoracic vertebral bone metastasis from uterine leiomyosarcoma

We report a patient with solitary thoracic vertebral bone metastasis (Th 8) from uterine leiomyosarcoma. The vertebral metastatic lesion was treated surgically, and vertebral body replacement with ceramic prosthesis and anterior spinal stabilization were performed. Such aggressive surgical intervention for solitary vertebral bone metastasis may contribute to the improvement of prognosis and maintenance of general quality of life in the patient.     

Peripheral bone metastasis of a rare lung cancer

This article describes the case of a 54 year-old man with a rare large cell cancer of the lung who presented with a metastasis to the right hand. Radiography showed destruction of the phalanx, and histology study confirmed a metastasis of the lung cancer. Metastatic spread is discussed and compared to other metastatic diseases of the hand.     

Cold metastases detected by bone scintigraphy in aggressive lung cancer

A case of a 55-year-old man was remitted to Traumatology Department to present back pain of two weeks of evolution. The results of bone scintigraphy and the patient's evolution allowed the diagnosis. This case report and a literature review showed the importance of using a routine bone scan in diagnosis of bone metastases.     

Positron emission tomography and bone scintigraphy of an osteoclast metastasis

We present the case of a 66-year-old-male patient who suffered from a bronchial carcinoma with a rib metastasis which was detected by PET staging with a relevant 18F-FDG-Uptake. The bone scintigram with 99mTc-DPD showed a defect in this area. The aggressive disease induced no osteoblastic response.     

Cellular and molecular mechanisms of breast and prostate cancer metastasis to bone

Coordination between karyokinesis and cytokinesis in the cell division cycle is fundamental to a precise transmission of duplicated genome into dividing daughter cells. byr4, a previously isolated essential gene, affects the mitotic cell cycle and cytokinesis in S. pombe. Phenotypic analyses of the null alleles and the overexpression of byr4 suggest that byr4 is a dosage-dependent coordinator of karyokinesis and cytokinesis (Song et al., 1996). In this study, the functional mechanisms of byr4 were investigated using a byr4 mutant that exhibits byr4 overexpression phenotypes in thiamine deficient media. Genetic suppression analyses of this byr4 mutant with other cytokinesis regulatory genes in S. pombe, cdc16, cdc7, cdc15, cdc14, and plo1, show that byr4 overexpression phenotypes are suppressed by the overexpression of cdc16 and cdc7, but not by plo1, cdc14, and cdc15. Also, the basal expression of byr4 and cdc7 suppresses the temperature-sensitive cdc16 mutation. However, the basal expression of either byr4 or cdc16 does not suppress the temperature-sensitive cdc7 mutation. The results of these suppression tests suggest that byr4 genetically interacts with cdc16 and cdc7: byr4 functions at the same level with or downstream of cdc16 and upstream of cdc7. In the present study, we also show that Byr4 interacts with Cdc16 and Spg1 in the yeast two-hybrid assays. Recent reports suggest a possible small GTPase pathway to regulate the timing of cytokinesis where Cdc16 functions as a GAP (GTPase activating protein), Spg1 as a GTPase, and Cdc7 as a downstream effector. Combined genetic and two-hybrid analyses of this study strongly suggest that Byr4 directly interacts with this possible small GTPase pathway including Cdc16, Spg1, and Cdc7 to regulate cytokinesis in S. pombe.     

Relevance of hydroxyproline excretion to bone metastasis in breast cancer

In 181 consecutive patients with breast cancer, urinary hydroxyproline excretion has been critically evaluated in conjunction with clinical, biochemical, radiological and scintigraphic parameters. The urinary hydroxyproline/creatinine ratio is a sensitive index of the presence of bone metastases. Urinary hydroxyproline excretion is a reliable method of selecting those patients whose elevated serum alkaline phosphatase is secondary to bone disease rather than liver idsease. The estimation of hydroxyproline excretion furthermore gives information on the activity of bone metastasis, and its response to treatment, which cannot be given by radiological or scintigraphic methods. It is doubtful whether urinary hydroxyproline estimation will help to detect bone metastases before they are apparent on scintigrams. When the bone scan is doubtful, as often occurs in older subjects, hydroxyproline excretion has been found to be helpful in classifying the patient. When scintigraphy is not available, an elevation of hydroxyproline excretion, together with an elevation of Ca/cr ratio or alkaline phosphatase activity, may pre-date by several months the radiological demonstration of osseous metastases.     

A directly spliced exon 10-containing CD44 variant promotes the metastasis and homotypic aggregation of aggressive non-Hodgkin's lymphoma

Variants of the CD44 cell-surface adhesion molecule include additional sequences encoded by combinations of exons from the membrane proximal domain (exons 6-14). Preliminary studies suggest that these additional variable membrane proximal sequences may alter the ligand specificity, glycosylation, and biologic function of CD44. In earlier studies, we found that primary extranodal and widely disseminated aggressive non-Hodgkin's lymphomas (NHLs) and normal activated B cells expressed a directly spliced exon 10-containing variant (CD44ex10), whereas normal resting B cells expressed larger exon 10-containing variants (CD44ex10-14 and CD44ex7-14). To obtain additional information regarding the function of exon 10-containing CD44 variants in aggressive NHL, we generated aggressive NHL transfectants that expressed CD44ex10, CD44ex10-14, CD44ex7-14, the standard CD44 isoform (CD44H), or vector alone, and evaluated the local tumorogenicity, aggregation, and metastatic potential of these transfectants. CD44ex10 aggressive NHL transfectants were more likely to cause local tumor formation in nude mice than transfectants expressing the larger exon 10-containing variants, CD44H, or vector alone. In addition, cell suspensions derived from CD44ex10 local tumors exhibited far greater homotypic aggregation than those obtained from other CD44 or vector-only local tumors. In nude mice that received CD44ex10 transfectants, distant metastases were also significantly more likely to develop than in animals that were given either the CD44ex10-14, CD44ex7-14, CD44H, or vector-only transfectants. These data provide the first evidence that the directly spliced exon 10-containing CD44 variant (CD44ex10) has a unique biologic function in aggressive NHL.     

The usefulness of early whole body bone scintigraphy in the detection of bone metastasis from prostatic cancer

Early whole body bone scintigraphy was performed on 25 patients with prostatic cancer (15 cases with bone metastases and 10 cases without bone metastasis) to obtain anterior and posterior whole body images five minutes after administration of 99mTc-HMDP. The results were compared with the findings of routine bone scintigraphy after three hours, and the usefulness of the above method for the diagnosis of bone metastasis from prostatic cancer was evaluated. In cases in which increased activity was found in the upper and lower lumbar vertebrae by routine bone scintigraphy but no abnormality was seen by early whole body bone scintigraphy, senile degenerative bone changes such as spondylosis deformans were observed by bone radiography. In cases with multiple bone metastases, abnormal multiple accumulations were found by both early whole body bone scintigraphy and routine bone scintigraphy. In addition, in cases showing super bone scan, high accumulation in the skeletal system had already been detected by early whole body bone scintigraphy. When the courses before and after treatment in nine cases of multiple bone metastases were passaged from the results of early whole body bone scintigraphy and from changes in tumor markers (prostatic specific antigen, gamma-semino protein and prostatic acid phosphatase), increased activity and the appearance of new hot spots as well as an increase in tumor markers were detected by early whole body scintigraphy in three of the four advanced cases, whereas decreased accumulations and a decrease in and normalization of tumor markers were observed in five improved cases.     

Fine needle aspiration diagnosis of aggressive giant cell tumor of bone. A case report

Giant cell tumors of bone are neoplasms with potential local and systemic aggressiveness. A case of giant cell tumor with radiologic and histologic features suggestive of locally aggressive behavior is reported. Cytologic material was obtained by fine needle aspiration from an intraosseous tumor that destroyed the cortex and from the invaded, adjacent soft tissues. The smears from the osseous aspirate showed the typical cytologic features of giant cell tumor, whereas the invaded tissues had a prominent loss of cohesiveness between mononucleate and giant cells. In addition, mitotic figures in the mononucleate component were noticeable. The differential diagnosis based on clinical and cytologic findings is discussed.     

Effects of aggressive cartoons on children's aggressive play.

"The purpose of this study was to test the hypothesis that exposure to aggressive fantasy in an animated cartoon may intensify children's impulses to aggression. Subjects were 36 first grade children, 18 girls and 18 boys, of middle class origin. The intensity of the child's aggressive impulses were inferred from his responses to questions concerning desire to 'play with' or 'pop' a large yellow balloon held by a tester. The experimental findings clearly supported the major prediction." From Psyc Abstracts 36:04:4FF61M. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Suicidality and aggressive behaviour

Delayed wound healing is one of the complications of diabetes mellitus, exhibited by increased wound collagenase and decreased granulation tissues. The current study compared wound healing in normal and diabetic rats, and the effects of topically applied 1% or 3% concentrations of chemically modified tetracycline-2 (CMT-2) on 6-mm circular full-thickness skin wounds healed by secondary intention. On day 7 after wounding, tissues were removed for biochemical analysis and histology. The wound granulation tissue hydroxyproline was less in the untreated diabetic rat with increased collagenase and gelatinase. Treating the diabetic rat wounds with 3% CMT-2 increased the wound hydroxyproline and decreased activities of gelatinase and collagenase. There was a delay in wound filling by granulation tissue in diabetic rats. In CMT-2-treated diabetic rats, the volume of granulation tissue was greater than that in untreated diabetic rats. CMT-2 appears to normalize wound healing in diabetic rats and may be a valuable adjunct in the treatment of chronic wounds.     

Coincidence of epilepsy and Asperger syndrome. Case report and review

Asperger syndrome is an autistic disorder and was first described by Hans Asperger in 1944 without further acceptance in the literature over almost four decades. Following several publications in the 1980s, for the disorder became more widely known and was first introduced into ICD-10 and DSM-IV as a new diagnosis in 1988 and 1994, respectively. The etiology is unknown. We present a female patient with typical features of Asperger syndrome, suffering also from epilepsy and internal medical disorders. The associated diseases, diagnostic criteria and possible therapeutic options are discussed.